THIS WEEK’S DOSE
Following a tumultuous first week of the 118th Congress, the House moved ahead with organizing activities for the new Congress this week and began to undertake legislative business. The Senate was in recess this week and returns to session January 23. The COVID-19 public health emergency (PHE) was officially extended through mid-April, and the US Department of Health and Human Services (HHS) released information on the Medicare drug price negotiation program.
House Adopts Rules Package, New Committee Leaders Named. The Republican-controlled House got down to business this week, following last week’s extended floor proceedings to elect Rep. Kevin McCarthy (R-CA) as Speaker on the 15th ballot. On January 9, the House approved its rules package for the 118th Congress largely along party lines, with one Republican voting against the package.
On January 10, the House Republican Steering Committee met to determine its picks for House committee chairs. Of note to healthcare stakeholders, Rep. Jason Smith (R-MO) will lead the powerful Ways and Means Committee, beating out Reps. Vern Buchanan (R-FL) and Adrian Smith (R-NE) for the coveted chair role. Rep. Smith been a strong proponent of telehealth and rural healthcare, and has also been active on mental health issues. As chair, he is also expected to focus on oversight.
On January 11, the Steering Committee met to begin determining House committee rosters, beginning with the so-called “A” committees. New Republican members on committees of importance to healthcare stakeholders include the following:
- Ways and Means Committee – Reps. Mike Carey (R-OH), Randy Feenstra (R-IA), Michelle Fischbach (R-MN), Brian Fitzpatrick (R-PA), Nicole Malliotakis (R-NY), Blake Moore (R-UT), Michelle Steel (R-CA), Greg Steube (R-FL), Claudia Tenney (R-NY) and Beth Van Duyne (R-TX)
- Energy and Commerce Committee – Reps. Rick Allen (R-GA), Troy Balderson (R-OH), Kat Cammack (R-FL), Russ Fulcher (R-ID), Diana Harshbarger (R-TN), Mariannette Miller-Meeks (R-IA), Jay Obernolte (R-CA), August Pfluger (R-TX) and Randy Weber (R-TX)
- Appropriations Committee – Reps. Stephanie Bice (R-OK), Jerry Carl (R-AL), Juan Ciscomani (R-AZ), Michael Cloud (R-TX), Andrew Clyde (R-GA), Jake Ellzey (R-TX), Scott Franklin (R-FL), Michael Guest (R-MS), Jake LaTurner (R-KS) and Ryan Zinke (R-MT).
Of the 20 members who held out against Speaker McCarthy last week, none were added to the Ways and Means or Energy and Commerce Committees. Two did gain seats on the Appropriations Committee: Reps. Cloud and Clyde.
Once committee rosters are set, subcommittee determinations are made and staff is in place, committee leaders will begin to lay out their agendas for the 118th Congress, including legislative, oversight and investigative priorities. We will continue to provide updates and analyses as such decisions are announced, regarding potential implications for health policy in the new Congress.
PHE Officially Extended Until Mid-April. On January 11, HHS Secretary Xavier Becerra extended the COVID-19 PHE for an additional 90 days, until mid-April.
The HHS Secretary has maintained a commitment to provide 60-days’ advance notice if the agency is planning to end the PHE. With this latest renewal, the next 60-day deadline will occur in mid-February. The Administration has continued to signal its consideration of the winding down of the PHE through requests for information and listening sessions. The repeated requests to Congress for supplemental COVID-19 funding have not been fulfilled, and are not likely to be. Further, through the recently enacted Consolidated Appropriations Act, 2023, Congress untied some PHE-related flexibilities from the PHE, including telehealth and hospital at home provisions, which were extended through the end of 2024, and decoupled Medicaid continuous coverage requirements from the PHE.
Many other administrative flexibilities around payment and coverage, as well as access to free COVID-19 tests, are currently tied to the PHE. With a recent uptick in COVID-19 cases and a new variant becoming dominant, it remains possible for the Administration to renew the PHE, but planning for it to end in April will leave health stakeholders best prepared in either scenario.
HHS Releases Key Dates and Information on Medicare Drug Price Negotiation Program. On January 11, HHS and the Centers for Medicare & Medicaid Services (CMS) announced key dates and other information related to the Medicare drug pricing negotiation provisions included in the Inflation Reduction Act (IRA).
A full timeline of key dates can be found here, and highlights include the following:
- By September 1, 2023, CMS will publish the first 10 Medicare Part D drugs selected for the Medicare drug price negotiation program.
- The negotiated maximum fair prices for these drugs will be announced by September 1, 2024, and prices will be in effect starting January 1, 2026.
- In future years, CMS will select for negotiation 15 more Part D drugs for 2027, 15 more Part B or Part D drugs for 2028, and 20 more Part B or Part D drugs for each year after that, as outlined in the IRA.
CMS also released a memo with more details on the implementation steps for the Medicare drug price negotiation program, laying out the opportunities for engagement and public feedback throughout the implementation process, providing details on program guidance and data collection, and offering a timeline for these implementation activities.
HHS Releases Updated ACA Marketplace Enrollment Numbers. On January 11, HHS announced that approximately 15.9 million people nationwide have selected Affordable Care Act marketplace health plans since the beginning of the 2023 marketplace open enrollment period (OEP) on November 1, 2022.
The updated data represents activity through week 10 of the OEP (January 7) for the 33 marketplaces using HealthCare.gov, and through week 9 (December 31, 2022) for the 18 state-based marketplaces in 17 states and the District of Columbia that are using their own eligibility and enrollment platforms. Compared to this time last year, approximately 1.8 million more people have signed up for health insurance, representing a 13% increase.
The 2023 OEP runs from November 1, 2022, to January 15, 2023 for marketplaces using the HealthCare.gov platform. Generally, applications must be submitted and plans must be chosen by January 15 for coverage to begin on February 1. State-based marketplace enrollment deadlines vary and are available, along with other information, in this fact sheet.
- The Medicare Payment Advisory Commission (MedPAC) held a two-day public meeting covering a variety of topics, including updating Medicare payments for hospital services, physician services, skilled nursing facility services, home health agency services and inpatient rehabilitation facility services. MedPAC also received status reports on Medicare Advantage and Medicare Part D, and discussed issues related to Medicare clinician and outpatient behavioral health services, telehealth use and Medicare Part B drug prices.
- The US Government Accountability Office (GAO) released a request for MedPAC nominations. Letters of nomination and resumes are due by February 10 and should be submitted to MedPACappointments@gao.gov.
- HHS announced almost $245 million in funding to support youth mental health, to help the healthcare workforce address mental health needs and to fund other critical mental health supports. The funding includes $185.7 million from the Substance Abuse and Mental Health Services Administration and almost $60 million from the Health Resources and Services Administration.
- GAO released a report on the Federal Employees Health Benefits Program, identifying additional monitoring mechanisms and fraud risk assessments needed to better ensure member eligibility.
- The Office of Information and Regulatory Affairs, part of the Office of Management and Budget, released the latest unified agenda, which provides information on the regulatory and administrative actions that federal agencies plan to issue in both the near and long term. The HHS-specific part of the unified agenda can be found here.
NEXT WEEK’S DIAGNOSIS
The House and Senate are both in recess next week, returning to session the week of January 23.
For more information, contact Debra Curtis, Kristen O’Brien or Erica Stocker.
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