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Federal Health Policy Updates for the Week of February 26, 2024

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Fixes and patches 
But the long-term plan evades 
Here we go again 


The Rundown

  • Congress passes another continuing resolution to fund the government through March 
  • E&C focuses on rare disease legislation  
  • What’s up NC delegation  
  • The latest from our desks  
  • Join the Duke Health Advocacy Network! 

Federal Updates

Government funding negotiations pushed further into March 
The dance is the two-step, but who is leading? What do we mean? Keep reading. As we have previously reported, Congress has been approaching the federal funding deadline (that it set) to act on the still pending FY 2024 spending bills. With only a few days to spare, and as talk of a government shutdown heated up, Congress made some progress and will again avoid a shutdown this week. 

On Wednesday, Congressional leaders announced a government funding deal on six annual spending bills. These bills are in line with the topline funding deal negotiated between House Speaker Mike Johnson (R-LA) and Senate Majority Leader Chuck Schumer (D-NY) that was announced last month. But with the first part of the January CR set to expire later today, there is not enough time to pass these six bills. So instead, Congress decided to pass another CR (its fourth) to create two new sets of deadlines -- another two-step process. The House passed the new CR yesterday afternoon, and the Senate followed along later that evening. 

Under this new plan, the six annual spending bills that have deals (the Agriculture-FDA, Energy-Water, Military Construction-VA, Transportation-HUD, Interior-Environment, and Commerce-Justice-Science bills) will be funded under current Fiscal Year (FY) 2023 levels until March 8, giving appropriators another week to finalize the text and pass the bills for FY 2024. Continued funding for the remaining FY 2024 spending bills, including for Defense, Homeland Security, and Labor-Health and Human Services-Education, got a new deadline of March 22. Negotiations around this second group of bills have been more contentious, so it remains to be seen if even the new March 22 deadline will provide enough time to get them over the finish line. 

Further complicating the picture, appropriators will have to immediately pivot to FY 2025 spending bills for the new fiscal year that begins on October 1. President Biden is set to unveil his FY 2025 budget request on March 11, following his State of the Union address on March 7. 

While our office continues to advocate on behalf of Duke Health priorities for FY 2024, we are actively working on our funding requests for FY 2025 in support of the institution’s missions.     

Heard on the Hill: Focus on Rare Disease Legislation
This week, the House Energy and Commerce Health Subcommittee held a hearing to examine legislative proposals to support patients with rare diseases. The hearing also coincided with Rare Disease Day.  

One of the bills discussed at the hearing was H.R 4758, the Accelerating Kids Access to Care Act, which would improve children’s access to needed out-of-state healthcare by streamlining the burdensome and time-consuming Medicaid provider screening and enrollment process. Our office has worked with Duke Health experts to bring attention to the red tape that delays critical patient care and is administratively burdensome and time-consuming to healthcare providers, including Duke Health team members wanting to provide care.  

Currently, NC Reps. Don Davis (D-NC-01), Deborah Ross (D-NC-02), and Richard Hudson (R-NC-09) are cosponsors of H.R. 4578, while Senators Thom Tillis (R-NC) and Ted Budd (R-NC) have cosponsored the Senate version of the bill. Our office worked with Rep. Hudson’s office to provide information in preparation for the hearing.  

Another bill discussed at the hearing was H.R. 6664, the Innovation in Pediatric Drugs Act, which would, among other things, increase the Best Pharmaceuticals for Children Act (BPCA) program funding level from $25 million to $50 million. The National Institutes of Health authorized this program to study older, generic drugs that the BPCA exclusivity incentive is unable to reach since the drugs are long-since off-patent. The program fills an essential gap in pediatric drug research and has resulted in 18 drug and 2 device labels being changed with important new pediatric information. The Pediatric Trials Network, funded by the NIH BPCA program and led by Dr. Danny Benjamin at the Duke Clinical Research Institute, has studied a total of 132 drugs in children and 30 drugs in breast milk to determine infant drug exposure.  

In her opening statement at the hearing, full Committee Chair Cathy McMorris Rodgers (R-WA) discussed progress on innovation to find for rare disease treatments but said that more needs to be done. She also discussed making sure patients can access drugs once they are approved, referencing the Accelerating Kids Access to Care Act.  

A full list of legislation discussed at the hearing can be viewed at the link above. 

What’s up, NC delegation: Showing Support for Duke Health Priorities 
Over the most recent recess, our office continued building support for Duke Health priorities. We are pleased to share the following updates that illustrate support from NC delegation members for important healthcare legislation impacting Duke Health, our patients, and our community.  

Rep. Valerie Foushee (D-NC-04) signed on as a cosponsor of the Safety from Violence for Healthcare Employees (SAVE) Act at Duke Health’s request. This bill would help protect healthcare workers from violence, alleviate workforce challenges, and sustain quality patient care by providing federal protections from violence for healthcare workers similar to those that apply to aircraft and airport workers. NC Reps. Don Davis (D-NC-01), Deborah Ross (D-NC-02), Kathy Manning (D-NC-06), and David Rouzer (R-NC-07) are also cosponsors of this important bill.  

Our office advocated for the newly introduced Dr. Lorna Breen Health Care Provider Protection Reauthorization Act, which would reauthorize grant programs, created under the Dr. Lorna Breen Health Care Provider Protection Act (P.L. 117-105), for an additional five years. This program has supported Duke’s Health and Public Safety Workforce Resiliency Training Program grant from the Health Resources and Services Administration. Reps. Ross and Davis cosponsored the bill at our request.  

Our office also urged our Senators to support efforts to address the 3.37 percent cut to Medicare physician payments that went into effect on January 1, 2024. Senator Tillis joined efforts led by Senators John Boozman (R-AR) and Peter Welch (D-VT) urging Senate leadership to mitigate the cut.  

Last week, Rep. Foushee was appointed to a new House bipartisan task force on artificial intelligence. House Speaker Mike Johnson (R-LA) and Minority Leader Hakeem Jeffries (D-NY) created the task force and appointed 24 members to produce a report of policy proposals for governing the technology in coordination with the committees of jurisdiction. Our team is working with Rep. Foushee’s office and staff of other task force members to connect Duke Health expertise on AI in healthcare to help inform their efforts. 

From our desk(s): Duke Health GR this week
A big thank you to everyone who participated in our office hours this week. We had a lot of great questions and discussions and will be back in March - date TBD soon!   

During the recess week, Rep. Foushee visited Duke Health to meet with leadership, including Dr. Craig Albanese, Dean Mary Klotman, and Dr. Terry McDonnell, and discuss federal opportunities to address ongoing nursing and health care workforce challenges, artificial intelligence, and the importance of federal support for research funding.   

Our office joined Dr. Gary Maslow, Co-Division Director of Child and Family Mental Health and Community Psychiatry, at a Mental Health Roundtable hosted by Rep. Ross. Featuring representatives from local government, community organizations, healthcare, and higher education, the discussion focused on options for inpatient and outpatient care, health equity’s impact on disparities, healthcare staff recruitment and retention, and mental health and policing. 

We also coordinated Duke Health’s endorsement of the Ad Hoc Group for Medical Research’s recommendation of at least $51.303 billion for the National Institutes of Health (NIH) in FY 2025. Duke Health is joining others in the community in recommending this funding level as Congress begins developing its FY 2025 funding bills. The Ad Hoc Group for Medical Research includes organizations representing patients, scientists, health professionals, research and academic institutions, educators, and industry.  

Join the Duke Health Advocacy Network!
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