Appropriations

During the week of November 1, 2021, there is a meeting scheduled between House and Senate Appropriations Chairs DeLauro and Leahy and Ranking Members Granger and Shelby to begin discussing ways to move forward with the fiscal year 2022  appropriations conference. The holdup is a disagreement on how much to spend for all 12 bills and how to split the funds between defense and domestic accounts. The Senate bills include a five percent increase for defense with domestic spending recommendations increasing by 13 percent. The House bills recommend a two percent increase for defense with a 16 percent increase for domestic programs, which is more in line with the President’s budget request. Senate Appropriations Ranking Member Shelby said it would take a miracle to have a deal before the current continuing resolution (CR) expires on December 3. Representative Cole, Ranking Member on the House Labor-HHS Subcommittee stated that he expects a CR into early 2022.

Reconciliation

Reconciliation Framework

On October 28, 2021, President Biden released the framework for his Build Back Better Plan. In place of the original $3.5 trillion plan, the scaled down version includes approximately $1.75 trillion. The legislation would overhaul the country’s health care, climate, education, and tax laws and includes new spending to enhance childcare, free prekindergarten to all American families. The legislation is still being drafted and is not expected to see House or Senate floor action for a week or two.

Health Care Infrastructure Workforce

The framework package includes $7 billion in funding to support core public health infrastructure activities to strengthen the public health system through grants to state, territorial, local, or Tribal health departments, and expanding and improving activities of the CDC. Activities eligible for the funding include: health equity activities; workforce capacity and competency; epidemiology and disease surveillance; contact tracing; all hazards public health and preparedness; testing capacity, including test platforms, mobile testing units, and personnel; health information, health information systems, and health information analysis; policy and communications; financing; community partnership development; and relevant components of organizational capacity.

Other Legislation and Happenings Around the Nation

Abortion

The Supreme Court will hear arguments on November 1, 2021, on two different challenges, one brought by abortion providers in Texas and the other by the Justice Department. Both challengers said the law, which bans most abortions after six weeks of pregnancy, is at odds with Roe v. Wade, which prohibits states from banning abortions before fetal viability, or around 23 weeks. The Texas law, which has been in effect since Sept. 1, makes no exceptions for pregnancies resulting from incest or rape, bars state officials from enforcing it and instead deputizes private individuals to sue anyone who performs the procedure or “aids and abets” it. The Supreme Court refused to block the law on Sept. 1 in a divided 5-to-4 ruling.

Vaccines

A Fourth Shot for Immunocompromised
The CDC updated its COVID-19 booster recommendations on October 27, 2021, to clarify that certain immunocompromised patients, aged 18 and older can receive a fourth dose of any of the  FDA-authorized or approved mRNA vaccines for optimal protection against coronavirus.

Vaccines for Kids
On October 26, 2021, the FDA’s Vaccines and Related Biological Products Advisory Committee voted 17-to-0 in favor of authorizing the Covid-19 vaccine made by Pfizer and BioNTech for children ages 5 to 11. As early as today, the FDA is expected to approve an emergency use authorization for the vaccine for the 5 to 11 age group. The process will then move to the CDC Advisory Committee on Immunization Practices where a meeting is scheduled for November 2 to make its recommendation followed by a final sign off by the CDC Director. Shots in arms could begin as early as November 3. Vaccines will be distributed at doctors’ offices, hospitals, pharmacies, community health centers, and school- and community-based sites.