Newly elected Speaker of the House Mike Johnson (R-LA) will be facing significant challenges in healthcare policy as he leads the lower chamber through spending negotiations as fiscal tensions mount.
On Thursday, Johnson announced his legislative priorities regarding the remainder of the appropriations bills that will need to be passed to fund the federal government. Johnson has said, however, that he would like to pass a short-term extension of government funding if necessary to avoid a government shutdown by the Nov. 17 deadline set last month to allow for more time to build consensus.
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Bills relating to the Departments of Labor and Health and Human Services will be saved for the week of Nov. 13, which some analysts say is to ensure that there is enough time to work through the controversies surrounding abortion in several of the funding measures.
Johnson is a well-known anti-abortion advocate who has signed onto several bills that would place federal limits on the controversial procedure, but he has less of a profile with respect to the bread-and-butter appropriations issues regarding public health.
There are three essential areas of public health funding Johnson will need to manage in the coming weeks.
The Pandemic and All Hazards Preparedness Act
Differing priorities between the House and the Senate on the Pandemic and All Hazards Preparedness Act will continue to put pressure on Johnson in avoiding a shutdown.
First enacted in 2006 and then reauthorized in 2019 shortly before the beginning of the COVID-19 pandemic, the bill is intended to provide the foundation for national biosecurity policy and emergency public health response.
The Senate Health, Education, Labor, and Pensions Committee expanded some of the provisions of the act in July, including efforts to increase accountability for various government entities, including the Centers for Disease Control and Prevention and the National Institutes of Health. The Senate's version of the bill also contained language regarding ensuring that the strategic national stockpile of emergency medical supplies, including medicines, is more responsive to market demands to avoid shortages in periods of crisis.
In August, a group of 19 Republican lawmakers pressured then-Speaker Kevin McCarthy (R-CA) into significant cutbacks in the law in an effort to rein in some of the policies utilized during the pandemic.
“House Republicans should not bring such legislation to the floor for consideration either at all, or without desperately needed reforms to protect the American people from tyrannical, incompetent, and largely unchecked public health bureaucrats,” wrote Rep. Chip Roy (R-TX), a leader in the effort to slim down the bill.
The President's Emergency Plan for AIDS Relief
Bipartisan support for the long-standing President's Emergency Plan for AIDS Relief fractured in May when several anti-abortion organizations and Rep. Chris Smith (R-NJ) accused the program of violating rules on funding abortion through foreign aid dollars.
The bill was originally passed in 2003 under George W. Bush and has been reauthorized on a bipartisan basis four times. Several federal rules apply to the program prohibiting the use of U.S. taxpayer aid dollars being used to either promote or discourage abortion abroad.
Although funding for the permanent provisions of the bill is not in question, several requirements in the program are time-bound and set to expire in 2023 and 2024 if not renewed, including U.S. participation in the Global Fund to Fight AIDS, Tuberculosis, and Malaria.
State Department officials have warned that not reauthorizing the elements of the program nearing their sunsets will hinder the program's long-term procurement of critical commodities and the ability of the U.S. to fund innovative research. The National Security Council has also said that either Russia or China could fill the vacuum left in Africa if American support for foreign public health aid cools.
It is unclear how Johnson's anti-abortion beliefs will factor into the reauthorization of the program.
Opioid epidemic programs
Several appropriations measures for federal programs in the fight against the opioid epidemic are up for reauthorization as well. Although the House Energy and Commerce Committee advanced a bipartisan appropriations bill on these measures earlier this year, similar bills have faced stumbling blocks in the Senate HELP committee.
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In 2021, Johnson applauded funding from the Office of National Drug Control Policy being directed toward two nonprofit groups in parishes in his Louisiana district.
“The federal government funds these programs because they have proven to play a critical role in reducing youth misuse of prescription drugs,” Johnson said at the time. “As addiction crises continue to affect communities across our country, we all have an important role to play as well in caring for our families, friends and neighbors.”