Appropriations bills are very slowly moving through Congress
The House has passed the first half of their FY23 appropriations bills as a single consolidated bill, but have not scheduled a vote for the on Labor, Health and Human Services, and Education (Labor-HHS) or Commerce, Justice and Science bills yet. You can find a summary of the House FY23 Labor-HHS bill HERE and the bill text HERE. The Senate Appropriations Committee is rumored to be planning a release of their FY23 bills by the end of July, although there is no word yet on when or if they will hold markups.
If Congress does not pass and the president does not sign all 12 appropriations bills by October 1, the government will either shut down or require a continuing resolution (CR) to continue operating. At this point, we expect FY23 to begin with a CR, which requires level funding and no new programs, with full appropriations being approved closer to the end of the calendar year.
Senate Democrats are moving forward on ACA subsidies and drug pricing
Senate leadership has reportedly struck a deal with Sen. Joe Manchin (D-WV) to give Medicare narrow authority to negotiate lower drug prices and extend key Affordable Care Act (ACA) subsides for another two years. The deal would all Medicare to negotiate for lower prices on up to 10 drugs in 2026 and up to 20 drugs starting in 2029. The deal also includes a $2,000 cap on out-of-pocket drug costs. Senate Democrats are planning on using a process called reconciliation to pass this bill, which allows for the bill to be exempt from filibusters in the Senate. Reconciliation is a complex pathway that has significant limitations in what is allowable in the legislation as it only permits legislation that directly impacts federal spending or revenues, making provisions such as private insurance pricing caps being unclear.
Biden Administration picks Dr. Bertagnolli as director of the National Cancer Institute.
The Biden administration has selected Monica Bertagnolli, a renowned surgical oncologist, as the next director of the National Cancer Institute (NCI). Bertagnolli, currently a surgeon at Dana-Farber Cancer Center and a professor at Harvard Medical School, will take the reins of the country’s largest biomedical research institute — a $7 billion agency that funds the lion’s share of U.S. cancer research and is central to the White House’s “Cancer Moonshot.” The pick marks the start of a new era at the NCI, which is the largest of the 27 agencies that compose the National Institutes of Health. The agency’s former director, Ned Sharpless, stepped down in April after a nearly five-year tenure. Dr. Bertagnolli is the first woman to lead the NCI.
House passes bill to protect contraceptive access post-Dobbs
The House passed legislation that would protect the right to purchase and use contraception without government restriction, moving over almost unanimous Republican opposition. Some Republicans said that they supported contraception in practice but viewed Democrats’ bill as a gateway to allowing abortion. Anti-abortion groups encouraged lawmakers to oppose the measure, claiming that the bill’s definition of contraceptives could be interpreted to include pills that induce abortion. The bill is unlikely to move past a Senate filibuster.
Biden Administration announces $140 million for monkeypox research
The White House Office of Science and Technology Policy will lead a $140 million, 22-target research agenda for monkeypox to better understand and handle rising case counts across the country. While vaccines, therapeutics, and diagnostics exist that can help prevent, detect, and treat monkeypox, more research is needed to help determine the best use of these products. There are additional questions about how long people will be sick, and why some people become more ill than others. The current outbreak seems to be different than prior outbreaks of monkeypox, raising questions about how people get infected, virus changes, detection in various specimen types, and risk factors for becoming sick. This comes as Congress becomes increasingly concerned about the federal response to COVID-19. Senate HELP Committee Chairwoman Patty Murray (D-WA) wrote a letter to HHS questioning the existence of a concerted monkeypox response.
Biden Administration is elevating ASPR
The Biden Administration is creating a new division within HHS to coordinate the nation’s response to pandemic threats and other health emergencies, a recognition that the department is structurally ill equipped to handle disasters like the coronavirus pandemic. The change will elevate the existing office of the Assistant Secretary for Preparedness and Response (ASPR) to its own operating division as the Administration for Strategic Preparedness and Response (ASPR). The move creates a new federal agency on par with the CDC or FDA that will be responsible for health logistics, including oversight of the Strategic National Stockpile.
Biden signed an executive order to protect women’s reproductive rights and privacy
In the wake of Dobbs, President Biden signed an order directing HHS to consider additional actions to safeguard sensitive information related to reproductive health care, including under the Health Insurance Portability and Accountability Act (HIPAA). Secretary Becerra has directed the HHS Office for Civil Rights to issue new guidance related to the HIPAA Privacy Rule to clarify that doctors and medical providers are in most cases not required – and in many instances not permitted – to disclose the private information of patients, including to law enforcement. The office will also issue a guide for consumers on how to protect personal data on mobile apps.
What I’m reading…
There are plenty of studies that have shown how sexism and racism contribute to inequality in academia. But Dr. Cech published in ScienceAdvances a new study that uses intersectionality analysis of 32 intersecting identities to discover that white, able-bodied heterosexual men experience more social inclusion, professional respect, and career opportunities, and have higher salaries and persistence intentions than STEM professionals in 31 other intersectional groups. These results persisted after adjusting for differences in education, experience, hours worked, family responsibilities and more than a dozen other confounding factors.
Closer to home, Chantarat and colleagues published the results of their study of perceptions of workplace climate and diversity, equity and inclusion within health services and policy research (HSPR). This study surveyed participants at AcademyHealth’s annual research meeting in 2020 and recruited other researchers through a range of methods including social media. Overall, 40 percent of respondents strongly agreed/agreed that their organization’s DEI initiatives were tokenistic; that percentage was 62 percent among Black/African American respondents. The authors concluded that professional discrimination in the HSPR workplaces is highly prevalent, especially among those from historically and structurally excluded groups.
An adult male in New York has been diagnosed with polio, the first case in the United States in nearly a decade. As we work to combat misinformation, hesitancy, and opposition to the COVID-19 vaccine and boosters, we also work to make sure that our patients and communities are up to date on all of the other necessary vaccinations that prevent severe illnesses.
The country is only beginning to understand the full impact and myriad ramifications of the Dobbs decision on healthcare for women. In the wake of this ruling, one of the new threats to women’s health is in medical misinformation. YouTube has announced that it will begin removing content that provides instructions for unsafe abortion methods, as well as provide a new information panel that it will attach to videos to provide viewers with abortion information from trusted health authorities. It is not just on YouTube, but rather on all of us to identify and debunk bad medical information that can cause even greater pain on pregnant people.
Health systems are struggling to respond to new abortion bans amid legal confusion, and it is the patients that are suffering. Surgical procedures and medications that are used for miscarriages are identical to those used in abortion, and patients are facing delayed or denied care. A recent podcast from AcademyHealth Board member Chip Kahn explores some of the potential scenarios and it is chilling.
The CDC and the National Center for Health Statistics (NCHS) released data showing that overdose death rates in the US increased dramatically in 2020, especially among Black, American Indian and Alaska Native individuals. The rates rose 44 percent in 2020 for Black people and 39 percent for American Indian and Alaska Native people, compared to 22 percent for white people. This report highlights that health disparities in overdose rates continue to worsen.