Summary
Congress is in session this week before recessing at the end of the week for the Thanksgiving holiday. The House is scheduled to vote on a number of suspension bills on Monday while the Senate will be occupied with confirmations. We expect the Administration to finally send up an official disaster aid request to refill the coffers of the Small Business Administration and the Federal Emergency Management Agency in the wake of Hurricanes Milton and Helene. Reports are the request could be as high as $100 billion, though the top House appropriators expect bipartisan support for the measure.
Beyond the disaster aid package, it remains uncertain if Congress will be able to pass a final FY 2025 budget bill this calendar year. A resolution on the top-line spending amount would need to happen soon in order to give the appropriators time to finalize all 12 bills. Additionally, House Speaker Mike Johnson (R-LA) indicated over the weekend that he would prefer passing a 3-month Continuing Resolution and then taking it up again when the Republicans control both sides of the Capitol and the White House.
Outstanding Election Results: Nearly two weeks after election day, there are still 5 House elections yet to be called, though the Republicans have reached the 218-vote threshold needed to retain their majority. Of the five outstanding races Republicans are in currently marginally ahead in two races, Democrats are marginally ahead in two races and one race is evenly tied. So far, the incoming Trump Administration has also poached three sitting House members to join the Administration (pending Senate confirmation), leaving the margins between the two parties extraordinarily tight. While the Republican party feels an electoral mandate following Trump’s decisive win, the reality is legislative governing will likely continue to be difficult. Be on the lookout later today for our comprehensive post-election analysis!
Leadership in the 119th Congress: Last week House Republicans elected Representative Mike Johnson and Senator John Thune (R-ND) to lead their parties in the House and Senate. Speaker Johnson did not face any resistance and ran unopposed, while Senator Thune managed to beat out Senators John Cornyn (R-TX) and Rick Scott (R-FL). Speaker Johnson won the confidence of his party but will still need to be re-elected Speaker when the 119th Congress organizes in January.
Leadership of the House and Senate Democratic caucuses will be formally elected on Tuesday, though no changes are expected to occur, and Hakeem Jeffries (D-NY) and Chuck Schumer (D-NY) should keep their respective positions as House and Senate Democratic leaders.
Trump’s HHS Secretary Nomination: President-elect Trump has wasted no time setting up his new Administration, making a number of nomination announcements last week. On Thursday he announced he would nominate Robert F. Kennedy, Jr., to be the Secretary of Health and Human Services. So far, there has been a lot of speculation and discussion about Mr. Kennedy’s more extreme positions questioning the safety of vaccinations and fluoride in drinking water, but there are few actual policy details. We do know that RJK Jr. founded Children’s Health Defense, a non-profit org whose mission is to end childhood chronic health conditions caused by environmental exposures. Mr. Kennedy said in a recent interview that President Trump “wants to see measurable concrete results within two years in terms of a measurable diminishment in chronic disease among America’s kids.” While his focus has been on children, these same conditions could also be targeted in Medicare. There have also been reports that Mr. Kennedy wants to let Medicare and Medicaid cover “clean foods” and exercise. What has advocates most concerned, however, is the rhetoric Mr. Kennedy has vocalized that threaten to “shake up” the leadership at federal health agencies and his statement to MSNBC that he’d like to see “entire departments ” at the FDA, particularly nutrition regulators, dismissed.
Hearings This Week:
House Appropriations: The House Labor-HHS Appropriations Subcommittee will hold a hearing on Tuesday on the National Institutes of Health.
Senate Joint Economic Committee: the Senate Joint Economic Committee will hold a hearing on Tuesday to examine the 2025 tax policy debate, focusing on the Tax Cuts and Jobs Act.
Senate Appropriations: On Wednesday the Senate Appropriations Committee will hold a hearing to examine disaster funding needs, featuring testimony from several administration officials, including the Deputy Secretaries for the U.S. Department of Agriculture and the Department of Housing and Urban Development, and the Administrator for the Federal Emergency Management Agency (FEMA).
Senate Banking Committee: On Wednesday the Senate Banking, Housing, and Urban Affairs Subcommittee on Economic Policy will hold a hearing to examine the 2025 tax policy debate, focusing on implications for the American economy.
Regulatory Update
The Office of Management and Budget (OMB) is reviewing the following:
Medicare
- Medicare Advantage – The proposed rule would make policy and technical changes to the Medicare Advantage, Medicare Prescription Drug Benefit, and Medicare Cost Plan Programs, and PACE for contract year 2026 (September 2024).
Other Topics
- Healthcare System Resiliency and Modernization – The proposed rule would revise and update national emergency preparedness requirements for Medicare- and Medicaid-participating providers and suppliers (was set for December 2023).
- Retail Pharmacy Standards – The final rule would require pharmacies and vendors to modify the currently adopted National Council for Prescription Drug Programs (NCPDP) standards to the Telecommunications Standard Implementation Guide Version F6 (F6); Batch Standard Implementation Guide version 15; and Batch Standard Subrogation Implementation Guide version 10 (was set for February 2024).
- Organ Transplants – The final rule would establish a new mandatory Medicare payment model, the Increasing Organ Transplant Access Model (IOTA Model), that would test whether performance-based incentive payments paid to or owed by participating kidney transplant hospitals increase access to kidney transplants for patients with end-stage renal disease (ESRD) while preserving or enhancing the quality of care and reducing Medicare expenditures.
- Cybersecurity – The proposed rule would make modifications to the Security Standards for the Protection of Electronic Protected Health Information (the Security Rule) under the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and the Health Information Technology for Economic and Clinical Health Act of 2009 (HITECH Act). These modifications will improve cybersecurity in the health care sector by strengthening requirements for HIPAA regulated entities to safeguard electronic protected health information to prevent, detect, contain, mitigate, and recover from cybersecurity threats.