Appropriations

On November 2, the House and Senate Chairs and Ranking members of the Appropriations met to discuss top line spending for all 12 subcommittees, how to divide the funding between defense and non-defense, and language on abortion, immigration, and numerous other policy riders. No agreement was reached on funding or any of the policy provisions. Senate Appropriations ranking member Shelby, R-Ala., said the “impasse will lead Congress to extend funding past Dec. 3 with another CR. Then, if there’s no progress, then we could be headed for a year-long CR. A lot of people would like that. One, that keeps all the riders off (abortion, immigration, etc.). That strategy would  prevent Democrats’ new policy provisions and extraneous matters from taking effect.” But a yearlong CR would block defense spending funding increases, and Republican earmarks in the proposed legislation. “I know we have heard a lot from the defense industry that if we go to a CR, that is a huge cut for them,” Senate Appropriations Chair Leahy stated. House Appropriations Chair DeLauro said “Democrats want to negotiate spending levels first, then work through the conference process to debate policy. The issue is we have not had a counterproposal from Republicans.”

Build Back Better and Bipartisan Infrastructure Legislation

Today, after months of negotiations, the House plans to vote on two landmark pieces of legislation – the Build Back Better Act and the Bipartisan Infrastructure Investment and Jobs Act. After the Houses vote, the Bipartisan Infrastructure Act will go to the President for signature. But Build Back Better still faces major hurdles and is expected to be amended by the Senate. After Senate passage then bill will then need to back to the House for another vote before going to the President for signature. The $1.75 trillion package marks a dramatic shift toward boosting support for families with children. Senate Majority Leader Schumer (D-N.Y.) said he hopes to pass the legislation in the Senate before Thanksgiving. But even that schedule may be ambitious. Sen. Joe Manchin (D-W.Va.), who has fought to trim the size of the package, continues to object to provisions favored by the House, such as paid family leave and immigration. He also said he wants a clearer assessment of the impact of the expansive tax and spending package on inflation and debt. “I have a lot of concerns, let’s put it that way,” Manchin said.

The revised bill text can be found here

The revised summary can be found here

Other Legislation and Happenings Around the Nation

Abortion

On November 1, 2021, a majority of Supreme Court justices seemed willing to allow a challenge brought by abortion providers to the Texas law that bans most abortions after six weeks of pregnancy and allows enforcement by private citizens. The court’s three liberal justices have already said they believe that the law is unconstitutional and that it should be halted until federal courts can look at it more closely. The court, in a 5-to-4 vote, turned down that option before the law went into effect on September 1, 2021. Justices Kavanaugh and Barrett surprised the audience when they sounded receptive to the arguments that opponents have leveled against Texas’ abortion ban. A decision on the case could be announced in the next several weeks.

COVID-19

Vaccines for kids 5 to 11: On November 2, the CDC approved the Pfizer-BioNTech vaccine for children ages 5 to 11. The CDC’s approval followed the FDA’s recommendation. Walgreens and CVS are accepting online appointments for children in that age group. Walgreens and CVS will begin administering the pediatric doses at thousands of stores nationwide starting on November 6.

OSHA Standards for Vaccinations:  On November 4, 2021, the Occupational Safety and Health Administration released its emergency temporary standard which will require with companies with 100 or more workers to mandate vaccinations for all employees. Workers who refuse to get vaccinated must undergo weekly testing. The link below to contains a variety of documents to help explain the standard. The standard goes into effect on December 5, 2021, with workers required to be vaccinated by January 4. The regulation does not require employers to pay for tests, which means workers could be charged.

More details of the OSHA standard can be found here 

Safety-net STD clinics see change in patients

Those who seeks care at public clinics that test and treat people for sexually transmitted diseases has shifted over the last decade, a new CDC analysis reports. From 2010 through 2018, visits to 14 clinics in five cities (Baltimore, New York City, Philadelphia, San Francisco, and Seattle) fell by 30 percent but not in all groups: They dropped 42 percent in men who have sex with women and 51 percent in women (66 percent from women age 15 to 24), but jumped 44 percent in men who have sex with men. The researchers note that funding cuts have affected some clinics and the Affordable Care Act may have improved access to care elsewhere. Some people say they continue to use public clinics because they want to keep STD testing private, value their providers’ expertise, or prefer their inclusive care.

Syphilis

On November 1, National Public Radio, Morning Edition, broadcast a news item entitled: “Syphilis is resurging in the U.S., a sign of public health’s funding crisis.” The broadcast interviewed Mai Yang, a communicable disease specialist, regarding her search for a pregnant woman who tested positive for syphilis, in order to get her treated before she delivered her baby. Ms. Yang discussed the alarming US rates of more than 129,800 syphilis cases recorded in 2019, double the case count of five years prior. During the same time period, cases of congenital syphilis quadrupled: 1,870 babies were born with the disease; 128 died. Case counts from 2020 are still being finalized, but the CDC has stated that reported cases of congenital syphilis have already exceeded the prior year. Black, Hispanic and Native American babies are disproportionately at risk.

David Harvey, executive director of the National Coalition of STD Directors said in the broadcast, ”We have a long history of nearly eradicating something, then changing our attention, and seeing a resurgence in numbers,” “We have more congenital syphilis cases today in America than we ever had pediatric AIDS at the height of the AIDS epidemic. It’s heartbreaking.” When discussing the closure of health care clinics Harvey stated, “many STD clinic were shuttered in 2010 amid the Great Recession. Many others have vanished since the passage of the Affordable Care Act. Health leaders thought “by magically beefing up the primary care system, that we would do a better job of catching STIs and treating them. That hasn’t worked out; people want access to anonymous services, and primary care doctors often don’t have STDs top of mind.”

The article and broadcast can be found here