This Week in Congress

House and Senate

The House and Senate are out of session and will return on April 17 for official business.

House Republican Debt Limit Plan

House Republican leaders have begun informally putting together a debt-limit package they intend to socialize with their rank-and-file members when Congress returns to Washington next week. The legislation would lift the debt limit until May 2024. GOP leadership is considering either a cap on non-defense discretionary spending or a cap on overall discretionary spending after reducing it to FY’22 levels. The plan would limit budget growth to 1% annually for the next 10 years. The House GOP proposal would rescind unspent COVID-19 funds, prohibit student loan forgiveness, repeal some green tax credits, institute work requirements for social programs and implement the House Republican energy plan.  This plan has no chance of passing the Senate, but the House GOP leadership is hoping to use this outline to start negotiations with the White House.

Other Legislative Happenings from Around the Nation

STI Epidemic Continues to Escalate

Reported cases of the sexually transmitted infections (STIs) chlamydia, gonorrhea, and syphilis all increased between 2020 and 2021 – reaching a total of more than 2.5 million cases according to CDC’s final surveillance data. Gonorrhea rates increased more than 4%, syphilis rates surged, increasing nearly 32% for combined stages of the infection, cases of congenital syphilis rose by an alarming 32% and resulted in 220 stillbirths and infant deaths, chlamydia rates increased nearly 4%.

The CDC press release can be found here.

David C Harvey, the NCSD Executive Director stated “The latest CDC data shows record high STI rates in America for the eighth straight year. This is not business as usual – it is a rapidly deteriorating public health crisis in a dangerous time. STI rates will continue to rise unless we take drastic action. For years, we have sounded alarm bells about how the stretched public health system and lack of funding has hampered STI prevention, testing, and treatment. The need to fund prevention programs and clinical services is more acute than ever and it has been ignored for far too long. What’s worse, instead of seeing expanded prevention efforts, we see states and courts increasingly taking aim at preventive health services, sex education, and LGBTQ+ people – actions that fragment the nation’s health and undercut tools to protect communities.”

The NCSD press release can be found here.

Doxycycline

The CDC is drafting recommendations for Doxycycline as a kind of morning-after pill for preventing STDs. The drug is already used to treat a range of infections. A study published last week in the New England Journal of Medicine showed its potential to prevent STIs. In the study, about 500 gay men, bisexual men and transgender women with previous STD infections took one doxycycline pill within 72 hours of unprotected sex. Those who took the pills were about 90% less likely to get chlamydia, about 80% less likely to get syphilis, and more than 50% less likely to get gonorrhea compared with people who did not take the pills after sex, the researchers found.

HPV Vaccine

A bill pending in the California legislature would require schools to notify parents that their kids are expected to be vaccinated for HPV before entering eighth grade, as part of a push to get more children inoculated against the cancer-causing strains of the virus, theoretically before they become sexually active. The bill stops short of mandating the vaccine for middle schoolers, as the bill originally proposed. Lawmakers stripped out that provision without any debate, reflecting the contentious nature of school vaccine mandates even in a state with some of the nation’s strictest immunization laws.

Mpox

Vaccine

A new study in JAMA Network Open shows that availability of the two-dose Jynneos vaccine to protect against mpox was not widespread during last summer’s outbreak, with only 17.1% of the US population living within 15 minutes of a vaccination site and 50% living more than an hour away.

The article can be found here.

Cases in Black and Hispanic Men

The CDC and its state partners published two studies in Morbidity and Mortality Weekly Report showing Black and Hispanic men made up a disproportionate number of cases during last year’s mpox outbreak. Between May and December of 2022, mpox incidence in Black and Hispanic males was higher than their White counterparts.

The article can be found here.

Abortion

Mifepristone

On April 12, a federal appeals court ruled that the abortion pill mifepristone could remain available, but the judges blocked the drug from being sent to patients through the mail and also restricted the drug to be used only up to seven weeks into pregnancy, not ten. The three-judge panel said its ruling would hold until the full case is heard on appeal. The panel’s order comes after a federal judge in Texas ruled that the FDA had improperly approved the drug in 2000, threatening access to the medication around the country. Pharmaceutical and biotechnology industry leaders say the ruling ignores science, diminishes FDA’s regulatory authority, poses a threat to other drug approvals and creates regulatory uncertainty for the drug industry. The ruling, if upheld by the appeals court and Supreme Court, not only would pull mifepristone from the market and effectively ban use of the drug in states even where abortion is legal, it also could have widespread consequences for all other FDA decisions, including drug approvals, FDA and the Justice Department warned the court in January. On April 13, Attorney General Garland said that the Justice Department “strongly disagrees” with the decision and “we will be seeking emergency relief from the Supreme Court to defend the FDA’s scientific judgment and protect Americans’ access to safe and effective reproductive care,”

HHS Proposes Reproductive Data Privacy Protections Under HIPAA

The Biden administration has proposed new health privacy protections to prevent health information from being used to investigate or sue people who facilitate abortions. The changes, put forth by the Department of Health and Human Services’ Office for Civil Rights, would bolster reproductive health care privacy. The new language is aimed at strengthening existing privacy rule protections under the Health Insurance Portability and Accountability Act of 1996.

Florida

Governor DeSantis signed a bill to ban most abortions after six weeks of pregnancy, just a few hours after the Florida legislature sent the bill to his desk after it was passed by the Florida House. The legislation prohibits abortion in most cases after six weeks, with exceptions for rape, incest and human trafficking. In those cases, women with documentation showing evidence of the crime may have abortions up to 15 weeks of pregnancy. Because many people don’t realize they are pregnant before six weeks, the measure could effectively eliminate most abortions in Florida if it is allowed to take effect. That will depend on a Florida Supreme Court ruling expected later this year on the constitutionality of the state’s previously passed ban on abortions after 15 weeks.

Maine

Maine Democratic Governor Mills has formally introduced a bill to expand reproductive rights for women and access to abortion services in the state, allowing for abortions later in pregnancy beyond the point of fetal viability. The bill appears to have the votes for passage, as a majority of House members and Senate members co-sponsored the legislation.

Nebraska

Lawmakers advanced legislation that would ban abortion once cardiac activity can be detected in an embryo, which is generally around the sixth week of pregnancy and before most women even know they are pregnant. The bill will continue to be debated and could pass before the end of the legislative session.

New Hampshire

The penalties associated with New Hampshire’s 24-week abortion ban will remain in place after the state Senate killed legislation that would have removed them. The Republican-led Senate voted along party lines to reject a bill that would have removed the civil and criminal penalties from the 2021 ban on abortion after the 24th week of pregnancy. It also rejected adding an explicit right to abortion up to 24 weeks to state law. Both bills had passed the House, where Republicans hold a narrow majority.

Birth Control Access

Iowa Republican Governor Reynolds has backed a plan to allow residents who are 18 and older to receive birth control from a pharmacist without a prescription. The Republican-controlled Senate last month approved legislation to permit it. But the bill is moving through the statehouse as a rift is growing in the Republican Party over birth control, with some anti-abortion groups opposing access.

Transgender Care

Missouri

Missouri’s attorney general announced new restrictions on gender-affirming care for adults in addition to minors in a move that is believed to be a first nationally and has advocacy groups threatening to sue. Missouri Attorney General Bailey announced plans to restrict health care for transgender people weeks ago, when protesters rallied at the Capitol to urge lawmakers to pass a law banning puberty blockers, hormones, and surgeries for children. But the discussion was focused on minors, not adults.