Biden faces deadline to finalize health rules

Mar 29, 2024

With Carmen Paun

Driving The Day

President Joe Biden walks out of the Oval Office

President Joe Biden is under pressure to finalize health rules to avoid missing a deadline that would render them vulnerable to repeal in the next Congress. | Andrew Harnik/AP Photo

‘TOOLS IN PLACE TO FIX THIS PROBLEM’ — Left-leaning groups worry that the Biden administration won’t finalize certain health rules in time to avoid a key congressional deadline that would allow lawmakers under a new administration to overturn them.

The rules — which include setting minimum staffing levels at nursing homes, expanding anti-discrimination laws, protecting abortion data and banning menthol cigarettes — could be easy pickings for Republicans should former President Donald Trump beat President Joe Biden in November and bring a Republican Congress with him.

The Congressional Review Act allows lawmakers to easily undo rules adopted 60 days before the end of a congressional session by barring the use of a Senate filibuster. The deadline is likely this summer.

The president must sign any bills that would overturn rules under the act, so a Biden win in November would likely secure his regulations no matter what happens in congressional elections.

Advocates of the pending rules are fretting.

“We’re very concerned about the CRA being used to peel back a number of potential protections that would improve access to care and save patients money,” said Ben Anderson, senior director of health policy at left-leaning consumer advocacy group Families USA. “The administration has all the tools in place to fix this problem now.”

An HHS spokesperson said the agency was aware of the deadlines.

“Each proposed rule reflects our mission at HHS to enhance the health and well-being of everyone across America and we will continue to fight for solutions to do just that,” the spokesperson said via email.

When Trump took office in 2017, he and a Republican House and Senate overturned 16 of President Barack Obama’s rules, including HHS regulations around family planning grants. The Biden administration and a Democratic Congress overturned three of the Trump administration’s rules in 2021, including a rollback of methane emissions standards. HHS regulations have been frequent targets of CRA bids.

Supporters of Biden’s regulatory plans fear that failing to meet the CRA deadline would put the rules’ protections at risk, particularly for people of color, those with low incomes and other vulnerable groups.

The pending rules would “prevent discrimination and improve access to care for low-income and underserved populations,” said Dania Douglas, a senior attorney at the National Health Law Program. If they’re overturned, it could be “devastating,” she said.

“There’s a lot to do in the next short period of time,” she added.

WELCOME TO FRIDAY PULSE. Happy Easter to those who celebrate. We can’t wait to see the perpetually surprised White House Easter Bunny return to the Easter Egg Roll on Monday. Send your tips, scoops and feedback to ccirruzzo@politico.com and bleonard@politico.com and follow along @ChelseaCirruzzo and @_BenLeonard_.

Abortion

Marilyn Lands stands for a portrait.

Marilyn Lands, who flipped a state House seat in Alabama this week, spoke candidly about her abortion during her campaign. | Marilyn Lands via AP

GETTING PERSONAL ABOUT ABORTION — Democratic women running for office want voters to know their abortion stories.

One such woman is Marilyn Lands, who ran to represent a Northern Alabama state House district and spoke openly during her campaign about a nonviable pregnancy that ended in abortion. The Democrat shocked even her own supporters when she crushed her Republican opponent in a special election Tuesday by a whopping 25 points.

It was a gamble in a staunchly conservative state that paid off, POLITICO’s Liz Crampton reports.

Lands is just one of a growing number of women in state legislatures from Arizona to Georgia choosing to speak openly about their own abortion experiences. It’s an emotional decision they say helps shape the abortion debate in personal terms and drives voters to the polls. It also marks a major shift in public consciousness as more women, including politicians, feel comfortable talking about a procedure often kept secret.

“I never really was conflicted about whether I should share the story or not,” Lands told POLITICO. “It just felt like the right thing to do at this moment in time.”

Last week, Arizona Rep. Eva Burch went viral for speaking on the state House floor about the obstacles she’s encountered trying to end a pregnancy.

“Clearly, it can be an effective tactic,” said Alex Conant, a veteran Republican strategist. “It’s a way of making sure abortion is top of mind for voters when it is core to one of the candidates’ identities.”

Yet Conant cautioned against reading too much into a special election with a minuscule turnout. Slightly less than 6,000 ballots were cast in the district, which includes parts of Huntsville and Madison, making up fewer than 2 percent of the electorate, according to the latest unofficial election results.

Around the Agencies

MEDICAID OVERSIGHT SCRUTINIZED — CMS didn’t properly oversee states to ensure they complied with Medicaid managed plan requirements for mental health and substance use services, says an HHS Office of Inspector General report out Thursday.

Medicaid managed care plans are prohibited from applying stricter coverage limitations on mental health and substance use services than other medical services. In 2021, nearly 58 million adults experienced a form of mental illness, and 46.3 million people 12 and older had a substance use disorder, the report says.

Per a 2016 rule, CMS is required to review all Medicaid managed care contracts and ensure they comply with parity requirements.

However, an OIG audit of eight states that had Medicaid managed care contracts after the rule took effect — Arizona, Illinois, Kansas, Mississippi, New Jersey, New York, South Carolina and Texas — found that CMS didn’t ensure their managed care contracts contained required parity provisions. None of the eight states provided public documentation of compliance by the deadline or ensured all services adhered to parity requirements.

CMS’ response: In a written response, CMS agreed with OIG recommendations to improve its follow-up procedures to ensure states follow requirements and improve its oversight of state parity requirements.

Global Health

NO CHAMPAGNE — The last round of negotiations for an international agreement to help the world prevent, prepare for and respond to future pandemics ended Thursday with plans to resume in April, as negotiators failed to agree on any substantial articles in the draft text, Carmen reports.

The agreement is being negotiated among all 194 member states of the World Health Organization in Geneva.

“These closing moments could have been with champagne or anything you use to celebrate, but we all know that we are not there yet,” Roland Driece, one of the negotiating body chairs, said at Thursday’s closing session.

The next round will take place between April 29 and May 10 in Geneva. Countries hope to finalize substantive negotiations on the text by May 5, weeks ahead of a May 27 deadline.

Why it matters: Negotiations for an international agreement that would implement the lessons from Covid-19 started in 2022, but countries have failed to agree on how an equitable response to future outbreaks should work and how to compensate countries that share pathogen information.

“While equity remains at the center of the treaty, its contents have to be shaped up in the spirit of realizing solidarity and inclusivity,” Indonesia’s representative said, speaking on behalf of 29 countries from Africa, Asia and Latin America promoting the developing world’s position in the negotiations. “A treaty with mere political rhetoric cannot be an outcome of this process,” the representative said.

WHAT WE'RE READING

The Wall Street Journal reports on the Medicare plans offering to pay for weight-loss drugs.

KFF Health News reports on the rise in alcohol-related diseases among young women.

Follow us on Twitter