September 26, 2022

The Federal Health Policy Landscape and Women’s Health: What’s on the Horizon in 2022 and Beyond

With just days left until the end of the fiscal year and the impending November elections, there is a lot to watch on Capitol Hill. To help identify some of the challenges and opportunities that may arise in the months ahead, the Society for Women’s Health Research (SWHR) invited Jack DiMatteo, Senior Legislative Assistant in the Office of Congresswoman Lauren Underwood (IL-14) and Erin Morton, MA, Partner at CRD Associates and Executive Director of the Coalition for Health Funding, to its September Policy Advisory Council meeting. DiMatteo and Morton were invited to provide background on women’s health-focused legislation and on factors that could have bearing on federal health policy, respectively.

Maternal Health Landscape and Legislative Opportunities

DiMatteo began by calling out the critical need to implement evidence-based solutions to tackle the maternal health crisis in the United States. As he noted, the United States has the highest maternal mortality rate of any high-income country, with significant racial disparities (the maternal mortality rate for Black women in the United States is 2.5 and 3.5 times the rate for non-Hispanic white women and Hispanic women, respectively).

To help address this public health crisis, Rep. Underwood—along with her peers in Congress, including members of the Black Maternal Health Caucus—have implemented a two-pronged legislative approach, which has involved working to extend year-long postpartum Medicaid coverage from 60 days to 1 year and to pass a ‘Momnibus’ legislative package to address maternal morbidity, mortality, and disparities.

There has been progress on the Medicaid postpartum coverage extension, DiMatteo said, thanks in large part to the American Rescue Plan Act of 2021. Specifically, the Act added new incentives for states to take up Medicaid expansion as well as provided all states the option to extend the postpartum coverage period under Medicaid to a full year. He noted that, as of September 14, 23 states had extended that coverage to ensure people have access to the care and support they need in the postpartum period.

With respect to the second prong—the Momnibus—DiMatteo said that while one of the package’s bills (the Protecting Moms Who Served Act) has been signed into law, the other 11 bills have not, though there has been some movement. While nearly every other provision of the package passed the House as part of the Build Back Better (BBB) Act, these investments still have not passed in the Senate. Congresswoman Underwood and the Black Maternal Health Caucus are working to get the Momnibus enacted before the end of the 117th Congress. Looking to the 118th Congress, DiMatteo shared that Rep. Underwood is also preparing ‘Momnibus 2.0,’ which will expand the scope of the original package to look at conditions that are affecting women of reproductive ages that aren’t necessarily associated with maternal deaths but that are under-researched and underfunded, such as endometriosis. The bill could also incorporate legislation to expand access to infertility treatment and address partner violence.

Shake-ups in Congress and What It Could Mean for Health Policy

Beyond the legislative priorities for members of Congress between now and the end of the year, such as fiscal year 2023 spending legislation, the November elections and changes in health care committee leadership could have bearing on public health and health policy, said Morton.

From an election perspective, the midterms could change the makeup of Congress. While current election forecasts predict the Senate as a toss-up or leaning Democratic, they predict the House elections as favoring Republicans.

Further, Morton noted, there are a lot of changes in leadership slated to take place in the 118th Congress across the health committees. In the Senate Appropriations Committee, which along with its House counterpart has jurisdiction over spending bills, both Chairman Leahy (D-VT) and Ranking Member Shelby (R-AL) are retiring, which could cause a ripple effect in leadership on the Senate Health, Education, Labor, and Pensions (HELP) Committee leadership. If Sen. Murray (D-WA), who is next in line to take serve as chair of the Appropriations Committee, takes on that role, she will be required to give up her leadership position on HELP. In the House, Ways & Means Republican Leader Rep. Brady (R-TX) is retiring, and there are already a few Republican members vying over that seat.

Watch to Watch for in the Last Months of the 117th Congress

In addition to any spending legislation that will get passed prior to the end of the year, Morton also reviewed some other health legislation that could see movement this congressional cycle:

While increasing attention will be placed on the midterm elections, there is still ample opportunity to drive legislation this congressional cycle to promote women’s health and women’s health research. SWHR will continue to serve as a champion for women and elevate the needs of this population among members of Congress.

For questions, please contact SWHR Chief Advocacy Officer Lindsey Horan.