Federal Health Policy Updates for the
Week of October 11 - October 15, 2021
Votes are like water
Earned in drops, drained in buckets
And gone in high heat
The Rundown
- Guest column! Duke State Relations provides an update on congressional redistricting
- Democrats re-scope infrastructure as Congress works to head off December fiscal cliff
- Rep. David Price visits Duke Regional Hospital
- The latest from our desks
Federal Updates
Where in NC is the 14th District?
It’s fall in the year after a decennial census and right before an election year. That means it is federal congressional redistricting time in North Carolina, and we’ve asked our colleague Katie Lipe in the Duke State Relations office to give us an update on how the process is going in the state legislature.
By: Katie Lipe, Communications and Outreach Coordinator, Duke State Relations
North Carolina state lawmakers have begun drafting new state and congressional legislative district maps – a process that is statutorily required to occur every 10 years (or multiple times a decade if you’re in North Carolina… more on that later) following each decennial census due to population changes and the need to maintain equal representation. The redistricting process will determine which political party has the opportunity to control North Carolina’s state legislature in the future, as well as determine which way the state’s congressional delegation leans. North Carolina will also receive a 14th seat in the U.S. House of Representatives this year due to population growth, but it is still unknown where the new district will be created.
State legislators in NC have been ordered by the courts to redraw maps multiple times over the past 40 years due to partisan and racial gerrymandering. The Republican-controlled state legislature faced a number of legal challenges during the last redistricting cycle in 2011, with congressional maps declared unconstitutional in both 2016 and 2019. The most recent court ruling in 2019 required the General Assembly to redraw maps with an unprecedented level of transparency and fairness, and lawmakers intend to abide by a similar set of criteria this year. The N.C. House and Senate Redistricting Committees agreed to draw legislative districts with compactness, equal population, and contiguous boundaries, and without consideration of data related to race, partisanship, or election results.
Members of the public have had several opportunities to be involved in the redistricting process this year, with 13 public hearings scheduled in locations across the state last month and a public comment portal open on the General Assembly’s website. Legislators are likely to schedule another public hearing once map proposals are finalized. Last week, legislators began simulating new district maps on designated computer stations with the process live streamed for members of the public.
Both Republicans and Democrats will draw dozens of possible maps over the next two weeks with many iterations for lawmakers to consider. Democratic Governor Roy Cooper lacks veto authority over redistricting matters, once again leaving the Republican-controlled majority responsible for how new district lines are drawn unless the courts intervene again. Despite guardrails and criteria in place, critics remain skeptical that Republican leaders will fairly draw new district maps this year without facing future legal challenges. Although Republicans were in the spotlight over the past decade for gerrymandering, it was an issue even when Democrats held a majority in the state legislature prior to 2011. For years, advocates across the state have been in favor of redistricting reform that would take legislators out of the picture and rely on a nonpartisan independent redistricting commission. There is widespread bipartisan support for such reform, but it has yet to gain traction among legislative leaders.
Legislators are expected to wrap up the map-drawing process over the next couple of weeks, with the goal of approving new district maps by the end of October to allow the State Board of Elections ample time to prepare for candidate filing in December. For updates and additional information on the redistricting process, visit the Duke State Relations Blog.
We’ll follow up again with Katie and the State Relations Office in a few weeks once the final map is set for approval. In the meantime, you can take a shot a drawing your own congressional district map… and maybe win a prize in the process. Learn more here.
Deals, deadlines, and… doomsday? Let’s take a breath
Those of us hoping for a more predictable federal legislative holiday season after the absolute circus of December 2020 are resigned to disappointment a month and half early. Yet, even with a number of critical deadlines set to converge within a matter of days and weeks in the last month of the year, there’s no way we’ll be sweating out votes and behind-the-scenes negotiations through the stroke of midnight on January 1, right? Right?
Reconciliation/infrastructure
There are signs that the self-imposed and non-binding Halloween deadline for Democratic leaders to reach an intra-party and inter-chamber agreement on a scaled-back version of the budget-reconciliation driven Build Back Better Act will slip into November. That is not entirely unexpected, as satisfying both moderate and progressive factions of the Democratic caucus while also trimming over $1 trillion from the originally constructed “human” infrastructure package will take some finesse. Some of this will be accomplished by changing the effective dates of certain policies, but other pieces will likely need to be cut completely. There is also the matter of the second, Senate-passed bipartisan “traditional” infrastructure bill, which may or may not need the unified votes of House Democrats to succeed but almost certainly will not have them without an agreement on a Build Back Better framework.
FY 2022 spending and the debt limit
The good news is that we have avoided potential default on the federal debt limit until December 3rd through a temporary debt limit hike passed by Congress this week. The complicating news is that the debt limit boost is set to expire on the same day as the continuing resolution that’s keeping the federal government running absent a final agreement between the House and Senate on FY 2022 spending. The most recent time these two were linked in late September didn’t work out so well, and while Democrats may ultimately to decide to address the debt limit expiration through the reconciliation process, they won’t have that luxury for negotiations on appropriations. Compromises will be necessary.
Rep. David Price visits Duke Regional
On October 8, Rep. David Price (D-NC-04) visited Duke Regional Hospital to tour the new Duke Behavioral Health Center. The Congressman met with Duke Regional Hospital President Katie Galbraith and other hospital and behavioral health leaders to talk about behavioral health challenges and policy priorities, COVID-19 response, the health system workforce, and opportunities to collaborate on issues supporting Duke Regional staff and the surrounding communities served by the hospital’s professionals and programs.
From our desk(s): Duke Health GR this week
This week, our team joined Duke State Relations to provide a federal and state policy overview and outlook as part of the Duke Family Medicine and Community Heath Grand Rounds, Duke OB/GYN Grand Rounds, and for the Duke University Health System Center for Advanced Practice Leadership. Our offices routinely engage with departments and cohorts throughout the health system to discuss policy priorities and advocacy opportunities. If you are interested in connecting with our federal team, please let us know at govrelations@dm.duke.edu.
We monitored a virtual hearing of the House Financial Services Committee Task Force on Artificial Intelligence, of which Reps. Alma Adams (D-NC-12) and Ted Budd (R-NC-13) are members, as well as a House Veterans’ Affairs (VA) Subcommittee on Health legislative hearing on various framework drafts supporting Veterans’ mental health and the VA workforce. Next week, we will be following a key public health legislative hearing of the House Energy and Commerce Committee.
As Congress continues to work toward a negotiated reconciliation package, our office is urging that provisions from the “Black Maternal Health Momnibus Act” are included. This week, one of the 12 bills that make up the Momnibus, the “Protecting Moms Who Served Act,” passed the Senate with unanimous support. That bill is led by Senators Tammy Duckworth (D-IL) and Susan Collins (R-ME), and Representative Lauren Underwood (D-IL-14). In a statement following passage, Rep. Underwood noted "the U.S. suffers unacceptable rates of preventable maternal mortality, and veterans are uniquely at-risk. With the ‘Protecting Moms Who Served Act’, we can make sure that the Department of Veterans Affairs provides the highest quality maternal health care and support for moms who have served." The bill was modified slightly from the House bill and will have to go back to the House for consideration before it is signed into law.
We shared a new report from the ABC Science Collaborative with several congressional staff that discussed how a masking mandate in North Carolina schools during the early weeks of the Delta variant surge resulted in a lower rate of infection among school children and staff members than what was reported in the broader community. The Duke University School of Medicine and the Duke Clinical Research Institute developed the ABC Science Collaborative in response to COVID-19 and its impact on schooling. Our office shares information from experts, like the ABC Science Collaborative, so they can serve as resources for policy makers.
We are also following reports that President Biden is preparing to name Robert Califf, MD, as his nominee to lead the Food and Drug Administration (FDA). Dr. Califf previously served as FDA Commissioner in the final year of the Obama administration. Before joining the FDA, he was a professor of cardiology and vice chancellor for clinical and translational research at Duke. He also served as director of the Duke Translational Medicine Institute, founding director of the Duke Clinical Research Institute, and later became the founding director of Duke Forge. If nominated, Dr. Califf’s appointment will require Senate confirmation.