Final Week for the 114th Congress.

This is the final week of legislative activity for the 114th Congress, with the House and Senate expected to work through the outstanding items that remain for 2016.

Lawmakers are scheduled to be in session until Dec. 16, but resolution and passage of a spending measure to keep the government funded into 2017, the annual national defense authorization act, and the biomedical innovation bill, among a handful of other final legislative items should be finished this week, enabling members to depart Washington, D.C., at the end of this week.

Negotiations over a continuing resolution have been ongoing and press reports indicate congressional leaders are close to a deal that should be ready for a vote this week. Current government funding expires on Dec. 9. Although initial discussions on the CR were focused on a three-month extension of current spending authority into March 2017, leadership now seems to be agreed on extending that authority into April after acknowledging the reality of the congressional calendar. Both chambers are anticipating an active legislative agenda in the first few months of the 115th Congress, and the Senate will be particularly busy with the confirmation process for appointees to the new administration. Republican leadership recognizes that it would be challenging to add an appropriations deadline to the agenda in the first 100 days of the new session. Legislative text has not yet been released, but House leadership indicated on Friday that the text of the spending bill would be ready to permit a vote this week. Although the funding portion is easily crafted, many funding anomalies and various legislative provisions that can be agreed upon must be crafted, making the final drafting of the CR a laborious and time-consuming task.

In addition to the expected consideration of a CR this week, the Senate is set to take up two additional lame duck priorities. Following the successful passage of both the biomedical innovation bill (H.R. 34, the 21st Century Cures Act) and a $619 billion conference report to the National Defense Authorization Act (S. 2943) through the House of Representatives last week, the Senate is now poised to take action on these measures. Senators are scheduled to return on Monday for a procedural vote on the 21st Century Cures Act, legislation that will invest greater resources in medical innovation and speed up the process by which the U.S. Food and Drug Administration approves new drugs and devices. The legislation also includes additional provisions to address the opioid epidemic and to bolster the country’s mental health systems. There is widespread, bipartisan support for the measure, and even though several Senate Democrats have criticized the final version of the bill and announced their opposition, the legislation is expected to see Senate approval this week and be signed into law by the president.

Once the 21st Century Cures Act has been dispensed with, the Senate will begin consideration of the conference report to the National Defense Authorization Act, which passed the House last Friday by a vote of 375-34. This legislation provides an additional $8 billion in funding for overseas contingency operations and readiness shortfalls and covers the $5.8 billion supplemental request sent by the president to Congress in November. It also includes a 2.1 percent pay raise for U.S. troops. The funding in the bill is simply an authorization, and defense hawks have been critical of the CR strategy that congressional leaders have been pursuing because a CR will not provide the military with all of the funds authorized by this bill

The House is scheduled to convene again on Monday when it will take up six bills under suspension of the rules, including S. 1635, legislation authorizing the activities of the Department of State for FY 2017.

On Tuesday, members will consider a suspension package consisting of 21 bills, reported out of the Energy and Commerce, the Natural Resources, or the Veterans Affairs Committees.

On Wednesday and during the remainder of the week it is possible for the House to take up additional measures under suspension of the rules. Also expected for floor consideration is H.R. 5143, the Transparent Insurance Standards Act of 2016. The legislation would require the Treasury Department and Federal Reserve to provide additional reports to Congress on international negotiations regarding regulatory standards in the insurance industry. Chief sponsor of the bill, Rep. Blaine Luetkemeyer, R-Mo., chairman of the House Financial Service Committee’s Housing and Insurance Subcommittee, stated the bill is intended to “increase transparency and strengthen Congress’ role in supervising foreign standards setting organizations.” Consideration of H.R. 5143 will be subject to a rule. Finally, the House will tackle the CR when it becomes available.

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Bipartisanship Breaks Out

For a Congress best known for years of rancor, the extent of cooperation surrounding the he 21st Century Cures Act — coming on the heels of the bipartisan “doc fix” — suggests that Capitol Hill may really be focusing on legislating. Last Thursday’s  51-0 vote to advance the Cures Act to the full U.S. House of Representatives was an important milestone for a fast-evolving bill.

“This really kind of blows your mind considering all the angst and animosity and other kinds of … engagements that we have,” said Rep. Bobby Rush, D-Ill., who labeled Thursday’s hearing a “lovefest.” (Creddit AP).

Moreover, a 49-page amendment approved as part of Thursday’s vote at the Energy & Commerce Committee addressed a key concern by earmarking $550 million over five years to help the U.S. Food and Drug Administration fulfill new duties created by the bill. Those include development of new “biomarkers” to gauge drug effectiveness, enhanced incorporation of patient perspective into approval decisions, and grants to study so-called continuous drug manufacturing that could reduce production costs.

In addition, the amendment would exempt from budget sequestration the user fees paid by drug and device makers to support FDA reviews and inspections. Sequestration only kicks in if spending caps are exceeded, but the Cures bill now provides peace of mind for companies that complained about private money being locked away in 2013 because of political spending fights.

“FDA user fees were never intended, I think, to be part of the sequester,” Rep. Fred Upton, R-Mich., said on Thursday. (Credit AP).

Other substantive provisions were notable for their omission, including possible changes to dial back use of the 340B drug discount program by hospitals and clinics. Any such change could have alienated Democrats and jeopardized bipartisan support, and the provision’s absence won praise.

One provision would delay so-called reinsurance subsidies that go to health insurance plans in Medicare Part D in order to partly offset the costs of unusually expensive policyholders. The proposal stems from a 2013 inspector general’s report that found delays of certain advance payments would allow Medicare to generate more interest income — roughly $110 million in 2009 alone.

The current financial impact of that step is not yet public, but trade group America’s Health Insurance Plans reacted angrily on Thursday, saying that it “strongly opposes” the idea. Elsewhere, a new section starting in 2020 would cap Medicaid reimbursement for durable medical equipment at the amount paid under Medicare’s new competitive bidding program. The section is based on a provision in next year’s budget blueprint for the U.S. Department of Health and Human Services, which predicted $4.3 billion in savings over 10 years.

Nevertheless, Rep. Joe Barton, R-Texas, suggested that the vote was historic against any backdrop, and perhaps unprecedented in his nearly three decades on the Energy & Commerce Committee.

“I don’t think we’ve ever had a major bill — major bill — that didn’t have somebody … that voted no,” Barton said. “This is a real achievement.” (Credit AP).