HOUSE STILL WITHOUT SPEAKER

The House of Representatives has now been without a speaker for 20 days. Last week, Rep. Jordan (R-OH) dropped out of the speaker race after an internal Republican Conference vote showed he had no path to victory. This week, there are nine Republicans running for speaker. The top candidate is Rep. Emmer (R-MN). However, it is unclear whether this week will end any differently than last week.

Setting aside the ongoing quest to elect a speaker, the substantive question remains whether the next speaker of the House will be empowered—or will even want—to cut a deal to avoid a government shutdown on November 17 and negotiate a permanent solution to fiscal year 2024 appropriations. Also looming is the emergency supplemental spending package for Israel and Ukraine, which President Biden sent to Congress late last week. The Senate is expected to move first on that, with an Appropriations Committee hearing scheduled for October 31. As we’ve covered, the House cannot pass any legislation under the current speaker pro tempore structure, paralyzing Congress’s ability to reauthorize and fund the healthcare extenders or pass any of the bipartisan healthcare bills that have moved through committee in the House, such as pharmacy benefit manager reform and transparency proposals.

All this being said, congressional committees continue to do their jobs. In particular, the House Energy and Commerce Committee will hold a hearing on long-term services and supports (LTSS) access and workforce. This hearing will likely discuss the Medicaid home- and community-based services (HCBS) access proposed rule that was published earlier this year, which proposes changes to financing, transparency and reporting in Medicaid HCBS and LTSS. Hearings on rare diseases and hospital staffing are also planned, and the Senate Health, Education, Labor and Pensions (HELP) Committee is scheduled to vote Wednesday on nominating Dr. Monica Bertagnolli as director of the National Institutes of Health (NIH).