It’s January
Where 31 days can feel
Just like a whole year
The Rundown
- Negotiations continue on government funding, foreign aid, and immigration/border security
- House Budget Committee advances fiscal commission bill
- What’s up NC delegation
- Regulatory policy update
- The latest from our desks
- Join the Duke Health Advocacy Network!
Federal Updates
A quiet week of negotiations
With the passage of another continuing resolution (CR) and the House out this week, work on government funding has been quiet, with most of the conversations occurring amongst negotiators behind the scenes. Much of Congress’ attention has instead focused on the Biden Administration’s $105 billion supplemental funding request related to aid for Israel and Ukraine, federal disaster relief, and immigration/border security policy and funding.
While there had been some optimism that Senate negotiators were close to a comprehensive immigration and border security reform package that would be able to move the entire funding request forward, the realities of the political situation in the House of Representatives and the broader politics of the 2024 presidential election are starting to damper that optimism. Senate Minority Leader Mitch McConnell (R-KY) suggested on Wednesday that finding an agreement that would pass both chambers of Congress is unlikely.
As Senate negotiators regroup to decide what, if any, path forward exists, it remains to be seen how this will impact other necessary negotiations underway, including for government funding. Appropriators have a little over a month to write and pass 12 spending bills that adhere to the topline spending deal negotiated between Senate Majority Leader Chuck Schumer (D-NY) and House Speaker Mike Johnson (R-LA). If this is not accomplished by March 1, Congress will need to approve yet another CR to avoid a partial government shutdown.
Why does it matter? Even the slightest delay in timing or disgruntled Member attention over another priority could imperil negotiations and actions toward finalizing federal spending. Sure, there’s time, but there is also the unknown. For the majority that seems to want to reach a resolution, the clock ticks in their favor, for now. For those who may be content to let that clock run out, or to hit snooze a few more times, the possibility of mandated across-the-board cuts inch ever closer.
Our team continues to advocate for Duke Health priorities with the NC congressional delegation.
House Budget Committee advances fiscal commission bill
Late last week, the House Budget Committee approved the “Fiscal Commission Act of 2024,” which would create a fiscal commission, among other things, to examine and make recommendations regarding the solvency of the Trust Fund for Medicare Part A. While three Democratic members joined in supporting the bill, it is a contentious issue between the two parties, with several Democrats expressing concern that this is an opportunity to fast-track cuts to entitlements and that revenue raisers should also be considered. Senate Finance Committee Chairman Ron Wyden (D-OR) issued a statement following the markup in the House Budget Committee stating his concerns. The bill would have Congress vote on recommendations in November 2024.
Senators Mitt Romney (R-UT) and Joe Manchin (D-WV), who are both retiring at the end of this Congress, have introduced a similar bill in the Senate. We have concerns about the potential impact of any fiscal commission recommendations on hospitals and will monitor the process closely.
What’s up NC delegation
Late last week, Rep Greg Murphy, MD (R-NC-03), who serves as Co-Chair of the GOP Doctors Caucus, led a bipartisan coalition on the House floor in opposing the 3.37% cut to the Medicare Physician Fee Schedule (PFS), which took effect on January 1. He also introduced the “Preserving Seniors' Access to Physicians Act” to prevent the cut, which was included by the Centers for Medicare and Medicaid Services in its 2024 PFS final rule. Our team is also advocating to stop this cut. More on his efforts can be viewed here.
It rules: Regulatory and executive policy roundup
This week, the Biden administration issued an Executive Order directing federal agencies to take key actions to strengthen contraception and abortion access, as well as to educate providers and patients about their rights under the Emergency Medical Treatment and Labor Act (EMTALA).
Contraception access
The order directs the Departments of the Treasury, Labor, and Health and Human Services (HHS) to issue new guidance to clarify standards and support expanded coverage of a broader range of FDA-approved contraceptives at no cost under the Affordable Care Act. The Office of Personnel Management will take steps to offer expanded benefits and education to federal workers. HHS will also notify private insurers of their obligations to offer contraceptives to beneficiaries.
Abortion and medical abortion access and security
Actions include protecting access to safe and legal abortion by medication, steps by the Departments of Justice and Homeland Security to ensure the safety of those seeking legal abortions, and promulgating rule changes to strengthen privacy protections under HIPAA for pregnant people who choose to terminate a pregnancy.
EMTALA
HHS announced it will launch a series of actions to educate the public about their rights to emergency medical care and to help support efforts of hospitals to meet their obligations under EMTALA. These actions include:
- Publishing new informational resources to help individuals understand their rights under EMTALA and the process for submitting a complaint if they are denied emergency medical care, including an abortion under emergency circumstances;
- Partnering with hospital and provider associations to disseminate training materials on providers’ obligations under EMTALA;
- Convening hospital and provider associations to discuss best practices and challenges in ensuring compliance with EMTALA; and
- Establishing a dedicated team of HHS experts who will increase the Department’s capacity to support hospitals in complying with federal requirements under EMTALA.
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 February, date TBD soon!
This week our team joined other stakeholders and government relations colleagues on coalition and strategy calls to discuss a range of policy issues, including support for Accountable Care Organizations and the 340B Drug Pricing Program.
We were pleased to join our State Relations colleagues in presenting to the Duke MINDS affinity group about our work and how to engage. If you’re interested in learning more about our team and how we serve you and the health system, please let us know! We’d love to connect and explore opportunities to learn from each other and work together.
Join the Duke Health Advocacy Network!
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