Nothing’s impossible
With a heart full of love - and
Hands full of purpose
Federal Updates
Ain’t no love in the heart of the city
The line above was first recorded by the incomparable Bobby “Blue” Bland in 1974, and while the song on the surface may appear as just a soulful lament of lost love, the world in which it was written offers so much more subtext. The point? It’s layered – and that is precisely the way to describe the ongoing situation in Washington, D.C. Tensions remain understandably high, and a public return to any semblance of bipartisanship seems like an improbability rather than eventuality. Feeling the love in the heart of our nation’s capital? Probably not. But sometimes, we have to listen beyond the lyrics to see what’s going on. Behind the music is something else entirely – a steady beat beckoning for change and progress – one that we feel every day in our work. Sure, sometimes we clap on the 1 and 3, but we won’t stop until we catch the rhythm.
Biden invokes DPA; discussions begin on post-COVID relief priorities
The White House announced that President Biden has invoked his authority under the Defense Production Act (DPA) to compel increased production of needed COVID-19 vaccine and testing supplies. The DPA allows the president to direct various federal agencies to enter into priority contracts with manufacturers and suppliers to produce materials and equipment to strengthen national security during emergencies, including public health crises. The Trump administration also utilized the DPA to increase production of ventilators and medical masks last year. The COVID-19 pandemic marks the first time that the DPA has been invoked solely to respond to a public health emergency.
As Congress moves ahead to finalize a massive COVID-19 relief package through the budget reconciliation process, the Biden administration is beginning to test the waters on some of its other key economic priorities, including infrastructure. Biden met with a small bipartisan group from the Senate this week to begin outlining potential areas of agreement for infrastructure legislation. The meeting was characterized as productive, although plans may be complicated by a high price tag, and Democratic leaders are unlikely, for political capital and other reasons, to consider another round of budget reconciliation to move forward on this issue.
Among the provisions expected to be in consideration for a national infrastructure overhaul are efforts to further expand broadband and other technological access to underserved communities and geographic areas, which could have a significant impact on the future of healthcare delivery. Our office will be monitoring the debate and development of infrastructure-related priorities closely.
Senate impeachment trial opens
The impeachment trial of former President Donald Trump began in the Senate this week to decide whether Trump should be convicted on a single count of “incitement of insurrection” following the devastating attack on the U.S. Capitol on January 6, 2021. While early signals in the process suggest that there will not be the necessary 67 votes to convict, at least some Republicans are expected to join their Democratic colleagues in favor of conviction.
The beginning of the trial also means that other Senate priorities and functions have been slightly delayed. Senate committees are not scheduled to begin marking up individual reconciliation bills for a COVID-19 relief package until the trial concludes, nor are there any confirmation hearings planned for Biden administration cabinet nominees, including Health and Human Services Secretary (HHS) nominee Xavier Becerra. Denis McDonough, whose nomination as Veterans’ Affairs (VA) Secretary was recommended by the Senate VA Committee last week, was confirmed on Tuesday afternoon shortly before the trial gaveled into order.
More than a feeling: House committees move forward with COVID-19 reconicilation bills
They aren’t wasting time. This week, various House committees have been following instructions provided by the recently passed FY 2021 budget reconciliation resolution to draft and approve reconciliation bills with policies meeting specified spending and revenue targets. The individual bills are scheduled to be reported out of their respective House committees by February 16, when they will be combined into what will become the House’s legislative framework supporting the president’s $1.9 trillion COVID-19 relief package.
While reconciliation will allow Democrats to move forward with COVID-19 relief without Republican support if needed, the process does not preclude Republicans or Democratic members from offering amendments or policy suggestions.
Of note, the House Energy and Commerce Committee approved its individual reconciliation bill on Thursday. Highlights include:
- $7.5 billion to the Centers for Disease Control and Prevention (CDC) for vaccine distribution
- $5.2 billion to HHS for research and development, manufacturing, production, and purchase of vaccines, treatments, and supplies
- $46 billion for national testing and contact tracing strategies
- $1.8 million for vaccines and supplies for congregate settings (jails, nursing homes, etc.)
- $7.5 billion for HHS to provide public health workforce grants to the states to aid in the hiring and training of healthcare staff
- $7.6 billion for community health centers
- $3.5 billion to the Substance Abuse and Mental Health Services Administration (SAHMSA) for mental health services and substance abuse, prevention, and treatment
- Incentives to states to expand Medicaid coverage to more low-income adults, postpartum women, and prisoners 30 days before release
- Support for Medicaid and the Children’s Healthcare Insurance Program (CHIP) to provide the COVID vaccine with no cost-sharing
The House Ways and Means Committee, which has jurisdiction over Medicare, completed its markup on Thursday evening, and its bill includes, among other provisions, additional support for skilled nursing facilities and increased premium tax credits for purchasing insurance under the Affordable Care Act.
As work on the next round of COVID relief continues, Duke Health Government Relations will continue to advocate for support for the research enterprise, provider relief, telehealth expansion, and other key Duke Health priorities.
“Momnibus” Black maternal health bill reintroduced in Congress
On Monday, Reps. Alma Adams (D-NC-12) and Lauren Underwood (D-IL-14) reintroduced the “Black Maternal Health Momnibus Act of 2021” in the House. This legislation is made up of 12 individual bills sponsored by Members of the Black Maternal Health Caucus “to save moms’ lives and end racial and ethnic disparities in maternal health outcomes.” Rep. G.K. Butterfield (D-NC-01) is also an original cosponsor of this legislation, and Senator Cory Booker (D-NJ) reintroduced its companion in the Senate.
This issue has been an advocacy priority for Duke Health Government Relations, as the Black maternal health crisis continues to expose gaps in our healthcare system that must be fixed. As highlighted in the press release from the Black Maternal Health Caucus, “The United States has the highest maternal mortality rate in the developed world and the only rate that is rising. The maternal mortality rate is significantly higher among Black women, who are three to four times more likely than white women to die from pregnancy-related complications. Other birthing people of color, including Hispanic, Native American, and Asian American and Pacific Islander women, also suffer from disproportionately high rates of adverse maternal health outcomes.”
Late last year, members from the Duke Department of Obstetrics & Gynecology met with Rep. Adams to offer valuable insights on this important issue, and they continue to be engaged.
Duke joins effort opposing proposed fetal tissue research restrictions
Duke University joined a community letter led by the International Society for Stem Cell Research urging the Biden administration to withdraw a proposed rule issued by the Trump administration that would limit National Institutes of Health (NIH) extramural research involving human fetal tissue. Specifically, the rule would prohibit the use of NIH funds for the procurement of fetal tissue and restrict procurement from most healthcare facilities in the US.
The [Rep.] [David] Price is right: Bipartisan letter urges HHS nominee to support 340B Drug Pricing Program
Rep. David Price (D-NC-04), at the request of the Duke Health Government Relations office, signed onto a bipartisan letter to HHS Secretary nominee Xavier Becerra asking him to take immediate action to ensure that manufacturers are prohibited from imposing unilateral changes to the 340B Drug Pricing Program that are in direct conflict with congressional intent and decades of written guidance. Specifically, the letter urges Becerra, if confirmed as HHS Secretary, to: begin assessing civil monetary penalties on manufacturers that deny 340B pricing to covered entities in violation of their obligations under the 340B statute; require manufacturers to refund covered entities the discounts they have unlawfully withheld since 2020; halt, through guidance or other means, any attempt to unilaterally change 340B upfront discounts to post sale rebates; and immediately seat the Administrative Dispute Resolution Panel to begin processing disputes within the program.
Becerra previously demonstrated support for the 340B program as Attorney General of California, leading a multistate effort pushing back against manufacturers ignoring program guidance.
From our desk(s): Duke Health GR this week
The Duke Health Government Relations team continues to connect with staff and Members of the North Carolina congressional delegation. This week we connected with staff of newly appointed Senate Health, Education, Labor, and Pensions (HELP) Committee ranking member Senator Richard Burr (R-NC) on Duke Health priorities, including provider relief, COVID-19 response, and telehealth.
We also had conversations seeking support for the Temporary Reciprocity to Ensure Access to Treatment (H.R. 708 / S.168), which would provide some licensure flexibility for licensed medical and mental health professionals to practice across state lines during the COVID-19 public health emergency – and checked in with the office of Rep. Ted Budd (R-NC-13), who introduced similar licensure flexibility legislation last week.
Additionally, our team joined the North Carolina Healthcare Association’s (NCHA) government relations call with staff of the North Carolina congressional delegation and helped to lead discuss on key issues such as telehealth, immigration, 340B, provider relief, and COVID-19 response and vaccine distribution.
We continue our outreach and support for the Research Investment to Spark the Economy (RISE) Act, which was reintroduced last week in the House. Senator Thom Tillis (R-NC) and several colleagues reintroduced the companion bill in the Senate. We are grateful for the bipartisan support from the NC congressional delegation for investments to help our research infrastructure, including early career researchers, that has been impacted by COVID-19.
(Virtual) Hill days are coming - and we can help
With the calendar already at mid-February, we are getting closer to the kickoff of professional association Hill days. While these activities will be virtual this year, they are still wonderful opportunities to connect with your elected officials, showcase your work, and make connections on key federal policy issues for your field.
If you’re planning to join or even considering joining an association lobby day this year, we’d love to hear from you!
We know your associations provide great training opportunities and materials to prepare you for the big day, but please know that we’re your in-house resource every day of the year for consultation and to help you continue to build those relationships with staff and Members of Congress.
Contact Brian Lee in our office at brian.lee887@duke.edu to share your information
It’s not just our jobs - it’s also a lot of fun - and we look forward to connecting with you.