Lawmakers set to face ticking clock on health care priorities

The House and Senate left Washington for the month of August with a lengthy, time-sensitive to-do list waiting when they return, including multiple key health care priorities. 

There will only be three weeks before the end of the fiscal year to get everything done, and just 11 legislative days when both chambers will be in session at the same time. 

Congress faces a Sept. 30 deadline to reauthorize a sweeping pandemic preparedness bill, fund community health centers and renew opioid addiction services.

But the largest looming deadline is the appropriations bills to fund the Food and Drug Administration (FDA) and the Department of Health and Human Services (HHS), which are tied up in the House amid disagreements over abortion policies and spending levels. 

GOP leaders scuttled a vote planned for Friday on legislation funding the FDA and the Department of Agriculture after moderate Republicans objected to a provision that would reverse the FDA’s decision to allow the abortion pill mifepristone drug to be dispensed through the mail and in retail pharmacies. 

House Freedom Caucus members have also been demanding even deeper spending cuts than agreed to in the bipartistan debt ceiling deal. 

The Labor-HHS bill advanced through a House Appropriations subcommittee earlier this month, but hadn't even made it to the full committee before recess. The Republican-led House bill would slash or eliminate funding from a range of programs that deal with everything from family planning to teen pregnancy and even HIV.

Both FDA and HHS funding bills face a major fight in the Democratic-controlled Senate, where the Appropriations Committee has already passed its own version by near unanimous margins, owing to an agreement by Democratic and Republican leaders not to insert “poison pill” amendments. 

House Democratic Whip Katherine Clark (Mass.) argued in a floor speech that lawmakers should stay in Washington to strip out the “toxic, divisive, bigoted riders” in the bills, and ripped Republicans for delaying votes until September.

Pandemic preparedness

The House and Senate are taking different tracks in the reauthorization of the pandemic preparedness bill, complicating its path forward. 

The Senate advanced a bipartisan version of the Pandemic All-Hazards Preparedness Act out of committee, but the House is divided. House Energy and Commerce Committee Republicans advanced a bill on party lines after Democrats introduced their own version.

The primary disagreement is over drug shortages. Democrats are clamoring to give FDA more oversight authority to address the shortages, but Republicans are insisting on keeping the issues separate. 

The Senate version contains some provisions addressing drug shortages, but only one involves beefing up FDA authority. 

Congress is under pressure to stem drug shortages amid reports of doctors rationing cancer drugs and other medicine. Republicans on the Energy and Commerce Committee have said they are committed to dealing with the problems, but that it shouldn't be part of the preparedness bill. 

Energy and Commerce Committee GOP leaders released a discussion draft Friday of drug shortage legislation focusing on the economic reasons for shortages, including giving some generic drug manufacturers the ability to raise the cost of their drugs if hospitals keep prices "artificially low" to the point where there's no economic incentive to produce or sell them. 

Health centers

Legislation to reauthorize funding for community health centers also faces partisan challenges. But in this case, the House cleared its bill on a bipartisan basis, while the Senate is still working through disagreements, highlighting the work to be done.

Sen. Bernie Sanders (I-Vt.), chairman of the Senate Health, Education, Labor and Pensions (HELP) Committee, originally wanted tens of billions of dollars more for the centers. He was asking for $130 billion to fund the centers over the next five years as well as $60 billion to help grow the health care workforce.

But Sanders ended up canceling a planned markup during the last week of July. Raising some eyebrows, Sanders said he is working with Sen. Roger Marshall (R-Kan.) to craft a bipartisan bill that will be "ready by the first week of September." 

Separately, Sanders and Senate Finance Committee Chairman Ron Wyden (D-Ore.) issued a joint statement pledging to partner and work toward legislation in the fall aimed at addressing primary care and other health care workforce shortages.


At issue are several provisions of sweeping legislation signed into law in 2018 called the Support Act, which aimed to tackle the country's drug overdose epidemic. 

The House Energy and Commerce Committee advanced a bipartisan reauthorization and expansion bill, but advocates are concerned the Senate is behind. 

HELP Committee ranking member Bill Cassidy (R-La.) introduced his own version of the bill July 20, but hearings won't be scheduled until September. Cassidy has warned that the committee is wasting time on partisan bills instead of easy bipartisan wins, such as the Support Act. 

Insulin/PBM reform

Senate Majority Leader Chuck Schumer (D-N.Y.) has said for months that he wants to move legislation that would cap the cost of insulin at $35 per month for people with private insurance. 

There's hope to combine it with legislation reforming the pharmacy benefit manager (PBM) industry into a package that could get bipartisan support. 

But there's no looming deadline and no guarantee it will get taken up in September.  

Sen. Jeanne Shaheen (D-N.H.), who is a co-sponsor of one of the insulin bills with Sen. Susan Collins (R-Maine), said she still has Schumer's support heading into the fall but has not heard anything about timing.

Multiple committees have advanced PBM reform bills in both the House and Senate, so they will all need to be combined into one floor-friendly package.

Raskin slams ‘preposterous’ idea that Biden drug control strategy should include ‘faith’

Rep. Jamie Raskin (D-Md.) sharply rebuked a suggestion from Rep. Paul Gosar (R-Ariz.) that President Biden’s national drug control strategy is flawed because it does not mention God or faith, calling that idea “preposterous” in a hearing Thursday. 

In a hearing examining the Office of National Drug Control Policy’s efforts to combat the overdose crisis, Raskin argued that mentioning God or faith would violate the U.S. Constitution, which specifically prohibits Congress from making laws respecting an establishment of religion.

“The gentleman is somehow looking for some kind of religious test, which is explicitly forbidden in the Constitution [for] people for public office, in the drug control strategy,” Raskin said, referring to Gosar. “Surely, [faith] can make a difference in terms of people's individual lives and individual paths to recovery. People will derive sources of strength from many different places, including religious faith, including their friends and their family, including psychology and so on.”

“But the idea that our drug strategy is flawed because it doesn't put religion in the center seems to me to be preposterous,” said Raskin, the top Democrat on the House Oversight panel. 

Raskin was responding to Gosar’s criticism that the Biden administration’s drug control strategy is flawed, at least in part, because it does not mention God and faith. 

“Biden's National Drug Control Strategy is 150 pages. The words ‘God’ and ‘faith’ are not mentioned one time. People need a purpose to be happy,” Gosar said, before seeming to suggest there was a connection between greater government assistance, a lack of faith in God and a rise in drug overdoses. 

Gosar quoted Democratic long-shot presidential candidate Robert F. Kennedy Jr. in saying “unemployment kills,” and added, “The left offers endless benefits. In other words, dependency. Because dependent population votes for the providers of those benefits. But a human being needs a purpose — a good job, the ability to provide for a family, a belief in a creator — in order to be happy.”

How the Dobbs decision stunted anti-abortion action in the House GOP

The Supreme Court case that eliminated the federal right to obtain an abortion was preceded by years of legislative attempts by congressional Republicans to chip away at those protections.

But a year after the high court handed down its decision in Dobbs v. Jackson Women’s Health, there is little appetite among Republicans in the House — the only chamber where they control the majority — to take steps to restrict abortion at the national level.

Though House Republicans passed 20-week abortion ban bills three times in the last decade, many of the same abortion opponents behind those proposals now say the issue should be handled at the state level. 

And Republicans in swing districts are loath to spend political capital on a messaging bill that is dead on arrival in a Democratic-controlled Senate — particularly as more and more Americans say they are in favor of increasing abortion access.

“There's political realities in a four-seat majority,” said Rep. Don Bacon (R-Neb.), who represents a district that President Biden won in 2020. While he supports some proposed anti-abortion measures in theory, he understands why others do not.

“Some people are very sensitive about it. Though they would agree to it, they're just afraid that it becomes a big issue in the next election,” Bacon said. 

That concern isn’t unfounded. Abortion played a major role in the 2022 midterms, coming in behind only inflation as the issue voters were most concerned about. The liberal side prevailed in each of the five abortion-related referendums on state ballots in November — including in Montana and Kentucky — as well as in a Kansas special election last summer and a Wisconsin Supreme Court election earlier this year that turned heavily on the issue of abortion.

A Gallup poll conducted in May found record-high support for abortion access.

Meanwhile in the House, Republicans seem to be pulling back on taking even incremental steps against abortion.

A bill to permanently codify and expand the Hyde Amendment, a provision that prohibits certain federal funds from being used on abortion procedures, was included in a list of 12 pieces of legislation House Republicans planned to pass in the first weeks of the new House majority. That bill, the No Taxpayer Funding for Abortion and Abortion Insurance Full Disclosure Act was given the high bill number of H.R. 7 — symbolic of its importance to the Republican platform.

But it never came to the floor, with opposition from moderate House Republicans being a factor.

One of those is Rep. Lori Chavez-DeRemer (R-Ore.), a first-term Biden-district Republican.

“I will continue opposing standalone federal action on limiting taxpayer funding for abortion. The Dobbs decision made clear that it's an issue that should be decided at the state level, and Oregonians recently rejected efforts to limit taxpayer-funded abortion overwhelmingly,” Chavez-DeRemer said in a statement.

House Majority Leader Steve Scalise (R-La.) said that leaders are “going to keep working to move” the bill, and said Republicans will work to include provisions prohibiting spending on abortion in appropriations bills.

Staff for the Republican Study Committee, the largest conservative caucus in the House, released a memo Friday urging Republicans to stand together to pass the No Taxpayer Funding for Abortion and Abortion Insurance Full Disclosure Act — noting that it passed with universal GOP support in January 2017, the last time the party held the House majority. 

Rep. Nancy Mace (R-S.C.) has been an outspoken critic of how her party has handled abortion issues, saying in April that Republicans could “lose huge” if they continued trying to enact strict bans, but is a cosponsor of the legislation. 

She said the bill was supposed to get a floor vote last week but was pulled down due to concerns from GOP members in swing seats.

Some members took issue with the bill being “Hyde plus,” including prohibiting qualified health plans under the Affordable Care Act from providing abortion coverage. 

While Mace supports bans on the procedures as long as there are exceptions, she thinks Republicans should put more focus on options such as expanding access to birth control and adoption.

“For me as a woman and as a victim of rape, it's really important that we as Republicans let women know we care about them,” Mace said.

The House did pass two measures related to “pro-life” issues in February: A bill to require care to be given to an infant who survives an abortion procedure (Democrats have argued that a 2002 law already guarantees infants’ legal rights), and a resolution condemning attacks on anti-abortion centers and churches.

And some moderate Republicans think the House should not go much further than that.

Rep. Brian Fitzpatrick (R-Pa.), another Republican who represents a district that Biden won, said he does not think there should be more action in the House GOP to implement more abortion restrictions.

“I think that it's a very divisive issue, and we need to start building a bridge on it,” Fitzpatrick said. “I'm a big believer in legislating between the 40-yard lines and eliminating extreme options on all sides.”

That marks a stark change from the abortion politics in Congress over the last decade, when incremental nationwide ban legislation helped gradually build momentum for the anti-abortion cause leading up to the Dobbs decision.

House Republicans passed a 20-week abortion ban when they controlled the House in 20132015 and 2017. Last year, that bill was modified to ban abortions after 15 weeks.

But now, House GOP leaders are distancing themselves from any kind of national abortion ban.

“It works through committee. The Supreme Court has made that decision. It goes to the states, the states will take up that issue,” Speaker Kevin McCarthy (R-Calif.) said in a press conference in April when asked if Republicans will put forward a national ban on abortion in any form.

Interest in pursuing a national abortion ban also appears low in the Senate GOP.

“Most of our folks are of a mind that, you know, letting states decide is the best course of action,” Senate Minority Whip John Thune (R-S.D.) said. 

But Thune warned that Democrats will define Republicans by the most restrictive bans and will work to guarantee abortion access at the national level — which could push the debate to Congress eventually.

“At some point, there will be a debate here at the national level,” Thune said. “The position I've come behind is the 15-week ban.”

Sen. Lindsey Graham (R-S.C.) said he still thinks Republicans should support the 15-week ban proposal he spearheaded last year, calling it a reasonable “national minimum standard.”

But Republicans are long way away from having a filibuster-proof majority in the Senate that could usher an abortion ban into law.

It's not only vulnerable Republicans veering away from a national abortion ban. Conservative Republicans in solidly red districts also say the issue should be left to the state level. 

“Nobody's bringing up a national ban. Nobody is trying to push that,” Rep. Byron Donalds (R-Fla.) said. Donalds said that his read of the Dobbs decision is that “abortion is now to be regulated by the states, as it should have been this entire time — not by the Supreme Court and not by Congress.”

They also worry that being too assertive with anti-abortion messaging could endanger Republicans — and the anti-abortion cause — overall, now that voters have a much heightened awareness of the issue.

“I think going into a ‘24 election, presidential election, you have a lot of lessons learned from the midterms. And I think, collectively, you're seeing the states step up, particularly after Roe v. Wade, making decisions that we for the longest time have advocated for — that this was a states rights issue,” Rep. Kat Cammack (R-Fla.), co-chairwoman of the Pro-Life Caucus.

“But people are very cognizant of where they need to fall in terms of the messaging on this, because we certainly lost seats and had missed opportunity as a result of some pretty aggressive, extreme messaging,” Cammack said.

Mychael Schnell and Al Weaver contributed. 

Louisiana congressman manhandles activist during press conference: ‘You’re out’

Louisiana Rep. Clay Higgins (R) physically pushed back an activist approaching a press conference in front of the Capitol on Wednesday. The man was attempting to ask Rep. Lauren Boebert (R-Colo.) questions as he walked toward the podium.

In a video posted online and shared with The Hill, Higgins can be seen grabbing the man’s arms and pushing him back several yards, nearly lifting him off the ground.

The man, Jake Burdett, was at the Capitol on Wednesday with the Maryland Progressive Healthcare Coalition to show support for the reintroduction of the Medicare for All Act alongside Sen. Bernie Sanders (I-Vt.) and Rep. Pramila Jayapal (D-Wash.).

Kristy Fogle, founder of the Maryland Progressive Healthcare Coalition, told The Hill that her group saw the press conference being held in front of the Capitol, and Burdett said he was interested in asking Boebert a “tough question” when she was at the podium.

Rep. Clay Higgins (R-La.)

Rep. Clay Higgins (R-La.) asks questions during a House Oversight and Accountability Committee hearing to discuss fraud and waste in federal pandemic spending on Wednesday, February 1, 2023. (Greg Nash)

Fogle said that, from her perspective, several men who were at the press conference blocked Burdett from approaching. In a video provided to The Hill, Burdett can be heard questioning Rep. Paul Gosar (R-Ariz.), who was speaking at the podium, on his affiliation with far-right white supremacist Nick Fuentes, as well as political ads that featured Gosar's family denouncing the congressman.

In the video taken by Burdett, Higgins can be heard telling him, “I’m a congressman. I’ll make you a deal. Listen, let this man talk, and then I’ll come talk to you privately.”

“All I’m asking you to do is just peacefully stand by with your camera, and I promise you — look at me — I’ll come talk to you straight-up and answer all your questions,” Higgins continued.

In a second video, Burdett approaches the press conference as Boebert is at the podium, questioning her about her recently filed divorce and her restaurant. At this point, several men, including Higgins, begin ushering Burdett away before he walks behind the podium.

After getting close to Boebert, Higgins is heard saying to Burdett, “Nope. You’re out, you’re out,” and begins to push him further and further away from the conference.

“Aren’t you a congressperson touching me?” Burdett asked Higgins, to which Higgins replied, “Yes sir. Yes sir, I am.”

Higgins can then be heard repeatedly saying, “stand by” and “calm down.”

“Rep. Higgins, who I didn't realize this was him at the time, he grabbed him, pushed him and continued to push him backwards,” Fogle said. “ I honestly didn't realize that was a representative. I thought that was a bodyguard, the way that he was acting.”

A tweet from Higgins on Thursday accused an unnamed activist of being "a 103M," referring to the police code for "disturbance by mental person."

"One agitator activist protestor became very disruptive and threatening in violation of the law," Higgins said. "Congressman Higgins successfully de-escalated the situation."

Boebert tweeted on Thursday that Higgins had "defended me as a radical socialist attempted to disrupt me during a press conference."

After the incident, U.S. Capitol Police came and interviewed Burdett, according to Fogle, while Higgins returned to the press conference.

In a statement to The Hill, U.S. Capitol Police said, “We are aware of this situation, interviewing the people who were involved, and reviewing the available video.”

Updated: 3:58 p.m.