Since returning from the holidays, Congress has primarily focused on funding the federal government which is operating under two Continuing Resolutions (CRs). The first of these CRs expires on January 20th meaning Congress must act by January 19th to avoid a partial government shutdown. Congress and President Biden announced they had reached an agreement on top-line spending figures – an important first step toward funding the government for the rest of the fiscal year.

However, opposition to the top-line figures from some conservative House Members means Congress still has a long way to go to pass a full FY 2024 spending bill. Another CR is increasingly likely. We are closely monitoring the January 19th funding bill to see if it will include a provision to mitigate some or all of the 3.37% reduction to the 2024 Medicare Physician Fee Schedule Conversion Factor.

This newsletter originated as an update about the federal response to the COVID-19 public health emergency (PHE). While the COVID-19 situation has certainly improved since 2020, COVID-19 is unfortunately back in the news due to rising case levels across the country. 12.4% of COVID-19 tests at the end of 2023 were positive, compared to 10.6% at the end of 2022.

Last week, the CDC reported that 62% of recent COVID-19 cases are of the JN.1 variant, which is descended from the omicron variant. The prevalence of this variant has increased over the past few months, with 66% of recent wastewater measurements indicating JN.1 as the primary variant. Data does not currently demonstrate that the JN.1 variant causes more severe disease than previous variants. Both ED visits and hospitalizations due to COVID-19 have increased in the last week.

The high COVID-19 infection rate is accompanied by increases in other respiratory illnesses, including influenza and RSV. According to the CDC, 22 states have reached “very high” levels of respiratory illness. States with “very high” levels are concentrated in the southeast U.S. This has prompted healthcare workers in states such as California and New York to return to masking in hospitals.

Vaccination also offers an opportunity for protection against these respiratory illnesses. However, the CDC identifies that a limited number of adults and children have received an updated COVID-19 vaccine during this viral season. This phenomenon is similar for flu and RSV vaccines. For example, pharmacies administered 7.85 million fewer flu vaccines by mid-December 2023 compared to the same time in 2022. Only 17.7% of adults over the age of 60 have received an RSV vaccine.

The COVID-19 Public Health Emergency (PHE) expired in May of 2023. The federal government is not expected to issue another PHE declaration for rising cases. 

HHS has contacted states in which high numbers of children have been disenrolled from Medicaid. One federal rule allows an additional 12 months to process enrollment for children in order to maintain coverage.

A KFF analysis of Medicaid Unwinding found that over 14 million people have been disenrolled as of January 9th. They determined that 71% of terminations are because of varying procedural issues across states.

Medicaid enrollees in North Dakota will have access to free naloxone through a 1-year standing order developed by the ND Board of Pharmacy and HHS.

ACA marketplace enrollment has reached record-breaking numbers ahead of the closing of the enrollment period on January 16^th. Over 20 million people have enrolled themselves in ACA plans for 2024.

The Senate Health, Education, Labor, and Pensions Committee is launching an investigation into the cost of asthma inhalers. The Committee has sent letters to AstraZeneca, Boehringer Ingelheim, GlaxoSmithKline, and Teva to collect more information on manufacturing costs.

The FDA has given Florida authorization to import prescription drugs from Canada. Florida’s proposed plan regarding important estimates $150 million in annual savings once fully implemented.

The American Red Cross is experiencing a severe blood shortage. In a partnership with the NFL to encourage blood donations, anyone who donates blood in January will be entered to win a trip to the Super Bowl in February.

A Becker’s Hospital Review article argues that HHS should create a Chief Patient Officer position. This Chief Patient Officer could provide more advocacy for the patient perspective in the healthcare system.