Democrats will retain control of the Senate in the 118th Congress, after key races in Arizona and Nevada were called in their favor. The December 6 runoff election in Georgia will determine whether Democrats’ majority is 50–50 (with Vice President Harris breaking ties) or 51–49. After a handful of pending House races were called this week, Republicans will take narrow control of the House. In House leadership news, Speaker Pelosi (D-CA), along with Majority Leader Hoyer (D-MD), announced that they will step down from their leadership roles in the new Congress, paving the way for the next generation of Democratic leadership in the House. On the regulatory front, the US Department of Health and Human Services (HHS) hosted a meeting on patient and healthcare worker safety, and the White House held a summit focused on COVID-19 and equity.
Congressional Leadership and Committee Updates. On November 17, Speaker Pelosi announced in a speech on the House floor that she will step aside from her role as the Democratic leader and pass the torch to a new generation of leaders. She also made clear that she’s not giving up her seat in the House at this time, and that she will be honored to continue representing her community of San Francisco in Congress. She has led Democrats in the House since 2002 as speaker or minority leader, and is the first woman to do so.
Soon after Speaker Pelosi’s speech, the Democrats’ second-in-command, Majority Leader Hoyer, announced that he will also step down from his leadership role. Rep. Clyburn (D-SC), who serves as the Democrats’ number three position in leadership, is expected to continue as assistant leader. While Pelosi did not endorse anyone, Rep. Jeffries (D-NY) is widely seen as the choice to become the new Democratic leader. Rep. Clark (D-MA) is running to be the Democratic whip, and Rep. Aguilar (D-CA) is running for caucus chair. Jeffries, Clark and Aguilar are running as a team of candidates for these roles, and the Democratic leadership elections are scheduled for November 30.
In committee leadership news, Sen. Paul (R-KY) announced on November 17 that he would not seek the top Republican position on the Senate Health, Education, Labor and Pensions (HELP) Committee, instead choosing to pursue the top Republican spot on the Senate Homeland Security and Governmental Affairs Committee. Paul’s decision clears the way for Sen. Cassidy (R-LA) to be the ranking Republican on the HELP Committee in the 118th Congress.
Senate Approves Resolution to End COVID-19 National Emergency Declaration. On November 15, the Senate approved a resolution to end the national emergency concerning COVID-19 declared by the president on March 13, 2020. The resolution was approved by a bipartisan vote of 62–36, with 13 Democrats joining all present Republicans in voting for the resolution.
While ending the national emergency is different than ending the public health emergency (PHE), which is declared by HHS, the two are related, as the PHE must be tied to another declaration. Should the national emergency declaration end (as intended in this Senate resolution), most current waivers would terminate. There are notable exceptions, however, where other pieces of legislation have enacted additional flexibility (including telehealth waivers), and where policy changes in HHS rulemakings specified that policy changes are tied to the PHE. Should the national declaration end but the PHE stand, such policies would continue until the end of the PHE. Should both the national emergency declaration and the PHE end, all waiver authority would cease. Please see this +Insight for additional information.
The COVID-19 PHE, which is extended in 90-day increments, was most recently extended in mid-October, until mid-January 2023. The Biden Administration has maintained a commitment to provide 60 days’ advance notice of any plans to end the PHE, and that 60-day mark recently passed with no indication that the PHE will end in mid-January. This indicates that the PHE is likely to be extended at least once more, through mid-April 2023.
Senate passage of this resolution will not have a tangible impact, as it is unlikely to be taken up by the Democratic-controlled House this year, and the president has threatened to veto it. However, the vote in the Senate demonstrates “pandemic fatigue” as well as significant bipartisan support for ending COVID-19 declarations, which suggests that the next presumed PHE extension through mid-April 2023 could be the last.
Senate Democrats Seek Additional Consumer Protections in Medicare Advantage. Thirteen Senate Finance Committee Democrats recently sent a letter to HHS and the Centers for Medicare & Medicaid Services (CMS), asking that CMS take additional steps to implement consumer protections in the Medicare Advantage program (MA).
Led by Finance Committee Chairman Wyden (D-OR), who recently released a report detailing an increase in deceptive marketing practices in MA, the letter applauded steps recently taken by CMS to protect Medicare beneficiaries, and urged that additional steps be taken to accomplish the following:
The full report from the Finance Committee Democrats can be found here.
HHS Holds Meeting on Patient and Healthcare Worker Safety. On November 14, HHS convened a meeting and listening session focused on protecting the safety of patients and healthcare workers. The meeting included leaders from the Agency for Healthcare Research and Quality, the Centers for Disease Control and Prevention, CMS, and the US Food and Drug Administration (FDA).
During the event, HHS Secretary Becerra announced the creation of the National Healthcare System Action Alliance to Advance Patient Safety in partnership with healthcare systems, patients and families, as well as other stakeholders. The Action Alliance will help HHS equitably address patient safety concerns and help ensure that patients and providers feel confident and safe when receiving and delivering care.
HHS will issue a forthcoming request for information to provide all interested stakeholders the opportunity to contribute to the development of the Action Alliance and answer the following questions:
Congress will be in recess next week for the Thanksgiving holiday and is scheduled to return to session the week of November 28. Our weekly Check-Up will also be on hiatus next week, returning on December 2.
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