Summary
We are now in week three without a functioning House of Representatives. Last week was another drama filled week as Rep. Jim Jordan (R-OH) lost three floor votes in his bid to become Speaker. Following the third failed vote on Friday, Rep. Jordan lost an internal conference vote that was intended to show confidence in him remaining as his party’s speaker designee, leaving the conference without a leader. Last week the conference also voted against temporarily expanding Speaker Pro Tem Patrick McHenry’s (R-NC) powers to enable him to serve as Speaker through the end of the current Continuing Resolution (CR). This evening the conference will meet again to discuss the candidacies of nine members who have expressed interest in running for the position of Speaker, including Republican Whip Tom Emmer (R-MO). Tomorrow they will start to vote with the hope that they can coalesce around one unity candidate, but at this point, there is no clear direction forward.
With under a month to go before the CR expires and the government runs out of funding, the Senate has had their own difficulties passing appropriations bills. Majority Leader Schumer (D-NY) had hoped to pass the first “minibus” last week but was not able to achieve agreement on the amendment process. Senate Appropriations Committee Ranking Member Susan Collins (R-ME) stated last week that she has hope that the “last hurdle” can be overcome, and the bill will proceed this week.
Adding to the pressure, President Biden submitted an emergency funding supplemental request to Congress last week that includes $61 billion for Ukraine, $14 billion for Israel, $14 billion for border operations, $10 billion in humanitarian aid and $2 billion for Indo-Pacific security assistance. The foreign aid request is supported by both Majority Leader Schumer and Minority Leader Mitch McConnell (R-KY). The Administration is expected to request an additional emergency spending package this week focused on domestic priorities including childcare, broadband and disaster needs. The second package, however, will face stiffer opposition in the Senate. Action in the House on funding bills or any other legislation is on hold until a Speaker is confirmed.
Hearings
- The House Energy & Commerce Subcommittee on Health is scheduled to have a hearing on Wednesday titled “Supporting Access to Long-Term Services and Supports: An Examination of the Impacts of Proposed Regulations on Workforce and Access to Care.” The hearing examines the impacts of the Administration’s proposed nursing home ratio regulations.
- On Wednesday the Senate Aging Committee is scheduled to hold a hearing on access to therapies for people with progressive diseases like Alzheimer’s and ALS.
- The Senate HELP Committee will have a field hearing in New Brunswick, New Jersey on Friday titled, “Overworked and Undervalued: Is the Severe Hospital Staffing Crisis Endangering the Well-Being of Patients and Nurses?”
Regulatory Update
The Office of Management and Budget (OMB) is reviewing the following rules:
- CMS Enforcement of State Compliance with Medicaid Reporting and Renewal Requirements –The interim final rule would establish rules regarding CMS enforcement of states’ compliance with reporting requirements and renewal requirements during the period that begins on July 1, 2023 and ends on June 30, 2024. The interim final rule may codify existing guidance and provide more details on how CMS may enforce the requirements. The interim final rule was not included in the Spring 2023 Unified Agenda.
- Annual Rulemaking for Commercial Insurers – Proposed rules for the CY 2025 Policy and Technical Changes to Medicare Advantage and Part D (expected in October 2023) and CY 2025 Notice of Benefit and Payment Parameters (expected in November 2023)
- Annual CY 204 Medicare Payment Updates – Final rules for home health, hospital outpatient and ambulatory surgical centers, end-stage renal disease, and the physician fee schedule.
- 340B Program – Final rule on the Hospital Outpatient Prospective Payment System: Remedy for 340B-Acquired Drugs Purchased in Cost Years 2018-2022.
- Surprise Billing Regulations – A proposed rule to amend requirements for the independent dispute resolution (IDR) process
- Conscience Rights in Health Care – Final rule to safeguard the rights of federal conscience and religious nondiscrimination while protecting access to care, including abortion.
- Skilled Nursing Facilities – Final rule to require the disclosure of certain ownership, managerial, and other information regarding Medicare skilled nursing facilities (SNFs) and Medicaid nursing facilities. Interestingly, the Unified Agenda forecasted action in February 2026.
- Health Data Interoperability – Final rule to implement certain provisions of the 21st Century Cures Act and make several enhancements to the ONC Health IT Certification Program to advance interoperability, improve transparency, and support the access, exchange, and use of electronic health information.