This Week in Congress

House and Senate

The House and Senate were in session this week and continued to make committee assignments.

Senate Republican Committee Assignments

Senate Republican Leader McConnell announced the Senate Republican Conference Committee Assignments for the 118th Congress. The assignments have been ratified by the Republican Conference and are expected to be ratified by full Senate soon. The assignments can be found here. 

Senate Appropriations

This week Senate appropriators were not quite ready to announce their subcommittee chairs and ranking members, though both parties have finalized their committee lists. Both sides of the aisle will see major changes in their subcommittee leadership lineups, with two key retirements on the Republican side and incoming Senate Appropriations Chair Patty Murray, D-Wash., leaving her role leading the Labor-HHS-Education Subcommittee as she takes over the full committee, per conference rules. Sen. Christopher S. Murphy, D-Conn., said Murray leaving that slot has led to a reshuffling among Democratic appropriators.

White House Meeting on the Debt Limit

President and Speaker McCarthy met to discuss how to raise the debt limit, but no agreements or promises were made other than a commitment to continue talking. The meeting marked the formal kickoff for what is expected to be months of negotiations over increasing the government’s borrowing authority to keep paying its bills. McCarthy said, “We both have different perspectives on this.  But I thought this was a good meeting. We promised we would continue the conversation. We’ll see if we can get there.” White House readout of the meeting said Biden made clear to McCarthy that lifting the debt ceiling is “not negotiable or conditional.” McCarthy, who is pushing for spending cuts in exchange for lifting the debt limit, said he talked to Biden about “a lot of different ideas” but he did not reveal any details. However, he did hint that he’s looking for a two-year discretionary spending cap agreement, a result not unlike past debt limit negotiations.

FY’24 Budget

The Administration will release the FY’24 budget on March 9.

Other Legislative Happenings from Around the Nation

COVID-19

Ending the Public Health Emergency

The Biden administration will end the Covid-19 national and public health emergencies on May 11. Congress has already extended some provisions originally tied to the emergency, including expanded Medicare and high-deductible health plan telehealth access and hospital-at-home care. But ending the emergencies will restructure the federal government’s coronavirus response and shift the responsibility for the distribution of most vaccines and treatments to the private sector. The Administration’s announcement came the same day the WHO announced that the global health emergency posed by COVID-19 is not over, saying the number of deaths, low vaccination rates and the threat of emerging variants still pose a significant threat to human health. Last week, an average of 536 people per day died in the U.S. from the virus.

Pandemic Preparedness

The WHO shared plans for an international agreement aimed at improving pandemic preparations. The plan lays out ideas to avoid the failures from the Covid-19 response, including inequitable vaccine distribution. The plan would require countries to allow WHO rapid-response teams access to their territories to assess and support efforts to combat emerging outbreaks – after China didn’t grant fast access to international experts to the Wuhan virology lab at the pandemic’s outset;  demands that countries support temporary waivers of intellectual property rights on products; and requires manufacturers that received public funding for their development to waive their rights (this provision will likely be contested by pharmaceutical companies). Governments will start negotiations on the agreement at a meeting later this month, with discussions continuing for the next year.

Immune Compromised People

Following the FDA’s decision last week to pull its authorization of Evusheld, the last antibody treatment to fight COVID-19, the CDC is urging those with weakened immune systems and members of their households to protect themselves with multiple prevention measures. That means staying up to date on their Covid vaccinations, masking, social distancing, improving ventilation, continuing to wash their hands, testing at the first sign of symptoms, and, if positive and eligible, getting treatment such as Paxlovid, remdesivir, or molnupiravir. Evusheld, given to people at high risk of severe illness before exposure to the virus, is another casualty of the mutating coronavirus. The FDA warned in October that Omicron subvariants were undermining its power and, earlier this month, the agency said that it anticipated it would not neutralize now-dominant XBB.1.5. Post-infection antibody therapies are also history. Authorization for the last of those treatments, bebtelovimab, was withdrawn in November.

Mpox

A new warning from the FDA urges consumers to beware of marketers attempting to sell illegal and unproven mpox “medication” and “cures” in order to swindle scared, vulnerable people and bilk them out of their money. The agency also shared a series of pictures of the alleged illegal products for sale. The letter can be found here

Gonorrhea

The disease that affects almost 700,000 Americans a year is overcoming the last antibiotics now available to treat it. If it gains the ability to evade those drugs, our only options will be desperate searches for others that aren’t approved yet—or a return to a time when untreated gonorrhea caused crippling arthritis, blinded infants at birth, and made men infertile through testicle damage and women via pelvic inflammatory disease. The bacterium is very good at amassing mutations that protect it against antibiotics. It churned through sulfa drugs in the 1940s; penicillin and tetracycline in the 1980s; and fluoroquinolones such as Cipro by the mid-2000s. Until two years ago, successful treatment relied on administering azithromycin, a macrolide introduced in the mid-1980s, alongside ceftriaxone—but in revised CDC guidelines in 2020 the agency removed azithromycin from the regimen because resistance to it had spiked. As early as 2012, academic and CDC researchers warned in the New England Journal of Medicine that “untreatable gonococcal infection” was on the way.  The article can be found here

340B

Germany-based Bayer HealthCare Pharmaceuticals and EMD Serono, have announced they will restrict the number of contract pharmacies hospitals and clinics can use to dispense discounted drugs under the 340B program. The new policies are expected to go into effect March 1, making the companies the 20th and 21st drug makers to impose such restrictions since 2020. The announcements come after the Third Circuit Court of Appeals ruled that drug companies are permitted to limit 340B entities to using just one contract pharmacy to distribute discounted drugs. The 340B Health President and CEO Maureen Testoni blasted the announcements, noting that Bayer received more than $28 billion in revenues in 2021 even as it provided 340B discounts without restrictions, and EMD Serono took in more than $8 billion that same year.

American Hospital Association Asks To Work With CMS On 340B Underpayments

The AHA has asked to meet with CMS officials to craft a regulation to repay hospitals for the 340B drug pay cuts the Supreme Court deemed unconstitutional, warning that any attempt by CMS to prospectively repay hospitals or to claw back funds from hospitals as it repays the 340B participants could lead to more lawsuits. “Working together, HHS and the AHA can develop a fair and administrable remedy that avoids further legal or administrative delay. We look forward to discussing how to accomplish this common goal,” AHA General Counsel and Secretary Melinda Reid Hatton stated.  The U.S. District Court for DC gave HHS the first opportunity to come up with how to repay 340B hospitals for years’ worth of pay cuts in light of the Supreme Court’s decision that the 340B drug pay cuts were unconstitutional. CMS’ unified agenda says the agency plans to release a rule on how to repay 340B hospitals for the cuts in April, and AHA says the agency should meet with hospitals as it works on the regulation.

Contraceptive Coverage

Biden Administration Seeks To Bolster Obamacare’s Contraception Coverage

The proposed rule from three federal agencies would remove an employer’s ability to object to contraceptive coverage on moral grounds while still allowing religious objections. But individuals whose coverage is provided by employers or schools with religious objections could still access contraceptive care through a willing provider. The article can be found here

Abortion

Medication Abortions

Medication abortions, which account for more than half of all abortions in the US, have become more common since the Supreme Court overturned the federal right to abortion last summer. But in federal courts and state legislatures, abortion opponents are trying to limit the use of abortion-inducing pills. Meanwhile, abortion rights supporters have filed lawsuits arguing the opposite — that federal approval of the drugs should prevail over state restrictions. The article can be found here

Republican AGs Warn Pharmacies Against Mailing Abortion Pills Within Their States

Republican attorneys general from 20 states wrote letters to executives at CVS and Walgreens warning the pharmacy chains against using the mail to dispense abortion pills in their states, in a shot against a new Biden administration policy. The article can be found here

West Virginia

West Virginia’s only abortion clinic and the clinic’s primary doctor filed a lawsuit challenging the near-total abortion ban passed by the state last year, saying it violates patients’ constitutional rights. In their complaint in the Charleston, West Virginia federal court, Women’s Health Center of West Virginia and the doctor, identified as John Doe, are asking the court for an immediate order blocking enforcement of the law while the case goes forward.

Nebraska

The Nebraska Legislature’s Health and Human Services Committee heard nearly eight hours of testimony before adjourning without a vote on whether to advance a bill that would outlaw abortion at a point before many women know they’re pregnant. The so-called heartbeat bill would ban abortions once cardiac activity can be detected in an embryo, which is generally around the sixth week of pregnancy.

South Carolina

The State’s attorney general asked the South Carolina court to reconsider its ruling striking down the state’s six-week abortion ban. South Carolina Attorney General Alan Wilson filed a rehearing request with the South Carolina Supreme Court. The court, in a 3-2 decision earlier this month, ruled that the 2021 law banning abortions when cardiac activity is detected, about six weeks after conception, violated the state constitution’s right to privacy. (1/30)

Massachusetts

Massachusetts launched a hotline Monday offering free legal advice to people seeking abortions in the state, as well as their health care providers and helpers — joining several other states in a move spurred by the U.S. Supreme Court overturning Roe v. Wade last summer. “It will help people and families, including those who travel from out of state seeking care, access these critical health care services,” Attorney General Andrea Campbell said at a news conference.