THIS WEEK’S DOSE

• House Hearing on Artificial Intelligence in Healthcare: The House Energy & Commerce Health Subcommittee discussed the potential for artificial intelligence (AI) to improve healthcare.
• House Hearing on Fiscal Commissions: The House Budget Committee examined legislative proposals to address the budget deficit through fiscal commissions.
• Marketplace Open Enrollment Activity: The Centers for Medicare & Medicaid Services (CMS) provided an update on the 2024 Marketplace Open Enrollment Period (OEP).

CONGRESS

House Energy & Commerce Health Subcommittee Committee Examines AI. The hearing explored the transformative potential of AI in healthcare, acknowledging its promise in enhancing efficiency, improving patient care and advancing medical research. The discussion included questions about the role of existing agencies such as the US Food and Drug Administration, the need for specialized AI regulatory bodies and the importance of transparency in AI decision-making. Members and witnesses noted that ethical considerations—including biases in algorithms and patient consent—must be addressed. They also emphasized the delicate balance between fostering innovation and safeguarding patient well-being. The discussion highlighted the need for AI to be implemented as a supportive tool in healthcare, rather than as an autonomous decision-maker. The hearing underscored the importance of implementing careful oversight and guardrails to address complex ethical and practical considerations, including data security, user consent and the potential financial implications of AI applications in healthcare.

House Budget Committee Reviews legislative Proposals for Fiscal Commissions. The hearing examined three bipartisan legislative proposals, H.R. 710, H.R. 5779 and S. 3262, all of which would create fiscal commissions aimed at addressing the budget deficit. There was bipartisan consensus on the need to address the debt, interest payments and budget quickly to preserve the solvency of the Medicare and Social Security Trust Funds. There was some skepticism on whether the creation of a commission would be the most appropriate and effective way to address the budget deficit.

ADMINISTRATION

CMS Provides Update on Marketplace OEP. CMS issued a press release noting that about 4.6 million people have selected an Affordable Care Act (ACA) Health Insurance Marketplace plan since the 2024 Marketplace OEP began on November 1, 2023. This represents activity through November 18 (week three) for the 32 states using HealthCare.gov, and through November 11 (week two) for the District of Columbia and the 17 states with state-based Marketplaces. Total plan selections include 920,000 people (20% of total enrollees) who are new to the Marketplaces for 2024, and 3.7 million people (80% of total enrollees) who have active 2023 coverage and returned to their respective Marketplaces to renew their coverage or select a new plan for 2024.

The 2024 Marketplace OEP runs from November 1, 2023, to January 15, 2024, for Marketplaces using the HealthCare.gov platform. Consumers who enroll by midnight on December 15, 2023, can receive full-year coverage that starts January 1, 2024. Some states have open enrollments that run through January 2024.

Read the CMS fact sheet here.

QUICK HITS

• Administration Announces Actions to Bolster Medical Supply Chain. The US Department of Health and Human Services (HHS) announced that President Biden will issue a presidential determination broadening HHS’s authorities under Title III of the Defense Production Act to enable investment in domestic manufacturing of essential medicines, medical countermeasures and other critical inputs that the President deems essential to the national defense. HHS also will designate a new supply chain resilience and shortage coordinator to improve critical medical product and food supply chains and address shortages.
• Administration Updates Resource to Support Inclusion of Children with Disabilities in Early Childhood Programs. HHS and the US Department of Education (DOE) released a policy statement that reiterates expectations for inclusive early childhood settings. The policy statement also updates recommendations for state and local agencies that implement Individuals with Disabilities Education Act programs, Head Start, child care, home visiting, preschools and public schools to increase inclusive early learning opportunities for all children. Read the HHS press release here.
• Administration Launches Partnership to Distribute Free COVID-19 Tests to Schools. The Administration for Strategic Preparedness and Response and the DOE announced their partnership and encouraged school districts to order tests directly from the federal government to be made available to students, parents, staff and school communities.
• HHS, Labor and Treasury Release New Batching Guidance for Surprise Billing Disputes. The guidance is very limited, so until the Departments finalize the Independent Dispute Resolution (IDR) Operations Rule, certified IDR entities have full discretion to determine whether services can be batched in accordance with the statute and the remaining regulations. The IDR portal is still not open for batched cases.

NEXT WEEK’S DIAGNOSIS

Healthcare activity is expected at the committee level next week, including a Senate Finance Committee hearing on drug shortages and a House Energy & Commerce Committee markup of healthcare bills.

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