Bipartisan Infrastructure bill

On November 15, 2021, President Biden signed the infrastructure Investment and Jobs Act. The legislation includes funding to rebuild roads and bridges, eliminate the nation’s lead pipes, expand access to high-speed internet in rural communities, and provisions to address climate change. Later in the week, President Biden named former New Orleans Mayor Mitch Landrieu to oversee implementation of the Act. Landrieu, also served at Louisiana lieutenant governor and led New Orleans from 2010 to 2018. He played a key role in helping the city rebound from Hurricane Katrina in 2005.

Appropriations

On November 17, 2021, House Appropriations Chair DeLauro and all of the other Subcommittee chairs released a joint statement urging Republican members to begin negotiations on the FY’22 appropriations bills and the December 3, 2021, expiring continuing resolution. House and Senate Democrats have released their proposed bills, but without an agreement on top line spending, the split between defense and non-defense spending, and policy riders, negotiations can’t begin. The Democratic statement sharply criticized Republicans who have suggested a full-year CR if an agreement can’t be reached. Negotiations continue on the date of the next CR, with some calling for an extension through December 17, while others want to push the date into February or March of 2022.

Reconciliation/Build Back Better Plan

On November 18, 2021, the House began consideration on the $1.75 trillion Build Back Better Plan and passed it early today, November 19. After House passage, the Senate will take up the legislation, which is expected to make major changes to the package. Senate Majority Leader Charles E. Schumer, D-N.Y., set a Christmas deadline for final passage but some predict that the legislation may not be completed until January or February of 2022.

Debt Ceiling

House Budget Chairman Yarmuth stated that Democrats need to decide on a legislative strategy to address the debt limit by Dec. 1 to meet the Dec. 15 deadline for action recommended by Treasury Secretary Yellen. Yarmuth said that the decision is in the Senate’s court, where without the reconciliation process, any bill would need 60 votes to overcome a filibuster. Yarmuth suggested that Democrats “embark on a parallel course” where they advance a debt limit bill through regular order and then “initiate the reconciliation process.”

Cures 2.0

On November 16, 2021,  Reps. DeGette and Upton released the draft text of their Cures 2.0 legislation. The legislation is an upgrade of the 2016 21st Century Cures Act and includes: $6.5 billion for President Biden’s proposed Advanced Research Projects Agency for Health; advance medical innovations; new drug research; federal telehealth; long-term studies on COVID-19 and its effect on the health system; new financial incentives for antibiotic development; and clinical trial diversity.

The draft text can be found here

The section-by-section summary can be found here

Other Happenings Around the Nation

FDA Commissioner

President Biden has nominated former FDA chief Robert Califf to once again lead the agency. Califf, 70, led the agency in 2016-2017, in the last year of the Obama administration. The White House called Califf “an internationally recognized expert in clinical trial research, health disparities, healthcare quality, and cardiovascular medicine.” In 2016, Senators Manchin and Markey both opposed Califf’s confirmation and argued that Califf was unlikely to make changes at the agency to reduce access to opioid painkillers. But despite some  Democratic opposition, Califf received overwhelming bipartisan support in his 2016 nomination for the job, with the Senate voting 89-4 to confirm him.

COVID-19

As cases of Covid-19 rise throughout the U.S., health officials warn that an increasing number of fully vaccinated people are being hospitalized or going to the emergency room. As a result, on November 19, 2021, the FDA authorized booster shots of both the Pfizer-BioNTech and Moderna vaccines for everyone 18 and older, opening up eligibility to tens of millions more fully vaccinated adults. The CDC is also expected follow the FDA’s recommendation. Dr. Anthony S. Fauci, the federal government’s top infectious disease expert, has argued relentlessly over the past month for booster shots for all adults, a position shared by most of Mr. Biden’s other health advisers. President Biden’s chief medical adviser Anthony Fauci urged those 18 and older to get a booster shot for added protection against COVID-19. Fauci said he has believed “for some time now” that boosters are effective and should be recommended for all adults in the U.S. who received their vaccine six months ago or longer. “If you’re 18 or older, go get boosted,” Fauci said.

A federal appeals court has upheld its stay on President Biden’s vaccine-or-test mandate for companies with at least 100 employees. In a 22-page ruling on November, the 5th U.S. Circuit Court of Appeals said the mandate was “fatally flawed,” and barred the Occupational Safety and Health Administration from enforcing the mandate “pending adequate judicial review” of a motion for permanent injunction. OSHA shall “take no steps to implement or enforce the mandate until further court order,” the ruling stated. While OSHA intends to release new guidance on individual exemptions from vaccine requirements under the agency’s COVID-19 emergency temporary standard, the agency is emphasizing that all work on implementation of the rule is paused due to an appellate court’s order.