The end of the world?
Hyperbole matches tone
But let’s get this done
The Rundown
- Congress passes debt limit legislation
- CMS ends vaccine mandate requirement for healthcare workers
- The latest from our desks
- Join the Duke Health Advocacy Network!
Federal Updates
When the hard thing is the right thing: Congress passes debt limit bill
There was another version of this article that made reference to icons of rock and soul, that assumed even with the best of intentions that ego and political posturing would get in the way of expediency – that doing the right thing, the thing we all believed would eventually happen anyway, would take longer than it should.
And then this week, despite the public perception of dysfunction and hyper-partisanship, Congress did the expected in an unexpected way – by just doing it. Sure, there was plenty of noise, and the final product, discussed in more detail below, is not without serious limitations. It’s the reality of a divided government, one that this week was able to largely come together to avoid potential catastrophe. Imagine what might be possible if we were to also raise our expectations for what the 118th Congress could accomplish. Demand more, better. What might happen then?
Congress has now passed legislation to suspend the debt limit through calendar year 2024 and prevent the United States from defaulting on its financial obligations. The House approved the legislation 314-117 Wednesday evening, and after coming to an agreement on votes for messaging amendments and a separate statement for the record expressing policy concerns and preferences, the Senate quickly followed suit with a 63-36 final vote.
In exchange for the debt limit suspension, the Fiscal Responsibility Act (H.R. 3746) would effectively cap non-defense spending at current levels for FY 2024, with modest increases allowed for Veterans and defense spending. These levels would be allowed to increase by 1% in FY 2025. The deal does not include work requirements for Medicaid beneficiaries but would impose expanded work requirements on other federal aid programs. The deal largely exempts Medicaid and Medicare from cuts and would also rescind a large chunk of unobligated COVID funding, apart from retaining $5 billion for COVID vaccine and treatment development.
They did it, and now it’s time for the even harder part: everything that comes after. Our team will be navigating a new policy and funding environment while working to elevate Duke Health’s missions and federal priorities. There will be immense challenges and opportunities across the board. And we’re no strangers to the hard things because that’s what we all do here. That’s our baseline. That’s what we do together. That’s why we succeed.
CMS ends vaccine requirement for healthcare workers
On Thursday, the Centers for Medicare and Medicaid (CMS) published a final rule to end the COVID-19 vaccine mandate for healthcare workers as a condition for facilities to participate in Medicare and Medicaid. Instead, it will now use quality reporting and value-based incentives to encourage facilities to keep workers and residents “up to date” on COVID-19 vaccines.
The final rule also makes permanent policies requiring long-term care providers to educate and provide COVID-19 vaccines to staff and residents and removes expired COVID-19 testing requirements for those populations.
CMS previously announced that it was planning to end the mandate following the expiration of the public health emergency on May 11th. While the final rule will not take effect until 60 days after being published in the Federal Register, CMS has indicated that it is no longer enforcing the mandate.
From our desk(s): Duke Health GR this week – with a special note of thanks
This week our office attended a Gun Violence Prevention Community Discussion hosted by Rep. Valerie Foushee (D-NC-04). We also joined a White House briefing on the Bipartisan Budget Agreement and participated in coalition meetings on data privacy, telehealth, surprise billing, and medical research.
Because this week has been all about the debt ceiling, we’d also like to take a moment to express a debt of gratitude to Dr. Hubert (Hubie) Haywood, Senior Assistant Resident, who is participating in the Management & Leadership Pathway for Residents (MLPR) program. Dr. Haywood recently completed a rotation through our office as part of the MLPR program, and we are grateful for his insights, enthusiasm, good humor, and willingness to step into a challenging policy environment. His thoughtful approach informed government relations activities on behalf of Duke Health, and we appreciate his contributions to developing strategic materials on some of the most pressing health policy challenges facing Congress, including strengthening the healthcare workforce. Thank you, Hubie!
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