Week of August 6th - 10th
Week of July 30th - August 3rd
- The Trump administration moved this week to freeze fuel economy and greenhouse gas emission standards for cars and trucks, undoing Obama-era rules that would have required automakers to steadily improve fuel efficiency and curb pollution. The administration is also seeking to revoke California’s authority to set stricter environmental standards, setting up a legal challenge.
- The House Energy and Commerce Committee sent letters to three major pharmaceutical companies whose products helped fuel the opioid crisis, seeking more information about kickback schemes to boost opioid prescribing and when companies learned their products were being abused.
- Representatives Rosa DeLauro, Jan Schakowsky, and Steve Cohen introduced legislation that would create a competitive grant program to fund health and nutrition education for children, with the goal of preventing diet-related chronic disease.
- Three cities are suing the Trump administration, alleging that President Trump is violating Article II of the Constitution, which requires the executive to “take care that the laws be faithfully executed.” In the case of the Affordable Care Act, these cities argue that the Trump administration has repeatedly attempted to undermine the law, including refusing to defend the law in court and President Trump’s frequently expressed desire to see the law fail.
- August 7 is the deadline to submit comments to the US Census Bureau opposing the Trump administration’s move to add a question about citizenship status. US Census Bureau data provides a wealth of information about who lives in the US, historically without regard to immigration status. This data is collected every 10 years and is used to determine political representation, distribute federal funding, and understand the demographics (including health status) of people living in the US. If adding a new question about citizenship status lowers the response rate among immigrants—as Census researchers warn it will—communities will lose political representation and federal funding for safety-net programs like Head Start, the National School Lunch Program, food assistance, Medicaid, Temporary Assistance for Needy Families, public transportation, special education grants, housing assistance, substance abuse treatment and prevention, social services for low-income children and domestic violence survivors, and much more. Click here to submit a comment using a template created by members of Public Health Awakened.
- Click here to read PI's weekly media digest for the week of July 30th - August 3rd.
Week of July 22nd - 27th
- On Thursday, the court-ordered deadline for the Trump administration to reunite separated families passed. Approximately 1,442 children between the ages of five and 17 have been reunited with their parents. Many of these parents (approximately 900) face final deportation orders within the next few days. At least 711 children who were separated from their parents remain in government custody, in the majority of cases because the US government deported their parents and now claims these families are “ineligible” or “unavailable” for reunification.
- Physicians and mental health professionals want Congress to hold hearings on the government’s treatment of migrant children who have faced medical neglect and child endangerment in immigrant detention centers.
- In a letter to Senate leadership, healthcare and advocacy groups urged a vote on bipartisan legislation to address the opioid crisis, expressing concern that “the cost of the opioid epidemic is too high to defer consideration of legislation. Every day that we put off action, we leave hundreds of thousands without treatment and recovery and put thousands of lives at risk." Politico warned earlier this week that the package of opioid legislation may “languish” past midterm elections given other priorities for Senate leadership, such as filling the open Supreme Court seat.
- August 3 is the deadline for all public housing units to go smoke-free.
- Click here to read PI's weekly media digest for the week of July 22nd - 27th.
Weeks of July 8th - 14th and July 15th - 21st
- The Department of Health and Human Services has spent at least $40 million in the past two months to detain and attempt to reunite migrant children separated from their families under the Trump administration’s family separation policy. These funds are being drained from existing HHS programs, including funds designated to address public health emergencies. An analysis by the Associated Press finds that detaining immigrant children has “morphed into a surging industry in the US that now reaps $1 billion annually – a tenfold increase over the past decade.”
- The House voted to go to conference with the Senate to craft a compromise on the farm bill. The version approved by the House would impose strict work requirements on some recipients, which the Senate version would not do. Current farm bill funding is set to expire at the end of September.
- Seema Verma, head of the Trump administration’s Centers for Medicare and Medicaid Services, announced that a federal judge’s decision to block the state of Kentucky from implementing new work requirements on Medicaid recipients will not affect the administration’s consideration of work requirement proposals by other states.
- This week, the Los Angeles County Board of Supervisors approved adding a measure to the November 2018 ballot that would fund a Safe, Clean Water Program for the county. If approved by voters, the ballot measure would implement a 2.5-cents per square foot parcel tax within the Los Angeles County Flood Control District to fund infrastructure projects that would make water supplies safer and more reliable; reduce polluted water runoff in streets, rivers, and at beaches; create more greenspace in neighborhoods; and generate jobs and career pathways.
Week of July 1st - 7th
- EPA administrator Scott Pruitt resigned on Thursday, in the wake of a series of ethics scandals. His interim replacement, Andrew Wheeler, has a background as a coal lobbyist and is expected to carry on Pruitt’s deregulatory agenda. Politico reports that Democrats are cautious about Pruitt’s replacement: "Pruitt's legal and ethical failures have overshadowed the Trump Administration's reckless assault on human health and the environment," said Rep. Frank Pallone, the ranking member of the House Energy & Commerce Committee. "The Trump EPA continues to undo critical health protections that safeguard our communities from dangerous chemicals and ensure Americans have safe drinking water and clean air."
- The Trump administration is facing a court deadline to reunite families, with children under the age of five required to be reunited with their parents by next Tuesday. In a conference call with reporters this week, with Department of Health and Human Services Secretary Alex Azar estimated that up to 3,000 children may still be in government custody. According to the New York Times, in hundreds of cases, parents and children have “no connection to one another” in federal databases.
- The Trump administration reversed Obama-era guidance on affirmative action in college admissions, instead warning colleges to consider race as little as possible in admissions.
- Last Friday, June 29, a federal judge blocked the state of Kentucky from implementing Medicaid work requirements, labeling the Department of Health and Human Services’ approval of the work requirement proposal “arbitrary and capricious” and citing HHS’s failure to evaluate whether recipients would lose coverage under the plan. This week, Kentucky’s Republican Governor Matt Bevin suspended dental and vision benefits for approximately 450,000 Medicaid recipients covered by the Medicaid expansion, which Bevin’s administration described as a cost-saving measure.
Week of June 24th - 30th
- The Senate and House released their Fiscal Year 2019 Labor-Health and Human Services-Education appropriations reports this week. The Senate version provides a $47 million boost to base funding for the Centers for Disease Control and Prevention and cuts $15 million from REACH (which was the amount allocated previously to the Good Health and Wellness in Indian Country program). The House version increases base funding for CDC programs by $427 million, which includes $300 million for an infectious disease rapid response fund. Full funding is maintained for REACH under the House bill. The House version also eliminates the CDC’s Climate and Health program (which is maintained at full funding in the Senate).
- A federal judge for the US District Court for the Southern District of California ordered the Trump administration to reunify separated immigrant families within 14 days for children under the age of five, and within 30 days for all children. As of earlier this week, the government reported that there were still over 2,000 children in federal custody.
- Justice Anthony Kennedy announced his retirement from the Supreme Court this week, effective July 31. Kennedy provided a swing vote on key cases relating to women’s reproductive rights (though Kennedy allowed many abortion restrictions to stand, effectively chipping away access to abortion, he defended the core of Roe v. Wade), gay rights (among other cases, Kennedy wrote the ruling affirming the right of same-sex couples to marry), affirmative action (Kennedy voted to uphold affirmative action in college admissions), racial discrimination (a more conservative court might require racial discrimination cases to prove intent, which would make it virtually impossible to enforce civil rights legislation), and criminal justice (Kennedy voted to ban the death penalty for juveniles). Kennedy’s announcement followed on the heels of several Supreme Court decisions that weakened public-sector unions and upheld President Trump’s travel ban, declined to strike down several racially gerrymandered districts in Texas, and struck down a California law that would have required crisis pregnancy centers – which do not provide abortions and frequently withhold information or present false information – to inform patients of their options for abortion care.
- A budget trailer bill passed the California State Legislature and was signed into law by Governor Jerry Brown this week, blocking cities and counties from passing new taxes on sugary drinks until 2030.
- Responding to a lawsuit filed by advocacy groups on behalf of 16 Medicaid beneficiaries, a federal judge from the U.S. District Court for the District of Columbia has blocked Kentucky from instituting Medicaid work requirements. The judge has vacated the administration’s approval of the waiver and remanded it back to HHS for further review.
- Click here to read PI's weekly media digest for the week of June 25th - 29th.
Week of June 18 - 24
- On Wednesday, in the face of rising public outcry, President Trump issued an executive order to stop the separation of immigrant families. The order suggests that the administration’s policy going forward will be to detain families together, which is expected to run afoul of the 1997 Flores ruling that children cannot be held in government detention for more than 20 days. An alternative would be dropping the “zero-tolerance” policy that criminally prosecutes undocumented immigrants for crossing the border. At this point, there are no public plans to reunite more than 2,342 children with their parents.
- On its second attempt, the House passed a Farm Bill that imposes stricter work requirements for the Supplemental Nutrition Assistance Program. No Democrats voted for the bill. The Washington Post reports that the SNAP provisions “are dead on arrival” in the Senate.
- House Republicans released a deficit-reduction plan this week that would force cuts over at least $302 billion over the next 10 years, including steep cuts to Medicare and Medicaid. Politico reports that the proposal potentially “lay[s] the groundwork for another repeal vote on Obamacare.”
- The House Appropriations Committee released the text of the FY 2019 Labor-HHS-Education Appropriations bill, which would cut the budget of the Centers of Disease Control and Prevention by $663 million. The CDC Climate Change program and Teen Pregnancy Prevention Grants, among other programs, were terminated. Let’s actually hold until next week when the text of the report is available giving more insights into the numbers.
- The Senate rejected taking up the Trump administration’s rescissions package, which would have cut $15 billion from the spending plan approved by Congress earlier this year.
- Surgeon and author Atul Gawande will lead the new healthcare company launched by Amazon, Berkshire Hathaway, and JPMorgan Chase to address rising healthcare costs among their one million total employees. “I have devoted my public health career to building scalable solutions for better healthcare delivery that are saving lives, reducing suffering, and eliminating wasteful spending both in the US and across the world,” Gawande said in a statement. “Now I have the backing of these remarkable organizations to pursue this mission with even greater impact for more than a million people, and in doing so incubate models of care for all.”
- On Tuesday, the Trump administration issued new rules to expand access among small businesses to association health plans that don’t meet Affordable Care Act coverage requirements. Attorneys general from New York and Massachusetts plan to sue the administration, arguing in a joint statement that the new rules will "invite fraud, mismanagement, and deception, and, as we've made clear, will do nothing to help ease the real healthcare challenges facing Americans… We believe the rule, as proposed, is unlawful and would lead to fewer critical consumer health protections."
- Click here to read PI's weekly media digest for the week of June 18th - 24th.
Week of June 9 - 17
- The US government continues to separate families at the border, and Attorney General Jeff Sessions issued a ruling last week that would make it almost impossible for asylum seekers who cite fears of domestic violence or gang violence to enter or stay in the US. This Department of Justice ruling fits into a broader pattern of immigration enforcement under the Trump administration designed to make it harder for people to claim asylum in the US and deter would-be immigrants from attempting to the enter the country by implementing extreme measures like separating parents and children. Public outcry over family separation is growing, while the White House falsely insists that only Congress can prevent family separation. The House is expected to vote on two immigration bills this week, neither of which would prevent family separation. The ‘compromise’ bill would extend citizenship to some Dreamers – or Deferred Action for Childhood Arrivals recipients – while adding new restrictions on family-based immigration and asylum seekers, and promising – though not appropriating -- $25 billion to build a wall along the US-Mexico border. The hardline immigration bill would provide only temporary legal status for Dreamers, with no route to citizenship; make overstaying a visa a criminal offense; and sharply cut family-based immigration.
- The House is spending two weeks voting on over 70 bills to address the opioid epidemic, with 35 bills having passed out of the House so far, including bills to expand access to substance misuse treatment, research non-opiate pain management options, and crackdown on imported illegal drugs.
- On Friday, June 15, a federal judge for the US District Court for the District of Columbia heard a legal challenge to Medicaid work requirements in Kentucky. The case was brought the Southern Poverty Law Center, Kentucky Equal Justice Center, and National Health Law Program on behalf of 16 Kentucky Medicaid participants, and argues that work requirements do not further Medicaid’s role as a safety-net healthcare coverage provider.
- Senate Majority Leader Mitch McConnell has until June 22 to bring the $15 billion rescissions package up for a vote in the Senate (the package passed the House earlier in June). As of June 19, no vote was scheduled.
- Click here to read PI's weekly media digest for the week of June 9th - 17th.
Week of June 3 - June 8
- The Trump administration is urging a Texas judge to dismantle two key provisions of the Affordable Care Act, community rating and guaranteed issue, which ensure that people with preexisting conditions receive coverage, arguing that these provisions are inseparable from the individual mandate, which will end in January 2019. Former Solicitor General Don Verrilli, who defended the Affordable Care Act before the Supreme Court in 2012, among other former members of the Department of Justice, expressed shock that the Trump administration will not defend a sitting law, stating, "The Department of Justice has a duty to defend federal laws when reasonable arguments can be made in defense of the law.”
- The Senate Agriculture Committee is slated to mark up the Senate version of the Farm Bill next week, which is not expected to make substantial changes to the Supplemental Nutrition Assistance Program. The House is likely to vote again on its version of the Farm Bill on June 22.
- Suicide rates in the US climbed almost 30% from 2009 to 2016, with nearly 45,000 deaths reported in 2016, according to the latest data from the Centers for Disease Control and Prevention. While the rates increased across genders, races, ethnicities, and age groups, the largest increase came among people age 45 to 64. “The National Strategy for Suicide Prevention calls for a public health approach to suicide prevention with efforts spanning multiple levels (individual, family/relationship, community, and societal). Such a comprehensive approach underscores that suicide is rarely caused by any single factor, but rather, is determined by multiple factors,” the CDC report notes. “In addition to mental health conditions and prior suicide attempts, other contributing circumstances include social and economic problems, access to lethal means (e.g., substances, firearms) among persons at risk, and poor coping and problem-solving skills.”
- Virginia became the 33rd state to expand Medicaid this week. The expansion will go into effect in January 2019, and approximately 400,000 Virginians are expected to be eligible for coverage. The state is also seeking a waiver from the Trump administration to implement work requirements, as well as co-pays and premiums from some beneficiaries.
- Click here to read PI's weekly media digest for the week of June 3rd - 8th.
Week of May 20-26
- On Thursday, May 24, Representative Barbara Lee introduced the Health Equity and Accountability Act, which seeks to eliminate health and healthcare disparities by changing policies and expanding federal healthcare resources to better address healthcare access and quality of care among racial and ethnic minorities, as well as populations that face discrimination and barriers to accessing health services due to immigration status, English-language proficiency, sex, age, ability, and sexual orientation. These efforts would include a focus on eliminating health inequities, protecting sensitive locations for immigrant communities seeking healthcare services, expanding culturally and linguistically appropriate healthcare and public health services, and training the healthcare workforce to better serve and more fully represent minority communities. Senator Mazie Hirono plans to introduce the Senate companion bill once it clears the legislative council. The Congressional Tri-Caucus described the bill as a “bold, comprehensive vision for addressing persistent ethnic and racial health disparities and improving health outcomes in communities of color.”
- Under the Housing spending proposal for the coming fiscal year, the Labor, Health and Human Services, and Education budget would be flat-funded at $177.1 billion, with details to come in late June. Representative Rosa DeLauro warned that medical research, opioid treatment and prevention, federal student aid, and other vital health and social services could face spending cuts under the House proposal. The Senate spending proposal would raise the Labor-HHS-Education budget by $2 billion.
- A House vote on the Farm Bill failed last week after the House Freedom Caucus pulled their support over a dispute within the Republican party on immigration policy. The House proposal that failed would have ended access to food benefits from millions of people by imposing stricter time limits and work requirements, and ending ‘categorical eligibility’ for the Supplemental Nutrition Assistance Program (SNAP). A second vote in the House is likely in late June.
- Last week, Senators Orrin Hatch and Marco Rubio introduced the Puerto Rico Economic Empowerment Act of 2018. As currently written, the bill would cut at least $4.3 billion from the Prevention and Public Health Fund.
Week of May 13-19
- The White House and outside conservative groups, including the Heritage Foundation, are planning to release a new proposal to repeal the Affordable Care Act later this month. According to a leaked summary, the plan would block grant state healthcare finances, and require states to spend at least 50% of funds purchasing private insurance for low-income residents; repeal the employer mandate; repeal ACA spending on the Medicaid expansion, cost-sharing reductions, and tax credits; allow short-term, barebones insurance policies that don’t comply with the ACA’s Essential Benefits to be renewed; and expand health savings accounts.
- The Trump administration announced changes to Title X family planning funding last week that would strip federal funding from clinics that provide abortions or refer patients for abortion services. “Federal family planning laws already ban direct funding of organizations that use abortion as a family planning method. But conservative activists and Republican lawmakers have been pressing Alex M. Azar II, the secretary of health and human services, to tighten the rules further so that abortions could not occur — or be performed by the same staff — at locations that receive Title X federal family planning money… Dawn Laguens, the executive vice president of Planned Parenthood Federation of America… said in a statement late Thursday, [that the policy] is ‘designed to make it impossible for millions of patients to get birth control or preventive care from reproductive health care providers like Planned Parenthood. This is designed to force doctors and nurses to lie to their patients. It would have devastating consequences across this country.’”
Week of May 6-12
- The White House released its rescission package this week, calling for $15.4 billion in spending cuts, including approximately $7 billion in cuts to the Children’s Health Insurance Program and $800 million from the Centers for Medicare & Medicaid Services Innovation Center. The House could vote on the rescission package as soon as the week of May 14, while the Senate grapples with a legal dispute over cuts to the Children’s Health Insurance Program.
- This week, the House Energy & Commerce Committee approved 25 bills to address the opioid crisis, ranging from substance misuse treatment to the development of alternative pain management techniques to public education campaigns around the risk of spreading infectious disease through injection drug use. On Monday, opioid distributors testified in front of the committee to discuss their role in the opioid crisis. Next week, the committee will take up another set of opioid bills.
- New Hampshire became the fourth state approved to implement work requirements for Medicaid recipients. Kansas’ proposal to instate lifetime limits on Medicaid was rejected by the Centers for Medicare & Medicaid Services. CMS administrator Seema Verma passed on the question of whether work requirements would apply to Native American tribes to the state level. Politico reported on the Trump administration’s “unpredictable” stance on Medicaid waivers: "They won't tell us what they will or won't approve until we apply. We're throwing spaghetti on the wall and seeing what sticks," said Utah state Sen. Daniel Hemmert, whose state has asked the Department of Health and Human Services to limit certain Medicaid enrollees' benefits in his state to five years, among other conservative changes. "We only get one toss per year, basically," he added. "To innovate within Medicaid, it's frustrating and slow."
- Menu labeling for chain restaurants, cinemas, and prepared foods went into effect on Monday, May 7, eight years after it first passed as part of the Affordable Care Act.
Week of April 29-May 5
- On Monday, May 7, the Trump administration is expected to ask Congress to cut $11 billion as part of their rescission efforts from old spending accounts that have been approved but not yet spent, potentially to include Affordable Care Act implementation funds.
- A new state health system scorecard from the Commonwealth Fund finds that deaths from substance misuse and suicide in the United States have spiked by 50% since 2005, with fatalities doubling in five states: Delaware, Ohio, New Hampshire, New York, and West Virginia. Preventable deaths more broadly are on the rise in every US state.
- The House Energy & Commerce subcommittee will continue its hearings on draft opioid legislation next week, looking at drug distribution and treatment, while the House Education and the Workforce Subcommittee on Workforce Protections and the House Judiciary Committee will take up other implications of the opioid epidemic. According to POLITICO, Congressional leaders are aiming to pass an opioid package by Memorial Day
Week of April 23rd
- The Department of Housing and Urban Development proposed raising monthly rent contributions for families in subsidized housing and encouraging housing authorities to implement work requirements for people receiving housing subsidies. The proposal would raise rents from 30% of adjusted income to 35% of gross income for most tenants, and would triple rent for the poorest families, who currently pay a minimum of $50 per month.
- The beverage industry is pushing an effort to place a constitutional amendment on the November 2018 ballot in California that would require any new taxes or fees to clear two-thirds supermajorities in the legislature or secure support from two-thirds of voters to enact new taxes or fees, such as taxes on cigarettes or sugar-sweetened beverages.
- The Trump administration may be “downsizing” its plan to cut federal spending to approximately $25 billion, according to Politico, which had previously reported that the administration was considering cuts of up to $60 billion. The administration is expected to submit its rescission proposal to Congress in May.
- The House Energy and Commerce Health Subcommittee and Senate HELP Committee both approved largely bipartisan proposals to address the opioid epidemic this week. Many of the proposals are modest in scale, focusing on expanding access to substance abuse treatment and telehealth services, increasing reimbursement rates for some treatments, and incentivizing the development of non-opioid methods of pain treatment, with no significant increase in resources available to address the epidemic.
- The Trump administration has rebuffed Native American tribes' requests for an exemption from proposed Medicaid work requirements. A group of senators warned that the administration's move could have "potentially devastating" for access to medical care, according to Politico.
Week of April 16th
- White House budget director Mick Mulvaney announced that he will propose spending cuts – also known as ‘rescissions’ – to modify appropriations in the $1.3 trillion omnibus spending bill that passed last month. Republican leaders in the Senate, including Appropriations Chairman Richard Shelby and Majority Leader Mitch McConnell have ruled out the possibility of spending reductions.
- Conservative think tanks are calling for another attempt to pass the Graham-Cassidy healthcare proposal, declaring that “Obamacare is broken and cannot be fixed, and there is a better way forward.” General consensus (extending to Senate Majority Leader Mitch McConnell) holds that Graham-Cassidy is unlikely to move forward.
- Vermont Senator Bernie Sanders has unveiled legislation, the Opioid Crisis Accountability Act, to create an opioid reimbursement fund to pay for Head Start, mental healthcare, and other programs within the Labor, Justice, and Education departments, and prohibit marketing of opioids that “suggests the drugs aren’t addictive.” Companies that run afoul would face penalties of up to 25% of profits.
- Click here to read PI's weekly media digest for the week of April 9th - 13th
Week of April 9th
- President Trump signed an executive order, ‘Reducing Poverty in America by Promoting Opportunity and Economic Mobility,’ calling on Cabinet secretaries to scrutinize their department’s social welfare programs and propose stricter regulations for eligibility, such as work requirements, cut funding, and give states more flexibility to administer these programs. Programs that may be affected include the Supplemental Nutrition Assistance Program, Medicaid, and low-income housing subsidies, among many other programs that support low-income people.
- The House Agriculture Committee released its draft Farm Bill on Friday, April 13, which includes changes to the Supplemental Nutrition Assistance Program that could result in millions of people losing access to benefits. The draft propose stricter time limits and work requirements for certain recipients. The bill would make more people subject to work requirements, eventually covering ‘nondisabled’ adults without dependents ages 18-59, and applying time limits to parents of children older than age 6. The bill would also limit states’ ability to waive work requirements and time limits when the unemployment rate rises. Additionally, the Farm Bill would end ‘categorical eligibility’ for SNAP, which currently streamlines access to SNAP and free and reduced-price school meals for low-income families in 40 states.
- Click here to read PI's weekly media digest for the week of April 9th - 13th
Week of March 23rd
- On Friday, Congress passed and President Trump signed an omnibus spending bill to fund the government through the end of September. We want to share an initial overview of a 2,323-page, $1.3 trillion spending package, recognizing that more in-depth analysis will emerge in coming days. Compared to earlier drafts of the House and Senate spending bills and the Trump administration’s proposed budget, prevention and public health fared better than expected, and non-defense spending is at its highest level since 2010:
- Public health and equity: After a strong push from advocates, Racial and Ethnic Approaches to Community Health (also known as REACH) -- which had been zeroed out in the House and Senate spending proposals, and in the Trump administration’s proposed budget -- has been funded at $50.95 million. Funding for the Centers for Disease Control and Prevention -- which had faced steep cuts -- will receive a $806 million boost. The Prevention and Public Health Fund is included at $800.9 million. The CDC Office on Smoking and Health will receive a $5 million increase over last year’s funding levels, to $210 million (the original House spending proposal had cut the Office of Smoking and Health by $50 million).
- Gun violence prevention: Lawmakers agreed that the CDC “has the authority to conduct research on the causes of gun violence,” clarifying language in the Dickey Amendment that states that “none of the funds… may be used, in whole or in part, to advocate or promote gun control,” a provision that has effectively barred the CDC from researching gun violence since 1996. The Fix NICS Act would strengthen federal background checks for gun purchases by incentivizing states to update the National Instant Criminal Background Check System. The STOP School Violence Act of 2018 focuses on school security.
- Opioids: The spending bill allocates over $4.65 billion to address the opioid epidemic, with funding going to Mental Health Block Grants and State Opioid Response Grants; opioid addiction research at the National Institutes of Health; overdose prevention, surveillance, and prescription drug monitoring at the Centers for Disease Control and Prevention; access to treatment in rural and underserved communities; mental health support services at the Department of Veterans Affairs; and other programs.
- Housing: The Department of Housing and Urban Development will receive a one-year increase in funding for housing vouchers; the Low Income Housing Tax Credit, which incentivizes development of affordable housing units; repair and maintenance of public housing; supportive housing for veterans, people with disabilities, and the elderly; lead abatement; homeless assistance programs; and other affordable housing measures. The Community Development Block Grant -- which funds local affordable housing and anti-poverty programs, and was zeroed out in the administration’s proposed budget -- is being nearly doubled to $5.2 billion.
- Education: The spending bill more than doubles funding for Student Support and Academic Enrichment grants, which had been eliminated in the administration’s proposed budget. These grants fund trauma-informed classroom management, mental health support services, and school violence prevention.
- Immigration: The spending bill does nothing to address the status of hundreds of thousands of Dreamers, participants in the Deferred Action for Childhood Arrivals program. The Congressional Hispanic Caucus urged lawmakers to oppose the spending bill: "It is indefensible for Congress to pass a spending bill that not only leaves DREAMers without permanent protections but also funds their deportations and those of immigrants with deep ties to their communities.” The spending bill does not defund sanctuary cities, despite pressure from the Trump administration to do so.
- Environmental protection: The spending bill maintains overall funding levels for the Environmental Protection Agency and adds $753 million to fundwater infrastructure improvements, accelerate clean-up activities at Superfund sites, among other activities.
- Healthcare: The final spending bill does not include funding to stabilize the Affordable Care Act marketplaces. Republican lawmakers had attached anti-abortion policy riders to ACA funding.
- A new director was appointed to head the Centers for Disease Control and Prevention this week. Robert Redfield is a virologist who researches HIV.
- Click here to read PI's weekly media digest for the week of March 19th - 23rd
Week of March 16th
- The Trump administration is finalizing an opioid strategy that reportedly includes capital punishment for some drug dealers. The full plan is expected to be released on Monday, March 19. The House Energy and Commerce Health Subcommittee will review approximately 25 bipartisan opioid-related policy proposals next week focusing on treatment and prevention approaches. Meanwhile, more than a year after Congress appropriated $500 million to help states address the opioid crisis, three-quarters of that funding remains unused. Politico reports that “the slow drip of dollars into communities hit hard by addiction shows the perils of Congress funneling money through a one-off approach rather than a longer, more stable commitment, state officials, addiction experts and treatment organizations say… ‘One-time money really changes the parameters of what you think you can fund,’ said Katie Marks, project director for the Kentucky Opioid Response Effort, where officials will receive $21 million in grants over two years. ‘Some of these programs are going to take a fair amount of development before they can sustain themselves.’”
- The $1.3 trillion spending package process is held up due to more than 100 policy riders pertaining to contentious issues like abortion, environmental regulations, and campaign finance reform. House Speaker Paul Ryan’s insistence that language prohibiting federal funding of abortion accompany any Affordable Care Act stabilization plan may sink the stabilization plan’s prospects.
- The Food and Drug Administration is considering setting a maximum nicotine level in cigarettes to reduce the product’s addictiveness, and is now accepting public comments on the proposal. An FDA-funded analysis published this week in the New England Journal of Medicine found that limiting nicotine to 0.4 milligrams per gram of tobacco filler could potentially lower the smoking rate among adults from 15% to 1.4%.
- Click here to read PI's weekly media digest for the week of March 12th - 16th
Week of March 5th
- The Trump administration instructed Idaho officials that the state must still uphold the Affordable Care Act, though Idaho can offer barebones health insurance plans for short-term use. Also this week, Health and Human Services Secretary Alex Azar expressed support for Republican proposals to let customers renew so-called “short-term” health plans beyond the 364-day limit previously proposed by the Trump administration.
- The House is likely to take up the $1.3 trillion omnibus spending bill next week, ahead of the March 23 expiration of the continuing resolution.
- Efforts to stabilize the Affordable Care Act insurance marketplaces are in jeopardy, as the White House pushes to add abortion restrictions to federal tax credits, raise premiums for older people, and expand short-term insurance plans that aren’t compliant with the Affordable Care Act.
- Final decisions about how to spend $286 million in Title X funding – which funds family-planning services at providers like Planned Parenthood -- will be up to a Trump administration official with a history of promoting abstinence-only education.
- Democrats and Republican members of the House Budget Committee are pushing the Congressional Budget Office to assess savings associated with preventive health efforts 20 to 30 years into the future, rather than the CBO’s usual 10-year projections.
- Department of Agriculture assistant to the secretary for rural development Anne Hazlett proposed various ways the next farm bill could address the opioid crisis in rural communities, such as expanding access to telemedicine.
- Representative Keith Ellison (D-Minnesota) replaced former Representative John Conyers as the primary sponsor of single-payer legislation in the House. In an interview with Politico, Ellison said, "We think that a single payer, Medicare-for-all style is the way to go… We've got to try to protect the Affordable Care Act, but we also have a duty to imagine a better health care system than the one we even have."
- Click here to read PI's weekly media digest for the week of March 5th - 9th
Week of February 26th
- This week, the White House hosted a summit on the opioid crisis, convening key stakeholders and families of those affected by opioid misuse and addiction. In an interview with NPR, Surgeon General Jerome Adams said, “My motto is better health through better partnerships…public health people will tell you, the number one touch point for individuals with mental health issues and substance use disorder, unfortunately, is the law enforcement community. So we cannot solve this problem, we cannot dig our way out of this epidemic unless we engage with law enforcement. I hope to work with law enforcement and help them understand that we need a public health-informed approach.”
- Democrats from the Senate’s Health, Education, Labor, and Pensions committee released a letter describing their wishes for the next Director of the Centers for Disease Control and Prevention.
- Twenty state attorneys general filed a new lawsuit challenging the Affordable Care Act. The brief argues that -- since the individual mandate has been effectively dismantled -- the ACA as a whole is no longer workable and should be struck down.
- Earlier this year, Kentucky became the first state to receive approval from the Trump administration to institute work requirements for able-bodied adults receiving Medicaid. Now, Kentucky Governor Matt Bevin estimates that implementing these work requirements will cost the state $200 million in the first six months alone.
- A Supreme Court ruling this week denied immigrants who are held in detention pending deportation proceedings access to periodic bond hearings, opening the door for indefinite detention of immigrants, including immigrants with protected legal status. In a separate ruling, the Supreme Court rejected the Trump administration’s attempt to fast-track the appeals process by asking the Supreme Court take up a California district court order that has kept the Deferred Action for Childhood Arrivals program functioning. This keeps DACA on “life support” as the case makes its way through the federal court system.
- Click here to read PI's weekly media digest for the week of February 26 - March 2.
Week of February 5th
- Congress passed and President Trump signed a budget deal on February 9th that will keep the government open through March 23, as well as raise the debt ceiling, increase domestic and defense spending over the next two years, extend funding for the Children’s Health Insurance Program (from six years to 10 years), renew funding for community health centers, increase funding for the National Institutes of Health, provide disaster relief and increased Medicaid funding for Puerto Rico, and funnel $6 billion to address the opioid crisis over the next two years. The bill cuts the Prevention and Public Health Fund by $1.35 billion over the next 10 years – but this cut is less severe than feared, and in fact restores some of the money that was cut from the Fund in the continuing resolution passed in December.
- Vox reported that the Trump administration is developing new rules that could deny immigrants the ability to stay in the US if their families use certain social services – services which immigrants and/or their US-born children are legally entitled to access. Social service programs under consideration include Head Start; the Children’s Health Insurance Program; the Supplemental Nutrition Assistance Program; Women, Infants, and Children food assistance program; housing support; Low-Income Home Energy Assistance Program; and more.
- The Department of Health and Human Services and the Treasury Department are expected to release new guidance on how states can restructure their health insurance marketplaces. Under the Affordable Care Act, states needed to show that their proposals would not sacrifice comprehensive coverage. The new guidance is expected to expedite the review process and loosen requirements that state waivers must meet. According to Politico, “the new guidance contains fewer references to protecting vulnerable populations like low-income individuals, elderly individuals and those with pre-existing conditions, according to those who've read the draft. The Obama administration's guidance on state waivers emphasizes the ACA's protections for these groups.”
- Click here to read PI's weekly media digest for the week of February 5 - 9.
Week of January 8th
Week of December 11th
- On Wednesday night, the House Appropriations Committee released a proposed continuing resolution that would fund the government through January 19, 2018, including reauthorizing the Children's Health Insurance Program for five years. This would be paid for, in part, by cutting $6.35 billion from the Prevention and Public Health Fund.
- The House and Senate have reached agreement on the tax bill which includes the repeal of the ACA’s individual mandate, resulting in destabilization of the healthcare marketplace according to health policy experts.
- The Senate Finance Committee will delay the confirmation hearing for HHS secretary nominee Alex Azar until January.
- The Federal Communications Commission ended net neutrality earlier this week. In response, Malkia Cyril, founder and executive director of the Center for Media Justice, outlined why net neutrality and an open internet matter, especially to low-income, rural, and/or immigrant communities, and communities of color: ““Movements fighting for rights and justice for these groups will suffer too from the slowing down and blocking of content and the preferential treatment that paid content is likely to receive over content that is free and available to the public. What happens to the Black voters of Alabama who surely used the open internet to turn the tide in that race? Or the #MeToo movement that used the open internet to speak truth to power? The movements against police violence and for a clean Dream Act will all suffer if they don’t have a fair and unbiased platform on which to speak.”
- Click here to read PI's weekly media digest for the week of December 11 - 15.
Week of November 27th
- Senate Republicans are likely hours away from passing tax overhaul legislation that repeals the Affordable Care Act’s individual mandate which would drive up insurance premiums and could result in 13 million more uninsured Americans according to the non-partisan Congressional Budget Office. The CBO has also found that even enacting the bipartisan ACA stabilization bill proposed by Senator Alexander (R, TN) and Senator Murray (D, WA) would not fully address the impact of repealing the individual mandate. Even if the Alexander-Murray legislation passes, repealing the individual mandate would still lead to insurance premium increases of 10% and 13 million more American uninsured by 2027 according to CBO estimates.
- The tax bill could trigger a Senate rule known as unless Congress takes direct action to waive the pay-go requirement. Under the pay-go rules, there could be cuts totaling as much as $150 billion per year across a swath of federal initiatives—from $25 billion cuts to Medicare annually to elimination of the Prevention and Public Health Fund. Ahead of the final tax vote, Republican leadership has vowed that they would work to waive these pay-go requirements, likely in the year end funding bill.
- Ahead of the December 8th deadline to renew government funding, Speaker Ryan (R, WI) has confirmed that the House will vote on two short-term funding bills: one through December 22nd and the other through the end of January.
- The Congressional Asian Pacific American Caucus, Congressional Black Caucus, and Congressional Hispanic Caucus (collectively known as the Tri-Caucus) organized a letter with 57 Members of the House of Representatives signed on to the House Appropriations Committee supporting full funding for the Racial and Ethnic Approaches to Community Health program.
- Click here to read PI's weekly media digest for the week of November 27 - December 1.
Weeks of November 6th and November 13
Week of October 30, 2017
- Later this week, the U.S. House of Representatives will vote on the Championing Healthy Kids Act, which would reauthorize overdue funding for community health centers and the Children’s Health Insurance Program, both of which expired at the end of September. The bad news is that this bill would pay for these programs by cutting the Prevention and Public Health Fund by 75%--and zeroing out all funding for the Prevention Fund from 2020 to 2026.
- The CHAMPIONING HEALTHY KIDS ACT (H.R. 3922) passed the House on Friday November 3rd in a close to party line vote of 242-174. The final bill reduced the proposed cut to the Prevention and Public Health Fund to the committee-approved level of $6.35 billion. Our colleagues at Trust for America’s Health have prepared the following helpful overviews that highlight the impacts of the proposed cuts to the Prevention Fund:
- Click here to read PI's weekly media digest for the week of October 30-November 3.
Week of October 23, 2017
While the bipartisan agreement reached by Senators Alexander (R, TN) and Murray (D, WA) to stabilize the ACA marketplace had been gaining momentum, President Trump has since indicated that the White House intends to focus on tax reform rather than healthcare right now. Senate Majority Leader Mitch McConnell (KY) had previously indicated that he will not bring the legislation to the floor unless there are clear indications it would be signed by the President which means that a deal to continue funding the cost sharing subsidies may be included as part of end of the year budget negotiations for FY18.
Senate Finance Committee Chairman Orin Hatch (R, UT) and House Ways and Means Chairman Kevin Brady (R-TX 8th District) have introduced their own bill which would also fund the cost sharing subsidies for two years. The Hatch-Brady bill intends to appeal more to Republicans concerned that there were not enough concessions in the agreement that Senator Alexander reached with Senator Murray—including eliminating the ACA;s individual mandate penalties through 2021, expanding the use of health savings accounts, exempting businesses from the employer mandate 2015-2017 and applying “pro-life protections” to the use of the cost sharing subsidies.
The Congressional Budget Office scoring of the Alexander-Muray bill to stabilize the ACA marketplace finds that the bill would cut the federal deficit by $3.8 billion and help keep insurance rates steady in 2019. The CBO concludes that it is too late for the bill to have an impact on 2018 insurance premiums or to have a substantive impact on the number of people covered.
President Trump has declared that the opioids epidemic is a public health emergency. Under a public health emergency declaration, which is narrower in scope than a national emergency declaration, agencies can reallocate existing resources and reduce “bureaucratic delays” in deploying personnel. However, the public health emergency declaration does not come with any additional funding and there are only $57,000 available through the HHS public health emergency fund.
Click here to read PI's weekly media digest for the week of October 23-27.
Week of October 16, 2017
- Senators Lamar Alexander (R, TN) and Patty Murray (D, WA) have reached a bipartisan agreement to stabilize the ACA marketplace and fund the cost sharing subsidies for two years. The White House has sent mixed signals about its support for the agreement.
- Click here to read PI's weekly media digest for the week of October 16-20.
Week of October 9th, 2017
- On October 10th, EPA Administrator Scott Pruitt announced a proposed rule to repeal the Clean Power Plan. The Clean Power Plan was designed to cut carbon pollution from existing power plants by 32% by the year 2030. The Supreme Court put a stay on implementation in 2015.
- The Trump administration issued two executive orders to alter the functioning of the Affordable Care Act health insurance exchanges and the quality and price of plans sold there.
o The first executive order would allow the sale of loosely regulated association health plans and short-term policies across state lines which would open the door to bare-bones health plans that don’t necessarily cover the essential health benefits required by the ACA. Policy experts have warned that such plans could harm the overall ACA marketplace by prompting younger, and healthier, members to select these cheaper plans, driving up premiums on the exchanges for those requiring comprehensive coverage.
o The second executive order would cut off cost-sharing reductions payments from the federal government to subsidize insurance plans for lower income Americans that are purchased on the exchanges. These payments reduce the out-of-pocket costs for low-income health exchange members and are considered critical to the overall stability of the ACA marketplace. Senator Lamar Alexander (R, TN) and Senator Patty Murray (D, WA) are heading up bipartisan healthcare negotiations that include addressing the feasibility of congressional appropriations for the cost-sharing reduction payments. President Trump has since indicated he would not sign a bill that only addresses the subsidies without movement on his own priorities, including repealing the ACA and funding the border wall.
- Previously in the month, the Trump Administration announced two new rules to roll back the ACA’s contraception coverage requirement by allowing virtually any employer to claim a religious or moral exemption from having to cover FDA-approved birth control as part of their employer health plans.
Week of September 25th, 2017
- Secretary of Health and Human Services Tom Price resigned on Friday September 29th and Don J. Wright will serve as acting secretary.
- Republican leadership cancelled a planned vote on the Graham-Cassidy healthcare bill this week ahead of the September 30th deadline to pass repeal with only 50 votes. The third GOP senator to oppose the Graham-Cassidy bill was Senator Susan Collins of Maine, who announced her plan to vote no on Monday evening immediately after the Congressional Budget Office released a partial score of the bill, anticipating that millions of people would lose insurance coverage and that federal spending on Medicaid would fall by approximately $1 trillion by 2026. Co-author Lindsey Graham vowed to reintroduce Graham-Cassidy in the future.
- Senate HELP Chairman Lamar Alexander (TN) and ranking member Patty Murray (WA) have resumed their discussions on a bipartisan framework to stabilize the healthcare exchanges. Discussions thus far include providing 2 years of funding through Congress for the cost-sharing reduction subsidies and allowing for state flexibility on the 1332 waivers.
- The Senate Budget Committee released their FY18 budget blueprint that includes budget reconciliation instructions to pave the way for tax reforms with only 51 votes. The reconciliation instructions allow the Senate Finance Committee to add up to $1.5 trillion to the deficit over the next 10 years and also instructs the Senate Energy and Natural Resources Committee to save at least $1 billion over the next 10 years.
- Under Secretary Price, the Department of Health and Human Services cut the open enrollment period for the healthcare exchanges by 1.5 months; cut funding to promote the exchanges and connect people with navigators who assist in enrollment by 90% and 40%, respectively; and plans to close the federal health exchange website for maintenance for 12 hours every Sunday during the open enrollment period.
- Amidst the ACA repeal debate, Congress has missed the September 30th funding deadline to renew funding for the Children's Health Insurance Program (CHIP). The House Energy and Commerce Committee won’t mark up their bill to renew funding for CHIP and community health centers until next week.
- The Food and Drug Administration has announced a proposed delay for the implementation of the revised Nutrition Facts label until January 2020, for large companies (annual sales over $10 million) and until January 2021, for small companies. A 30 day public comment period for this proposed rules change begins on October 2nd.
- Click here to read PI's weekly media digest for the week of October 9-13.
Week of September 18th, 2017
- There has been a lot of activity surrounding the Graham-Cassidy proposal to repeal the ACA:
- Senator John McCain (AZ) announced that he could not “in good conscience” vote for the Graham-Cassidy healthcare bill. Citing concerns about a lack of “hearings, debate and argument,” McCain said that “the issue is too important, and too many lives are at risk, for us to leave the American people guessing from one election to another about how they will acquire health insurance. A bill of this impact requires a bipartisan approach.”
- Three Republicans must oppose the bill for it to fail. Senator Susan Collins of Maine has indicated that she is leaning no but has not come out with an official decision. Likewise Senator Lisa Murkowski of Alaska could be a no vote as well. Senator Rand Paul (KY) has been sharing his opposition to the bill as well.
- Prior to Senator McCain’s opposition, the bill was slated to go to the Senate floor as early as September 26th or 27th.
- A bipartisan group of 10 governors wrote a letter to the Senate in opposition to Graham-Cassidy.
Week of September 11th, 2017
- A disaster relief package for Hurricane Harvey includes an extension to raise the debt ceiling and fund the government through December 8th. This prompts end-of-the-year negotiations that are likely to include legislative measures for DACA recipients.
- Affordable Care Act Updates:
- The budget reconciliation process that allows for repeal of the ACA this year through a simple majority expires on September 30th.
- Chairman Lamar Alexander (TN) and Ranking Member Patty Murray (WA) are leading bipartisan efforts through the Senate HELP Committee to put in an ACA stabilization plan in place by September 30th—including securing congressional funding for the cost sharing subsidies. The HELP Committee is holding a series of hearings to examine ACA stabilization fixes featuring testimony from state insurance commissioners (from OK, WA, TN, PA, and AK); governors (from MA, MO, CO, TN and UT); and discussions on state level flexibility.
- At the same time, Republican Senators Lindsey Graham (SC) and Bill Cassidy (LA) are set to unveil their own plan to repeal significant portions of the ACA in favor of $1.2 trillion in state block grants by 2026 state block grants. The Graham-Cassidy plan would eliminate the ACA’s individual and employer mandates, repeal some ACA taxes, and set Medicaid budget caps. The full bill is expected on Wednesday, September 13th.
- The Senate Appropriations Committee has marked up its Labor, Health and Human Services (LHHS) appropriations for FY 2018 (link to attached PDF). The Committee recommendation provides $7,175,211,000 for the CDC including $800,900,000 in transfers from the Prevention and Public Health Fund. Unfortunately the Racial and Ethnic Approaches to Community Health program (REACH) has been zeroed out from both the Senate and House LHHS mark-ups. Here is an updated Prevention and Public Health Chart FY16-18 (Source: Trust for America’s Health).
- Senate Democrats sent a letter to FDA Commissioner Scott Gottlieb asking the agency to ban menthol in cigarettes. The letter co-signers include Senators Murray (WA.), Reed (R.I.), Warren (D-Mass.), Van Hollen (MD.), Blumenthal (CO), Brown (OH), and Whitehouse (R.I.)
- After announcing another delay to the long-awaited implementation of nation-wide menu labelling, FDA Commissioner Scott Gottlieb has clarified that the rule will take effect in May 2018.
- The California Assembly has formed a new committee—the Assembly Select Committee on Health Care Delivery Systems and Universal Coverage—to explore universal healthcare after the previous single-payer effort (S.B. 562) was parked in committee earlier in the year.
On Wednesday, September 13, Senator Bernie Sanders, accompanied by 16 Democratic co-sponsors, released his plan for ‘Medicare for All,’ a proposal that would transform the health system into a single-payer system with the goal of achieving universal coverage. The bill would overhaul Medicare as it currently exists, expanding what’s covered, as well as eliminating premiums, deductibles, and co-payments, and would gradually lower the Medicare eligibility age over four years until everyone would be covered.
Week of September 4, 2017
- The Trump administration announced this week that it will phase out Deferred Action for Childhood Arrivals (DACA), a program that currently shields 800,000 young people from deportation, while providing access to temporary social security numbers, work permits, and higher education. This decision breaks trust with a generation of young people who have grown up in this country, and Prevention Institute calls on Congress to step in to protect the Dreamers and provide pathways to legal status for undocumented people who live in fear of detention and deportation, at great cost to their health and wellbeing. Communities don’t face challenges one at a time, and our most vulnerable communities – especially undocumented communities and low-income communities of color – face multiple and cumulative threats to their health and safety, from living on the frontlines of climate change to facing rising racism and xenophobia. Now more than ever, we need a unified approach to ensuring that all people and communities can be safe and healthy. Our partners at California Pan-Ethnic Health Network, Public Health Institute, and the California Endowment, and WeAreHereToStay shared opportunities to take action on behalf of and in partnership with Dreamers and immigrant communities.
- Click here to read PI's weekly media digest for the week of September 4-8.
Week of August 7th, 2017
- TalkingPointsMemo reported that organizations that previously allied with the Obama administration to enroll Latinos in the health insurance exchanges have not received any support from the Trump administration to continue their outreach programs. “Since Obamacare’s exchanges launched in 2014, a massive amount of work happened behind the scenes to spread the word to millions of uninsured Latinos so they could take advantage of the new coverage and to convince enough people to sign up to keep the insurance markets afloat. Much of that work happened in partnerships between the White House, HHS, and hundreds of partner groups. Latinos, who disproportionately lacked health insurance, were a key target of the Obama administration, which poured federal resources into education and outreach specifically aimed at Latinos.”
- President Trump announced Thursday that he will declare a national emergency over the opioid epidemic.
- Click here to read PI's weekly media digest for the week of August 7-11.
Week of July 31st, 2017
- After a proposed one-year delay met with fierce opposition from 15 state attorneys general, the Environmental Protection Agency backed away from the delay and announced that it will implement an Obama administration rule targeting ground-level ozone.
- Click here to read PI's weekly media digest for the week of July 31- August 4.
Week of July 24th, 2017
- The Senate failed to pass a healthcare bill that would have repealed parts of the Affordable Care Act (including the Prevention and Public Health Fund) early Friday morning, effectively quashing wholesale repeal efforts for the near future. There are reports that a bipartisan group of House members called the Problem Solvers has been meeting for the last month to work on ways to stabilize the ACA.
- The Senate voted 50-50, with Vice President Mike Pence casting the tie-breaking vote, to advance the motion to proceed on healthcare debate. As of Thursday, July 27, the Senate had voted on the Better Care Reconciliation Act (which failed to pass), and the Obamacare Repeal Reconciliation Act (previously passed by the Senate and vetoed by President Obama in 2015, which also failed to pass). Once debate concludes, members of both parties will be able to propose relevant amendments, followed by voting on amendments and a likely final vote on the so-called 'skinny repeal' plan, which would repeal the individual and employer mandates, end the medical device tax, and eliminate the Prevention and Public Health Fund.
- On Thursday, July 27, the American Public Health Association, Prevention Institute, Public Health Institute, Society of Public Health Education, and Trust for America’s Health issued a joint statement opposing repeal of the Prevention and Public Health Fund.
- Click here to read PI's weekly media digest for the week of July 24 - 28.
Week of July 17th, 2017
- Republican efforts to repeal-and replace the Affordable Care Act failed after Senator Lee (UT) and Moran (KS) joined Senators Collins (ME) and Paul (KY) in opposition to the Better Care Reconciliation Act.
- Leader McConnell announced that the Senate will vote next week on a “clean” repeal of the ACA instead (a repeal that does not offer a replacement option). The vote is expected to fail as Senators Collins (ME), Capito (WV), and Murkowski (AK) have already announced they will vote no which will take the total below the 50 threshold needed to pass.
- The House Appropriations Committee markup of the Labor/HHS Appropriations will take place on Wednesday. Here is the funding bill and committee report. A few CDC items to highlight under the House bill (Source: Trust for America’s Health):
- All $840.6 million available from the Prevention Fund is allocated to the CDC
- $1.04 billion is made available to the chronic disease center ($74 million cut), with rejection of the President's America's Health Block Grant proposal
- Elimination of the Racial and Ethnic Approaches to Community Health (REACH) program, while $16 million remains in funding for Indian Country
- The tobacco program is cut by $50 million
- Environmental health is cut by $21 million
- Climate change is zeroed out
- CDC preparedness program is increased by $45 million
- Click here to read PI's weekly media digest for the week of July 17 - 21.
Week of July 10th, 2017
- Senator McConnell delayed the start of August recess by 2 weeks to allow Republicans additional time to work on their legislative agenda—including ACA repeal, increasing the debt limit, and nominees still awaiting confirmation.
- Hopeful that they can vote on ACA repeal the week of July 17th, Senate Republicans unveiled revisions to their ACA repeal bill. The revised bill would:
- Maintain the repeal of the Prevention and Public Health Fund effective October 1st, 2017
- Keep more of the ACA’s taxes on the wealthy (including taxes on investment incomes, Medicare payroll tax on high-income taxpayers, and taxing some high earning health insurance executives);
- Direct an additional $100 billion towards the opioid epidemic and helping lower-income Americans afford coverage;
- Include an amendment authored by Senators Cruz (TX) and Lee (UT) that allows insurers to sell inexpensive plans that don’t meet the ACA’s essential coverage requirement provided they also offer separate plans that do meet these coverage requirements;
- Maintains significant cuts of over $700 billion to Medicaid and offers only minor changes to the originally proposed Medicaid overhaul including lifting caps on payments in the event of a health emergencies (e.g. a Zika outbreak); and
- Allow the use of pre-tax health savings accounts to pay for monthly premiums.
- The CBO will release the scores of the revised bill on July 17th (there will be one score that includes the Cruz-Lee amendment and one score that excludes it).
- America's Health Insurance Plans and The Blue Cross Blue Shield Association are amongst those in the healthcare industry that are opposing the Cruz-Lee Amendment. Allowing a secondary set of catastrophic plans that do not meet basic coverage requirements would likely destabilize and fracture the insurance market into separate risk pools that would significantly drive up costs and premiums for those purchasing more robust plans
- The House Appropriations Committee released their Labor Health and Human Services 2018 budget proposal which includes:
- A $1.1 billion increase to NIH ($8.6 billion more than the president’s budget request)
- $7 billion for CDC (a $198 million decrease from last fiscal year; the president’s budget request included a $1.3 billion cut to CDC)
- Maintaining the Prevention and Public Health Fund for the upcoming fiscal year (despite the fact that the Senate ACA repeal bill repeal the Fund effective the next Fiscal Year)
- Maintains the ban on the use of federal dollars to advocate for gun research
The Congressional Budget Office scored the Trump administration’s proposed budget and found that, contrary to the administration’s claims that the budget would eliminate deficits within 10 years, the budget would increase the deficit to $720 billion, while sharply cutting Medicaid, Social Security Disability Insurance, health, education, environmental protection, and social safety net programs like food assistance
Click here to read PI's weekly media digest for the week of July 10 - 14.
Week of July 3rd, 2017
- Congress is on recess for the week. The Senate returns on Monday July 10th and the House on Tuesday July 11th.
- On July 6th, 14 Senators from the Senate Health, Education, Labor and Pensions (HELP) Committee sent out a Dear Colleague letter on the Prevention and Public Health Fund along with fact sheets showing the impact of the Prevention Fund on all 50 states
- Based on current information, the Senate is not expected to take up the vote on the Better Care Reconciliation Act until at least the week of July 17th (and the potential vote could also be pushed further to the end of July).
- An analysis released by George Washington University’s Milken Institute School of Public Health and The Commonwealth Fund finds that if it becomes law, the Senate’s Better Care Reconciliation Act could lead to the loss of 1.45 million jobs across the U.S. by 2026 compared to the trends under the Affordable Care Act. There would be 919,000 fewer healthcare jobs in particular though job losses would be experienced across sectors. States that expanded Medicaid would suffer the greatest job losses.
- HHS Secretary Tom Price named Dr. Brenda Fitzgerald as director of the Centers for Disease Control and Prevention. Dr. Fitzgerald is an obstetrician-gynecologist and has been the commissioner for the Georgia Department of Public Health. She is the president-elect of the Association of State and Territorial Health Officials.
- Click here to read PI's weekly media digest for the week of July 7th 2017. Each week PI compiles a round-up of the latest public health-related news, with an eye toward media framing and language, particularly as they relate to the role of primary prevention. The views expressed in these articles do not reflect those of Prevention Institute.
- Click here to read PI's weekly media digest for the week of July 3 - 7.
Week of June 26th, 2017
- 22 million fewer Americans will be insured in 2026 if the Senate’s Better Care Reconciliation Act (BCRA) passes according to an analysis conducted by the nonpartisan Congressional Budget Office (CBO) and staff of the Joint Committee on Taxation (JCT).
- Following the release of the CBO score, more Republican Senators expressed their concerns with the BCRA prompting Leader McConnell to postpone the vote until after the July 4th recess to allow time to reconsider portions of the legislation (which would then require a new CBO score).
- President Trump nominated Dr. Jerome Adams, Indiana’s state health commissioner, to be the next Surgeon General. Dr. Adams is an anesthesiologist and has been at the forefront of Indiana’s efforts to address the opioid crisis—including advocating for needle exchange efforts in response to an HIV outbreak.
Week of June 19th, 2017
- Senate Republicans unveiled their discussion draft to repeal the Affordable Care Act on June 22, 2017. The Congressional Budget Office is expected to release their score of the bill on June 26th and a vote in the Senate is anticipated to be held between June 28th and June 30th. The Better Care Reconciliation Act of 2017 would:
- Repeal the Prevention and Public Health Fund starting in Fiscal Year 2018 (which starts October 1, 2017).
- Restructure Medicaid by converting the program into a block grant for states, a move that will sharply cut benefits and coverage. The bill also phases out the Affordable Care Act’s Medicaid expansion, which has been responsible for the greatest gains in insurance coverage under the ACA.
- Eliminate the ACA’s taxes on the wealthy.
- Shrink subsidies to help people afford health insurance, and prohibit subsidies from being used for plans that cover abortion services.
- Cut all federal funding from Planned Parenthood for one year.
- Remove the requirement that mid-size and large companies provide coverage to workers.
- Slash employment in the healthcare industry across the nation.
- Provide just $2 billion to states in 2018 to address the opioid crisis.
- Click here to read PI's weekly media digest for the week of June 19 - 23.
Week of June 5th, 2017
Week of May 29th, 2017
- Congress was on recess for the week.
- President Trump announced that the US will be withdrawing from the Paris Climate Agreement.
- Click here to read PI's weekly media digest for the week of May 29 - June 2.
Week of May 22nd, 2017
- 23 million fewer Americans will be insured in 2026 if the American Health Care Act (AHCA) passes, according to the nonpartisan Congressional Budget Office (CBO). And older adults (50-64) with incomes less than 200% of the federal poverty line would be disproportionately impacted.
- The Trump administration released their proposed FY2018 budget which includes significant cuts across agencies and programs that support the conditions for health—from health and prevention, education, and scientific research to environmental protection, housing and social services. The budget would cut over $1.2 billion from the Centers for Disease Control and Prevention (a 20% reduction), including eliminating the Racial and Ethnic Approaches to Community Health (REACH) program; the Prevention Research Centers; the Injury Control Research Centers; and the Elderly Falls program amongst others. CDC chronic disease prevention programs alone face cuts of $222 million. Under the President’s budget, greater responsibility shifts to states for chronic disease prevention through a new $500 million America’s Health Block Grant (funded entirely through the Prevention Fund) to “increase State, Tribal, and territorial flexibility on the leading chronic disease challenges specific to each State.” This amount is not nearly enough to cover the programs slated for elimination or deep cuts.
- Here are the budget numbers by agencies and departments: http://www.cnn.com/2017/05/23/politics/trump-budget-cuts-programs/Source:
- Environmental Protection Agency: 31.4% decrease
- State Department: 29.1 % decrease
- Corps of Engineers: 16.3% decrease
- Department of Labor: 19.8% decrease
- Department of Education: 13.5% decrease
- Housing and Urban Development: 13.2% decrease
- Department of Transportation: 12.7% decrease
- Department of the Interior: 10.9% decrease
- Department of Justice: 3.8% decrease
- Department of Defense: 10.1% increase
- Homeland Security: 6.8% increase
- Veterans Affairs: 5.8% increase
- The White House has requested another 90-day delay in appealing the lawsuit against the ACA’s cost-sharing subsidies. The cost-sharing subsidies are paid directly by the Administration to insurers to reduce the out-of-pocket expenses for eligible enrollees. A district court judge sided with House Republicans in their lawsuit against the Obama Administration contending that these payments are not allowed without an associated Congressional appropriation. The Trump White House is continuing the payments for the time being but has threatened to cut them off which would destabilize the ACA marketplace according to health plans.
- Click here to read PI's weekly media digest for the week of May 29 - June 2.
Week of May 15th, 2017
- The Trump administration will release its budget proposal on Tuesday May 23rd.
- The Congressional Budget Office and the Joint Committee on Taxation will release the score of the House-passed American Health Care Act which repeals the ACA on the afternoon of Wednesday May 24th. Because Budget Reconciliation is being used as the procedural tool to advance ACA repeal, the CBO must find that the American Health Care Act results in at least $2 billion in savings before the House can send it to the Senate. The House passed the American Health Care Act on May 4th without a revised CBO score.
- The Senate has held a brief initial meeting to discuss bipartisan options for advancing health reform. Attendees included Senators Collins (R, ME); Cassidy (R, LA); Heller (R, NV); Sullivan (R, AK); Graham (R, SC); Capito (R, WV); Manchin (D, WV); Heitkamp (D, ND); and Donnelly (D, IN).
- The FDA is delaying parts of the implementation of a rule to regulate e-cigarettes like other tobacco products. Additionally, FDA head Scott Gottlieb indicated a willingness to reconsider e-cigarette restrictions introduced under the Obama administration.
- Click here to read PI's weekly media digest for the week of May 15 - 19.
Week of May 8th, 2017
- Now that the American health Care Act has passed the House, the Senate has indicated that they will work on their own version of a repeal and replacement bill for the ACA. Senate Majority Leader Mitch McConnell has set up a repeal and replace working group that includes Senators Alexander (TN); Cruz (TX); Cotton (AR); Lee (UT); Gardner (CO); Portman (OH); Toomey (PA); Enzi (WY); Hatch (UT); McConnell (KY); Cornyn (TX); Thune (SD); and Barrasso (WY).
- Click here to read PI's weekly media digest for the week of May 8 - 19.
Week of May 1st, 2017
- The American Health Care Act (AHCA, H.R. 1628) narrowly passed the House of Representatives in a 217-to-213 vote. The bill now heads to the Senate.
- On May 5th President Trump signed H.R. 244: The Consolidated Appropriations Act of 2017 which funds the government through September 30th, 2017.
- Click here to read PI's weekly media digest for the week of May 1 - 5.
Week of April 24, 2017
- The first hundred days of the Trump Administration draws to a close.
- Lawmakers agree to a continuing resolution to extend federal funding for one week and avert a government shutdown while they continue appropriations negotiations.
- A new amendment to the American Health Care Act is finalized that would allow states greater flexibility to opt out of Affordable Care Act provisions such as requiring coverage for essential health benefits and pre-existing conditions, but the House vote has been delayed until next week at the earliest.
- The Food and Drug Administration submitted an interim final rule to the Office of Management and Budget that would likely delay implementation of the Affordable Care Act’s menu labeling requirement, which was scheduled to take effect next week.
- The Senate confirms Sonny Perdue as Secretary of the United States Department of Agriculture by an 87-11 vote. Perdue served two terms as Governor of Georgia.
- Scott Gottlieb's nomination for Commissioner of the Food and Drug Administration (FDA) advanced to the full Senate on a Senate Committee on Health, Education, Labor & Pensions vote of 14-9. Gottlieb previously served as the FDA Deputy Commissioner for Scientific Affairs from 2005 to 2007.
- Click here to read PI's weekly media digest for the week of April 24 - 28.
Week of April 17, 2017
- Congress is on spring recess this week.
- President Trump and congressional leadership reaffirm their commitment to repealing the Affordable Care Act (ACA) with a new amendment to the American Health Care Act that would allow states greater flexibility to opt out of ACA provisions. The legislation could be taken up as early as next week when Congress returns from recess.
- Lawmakers are still far from a deal to fund the federal government as they head into the final days of the current continuing resolution, which expires on April 28.
- The Trump administration announces 21st Century Cures Act grants totaling $485 million for states to address the opioid epidemic.
- The Trump Administration dismisses Surgeon General Vivek Murthy who was confirmed for a four-year term in December 2014.
- The White House announces its intent to nominate Elinore McCance-Katz, who previously served as the Chief Medical Officer at the Substance Abuse and Mental Health Services Administration, as the first Department of Health and Human Services Assistant Secretary for Mental Health and Substance Use.
- Click here to read PI's weekly media digest for the week of April 17 - 21.
Week of April 10, 2017
- Congress is on spring recess this week.
- The Center for Medicare and Medicaid Innovation announced 32 recipients of Accountable Health Communities cooperative agreement awards in the Assistance and Alignment tracks totaling $120 million.
- The Trump Administration lifted the federal hiring freeze while instructing agencies to make workforce cuts and produce cost savings in line with President Trump’s budget blueprint. The Department of Health and Human Services indicated it would maintain the hiring freeze, for now.
- After President Trump threatened to eliminate $7 billion or more in Affordable Care Act (ACA) subsidies in an attempt to bring Democrats to the table on ACA repeal, they responded by demanding that the subsidies be included as permanent mandatory spending in the next federal government spending bill.
- The White House announces its intent to nominate Stephen Parente, an economist at the University of Minnesota, to be an Assistant Secretary of Health and Human Services, Planning and Evaluation.
- Click here to read PI's weekly media digest for the week of April 10 - 14.
Week of April 3, 2017
- The Senate confirms the nomination of Neil Gorsuch to the Supreme Court by a 54-45 vote after a rule change vote that blocked a filibuster by Senate Democrats.
- The Trump administration renews efforts to repeal the Affordable Care Act but is unable to reach a deal with lawmakers ahead of spring recess. The House Rules Committee approves an amendment to the American Health Care Act that establishes a $15 billion risk-sharing program.
- For the first time, according to a new Gallup poll, a majority of Americans approve of the Affordable Care Act. A separate Kaiser Family Foundation poll finds that three in four Americans want the Trump administration to do what it can to make the Affordable Care Act work.
- The Senate Health, Education, Labor and Pensions Committee holds a confirmation hearing for Dr. Scott Gottlieb, nominee for Commissioner of the Food and Drug Administration.
- A coalition of Senate Democrats submitted a letter to Health and Human Services Secretary Tom Price demanding that he share the list of potential Affordable Care Act regulatory changes that were under consideration during repeal negotiations in March.
- Click here to read PI's weekly media digest for the week of April 3 - 7.
Week of March 27, 2017
- President Trump signed an executive order that begins to roll back several actions the Obama administration took to address climate change.
- President Trump issued an executive order to establish a Commission on Combating Drug Addiction and the Opioid Crisis to provide recommendations, by October 1, 2017, on how the federal government can address the opioid epidemic. The Commission will be chaired by New Jersey Governor Chris Christie.
- The Senate Agriculture Committee conducted a confirmation hearing for Sonny Perdue, former Governor of Georgia and President Trump’s nomine to the United States Department of Agriculture.
- Senator Heidi Heitkamp (D-ND) and Representative Danny Davis (D-IL-7) introduce the Trauma-Informed Care for Children and Families Act of 2017 (S 774 and HR 1757).
- Click here to read PI's weekly media digest for the week of March 27 - 31.
Week of March 20, 2017
- After determining that there were not sufficient votes to pass the American Health Care Act out of the House, Republican leadership pull the bill – which includes several recent revisions – just minutes before a key floor vote. This follows days, and weeks, of vigorous negotiations and debate.
- Separate from the budget blueprint that was released last week, the White House submitted to members of Congress a list of optional spending cuts totaling nearly $18 billion across multiple federal departments and agencies as lawmakers consider fiscal year 2017 appropriations. Proposed cuts include:
- $11 million ($19%) in new grants from the Office of Minority Health
- $100 million (20%) from the Substance Abuse and Mental Health Services Administration’s Mental Health Block Grant program
- Reductions to injury prevention, climate change, and tobacco control initiatives at the Centers for Disease Control and Prevention
- Elimination of US Department of Transportation’s $499 million TIGER grant program
- Elimination of US Department of Housing & Urban Development’s $125 million Choice Neighborhoods Initiative
- A Quinnipiac University poll finds that 56% of voters disapprove of the American Health Care Act, 17% of voters support the bill, and 26% are undecided.
- The Congressional Budget Office publishes an updated score on the revised American Health Care Act, which finds that an estimated 24 million additional people would by uninsured by 2026 compared to the current law and that the bill would save $186 billion less than the previous version.
- The Senate Agriculture Committee holds a confirmation hearing for George "Sonny" Perdue, former Governor of Georgia, to be Secretary of the United States Department of Agriculture.
- Congresswoman Eddie Bernice Johnson introduces the National Nurse Act of 2017, which would designate the Chief Nurse Officer position of the U.S. Public Health Service as “The National Nurse for Public Health.
- President Trump revoked an executive order issued by President Obama that required companies that contract with the federal government to adhere to 14 different labor and civil rights standards, including a broadened non-discrimination policy that covers race, color, religion, sex, sexual orientation, gender identity and national origin.
- Click here to read PI's weekly media digest for the week of March 20 - 24.
Week of March 13, 2017
- The American Health Care Act (AHCA) was passed out of the House Budget Committee by a 19-17 vote, sending the bill to the floor of the House where it is scheduled for a vote next Thursday. The AHCA would repeal large portions of the Affordable Care Act, including the Prevention and Public Health Fund.
- President Trump released a budget blueprint for fiscal year 2018, which would boost military spending by $54 billion while cutting domestic programs and foreign aid by the same amount. If enacted, cuts under this budget would include:
- Department of Agriculture: $4.7 billion (-21%)
- Department of Educations: $9 billion (-13%)
- Department of Health and Human Services: $15.1 billion (-18%)
- Department of Housing and Urban Development: $6.2 billion (-13%)
- Department of Labor: $2.5 billion (-21%)
- Department of Transportation: $2.4 billion (-13%)
- Environmental Protection Agency: $2.6 billion (-31%)
- The White House announced the selection of Eric Hargan as Deputy Secretary of the US Department of Health and Human Services (HHS). Hargan help a number of positions at HHS from 200 to 2007, including as Acting Deputy Secretary under President George W. Bush.
- The Senate confirmed Seema Verma as Administrator of the Centers for Medicare & Medicaid Services. Verma developed an alternative model for Medicaid expansion in Indiana that requires enrollees to pay into health savings accounts, incorporates work requirements for enrollees, and encourages greater use of private insurers to manage enrollees' care.
- The Congressional Budget Office (CBO) and Joint Committee on Taxation (JCT) released their cost analysis of the American Health Care Act (AHCA), which estimates that 14 million people would lose healthcare coverage in 2018 and another 24 million would be uninsured within the next decade, if the bill becomes law. CBO and JCT also estimated that the AHCA would cut $880 from Medicaid over a decade. The AHCA would repeal large portions of the Affordable Care Act, which reduced uninsurance rates to a record low (enabling about 20 million people to gain coverage) by expanding Medicaid, among other provisions.
- Click here to read PI's weekly media digest for the week of March 13 - 17.