Hart Health Strategies provides a comprehensive policy briefing on a weekly basis. This in-depth health policy briefing is sent out at the beginning of each week. The health policy briefing recaps the previous week and previews the week ahead. It alerts clients to upcoming congressional hearings, newly introduced bills, regulatory announcements, and implementation activity related to the Patient Protection and Affordable Care Act (PPACA) and other health laws.


2023 Calendar for House of Representatives

Majority Leader-Elect Steve Scalise (R-La.) released the House of Representatives’ calendar for the first session of the 118th Congress last week. The chamber will be in session for 30 weeks in 2023, meeting for three or four days each week lawmakers are in session for votes. The calendar is available here.

Democratic Leadership Elections Update

In the first major leadership change for the party in two decades, Democrats in the House of Representatives unanimously elected Rep. Hakeem Jeffries (D-N.Y.) to serve as minority leader next year. Jeffries will be the first Black lawmaker to lead either party in Congress in the nation’s history. Rep. Pete Aguilar (D-Calif.) will serve as chair of the House Democratic Caucus and Rep. Katherine Clark (D-Mass.) will serve as the next Democratic whip. The new leadership team all ran unopposed during last Wednesday’s leadership elections. Jeffries, Aguilar, and Clark will replace Speaker Nancy Pelosi (D-Calif.), Majority Leader Steny Hoyer (D-Md.), and Majority Whip Jim Clyburn (D-S.C.). While Pelosi and Hoyer announced their decisions to step away from party leadership last month, Clyburn was elected to serve as assistant leader in the 118th Congress after facing a last-minute challenge from Rep. David Cicilline (D-R.I.).

The Senate Democratic caucus is scheduled to hold its leadership elections on December 8. Majority Leader Chuck Schumer (D-N.Y.) plans to nominate Sen. Patty Murray (D-Wash.) as Senate president pro tempore to replace the retiring Patrick Leahy (D-Vt.). The rest of the Democratic leadership team are expected to run unopposed and remain in place. Democrats rejected a proposal that would have prohibited senators serving in leadership from simultaneously heading committees in a secret ballot vote last week. Three members of Democratic leadership would have been subject to the rule, including: Majority Whip Dick Durbin (D-Ill.), Senate Judiciary Committee Chair; Democratic Policy and Communications Committee Chair Debbie Stabenow (D-Mich.), Agriculture Committee Chair; and Steering Committee Chair Amy Klobuchar (D-Minn.), Rules Committee Chair.

Republicans to Retain Earmarks in 118th Congress

Republicans in the House of Representatives agreed to retain the use of spending earmarks when they control the chamber during the 118th Congress in a 158-52 closed-door vote last week. Republicans banned earmarks for member projects when they controlled the chamber in 2011, but the practice was revived by Democrats in the fiscal year 2022 spending bill. That package ultimately contained a total of $9.7 billion in lawmaker-directed community funding projects.

Negotiations on Year-End Omnibus Continue

President Joe Biden and congressional leadership have agreed to avoid another continuing resolution and complete work on a fiscal year (FY) 2023 government funding bill before the end of the year but have yet to agree upon a total level of spending. Republicans have indicated that they will only support a full-year appropriations package with lower total spending levels and additional funding for border security. Democrats support a total of $1.6 trillion in discretionary spending –$100 billion more than current funding levels – and are also seeking to include additional COVID-19 and public health response funding as requested by the White House. The current stopgap spending measure expires on December 16, but many expect this to be further extended until December 23.

Lawmakers are also jockeying to determine what measures will be attached to the must-pass year-end package. The GOP Doctors Caucus is pushing Republican committee leadership in the House of Representatives to use the package to address impending cuts to Medicare physician reimbursement. Providers face nearly a 4.5% physician fee schedule cut and a 4% PAYGO cut in the new calendar year. Senate Health, Education, Labor, and Pensions (HELP) Committee Ranking Member Richard Burr (R-N.C.) has indicated that it is unlikely that reform of dietary supplements regulations will be included but believes the outlook for an overhaul of laboratory diagnostics and cosmetics regulations is more positive. Burr has also stated that inclusion of the PREVENT Pandemics Act is also still on the table. Sen. Bill Cassidy (R-La.), who will replace the retiring Burr atop the HELP Committee next congress, has said that he is optimistic his bill the Healthcare Cybersecurity Act to strengthen cybersecurity coordination between the U.S. Department of Health and Human Services and the Department of Homeland Security will be attached to the omnibus spending package as well. Senate Finance Committee Chair Ron Wyden (D-Ore.) recently stated that he is working to include an extension of COVID-19 era telehealth flexibilities for “as-long-as-possible” in the end-of-year vehicle. Wyden, alongside Finance Ranking Member Mike Crapo (R-Idaho), is also pushing to add the panel’s series of mental health recommendations to the package.

Senate Passes Heart Disease, Hearing Screening Legislation

The Senate passed the Cardiovascular Advances in Research and Opportunities Legacy (CAROL) Act (H.R. 1193) by unanimous consent last week. The bill directs the U.S. Department of Health and Human Services to develop best practices for the treatment of valvular heart disease. The Senate also passed the Early Hearing Detection and Intervention Act (S. 4052) by voice vote. The legislation would reauthorize activities that support hearing screening and early intervention services for newborns, infants, and young children for the next five years. It also requires the Government Accountability Office to conduct a study of state early hearing detection and intervention programs and access to such programs.

Biden Administration Criticizes GOP Debt Limit Plan

The White House has characterized congressional Republicans’ plan to tie U.S. debt limit negotiations to an overhaul of entitlement programs as a “non-starter.” Republicans have suggested that a vote to increase the debt ceiling could be leveraged to reform the Social Security, Medicare, and Medicaid programs and increase their fiscal sustainability. The idea was most recently pitched by Sen. John Thune (R-S.D.) to reporters last week. Voters “overwhelmingly rejected efforts to gut Medicare and Social Security,” a White House spokesperson responded. President Joe Biden also stated that he would not yield to such demands but has expressed opposition to getting rid of the debt ceiling altogether, as some Democrats have called for.

Finance Leadership Release Final Mental Health Proposal

Bipartisan leadership of the Senate Finance Committee released their fifth and final mental health discussion draft last week. The legislation includes policies to improve mental health parity and access to mental health and substance use disorder services in the Medicare and Medicaid programs. The bill would:

  • Strengthen the accuracy of provider directories in Medicare Advantage (MA) plans and Medicaid programs.
  • Direct GAO to conduct a study of the differences in enrollee cost-sharing and utilization management between behavioral and non-behavioral health services in MA and compared to traditional fee-for-service Medicare.
  • Require Medicare to provide guidance to health care providers detailing the extent to which Medicare beneficiaries with substance use disorders can receive partial hospitalization program services.
  • Direct GAO to report on Medicaid payment rates for behavioral health services compared to medical and surgical services across a sample of states.

December 5, 2022: | Page 1 Page 2



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