POLICY BRIEFINGS

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President to Deliver State of the Union Address Feb. 7

President Joe Biden will deliver his annual State of the Union address to Congress on February 7. The President is expected to tout his legislative victories over the last year, including the infrastructure bill and the Inflation Reduction Act. He will also lay out the administration’s vision for areas of potential bipartisan compromise in the newly divided Congress and is likely to discuss the need to raise the federal government’s borrowing authority this year.

Treasury to Begin Extraordinary Measures to Avoid Debt Default

Treasury Secretary Janet Yellen has informed House Speaker Kevin McCarthy (R-Calif.) that the U.S. is projected to reach its $31.4 trillion borrowing limit in less than a week. The Treasury Department will begin taking “extraordinary measures” on January 19 to delay a default on the national debt. Yellen urged Congress to act in a timely manner to raise or suspend the debt ceiling before the extraordinary measures run out, which could occur as early as June. Republicans have pledged that any action to address the debt limit should be tied to spending cuts.

COVID-19 PHE Renewed Through April

The Biden administration renewed the COVID-19 public health emergency (PHE) for the 11th, and possibly final, time last week. Senior White House officials are reportedly preparing to end the COVID-19 emergency designation this spring. The administration has pledged to provide a 60 days’ notice before terminating or allowing the PHE to expire – a deadline which has now been pushed until early February given the latest 90-day PHE extension to mid-April. Allowing the PHE to expire would result in the restructuring of the federal COVID-19 response and shift much of the responsibility for vaccine and treatment distribution to the private sector. Other flexibilities and regulatory authorities instituted in response to the COVID-19 PHE would also end, though some measures have already been de-linked from the emergency declaration. The most recent omnibus spending package, for example, included a two-year extension of telehealth policies and permits states to resume Medicaid redeterminations in April. Other provisions, such as the Drug Enforcement Administration’s virtual prescribing of controlled substances waivers, were not extended in the year-end funding bill.

The administration is weighing whether to begin scaling back its COVID-19 team in the coming months or keep it intact through the end of the year. Staff members who leave the administration in the interim, however, are not expected to be replaced, nor will a new chief medical adviser be named following the departure of Anthony Fauci at the end of last year. Although little federal funding for COVID-19 response remains following Congress’ failure to allocate more money last year, the administration continues to work to increase vaccine uptake and make treatments more widely available particularly in response to the rapid spread of the new COVID-19 subvariant XBB.1.5.

FLOTUS Undergoes Surgery to Remove Skin Lesions

First Lady Jill Biden underwent Mohs surgery at Walter Reed National Military Medical Center last week to remove two basal cell cancerous lesions. Doctors do not expect any further procedures to be necessary. According to White House physician Dr. Kevin O’Connor, the first lady “is in good spirits and is feeling well.”

CMS Announces Distribution of First Tranche of New GME Slots

The Centers for Medicare and Medicaid Services (CMS) announced the distribution of 200 graduate medical education (GME) slots created as a part of the Consolidated Appropriations Act, 2021, which provided for the creation of 1,000 additional Medicare-funded physician residency slots over the course of five years. Of these direct GME slots, 125 of the residency slots are being allocated for primary care (including obstetrics/gynecology), and 20 slots are being allocated for psychiatry. This year’s slots, distributed to 100 teaching hospitals in 30 states, the District of Columbia, and Puerto Rico, will be effective July 1, 2023. The application period for the 200 fiscal year 2024 slots will open later this month and close on March 31, 2023.

USPSTF Welcomes Three New Members

The U.S. Preventive Services Task Force (USPSTF) announced the addition of three new members to the task force last week. Each are appointed to serve four-year terms starting this month.

• Dr. Sandra Millon Underwood, R.N., Ph.D., professor emerita in the College of Nursing at the University of Wisconsin-Milwaukee
• Dr. Goutham Rao, M.D., FAHA, chair of the Department of Family Medicine and Community Health, and chief clinician experience officer for the University Hospitals Health System
• Dr. Joel Tsevat, M.D., M.P.H, general internist, professor of medicine, and Joaquin G. Cigarroa, Jr., M.D., distinguished chair in the Joe R. and Teresa Lozano Long School of Medicine at The University of Texas Health Science Center at San Antonio

Maine Epidemiologist Chosen for CDC Leadership Post

Nirav Shah, MD, JD has been tapped to serve as Principal Deputy Director of the Centers for Disease Control and Prevention. Shah, a doctor, lawyer, and epidemiologist, currently serves as Director of the Maine Center for Disease Control and Prevention. He will begin working as the CDC’s second-in-command in March. Shah previously served as the president of the Association of State and Territorial Health Officials from March 2021 through September 2022.

Gallup Releases Annual Poll on Professional Ethics Ratings

Nurses, doctors, and pharmacists have topped the ranks of Gallup’s measurement of American’s professional ethics ratings. Approximately 79% of U.S. adults say nurses have “very high” or “high” honesty and ethical standards, with medical doctors and pharmacists ranking second and third respectively – with 62% and 58% of Americans rating them highly. All three professions, however, have seen a drop in their ratings since the bumps shown in 2020 at the height of the COVID-19 pandemic. Telemarketers and members of Congress received the lowest ratings, with less than 10% of Americans rating their ethics highly.

Recently Introduced Health Legislation

H.Res.7 — Recognizing the importance of access to comprehensive, high-quality, life-affirming medical care for women of all ages; Sponsor: Biggs, Andy [Rep.-R-AZ-5]; Committees: House - Energy and Commerce

H.Res.9 — Expressing the sense of the House of Representatives that China is responsible for the COVID-19 pandemic and must be held financially liable for $16,000,000,000,000; Sponsor: Nehls, Troy E. [Rep.-R-TX-22]; Committees: House - Foreign Affairs

H.J.Res.7 — Relating to a national emergency declared by the President on March 13, 2020; Sponsor: Gosar, Paul A. [Rep.- R-AZ-9]; Committees: House - Transportation and Infrastructure

H.R.26 — To amend title 18, United States Code, to prohibit a health care practitioner from failing to exercise the proper degree of care in the case of a child who survives an abortion or attempted abortion; Sponsor: Wagner, Ann [Rep.-R- MO-2]; Committees: House – Judiciary

H.R.31 — To amend title XIX of the Social Security Act to provide for a demonstration project under the Medicaid program for political subdivisions of States to provide medical assistance for the expansion population under such program, and for other purposes; Sponsor: Doggett, Lloyd [Rep.-D-TX-37]; Committees: House - Energy and Commerce

H.R.33 — To amend title XVIII of the Social Security Act to provide for coverage of dental, vision, and hearing care under the Medicare program; Sponsor: Doggett, Lloyd [Rep.-D-TX-37]; Committees: House - Energy and Commerce; Ways and Means

H.R.34 — To amend the Social Security Act and the Internal Revenue Code of 1986 to include net investment income tax imposed in the Federal Hospital Insurance Trust Fund and to modify the net investment income tax; Sponsor: Doggett, Lloyd [Rep.-D-TX-37]; Committees: House - Ways and Means

H.R.35 — To amend title XVIII of the Social Security Act to provide for certain reforms with respect to medicare supplemental health insurance policies; Sponsor: Doggett, Lloyd [Rep.-D-TX-37]; Committees: House - Ways and Means; Energy and Commerce

H.R.41 — To amend title 38, United States Code, to direct the Secretary of Veterans Affairs to ensure the timely scheduling of appointments for health care at medical facilities of the Department of Veterans Affairs, and for other purposes; Sponsor: Baird, James R. [Rep.-R-IN-4]; Committees: House - Veterans’ Affairs

H.R.46 — To authorize funding to increase access to mental health care treatment to reduce gun violence; Sponsor: Jackson Lee, Sheila [Rep.-D-TX-18]; Committees: House - Energy and Commerce; Judiciary

H.R.55 — To amend title 18, United States Code, to enhance criminal penalties for health related stalking, and for other purposes; Sponsor: Jackson Lee, Sheila [Rep.-D-TX-18]; Committees: House – Judiciary

H.R.62 — To protect health care providers and people seeking reproductive health care services, and for other purposes; Sponsor: Jackson Lee, Sheila [Rep.-D-TX-18]; Committees: House - Energy and Commerce; Judiciary

H.R.69 — To abolish the Occupational Safety and Health Administration, and for other purposes; Sponsor: Biggs, Andy [Rep.-R-AZ-5]; Committees: House - Education and Labor

H.R.70 — To abolish the Agency for Toxic Substances and Disease Registry, and for other purposes; Sponsor: Biggs, Andy [Rep.-R-AZ-5]; Committees: House - Energy and Commerce

H.R.71 — To amend the Federal Food, Drug, and Cosmetic Act to exempt from regulation as devices non-invasive diagnostic devices, and for other purposes; Sponsor: Biggs, Andy [Rep.-R-AZ-5]; Committees: House - Energy and Commerce

H.R.72 — To prohibit the use of Federal funds to maintain or collect information that can be used to identify any individual to whom a COVID-19 vaccine is administered, and for other purposes; Sponsor: Biggs, Andy [Rep.-R-AZ-5]; Committees: House - Energy and Commerce

H.R.73 — To prohibit the use of Federal funds for the HHS Reproductive Healthcare Access Task Force; Sponsor: Biggs, Andy [Rep.-R-AZ-5]; Committees: House - Energy and Commerce

H.R.74 — To prohibit the use of Federal funds to propose, establish, implement, or enforce any requirement that an individual wear a mask or other face covering, or be vaccinated, to prevent the spread of COVID-19, and for other purposes; Sponsor: Biggs, Andy [Rep.-R-AZ-5]; Committees: House - Energy and Commerce

H.R.75 — To repeal the authority of the Food and Drug Administration to require that drugs be dispensed only upon prescription, and for other purposes; Sponsor: Biggs, Andy [Rep.-R-AZ-5]; Committees: House - Energy and Commerce

H.R.76 — To amend title XXVII of the Public Health Service Act to provide for a definition of short-term limited duration insurance, and for other purposes; Sponsor: Biggs, Andy [Rep.-R-AZ-5]; Committees: House - Energy and Commerce

H.R.77 — To amend the Public Health Service Act to provide for cooperative governing of individual health insurance coverage; Sponsor: Biggs, Andy [Rep.-R-AZ-5]; Committees: House - Energy and Commerce

H.R.79 — To direct the President to withdraw the United States from the Constitution of the World Health Organization, and for other purposes; Sponsor: Biggs, Andy [Rep.-R-AZ-5]; Committees: House - Foreign Affairs

H.R.93 — To require a particular jury instruction in Federal civil actions that include a claim for damages based on negligence arising from the transmission of COVID19; Sponsor: Biggs, Andy [Rep.-R-AZ-5]; Committees: House – Judiciary

H.R.104 — To require the Secretary of Veterans Affairs to formally recognize caregivers of veterans, notify veterans and caregivers of clinical determinations relating to eligibility for caregiver programs, and temporarily extend benefits for veterans who are determined ineligible for the family caregiver program, and for other purposes; Sponsor: Biggs, Andy [Rep.-R-AZ-5]; Committees: House - Veterans’ Affairs

H.R.105 — To amend title 38, United States Code, to direct the Secretary of Veterans Affairs to furnish hyperbaric oxygen therapy to veterans with traumatic brain injury or post-traumatic stress disorder; Sponsor: Biggs, Andy [Rep.-R-AZ-5]; Committees: House - Veterans’ Affairs

H.R.106 — To amend the Internal Revenue Code of 1986 to provide that amounts paid for an abortion are not taken into account for purposes of the deduction for medical expenses; Sponsor: Biggs, Andy [Rep.-R-AZ-5]; Committees: House - Ways and Means

H.R.107 — To amend the Internal Revenue Code of 1986 to allow for tax-advantaged distributions from health savings accounts during family or medical leave, and for other purposes; Sponsor: Biggs, Andy [Rep.-R-AZ-5]; Committees: House - Ways and Means

H.R.109 — To amend the Internal Revenue Code of 1986 to allow an above-the-line deduction for health insurance premiums; Sponsor: Biggs, Andy [Rep.-R-AZ-5]; Committees: House - Ways and Means

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