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.


Biden Slated to Release FY23 Budget

Later today, President Joe Biden is expected to unveil his fiscal year (FY) 2023 budget request. According to various press reports, the request will include a $1 trillion reduction in deficit spending over the next decade, generated in part by a new tax on the income and unrealized capital gains of billionaires. The elimination of pandemic assistance programs and emergency financing to state and local governments will result in a $1.3 trillion reduction in federal spending compared to last year alone. The President’s budget proposal is not expected to include the costs or revenues stemming from the policies pursued by Democrats and the administration as a part of the now-stalled Build Back Better package, so as not to interfere with ongoing congressional negotiations on the reconciliation bill. Instead, the budget request will more broadly endorse the climate and social safety net spending and tax changes pursued as a part of the Build Back Better agenda. The President’s budget will propose a new 20% minimum tax on the income and rising asset values of the wealthiest Americans - households worth more than $100 million. It is also expected to include funding for the White House’s Unity Agenda, those measures which the President believes should garner bipartisan support. Such measures include combating the opioid epidemic, expanding access to mental health care, supporting the health of veterans, and providing funding for the Cancer Moonshot Initiative and the Advanced Research Projects Agency for Health (ARPA-H).

Democrats, Romney Consider Offsets for COVID Funding

The Senate is working to draft a new COVID-19 spending bill after the previous $15.6 billion proposal stalled over a Democratic policy to rescind $7 billion in aid to state and local governments to offset the legislation. Sen. Mitt Romney (R-Utah) is serving as the GOP point person in negotiations with Democrats. He stated that progress is being made on a new proposal. House Speaker Nancy Pelosi (D-Calif.) has acknowledged that the new bill will need to be larger in scope than the prior $15.6 billion measure, given additional needs as time has passed, while also conceding that the bill will need to be offset to pass the evenly divided Senate.

Office of Management and Budget (OMB) Director Shalanda Young, outgoing White House COVID-19 response coordinator Jeff Zients, and U.S. Department of Health and Human Services (HHS) Secretary Xavier Becerra briefed Democratic senators last week on the need to approve more funding for COVID-19 response before key programs run out of money. The White House has urged that $22.5 billion is necessary to continue the administration of vaccines, care for the uninsured, provide global coronavirus aid, and maintain supplies of COVID-19 tests and treatments. Republicans continue to demand a full accounting of how prior COVID-19 response resources before any additional emergency spending is passed.

Warnock, Collins, Shaheen Work to Craft Insulin Pricing Measure

Senate Majority Leader Chuck Schumer (D-N.Y.) stated in a press conference last week that he intends to consider bipartisan legislation to impose a $35 price cap on insulin to be considered on the Senate floor after the two-week mid- April recess. According to Schumer, the bill will be paired with other policies to address the cost of prescription drugs, such as a proposal still under negotiation to overhaul the pharmacy benefit managers (PBM) rebate system. Schumer believes the measure “has a good chance of passing.” Sen. Raphael Warnock’s (D-Ga.) original bill would have capped out-of-pocket insulin costs for insured patients. Sens. Susan Collins (R-Maine) and Jeanne Shaheen (D-N.H.), co-chairs of the Senate Diabetes Caucus, are working to draft legislation in collaboration with Warnock (D-Ga.) that would make insulin more affordable for all patients, not just the insured.

House GOP Holds Annual Retreat

House Republicans met in Florida last week for their annual issues conference to discuss the GOP’s legislative agenda for the months leading up to November’s midterm elections. During the conference Republicans heard from the heads of the seven task forces established by Minority Leader Kevin McCarthy (R-Calif.) last June – Jobs and the Economy; Big Tech Censorship and Data; Future of American Freedoms; Energy, Climate, and Conservation; American Security; Healthy Future; and China Accountability. The Republican’s policy agenda has been termed “Commitment to America” and is expected to be finalized around August. Republicans must only net five seats to win the majority in the House of Representatives this election cycle.

CDC Responds to Request for Long COVID Data

Rep. Don Beyer’s (D-Va.) office announced that they received a briefing from the Centers for Disease Control and Prevention (CDC) in response to a request from him and Rep. Ayanna Pressley (D-Mass) to publicly release data on long COVID broken down by race, ethnicity, age, gender, previous disability, and other demographics. During the briefing, the lawmaker reportedly learned that the CDC would not have the internal dataset from which to publicly post disaggregated data for two years. The PREVENT Pandemics Act (S. 3799) recently advanced out of the Senate Health, Education, Labor, and Pensions (HELP) Committee included provisions directing the U.S. Department of Health and Human Services (HHS) to identify and develop tools and strategies to care for individuals with long COVID and requiring a report to Congress on related research.

Lawmakers Ask FDA to Act on E-Cigarettes

Abipartisan group of 15 senators has sent a letter to the Food and Drug Administration (FDA) calling on the agency to take steps to remove e-cigarettes from the market. The FDA was previously ordered by a U.S. District Court to complete a review of e-cigarette products by September 9, 2021, to determine whether they are a danger to public health and should be removed from the market. The FDA has still not completed its review. “Now that FDA is six months past the court deadline, these unreviewed products are only being permitted to stay on the market due to the agency exercising enforcement discretion. It makes no sense, and runs contrary to the Tobacco Control Act’s statutory framework, that products that have not been granted authorization are being allowed to stay on the market and attract new, young users. FDA has the authority and responsibility to halt this grace period today and restore the statutory burden of proof on manufacturers to demonstrate their product is ‘appropriate for the protection of public health’ prior to market entrance,” the letter states.

Marijuana Legislation Sees Movement in Congress

The Senate passed bipartisan legislation last week to expand medical and scientific research on marijuana and its compounds. The Cannabidiol and Marihuana Research Expansion Act (S. 253) would require the U.S. Department of Health and Human Services (HHS) and the National Institutes of Health (NIH) to submit a report to Congress on the potential harms and benefits of marijuana use. The House of Representatives could also vote this week on legislation (H.R. 3617) to decriminalize cannabis. The House Rules Committee is scheduled to meet on Wednesday to report a Rule for the Marijuana Opportunity Reinvestment and Expungement (MORE) Act.

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