This Week’s Dose

As House Committees complete reconciliation markups, Energy and Commerce Democrats break ranks on advancing drug pricing reform proposals. The government funding deadline approaches. 

Congress

Key House Committees Completed Markups of Infrastructure-related Reconciliation Bills.

The markups were a key step in advancing Democratic human infrastructure priorities through a reconciliation bill. The House Committees on Energy & Commerce (E&C) and Ways & Means (W&M) each spent several days debating dozens of Republican- proposed amendments, none of which passed. One roadblock occurred during the E&C markup when three Democrats—Reps. Kurt Schrader (OR), Kathleen Rice (NY) and Scott Peters (CA)—crossed the aisle and voted against the prescription drug pricing reform subtitle, which would provide $700 billion in savings by, among other things, authorizing Medicare to negotiate prices with drug manufacturers. Because W&M passed the same prescription drug pricing language, the bill that will be considered by the full House can still include drug pricing reform, but given very slim Democratic majorities in the House, it calls into question overall support for a key priority of the package. House Democrats are relying heavily on drug pricing reform savings to finance other major healthcare priorities that include: permanent expanded ACA subsidies; adding dental, hearing and vision benefits for Medicare beneficiaries; investments in Home and Community Based Services through Medicaid; and closing the Medicaid coverage gap in states that have not expanded Medicaid.

Congress Looks to Address Funding Deadline.

While the non-binding September 27 date to vote on the bipartisan infrastructure bill and human infrastructure reconciliation bill is just under two weeks away, Congress must now also quickly draft and pass a Continuing Resolution (CR) to keep the government funded ahead of September 30, which is when the federal government’s fiscal year ends and current funding runs out. This imperative is likely to be the core focus of the House next week and may overtake the goal of voting on the infrastructure bills by September 27. The CR is a necessary measure with an inflexible deadline – if Congress does not enact legislation to fund the government by then, the government will shut down – and it will shift the spotlight to another divisive issue: the debt ceiling. Republican leadership has maintained that Republicans are not interested in facilitating more spending by raising the debt ceiling. Yet, Democrats will need Republican votes in the Senate to achieve a 60-vote threshold to withstand a filibuster and vote to increase the debt limit. This is a high stakes battle with potential to lead to a government shutdown, making it front and center next for at least the next week.

Quick Hits

• The Centers for Medicare and Medicaid Services (CMS) announced recipients of the Community Health Access and Rural Transformation Awards (CHART). This program will distribute $20 million to entities in four states to improve rural health care.

• A total of 2.8 million individuals gained health insurance coverage during the Special Enrollment Period that ended in August, bringing the total number of Marketplace enrollees to 12.2 million.

• The Health Resources and Services Administration distributed $48 million to help expand pre-exposure prophylaxis efforts to fight the HIV epidemic.

• CMS granted $19.6 million to State Departments of Insurance to support implementation of available and renewable coverage requirements and essential health benefits.

• CMS proposed a sweeping claims-review demonstration for inpatient rehabilitation facilities in certain states. 

M+ Resources

• In the Breakroom this week, Debbie Curtis and Rodney Whitlock share their thoughts on what reconciliation means for future legislative action.

• Event of Interest. The Congressional Sleep Health Caucus – Sleep Health and the Pandemic Briefing. Sleep patients, medical professionals, and scientists will discuss sleep health during the COVID-19 pandemic, and how we move forward. Virtual event, September 21st from 10:30 am – 11:30 am (ET). Register here.

Next Week’s Diagnosis

The House returns from recess next week as the government funding deadline approaches. The Senate Finance Committee will consider the nomination of Christi Grimm to the post of Inspector General of Health and Human Services. The FDA will debate the merits of distributing COVID-19 boosters.