PPC CAPITOL CONNECTION
October 19, 2021
What Matters Now in Washington:
- The fate of President Biden’s agenda remains uncertain as Democrats push negotiations out. More…
- A COVID-19 vaccine for 5- to 11-year-olds is on the horizon, and pediatricians are preparing for the rollout. More…
- Dr. Francis Collins will leave the NIH by the end of the year, according to a recent announcement. More…
- Find new funding opportunities, research findings, and more below. More…
- PPC members authored policy commentaries in Pediatric Research exploring the intersections of child health policy, advocacy, and pediatric research. More…
Congress PUnts on Key Deadlines, Leaving Biden Agenda in Limbo. Democrats’ efforts to pass sweeping physical and human infrastructure legislation are on hold after the progressive and moderate factions of the party failed to come to an agreement on the contours of a deal, opting instead to buy themselves time by pushing back looming legislative deadlines. The intraparty conflict means that Congress leaves town with little consensus on the path forward for President Biden’s agenda.
The rift emerged in late September as the House approached a scheduled vote on the $1 trillion bipartisan infrastructure legislation, which Speaker Nancy Pelosi (D-Calif.) agreed to put on the floor in a deal with House Democratic moderates in exchange for their votes on the $3.5 trillion social spending agreement. Moderate Democrats in swing districts have touted the more modest infrastructure bill as evidence that Congress can still pass consequential legislation in a bipartisan fashion and pushed for speedy passage to bolster their own reelection prospects.
However, mutual suspicion has clouded efforts to unite the Democratic caucus behind both pieces of legislation. Progressives fear that passing the bipartisan legislation before a final agreement on the larger social spending bill is struck will allow moderates wary of additional spending to walk away. They are holding up the bipartisan bill as an insurance policy for their own more ambitious efforts.
On the flip side, moderates are concerned that holding the infrastructure package until the social spending bill is ready will diminish its bipartisan credentials and may force them to support a larger deal than they are comfortable with to secure passage of the infrastructure legislation. These dynamics in the House Democratic caucus come alongside tense negotiations between the White House and Sens. Joe Manchin (D-W.Va.) and Kyrsten Sinema (D-Ariz.), who are both holding out for a dramatically scaled back social spending package.
Further complicating matters, the late September timeframe for consideration of President Biden’s agenda collided with major legislative deadlines: the start of a new fiscal year and the impending breach of the U.S. debt ceiling. Faced with the prospect of a government shutdown and a devastating default on U.S. government debt, Democrats and Republicans agreed to extend government funding and lift the debt ceiling through early December, setting up a year-end scramble to fund the government, raise the debt ceiling, and pass the President’s agenda.
In the meantime, the full scope of policies that will ultimately be enacted remains more uncertain than ever, leaving key child health and pediatric research priorities in the balance. There has been some progress narrowing the gap in proposed spending between moderates like Manchin who want a social spending bill amounting to $1.5 trillion and progressives who feel that even the initially agreed $3.5 trillion is insufficient. At the moment, a topline number of roughly $2 to $2.5 trillion appears likely, though that number is subject to change. Whatever the final number, a negotiated spending level will force hard choices about which priorities are included and the length of time they’re funded for.
Initial draft legislation put forth by key House committees called for permanent funding for the Children’s Health Insurance Program (CHIP), 12-month continuous eligibility for children in state Medicaid programs, a new agency at the National Institutes of Health (NIH) to fund high-risk, high-reward biomedical research, an extension of monthly Child Tax Credit payments, nationwide paid family and medical leave, and ambitious climate change proposals. Many of these proposals will be subject to negotiation. Already, Sen. Manchin has sought work requirements and means-testing for the Child Tax Credit, and reporting indicates that the proposed Advanced Research Projects Agency for Health (ARPA-H) at the NIH may have been dropped from the package. Additional disputes over the scope of the package are likely, but clarity may not arise on the final contours of the package until the early December deadlines force action.
Pediatricians Prepare to Vaccinate Younger CHildren as Pfizer BioNTech COVID-19 Vaccine Moves Towards Authorization for 5 to 11 year Olds. Last week, Pfizer and BioNTech requested emergency use authorization from the U.S. Food and Drug Administration (FDA) for their COVID-19 vaccine in children ages 5 to 11. The request is based on clinical data showing the vaccine is safe and effective in this population. Pfizer BioNTech’s vaccine will have different doses, dilution requirements, and storage conditions than the vaccines currently available for adolescents and adults. An FDA authorization for this product will make COVID-19 vaccination available to 28 million additional children.
FDA authorization could come as soon as Halloween, and the Centers for Disease Control and Prevention (CDC)’s Advisory Committee on Immunization Practices is expected to meet shortly after to formally recommend the vaccine’s use. In the meantime, pediatricians can take steps now to prepare to vaccinate children against COVID-19 by preparing to stock and administer it as soon as it’s available.
NIH Director to Step Down at End of Year. Francis Collins, MD, PhD, announced earlier this month that he would leave the NIH by the end of the year. He has served as Director of the agency since 2009, when he was appointed by President Barack Obama. During his tenure, Dr. Collins has stood up major trans-NIH research initiatives like the Cancer Moonshot and the BRAIN Initiative and helped secure billions of additional dollars in funding for the NIH annually through the congressional appropriations process. He has also led the agency’s response to the COVID-19 pandemic, which required it to shift rapidly to address a complex public health crisis. Dr. Collins’ success stemmed in part from his broad appeal with lawmakers on Capitol Hill, where his leadership attracted bipartisan acclaim. A replacement for Dr. Collins is expected to be named by President Biden in the coming months, and his nominee will have to be confirmed by the Senate.
Key Research Updates
- The Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) is soliciting feedback on promoting equity, diversity, and inclusion (EDI) in the institute’s workforce and among those who participate in and conduct its research. To learn more about STrategies to EnRich Inclusion and AchieVe Equity (STRIVE) initiative and submit your ideas, visit this page.
- The Institute for Firearm Injury Prevention at the University of Michigan is hiring 3 to 4 open rank tenure track faculty positions.
- The Centers for Disease Control and Prevention (CDC) will be soliciting new firearm research funding opportunities beginning October 15.
- NICHD Director Diana Bianchi, MD, coauthored a post on research efforts to address the long-term impact of the pandemic on children with NIH Office of Behavioral and Social Sciences Research William Riley, PhD.
- New NIH-funded research has found that 140,000 children in the U.S. lost a primary or secondary caregiver due to the COVID-19 pandemic, with stark disparities by race and ethnicity.
- A new study is looking at the relationship between cytokines in saliva and COVID-19 infection to help predict the severity of infection in children.
PPC POLICY COMMENTARIES. Members of the PPC have authored commentaries detailing the policy implications of research published in Pediatric Research. You can read these PPC-authored commentaries online: