THIS WEEK’S DOSE
Democrats will retain control of the Senate in the 118th Congress, after key races in Arizona and Nevada were called in their favor. The December 6 runoff election in Georgia will determine whether Democrats’ majority is 50–50 (with Vice President Harris breaking ties) or 51–49. After a handful of pending House races were called this week, Republicans will take narrow control of the House. In House leadership news, Speaker Pelosi (D-CA), along with Majority Leader Hoyer (D-MD), announced that they will step down from their leadership roles in the new Congress, paving the way for the next generation of Democratic leadership in the House. On the regulatory front, the US Department of Health and Human Services (HHS) hosted a meeting on patient and healthcare worker safety, and the White House held a summit focused on COVID-19 and equity.
Congressional Leadership and Committee Updates. On November 17, Speaker Pelosi announced in a speech on the House floor that she will step aside from her role as the Democratic leader and pass the torch to a new generation of leaders. She also made clear that she’s not giving up her seat in the House at this time, and that she will be honored to continue representing her community of San Francisco in Congress. She has led Democrats in the House since 2002 as speaker or minority leader, and is the first woman to do so.
Soon after Speaker Pelosi’s speech, the Democrats’ second-in-command, Majority Leader Hoyer, announced that he will also step down from his leadership role. Rep. Clyburn (D-SC), who serves as the Democrats’ number three position in leadership, is expected to continue as assistant leader. While Pelosi did not endorse anyone, Rep. Jeffries (D-NY) is widely seen as the choice to become the new Democratic leader. Rep. Clark (D-MA) is running to be the Democratic whip, and Rep. Aguilar (D-CA) is running for caucus chair. Jeffries, Clark and Aguilar are running as a team of candidates for these roles, and the Democratic leadership elections are scheduled for November 30.
In committee leadership news, Sen. Paul (R-KY) announced on November 17 that he would not seek the top Republican position on the Senate Health, Education, Labor and Pensions (HELP) Committee, instead choosing to pursue the top Republican spot on the Senate Homeland Security and Governmental Affairs Committee. Paul’s decision clears the way for Sen. Cassidy (R-LA) to be the ranking Republican on the HELP Committee in the 118th Congress.
Senate Approves Resolution to End COVID-19 National Emergency Declaration. On November 15, the Senate approved a resolution to end the national emergency concerning COVID-19 declared by the president on March 13, 2020. The resolution was approved by a bipartisan vote of 62–36, with 13 Democrats joining all present Republicans in voting for the resolution.
While ending the national emergency is different than ending the public health emergency (PHE), which is declared by HHS, the two are related, as the PHE must be tied to another declaration. Should the national emergency declaration end (as intended in this Senate resolution), most current waivers would terminate. There are notable exceptions, however, where other pieces of legislation have enacted additional flexibility (including telehealth waivers), and where policy changes in HHS rulemakings specified that policy changes are tied to the PHE. Should the national declaration end but the PHE stand, such policies would continue until the end of the PHE. Should both the national emergency declaration and the PHE end, all waiver authority would cease. Please see this +Insight for additional information.
The COVID-19 PHE, which is extended in 90-day increments, was most recently extended in mid-October, until mid-January 2023. The Biden Administration has maintained a commitment to provide 60 days’ advance notice of any plans to end the PHE, and that 60-day mark recently passed with no indication that the PHE will end in mid-January. This indicates that the PHE is likely to be extended at least once more, through mid-April 2023.
Senate passage of this resolution will not have a tangible impact, as it is unlikely to be taken up by the Democratic-controlled House this year, and the president has threatened to veto it. However, the vote in the Senate demonstrates “pandemic fatigue” as well as significant bipartisan support for ending COVID-19 declarations, which suggests that the next presumed PHE extension through mid-April 2023 could be the last.
Senate Democrats Seek Additional Consumer Protections in Medicare Advantage. Thirteen Senate Finance Committee Democrats recently sent a letter to HHS and the Centers for Medicare & Medicaid Services (CMS), asking that CMS take additional steps to implement consumer protections in the Medicare Advantage program (MA).
Led by Finance Committee Chairman Wyden (D-OR), who recently released a report detailing an increase in deceptive marketing practices in MA, the letter applauded steps recently taken by CMS to protect Medicare beneficiaries, and urged that additional steps be taken to accomplish the following:
- Reinstate protections loosened during the previous Administration
- Monitor MA disenrollment patterns and use enforcement authority to hold bad actors accountable
- Provide clear guidelines and trainings to ensure that agents and brokers understand and adhere to best practices
- Implement robust rules around MA marketing materials and close regulatory loopholes that allow cold calling
- Support unbiased sources of information for beneficiaries, including State Health Insurance Assistance Programs and the Senior Medicare Patrol.
The full report from the Finance Committee Democrats can be found here.
HHS Holds Meeting on Patient and Healthcare Worker Safety. On November 14, HHS convened a meeting and listening session focused on protecting the safety of patients and healthcare workers. The meeting included leaders from the Agency for Healthcare Research and Quality, the Centers for Disease Control and Prevention, CMS, and the US Food and Drug Administration (FDA).
During the event, HHS Secretary Becerra announced the creation of the National Healthcare System Action Alliance to Advance Patient Safety in partnership with healthcare systems, patients and families, as well as other stakeholders. The Action Alliance will help HHS equitably address patient safety concerns and help ensure that patients and providers feel confident and safe when receiving and delivering care.
HHS will issue a forthcoming request for information to provide all interested stakeholders the opportunity to contribute to the development of the Action Alliance and answer the following questions:
- What are the main challenges that your system is facing in meeting your commitments to advancing patient safety as you emerge from the pandemic?
- What can HHS bring to the Action Alliance in terms of coordination, alignment, tools, training and non-financial resources to support the effectiveness of the Action Alliance in assisting healthcare delivery systems in advancing patient and healthcare worker safety?
- How can the Action Alliance most effectively support your organization in advancing patient safety? Are there specific priorities for your system or settings of care?
- A bipartisan group of House Energy and Commerce Committee members reintroduced the Pre-Approval Information Exchange Act, a bill to provide patients with faster access to new drugs and medical devices approved by the FDA.
- The White House held a summit on COVID-19 equity, highlighting interventions and approaches that have moved the needle on equitable outcomes, and focusing on a path forward.
- The CMS Office of Minority Health hosted a webinar in recognition of National Rural Health Day to discuss the agency’s commitment to improving the health outcomes of rural, frontier, Tribal and geographically isolated populations. The webinar included an overview of the six priorities in CMS’s recently released Framework for Advancing Health Care in Rural, Tribal, and Geographically Isolated Communities.
- In a speech at the HLTH conference, HHS Secretary Becerra outlined agency priorities for 2023, recognizing a divided Congress. He highlighted several regulatory priorities for 2023, including implementation of the Medicare drug price negotiation provisions in the Inflation Reduction Act, standing up the Advanced Research Projects Agency for Health, long COVID-19 research and CMS payment reforms.
- HHS shared health sector emissions reduction and climate resilience announcements at the United Nations Climate Conference (COP27).
NEXT WEEK’S DIAGNOSIS
Congress will be in recess next week for the Thanksgiving holiday and is scheduled to return to session the week of November 28. Our weekly Check-Up will also be on hiatus next week, returning on December 2.
For more information, contact Debra Curtis, Kristen O’Brien or Erica Stocker.
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