Federal Health Policy Updates for the
Week of July 26 - July 30, 2021
Complicated? Sure
Necessary? It’s process
Finished? Ha! Not yet
The Rundown
- House begins appropriations votes ahead of August recess
- Bipartisan negotiators reach a final deal, but there is still much work ahead on infrastructure
- The latest from our desks
Federal Updates
House begins consideration of FY 2022 appropriations bills while eyeing August exit
This week, the full House of Representatives began consideration of its twelve annual appropriations bills. This includes a seven-bill FY 2022 minibus appropriations package passed by the House on Thursday that contains the Labor-Health and Human Services-Education (Labor-HHS) spending bill approved by the House Appropriations Committee the week of July 12. The House Labor-HHS bill recommends increased investments in key federal healthcare and biomedical research agencies, including the National Institutes of Health (NIH) and Centers for Disease Control and Prevention (CDC). Also included in the minibus is the bill that funds the Food and Drug Administration (FDA), along with the Department of Agriculture.
The House is expected to adjourn for a monthlong August recess period later today and will likely take up the remaining appropriations bills upon returning in September. House Democratic leaders are hoping to complete work on all twelve bills before the September 30 end of the current fiscal year.
The Senate is scheduled to remain in session through next week before beginning its own August recess. Senate Appropriations Committee Chair Patrick Leahy (D-VT) has announced a tentative schedule for the committee to begin its work, but the timing of most subcommittee mark ups, including for the Senate version of the Labor-HHS-Education bill, are expected to slip into September. The delay increases the likelihood of at least a short-term continuing resolution (CR) to buy more time for House and Senate leaders to reach an agreement on FY 2022 spending and to avoid a government shutdown.
Unfortunately, CRs have become more of the norm than exceptions in recent years as appropriations work has extended well into the beginning of new fiscal years. We continue to advocate for Duke Health federal funding priorities throughout the FY 2022 appropriations cycle and will provide additional updates as they are available.
There’s (finally) a deal – and a lot of work ahead
It’s not quite the Tokyo Olympics, but the back and forth on infrastructure negotiations over the past couple of months has provided just about all us policy wonks can handle of Washington, D.C.’s version of competitive drama and intrigue.
In what can be described as a photo finish, Senate negotiators finally reached a deal on outstanding issues to allow the chamber to vote to open debate on a roughly $1 trillion (roughly half of that total comprised of new spending) bipartisan infrastructure package. The bipartisan legislation focuses largely on more traditional infrastructure spending priorities, including highways, bridges, and transit.
While full details have not been released, there is mixed news on how negotiators have agreed to offset the costs of infrastructure investments. Our office, in partnership with the American Hospital Association, Association of American Medical Colleges, and other stakeholders, successfully advocated for the removal of a provision to use unspent COVID-19 provider relief funds to pay for the legislation. However, a provision remains that would extend the current Medicare sequester cuts beyond their current 2030 expirations. The Medicare sequester has been temporarily suspended due to the COVID-19 public health emergency and is scheduled to resume next year absent further suspension or other congressional intervention.
All of this work sets the stage for congressional Democrats to continue work on a separate $3.5 trillion infrastructure package through the budget reconciliation process, which will bypass the need for Republican support, especially in the Senate. Democratic leaders are pushing for the reconciliation bill to include more healthcare related provisions, including drug pricing reform and Medicare expansion.
While the Senate may be able to move on the bipartisan infrastructure package before leaving town next week, work on both pieces of legislation will almost certainly carry into at least September.
We continue to monitor developments closely.
From our desk(s): Duke Health GR this week
This week, the Duke Health Government Relations office connected health system experts with staff of Senator Richard Burr (R-NC), ranking member of the Senate Health, Education, Labor, and Pensions (HELP) Committee, to answer questions about COVID-19 vaccinations, concerns about the delta variant, and potential for breakthrough infections of the fully vaccinated.
We reached out to the offices of Senator Burr and Senator Thom Tillis (R-NC) to urge their support for the Conrad State 30 and Physician Access Reauthorization Act (S.1810). The Conrad State 30 program provides states with waivers to allow doctors with J-1 visas to remain in the United States for three years after their end of their residencies if they commit to practicing in rural and underserved areas. Reps. David Price (D-NC-04) and G.K. Butterfield (D-NC-01) are cosponsors of the companion bill in the House. We also encouraged Senators Burr and Tillis to join a letter being circulated by Senator Padilla (D-CA) to Secretary of State Antony Blinken, encouraging the State Department to better prioritize and speed up the processing of international student visas.
Our team coordinated with Duke Health clinical and operations experts for a conversation with experts at University Hospitals to discuss mutual experiences with implementing hospital at home and home care programs, as well as advocacy efforts to ensure current Medicare-related hospital at home waivers remain in place following the end of the public health emergency.
Finally, we connected Duke Health neurological disease experts with staff of Reps. Butterfield and Richard Hudson (R-NC-08) to inform their preparation for a July 29 Energy and Commerce Subcommittee on Health hearing on accelerating treatments and cures for neurodegenerative diseases. Witnesses from NIH, FDA, the researcher, caregiver, and patient communities joined the conversation highlighting the needs for increased investment and expanded clinical trials for ALS, Alzheimer’s, Parkinson’s, and other progressive neurological conditions.
Want to Join Team Advocacy?
Thanks to the PDC and our partners in the Duke State Relations office, Duke Health physicians and providers can engage with policymakers through the PDC Provider Advocacy Network.
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Learn more here. (NOTE: You must register and use a non-Duke email address to receive action alerts.