Skip to main content

Press

Politico Pro (3/22/2024): House sends $1.2T funding deal to Senate ahead of midnight shutdown cliff - The House approved a $1.2 trillion funding package on Friday, sending the colossal measure off to the Senate with just hours to spare before federal cash expires for most of the government after midnight. Speaker Mike Johnson leaned heavily on Democratic votes to pass the package in a 286-134 vote, his usual practice with spending legislation ever since he assumed the gavel five months ago. Just 101 Republicans supported the measure, falling short of a majority of the GOP conference. The vote was held less than 36 hours after more than 1,000 pages of bill text was released in the middle of the night, a fact that infuriated conservatives. Once the Senate clears the bill, Congress will have finally closed out a particularly chaotic government funding cycle dominated by House Republican infighting. "Remember, last Congress we were all complaining: 'We can't even read these thousands of pages before we have to vote on them.’ We're now back to the House of hypocrites, and I'm so sick and tired of it,” said Rep. Marjorie Taylor Greene (R-Ga.). To try to avert a partial shutdown, Johnson defied many of the funding conditions House conservatives forced upon former Speaker Kevin McCarthy — resulting in Greene filing a motion to boot him from the speakership during the vote on Friday.

Politico Pro (3/22/2024): Granger announces plans to leave powerful spending perch early - House Appropriations Committee Chair Kay Granger plans to give up her gavel early, asking Republicans on Friday to choose a successor soon so she can step down. In a letter to Speaker Mike Johnson on Friday, the Texas Republican asked the GOP Steering Committee and the rest of the conference to elect a new chair “as soon as possible.” Granger, who isn’t running for reelection next year, said she plans to serve out the remainder of her term in the House and serve as “chair emeritus.” Granger’s announcement comes just hours after the House passed a massive $1.2 trillion funding package to stave off a shutdown at midnight, finally closing out funding needs on a fiscal year that started five months ago. It's likely the last major spending deal that she will oversee as Congress barrels toward a presidential election. In a statement, Rep. Tom Cole (R-Okla.), a senior Republican appropriator, confirmed that he's running to replace Granger. And a supporter was collecting signatures from top House Republican appropriators for a letter backing Cole's bid for chair, according to a person familiar with the letter. Some of those so-called cardinals have already announced that they're backing Cole for the gavel, including Rep. Ken Calvert (R-Calif.), who leads the Defense spending panel.

Politico Pro (3/21/2024): Here’s what’s in the spending deal for health care - The Department of Health and Human Services is set to get a slight increase in funding under a fiscal 2024 spending package released Thursday, an increase of $955 million above current funding to more than $117 billion. The proposed less-than-1-percent bump — which doesn’t keep pace with inflation — includes modest funding boosts for the National Institutes of Health, Biomedical Advanced Research and Development Authority, organ transplant system modernization and the 9-8-8 mental health crisis hotline. It also includes a one-year extension of the U.S.’ leading program to fight HIV/AIDS, known as PEPFAR. Republicans had pushed back against a reauthorization over fears funding would go to abortion providers, which the Biden administration, the program’s leaders and outside development experts deny. The deal also includes legacy riders, like the Hyde amendment prohibiting federal funding for abortion, but it doesn’t include new abortion- and reproductive health care-related provisions for which House Republicans had pushed. The details of the spending agreement come less than 48 hours before a partial government shutdown would kick in at the end of the day Friday. The House could vote on the package on that day, which means Senate action could go into the weekend. If so, a short partial shutdown may not be averted.

Politico Pro (3/21/2024): Two Johns’ subtle differences on Social Security, Medicare - Two of the top contenders to be the next Senate GOP leader are taking subtle but different approaches to the future of Social Security and Medicare. Minority Whip John Thune (R-S.D.) suggested that lawmakers take steps to ensure the programs’ continued viability — amid Democratic attacks on his party for potentially entertaining new limits to entitlements. “It's going to take courage at some point,” Thune said. “And this maybe isn't the season, but we can't wait much longer,” referring to the presidential election. The South Dakotan added: “At some point, we've got to confront the reality that Social Security and Medicare are headed for bankruptcy.” By contrast, John Cornyn (R-Texas) — Thune's chief rival so far in the race to succeed Mitch McConnell — largely demurred on entitlements. Cornyn said the political reality is that both President Joe Biden and former President Donald Trump have resisted major changes to the programs, alterations to which are a long-running third rail of U.S. politics. Both men are running to be the next Senate GOP leader in a field that could continue to grow. Their answers offer a glimpse into how they could contend with one of the thorniest issues facing Congress — the future viability of two of the nation’s most popular programs — as Republican leader.

Politico Pro (3/19/2024): CMS wants to pay docs to enter value-based care - The Biden administration will give certain primary care doctors cash to jumpstart a major shift in how Medicare pays them. On Tuesday, CMS announced a new voluntary payment model that seeks to defray the high costs of moving into value-based care, which pays doctors based on the quality of care delivered rather than reimbursement for each item or service. This shift can be expensive for primary care doctors. Medicare beneficiaries can “get care in more convenient ways, like care based at home or through virtual means,” CMS Administrator Chiquita Brooks-LaSure said in a statement making the case for value-based payment that provides doctors an incentive to pursue new ways of delivering their services. This is the latest bid by CMS to tackle the high cost of becoming an accountable care organization — providers in value-based payment arrangements that try to keep spending below a certain amount in exchange for a share of the savings. They must repay Medicare for going over the figure.

Bloomberg (3/15/2024): HHS discretionary funding for 2024 no longer faces the threat of automatic, across-the-board cuts - HHS discretionary funding for 2024 no longer faces the threat of automatic, across-the-board cuts if lawmakers rely too long on a stopgap funding measure, Jack Fitzpatrick reports. The sequestration measure in the 2023 debt-limit deal (Public Law 118-5) — which would impose a 1% cut to all discretionary spending if Congress relies on a continuing resolution until the end of April — would no long apply to nondefense discretionary spending, the Congressional Budget Office said yesterday. That’s because lawmakers have passed six spending bills that, combined with a stopgap for the rest of the government, already equate to more than a 1% cut to base nondefense discretionary spending, avoiding the need for a sequestration order. The development lifts the burden of a possible sequestration order for domestic agency budgets at the end of next month.

Politico Pro (3/13/2024): Bucshon expects Medicare pay fix by year’s end - Rep. Larry Bucshon thinks Medicare pay reforms are on the way — and soon. At the POLITICO Health Care Summit today, Bucshon (R-Ind.), a heart surgeon and member of the GOP Doctors Caucus, said he thought a multi-pronged health package would be possible before the end of the year. “We need to address the reimbursement issues at CMS,” he said, noting it was a goal before he retires from Congress early next year. He said the package could include changes to how doctors are paid by Medicare, transparency requirements for health institutions to report on their finances and other provisions aimed at getting prices down. “The American people need to understand why things cost what they do, where the money is going and where we can better utilize the resources that we have to make everyone’s life better,” he said. His comments come amid a flurry of activity in the House and Senate on reforming Medicare pay for health providers. Lawmakers hope to end the annual ritual in which the CMS proposes pay cuts for doctors, based on a complex formula Congress ordered it to create decades ago — and then doctors lobby representatives and senators to eliminate the cuts, often in a last-minute must-pass package.

Politico Pro (3/13/2024): Kelly: Doctor Medicare payments to be included in spending bill - Portions of legislation addressing the Medicare payment schedule for physicians “will be baked into” an appropriations package expected to advance this month, Rep. Robin Kelly (D-Ill.) said Wednesday. Language around the geographic index factor and other issues will be included, the House Energy and Commerce Committee member said at POLITICO’s Health Care Summit. “We don’t want doctors to cut back on their Medicare patients or to stop doing some of the charity care they do,” Kelly said. Kelly also said Medicare should cover weight-loss drugs like Wegovy and Zepbound because “obesity is a disease.” The government payer is statutorily prohibited from covering weight-loss medications. But Kelly acknowledged the difficulty of addressing the branded drugs’ cost. “Hopefully, we won’t have to legislate it, but there is a problem in the United States with obesity, so there are a lot of people that can benefit,” she said. “If enough people use it, it seems like you could bring the price down.” Kelly also voiced her support for the FDA’s proposal to ban menthol cigarettes, despite fears that moving forward with the rule could discourage Black voters from backing President Joe Biden’s reelection bid. “It might hurt him with some voters, but it’s going to save so many lives,” she said.

Politico Pro (3/13/2024): 3 takeaways from POLITICO's conversation with FDA's No. 2 - FDA Principal Deputy Commissioner Namandjé Bumpus on Wednesday didn't rule out ascending to the agency's top role if the agency's current chief were to step aside in the coming months. "Working for Commissioner [Robert] Califf's been great — he is a big reason why I'm here," Bumpus said at POLITICO’s Health Care Summit. "And I'm a civil servant, so I'm here to serve in any capacity." Bumpus displayed her diplomatic chops while responding to earlier remarks from Sen. Joe Manchin (D-W.Va.) criticizing the FDA for approving myriad opioid medications as the addiction crisis grew in the U.S. in the 2000s. Here are three policy takeaways from Bumpus' discussion: 1. The FDA wants to ensure it isn't "reinforcing biases" when using artificial intelligence; 2. Agency guidance on diversity in clinical trials is "to come;  3. Science underpins her vision for the FDA.

Politico Pro (3/11/2024): Biden budget would raise Medicare taxes on the wealthy, expand drug price negotiations - The White House’s proposed fiscal 2025 budget puts a spotlight on protecting the future of Medicare, reiterating last year’s proposal to raise taxes on the rich to increase the Medicare trust fund. “Social Security and Medicare are more than government programs. They’re a promise, a rock solid guarantee that generations of Americans have counted on that after a life of hard work, they will be able to retire with dignity and security,” Shalanda Young, director of the Office of Management and Budget, told reporters on Monday. The budget asks for $130.7 billion for HHS, a $2.2 billion increase from 2023. It includes proposals that President Joe Biden outlined in his State of the Union address, including expanding the number of drugs subject to Medicare price negotiations from 20 to eventually 50 a year, extending the $2,000 out-of-pocket prescription drug spending cap that’s set to take effect for Medicare beneficiaries next year to commercial insurance plans and extending the $35 insulin cap to the commercial market. It also proposes limiting Medicare Part D cost-sharing for more expensive generic drugs to $2 for Medicare beneficiaries and making permanent expanded premium tax credits that make Obamacare plans more affordable for middle-income people. Biden had also promised during his State of the Union address to protect Medicare and the Affordable Care Act. His budget proposes increasing taxes on the rich to extend indefinitely the solvency of the Medicare Hospital Insurance Trust Fund, as well as direct some savings from Medicare drug price negotiations into the fund.

Politico Pro (3/7/2024): In State of the Union, Biden presses to expand drug pricing wins - President Joe Biden made a bid to expand his administration’s efforts to lower drug prices during the State of the Union. “Americans pay more for prescription drugs than anywhere else in the world,” he said. “It’s wrong, and I’m ending it.” Biden scored major victories on drug pricing in the 2022 Inflation Reduction Act, chief among them giving Medicare the power to negotiate for lower prices. His administration is expected to wrap up talks with drugmakers over 10 products in September, but older Americans won’t see prices go down until 2026. On Thursday, Biden called for going further during his speech, pressing to increase the number of drugs up for negotiation to 50. He also called for expanding a $35 cap on insulin copays for Medicare patients that went into effect last year to all Americans who need the drug. Biden also pressed Congress to expand to commercial plans a $2,000 cap on out-of-pocket costs in Medicare’s prescription drug program, which is set to take effect next year. Starting this year, pharmaceuticals covered under Medicare’s Part D for prescription drugs have a cap of $3,300 for out-of-pocket costs. Patients aren’t responsible for drug costs after hitting the cap.

Politico Pro (3/6/2024): House clears long-delayed spending package ahead of shutdown deadline - The House approved a six-bill government funding package on Wednesday, sending the bill to the Senate with little time to spare before yet another government shutdown deadline. The upper chamber must now lock down an agreement to speed up votes on the $459 billion measure before the weekend, which requires consent from all 100 senators. Republicans will likely demand a number of amendment votes in exchange, though none are expected to succeed. Facing heat from his right flank, Speaker Mike Johnson relied on robust support from Democrats to pass the package in a 339-85 vote. He managed to still secure backing from a majority of the House GOP, a muted win for the speaker as conservatives grumble about his tendency to heavily lean on Democrats to pass major legislation. Ultimately, 132 Republicans supported the measure, while 207 Democrats voted in favor of the bill. And another deadline is fast approaching. Congressional leaders have until March 22 to clear another six spending bills that present an indisputably bigger challenge, comprising about 70 percent of the federal discretionary budget, including the Pentagon and health, labor and education programs.

Politico Pro (3/4/2024): Senators, representatives plan push to overhaul Medicare reimbursement - Bipartisan groups in the House and Senate want to reform, before the end of the year, how Medicare sets reimbursement rates for doctors, according to three congressional staffers granted anonymity to discuss future legislative plans. The idea, they said, is to end the annual process in which the Centers for Medicare and Medicaid Services proposes pay cuts, based on a complex formula Congress ordered it to create decades ago, and doctors lobby representatives and senators to eliminate the cuts. Lawmakers agreed to a tentative deal over the weekend to end most of a 3.4 percent cut that took effect on Jan. 1, but without any change to the formula. In the Senate, a bipartisan working group consisting of Democrats Catherine Cortez Masto of Nevada, Debbie Stabenow of Michigan and Mark Warner of Virginia, and Republicans John Barrasso of Wyoming, Marsha Blackburn of Tennessee and John Thune of South Dakota formed last month and plans to solicit ideas from stakeholders.

Politico Pro (3/3/2024): What’s in — and out — of Congress’ spending bill for health care - Lawmakers on Sunday released the text of a deal to fund a portion of the federal government including the FDA and the VA through the end of the fiscal year that includes a deal to blunt a doctor pay cut in Medicare. Congress now has until Friday to get the bill onto President Joe Biden’s desk and signed into law. The rest of government funding, including for HHS, is set to expire on March 22 under a stopgap measure signed into law last week. Under the package, the FDA would get funding closely in line with previous levels at $6.7 billion. The VA's topline funding under the package sits at $307 billion, a $24 billion boost when accounting for funding under the debt-ceiling deal related to toxic exposures. That includes a $2.3 billion boost over last fiscal year for VA medical care, coming from areas including rural health, homeless prevention and mental health.

Politico Pro (3/2/2024): Congress nears deal to blunt doctor pay cut - Lawmakers appear close to a deal to mitigate Medicare pay cuts to doctors. The tentative agreement would have Congress cut Medicare payments 1.68 percent beginning in April, according to three congressional staffers and five lobbyists granted anonymity to discuss ongoing negotiations. That’s roughly half the pay cut physicians have been dealing with since January. The deal, which is not finalized, is expected to be part of a narrow health package taken up ahead of the Friday deadline to fund a part of the federal government. The package would also include a 1.88 percent bonus for doctors who enter into alternative payment models, which compensate physicians based on the value of care delivered, according to one of the staffers and two of the lobbyists. The figure is below the 3.5 percent for 2023.

Politico Pro (3/1/2024): Docs eye pay bump as health package talks progress – The Senate cleared a stopgap funding bill Thursday night for President Joe Biden’s signature, buying more time to finalize half a dozen spending bills that congressional leaders aim to pass next week. With the immediate threat of a government shutdown averted — for now — jockeying has begun for the packages that will fund key agencies, including the FDA and HHS, through September. Doctors’ groups are focused on the congressional talks to mitigate the cut to their pay from Medicare, which have advanced this week, Megan, Robert and Daniel report. Five lobbyists said they believe a pay bump — between 1.25 percent and 1.75 percent — could be in order. That proposal would still leave much of the 3.4 percent cut in effect. Lobbyists said a deal on the amount is close to being done. “The number has bounced around a bit during negotiations, in part as a trade-off for the size of the package, and in particular the size of the community health center provisions,” said Dean Rosen, a partner at Mehlman Consulting who’s been working on the issue. “With the leadership reaching an agreement on the broader spending framework, work has accelerated over the last 24 hours on the healthcare package.”

But “the health package is still under negotiation,” a spokesperson for Senate Majority Leader Chuck Schumer told Daniel in an email.

Politico Pro (2/29/2024): Senate sends government shutdown patch to Biden’s desk – The Senate approved a stopgap funding bill Thursday night for President Joe Biden’s signature, thwarting a partial government shutdown on Saturday and buying more time to finalize half a dozen spending bills that congressional leaders aim to pass next week. Congress now officially has until March 8 to clear that initial six-bill bundle, which leaders struck a deal on earlier this week. But they're still working on an agreement to fund the rest of the government, including the military and some of the biggest domestic programs, before a second deadline on March 22. The upper chamber cleared the measure in a 77-13 vote, following votes on four Republican amendments that were defeated on the floor. Appropriators are optimistic that this latest stopgap — the fourth enacted by Congress this fiscal year alone — will finally deliver enough time to wrap up funding negotiations after a particularly chaotic cycle largely derailed by House Republican infighting. If congressional leaders can successfully pass the six bills next week to fund the departments of Agriculture, Energy, Veterans’ Affairs and Transportation, they’ll face an even bigger test in trying to strike a compromise on the remaining six bills that fund the rest of the federal government.

Politico Pro (2/28/2024): Here’s what’s in the stopgap funding bill for health care - Lawmakers agreed Wednesday on a stopgap measure to fund the government later into March and extend funding for health agencies. The continuing resolution would push back the dual set of deadlines for funding bills to March 8 for those covering the FDA and VA, and March 22 — the beginning of Easter recess — for the tranche of bills including HHS, which has proven more contentious. Lawmakers came to an agreement on the bills covering the FDA and VA, and Congressional leaders aim to release text by this weekend and fund those agencies through September next week. Lawmakers have until midnight Saturday to vote on this latest agreement and avoid a partial shutdown. If that doesn’t happen, funding for the FDA and VA will expire. HHS funding expires March 8 as does money for community health centers, special diabetes programs, teaching health centers and the National Health Service Corps. Provisions avoiding steep cuts to hospitals that have a high volume of Medicaid and uninsured patients also sunset then. The legislation doesn’t address the myriad expired health programs that Congress still must reauthorize, including the global HIV/AIDS program, PEPFAR; the SUPPORT Act, which tackles the opioid epidemic; and the Pandemic and All-Hazards Preparedness Act. It also doesn’t include a deal on pharmacy benefit manager reform, with lawmakers at an impasse.

Politico Pro (2/26/2024): Overhaul of pharmacy middlemen flounders despite bipartisan support - Bipartisan legislation to overhaul how pharmacy benefit managers operate is in flux after negotiations broke down over the scope of the reforms, according to seven lobbyists and two congressional aides granted anonymity to discuss the talks candidly.

PBMs are middlemen who negotiate drug purchases on behalf of insurers and decide which medicines an insurance plan will cover. Drugmakers have funded major advertising and lobbying campaigns to convince Congress that PBM practices are to blame for the high prices patients face at the pharmacy. Community pharmacists have raised similar concerns and lawmakers of both parties agree there’s a problem. The House would mandate more transparency of how PBMs operate in the Lower Costs, More Transparency Act that it passed overwhelmingly in December. The Senate HELP Committee last May approved legislation 18-3 that would go further, requiring PBMs to pass along drug rebates they receive to commercial health insurance plans and banning “spread pricing” in which PBMs charge insurers more for drugs than what they are reimbursed by pharmacies. And the Senate’s Finance panel in November unanimously approved a bill that would limit what Medicare enrollees pay for some drugs and require HHS to lower drug costs, partly by “de-linking” how much PBMs profit from the list price cost of a drug. Lawmakers haven’t been able to reconcile the different approaches, with House members rejecting the specific reforms in both Senate bills, according to lobbyists.

Politico Pro (2/26/2024): Looming budget cuts are keeping the new NIH director up at night - The new director of the National Institutes of Health, Dr. Monica Bertagnolli, is grappling with a proposed fiscal 2024 budget so tight that it could force her to reduce the grants that seed medical innovation at American research universities. With a March 8 funding deadline approaching, the Republican-controlled House has proposed an 8 percent, $3.8 billion budget cut to the $48 billion NIH got last year, while the Democrat-controlled Senate wants to keep the agency's funding almost flat, offering a $265 million bump. Those figures concern Bertagnolli, she told POLITICO during a sit-down Wednesday in her office on NIH's Bethesda campus. A sizable budget cut or keeping it flat would also mark a major change in direction for the agency that helps fund and develop many life-saving drugs and vaccines. NIH funding has risen consistently year-over-year in recent years, by an average 5 percent over the past decade. "I know the last time NIH saw significant funding cuts we lost a generation," Bertagnolli said, referencing budget cuts during the federal spending war between President Barack Obama and the Republican-controlled House in 2013. She added: "The funding level of grants goes down. Junior people see this. They decide: ‘Why would I go into biomedical research? I won't be able to have a stable job.’ They move away from this field."

Politico Pro (2/23/2024): EPA air rule pits public health against medical devices - A looming EPA air regulation aimed at stanching industrial releases of a carcinogenic gas is pitting several of the Biden administration’s most prominent public health priorities against each other. The regulation would limit emissions of ethylene oxide — an odorless, colorless gas linked with breast cancer and white blood cell cancer in people who face chronic exposure — from facilities that use it to sterilize medical devices. Nearly 13 million people live near these facilities, which pose a disproportionate risk to low-income and minority communities, according to an analysis by the Union of Concerned Scientists. The Biden EPA has made addressing the potent pollutant a key part of its environmental justice work. But the medical device industry argues that the nation’s 86 sterilization facilities are working at full tilt to keep hospitals and doctors’ offices supplied with everything from surgical kits to devices used in open-heart surgery. The industry and its federal regulator, the Food and Drug Administration, have warned that the stringent rules EPA proposed last spring would force facilities offline for upgrades, potentially disrupting supply chains and cutting off access to lifesaving equipment. The new regulation is due out March 1 under a court settlement and is currently undergoing review at the White House. Both environmental and industry advocates say that the prospect of medical supply chain problems is raising major concerns among White House policy staffers.

Bloomberg (2/21/2024): GOP Exodus Opens Key Roles in Health Policy - A House panel with jurisdiction over health care policy faces a GOP leadership shakeup in 2025, with multiple Republicans expected to compete for the top spot in the wake of Chairw Cathy McMorris Rodgers’ (Wash.) decision to retire from Congress next year. Reps. Bob Latta (Ohio) and Brett Guthrie (Ky.), the most senior Republicans on the committee, have emerged as the leading contenders for the chairmanship or ranking member spot of the Energy and Commerce Committee, depending on which party wins the House majority in November. Yet Republicans don’t determine committee leadership solely based on seniority, easing the way for dark horse candidates to come forward. The jockeying mirrors a dynamic across the conference, as experienced, policy-focused Republicans bail out amid the dysfunction and intraparty fighting that have plagued the House since the party took over the majority. The resulting committee, subcommittee, and conference leadership vacancies would allow ambitious members to take a shot at climbing the House ladder. But long-serving members warn of a brain drain if Republicans replace their policy wonks with greener lawmakers who are more interested in politics than policy.

Bloomberg (2/21/2024): Lawmakers Probe Teva, Pfizer, Sandoz on Medication Shortages - Democrats on the House Oversight Committee request a briefing and information from TevaPfizer, and Sandoz related to ongoing shortages of cancer drugs, amoxicillin and stimulant medications like Adderall, in letters to company leaders. Lawmakers request information related to shortages no later than March 6 to help determine root causes and solutions

Bloomberg (2/20/2024): GOP Eyes Hearing to Spotlight IRA’s Pitfalls - The House Energy and Commerce Committee is looking at holding a health care hearing toward the end of the month that could examine some of the drug pricing provisions in the President Joe Biden’s Inflation Reduction Act, three people familiar with the discussions told Bloomberg Government. Details are still being ironed out, but people expect it to focus on the rare disease provisions of the IRA. Some cancer policy bills may also be on the table. Rare-disease advocates, the biotech sector, and others have been working to address what they feel are shortcomings in both the Biden administration’s interpretation of the landmark law and the program itself, which lets the Medicare agency negotiate prices directly with drug makers for the first time in history.

The Inflation Reduction Act exempts orphan drugs from price negotiations if the FDA has only approved them to treat “only one rare disease or condition” and “for which the only approved indication (or indications) is for such disease or condition.” Since the FDA must issue the orphan drug designation before a company submits an application to approve a drug, there are concerns drugmakers will stop testing rare-disease drugs to see if they can work on new therapies as those drugs will be subject to Medicare negotiations. Alnylam halted work in 2022 to study whether an approved therapy could treat a rare eye disease, citing the Inflation Reduction Act. The hearing will likely fall on or near Rare Disease Day, which is Feb. 29 this year, capping a busy month for the committee on health policy.