Framing the Week

Back from recess, lawmakers hit the ground running with less than three months to secure a deal on surprise medical billing and prescription drug pricing legislation for inclusion in the “must-pass” health care extenders package due May 22. Pressure is high for Congress and the Trump administration to deliver, as the top priority for American voters of both parties is taking action to lower health care costs and prescription drug prices, according to the recent POLITICO-Harvard T.H. Chan School of Public Health survey.

Democratic Primaries

Tomorrow evening, Democratic presidential candidates will duke it out in Charleston, South Carolina ahead of the state primary elections on Saturday. Sen. Bernie Sanders (34 delegates), former South Bend Mayor Pete Buttigieg (23 delegates), Sen. Elizabeth Warren (8 delegates), former Vice President Joe Biden (8 delegates), Sen. Amy Klobuchar (7 delegates), former NYC Mayor Mike Bloomberg, and businessman Tom Steyer have qualified for the debate.

HHS Budget

This week, Health and Human Services (HHS) Secretary Alex Azar makes his rounds on Capitol Hill to defend the President’s fiscal year (FY) 2021 budget proposal. Azar will appear before the Senate and House Appropriations Subcommittees on Labor-HHS-Education, the House Ways and Means (W&M) Committee, and the House Energy and Commerce (E&C) Subcommittee on Health. House appropriators are aiming to begin marking up FY 2021 spending bills on April 21, with the goal of completing markups by May 19 and passing legislation before July.


Over the weekend, the Trump administration signaled that it would soon request emergency supplemental funding for the coronavirus response – likely in anticipation of pointed questions from E&C Health Subcommittee Democrats on Wednesday. The news marks an about-face from an earlier consideration to reallocate $136 million from other programs and resistance to Democrats’ pressure to do so. Still, Secretary Azar and the other health officials will have a lot of explaining to do. Democrats will likely demand details on how exactly the administration plans to respond to the outbreak – including how it intends to support the frontline efforts of state and local public health departments. Following up on last week’s letter led by Rep. Jan Schakowsky (D-IL), Democrats will likely press Azar on the administration’s decision to issue exclusive licenses for the development of a potential coronavirus vaccine, citing access and affordability concerns.


Unsatisfied with the administration’s industry-friendly approach to regulating e-cigarettes, House Democrats will hold a vote on Protecting American Lungs and Reversing the Youth Tobacco Epidemic Act of 2019 (H.R. 2339). The legislation would prohibit all flavored tobacco products, including menthol, which was exempt from the FDA’s enforcement policy, along with tobacco-flavored products, open tank vaping systems, and disposable products. The Senate companion (S. 3174), introduced by Sen. Sherrod Brown (D-OH), has 10 cosponsors, including several Democrats who joined Senate Health, Education, Labor and Pensions (HELP) Committee Ranking Member Patty Murray (D-WA) in a letter requesting Secretary Azar clarify his recent comments implying that the FDA may not review all vaping products.

Women’s Health & Abortion

In a clear response to the President’s call for legislation banning late-term abortion in his State of the Union address, the Senate will vote on motions to consider two bills that would have the effect of limiting access to abortion, particularly abortion care later in pregnancy. Specifically, the Pain-Capable Unborn Child Protection Act (S. 3275), premised on the unproven assertion that a fetus can feel pain at 20 weeks, would impose a 20-week abortion ban (2-4 weeks prior to the standard of “viability” established under Roe vs. Wade). The Born-Alive Abortion Survivors Protection Act (S. 311) would subject health care providers to criminal charges if they do not provide certain medical care in the event that a fetus survives an abortion procedure. Opponents of the bill object to the inflammatory language used, noting that the standard of care for an abortions later in pregnancy – which represent less than one percent of abortions and are typically in response to a fetal abnormality or health risk for the mother – does not allow for a baby to be “born alive.”

While the two measures are unlikely to surpass the 60-vote procedural threshold, the votes will force vulnerable Democrats (i.e., Doug Jones of Alabama) to go on the record on the issue, as well as rile up the conservative base ahead of the 2020 election.


Later this week, the Medicaid and CHIP Payment and Access Commission (MACPAC) will convene to discuss maternal health initiatives, recommendations to improve the Medicare Savings Programs, value-based payment strategies, integrated care for dually eligible beneficiaries, and program integrity. Notably, this will be the last meeting before the Commission releases its March Report to Congress.

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Alyssa Llamas has a diverse background in health policy and public health, with seven years of experience in government, research