Lawmakers returning to Washington are far apart on a series of must-pass health care bills that could have far-reaching consequences on local health centers, federal authority and pandemic preparedness.
The bills will be part of a post-recess scramble as the House and Senate return ahead of a Sept. 30 government funding deadline.
The White House has called on Congress to pass a short-term funding bill, which could buy time for further negotiations on some of the pricklier issues. But the coming weeks will signal whether Democrats and Republicans can find common ground on extending critical health programs.
The biggest looming issue is massive funding bills for agencies like the Food and Drug Administration (FDA) and the Department of Health and Human Services (HHS).
The bills are tied up in the House amid disagreements over abortion policies and spending levels. The Senate is moving ahead to pass its own bipartisan version, starting with a “minibus” package that includes the FDA.
Funding for community health centers also continues to be a sticking point in the Senate.
Sen. Bernie Sanders (I-Vt.), chairman of the Senate Committee on Health, Education, Labor and Pensions (HELP), wants a major hike in funding for community health centers — $20 billion a year over the next five years — and Republicans remain opposed to his demands.
Discussions over community health centers continued during the August recess, but Republican staffers say there has not been a breakthrough.
Here is where things stand on the must-pass bills:
Community health centers
Sanders and HELP Committee ranking member Bill Cassidy (R-La.) have introduced competing legislation to reauthorize funding for the Community Health Center Fund that was established through the Affordable Care Act.
Cassidy’s office said in July that he introduced his reauthorization bill due to a lack of progress in negotiations with Sanders. A GOP staffer on the HELP Committee told The Hill last week that little has changed in negotiations with Sanders.
The bill introduced by Cassidy would increase community health center funding from $4 billion to $4.2 billion a year for the next two years, compared to Sanders’s plan to quintuple annual spending.
One roadblock to Republican support for Sanders’s $100 billion plan is identifying offsets to his investments. Sanders’s office did not have any update when asked about the ongoing talks.
Appropriations
The Senate Appropriations Committee advanced the funding bills for HHS and FDA before the recess, with members agreeing to leave out any “poison pill” measures.
The House appropriations bill for HHS hadn’t even made it to the chamber’s Appropriations Committee before recess. A bipartisan agreement appears out of reach as House Republicans seek deep spending cuts for both HHS and FDA as part of efforts to tackle “wasteful bureaucracy.”
While the Senate advanced a reauthorization that raised FDA spending by $20 million over last year, the House Appropriations Committee advanced a highly pared down spending bill along party lines that provided $8 billion less than what was allotted for the agency in 2023.
Democrats took issue with both the proposed spending level and two riders that would limit or reverse FDA decisions. The GOP-led bill included provisions that would block FDA from banning menthol in cigarettes and reverse the decision to allow the abortion treatment mifepristone to be sent through the mail.
Pandemic preparedness
Committees in both chambers advanced their respective bills to reauthorize the Pandemic All-Hazards Preparedness Act before the August recess, but a stark difference remains in the two versions.
While the Senate advanced a bipartisan bill that was agreed on ahead of a July markup session, the House bill was advanced by Republicans on the Appropriations Committee along party lines.
The primary disagreement is over drug shortages. The GOP-led version of the bill excluded measures to expand FDA authority in order to better address drug shortages, with Republican members saying the issue could be revisited later.
The Senate version included a measure that would give FDA the ability to require notice from drug manufacturers that experience increases in demand likely to stretch their production capacity, to identify potential shortages sooner.
