Summary
With only two weeks left before the scheduled August recess, senators are racing to finalize the legislative text of the $579 billion bipartisan infrastructure agreement as soon as today. The pay-fors are among the issues still being debated. At the moment, lawmakers are considering the following health-related pay-fors:
- Repurposing unallocated CARES Act Provider Relief Fund (PRF). Up to $43.7 billion of $178 billion in PRF remains unobligated, according to the Government Accountability Office (GAO)
- Delaying the Trump-era Medicare Part D rebate rule, currently set to take effect on January 1, 2023, and is estimated to save $177 over 10 years, according to the Congressional Budget Office (CBO)
- Prohibiting spread pricing by pharmacy benefit managers, which is estimated to save nearly $1 billion over 10 years, according to CBO; and
- Extending the 2 percent Medicare sequester, currently set to take effect on January 1, 2022 and go through 2031.
Provided a deal is reached, the Senate will take a procedural vote to move forward with debate on the bipartisan infrastructure bill, teeing up the package for Senate passage before recess.
The suspension on the statutory debt limit expires on Saturday, July 31. Last week, Treasury Secretary Janet Yellen informed congressional leadership that Treasury will begin to take “extraordinary measures” on August 2 absent congressional action. CBO estimates that Treasury can use those extraordinary measures to borrow until October or November, providing lawmakers with some time to act, though not much given all that is on their to-do list – infrastructure, budget reconciliation, and appropriations.
FY 2022 Appropriations
Before adjourning for recess at the end of the week, the House will vote on the fiscal year (FY) 2022 Labor-Health and Human Services-Education appropriations bill as part of a minibus (H.R. 4502). The bill provides $119.8 billion for HHS, an increase of $22.9 billion above the FY 2021 enacted level and $129 million below President Biden’s budget request. The bill includes $3 billion to establish the Advanced Research Projects Agency for Health (ARPA-H) and increases funding to address numerous health issues, including public health infrastructure, health disparities, maternal mortality, gun violence, and mental health and substance use disorder.
The Hyde amendment, the longstanding ban on federal funding for most abortions, was not included in the FY 2022 Labor-HHS-Education appropriations bill, but it is likely to be added back in given the razor thin margins in the Senate. Sen. Joe Manchin (D-WV), along with Sen. Roger Wicker (R-MS) sent a letter to leadership requesting the continued inclusion of the Hyde Amendment.
COVID-19
Tomorrow, the Senate Health, Education, Labor and Pensions (HELP) Committee convenes a hearing to discuss lessons learned from the COVID-19 pandemic. The panel includes perspectives from a state health official, public health expert, health care provider, and pharmaceutical trade association. Their discussion will inform the forthcoming bipartisan public health and medical preparedness legislation from Chair Patty Murray (D-WA) and Ranking Member Richard Burr (R-NC). The duo aims to move their package through Committee in the fall.