Critical time for health care on the Hill

The contours of power are taking shape a week after Election Day: Democrats will control the Senate in 2023 by a margin of one or two votes. Republicans have the House but with a narrow majority.

Until the new Congress is seated in January, Democrats will continue to have unified control.

Next year, Democrats won’t be able to use the budget process that enabled them to enact Covid-19 relief legislation and to reform drug pricing as they did in the current Congress. Instead, they’ll have to work with the GOP.

Oliver Kim, the health policy director of the Bipartisan Policy Center, a Washington think tank, spoke with Ben about what to expect during the lame-duck session that will bring 2022 to an end, and thereafter. The interview has been edited for length and clarity.

What do you expect will be the health care priorities in the lame-duck session and in the new Congress? 

In the lame duck, it’ll be the omnibus spending bill. And my questions are: Can they tack on the FDA policies left off the user fee reauthorization, any additional pandemic work and Medicare physician payment issues?

All of us are trying to wrestle with what the next Congress will look like. I’m wondering how the debt limit plays into larger conversations on taxes and entitlements.

Sen. Bill Cassidy is now in line to be the ranking member of the Senate HELP committee after Sen. Rand Paul announced he’s seeking the top Republican oversight role. How do you see Cassidy?

Cassidy is often involved in deal-making. A lot of the stakeholders inside the Beltway would feel more comfortable and welcome Cassidy in a leadership role.

What provisions are more likely to be included in the omnibus? 

It depends on where some of the retiring members want to focus their chips. Sen. [Richard] Burr is retiring, and he’s been influential in a lot of different things, from FDA drug issues to pandemic preparedness. It depends on where he wants to push.

[Energy and Commerce Chair Frank] Pallone and [ranking Republican Cathy] McMorris Rodgers did a lot of things on the user fees that didn’t make it into what was passed in September. They’ll have a say, too.

How significant is Democrats’ holding the Senate in terms of getting health care nominees confirmed?

Being able to expedite some of those with potentially 51 votes is going to be pretty big. You don’t have to schedule some of these key votes around the vice president’s schedule.

And the president’s ability to move judges is going to have a huge impact on health policy. A lot of the lawsuits on the Affordable Care Act are up to statutory interpretation.

What can get done on a bipartisan basis in the new Congress? 

They both have an interest in the use of tech, whether digital apps or telehealth, and to modernize the way agencies integrate that. There’s definitely an interest in payment issues. There’s still interest in behavioral health and the opioid crisis.

Americans have gotten used to free Covid tests, vaccines and treatments. Does that end next year?

It seems like a lot of things will disappear. There are still insurance mandates tied to the public health emergency, but that’s only for people who have insurance. Those who are uninsured may have less ability to get a test or vaccine.

This is where we explore the ideas and innovators shaping health care. 

Researchers at the University of Edinburgh found that the same bacteria that causes leprosy may also be able to safely repair and regenerate organs. So far, this regenerative potential has only been observed on armadillo livers, but researchers are hopeful that it could transfer to humans.

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Today on our Pulse Check podcast, Grace talks with Lauren Gardner about President Joe Biden’s Covid-19 funding request, the intense lobbying efforts on possible health care legislation and a push by some key doctor and hospital groups for a public health emergency declaration for RSV.

The Global Fund to Fight AIDS, Tuberculosis and Malaria has missed its three-year fundraising target by more than 13 percent — which could mean a big cut in the United States’ pledged contribution.

The U.S. remains the biggest Global Fund donor and pledged $6 billion over the next three years to help the fund reach its $18 billion three-year fundraising target.

But the fund has fallen short after a September pledging event in New York raised $14.2 billion and subsequent pledges from the United Kingdom and Italy failed to close the gap. After the U.K. reduced its contribution to $1.19 billion to deal with its economic recession, the fund’s total sits at $15.6 billion.

Here’s what other top donors have pledged:

• France, $1.6 billion
• Germany, $1.35 billion
• Japan, $1.1 billion
• Canada, $900 million
• European Commission, $742 million

Unless the fund can raise more money, Congress will likely reduce the U.S. contribution to $5.2 billion. That’s because U.S. law allows the U.S. contribution to cover only about a third of the fund’s budget.

The future of masks is fashionable and functional … if people ever agree to wear them again.

HHS’ Biomedical Advanced Research and Development Authority has awarded $150,000 to mask designer Richard Gordon of Air99 for his Airgami mask and another $150,000 to Pennsylvania-based Global Safety First for its ReadiMask 365.

BARDA launched its mask-design competition last year, and contestants submitted more than 4,000 ideas. Entrants ranged from big firms, such as Levi Strauss and Amazon, to garage tinkerers. Ten other finalists were awarded $10,000 each.

– The Airgami “leverages origami principles to improve its fit, breathability, and aesthetics.” Gordon designed his face covering to protect his family from air pollution at their home in Suzhou, China, years before Covid-19 struck.

– The ReadiMask 365 adheres to faces without straps. Global Safety First CEO John Schwind started making masks after the 1993 World Trade Center bombing, aiming to help people escape hazardous situations. The Defense Logistics Agency helped produce it.

But who will buy their masks? 

Just 8 percent of Americans still mask daily, according to estimates made by the Institute for Health Metrics and Evaluation based on self-reported data.