This Week in Congress

House and Senate

The House and Senate returned to Washington this week to vote on debt ceiling legislation.

Fiscal Responsibility Act (FRA)

On May 31, by a vote of 314 to 117, the House passed the debt ceiling bill. On June 1, the Senate, by a vote of 63-36, also passed the legislation and sent it to President Biden’s desk for signature.  The President is expected to sign the legislation before the debt limit expires on June 5.

The package would claw back some unspent pandemic aid, redirect a portion of IRS funding for other uses, streamline energy permitting, end a pause on student loan repayments and toughen some work requirements for certain recipients of food stamps and cash assistance. A summary of the legislation can be found here

Disease Intervention Specialists Funding

There is much confusion as of this writing whether the FRA rescinds (cuts) the remaining $400 million available for the next two years for disease intervention specialists/contact tracers that was appropriated in the American Rescue Plan Act. If the FRA cuts the remaining $400 million appropriated for years 4 and 5, it will NOT impact years 1 through 3 of the DIS funding that has already been distributed to jurisdictions.  NCSD has advocated for full funding in the news media, with Congress, and with the administration. NCSD will continue to provide information as more details emerge.

Other Legislative Happenings from Around the Nation

New CDC Director

Mandy Cohen, former secretary of the North Carolina Department of Health and Human Services, is reported to be President Biden’s choice to lead the CDC. Cohen is known by many North Carolina families for her leadership through the COVID-19 pandemic, appearing in regular briefings with Governor Roy Cooper. Cohen would replace Dr. Rochelle Walensky, who is stepping down on June 30.

340B

The Office of Management and Budget on My 26 began its review of a CMS rule to repay hospitals for 340B drug pay cuts the Supreme Court deemed unconstitutional — a regulation hospitals had offered to work with CMS on to avoid more lawsuits. However, hospital stakeholders say they have no indication of how CMS plans to address the cuts. The CMS unified agenda post on the rule says: “In response to the Supreme Court decision in American Hospital Association v. Becerra, 142 S. Ct. 1896 (2022), CMS will issue a notice of proposed rulemaking regarding potential remedies affecting cost years 2018-2022,” but it does not say what those remedies might be. The U.S. District Court for the District of Columbia in January gave HHS first crack at coming up with how to repay 340B hospitals for years’ worth of pay cuts in light of the Supreme Court’s decision that the cuts were unconstitutional — much to the dismay of hospitals that had urged the court to require CMS promptly pay back providers. The American Hospital Association, which sued CMS over the 340B drug pay cuts along with America’s Essential Hospitals and the Association of American Medical Colleges, asked to meet with HHS officials as they put together the regulation and warned attempts by CMS to prospectively repay hospitals or to claw back funds from hospitals as it repays the 340B participants could lead to more lawsuits. AHA spokesperson said the group has met with HHS and the Department of Justice on the issue. America’s Essential Hospitals, meanwhile, told CMS in February it should not try to use a new acquisition cost survey to justify the past 340B drug pay cuts, nor should it look to recoup funds from some hospitals as it repays others. The Federation of American Hospitals has long warned against CMS unraveling the pay cuts by clawing payments back from hospitals or decreasing non-340B hospitals’ future pay.

Mpox

CDC Vaccine Briefing

On May 18, 2023, CDC held a briefing on the new mpox vaccine effectiveness data. The briefing was held by CDC’s Mpox response incident manager, Dr. Chris Braden and White House National monkeypox response Deputy Coordinator, Dr. Demetre Daskalakis, Eli Rosenberg, the Deputy Director for Science in the New York State Department of Health Office of Public Health and author of the New York MMWR. The briefing can be found here

US Cities

With Pride events planned across the country in the coming weeks, health officials and event organizers say they are optimistic that this year infections will be fewer and less severe. A bigger supply of vaccine, more people with immunity and readier access to a drug to treat mpox are among the reasons. But they also worry that people may think of mpox as last year’s problem. “Out of sight, out of mind,” said Dr. Demetre Daskalakis, who is advising the White House on its mpox response. “But we are beating the drum.” The article can be found here

UK Mpox Cases

The UKs Health Security Agency (HSA) has reported more mpox cases, all from London, and encouraged people to stay vigilant over the summer months. In a statement, the HSA said it received reports of 10 more cases over the past 4 weeks, putting the number for the year at 20. Half of the new cases were in unvaccinated people, and two in the group had received only one vaccine dose. Four patients likely contracted their infections abroad, and the source for one person is still undetermined. Officials urged eligible people who haven’t received their two vaccine doses to book the first dose by Jun 16 and the second dose by the end of July.

Abortion

Reproductive Health Poll

In a new poll, most respondents stated that they don’t trust the Supreme Court to decide cases related to reproductive and sexual health. Only 37 percent of adults said they trust the court “a lot” or “somewhat” to make the right decision on reproductive and sexual health, according to the poll released Friday by the Kaiser Family Foundation. The results come amid an ongoing lawsuit that seeks to undo federal approval of the common medication abortion pill mifepristone, and almost a year after the Supreme Court overturned Roe v. Wade.

Indianapolis

Supporters of an Indianapolis doctor voiced frustration this week with the Indiana medical board’s decision that she violated patient privacy laws when she talked with a newspaper reporter about providing an abortion to a 10-year-old Ohio rape victim. Some of Bernard’s colleagues criticized the Medical Licensing Board’s vote and the state attorney general’s pursuit of disciplinary action against her as trying to intimidate doctors in Indiana, where the Republican-dominated legislature enacted an abortion ban last year that courts have put on hold.

South Carolina

A South Carolina judge has temporarily blocked the state’s new law banning most abortions after fetal cardiac activity is detected, which is usually around six weeks of pregnancy. The injunction will remain in effect until the state Supreme Court can review the measure. The ruling comes just one day after the law took effect following Gov. McMaster’s (R) signature. The decision means the state will revert back to the previous law, which allows abortion up to about 20 weeks after fertilization.