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.


Government Funding Extended Through Feb. 18

President Joe Biden signed legislation (H.R. 6119) passed by Congress last week to fund the federal government through February 18 ahead of the December 3 expiration of the prior stopgap spending bill. The continuing resolution (CR) extends current program funding levels with very few exceptions. It also extends the temporary scheduling of fentanyl-like substances as Schedule 1 under the Controlled Substances Act. Lawmakers hope the February 18 deadline provides enough time to negotiate the 12 annual appropriations bills for the fiscal year that started on October 1, though little progress appears to have been made on disagreements surrounding total funding levels or abortion policy.

Passage of the CR occurred after the Senate struck a deal to allow a vote on an amendment by Sens. Roger Marshall (R-Kan.) and Mike Lee (R-Utah) to defund the White House vaccine mandate for employers. A group of conservatives led by Sen. Lee had previously threatened to shut down the government if funding for the mandate was kept intact. The amendment failed by a 48-50 vote. Republicans still intend to force a vote on a resolution of disapproval (S.J.Res.29) to overturn the vaccine mandate regulation in the coming days. Sen. Joe Manchin (D-W.Va.) announced last week that he strongly supports the Congressional Review Act (CRA) resolution sponsored by Sen. Mike Braun (R-Ind.), giving the measure enough votes to pass the Senate. It remains unlikely, however, that the resolution will have enough support to pass the Democratic-controlled House.

In previewing the House schedule for the coming week, House Majority Leader Steny Hoyer (D-Md.) highlighted possible consideration of legislation related to the debt limit as well as legislation related to end of the year health care provisions. The latest stopgap spending measure did not include any provisions to avert impeding cuts to Medicare reimbursements stemming from mandatory sequestration, statutory pay-as-you-go (PAYGO) requirements, or cuts to the Medicare Physician Fee Schedule. Both the Congressional Budget Office (CBO) and Treasury Secretary Janet Yellen have projected that the federal government could run out of cash by mid-December if Congress fails to raise the debt limit. Senate Minority Leader Mitch McConnell (R-Ky.) has offered assurances that the U.S. will not breach the debt ceiling, stating that he is in talks with Majority Leader Chuck Schumer (D-N.Y.) on a path forward. Democrats are also working to complete consideration of the must-pass National Defense Authorization Act (NDAA) (H.R. 4350) before the end of the year.

House Passes Several Health Bills

The House of Representatives passed a slate of health care related bills last week. The Immunization Infrastructure Modernization Act (H.R. 550) aims to support public health surveillance by improving data sharing for records of vaccination. The PREVENT HPV Cancers Act (H.R. 1550) would authorize a public education campaign to raise awareness of human papillomavirus (HPV) vaccination in the U.S. Finally, the Social Determinants of Health Data Analysis Act (H.R. 4026) would require the Comptroller General to submit a report to Congress on actions taken by the U.S. Department of Health and Human Services (HHS) to address social determinants of health. Additional health bills are included on the list of bills for possible consideration by the House this week, including the Accelerating Access to Critical Therapies for ALS Act (H.R. 3537), Dr. Lorna Breen Health Care Provider Protection Act (H.R. 1667), Oral Health Literacy and Awareness Act (H.R. 4555), Opioid Prescription Verification Act (H.R. 2355), and the CARING for Social Determinants Act (H.R. 3894).

Senate Dems, Parliamentarian Meet to Discuss Build Back Better

The Senate parliamentarian will meet with Democrats on Monday to review the health care provisions contained in the Build Back Better reconciliation package. Sometime following this meeting, the parliamentarian will hold a meeting with lawmakers of both parties. It is at this point in which Republicans are expected to challenge certain provisions of the bill, including the plan’s drug pricing proposal to penalize manufacturers who raise prices faster than inflation. While many Democrats continue to argue that Congress should send the bill to the President’s desk this month, many expect action on the reconciliation bill to drag into next year.

Sanders Asks White House to Curb Medicare Premium Increase

Sen. Bernie Sanders (I-Vt.) has sent a letter to the White House asking the administration to mitigate the impact of a forthcoming Medicare premium hike tied to the new Alzheimer’s treatment Aduhelm, priced at $56,000 annually. Medicare’s Part B premium for outpatient care is set to increase by $21.60 a month starting in January, the largest historical increase in dollar terms. “Biogen’s $56,000 price of Aduhelm is the poster child for how dysfunctional our prescription drug pricing system has become,” Sanders writes. “The notion that one pharmaceutical company can raise the price of one drug so much that it could negatively impact 57 million senior citizens and the future of Medicare is beyond absurd. With Democrats in control of the White House, the House and the Senate we cannot let that happen.”

Bob Dole Passes Away at 98

Former Senate Majority Leader and presidential candidate Bob Dole passed away Sunday morning at age 98. His personal and professional accomplishments are numerous. He served his country for 79 years, starting with his service during World War II, for which he received two Purple Hearts, followed by a long career in the Congress. He championed many health issues that improved care and access for many, including the Americans with Disabilities Act, protection and advocacy for the mentally ill, prostate cancer awareness and men’s health legislation, wounded warriors, and long- term care (including the PACE program). Senator Dole and President Ronald Reagan urged Congress to include hospice services in the Medicare program. Senator Dole then worked to establish the Medicare Hospice Benefit, first in 1982 as a temporary benefit, and then in 1986 when it became permanent, as well as provided states the option to include hospice in state Medicaid programs. Dole was known for his bipartisanship and is a co-founder of the Bipartisan Policy Center in Washington, DC. For those who worked alongside him, he was known for his smart wit. He used to joke that he knew there was a nurse shortage, but he didn’t have one since he had two nurses on his staff – Sheila Burke and Vicki Hart. Vicki Hart, founder of Hart Health Strategies, worked with Senator Dole during his time as majority leader and after they both left the Senate. “It was a privilege to work with Leader Dole to successfully advance sound health policy that helped so many,” said Vicki Hart. “He will be forever missed in the United States Senate.”

DeFazio to Retire

Rep. Peter DeFazio (D-Ore.) announced that he will not seek reelection next year after 36 years in Congress. DeFazio has been the top Democrat on the House Committee on Transportation and Infrastructure since 2015. He is the 19th House Democrat to announce plans to retire in 2022.

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