Both chambers of Congress have adjourned for the Memorial Day Recess. The Senate will resume voting on Monday, June 7, picking up consideration of the Endless Frontier Act after last-minute disagreements delayed final passage. Senators were unable to advance the $100 billion technology innovation package as previously planned last week after a group of GOP Senators \u2014 led by Sen. Ron Johnson (R-WI) \u2014 held up final votes over disagreements on the amendment process. <\/p>\n\n\n\n\n\n\n\n
Meanwhile, Senate\nMajority Leader Chuck Schumer (D-NY) penned a \u201cDear Colleague\u201d letter<\/a> outlining the\nmonth ahead in the chamber prior to wrapping up the May legislation. Leader\nSchumer announced that Senators will take up legislation pertaining to paycheck\nequity, voting & election reform, gun safety, and LGBTQ equality. The\nSenate will also continue its push to confirm President Joe Biden\u2019s pending\njudicial nominations. <\/p>\n\n\n\n In the House,\nlawmakers will meet for Committee Work Days next week, but will resume voting\nthe week of June 14. Looking ahead to this summer, lawmakers will ramp up\nactivity on key year-end priorities including fiscal year (FY) 2022\nappropriations, surface transportation reauthorization, and the National\nDefense Authorization Act (NDAA), among others. Congress must also address the\nexpiration of the debt ceiling suspension, as well as sequestration and \u201cPAYGO\u201d\nissues that were triggered by the American Rescue Plan at some point prior to\nthe August Recess. Democrats are also expected to continue their work on\ncrafting legislation that aligns with President Joe Biden\u2019s American Jobs Plan\nand American Families Plan, likely utilizing budget reconciliation to\ncircumvent GOP opposition in the 50-50 Senate.<\/p>\n\n\n\n Biden Releases FY 2022\nBudget Request<\/strong><\/p>\n\n\n\n Last Friday, the Biden\nadministration unveiled its full fiscal year (FY) 2022 budget request<\/a> (fact sheet<\/a>; appendix<\/a>) outlining $6\ntrillion worth of spending priorities for the year ahead. The President’s\nrequest includes $769 billion in spending for nondefense programs \u2014 a 16 percent\nincrease from FY 2021, including a significant boosts for the Department of\nHealth and Human Services (HHS) (23.5 percent). Lawmakers on the House\nAppropriations Committees will begin their work crafting FY 2022 spending bills\nnext month, with the goal of having each of the 12 spending bills passed by the\nend of July. A schedule on the Senate side is unclear as of now, fueling\nspeculation that a short-term continuing resolution (CR) may be needed to push\nthe funding deadline beyond September 30, 2021.<\/p>\n\n\n\n A significant chunk of\nthe policy proposals included in the President’s budget point to various\nprovisions included in his American Jobs Plan<\/a> and American Families Plan<\/a> \u2014\nnamely on infrastructure, clean energy and climate change, health care, and tax\nreform, among others. This includes calls for investments in Home- and\nCommunity-Based Services, the establishment of ARPA-H, and a permanent\nexpansion of the ACA subsidies included in the ARP Act. <\/p>\n\n\n\n The budget also states\nthe President\u2019s support for a public option and lowering the eligibility age of\nMedicare. President Biden calls for allowing individuals 60 and older the\noption to enroll in Medicare with the same premiums and benefits as current\nbeneficiaries but with a different financing mechanism. He also calls for a\npublic option available through the ACA exchanges. Beyond these topline\nproposals, the budget offers no specifics.<\/p>\n\n\n\n Additionally,\nPresident Biden\u2019s budget calls for new investments in mental health and\nsubstance use disorder (SUD) services. In particular, it asks Congress for $1.6\nbillion for the Community Mental Health Services Block Grant, over twice as\nmuch as was provided in FY 2021. It also calls for $10.7 billion in discretionary\nfunding for SUD services, $3.9 billion more than in FY 2021. Finally, the\nbudget asks for a $125 million increase in Certified Community Behavioral\nHealth Clinic (CCBHC) funding, for a total of $375 million. This would expand\nthe CCBHC program to 180 grantees.<\/p>\n\n\n\n CMS Proposed Delay for\n\u201cMultiple Best Price\u201d Reporting in Medicaid Drug Rebate<\/strong><\/p>\n\n\n\n Last Wednesday, the\nCenters for Medicare and Medicaid Services (CMS) proposed<\/a> to delay\nits forthcoming \u201cmultiple best price\u201d approach for Medicaid drug rebates by six\nmonths. This new approach was finalized in the December 31, 2020 final rule\nentitled, Establishing Minimum Standards in Medicaid State Drug Utilization\nReview (DUR) and Supporting Value-Based Purchasing (VBP) for Drugs Covered in\nMedicaid, Revising Medicaid Drug Rebate and Third Party Liability\n(TPL) Requirements. <\/em>The new best price definition finalized in\nDecember 2020 creates a structure in which manufacturers may\noffer prescription drugs to states at prices that are tied to patient\noutcomes without affecting the overall best price framework in the Medicaid\ndrug rebate program. Under this new approach, manufacturers that offer a value-based\npurchasing (VBP) arrangement to all states, may report a best price that\nincludes varying best price points (“multiple best price”) under that\nVBP arrangement. The announcement by CMS last week proposed to delay the\ncurrent effective date for these reporting requirements. CMS also proposed\nto delay the inclusion of U.S. territories in the MDRP, citing territories\u2019\ntechnical inability to comply with that inclusion. This would maintain the\nstatus quo with regard to territories in the MDRP through April 1, 2024.\nCommenters have 30 days to submit comments after the proposal is published in\nthe Federal Register, setting a likely deadline of June 27, 2021.<\/p>\n\n\n\n Congressional Health\nLeaders to Design Public Option Legislation<\/strong><\/p>\n\n\n\n The chairs of key\nCongressional health committees announced last week that they will develop\nlegislation that would establish a public health insurance option, a key\ncampaign promise from President Joe Biden. Senate HELP Committee Chair Patty\nMurray (D-WA) and House Energy and Commerce Chair Frank Pallone (D-NJ) penned a\nletter<\/a> to “all\ninterested parties” soliciting feedback on a design that prioritizes\n“quality, affordable” health coverage throughout the U.S. They note\nthat \u201cbold steps are necessary in order to achieve universal health coverage\nand lower health care costs.\u201d The health care leaders are seeking input from\nstakeholders to inform their forthcoming legislation, and looking for feedback\non eligibility, provider access, price determination, benefit package\nstructure, federal assistance, and more. Responses to the House<\/a> and Senate<\/a> Committees are due by July 31, 2021.<\/p>\n\n\n\n