McDermott+Consulting is pleased to provide the McDermottPlus Check-Up, your regular update on health care policy from Washington, DC.

This Week’s Dose

The House unveiled and advanced a three-week Continuing Resolution (CR) with an expiration date of March 11, as top appropriators from both Chambers continued to negotiate the final details of an omnibus funding bill for the remainder of FY 2022. Key healthcare committees in the House and Senate held hearings on topics including ARPA-H, youth mental health, workforce shortages, and dual eligible beneficiaries.  

Congress

House Advances Short-Term CR, Senate Expected to Follow Suit.  On February 7, House Appropriations Committee Chair Rosa DeLauro (D-CT) introduced a short-term continuing resolution (CR) that would provide temporary funding for federal operations to give top appropriators more time to complete negotiations on the details of an FY 2022 omnibus appropriations bill.

The current CR is set to expire on February 18. The new CR will provide government funding through March 11, giving appropriators an additional three weeks to hammer out the details of an omnibus package, and potentially include other priorities like disaster or COVID relief.  In a sign of progress, a broad agreement was announced February 9 on a framework for both defense and non-defense spending levels.

The House passed the three-week CR on February 8 by a vote of 272-162, with 51 Republicans joining Democrats to approve the bill, and just one Democrat voting against it. The vote tally in the House indicates that the bill will likely receive bipartisan support in the Senate, where Majority Leader Chuck Schumer (D-NY) has said that the bill will be brought up for a vote “quickly” and before the February 18 deadline.

The exact timing for a Senate vote remains unclear, as leaders may need to first resolve an issue related to recent reports about “Harm Reduction Program Grants” approved by the Department of Health and Human Services (HHS) aimed at reducing the spread of disease among drug users by distributing so-called “smoking kits”.  These reports—which the Administration has characterized as inaccurate—have led Senator Marsha Blackburn (R-TN) to place a hold on the CR until the issue is resolved.

We are nearly halfway through federal fiscal year 2022, which started on October 1, 2021, so an omnibus appropriation will provide full government funding for only a portion of the year. Nonetheless, enacting a proper appropriations measure, rather than short-term CRs, is important for a variety of reasons, including that government programs have continued to be funded at FY 2021 levels, and consistent with priorities established by the previous Administration.

House Energy and Commerce Committee Holds Hearing on ARPA-H.  On February 8, the House Energy and Commerce Health Subcommittee held a hearing titled “ARPA-H: The Next Frontier of Biomedical Research”.  The first panel was intended to include Office of Science and Technology Policy (OSTP) Director Eric Lander presenting the Administration’s perspective, however, as he resigned amidst controversy late the night before, the hearing proceeded without an Administration witness.

The Advanced Research Projects Agency for Health (ARPA-H) is a signature priority for President Biden and was included in his FY 2022 budget proposal. The intended purpose is to invest in breakthrough technologies and broadly applicable platforms, capabilities, resources, and solutions that have the potential to transform medicine and healthcare, and that cannot be accomplished through traditional research/activity. The President and others liken ARPA-H to the Defense Advanced Research Projects Agency (DAPRA), which supports research and development of emerging technologies for use by the military for the U.S. Department of Defense.

The current Cures 2.0 legislation introduced by Energy and Commerce Committee Members Diana DeGette (D-CO) and Fred Upton (R-MI) includes provisions that would establish ARPA-H with the National Institutes of Health. Health Subcommittee Chair Anna Eshoo (D-CA) has also introduced legislation to establish ARPA-H, but her bill would build the program as an independent agency within HHS.  In her opening statement at the February 8 hearing, Congresswoman Eshoo referred to ARPA-H as her “top legislative priority” this Congress.

President Biden also recently relaunched his Cancer Moonshot initiative, which includes related priorities specific to significantly cutting cancer death rates over the next 25 years and improving the experience of people living with and surviving cancer. Efforts to advance these two priorities—ARPA-H and the Cancer Moonshot—may become connected, though a specific path forward and funding levels are not yet clear.

Senate Finance Committee Holds Hearing on Youth Mental Health.  Also on February 8, the Senate Finance Committee held a hearing titled “Protecting Youth Mental Health: Part I - An Advisory and Call to Action”. The hearing included testimony from U.S. Surgeon General Dr. Vivek Murthy, who discussed his recent Advisory on youth mental health and provided the Committee with recommendations to combat the growing mental health epidemic.

The hearing was the first in a two-part series on youth mental health, the next of which will take place on February 15.  It is also part of a larger committee effort on mental health reform, which began in the fall of 2021 with a request for stakeholder feedback and will include hearings on additional topics in the coming weeks followed by the drafting and introduction of bipartisan mental health reform legislation later this year.

The Finance Committee’s mental health effort is divided into five key areas, each with a Democrat and Republican co-lead:

• Strengthening the workforce: Senators Debbie Stabenow (D-MI) and Steve Daines (R-MT)

• Increasing integration, coordination and access to care: Senators Catherine Cortez Masto (D-NV) and John Cornyn (R-TX)

• Ensuring parity between behavioral and physical health care: Senators Michael Bennet (D-CO) and Richard Burr (R-NC)

• Furthering the use of telehealth: Senators Ben Cardin (D-MD) and John Thune (R-SD)

• Improving access to behavioral health care for children and young people: Senators Tom Carper (D-DE) and Bill Cassidy (R-LA)

The Finance Committee hearing also follows mental health-focused hearings held in the Senate Health, Education, Labor and Pensions (HELP) Committee and House Ways and Means Committee the week of January 31. The House Energy and Commerce Committee also announced a hearing on “America’s Ongoing Mental Health Crisis” to be held February 17.  This bicameral, broadly focused interest suggests that Congress is likely to advance comprehensive mental health legislation in 2022.

Administration

What’s Next for the National Public Health Emergency?  The most recent 90-day renewal of the national public health emergency (PHE) runs through April 16, and the Administration has indicated it will give a 60-day notice before allowing the PHE to expire. Falling case numbers, the waning of the winter omicron surge, and the rolling back of COVID-related restrictions and mandates in a growing number of Democrat-led states all call into question how much longer the PHE will be extended. Though many anticipate at least one more 90-day extension, calls to end the PHE are growing—particularly among House Republicans, who on February 10 sent a letter to the President and HHS Secretary asking for a concrete plan and timeline on winding down the PHE.

The expiration of the PHE has numerous health policy implications, as many pandemic-related flexibilities—such as those related to the provision of telehealth services, for example—are tied to the PHE.  Using telehealth as a continued example, there are numerous bills in both the House and Senate, supported by both Democrats and Republicans, to extend telehealth PHE flexibilities, but there are also limited legislative vehicles on which to attach such extensions during this midterm election year. 

Our team is monitoring this situation closely and will continue to provide updates as developments occur.

Quick Hits

• The Senate HELP Committee held a hearing on employment for people with disabilities, focusing on efforts to overcome barriers to employment for workers with disabilities and ways to build upon recent progress, including the widespread use of inclusive practices to make work more accessible.

• The Senate HELP Committee held a hearing on healthcare workforce shortages, focusing on the need to increase recruitment, revitalization and diversification of the workforce—an issue that predates the current PHE but has been exacerbated by pandemic.

• The Senate Special Committee on Aging held a hearing on improving care experiences for beneficiaries eligible for both Medicare and Medicaid coverage.  During the hearing, Chairman Bob Casey (D-PA) announced that he and Ranking Member Tim Scott (R-SC) are introducing the PACE Expanded Act—a bill to reduce administrative barriers that prevent the development and expansion of Programs of All-Inclusive Care for the Elderly (PACE).

• Senators Cortez Masto and Todd Young (R-IN) introduced the Telehealth Extension and Evaluation Act, which would extend current telehealth flexibilities for two years beyond the end of the PHE. As the two Senators are members of the Finance Committee, this legislation could become the foundation of a consensus telehealth package in the Senate.

• HHS announced $66.5 million in American Rescue Plan funding to expand community-based outreach efforts to increase COVID-19 vaccine confidence and improve vaccination rates.

Next Week’s Diagnosis

The House is holding committee work days Tuesday through Thursday, but is not scheduled to return to DC for votes until Monday, February 28.  The Senate is scheduled to be in session next week and will then be in recess the week of February 22. House and Senate appropriators will continue to seek a bipartisan agreement on an FY 2022 omnibus bill—with the potential for the inclusion of other policies like disaster or COVID relief—with March 11 as the new deadline.