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.


2022 Midterm Elections Update

More than a week after Election Day, the majorities in the Senate and House of Representatives have been determined. Republicans will control the House of Representatives having won the minimum 218 seats necessary. Five House races remain undecided. The Georgia runoff between incumbent Senator Raphael Warnock (D) and Herschel Walker (R) on December 6th will determine whether Democrats have a 50 or 51-seat majority in the Senate next year. Hart Health Strategies is maintaining a document to summarize what is currently known about the ongoing election results. The latest document can be found here and includes updates on state ballot initiatives, health professionals in the 118th Congress, committee leadership and members changes, and what to expect in the lame duck.

Congressional Leadership Updates

Congressional Republicans held their party leadership elections last week. Minority Leader Mitch McConnell (Ky.) overcame a challenge from Sen. Rick Scott (Fla.) to remain the Republican party’s leader in the Senate. McConnell received 37 votes to Scott’s 10. McConnell will surpass Mike Mansfield’s (D-Mont.) 16-year record as the longest-serving Senate party leader next year. Senate Republicans also elected Sen. John Thune (S.D.) as Senate minority whip, Sen. John Barrasso (Wyo.) as chairman of the Senate Republican Conference, Sen. Joni Ernst (Iowa) to run the Senate Republican Policy Committee, Sen. Shelley Moore Capito (W.Va.) to serve as vice chair of the Senate Republican Conference, and Sen. Steve Daines (Mont.) to replace Scott at the top of the National Republican Senatorial Committee.

In the House of Representatives, current Minority Leader Kevin McCarthy (Calif.) was voted the Republican nominee for Speaker of the House during the GOP’s closed- door leadership elections. McCarthy received only 188 votes – short of the 218 he will need during the formal House speaker vote in January. Many conservative members of the Freedom Caucus backed Rep. Andy Biggs (Ariz.), who received 31 votes. Republicans also reelected Rep. Steve Scalise (La.) as the party’s number two leader. He was unopposed for the position of majority leader. Rep. Tom Emmer was elected whip of the House Republican Conference, besting Reps. Jim Banks (Ind.) and Drew Ferguson (Ga.) for the leadership post. Rep. Elisa Stefanik was re-elected conference chair, beating Rep. Byron Donalds (Fla.), and Rep. Richard Hudson (N.C.) defeated Rep. Darin LaHood (Ill.) for National Republican Congressional Committee Chair.

Senate Democrats will hold their leadership elections the week of December 5, and House Democratic leadership elections are expected to take place on November 30. Current Speaker Nancy Pelosi (Calif.), 82, who has served as the Democratic House leader for nearly two decades and is the only woman to ever serve as speaker, announced her exit from congressional leadership last week. She plans to remain in the chamber representing her San Francisco district. Chairman of the House Democratic Caucus Hakeem Jeffries (N.Y.), 52, is expected to be chosen as her successor when Democrats hold their leadership elections after Thanksgiving. He would be the first Black party leader in Congress. Majority Leader Steny Hoyer (D-Md.) also announced that he will not seek a leadership post in the next Congress.

Senate Committee Leadership Updates

Sen. Patty Murray (D-Wash.) officially announced that she will step down as chair of the Health, Education, Labor, and Pensions (HELP) Committee to seek the gavel on the Appropriations Committee following the retirement of Patrick Leahy (D-Vt.). Sen. Susan Collins (R-Maine) is expected to replace retiring Richard Shelby (R-Ala.) as the top Republican on the panel.

As a result, Sen. Bernie Sanders (I-Vt.) will seek to chair the HELP Committee next year. As chair, Sanders stated that he would focus on universal health care and lowering the cost of prescription drugs. Sen. Rand Paul (R-Ky.) has decided to replace the retiring Sen. Rob Portman (R-Ohio) and serve as the Ranking Member of the Senate Homeland Security and Governmental Affairs Committee (HSGAC) next Congress, foregoing the opportunity to lead Republicans on the HELP Committee. Paul has stated his intent to investigate the origins of COVID-19 from this leadership position. Sen. Gary Peters (D-Mich.) is expected to remain as HSGAC chair. Sen. Bill Cassidy (R-La.), a physician, is poised to take the Ranking Member position on HELP. His priorities for the panel include oversight of HHS spending and implementation of the No Surprises Act and reducing drug prices.

Indiana Republican Rudy Yakym Sworn-In to House of Representativesv

Rep. Rudy Yakym (R-Ind.) was sworn-in to the House of Representatives last week. Yakym was selected as the Republican nominee by Indiana’s 2nd congressional district GOP precinct committee to replace Rep. Jackie Walorski (R) following her death in a car accident in August of this year. He will serve the remainder of Walorski’s term as well as a full two-year term starting in January after winning the general election in November. Yakym is a businessman and served as the finance director of Walorski’s 2012 congressional campaign.

COVID-19 PHE Expected to Be Extended into April 2023

The U.S. Department of Health and Human Services (HHS) is expected to extend the COVID-19 public health emergency (PHE) beyond the current declaration’s expiration on January 12. In keeping with the Department’s commitment to provide a 60-day notice to states and health providers before terminating the PHE or allowing it to expire, HHS would have needed to issue such a notice by November 11 but did not do so. The continued PHE declaration will allow expanded Medicaid coverage, telehealth flexibilities, and other waivers and policies tied to the pandemic to remain in place presumably for at least another 90 days – extending into April 2023. Once the PHE concludes, the federal government will also stop paying for COVID-19 vaccines, tests, and treatments and shift those costs to the commercial sector. The current PHE was first declared in January 2020 and is revisited every 90 days. While daily deaths and case rates have been declining, more than 300 people still die each day from COVID-19 in the U.S. and public health professionals are preparing for a potential surge of COVID-19 infections – alongside projected increases of the flu and respiratory syncytial virus (RSV) – this winter. Congressional Republicans have been urging the administration to end the emergency declaration, with Republican leadership of the House Energy and Commerce Committee calling on the administration “to provide to the public what metrics it will use to evaluate the state of COVID-19 risk and what [the President’s] plan is to unwind the PHE.”

In related news, the Senate voted 62-36 last week to pass S.J.Res. 63, to end the COVID-19 national emergency. The joint resolution passed with the support of 12 Democrats. The measure would end the national emergency declared on March 13, 2020, in response to the emergence of COVID-19. This national emergency is separate from the HHS-declared PHE. The joint resolution is not expected to pass the House of Representatives and has received a veto threat from the White House, which argued that abruptly ending the emergency would be “a reckless and costly mistake.”

White House Requests Nearly $10 Billion in Supplemental Public Health Appropriations

The Biden administration is requesting that Congress provide approximately $10 billion in additional public health funding before the end of the year. According to a report from the Washington Post, the request will include $5 billion for an initiative known as Project Covid Shield to develop the next generation of COVID-19 vaccines and treatments, $2.5 billion for continued access to vaccines and therapeutics domestically, $750 million for long COVID research and treatment, $1 billion for global COVID-19 response, and $750,000 to respond to other public health problems like hepatitis C, HIV, and monkeypox. The White House’s prior requests for additional public health funding have been repeatedly rejected by Republican lawmakers this year who are skeptical that more pandemic response money is necessary when dollars from prior COVID-19 legislation remain unspent. The administration has predicted that those funds could be exhausted by early 2023. Democrats are expected to try and package the supplemental appropriations request with the year-end omnibus spending bill.

Marijuana Research Bill Sent to President for His Signature

The Senate passed legislation last week to ease restrictions on medical and scientific research on marijuana and its compounds. The Medicare Marijuana and Cannabidiol Research Expansion Act (H.R. 8454) was previously passed by the House of Representatives in July and will now be sent to President Joe Biden for his signature. The bill would streamline the registration process for conducting research with marijuana under the Controlled Substances Act. Senate Majority Leader Chuck Schumer (D-N.Y.) has indicated that he may bring other cannabis-related bills to the floor during the lame duck session.

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