Appropriations

Spending Caps

This week appropriations Chairs DeLauro and Leahy and Ranking Members Shelby and Granger met to begin discussions on top line numbers for the FY’23 appropriations bills. Chair DeLauro stated that it was an initial meeting and that there will be several more.  After the meeting, Senator Leahy stated that the leaders could reach agreement on a spending ceiling within weeks.  Senate Ranking Member Shelby emphasized the need for a defense spending increases in light of expected inflation. Other key Republicans, including Senate Armed Services Committee ranking member Inhofe have said the defense figure should be 3-5% higher than the rate of inflation.

Ukraine Supplemental

The White House has requested $33 billion in security, economic, and humanitarian aid for Ukraine.  Within the funds requested, $20.4 billion is for additional security and military assistance and for U.S. efforts to strengthen European security in cooperation with NATO allies and other partners in the region. Congress previously appropriated $13.6 billion for Ukraine on March 15. Read a summary of the supplemental request.

Lend-Lease

This week the House passed a bill that would streamline the process for lending and leasing weapons to Ukraine. The bill allows the President to lend or lease defense equipment to Ukraine for fiscal year 2022 and 2023, and also cuts bureaucratic red tape to make sure equipment is delivered quickly. The legislation is named for the revival of a World War II era program that helped supply allies in the fight against Nazi Germany. The Senate passed the bill earlier this month.  Both chambers agree on the need to send a clear message to President Putin that the US will supply Ukraine with the resources it needs to defend itself.

Immigration/Title 42

Local officials are expecting a surge of migrants crossing the border from Mexico after the Title 42 policy – implemented by the Trump administration as a public health measure during the pandemic to keep migrants seeking asylum out of the U.S. – is lifted on May 23. Immigration and Customs Enforcement and Customs and Border Protection officials are concerned that if the policy is lifted, they could run out of money to handle the surge as soon as July.  It is unclear if the White House would make a formal request for additional border dollars as part of the Ukraine package or separately. Some lawmakers were discussing the possibility of combining aid to Ukraine and COVID-19 relief — which stalled before the April recess over the Title 42 issue — into a single supplemental bill. But Senate Minority Whip Thune said Republicans want the two packages considered separately.  This week a federal judge in Louisiana issued a temporary restraining order against the Biden administration, forbidding it from moving ahead with its plan to end Title 42, the pandemic-era border policy.

Transgender Sports

House Republicans lawmakers signed a petition to force a vote on legislation — “Protection of Women and Girls in Sports Act — which was introduced by Rep. Greg Steube (R-Fla.) in January 2021.  The bill would ban transgender women and girls from playing on sports teams that match their gender identity. Nine lawmakers led by Rep. Jim Banks (R-Ind.) submitted the petition to release the bill from the Education and Labor Committee which would permit the House to take up the bill for a floor vote.

Other Legislation and Happenings Around the Nation

STD Rates

This week, USA Today published an article “Something needs to change: As STD rates rise, doctors sound alarm on messaging.”  The article stated that cases of sexually transmitted diseases reached an all-time high for the sixth consecutive year in 2019 and though those numbers appeared to decline a bit in 2020, public health experts believe the pandemic helped obscure some of that total. “With STD rates climbing, the country needs to take the STD crisis seriously and change its approach to reverse the trend.” Who is to be held accountable? What are we going to do differently in this country to lower STD rates? Something needs to change.” said David C. Harvey, executive director of the National Coalition of STD Directors. The most recent CDC data, which goes through the end of 2020 and was released this month, shows: Reported cases of gonorrhea increased 10% compared to 2019. Reported cases of primary and secondary syphilis increased 7% compared to 2019. Syphilis among newborns increased 15% from 2019; congenital syphilis has increased by 235% since 2016. Cases of chlamydia dropped 13% from 2019.  Young people ages 15 to 24 accounted for over half of reported cases. Mr. Harvey said tackling the STD epidemic would take increasing “prevention and care dollars to reach Americans at risk” and educating people on condom use. State and local health departments, Harvey added, should receive resources and support from a federal level to allow for a localized approach that suits communities. “This is not a one size fits all approach. The CDC must change how it’s responding to this out-of-control crisis.” The CDC recommends men who have sex with men be screened for HIV at least once a year and everyone who is pregnant be screened for syphilis, HIV, hepatitis B and hepatitis C starting early in pregnancy. Many STIs are asymptomatic, so regular screening is important, said Dr. Philip A. Chan, an infectious physician and an associate professor at Brown University. “It’s important to be screened because these other STIs really can have some pretty profound health complications,” Chan said. “Not in everyone, but in a subset of people; gonorrhea and chlamydia, for example, can cause infertility.”

Data to Reduce Health Disparities

The Health Resources and Services Administration will make nearly $90 million in American Rescue Plan funding available to help health centers collect better data to identify and reduce health disparities. The data modernization initiative is intended to improve data quality reporting for health centers.  Secretary of Health and Human Services Becerra stated that this funding, “will further enable health centers to utilize data to meet the needs of their community and help reduce gaps in care.” More than 90 percent of HRSA-funded health center patients are individuals or families living at or below 200 percent of the federal poverty guidelines. Nearly 63 percent of them are racial or ethnic minorities.

Abortion

The 5th U.S. Circuit Court of Appeals formally ended a legal challenge against Senate Bill 8, Texas’ six-week abortion ban enacted on Sept. 1, which is considered the most restrictive abortion law since Roe vs. Wade was decided in 1973. The federal challenge is remanded to the district court with instructions to dismiss all challenges to the law’s private enforcement provisions. The federal challenge was doomed after the 5th Circuit sent the case to Texas Supreme Court regarding a question on whether or not state medical licensing officials could reprimand providers who violate SB 8. The state’s high court said the law did not allow such enforcement.

The Oklahoma legislature approved a Republican bill to outlaw abortions after six weeks of pregnancy. The bill would immediately cut off most abortion access in a state that has absorbed nearly half of all Texas patients who have traveled out of state for abortions since Texas enacted a similar law last fall. The bill, which makes exceptions for medical emergencies but not for rape or incest, now goes to Gov. Kevin Stitt (R), who is expected to sign it.

LBGTQ Discrimination

Kansas lawmakers sustained Gov. Laura Kelly’s (D) veto of two bills accused of being discriminatory against LGBTQ+ people in the state. One of them, a transgender athlete ban, would have barred transgender women and girls from competing on school sports teams consistent with their gender identity. The other would have established a Parental Bill of Rights allowing parents to challenge classroom materials inconsistent with their personal beliefs. The state House of Representatives on voted to sustain Kelly’s veto of Senate Bill 160 – officially titled the “Fairness in Women’s Sports Act” – that would have required public schools from the elementary to the university level to designate sports teams by “biological sex,” or a student’s sex assigned at birth.

COVID-19

Infections

Nearly 6 in 10 people in the U.S. — including 3 in 4 children — have now been infected with Omicron or another coronavirus variant, according to the CDC. The new findings highlight just how widely Omicron has spread in the country. Before Omicron took off in the U.S. in December, about 1 in 3 people had been infected.

Deaths

More than two years after recording its first Covid-19 death, the U.S. is soon to reach one million deaths attributed to the disease, according to the CDC. The Covid-19 mortality count—over 990,000 and still rising—is reflected in death certificates recorded by the CDC. Of these certificates, at least 90% list Covid-19 as the underlying cause of death, the CDC said. The remainder list the disease as a contributing cause.

Vaccines for Kids

This week Moderna formally asked the FDA to authorize its Covid-19 vaccine for children under the age of 6. A top official at the company said it would finish submitting data to regulators by May 9. The submission steps up pressure on federal regulators to authorize a vaccine for the nation’s youngest children. Parents of the roughly 18 million youngest Americans, the only population group not yet eligible for vaccination, have been increasingly vocal about their frustration with delays, and members of Congress have been asking the F.D.A. why it can’t move faster. The request comes a month after the drug company signaled its two-dose regimen generated immune protection in the youngest children comparable to young adults, and amid growing impatience from lawmakers and parents for the administration to greenlight a vaccine for the nation’s youngest children.  Also this week the FDA will release a “tentative timeline” next week showing when the agency plans to hold advisory committee meetings on manufacturers’ applications to make Covid-19 vaccines available for emergency use in children under 5. Officials are considering waiting to authorize those pediatric vaccines until early summer so they can make two options — one by Pfizer-BioNTech and one by Moderna — available to children simultaneously. “Simply making a vaccine available doesn’t matter if parents don’t get their kids vaccinated,” Peter Marks, the head of the agency’s Center for Biologics Evaluation and Research, said during a Senate Health Committee hearing on FDA user fees. “So it’s critically important that we have the proper evaluation so that parents will have trust in any vaccines that we authorize.” Marks suggested that Pfizer and Moderna have yet to complete their applications, though he wouldn’t comment on their status when pressed by Senate HELP Committee Chair Patty Murray. “I would direct you to the fact that the manufacturers generally will make an announcement when they have a full and complete application in with us for emergency use,” he said. “But you can surmise what the situation is, because we will proceed with all due speed once we have complete applications.”

Treatment

The  White House unveiled new steps to make the highly effective COVID-19 treatment pills from Pfizer more widely available, saying more lives could be saved if use of the pills increases. To boost availability, the administration announced that the number of sites where the pills are available would soon increase from 20,000 to 30,000, and that it will work with pharmacies to increase that number to 40,000 “over the coming weeks. The FDA also gave its first full approval for a COVID-19 treatment for children under 12. The agency granted approval to the treatment remdesivir, also known as Veklury, made by Gilead Sciences, which has already been approved as a treatment for adults.

Hepatitis

Health authorities are investigating potential links between the pandemic and an outbreak of acute hepatitis that’s sickened children in the U.K., the U.S. and other countries. The U.K. has detected adenovirus, a family of pathogens that cause a range of illnesses including the common cold, in three-quarters of the cases of the liver-inflaming disease. Now they’re studying whether a lack of prior exposure to adenoviruses during pandemic restrictions or a previous infection with SARS-CoV-2 or another virus may be related.