President Biden gave his first State of the Union speech on March 1, focused on Ukraine as well as infrastructure, electric vehicles, gas prices, climate change, manufacturing such as the new Intel semiconductor site in Columbus, child care and paid leave, crime and police training, voting rights, and several health issues: COVID and his “Test to Treat” initiative, opioids, mental health, Cancer Moonshot, and biomedical research through ARPA-H. In the coming weeks, he will announce his FY2023 budget and then Congress can begin work on their 12 appropriations bills.
However, the omnibus appropriations bill for FY2022 that was up in the air with another Continuing Resolution passed that expires March 11, is finally being drafted with the House and Senate expected to consider it this week. The Appropriations Leadership of Reps. DeLauro (D- CT) and Granger (R-TX) and Senators Leahy (D-VT) and Shelby (R-AL) have worked hard over the past few weeks to agree to topline numbers, remove controversial policy riders, and add in funding to support Ukraine. With the Ukraine invasion and requisite supplemental funds needed as the U.S. now has more than 90,000 service members in Europe, attention has diverted from the omnibus package.
Meanwhile despite strong employment growth at the start of 2022, the sudden ups and downs in the stock market causing upheaval for many businesses and President Biden’s approval ratings continuing to linger around 42% make the Build Back Better legislation more elusive. Biden is expected to secure a victory with his new Supreme Court nominee, Ketanji Brown Jackson to be the first Black woman to sit on the court and just like 8 of the 9 justices also graduated from Harvard Law School. While historic, her seat on the bench won’t change expected rulings since she will replace Stephen Breyer.
BUDGET & APPROPRIATIONS
FY2023 — On February 17, the Senate passed a CR by a vote of 65-27 to extend funding for the federal government through March 11. Congress is finalizing the omnibus bill this week, aiming to send it to President Biden just in time before the CR expires. G2G has contacted almost all 435 House and 100 Senate offices to see what their deadlines are for appropriations requests, if they plan to pursue earmarks, and what information needs to be provided for both appropriations and earmark requests. Most offices are waiting until the president’s budget proposal is released, but with the omnibus expected to include earmarks, earmarks are expected to be included in the FY2023 process as well.
FY2022 — To wrap up FY2022 appropriations, the White House has lowered its initial emergency funding request for COVID response to $15 billion from $22.5 billion it had sought previously. Lawmakers expect a $1.5 trillion omnibus government funding package to be finished this week, along with spending bills that include Ukraine aid and COVID resources. Biden’s new coronavirus response request includes $10 billion for the Health and Human Services Department and $5 billion for the USAID to combat the coronavirus globally. Passage is expected by March 11 to prevent another CR.
Several health bills are moving through Congress with hearings and/or markups:
The Energy and Commerce Committee held a hearing on February 8 (see G2G’s summary). Rep. Diana DeGette (D-CO) said last month that she and Rep. Fred Upton (R-MI) have ironed out differences with Energy and Commerce Health Subcommittee Chair Anna Eshoo (D-CA) about how to establish ARPA-H, indicating there’s a path forward to clear the full committee. Eshoo is the author of the authorizing bill (H.R. 5585) for ARPA-H outside NIH but inside Health and Human Services Department. DeGette and Upton are the architects of Cures 2.0 (H.R. 6000) that include ARPA-H authorization inside the NIH as part of the follow-up bill to the 2016 21st Century Cures Act. Meanwhile, HELP Committee Chair Patty Murray (D-WA) and Ranking Member Richard Burr (R-NC) say they may fold ARPA-H authorizing language into their pandemic preparedness bill, a draft version of which they released in late January.
Pandemic Preparedness Bill
The PREVENT Pandemics Act will be introduced and marked up in the Senate Health Education Labor & Pensions (HELP) Committee around March 15 and is expected to include ARPA-H language, making sure both measures pass in a bundled bill. The discussion draft of the bill:
- Improves Strategy and Coordination among public health preparedness agencies
- Strengthens Supply Chain and Government Stockpiles of medical products, such as
masks, drugs, vaccines, and tests
- Ensures the CDC’s Accountability and Leadership by requiring a Senate-confirmed CDC
Director and an agency-wide strategic plan
- Improves our capabilities to Detect and Monitor Emerging Infectious Disease and other
threats, including updates to Public Health Data to quickly provide comprehensive,
actionable insight during public health emergencies
- Enhances the development and review of Tests, Treatments, and Vaccines, and
mitigates critical shortages of medical products
- Addresses Disparities that make public health emergencies harder on at-risk populations
- Improves Public Health Communication and addresses misinformation
- Revitalizes the Public Health Workforce
- Accelerates Biomedical Research to develop medical countermeasures for pandemic
threats, and enhances research on the long-term effects of COVID-19 and faster test development
- Ensures continued access to Mental Health and Substance Use Disorder services during Public Health Emergency responses to help people with trauma, depression, substance use disorders, and more
- Establishes an Independent Task Force to conduct a comprehensive review of the COVID-19 response
With the Medical Device User Fee Act set to expire September 30, the House and Senate are eager to complete this legislation on time and wrap in other policy riders, such as the VALID Act (H.R. 4128), which would establish a new framework for the FDA to regulate diagnostic tests. It would create a category of medical products called in vitro diagnostic tests, instead of keeping them as a subcategory within device regulations. That would allow the FDA to oversee tests regardless of whether they came from clinical laboratories or from commercial companies. A companion bill (S. 2209) was introduced in the Senate. Neither bill has seen action, but MDUFA determines the rates that device makers pay the agency and often includes policy riders that go beyond user fees the VALID Act. Congress must pass a law adopting the next iteration of device user fees for fiscal years 2023 through 2027 before the current one expires September 30.
Chair of the House Veterans’ Affairs Committee, Rep. Mark Takano (D-CA) succeeded in passing his bill to help U.S. Veterans exposed to toxic substances during deployments to Iraq and Afghanistan in the House 256 – 174 but faces objections to the $300 billion cost of his bill over the next decade. The Honoring our PACT Act (H.R. 3967) would speed health care and benefits to millions of Veterans exposed to burn pits. Because some Republicans say the price tag is too high, Senate passage is questionable. Roughly 3.5 million Veterans have had some burn pit exposure where open-air pits were used to burn jet fuel, paint, plastic, medical waste, and garbage. Veterans diagnosed with various cancers—especially rare cancers—as well as lung disease and other respiratory problems years after their deployments have sought help for these ailments but have been denied coverage for care by the VA, claiming they are not service connected. Honoring our PACT Act would shift the burden of proof, giving Veterans the benefit of the doubt when they seek help from the VA and would establish a presumption of connection between 23 respiratory illnesses and cancers and service personnel’s exposure to burn pits and airborne hazards.
US deployed an additional 15,000 forces and now has more than 90,000 U.S. service members in Europe. While far from the more than 775,000 U.S. service members deployed in Afghanistan over 20 years up to August 30, 2021, this number will grow. President Vladimir Putin said the war will continue as he plans to remove the current government until Ukraine accepts his demands, “demilitarizes” and halts resistance. Efforts continue to negotiate to no avail and oil closed in New York at the highest in a decade, after a day of wild swings on key energy markets. Average pump prices in the U.S. are now $4.173 per gallon, the highest level in records going back to 2000. The Biden administration is now poised to impose a ban on U.S. imports of Russian energy as soon as March 8, without the participation of our European allies. Russia now surpasses Iran as the world’s most-sanctioned nation as Netflix, TikTok, Samsung and credit card operators have all joined the lengthening list of businesses cutting their ties. Adding to current sanctions, Congress has outlined bipartisan legislation to bar imports of Russia’s oil into the U.S., clearing the way for a rapid crackdown on crude from that country. Congress is also planning to include supplemental funding in the FY2022 omnibus appropriations measure expected on the floor this week.
In a rare moment of bipartisanship, 18 House members — 9 Republicans and 9 Democrats — recently came together to empower local communities to address divisiveness that may be hindering the economy and other goals through new legislation called the Building Civic Bridges Act. It which would create a new, nonpartisan pilot program, led by the Office of Civic Bridgebuilding within AmeriCorps focused on building relationships across lines of difference. The office would allocate federal grants on a competitive basis to bolster civic organizations and spaces that are dedicated to the revitalization of civic culture and bridging the issues that divide neighbors and citizens. The pilot program created by the Building Civic Bridges Act will have four core pillars:
- Administering a grant program to support civic bridge-building programs across the nation, funding nonprofits, public institutions, schools and religious groups that are striving to heal toxic polarization in the United States.
- Supporting the training of AmeriCorps members in civic bridge-building skills.
- Supporting research on civic bridge building, civic engagement and social cohesion.
- Activating a public conversation about the importance of civic bridge building by serving
a key role as both a convening and coordinating partner to the national civic bridge- building movement, providing resources, networks and collaboration opportunities to the field.
The House passed the America COMPETES Act in February that must be reconciled with a similar, comparably massive bill called the U.S. Innovation and Competition Act (USICA) that passed the Senate in June 2021. This sweeping legislation promises to double the budgets of the National Science Foundation (NSF) and other key research agencies, pour money into high-tech industry, curb “malign foreign influence” on U.S. research, and root out sexual harassment in academic science. But ironing out the differences continues to be touch as the Democrats have razor-thin majorities in each body and didn’t garner enough bipartisan support to secure quickly sending a bill to the president for signature. Although USICA (S.1260) was approved by a vote of 68 to 32, including 19 Republican senators, COMPETES (H.R. 4521) was supported by just one Republican and passed the House on a 220 to 210 vote. (One Democrat said nay.) Although key House Republicans have said they support many of the research-related elements in the bill, they strongly object to other provisions, including language on trade and labor policy. Both bills come with hefty price tags: $250 billion for USICA and $350 billion for COMPETES that present another challenge to swift enactment.
Election day is 9 months away with primaries sneaking up, redistricting getting finalized, more retirement announcements coming, and state voting laws being changed. Texas kicked off the 2022 primary calendar on March 1. Then in May, 12 states are holding primaries and in June, another 18 states, then August another 16 states hold them. Post census, 38 states, most recently PA and NC, have finished redrawing congressional maps, plus 6 states only have 1 rep so that leaves 6 states still up in the air. Right now there are 177 Democratic-leaning seats, 160 Republican-leaning seats and 31 highly competitive seats in the new maps so far. How that compares to the old maps is: +12 Democratic-leaning seats, -5 Republican-leaning seats, -7 highly competitive seats. Democrats will likely flip around 3 seats in 2022 due to redistricting. With retirements totaling 50 members of Congress—7 in Senate and 43 in House—that generally favors the minority party. However, in the Senate most retirements are within the minority party. The breakdown includes 5 retiring Senators who are Republicans and 1 who is a Democrat. The opposite is in the House where of 28 retiring House members, 22 are Democrats and 6 are Republicans.
A final impact is the voting law changes occurring in statehouses across the country, especially with absentee voting. According to the Brennan Center for Justice, at least 19 states enacted 33 laws between the November 2020 election and September 2021 that make it harder for Americans to vote. At the same time, lawmakers in at least 25 states enacted 62 laws with provi-sions that expand voting access. The result was three more states with all-mail voting plans, increased digitization of registration, stiffer voter ID laws and new early voting schedules.