Dear ACH Member,

Happy Halloween! Hopefully, your night will be a nice reprieve, as the knocks at your door will likely be kids in costumes asking for candy rather than candidates and campaigners once again canvassing for your vote! Regardless, the election is less than a week away, and while the last month has been relatively quiet on the Hill, the rest of the year is gearing up to be quite a ride. (Luckily, Halloween candy will be on sale tomorrow to help fuel us through…)

 

Please continue reading for important member information and legislative updates below.

 

*Save the Date* 

ACH’s 4th Annual Member Meeting (AMM) will be held in Washington, D.C., at the Dupont Royal Sonesta Hotel from March 25 - 27, 2025. Registration is now open! Be sure to register before February 28 to take advantage of early bird pricing.

 

Earlier this week, we held a webinar on Congressional Directed Spending (Earmark) requests. The recording, slides, and FAQ document are available for those who could not attend. Additionally, we will hold a special Members-Only Office Hours on November 20th, at 12:00 (ET) on federal appropriations to provide one-on-one support and guidance on submitting proposals to your members of Congress.  

 

Finally, we know there is a lot of uncertainty (and anxiety) on the outcomes of next week’s elections. While Axios reminds us to essentially ‘keep calm and carry on’ as results drag in days and maybe weeks after the election, ACH is in the process of scheduling and preparing a members-only webinar about the election outcome, its impact on ACH’s work, and our strategies going into the next Administration and Congress. Stay tuned for additional details!

 

The Latest News from D.C.

With the election less than a week away, control of the White House, House, and Senate in 2025 is seemingly anyone’s game. We can anticipate votes to be counted faster than in 2020, but the margin of victory in swing states and other tight races will determine how long it takes to declare definitive results. 

 

While ACH continues to prepare for all potential outcomes, changes to party leadership in the House and Senate and key committee chairmanships will also impact our legislative strategies.  

 

House and Senate Republicans have scheduled their conference leadership elections on November 13th. Senators John Thune (R-SD), John Cornyn (R-TX), and Rick Scott (R-FL) are all running to be Senator McConnell’s heir, making this the first competitive GOP leader race in 18 years. While Senator Thune, the current minority whip, is generally seen as the frontrunner, the presidential election's outcome could significantly affect internal party politics and President Trump's influence if re-elected. The House GOP faces its leadership challenges, including whether enough House seats have been called to determine a majority party and if the currently fractured GOP can elect a potential Speaker without Democratic support. Punchbowl News provides a detailed breakdown of the politics, election outcomes, and rule changes that could impact leadership in the GOP.

 

Democrats, on the other hand, will likely not hold leadership elections until December and seem to have a much more obvious path to leadership regardless of the general election outcomes. Senator Schumer (D-NY) is presumed to remain the Senate party leader, and Congressman Jeffries (D-NY) will remain the top Democrat in the House. 

 

Election outcomes will also significantly impact Committee chairmanships in both chambers. In the House Energy and Commerce Committee, Chairwoman Cathy McMorris-Rodgers (R-WA) announced her retirement at the end of this term, leaving the top position open for Republicans. Reps. Brett Guthrie (R-KY), Bob Latta (R-OH), and Richard Hudson (R-NC) have indicated they are weighing the run to replace Rep. Rodgers.  Current ranking member, Rep. Frank Pallone (D-NJ), will likely remain the top Democrat, either as Chair or again as ranking member.

 

Regardless of outcomes, both chambers are scheduled to be back in D.C. on November 12, when we’ll see their lame-duck priorities, including which expiring health provisions they address and whether or not they can keep the government as we approach the December 20th and December 31st funding deadlines take shape.

 

As a reminder, ACH has created resources comparing the healthcare legislative priorities and insights of the nominated Democratic and Republican presidential tickets. This resource is available exclusively for ACH members and can be accessed via our Members-Only Portal. This side-by-side comparison includes policy issues like maternal health, reproductive rights, drug pricing, Medicare, Medicaid, workforce, and more.

Updates on ACH Priorities and Legislation

 

CHC Invest

• NHSC/THC Funding: Association for Clinicians for the Underserved and the American Association of Teaching Health Centers are urging Congress to reauthorize and invest in the NHSC and THCGME programs before funding expires on December 31st in a letter to Congressional leadership. Specifically, the letter asks Congress to provide new mandatory funding at the levels approved by the Senate HELP Committee in the Bipartisan Primary Care and Health Workforce Act, which provides $950 million per year for 3 years for the NHSC and $300 million per year for 5 years for THCs. *ACTION ITEM* ACH encourages you to sign on here. Organizational signors are due by COB on Friday, November 8, 2024.
• Funding Letter: Last month, ACH delivered a letter to congressional leaders and key staff urging Congress to reauthorize the Community Health Center Fund in an end-of-year funding package with sustained, long-term funding. The letter, signed by more than 550 healthcare organizations representing all 50 U.S. States and territories, specifically requested a minimum of $5.8 billion per year for at least three years. This week, Politico Pulse included ACH’s letter and efforts in their year-end CHC reauthorization conversation.

340B/C

Committee Action:

• While the status of the SUSTAIN Act’s introduction remains nebulous, we believe it is highly unlikely that there will be significant (or any) Committee action in the House or Senate regarding 340B reform before the new Congress. ACH will continue meeting with Congress to push policy changes to protect the 340B program for health centers and lay the groundwork for the 119th Congress to view 340B reform as a non-negotiable priority.
  

340B PATIENTS Act:

• On September 11, Senator Peter Welch (D-VT) introduced the Senate’s version of the House 340B PATIENTS Act. ACH endorsed the bill, thanking Senator Welch for sponsoring this legislation codifying the use of contract pharmacies to dispense 340B discounted drugs. See the Senator’s press release here, with comments from ACH’s CEO Amanda Pears Kelly and Bi-State Primary Care Association’s Tess Kuenning.

Rebate Model:

• On September 30th, Johnson and Johnson informed HRSA that it would forgo implementation of its controversial policy to use rebates rather than up-front discounts to disproportionate share hospitals. This concession comes after HRSA threatened the manufacturer with civil monetary penalties and cutting access to the Medicaid and Medicare Part B markets if it didn’t immediately end its proposal to convert specific 340B discounts to a rebate model.

Value-Based Care

• Last week, ACH participated in a call with the Alliance for Value-Based Patient Care. The coalition call focused on recommendations to CMMI on more inclusive model developments, which included broader expansion criteria, improved evaluation strategies, customizations, and adjustments to fill current model gaps (specialists, rural areas, etc.). Coalition recommendations and principles will be finalized toward the end of the year, and we look forward to continued collaboration with the group.
• As a reminder, ACH compiled an extensive list of VBC materials and resources exclusively for our members. We hope you find this helpful, and we look forward to continuing to expand our role and influence in creating value-based care arrangements that benefit health centers and the patients they serve. 

Health Equity

• *ACTION ITEM* ACH has launched a new grassroots initiative to re-engage with Members of Congress on H.R. 1072, the Health Center Community Transformation Hub Act, introduced by Rep. Yvette Clarke (D-NY). The bill will require re-introduction next Congress, so ACH is working to build more robust support on the Hill now. Thank you in advance for your efforts, and please let us know if you have any questions!
• Gender Gap in Health Center Visits: According to a National Health Statistics Report released last week, the visit rate to health centers among women was much higher than among men. While women tend to be more proactive about their health and live longer than men, they do so in worse health. 

FQHC Workforce

• The ACH-led Developing the Community Health Workforce Act, soon to be introduced by Congressman Raul Ruiz (D-CA), has been finalized by the House’s Legislative Counsel, and we are actively working to find a Republican co-sponsor. We have lots of leads, but please contact Molly Grady at mgrady@advocatesforcommunityhealth.org if you have a Republican office you are close with that you think might be interested in working with us on this bill. 
• Provider Burnout: ACH member El Rio became the first FQHC to receive gold-level recognition from the AMA’s Joy in Medicine Health System Recognition program. Read how El Rio identified pain points and incorporated specific programs and policies to alleviate burnout and improve workforce experience. 

 Emergency Preparedness

• ACH has continued to work with Rep. Nanette Barragan's office (D-CA) to introduce the Emergency Preparedness for Underserved Populations Act. We hope to identify a Republican co-sponsor and introduce the bill before the end of the year. 
• ACH has had several conversations with key Congressional and Administrative staffers about exploring the creation of an Emergency Response fund at HRSA dedicated specifically to community health centers in the wake of natural disasters and other mass casualty events. We will continue to keep members informed as these conversations progress.  

 

Other News from Across the Federal Government 

 

The White House

• Women’s Health Research: Last week, the First Lady announced $110 million in awards from the Advanced Research Projects Agency for Health (ARPA-H) to accelerate research and development in women’s health. The awardees are working on a range of women’s health issues, including pursuing new methods of prevention, detection, and treatment for cardiovascular conditions, ovarian cancer, and endometriosis.
• Cancer Moonshot: Entering the final months of his term, President Biden announced a pilot program to test a new system for ensuring uninterrupted access to key pediatric cancer medications. This pilot is the latest chapter in the Administration’s “Cancer Moonshot” initiative, which aims to cut cancer deaths in half by 2047. 

Health Resources and Services Administration

• 2023 340B Covered Entity Purchases: HRSA released its 2023 340B covered entities purchases data. The data shows that $66.3 billion in covered outpatient drugs were purchased under the program - health center programs account for only $3.6 billion of the total. 
• Health Center Program GeoCare Navigator: As of last week, 2023 UDS is now available in the GeoCare Navigator tool. This tool can be used to assist with New Access Points, Service Area Competition, Look-Alike applications, and change-in-scope requests.
• NHSC National Advisory Council: HRSA is looking for members to join the National Advisory on the National Health Service Corps to help address healthcare delivery needs in underserved areas. Clinicians and health officials with a background in primary care, oral health, or mental/behavioral health are encouraged to apply. The deadline for submitting nominations, including self-nominations, is December 6.
• PHE Telehealth Guidance: HRSA extended the expiration date for guidance on using telehealth for people who are not current health center patients. The updated telehealth FAQ is now in effect until a new policy is issued or until December 31, 2025. 

Centers for Medicaid and Medicare Services

• Culturally Appropriate Health Care: On October 16, CMS approved Section 1115 demonstration waiver amendments to allow, for the first time, Medicaid and CHIP coverage of traditional healthcare practices provided by Indian Health Service facilities, Tribal facilities, and urban Indian organizations. Arizona, California, New Mexico, and Oregon are among the first states to allow this coverage expansion, which is expected to improve access to culturally appropriate healthcare and improve the quality of care and health outcomes for their tribal communities.
• Marketplace Open Enrollment Period: The open enrollment period on HealthCare.gov begins November 1st and ends January 15th, 2025. This week, CMS announced a handful of policies to increase access and affordability of coverage. For the first time, DACA recipients will have access to marketplace coverage. CMS has also launched “window-shopping” for consumers to preview health coverage options before selecting a plan.
• Shared Saving Program ACOs: This week, CMS announced Medicare Shared Savings Programs yielded more than $2.1 billion in savings in 2023, the largest savings in the Shared Savings Program’s history. CMS also announced that Shared Savings Program ACOs led by primary care clinicians had significantly higher net per capita savings than ACOs with a smaller proportion of primary care clinicians, underscoring the importance of primary care to the program's success.  

Congress

• Lame-Duck Health Programs: In addition to the Community Health Center Trust Fund and funding for the National Health Service Corps and Teaching Health Centers programs, Congress has several other expired/expiring health programs to address during lame duck. Some of these programs to watch include:
  • Older Americans Act
  • Pandemic and All-Hazards Preparedness Act (PAHPA)
  • President’s Emergency Plan for AIDS Relief (PEPFAR)
  • COVID-era telehealth coverage extension

ICYMI

• Primary Care Moonshot: A Policy Proposal for Addressing Underinvestment in Primary Care, American Journal of Managed Care
• Senior-Focused Primary Care Organizations Increase Access for MA Members, Especially Underserved Groups, Health Affairs
• For Behemoth UnitedHealth, A New Threat to Medicare Profits, STAT News
• How Politics is Stressing Us Out More Than Ever, Axios
• Medicaid Enrollment & Spending Growth: 50 State Medicaid Director Survey, KFF
• How to Finally Abolish the Electoral College, POLITICO Magazine

 

Upcoming Events of Interest

• November 8: Advancing Value-Based Care in Community Health Centers, 12:00 PM (ET), Virtual
• November 20:  ACH Members-Only SPECIAL Policy Office Hours: Expert Assistance on Congressional Directed Spending Requests 12:00 - 1:00 PM (ET), Virtual.
• December 2 - 4: Third Annual Social Determinants of Health Policy Forum, Washington, D.C.
• March 25 - 27, 2025: ACH 4th Annual Member Meeting, Washington, D.C.

Please let us know if you have any questions and have a great rest of your week!

 

Sincerely,

 

Your ACH Policy & Government Affairs Team

 

Stephanie Krenrich, SVP, Policy & Government Affairs

Molly Grady, Director, Policy & Government Affairs