Summary
Congress enters its busiest season with less than 10 scheduled working days before lawmakers adjourn on December 13.
- Fiscal Year 2021 funding – With the current continuing resolution set to expire on December 3, lawmakers are expected to vote on a new CR to fund the government at least until mid-December, though it could be extended through late January.
- Debt ceiling – Treasury Secretary Janet Yellen estimates that the U.S. could reach its debt limit on December 15. How exactly Congress will address the looming cliff remains to seen, but Senate Majority Leader Chuck Schumer and Senate Minority Leader Mitch McConnell (R-KY) are trying to negotiate a deal.
- Build Back Better Act (R. 5376) – The House passed President Biden’s $1.75 trillion social spending and climate framework on November 19 (WHG summary). Senate Democrats want to pass the budget reconciliation package in December, though it could spill into the new year. We could see the President’s first State of the Union address in late January or early February as congressional Democrats’ self-imposed deadline to finalize BBBA and deliver President Biden a legislative victory to tout before the American people.
Some of the more contentious provisions (due to policy or process) around paid leave, immigration and so forth may be subject to change, especially in an attempt to secure the support of all 50 Democrats, including key moderates Joe Manchin (D-WV) and Kyrsten Sinema (D-AZ). For health care, the broad contours of the provisions are not expected to change drastically, though we could see tweaks to the components addressing Medicare benefit expansion, the Medicaid coverage gap, and expansions for home- and community-based services. Changes to other key health care policies – namely, drug pricing reform – would alter the savings currently expected from such changes, currently expected to save approximately $300 billion according to estimates from the Congressional Budget Office (CBO) and nearly cover the health care provisions of the bill that would increase federal spending.
- National Defense Authorization Act (H.R. 4350) – Today, the Senate will hold a procedural vote on an amendment to NDAA submitted by Sen. Jack Reed (D-RI), Chairman of the U.S. Senate Committee on Armed Services. The amendment includes the Maternal Health Quality Improvement Act ( 1675 / press release) introduced by Sens. Raphael Warnock (D-GA) and Marco Rubio (R-FL).
Tomorrow, the House will vote on a slate of relatively uncontroversial health-related bills. They include:
- Opioid crisis
- Social determinants of health
- Immunization data and vaccination rates
- Medical product development
- Supporting the Foundation for the National Institutes of Health and the Reagan-Udall Foundation for the Food and Drug Administration Act (R. 3743)
Regulatory Update
A number of notable developments occurred on the regulatory front last week. These include the following:
Federal Register
- The Food and Drug Administration (FDA) issued a proposed rule to reclassify HIV viral load monitoring tests as a means to reasonably assure the safety and effectiveness of this device type.
Office of Management and Budget (OMB)
- A final rule regarding the currently paused Most Favored Nation (MFN) model arrived for review at OMB. The Centers for Medicare & Medicaid Services (CMS) issued a proposed rule in August 2021 to rescind the model (details).
- A proposed rule for policy and technical changes to Medicare Advantage and Part D for Contract Year 2023 arrived at OMB for review.
A request for information for modernizing the organ transplant system cleared OMB review, meaning we may see its release in the Federal Register shortly.