Health Update (January 7)
The 116th Congress kicked off yesterday, officially ending unified Republican control of both chambers of Congress and the White House. Congresswoman Nancy Pelosi (D-CA) reclaimed the speakership with 220 votes, becoming the most recent Speaker of the House to reclaim the title since Sam Rayburn in 1955. She remains the only woman who has served as House speaker. In other House leadership positions: Representative Steny Hoyer (D-MD) is the Majority Leader, Rep. James Clyburn (D-SC) is the Majority Whip, Rep. Kevin McCarthy (R-CA) is the Minority Leader, and Rep. Steve Scalise (R-LA) is the Minority Whip. In the Senate, Senator Mitch McConnell (R-KY) remains Majority Leader and Senator Chuck Schumer (D-NY) remains Minority Leader.
The Senate Republicans have already announced new committee assignments for the 116th Congress. These will be ratified by the Republican Conference and the full Senate next week. Notably, two senators will serve on both the Appropriations Committee and Finance Committee: Sen. Steve Daines (R-MT) and Sen. Jim Lankford (R-OK). Such appointments required waivers from Senate GOP rules, which limit service to one of the four top Senate committees. Sens. Daines and Lankford are the first two senators to serve on both committees since Henry Cabot Lodge in 1944. The Judiciary Committee will also add Republican women to the roster: Sens. Marsha Blackburn (R-TN) and Joni Ernst (R-IA). The full list of Republican Senate committee assignments can be viewed by clicking here.
On the House side, full committee assignments have not been made. While these assignments are forthcoming, it is all but guaranteed that the top Democrats on the 12 Appropriations Subcommittees will become the “cardinals,” the term given to appropriations subcommittee chairpersons. Official committee assignments in the House are expected to be announced next week.
House Passed Package to Reopen Government
Amidst the celebration of the 116th Congress, the partial government shutdown continues with no end in sight. Late Thursday night, the House passed two bills that would fully reopen the federal government–without increased appropriations for a southern border wall. The first package included six bills that would reopen all unfunded agencies with the exception of the Department of Homeland Security (DHS). These bills would fund the closed agencies through the end of the 2019 fiscal year. The second bill would be a month-long funding extension for DHS to allow congressional leaders and the president to continue border funding negotiations.
To recap the partial government shutdown: nine government agencies are shut down and roughly 800,000 federal employees are furloughed or working without pay. This includes DHS and the Departments of Agriculture, Commerce, Justice, Housing and Urban Development, Interior, State, Transportation, and Treasury. The Environmental Protection Agency, NASA, and the National Parks Service are also impacted. Most Internal Revenue Service operations have ceased during the shutdown, which will likely impact tax filing season if the shutdown is prolonged through the end of the month (the federal government does not pay tax refunds during a government shutdown). Social Security, Medicare, and Medicaid are not affected because these programs already received funding for the 2019 fiscal year.
Health Priorities: What’s to Come
As the 116th Congress shifts into high gear, here’s what to expect from House Democrats in terms of health policy priorities: The House will vote on Wednesday (January 9th) to intervene in the Texas lawsuit against the Affordable Care Act (ACA). Speaker Pelosi indicated that she would intervene to defend the health law in court. The newly-passed House rules package, viewable here, authorizes the speaker to “intervene, otherwise appear, or take any other steps in the case of Texas v. United States or any other cases involving the Patient Protection and Affordable Care Act to protect the institutional interests of the House and to defend such Act.”
Incoming Energy and Commerce Committee Chairman Frank Pallone (D-NJ) issued a press release highlighting priorities for the committee. He announced three hearings to be held later this month. First, a hearing “assessing the environmental and economic impacts of climate change.” Second, a hearing “examining the impacts of a U.S. District Judge’s decision in Texas last month to strike down the Affordable Care Act.” Third, a hearing “examining the failures of the Trump Administration’s Family Separation Policy.” The full press release from Chairman Pallone can be viewed here.
A federal judge in Ohio granted a request to halt discovery in a set of opioid lawsuits, but he also allowed discovery to move forward in two additional opioid cases. Judge Dan Polster granted the motion on December 27th due to the government shutdown, but added the two additional cases to a set of lawsuits on Monday, December 31st. The initial cases have a trial date of September 3rd, but an additional track of bellwether cases will proceed in West Virginia, after Judge Polster concluded that the three initial cases in Ohio “include a large but incomplete fraction of the issues and parties relevant to the multidistrict litigation.”
White House Drug Czar
The Senate has officially confirmed the White House drug czar Jim Carroll, who previously served as acting drug czar. Carroll will lead the Office of National Drug Control Policy, which oversees the national response to the opioid crisis. Carroll has filled this role in an acting capacity since February.
Final ACA Signups
A final snapshot from the Centers for Medicare and Medicaid Services indicates that approximately 8.4 million people selected or re-enrolled in plans using HealthCare.gov during 2019 open enrollment. Additional data will be released in March. The full snapshot from CMS released this week can be viewed by clicking here.
Maine Medicaid Expansion
With a new governor, Maine is advancing Medicaid expansion after voters approved the referendum last year. Governor Janet Mills issued her first executive order to direct the Maine Department of Health and Human Services to begin the expansion. She is also reviewing the waiver from the Trump administration which will require some Medicaid recipients to fulfill work requirements. Implementation of a work requirement cannot begin until after July 1 of this year.
 Niels Lesniewski. “Daines, Lankford to serve on both Appropriations and Finance.” Roll Call, 4 Jan 2019. https://www.rollcall.com/news/politics/daines-lankford-serve-appropriations-finance
 Erica Werner, Damian Paletta, and Seung Min Kim. “House Democrats vote to reopen government and deny Trump wall money, defying veto threat.” Washington Post, 3 Jan 2019. https://www.washingtonpost.com/business/economy/house-democrats-prepare-vote-to-reopen-government-as-cracks-appear-in-gop-opposition/2019/01/03/24151490-0f96-11e9-8938-5898adc28fa2_story.html?noredirect=on&utm_term=.63cf840706fb
 Niraj Chokshi and Christina Caron. “What Is and Isn’t Affected by the Government Shutdown.” The New York Times, 2 Jan 2019. https://www.nytimes.com/2019/01/02/us/whats-affected-government-shutdown.html
 “Overnight Policy: Health Care.” The Hill, 4 Jan 2019. http://click1.email.thehill.com/ViewMessage.do?m=okwzffwm&r=mdccnyqw&s=drjszlgkjttblbtrcjjssjgwtgtnnmjkldw&q=1546562176&a=view
 “House Resolution 6.” House of Representatives, 3 Jan 2019. https://docs.house.gov/billsthisweek/20181231/BILLS-116hresPIH-hres6.pdf
 “Pallone Announces First Three Energy and Commerce Hearings.” House Committee on Energy and Commerce, 3 Jan 2019. https://energycommerce.house.gov/newsroom/press-releases/pallone-announces-first-three-energy-and-commerce-hearings
 Amanda Bronstad. “Opioid Judge Stays Discovery Due to Federal Government Shutdown.” Legaltech News, 3 Jan 2019. https://www.law.com/legaltechnews/2019/01/03/opioid-judge-stays-discovery-due-to-govt-shutdown-397-15347/?slreturn=20190004131109
 Lev Facher. “With Senate votes, Trump gets a permanent drug czar–and his first science adviser.” Stat News, 2 Jan 2019. https://www.statnews.com/2019/01/02/with-senate-votes-trump-gets-a-permanent-drug-czar-and-his-first-science-adviser/
 “Final Weekly Enrollment Snapshot for the 2019 Enrollment Period.” Centers for Medicare and Medicaid Services, 3 Jan 2019. https://www.cms.gov/newsroom/fact-sheets/final-weekly-enrollment-snapshot-2019-enrollment-period
 Tami Luhby. “Maine’s new governor moves ahead with Medicaid expansion.” CNN, 3 Jan 2019. https://www.cnn.com/2019/01/03/politics/maine-medicaid-expansion/index.html