HEALTH CARE BRIEFING: Tepid Response to Biden Indian Health Call

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Tribal nations saw a culmination of years of work when President Joe Biden announced his plan to grow the budget of the Indian Health Service and secure funding over time. But on the Hill, especially among key lawmakers, it was a surprise. These members say they aren’t ready to commit to Biden’s plan, largely because the administration hasn’t explained its benefits to them.

American Indian groups have lobbied Congress and previous administrations to end lawmakers’ control over the annual budget of the Indian Health Service, which provides care to federally recognized tribes. They say that the move is necessary to meet the needs of its beneficiaries, where the U.S. has historically fallen short. Biden has allies in Congress but must overcome aversion to automatic, or mandatory, government spending from some lawmakers, in particular from Republicans.

Rep. Rosa DeLauro (D-Conn.), head of the House Appropriations Committee, said on Thursday she was “just beginning to look” at the proposal. Sen. Brian Schatz (D-Hawaii), chairman of the Senate Indian Affairs Committee, said he “didn’t know much about this” when asked about it. Sen. Richard Shelby (R-Ala.), head Republican of the Senate Appropriations Committee, said he, too, hasn’t been briefed on Biden’s proposal.

Shelby said that he generally prefers to keep federal programs under discretionary funding—where Congress must decide their budget each year—instead of mandatory, which is automatic funding set over time for programs like Medicare. “Once you create an entitlement, it’s automatic spending, it’s outside the appropriators process, and that’s part of the runaway spending we have,” Shelby said.

Supporters of Biden’s plan inside and outside Congress say the time has come for the U.S. to fully meet its centuries-old compact with tribal nations by boosting the IHS and protecting it from year-to-year budget dynamics and government shutdowns. Health and Human Services Secretary Xavier Becerra on Thursday told House appropriators that the proposal to bolster IHS’s budget to $9.1 billion in fiscal 2023 and label it mandatory funding would be a “historic first step” toward delivering on our “commitment to tribal nations.” Read more from Alex Ruoff and Kellie Lunney.

CDC Ends Trump-Era Rule to Expel Migrants

The Biden administration announced on Friday it plans to lift Trump-era border controls that allowed authorities to quickly expel migrants and asylum seekers during the pandemic. The public-health authority, “Title 42,” will end May 23, giving officials some time to prepare for an expected influx of migrants at the Mexico border that poses key political and humanitarian challenges for the White House ahead of the midterm elections.

The Centers for Disease Control and Prevention announced on Friday the transition period would enable the Homeland Security Department to implement “appropriate Covid mitigation protocols, like scaling up a program to provide vaccinations to migrants and prepare for resumption of regular migration.”

Democratic lawmakers and immigrant-rights advocates long have pressured President Joe Biden to abandon Title 42, saying that the policy used Covid as a pretext to abandon legal obligations allowing entry to people seeking asylum. Yet White House officials and lawmakers have warned of a potential surge of migrants and asylum seekers if the measure is lifted. That could fuel criticism from Republicans that Biden’s policies are causing a rush at the border.

Some Democrats also have expressed apprehension about lifting Title 42. Sen. Joe Manchin (D-W.Va.) last week urged the CDC to leave the policy in place, citing rising global cases of Covid-19 and high border arrest numbers. Sen. Mark Kelly (D-Ariz.) and Kyrsten Sinema (D-Ariz.) urged the Biden administration not to lift the policy, and Kelly said Friday the administration had made the “wrong decision.” Read more from Jordan Fabian and Ellen M. Gilmer.

U.S. Must Face Suit Over Trump’s Separation Policy: The U.S. government must face negligence and emotional distress claims by immigrants who say they were traumatized by former President Donald Trump’s policy of separating families at the southern border. An Arizona federal judge on Friday rejected the government’s request to toss out a lawsuit filed in 2019 by the American Civil Liberties Union. But U.S. District Judge John Hinderaker dismissed 15 senior-ranking Trump administration officials from the case, ruling they can’t be held personally liable for the government’s conduct. Peter Blumberg and Malathi Nayak have more.

What Else to Know Today

House Votes to Decriminalize Pot, Senate Hopes Unclear: The House voted Friday on legislation (H.R. 3617) to decriminalize marijuana, expunge federal convictions on weed-related charges and levy taxes on producers and importers of cannabis. The legislation passed 220-204 with support from most House Democrats and three Republicans. Two Democrats opposed it. The House had passed a version of the bill in 2020, but it was never considered in the Senate, where Majority Leader Chuck Schumer (D-N.Y.) intends to offer a separate marijuana legalization bill this month.

But any move to decriminalize marijuana still faces significant hurdles in Schumer’s chamber, where many Republicans and some Democrats, including Jeanne Shaheen (N.H.) and Jon Tester (Mont.), oppose such a move, and legislation would need 60 votes to advance. Read more from Jarrell Dillard.

House Floor: The House is scheduled to consider several health-related bills today under expedited procedure, including:

U.S. Extends Postpartum Coverage for Medicaid, CHIP: As many as 720,000 pregnant and postpartum women could now be guaranteed Medicaid and Children’s Health Insurance Program coverage for 12 months after pregnancy through the American Rescue Plan, according to a Health and Human Services Department announcement. To receive funds and ensure consistency with federal standards, states must go through a formal process managed by the Centers for Medicare and Medicaid Services, according to HHS. Read more from Bloomberg Law.

Biden DOJ’s First Criminal Labor Antitrust Trials to Start: The Department of Justice’s first-ever criminal trials over companies’ alleged violations of labor-related antitrust laws are set to kick off. The pair of trials, which start Monday, will try federal antitrust regulators’ previously untested guidance that could prove a watershed moment for their prosecution of wage-fixing and no-poach agreements. In one trial, the Justice Department will target employers’ no-poach deals in USA v. DaVita in the U.S. District Court for the District of Colorado. In the complaint, the DOJ alleged that DaVita, a kidney dialysis service provider, formed no-poach contracts with competitors to refrain from hiring each other’s workers. Read more from Dan Papscun.

Contraceptives Fight Leads to Partial Missouri Win: A federal court partially ruled for Missouri in a dispute with federal health officials over Medicaid reimbursement for oral contraceptives. The Department of Health and Human Services argued Missouri’s claims weren’t qualified for reimbursement at 90% under the Medicaid statute, as the state had not shown that the prescriptions were for family planning purposes. Missouri said that the denial was improper because it represented a change in how the HHS scrutinized reimbursement claims for oral contraceptives that it didn’t announce. Read more from Christopher Brown.

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To contact the editors responsible for this story: Giuseppe Macri at; Michaela Ross at

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