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.


Federal Funding Deadline Fast Approaches as Congress Negotiates Year-End Package

Congressional leadership negotiations over how to fund the federal government beyond the expiration of the current continuing resolution (CR) on Friday, December 16, are ongoing. While Democrats had aimed to release their proposed government funding package on Monday, December 12, Senate Appropriations Committee Ranking Member Richard Shelby (R-Ala.) recently stated that the two parties remain roughly $26 billion apart on how much total funding should be directed to federal agencies. Many lawmakers expect to pass a one-week stopgap spending bill to avoid a government shutdown as negotiations on a topline spending figure continue, setting up another government funding deadline before Christmas. House Minority Leader Kevin McCarthy (R-Calif.) has called for passage of a CR extending into 2023 – which would give House Republicans more leverage as the incoming majority. Still, Senate Republicans do not appear to be on board with this plan. Democrats have threatened to bring a full-year CR for a vote if the current stalemate cannot be overcome.

Lawmakers continue to pitch various proposals for inclusion in the year-end package as they await topline spending figures. Two new letters to congressional leadership regarding the looming Medicare physician reimbursement cuts are circulating around the House of Representatives. The first, from Reps. Susan Wild (D-Pa.) and Mariannette Miller-Meeks (R-Iowa), requests that the cuts – a 4% PAYGO cut and a 4.47% cut to the Medicare conversion factor - be stopped entirely as they are in addition to the 2% Medicare sequestration cut, which resumed on July 1. Regarding spending offsets, the Wild-Miller-Meeks letter explicitly states opposition “to paying for preventing these cuts with additional provider cuts.” Another letter from the GOP Doctors Caucus requests support for policies to address impending Medicare payment cuts in legislation moving before the end of the year. While in the Senate, Sen. John Kennedy (R-La.) introduced the Protecting Medicare Patients and Physicians Act (S. 5194) last week. The bill would hold providers harmless against the cut to the Medicare conversion factor and suspend the 4% PAYGO cut for one year. Unspent COVID-19 provider relief funds would be transferred to the Medicare Part B Trust Fund to offset the cost of the proposal.

Other measures currently under consideration for inclusion in a year-end package include legislation to overhaul the nation’s addiction and mental health care system. The Restoring Hope for Mental Health and Well-Being Act (H.R. 7666) was passed by the House with overwhelming support earlier this year but never taken up by the Senate. The legislation would reauthorize and expand several federal mental health programs and grants through 2027, increase access to addiction treatment, and strengthen enforcement of mental health parity requirements. Bipartisan leadership of the Senate Finance Committee have also released multiple discussion drafts to tackle various aspects of the mental health system, and Sen. Bill Cassidy (R-La.) has expressed hope that his Mental Health Reauthorization Act (S. 4170) could be added to an omnibus package.

A group of congressional Democrats sent a letter to congressional leadership last week asking that they prevent a lapse in the federal Medicaid assistance percentage (FMAP) for Puerto Rico before the end of the year. Absent congressional action, the territory’s FMAP would revert to the statutory level of 55% from the temporarily increased 76% instituted by the Consolidated Appropriations Act. The New York congressional delegation has also begun a push for the inclusion of $3.6 billion in supplemental funding in the year-end package to strengthen the World Trade Center Health Program, which supports health-care costs for victims of 9/11. Leaders from the House Energy and Commerce Committee and Senate Health, Education, Labor, and Pensions Committee are negotiating the VALID Act, which would provide the Food and Drug Administration (FDA) with new authority to regulate laboratory developed tests. Finally, Rep. Fred Upton (R-Mich.) stated recently that he is still working with Rep. Diana DeGette (D-Colo.) to secure inclusion of the Cures 2.0 Act (H.R. 6000) provisions in the year-end bill.

Warnock Victory Secures 51-Seat Majority for Senate Democrats

Sen. Raphael Warnock (D-Ga.) defeated Republican challenger Herschel Walker in a runoff election last week. His victory secures for Democrats a 51-49 Senate majority and marks the first time in more than 100 years that voters have reelected every Senate incumbent seeking reelection. The Senate freshman class for the 118th congress will have just seven members: John Fetterman (D-Pa.), Katie Britt (R-Ala.), Ted Budd (R-N.C.), Markwayne Mullin (R-Okla.), Eric Schmitt (R- Mo.), JD Vance (R-Ohio), and Peter Welch (D-Vt.).

Sen. Warnock’s reelection means Democrats will strengthen their numbers in Senate committees and have expanded subpoena power. While Sen. Kyrsten Sinema (AZ) formally declared herself an Independent last week, her decision will not impact Democrats’ expanded control of the chamber, given her stated intent to not caucus with her Republican colleagues. Senate Majority Leader Schumer is allowing Sinema to keep her committee assignments. She joins Sens. Bernie Sanders (Vt.) and Angus King (Maine) as Senate independents. Sinema was first elected to the Senate in 2018 and faced censure by her state’s Democratic party over her decision to oppose changes to the filibuster for the passage of voting rights legislation. Her switch to Independent could have national implications for Democrats should she seek a second term in 2024 and face both Republican and Democratic challengers. In 2024, Democrats will be defending 23 seats compared to just 11 seats for Republicans.

Senate Democrats reelected Chuck Schumer (D-N.Y.) to serve as majority leader for another two years last Thursday. The full Senate Democratic leadership team for the 118th congress will include:

  • Democratic Whip: Dick Durbin (Ill.)
  • Chair of the Democratic Policy and Communications Committee: Debbie Stabenow (Mich.)
  • Chair of Steering Committee: Amy Klobuchar (Minn.)
  • Vice Chair of the Conference: Elizabeth Warren (Mass.), Mark Warner (Va.)
  • Chair of Outreach: Bernie Sanders (I-Vt.)
  • Vice Chair of the Democratic Policy and Communications Committee: Joe Manchin (W.Va.)
  • Senate Democratic Conference Secretary: Tammy Baldwin (Wis.)
  • Vice Chair of the Democratic Policy and Communications Committee: Cory Booker (N.J.)
  • Vice Chair of Outreach: Catherine Cortez Masto (Nev.)
  • Deputy Democratic Conference Secretary: Brian Schatz (Hawaii)

House Passes FY2023 NDAA

The House of Representatives approved the fiscal year (FY) 2023 National Defense Authorization Act (NDAA) last week. The compromise package would increase national security spending and repeal the military’s COVID-19 vaccine mandate. The latest national defense authorization is a $76 billion increase over FY 2022’s $781.8 billion in spending and provides the Pentagon with 30 days to undo its COVID-19 vaccine mandate. The bill authorizes $5 billion for global pandemic preparedness over the next five years and calls for a strategy to be developed by the White House to advance the Centers for Disease Control and Prevention’s Global Health Security Agenda. It also calls on the President to designate a coordinator of global health security and an ambassador-at-large to report to the secretary of State. The NDAA now heads to the Senate for a vote. While the White House, along with Pentagon officials, have expressed support for maintaining the vaccine mandate, the administration has not said whether the President would veto the bill over its elimination.

House Passes Bill to Help Address Maternal Mortality

The House of Representatives passed the Data Mapping to Save Moms’ Lives Act (S. 198/H.R. 1218) last week. The bill requires the Federal Communications Commission to create maps showing where poor maternal health outcomes and gaps in broadband service coincide. The legislation, which passed by a vote of 380-46, will now be sent back to the Senate, which passed a slightly different version of the bill in March under unanimous consent.

Warren, Jayapal Press USPTO on Drug Prices

Sen. Elizabeth Warren (D-Mass.) and Rep. Pramila Jayapal (D-Wash.) have sent a letter to the U.S. Patent and Trademark Office (USPTO) inquiring about efforts by the agency to combat high prices and anticompetitive business practices in the pharmaceutical industry. The letter questions whether USPTO is “fully cognizant of the ways in which evergreening, patent thickets, and product hopping undermine the legitimacy of our patent system or whether it views such practices as legitimate.” They ask the agency to respond with more information about its collaboration with the FDA, the patent appeals process, and the review of patent continuation applications by December 19.

December 12, 2022: | Page 1 Page 2



 -  2023

 +  2022

 +  2021

 +  2020

 +  2019

 +  2018