On health care, a congressional laundry list

Jan 10, 2024

Presented by Novavax

With Alice Miranda Ollstein

Driving The Day

An ambulance is parked outside of Capitol HIll.

Over the next few weeks, legislators on Capitol Hill will have a full plate of health policy issues to address. | Patrick Semansky/AP Photo

WHAT’S NEXT ON THE HILL — With all the shuffle on the Hill and programs expiring, we’d forgive you for forgetting some things lawmakers want to get done. Here’s a rundown from Ben of key issues they hope to address:

Government funding: Funds for the FDA and the VA run out on Jan. 19 and, for HHS, on Feb. 2. There’s increasing discussion about a short-term stopgap bill to keep funding going despite House Speaker Mike Johnson’s pledge not to use one.

Transparency and site-neutral: The House passed sweeping transparency legislation for pharmacy benefit managers, insurers and hospitals last month and hopes to reach a deal with the Senate on such provisions and so-called site-neutral payments. So far, a deal appears elusive as lawmakers negotiate a broader spending deal.

Senate Finance Chair Ron Wyden (D-Ore.) told Pulse on Tuesday that he is focused on PBM reforms and hasn’t yet discussed site-neutral provisions with the House.

PEPFAR: The global HIV/AIDS program’s authorization expired on Sept. 30 after a fight over abortion. Rep. Michael McCaul (R-Texas), the top Republican working on a deal, has said negotiations are deadlocked.

PAHPA: Most of the Pandemic and All-Hazards Preparedness Act, which has roots in the George W. Bush administration, expired Sept. 30. Biopharmaceutical lobbyists and public health interests are aiming to keep alive the two niche pandemic preparedness policies expiring on Jan. 19.

Doctor pay: A 3.4 percent cut to Medicare payments went into effect on Jan. 1. Doctors groups have said they’re trying to limit the damage and don’t anticipate they can stop the cuts entirely.

Other funding: Funds for graduate medical education, community health centers and special diabetes programs sunset on Jan. 19, and certain Medicaid disproportionate share hospital cuts are delayed until then.

Telehealth: Regulations intended to expand access to standalone telehealth plans expired with the public health emergency, and advocates hope to revive them via the January package.

HSA reform: On Tuesday, amid chatter that a reform of health savings accounts could ride on a bipartisan tax deal being discussed, Wyden said he aims to get a deal done before Jan. 29, the start of tax-filing season. Asked about the potential for HSA changes being tacked on, Wyden told Pulse he’s focused on pharmacy benefit manager reforms.

Opioid epidemic: The SUPPORT Act addressing the opioid epidemic expired Sept. 30, and advocates want to add a fix to the January package. Senate HELP Chair Bernie Sanders (I-Vt.) told Pulse on Tuesday he thinks lawmakers will get it done.

WELCOME TO WEDNESDAY PULSE. We’re still drying out from yesterday’s storm.

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At the White House

US Secretary of Defense Lloyd Austin

Defense Secretary Lloyd Austin’s complications were the result of a urinary tract infection and collections of abdominal fluid that had impaired his small intestines, according to the Pentagon. | Stefani Reynolds/AFP via Getty Images

ELECTIVE, NOT OPTIONAL — The Pentagon described Defense Secretary Lloyd Austin’s prostate cancer surgery as an “elective medical procedure,” which some might take to mean optional.

But cancer experts told Daniel that isn’t the case.

“Elective means it’s not done on an urgent basis — it’s scheduled,” said Dr. Nitin Yerram, urologist and director of urologic research at Hackensack University Medical Center. “Most cancer operations are done on an elective basis.”

Austin underwent a prostatectomy — surgery to remove part or all of the prostate — last month, which can be serious and is required for some patients, even if not urgently.

The doctors who spoke to POLITICO said they believe Austin had a relatively rare complication from the surgery, though they expect he will make a full recovery, in line with the Pentagon’s public statement on the secretary’s condition.

In related news: White House chief of staff Jeff Zients wants departments to review their process for delegating authority after the secret hospitalization of Austin surprised the White House, POLITICO’s Lauren Egan and Myah Ward report.

In Congress

GOP DOCS ASK SPEAKER’S HELP ON CUTS — The GOP Doctors Caucus is scheduled to meet with House Speaker Mike Johnson on Thursday to ask him to help block a cut in Medicare reimbursements for physicians, POLITICO’s Daniel Payne reports.

Two people with knowledge of the meeting told POLITICO the group plans to discuss funding priorities with the Louisiana Republican — including language to avert a 3.4 percent cut to how much Medicare pays doctors this year.

The Centers for Medicare and Medicaid Services finalized that cut in November. In the past, Congress has often approved legislation to stop or reduce cuts to doctor pay.

Caucus leaders have supported legislation that would halt the cut as well as larger reforms to how Medicare pays doctors.

But lobbyists for physicians have said privately that stopping the cut doesn’t seem likely this year — so they’re instead looking to reduce its size.

Why it matters: Doctors’ groups say the cut would force some physicians to stop taking Medicare patients, and that would leave millions of older Americans without access to affordable health care.

What’s next? Congress must pass new spending legislation covering CMS by Feb. 2, and the doctors hope to get language into the new law.

FAUCI TESTIMONY FALLS FLAT — Two days of testimony with Dr. Anthony Fauci, reviled by many in conservative circles, didn’t produce any fireworks or new information, Chelsea and Alice report.

Republicans on the House Select Subcommittee on the Coronavirus Pandemic grilled the nation’s former top infectious disease expert during a closed-door hearing on the Covid’s origins, while Democrats criticized their colleagues for allegedly mischaracterizing Fauci’s responses.

Fauci declined to comment on the hearings, but lawmakers said he agreed to testify in a future open session.

What’s next: Former NIH Director Francis Collins is scheduled to appear before the subcommittee Friday in another closed-door meeting. Former NIH Acting Director Lawrence Tabak testified last week.

A message from Novavax:

Telehealth

FOLLOWING UP WITH YOUR DOC — People who use telehealth are more likely to follow up with providers within a week than those who have in-office visits, but that gap narrows over time, according to a new Epic Research review of its 236 Epic health record systems.

The study, released Tuesday, comes after a study that found most specialty providers have a higher rate of follow-ups with in-person visits than telehealth visits within the first 90 days. The report on Tuesday, which looked at telehealth and office visits between January 2020 and August 2023, found that follow-up rates have stayed consistent regardless of whether the visit was in-person or via telehealth over the last three years.

The rate was under 40 percent for both office and telehealth visits within 90 days. The specialties with the highest rates of follow-ups after a telehealth visit included OB/GYNs, podiatrists and primary care, while the highest rates of follow-ups after an in-office visit included physical therapy, mental health and sleep providers.

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Names in the News

Mitch (Kost) Chaney is now a managing director at Innsena. She previously was outreach and coordination lead at HHS’ Office of the National Coordinator for Health Information Technology.

Anna Breedlove is joining Feldman Strategies as associate director. She was previously communications director for the Kentucky Democratic Party.

Stacy Sanders has been appointed chief competition officer at HHS. She’s a counselor to Secretary Xavier Becerra and was staff director of the Senate Special Committee on Aging.

Dr. Roy Herbst has been elected to the board of directors of Friends of Cancer Research. He is deputy director of the Yale Cancer Center.

WHAT WE'RE READING

POLITICO’s Ashleigh Furlong reports on the EU's hopes to regulate nicotine pouches.

CBS News reports on a lawsuit by trans youth challenging Louisiana’s ban on gender-affirming care.

A message from Novavax:

Novavax is a global leader in vaccine development and research. The company is working to make safe and effective vaccines available to help protect those who need them around the world. This includes an authorized vaccine for COVID-19 that’s currently available at major retail pharmacies across the U.S. Heading into the New Year, it is a critical time to learn about your vaccine options to safeguard your health against pressing diseases. You can help protect yourself, loved ones and colleagues by getting your COVID-19 vaccine. Because protecting one of us can help protect all of us. Learn more.