Policy Updates and Issue News July 2022

CHIPS Bill Moves

After months of negotiations between both parties and chambers of Congress, the Senate and House were at last able to pass a final version of the $280 billion CHIPS Act which would fund domestic semiconductor manufacturing and high-tech research. Over the past few months, the package has varied dramatically in size and scope as members of Congress from both parties have sought to fit funding for their own issues and projects into the bill. On July 27^th, the Senate passed the bill in a bipartisan vote of 64 to 33 and the following day the House was able to pass the bill with more modest bipartisan margins.

Reconciliation Process Begins

As outlined in our last overview, Democrats have spent the last year negotiating over the contours of a large package of social and environmental spending priorities and tax increases which they could pass on a party-line vote through the budget reconciliation process. Throughout this process, moderate Democratic Senators like Joe Manchin (D-WV) and Kyrsten Sinema (D-AZ) have served as gatekeepers of how much and what type of spending can be included in the bill. For many months it seemed as though Democrats would only be able to come to an agreement on a smaller package allowing Medicare to negotiate prescription drug prices and extending Affordable Care Act (ACA) subsidies through 2025.

However, following the passage of the CHIPS Act in the Senate, Democrats revealed a somewhat larger package dubbed the Inflation Reduction Act of 2022 (IRA). Beyond drug price negotiations and ACA subsidy extension the bill includes revenue raising tax provisions closing the carried interest loophole, increasing funding at the Internal Revenue Service for tax enforcement, and setting a 15% corporate minimum tax on businesses earning greater than $1 billion. With the estimated $739 billion raised by the changes to drug price negotiations and tax increases the IRA would use this money to fund a variety of energy and climate related spending totaling $369 billion and would use the remainder to pay down the federal deficit (estimated at $300+ billion). With this package outlined, Senate Democrats will have to begin the time-consuming and arduous budget reconciliation process which will likely take up the rest of the current congressional work period before the August recess. Following Senate passage, the bill will make its way to the House which will likely have to reconvene during the August recess to move it forward.

Miscellaneous Priorities

Beyond the CHIPS bill and beginning of the Reconciliation Process, both the House and Senate have a lot of smaller issues with varying levels of controversy which they want to address before the start of the August recess.

In the Senate, both parties want to undertake consensus votes on providing American approval to admitting Sweden and Finland as new NATO member states and passing the PACT Act, an important bill providing benefits to veterans who have been exposed to toxic chemicals. As well, Democratic Senate leadership would like to move forward a vote on the House passed Respect for Marriage Act, which would codify the protections extended to same-sex marriages that were created in the Supreme Court’s Obergefell v. Hodges decision in 2015, that received some Republican support in the House, but has an unclear path in the Senate.

Meanwhile, as the House awaits Senate action on the CHIPS bill and Reconciliation package, leadership is pursuing votes on public safety which are dividing Democratic membership. Recently, Democrats on the House Judiciary Committee moved a bill which would ban assault weapons that a number of front-line Democratic members have already declared their opposition to. At the same time, a group of moderate Democrats has been pushing a bill which would significantly increase funding to a variety of local policing programs which has seen some opposition from progressive Democrats. House Democratic leadership is currently trying to bridge the divide between moderates and progressives on both of these issues in the hope that they can pass something before the August recess, though odds seem unlikely.

Supreme Court Narrows EPA Authority

The Environmental Protection Agency does not have clear direction from Congress to require power plants to shift to cleaner energy sources according to the recent 6-3 decision from the Supreme Court. The ruling said administrative agencies must be able to point to clear congressional authorization to make decisions of vast economic and social significance and no such authorization exists in the Clean Air Act.  The decision could have implications for other administrative agencies which may be using broad interpretations of regulatory authority delegated by Congress to issue and enforce regulations.

National Grange Rural Voter Poll Sheds Light on Health Care Priorities

The National Grange sponsored a Morning Consult poll of 1,004 rural voters in July that focused on barriers to health care and participation in mental health care.  The survey found that rural voters feel their health care concerns are not being addressed by Congress and their health care priorities focus on lowering out-of-pocket costs and the overall cost of coverage.  Rural voters support increasing transparency, requiring rebates to patients at the pharmacy counter, making sure vulnerable communities have access to health care and can afford it, and capping out-of-pocket cost-share. Mental health care is an issue for rural voters.  The survey identifies several unique obstacles to mental health care which include cost, accessibility, and awareness of help or treatment.  Interestingly, 68% of rural voters polled said they would definitely vote and another 14% said they would probably vote in November.  When asked what is the most important issue impacting their vote in the midterm elections, the answer was inflation/cost of goods from 49% of those polled.  The next closest issue of concern was the economy/jobs among 15% of the respondents.

Give Patients Cost Savings at the Pharmacy Counter

The National Grange joined the National Community Pharmacists Association and over 200 patient advocacy and health care groups to support S. 4293, the bipartisan Pharmacy Benefit Manager Transparency Act of 2022 cosponsored by Senators Cantwell (D-WA.) and Grassley (R-IA).  The Act would require greater transparency when pharmacy benefit managers (PBMs) contract with plan sponsors and employers. It would also give the Federal Trade Commission greater enforcement authority to prohibit unfair or deceptive business practices.  The goal is to assure rebates and other drug-cheapening measures actually reach the patient who is paying the bill at the pharmacy counter.

Immunocompromised Populations Need Additional Treatment Options

As many as seven million individuals in the U.S. currently have limited options for protection against COVID-19. The National Grange joined Healthy Women and numerous other patient advocacy groups on a letter to Food and Drug Commissioner Califf to consider additional treatment options for these patients.  Such patients include those with organ transplants, cancer, HIV, other autoimmune diseases, and older Americans who manage their chronic conditions through multiple medications and may be fearful of drug interactions.