Health Care Checkup
April 1, 2022
THE BIG PICTURE
On Monday, President Joe Biden released his fiscal year (FY) 2023 budget proposal. The $5.8 trillion proposal makes significant national security investments to both bolster the U.S. military and support Ukraine in its security, humanitarian, and economic needs. The proposal also makes a myriad of investments on the domestic policy front, including expenditures for the nation’s supply chain, affordable housing initiatives, and anti-gun violence measures.

The budget request for the Department of Health and Human Services (HHS) proposes $127.3 billion in discretionary budget authority and $1.7 trillion in mandatory funding. President Biden calls for full parity between physical and behavioral health care. The budget includes funding for Community Mental Health Centers, improvements to Medicare and Medicaid mental health services, and funding for overdose prevention. In addition, the budget makes investments to better prepare for emerging public health threats, and to make health care more equitable. HHS’s budget summary can be found here.

On Thursday, Senate Republicans and Democrats reached a tentative agreement on an additional COVID-19 funding bill. The Senate is expected to consider the legislation next week. Senator Mitt Romney (R-UT), the lead Republican negotiator on the package, said that the bill would be fully paid for, but Republicans are still waiting on an analysis by the Congressional Budget Office (CBO). Passage of separate legislation is necessary because Democratic House Leaders had to strip out approximately $15 billion in funding from an Omnibus spending package that became law earlier this year in the face of opposition from several progressive caucus members who were concerned that the new funding would be offset by clawing back unspent state COVID relief funds.

Also on Thursday, the House voted 232-193 to pass H.R. 6833, the Affordable Insulin Now Act, which would cap the out-of-pocket cost of insulin for private-health plan enrollees and Medicare beneficiaries at $35 per month. Earlier in the week, the Congressional Budget Office (CBO) released a cost estimate on the legislation. As a reminder, H.R. 6833 is the companion bill to Senator Raphael Warnock’s (D-GA) bill (S. 3700). Senators Warnock, Susan Collins (R-ME) and Jeanne Shaheen (D-NH) are working together on additional measures in the bill to help lower the overall cost of insulin, so uninsured individuals can also pay less for insulin. Please find additional information here.

On Friday, the Biden Administration announced that it will end the Trump-era Title 42 Order that allowed for border agents to turn migrants at the border away. The policy was originally put in place by former President Donald Trump at the beginning of the COVID-19 pandemic to curb “mass uncontrolled cross-border movement.” The policy will officially end on May 23. 

The Centers for Medicare and Medicaid Services (CMS) released the 2021-2030 National Health Expenditure (NHE) report. The report found that, while patient demand for health care grew in 2021, growth in national health spending slowed by 5.5%. CMS attributes this decline in growth, in part, to the decline in COVID-19 supplemental funding. By 2030, national health spending is expected to reach $6.8 trillion, while annual growth is expected to average 5.1% over 2021-2030. Among major payers, Medicare spending is expected to grow at the fastest rate, averaging 7.2% over 2021-2030, followed by private health insurance spending (5.7%), and Medicaid spending (5.6%). Additional details can be found here.

On Wednesday, the Senate Committee on Finance held a hearing titled, “Behavioral Health Care When Americans Need It: Ensuring Parity and Care Integration.” Our summary of the hearing can be found here.
What to Expect Next Week: On Monday, April 4, the Senate Judiciary Committee is expected to finalize its consideration of Supreme Court Justice nominee, Judge Ketanji Brown Jackson. In light of Senator Joe Manchin’s (D-WV) statement that he intends to vote in Jackson’s favor, as well as Senator Susan Collins’s (R-ME) statement of support, it is likely that Judge Jackson will be confirmed as the nation’s next Supreme Court Justice. There will also be several health-related hearing on the Hill. On Tuesday, the Senate Finance Committee will hold a hearing on "The President’s Fiscal Year 2023 Health and Human Services Budget,” and the Senate HELP Committee will hold a hearing on “FDA User Fee Agreements: Advancing Medical Product Regulation and Innovation for the Benefit of Patients.” On Wednesday, the House Committee on Education and Labor will hold a hearing on “Examining the Policies and Priorities of the U.S. Department of Health and Human Services.”
DEEP DIVE
President Biden Releases FY23 Budget Proposal

On Monday, President Joe Biden released his fiscal year (FY) 2023 budget proposal. The $5.8 trillion proposal makes significant national security investments to both bolster the U.S. military and support Ukraine in its security, humanitarian, and economic needs. The proposal also makes a myriad of investments on the domestic policy front, including expenditures for the nation’s supply chain, affordable housing initiatives, and anti-gun violence measures.

On the health front, the budget request for the Department of Health and Human Services (HHS) proposes $127.3 billion in discretionary budget authority and $1.7 trillion in mandatory funding. Specifically, the proposal includes $9.7 billion in discretionary funding for the Centers for Disease Control and Prevention (CDC), $49 billion for the National Institutes of Health (NIH), $5 billion for the Advanced Research Projects Agency for Health (ARPA-H), $3.7 billion for the Food and Drug Administration (FDA), $10.1 billion for Substance Abuse and Mental Health Services Administration (SAMHSA) programs, $374 million for rural health programs, $660 million for the National Institute on Minority Health and Health Disparities program, and $1.64 billion in discretionary spending for Health Resources and Services Administration (HRSA) workforce development programs.

Also in the budget proposal, President Biden calls for full parity between physical and behavioral health care. The budget includes funding for Community Mental Health Centers, improvements to Medicare and Medicaid mental health services, and funding for overdose prevention. In addition, the budget makes investments to better prepare for emerging public health threats, and to make health care more equitable.
 
Budget proposals are not binding, and the President will need Congress to act in order to see his proposals come to fruition. However, the details of the President's budget request provide insight into the Administration's priorities. Additional resources on the FY23 budget proposal can be found below:
 



Senate Reaches Tentative Agreement on Additional COVID-19 Relief Bill

On Thursday, Senate Republicans and Democrats reached a tentative agreement on an additional COVID-19 funding bill. The Senate is expected to consider the legislation next week. Senator Mitt Romney (R-UT), the lead Republican negotiator on the package, said that the bill would be fully paid for, but Republicans are still waiting on an analysis by the Congressional Budget Office (CBO). Much of the funding in the package will be geared toward helping the U.S. acquire additional COVID-19 drugs and therapies. Senate Majority Leader Chuck Schumer, along with Senators Mitt Romney (R-UT), Richard Burr (R-NC), Roy Blunt (R-MO), Lindsey Graham (R-SC), and Patty Murray (D-WA) met Wednesday afternoon to discuss the package and negotiate pay-fors. Congress is looking to finalize a COVID funding bill before its two-week hiatus in April. Passage of separate legislation is necessary because Democratic House Leaders had to strip out approximately $15 billion in funding from an Omnibus spending package that became law earlier this year in the face of opposition from several progressive caucus members who were concerned that the new funding would be offset by clawing back unspent state COVID relief funds. As a result, the Senate negotiations major sticking point is how to offset the cost of any new relief, which Republicans are insisting be done by reprogramming or repurposing unspent funds from the March 2021 American Rescue Plan.

FDA Authorizes Second COVID-19 Booster Dose for Certain Vulnerable Populations

The U.S. Food and Drug Administration authorized a second booster dose of either the Pfizer-BioNTech or the Moderna COVID-19 vaccines for individuals 50 years of age and older and for certain immunocompromised individuals. The Director of the FDA’s Center for Biologics Evaluation and Research, Dr. Peter Marks, said that “Current evidence suggests some waning of protection over time against serious outcomes from COVID-19 in older and immunocompromised individuals,” and that a second booster dose could offer increased protection. The FDA’s full announcement can be found here.

Senate Judiciary Committee to Vote Next Week on Judge Ketanji Brown Jackson's Nomination to the Supreme Court

Next week, on Monday, April 4, the Senate Judiciary Committee is expected to finalize its consideration of Supreme Court Justice nominee, Judge Ketanji Brown Jackson. In light of Senator Joe Manchin’s (D-WV) statement that he intends to vote in Jackson’s favor, as well as Senator Susan Collins’s (R-ME) statement of support, it is likely that Judge Jackson will be confirmed as the nation’s next Supreme Court Justice. If confirmed, Jackson will fill the vacancy that will be left by Justice Stephen Breyer on the Supreme Court. Jackson currently serves on the U.S. Court of Appeals for the District of Columbia Circuit. Jackson was born in D.C. and grew up in Miami. She attended Harvard College and Harvard Law School and clerked for Justice Breyer from 1999-2000. The full Senate is expected to vote on the nomination before the end of next week.

CMS Releases 2021-2030 Projections of National Health Expenditures

The Centers for Medicare and Medicaid Services (CMS) released the 2021-2030 National Health Expenditure (NHE) report. The report found that, while patient demand for health care grew in 2021, growth in national health spending slowed by 5.5%. CMS attributes this decline in growth, in part, to the decline in COVID-19 supplemental funding. By 2030, national health spending is expected to reach $6.8 trillion, while annual growth is expected to average 5.1% over 2021-2030. Among major payers, Medicare spending is expected to grow at the fastest rate, averaging 7.2% over 2021-2030, followed by private health insurance spending (5.7%), and Medicaid spending (5.6%). Additional details can be found here.

Senate Finance Committee Unveils Mental Health Care Report

On Tuesday, the Senate Committee on Finance released a report documenting the “array of shortfalls that currently exist in the mental health care system.” Senate Finance Committee Chair Ron Wyden (D-OR) said that the report “marks the Finance Committee’s next step in the bipartisan effort to understand the mental health care crisis in the U.S. and, further, to craft a legislative package, which the Committee intends to consider this summer.” More can be found here.

CBO Releases Score on Bill that Would Cap the Out-of-Pocket Monthly Cost of Insulin at $35, as House Passes the Legislation

On Thursday, the House voted 232-193 to pass H.R. 6833, the Affordable Insulin Now Act, which would cap the out-of-pocket cost of insulin for private-health plan enrollees and Medicare beneficiaries at $35 per month. Earlier in the week, the Congressional Budget Office (CBO) released a cost estimate on the legislation. CBO estimates that the bill would increase government spending by approximately $6.6 billion over a 10-year period and reduce government revenue by $4.8 billion. Additionally, CBO estimates that the average annual cost to comply with the legislation would be $2 billion. As a reminder, H.R. 6833 is the companion bill to Senator Raphael Warnock’s (D-GA) bill (S. 3700). Senators Warnock, Susan Collins (R-ME) and Jeanne Shaheen (D-NH) are working together on additional measures in the bill to help lower the overall cost of insulin, so uninsured individuals can also pay less for insulin. Please find additional information here.
SENATE HEARINGS AND EXECUTIVE SESSIONS
Senate Finance Committee - Hearing
Full Committee Hearing: "The President’s Fiscal Year 2023 Health and Human Services Budget."
Tuesday, April 5 at 10:00 AM ET

Senate Health, Education, Labor and Pensions Committee - Hearing
Full Committee Hearing: "FDA User Fee Agreements: Advancing Medical Product Regulation and Innovation for the Benefit of Patients."
Tuesday, April 5 at 10:00 AM ET

Senate Armed Services Committee - Hearing
Subcommittee On Personnel Hearing: "To receive testimony on suicide prevention and related behavioral health interventions in the Department of Defense."
Wednesday, April 6 at 10:00 AM ET
HOUSE HEARINGS AND EXECUTIVE SESSIONS
House Committee on Natural Resources - Hearing
Subcommittee on Oversight and Investigations Hearing: The Opioid Crisis in Tribal Communities
Tuesday, April 5 at 10:00 AM ET

House Committee on Energy and Commerce - Hearing
Subcommittee on Health Hearing: "Communities in Need: Legislation to Support Mental Health and Well-Being"
Tuesday, April 5 at 10:15 AM ET

House Committee on Ways and Means Hearing: Proposed Fiscal Year 2023 Budget with Health & Human Services Secretary Becerra
Tuesday, April 5 at 2:00 PM ET

House Committee on Education and Labor - Hearing
House Committee on Education and Labor Hearing: Examining the Policies and Priorities of the U.S. Department of Health and Human Services
Wednesday, April 6 at 9:00 AM ET
ADMINISTRATION ANNOUNCEMENTS
Centers for Medicare & Medicaid Services
 
Food and Drug Administration
 
Guidance Documents from the Centers for Disease Control and Prevention

National Institutes of Health
QUICK LINKS
1341 G Street NW
Washington, DC 20005
202-585-0258