Congressional State of Play
The new Republican majority in the House of Representatives started their oversight at the beginning of February, holding hearings on Covid-19 pandemic relief spending implementation, energy security, and the fentanyl crisis. Additionally, House Republicans are pushing for an expedited conclusion to the Covid-19 public health emergency, arguing that the pandemic is now over, and that the country must return to normal. The Biden administration and Democrats in Congress have pushed back against this idea as many Covid-19 era health flexibilities, such as prescribing opioid treatment via telehealth, would expire should the health emergency end. However, the Biden administration has indicated it will end the public health emergency on May 11, 2023.
The Senate also returned to work in February, holding hearings on “must pass” legislation such as the 2023 Farm Bill. The Senate also continued its efforts to expeditiously confirm President Biden’s political and judicial appointees.
Lomustine Update
Nextsource officially rejoined the Medicare Part D program in January, after making the decision to leave the program. As a result, Lomustine is back under the Medicare Coverage Gap Discount Program. This news comes after years of advocacy from both the Society for Neuro-Oncology as well as the National Brain Tumor Society. It is unlikely that the company would have made the decision to rejoin Medicare Part D without the advocacy from SNO.
View all drugs included in the program here.
State of the Union
On February 7, 2023, President Biden delivered his second State of the Union address to a joint session of Congress.
The speech covered a range of topics including, American manufacturing jobs, federal investments in infrastructure and healthcare, President Biden’s upcoming economic plans, education, police reform, the fentanyl crisis, and the importance of maintaining American democracy. Energy and environment policy played a very minor role in the President’s speech, with only a few references to legislation passed in the first years of the Biden administration.
On energy and environment issues, President Biden referred to both the Inflation Reduction Act (IRA) and the bipartisan Infrastructure Investment and Jobs Act (IIJA). The President highlighted that the IRA is the world’s most significant investment in climate change and argued that it would lower energy costs, create jobs, and accelerate a clear energy future. He touted that the two bills would help build new weather resilient electric grids and install electric vehicle charging stations across the country. He emphasized that many Americans are only beginning to realize the benefits of this legislation, as they are now eligible for thousands of dollars of tax credits for purchasing electric vehicles and energy efficient appliances. President Biden emphasized that “we are still going to need oil and gas,” yet he criticized oil companies for making significant profits and not sufficiently investing in production capabilities.
With regards to the IIJA, President Biden made an important announcement regarding new Buy American standards. Under the new standards, all construction materials used in federally funded infrastructure projects must be made in America, including lumber glass, drywall, and fiber optic cables.
President Biden shifted his attention to the strengthening of the middle class and stated it is America’s backbone. He lamented that previous administrations had allowed manufacturing jobs to leave and cities to become shadows of their former selves and stated that he intended to instill pride in the American worker. He spoke about his iron worker guest Saria as an example. He stated that under his presidency, unemployment has reached 3.4%, a fifteen-year low. Furthermore, he stated that his economic changes have helped ten million Americans start businesses and have provided significant opportunities for Black and Hispanic workers.
President Biden then turned his attention to the CHIPS Act and semiconductors. He used this legislation as an example of bipartisan compromise to ensure that the supply chain for these vital materials would begin in the United States. He asserted that this legislation would create hundreds of thousands of jobs in the coming years, as many companies have already announced hundreds of billions of dollars in new manufacturing investments.
President Biden then stated that to have the strongest economy in the world, the nation must have the best infrastructure in the world. He touted the IIJA as a success and stated that it has already funded over 20,000 projects that will put thousands to work. He referenced a freight bridge project between Kentucky and Ohio as an example of this work uniting the nation. He asserted that all Americans should have access to high-speed internet and lead-free pipes and reiterated that all of these projects will abide by Buy American requirements.
President Biden then spoke on healthcare and stated that the IRA will take on powerful interest and bring costs down to relieve stress on American families. He stated that Americans pay more than any other country in the world for prescription drugs. However, President Biden explained that legislation under his administration has capped the price of insulin at $35 a vial for seniors. President Biden urged congress to pass legislation that would lower prescription drug costs for all Americans. He also told Republicans that he would veto any legislation that attempts to repeal provisions in the IRA related to lowering prescription drug costs.
President Biden then stated that the IRA is critical to fighting climate change in the coming years. He stated that its projects are not only creating industries that are less harmful to the environment but simultaneously strengthen our infrastructure against natural disasters. He specifically touched on electric vehicles and the Administration’s goal to create several thousand more charging stations across the country.
President Biden then spoke on taxes and stated that he wants wealthiest and biggest corporations to pay their fair share. He reiterated that no one making under $400,000 a year would see an increase in taxes. Then, he turned his attention to oil companies and their $200 billion in profits during a global energy crisis. He stated that the United States will need oil for at least another decade, however he said that their stock buy backs with these profits are unfair and called for Congress to quadruple the tax on corporate stock buy backs.
President Biden then spoke on the debt ceiling and stated that his administration has slashed the national debt by $1.7 trillion, the largest cut by any presidential administration. He stated that Congress raised the debt ceiling three times under the previous Administration and condemned Republicans for “taking the economy hostage” in ongoing negotiations. President Biden initially raised concerns that some members of the Republican party hoped to cut Social Security and Medicare, but he expressed excitement that the chamber seemed to be in bipartisan agreement that these programs should be preserved.
President Biden then noted he would announce his spending plan next month and invited Republicans to present their plan simultaneously. He stated that he has the American people’s back and that “capitalism without competition is extortion.” He called for Congress to crack down on junk fees, nursing home scams, as well as overcharge fees to protect the average consumer. He condemned noncompete agreements for many workers and affirmed his support for organized labor, urging congress to pass the PRO Act and support programs that provide workers with paid family leave and a child tax credit.
The President then stated that education must be an affordable ticket to the middle class. He stated that Congress should pass legislation to support early childcare, as it has a direct correlation with higher rates of high school graduation. He also called for teachers to get a raise and said that all Americans should access a good paying career with college or not.
President Biden then argued that the United States has broken COVID’s grip on our lives. He stated that the public health emergency will soon be over, but the nation can never forget the million who died during the pandemic. He pointed to American science as vital in this fight and also stated that he is committed to cracking down on fraud under the COVID relief system.
President Biden turned to law enforcement reform efforts, stating that public safety depends on public trust, which is too often violated. He used the recent killing of Tyre Nichols, whose parents were in attendance, as an example of a breach in this trust, and stated that many Black and brown Americans have to teach their kids a different set of rules when encountering law enforcement. He stated that he knows most police officers are honorable people but said the nation must do more to support resources that address mental health issues and alleviate pressure on law enforcement. He asked Congress to pass legislation similar to his executive order banning chokeholds and no-knock orders.
President Biden also called on Congress to ban assault weapons, to enact comprehensive immigration reform, to protect reproductive healthcare access, and to enshrine equal protections for LGBTQ community members.
President Biden then turned to discuss international relations. He first emphasized how “Putin’s invasion of Ukraine has been a test for the ages,” but he emphasized that the United States and its NATO allies have become even more united to stand up to Putin’s aggression. The President then turned to China policy, noting that his administration seeks “competition and not conflict.” As part of this competition, President Biden emphasized investments in American manufacturing capabilities, stronger alliances with international partners, and efforts to modernize the American military to deter Chinese aggression.
President Biden also discussed the fentanyl crisis and its continued toll on the American people. After mentioning a guest in the audience whose daughter passed away from a fentanyl overdose, President Biden called for a “major surge” of federal resources to stop the production, sale, and trafficking of fentanyl.
The President also mentioned the importance of addressing the national mental health crisis, especially because millions of young Americans are exposed to bullying and violence via social media platforms. He called for bipartisan legislation to prevent targeted advertising towards children. President Biden also noted the alarming rates of suicide among veterans and called for additional resources for mental health screenings.
Returning to discussions of healthcare, President Biden touted the potential of the Cancer Moonshot to cut cancer deathrates by at least 50% in the next 25 years. He lauded President Bush’s President's Emergency Plan for AIDS Relief (PEPFAR) as part of the global effort to fight HIV/AIDS; President Biden said a similar effort should eventually be undertaken to end cancer across the globe.
President Biden closed the speech by emphasizing the importance of American democracy and highlighting potential stressors on the democratic system. The President condemned acts of political violence and called to restore trust in American institutions. Noting the important “inflection point” in American politics, the President issued a call for unity among the American people.