Congress Releases Text of FY 23 Omnibus Appropriations bill

The $1.7 trillion FY 23 Omnibus Appropriations bill was released this morning. It contains a roughly 10% increase for defense related programming. House Democrats highlight a 9.3% increase for domestic programs, but their Republican colleagues claim the increase is actually only 5.5% when excluding a dramatic rise for Veterans’ health care.

The fiscal year 2023 Labor-H bill includes $209.9 billion in base discretionary funding. Including spending offset by savings in changes in mandatory programs, this represents an increase of $14.8 billion or 7.1 percent over the comparable fiscal year 2022 level.

The bill includes $579.3 million, an increase of 60.6 million for HRSA’s Title VII health professions programs.

The bill increases the maximum Pell Grant award by $500 or 7.2 percent to $7,395 for the 2023-24 school year. This is the largest increase in the maximum Pell grant award since the 2009-10 school year and further builds off the $400 increase provided last year.

The bill includes language from the Allied Health Workforce Diversity Act, amending the Public Health Service Act to allow for “increasing educational opportunities in physical therapy, occupational therapy, respiratory therapy, audiology, and speech-language pathology professions, which may include offering scholarships or stipends and carrying out other activities to improve retention, for individuals from disadvantaged backgrounds or individuals who are underrepresented in such professions.’’

The leadership expects to move the Omnibus through the Senate, followed by the House, before the December 23rd expiration of the current Continuing Resolution.

More details may be accessed here and here.

Integrating Behavioral Health Services Into Primary Care

Demand for behavioral health services, from addiction treatment to mental health care, is at an all-time high, yet many patients struggle to find the help they need. A new case study from the Commonwealth Fund explores how one group of providers has managed to increase its members’ access to these services without increasing overall health spending. 

The study can be obtained at Integrating Behavioral Health Services into Primary Care | Commonwealth Fund.

Health Spending Growth In 2021

A decline in federal government spending led to more modest growth in health care expenditures last year, according to figures released by the Office of the Actuary at the Centers for Medicare & Medicaid Services (CMS). The 2021 National Health Expenditures (NHE) Report found that U.S. health care spending grew 2.7% to reach $4.3 trillion in 2021, slower than the increase of 10.3% in 2020.  

More information can be obtained at https://www.cms.gov/newsroom/press-releases/national-health-spending-grew-slightly-2021.

Marketplace 2023 Open Enrollment Period Report

According to the Centers for Medicare & Medicaid Services (CMS), nearly 5.5 million Americans have signed up for 2023 individual market health insurance coverage through the Marketplaces since the start of the 2023 Marketplace Open Enrollment Period (OEP) on November 1. The number includes 4.9 million plan selections in the 33 Marketplaces using the HealthCare.gov platform for the 2023 plan year, through December 3, 2022 (Week 5), and 598,000 plan selections in the 18 State-based Marketplaces (SBMs) in 17 states and the District of Columbia that are using their own eligibility and enrollment platforms, through November 26, 2022 (Week 4).  

More information can be obtained at https://www.cms.gov/newsroom/fact-sheets/marketplace-2023-open-enrollment-period-report-national-snapshot-2.

CMS Approves Groundbreaking Section 1115 Demonstrations

Medicaid allows states to experiment with new ways of operating their programs and serving patients through what are known as Section 1115 demonstration waivers. The Centers for Medicare and Medicaid Services (CMS) recently approved waivers in Arkansas, Arizona, Massachusetts, and Oregon that seek to improve enrollment and address social drivers of health. 

More information can be obtained at CMS Approves Groundbreaking Section 1115 Demonstrations | Commonwealth Fund.

ASAHP Urges Health Professions Funding in FY 23 Appropriations

This week ASAHP joined with other members of two coalitions, the Federation of Associations of Schools of the Health Professions (FASHP) and the Health Professions and Nursing Education Coalition (HPNEC), in urging congressional leaders to include robust health professions funding in a FY 23 appropriations package.

The joint letter from FASHP advocates for strong funding for student aid programs like the Pell Grant program and campus-based aid programs, as well as continued support for the Public Service Loan Forgiveness Program (PSLF).

The joint letter from HPNEC urges Congress to provide at least the higher of the two funding levels from the draft House and Senate Labor-HHS-Ed spending bill for the HRSA Title VII health professions and Title VIII nursing workforce development programs for FY 2023.

The current Continuing Resolution (CR) expires on December 16, and Democrats and Republicans have yet to agree on spending levels for non-defense spending along with an array of other issues, increasing the likelihood of another Continuing Resolution into the following week, giving both parties more time to negotiate an Omnibus spending agreement. Many of the most conservative Members in the House and Senate would like to push final consideration of FY 23 funding until Republicans regain control of the House next month, allowing them to recraft the bills at significantly lower overall funding levels.

The FASHP letter may be accessed here and the HPNEC letter may be accessed here.

CMS Memorandum On Violence In Hospitals

The Centers for Medicare & Medicaid Services (CMS) issued a memorandum that reinforces the agency’s role in enforcing regulatory expectations that patients and hospital staff have an environment that prioritizes their safety to ensure effective delivery of health care. An April 2020 Bureau of Labor Statistics Fact Sheet found that health care workers accounted for 73% of all nonfatal workplace injuries and illnesses due to violence in 2018. This percentage has been growing steadily since tracking of these specific events began in 2011. 

The memorandum can be obtained at https://www.cms.gov/files/document/qso-23-04-hospitals.pdf.

Drop In Hospital Operating Margins

According to a new report from Kaufman Hall, U.S. hospitals and health systems in October 2022 experienced their 10th consecutive month of negative operating margins. Based on data from more than 900 hospitals, margins were down 43% from a year ago, as high labor and other costs continued to outpace revenues and labor shortages delayed discharges and admissions. 

The report can be obtained at https://www.kaufmanhall.com/sites/default/files/2022-11/KH-NHFR_2022-11.pdf.

Upcoming IPEC Webinar on Student & Community Mental Health

On Wednesday, December 7 at 2:00pm ET, the Interprofessional Education Collaborative (IPEC) will host a webinar in which 2022 IPEC COF Awardees from the University of North Florida will share details around their interprofessional education for collaborative practice project, OspreyPERCH: An Integrative Behavioral Health Clinical Training Program. The webinar will explore: how to engage learners and faculty in a multi-tiered approach to campus culture change; the importance of student participation in mental health, wellness, and resiliency activities; and "lessons learned” in developing and implementing a student learning and service program that addresses unmet student mental health needs.

More details including registration may be accessed here.

Supreme Court to Hear Arguments on the Student Loan Debt Relief Program

Today, the Supreme Court agreed to hear arguments on the legality of the Administration’s student loan debt relief program. The case will be argued in the February 2023 argument session. In the meantime, the program will remain on hold. Last week, the Administration extended the student loan payment pause, stating, “payments will resume 60 days after the Department is permitted to implement the program or the litigation is resolved, which will give the Supreme Court an opportunity to resolve the case during its current Term. If the program has not been implemented and the litigation has not been resolved by June 30, 2023 – payments will resume 60 days after that.”

The Department of Education’s press release on the student loan payment pause extension may be accessed here.

Global Pandemics: Gain-Of-Function Research Of Concern

Gain-of-Function (GOF) research is a broad area of scientific inquiry where an organism gains a new property or an existing property is altered. The terms gain of function and loss of function refer to any genetic mutation in an organism that either confers a new or enhanced ability or causes the loss of an ability. Such changes often occur naturally, however, scientists can induce some changes to organisms through experimentation. A new report from the Congressional Research Services discussed the risks/benefits of such investigations and current oversight mechanisms. 

The report can be obtained at https://sgp.fas.org/crs/misc/IF12021.pdf.

Health Insurance By Race And Hispanic Origin

The U.S. Census Bureau released a report today on health insurance coverage and the rate of uninsured in the United States by race and Hispanic origin. American Community Survey (ACS) one-year estimates for 2021 are used to describe how coverage varies across groups. 

The report can be obtained at Health Insurance Coverage by Race and Hispanic Origin: 2021 (census.gov).

Biden Administration to Ask Supreme Court to Reinstate Student Debt Relief

The Biden Administration plans to ask the U.S. Supreme Court to reinstate its student debt relief program. After two federal courts halted the program, the Biden Administration announced plans to appeal one of the rulings and is prepared to appeal the other case if needed. Announced in August, the Administration’s initiative includes $10,000 in student loan forgiveness based upon income, with an additional $10,000 in forgiveness for Pell Grant recipients.

More information may be accessed here.

ASAHP Joins ACE in Urging Congress to Protect DACA and Dreamers

ASAHP was one of 65 organizations, in an effort led by the American Council on Education (ACE), which urged Congressional leaders to pass legislation to provide permanent protection for Dreamers—young, undocumented, high-achieving individuals brought to our country as children—during the last weeks of the 117th Congress. Recent court rulings against the Deferred Action for Childhood Arrivals (DACA) program, which protects hundreds of thousands of eligible Dreamers, underscore the urgency for Congress to protect Dreamers, who have been living in continuous uncertainty.

The letter may be accessed here.

Protecting The Safety Of Patients And Health Care Workers

Health and Human Services Secretary Xavier Becerra and leaders from several other federal agencies held a listening session on November 14, 2022 to discuss the department’s plan to launch next year a National Healthcare System Action Alliance to Advance Patient Safety. 

More information about the listening session can be obtained at HHS Announces Listening Session on Protecting the Safety of Patients and Healthcare Workers | Agency for Healthcare Research and Quality (ahrq.gov).

Federal Court Strikes Down Student Loan Relief Program

On Thursday a federal judge struck down the Biden Administration’s student loan relief program. The Justice Department has filed an appeal of the court’s decision. Meanwhile, the Biden Administration has stopped accepting new applications to the program.

A statement from U.S. Secretary of Education Miguel Cardona may be accessed here.

Senate Finance Committee Releases Mental Health Care Integration Discussion Draft

Today the Senate Finance Committee released its fourth component, focusing on mental health integration, of a bipartisan mental health package. Prior components focused on telehealth, youth mental health, and the mental health care network.

The press release may be accessed here. The discussion draft text is available here and a summary is available here.

Health Sector Adds Jobs In October 2022

According to recent data from the U.S. Bureau of Labor Statistics, total health care jobs grew by over 52,000 in October 2022 to a seasonally adjusted 16.6 million.  Overall, jobs increased by 261,000. The data also show that hospitals and health systems continue to experience unprecedented workforce pressures and historic inflationary cost pressures that have outpaced any growth in both volume and revenue. 

More information can be obtained at https://www.bls.gov/news.release/empsit.t17.htm.