All the world’s a stage?
Big, if true. Drop the curtain!
We need the next act
The Rundown
- The votes are in – who’s running in November?
- Schedule update ahead of the summer session (now with more user fees!)
- E&C holds markup of key healthcare, mental health, and user fee legislation
- Administration poised to extend PHE
- The latest from our desks
- Join Duke Health Advocacy Network
Federal Updates
It's been decided (for now); primaries set the stage for November
On Tuesday, North Carolina held its primary elections for a number of state and federal offices, including the nominees vying for an open Senate seat and for the districts of two of the three individuals who have represented Duke University Hospital and the Durham community in the U.S. House of Representatives since 1993. Below is a brief summary of some of the federal races with big implications for the future makeup of the NC congressional delegation and our work. Our office continues to plan for the post mid-term environment and will identify opportunities for Duke Health to engage new members of Congress on priorities, while strengthening current and fostering new relationships amid the changing policy landscape.
U.S. Senate
After 27 years in Congress, Senator Richard Burr (R-NC) will retire at the end of this Congress. Both Republican and Democratic ballots were crowded with names looking for their party’s nomination. Current 13th District Representative Ted Budd (R) and former North Carolina Supreme Court Chief Justice Cheri Beasley (D) will be their party’s nominees on the ballot in November. Among election observers, this race is expected to be one of the most competitive races to decide control of the Senate beginning in 2023.
4th Congressional District (Duke University; Duke University Hospital; Duke Regional Hospital)
Rep. David Price (D-NC-04), who has served in Congress for more than 30 years, will also retire at the end of this Congress. State Senator Valerie Foushee (D) and Courtney Geels (R) will be their party’s nominees in November.
2nd Congressional District (Duke Raleigh Hospital)
Incumbent Deborah Ross (D) had no primary opposition and will face Christine Villaverde (R) in November.
1st Congressional District
Rep. G.K. Butterfield has served in Congress since 2004. He previously represented Duke University, Duke University Hospital, and Duke Regional Hospital before the districts changed last election. Rep. Butterfield will retire at the end of this Congress. Sandy Smith (R) and State Senator Don Davis (D) will be their party’s nominees in November.
11th Congressional District
Incumbent Madison Cawthorn (R) lost his primary to State Senator Chuck Edwards (R). Edwards will be on the ballot with Buncombe County Commissioner Jasmine Beach-Ferrara (D) in November.
13th Congressional District
The new 13th District is an open seat following redistricting. State Senator Wiley Nickel (D) and Bo Hines (R) will be their party’s nominees in November.
14th Congressional District
North Carolina received a new 14th Congressional District following the 2020 census. State Senator Jeff Jackson (D) will face Pat Harrigan (R).
Beltway schedule update
We’re edging closer to another brief recess/district and state work period for the House and Senate ahead of Memorial Day. Here’s a quick update on key priorities:
- FY 2023 federal budget and appropriations – Top line funding numbers for non-defense and defense discretionary spending? Haven’t seen them yet, although reports continue to suggest that Appropriations Committee leaders are close to a bipartisan agreement to help guide subcommittee work on the finer details of FY 2023 spending priorities. While it’s way too early to officially put the letters C(ontinuing) and R(esolution) together in reference to FY 2023, a busy summer and looming midterms raise the likelihood for an eventual continuing resolution to keep the conversation going (and the lights on) through at least early November.
- COVID supplemental package – We’ve discussed the risks outlined by the White House to the public health infrastructure and the nation’s COVID responses if Congress is unable to pass separate COVID-19 funding legislation – and reaching an agreement on scope and timing remains elusive. Given current schedules, it’s likely that any supplemental bill will have to wait until after Memorial Day – and it almost certainly won’t be the last needed this summer. The Biden administration recently announced it has again opened up ordering for free COVID tests for households – but additional resources for tests and vaccines will be needed to help the country fully move out of the pandemic phase.
- User fees – As noted in the article below, the House Energy and Commerce Committee completed its markup of Food and Drug Administration (FDA) user fee legislation this week. The Senate Health, Education, Labor and Pensions (HELP) Committee this week released its user fee reauthorization bill, the FDA Safety and Landmark Advancements (FDASLA) Act. The legislation reauthorizes FDA’s prescription drug, generic drug, biosimilar, and medical device user fee agreements and includes provisions to strengthen oversight of cosmetics and dietary supplements, modernize the regulation of diagnostic tests, invite market competition, and to prepare the FDA for the next generation of medical products.
- Other – This is a fun category because it contemplates a lot of things that our team is tracking that could break at any moment. The Senate Finance Committee continues its work on comprehensive mental health legislation, while the Senate HELP Committee is eyeing the summer work period to potentially move its PREVENT Pandemics Act. The administration is reportedly preparing final rules for the No Surprises Act and a permanent COVID healthcare workplace safety standard under the Occupational Safety and Health Administration. There is also the matter of pending Supreme Court decisions, not the least of which could transform federal protections for reproductive health and privacy. This is just a snapshot, of course, and it’s all coming our way sooner than it seems.
E&C holds full committee markup on key mental health and user fee legislation
In last week’s newsletter we provided an updated on six pieces of legislation advanced out of the E&C Health Subcommittee, including:
- Restoring Hope for Mental Health and Well-Being Act of 2022, which would reauthorize mental and behavioral health programs at the Substance Abuse and Mental Health Services Administration (SAMHSA) and Health Resources and Services Administration (HRSA).
- Food and Drug Amendments of 2022, which would reauthorize the prescription drug user fee program, the medical device user fee program, the generic drug user fee program, and the biosimilar user fee program through fiscal year (FY) 2027.
- Keeping Incarceration Discharges Streamlined for Child and Accommodating Resources in Education Act, which would “require state Medicaid programs to have in place medical and behavioral health screenings for eligible juveniles upon their release from incarceration. It would also direct the Centers for Medicare & Medicaid Services (CMS) to update its Medicaid school-based administrative claiming guide to help states submit claims for reimbursement for Medicaid eligible services furnished in schools.”
- The Advanced Research Project Agency-Health Act to formally authorize the Advanced Research Projects Agency for Health (ARPA-H). This version of authorizing legislation would establish ARPA-H as independent from the National Institutes of Health (NIH) within the Department of Health and Human Services. However, as previously reported, ARPA-H currently resides at NIH.
- Gabriella Miller Kids First Research Act 2.0 to reauthorize this program for five years.
- South Asian Heart Health Awareness Act of 2021 to award grants to states for to promote awareness for the increasing prevalence of heart disease, including (when appropriate), its relationship to type 2 diabetes in communities disproportionately affected by heart disease such as South Asian communities,
On Wednesday the full Committee advanced these pieces of legislation for full consideration by the House of Representatives. In addition, the Committee considered several amendments, including one to the Restoring Hope for Mental Health and Well-Being Act of 2022, which would remove “the requirement that a health care practitioner apply for a separate waiver through the Drug Enforcement Administration (DEA) to dispense certain narcotic drugs (e.g., buprenorphine) for maintenance or detoxification treatment.” A summary of offered amendments can be viewed here.
Are we in for another round? PHE extension expected
The Biden administration’s self-imposed 60-day deadline to notify state officials before the federal government’s intent to wind down the COVID-19 public health emergency (PHE) came and went earlier this week without any formal notice – and it is expected that the PHE will be extended at least one more time beyond July through mid-October.
The PHE declaration has provided both federal and state governments with numerous flexibilities to respond to the ebb and flow of the ongoing pandemic. There is growing political pressure for the administration to end the PHE despite the country again facing rising COVID cases and so many unknowns about the next phase. Stakeholders in the healthcare community have continued to press the Biden administration for an even longer extension, or at least a better sense of timing and more advanced warning of the PHE’s end – and the Biden administration may be offering the slightest signal that the next extension could be the last.
This week, the Department of Health and Human Services announced plans to better prepare states and entities for the eventual end of certain pandemic flexibilities. The Centers for Medicare and Medicaid Services (CMS) will hold the first of a planned monthly series of webinars with stakeholders next Wednesday, May 25th, in preparation for the restart of the Medicaid/CHIP redetermination process once the PHE ends and states are no longer required to maintain continuous coverage. More information on the webinar series, including registration, may be found here.
Our team will continue to closely monitor any new developments and updates from the administration.
From our desk(s): Duke Health GR this week
Over the past two days, second and third year internal medicine residents with an interest in health policy participated in the School of Medicine’s Advocacy in Clinical Leadership Track. Through collaboration with our office, residents developed and presented their own advocacy platform to congressional offices in Washington, D.C. Our team enjoyed the opportunity to help these residents prepare for advocacy meetings related to immigration and mental health legislation under consideration by Congress.
Members of our team met with Senate Appropriations subcommittee staff to discuss FY 2023 funding and programmatic priorities for the Duke-UCLA led National Child Traumatic Stress Network (NCTSN).
We joined the monthly gun violence research roundtable meeting with other government relations colleagues to discuss topics including federal funding, as well as stakeholder calls on federal telehealth policy and other key issues.
The Duke Health Government Relations team was also pleased to join our colleagues in the Duke State Relations office for a policy presentation with Duke Speech Pathology and Audiology. We appreciate these opportunities to connect directly with our Duke Health colleagues, share more about our work, and learn about the priorities and issues of importance for various departments and their team members. We’d love to engage more with you, too. If you are interested in having our team join yours for a brief conversation about our work, please contact us at govrelations@dm.duke.edu.
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