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GOP senators call for hearings on bipartisan insulin cost bill

Five GOP senators are calling on the Senate Finance Committee to hold hearings on bipartisan legislation to lower the cost of insulin.

Led by Sens. Pat Toomey (R-Pa.), and John Barrasso (R-Wyo.), the Republicans said they were concerned the legislation from Sens. Susan Collins (R-Maine) and Jeanne Shaheen (D-N.H.) will be brought to the Senate floor for a vote without going through the committee first.

“As with most proposals regarding drug pricing, [Senators Shaheen and Collins’] proposed changes involve trade-offs and far-ranging implications, which both deserve frank discussion,” the lawmakers wrote in a letter to committee Chairman Ron Wyden (D-Ore.) and ranking member Mike Crapo (R-Idaho).

The Finance Committee has jurisdiction over Medicare, and the legislation would radically change Medicare’s drug benefit, the senators said.

The other Republicans on the letter were Sens. Rob Portman (Ohio), Ben Sasse (Neb.), and Steve Daines (Mont.).

The Collins-Shaheen bill would cap out-of-pocket insulin costs at $35 per month and aims to lower the overall cost of the drug by eliminating rebates drugmakers pay to pharmacy benefit managers if they keep the price below a certain level.   

Senate Majority Leader Charles Schumer last month said the bill would come to the floor “very soon.”

But the bill will require support from at least nine other Republican senators in order to clear a filibuster, and it’s not clear there are enough votes for that to happen.  

Some Republicans have voiced concerns about the bill’s interference in the free market.  

At the same time, Democrats are moving forward with a separate drug pricing plan they hope to pass under a process known as reconciliation, ​​which would bypass a GOP filibuster, meaning it needs only 50 Democratic votes. 

The reconciliation plan does not include insulin caps.

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Cryptocurrency volatility pressures lawmakers to regulate the market

Volatility in crypto markets has put renewed pressure on lawmakers to regulate the industry, which isn’t subject to many of the investor protection and transparency rules governing traditional financial services.

Cryptocurrencies plummeted in May and June after so-called stablecoins that underpin the crypto ecosystem lost their value and investors shifted their money away from risky assets.

Bitcoin dipped to around $20,000, down 70 percent from its all-time high in November 2021. The total crypto market cap dropped below $1 trillion after nearly hitting $3 trillion late last year.

In response to market trouble, crypto lenders blocked users from withdrawing their funds, prompting fears that they might lose everything. Some stablecoin investors saw their assets become worthless in a matter of hours as prices plummeted.

That prompted the Treasury Department to call on Congress to regulate crypto. Sens. Cynthia Lummis (R-Wyo.) and Kirsten Gillibrand (D-N.Y.) unveiled a sweeping bill to regulate cryptocurrencies last month, but Congress won’t even begin to consider the legislation until after the November elections.

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Keeping global disease on the run

With COVID-19 in retreat, there is some additional good news in public health.

Over the past few months, several countries around the world have confirmed the elimination of a neglected tropical disease (NTD). These advances are in large measure a result of American investment in global health. We should continue these vital efforts. We are in fact at a unique moment where lasting progress is possible, but only if we act decisively.

NTDs, of which there are more than 20, have afflicted human beings for centuries and continue to kill and debilitate millions every year. They are endemic to nearly 150 countries, and the greatest burdens are found in low- and middle-income countries in Africa, Asia and Latin America. However, NTDs have increasingly been reported in higher-income countries like the United States. Of the 60 million people living across the Gulf Coast, 3 million to 4 million are infected with at least one NTD.

These diseases cripple communities and destabilize societies. They keep people out of work and children out of school, stunting economic growth and further entrenching cycles of poverty. Women and children are most at risk.

In 2006, Congress appropriated funds for the first time to the fight against NTDs, with the U.S. Agency for International Development (USAID) launching its NTD Program. Thanks to a coordinated global effort led by the World Health Organization and ministries of health, with unprecedented support from private companies and bilateral donors such as USAID, incredible progress has been made to end NTDs.

To date, more than 40 countries have eliminated at least one NTD and more than 600 million people no longer require treatment.

But we cannot stop there. NTDs should remain high on our country’s global health agenda until the harm and suffering they cause is a thing of the past.

One reason is the extraordinary return on investment fighting NTDs provides. Most NTDs can be prevented and treated for less than $0.50 per person. The private sector has played a unique and outsized role in making this possible. Most of the medicines needed to treat these diseases are donated — free of charge — by pharmaceutical companies and distributed to communities in need. In the last decade, more than 14 billion NTD treatments have been donated. In fact, every dollar invested by the U.S. in NTD programs leverages $26 in donated medicines, making it one of the best buys in global health.

Another reason is that reducing the burden of NTDs promotes economic development in other countries. This reduces the need for foreign assistance and grows markets for American products globally. U.S. leadership in global health also gives us a strategic advantage in diplomacy, just as it fortifies our ability to detect and guard against new disease threats.

Perhaps most importantly, eliminating the needless suffering and death caused by NTDs aligns with our values. Most of these diseases are entirely treatable and preventable at nominal cost.

Fortunately, there are concrete steps we can take to build on the historic progress of the last decade and finish the job.

Congress should fully fund NTD treatment efforts overseas through USAID. At a time when services are still recovering from COVID-19 disruptions, it is important we continue our efforts to combat these diseases. Congress should also plan to boost funding for NTD research through the Centers for Disease Control and Prevention (CDC). With strong funding, Congress and its private partners could bring about the eradication of some, if not all, of these neglected tropical diseases. That would truly be a victory worth celebrating.

Roger Wicker, who represents Mississippi in the U.S. Senate, is the founder and co-chair of the Senate Caucus on Malaria and Neglected Tropical Diseases.

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Russian diplomat knocks Biden administration 'hype' around Griner case

A top Russian diplomat on Thursday criticized the “hype” surrounding the high-profile detainment of WNBA star Brittney Griner.  

The remarks to reporters before Griner’s court appearance on Thursday by Deputy Foreign Minister Sergei Ryabkov follow news of a conversation between Griner’s wife Cherelle Griner, President Biden and Vice President Kamala Harris on Wednesday.

“The American side’s attempts to foment hype and make noise in the public environment are understandable, but they don’t help to practically resolve issues,” Ryabkov told reporters at the courthouse, according to an account by The Washington Post. 

Biden is facing intense pressure to get Griner home. But the administration has also appeared wary of getting into a prisoner exchange negotiation with the Kremlin for fear it would lead to more unjust prosecutions of Americans abroad.

Griner was arrested in Moscow on drug charges just before Russia’s invasion of Ukraine. She’s accused of having vape cartridges with cannabis oil in her luggage. She faces a possible 10-year sentence in Russia. Grinder pled guilty to the charges on Wednesday.

Ryabkov also Moscow is willing to cooperate with U.S. officials once Griner’s trial is complete, adding that “we have a long-established form for discussing these matters,” The Washington Post reported. 

“Clearly the necessary judicial procedures have not been completed. Until then, there is no nominal, formal, procedural basis for any further steps at all,” Ryabkov told reporters. 

Griner, who was named an honorary All-Star for 2022 WNBA All-Star Game, recently penned a letter to Biden over the Fourth of July holiday weekend urging him and other top officials to do anything they can to bring her home.

“[A]s I sit here in a Russian prison, alone with my thoughts and without the protection of my wife, family, friends, Olympic jersey, or any accomplishments, I’m terrified I might be here forever,” the 31-year-old basketball star wrote in her letter to Biden. 

Vanessa Nygaard, the head coach of Griner’s WNBA team, the Phoenix Mercury, made remarks on Monday asking if Los Angeles Lakers star forward LeBron James would be detained this long if he were in Griner’s position.

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Toxic ‘forever chemicals’ found in Florida oysters

Perfluoroalkyl and polyfluoroalkyl (PFAS) and phthalate esters (PAEs) are known as “forever chemicals” due to their inability to completely break down in the natural environment and their widespread use in consumer and commercial products. 

When researchers from Florida International University recently tested for the chemicals in 156 oysters from Biscayne Bay, Marco Island, and Tampa Bay, they found detectable levels in every single oyster. 

Because oysters are filter feeders, meaning they obtain food by filtering matter and organisms from water that passes through them, the species can reveal a lot about an ecosystem’s overall health.

The findings confirm the pollutants are in multiple water sources and have infiltrated the food chain. The chemicals have been found in human and animal blood and in the natural environment. 

Oysters collected from Biscayne Bay had the highest concentrations of most PFAS and PAES compounds compared with the other two locations, despite being the smallest specimens sampled. This is surprising given that the more time an oyster grows, the longer it has to become contaminated.

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In comparison, the largest oysters, found in Tampa Bay, had the lowest levels of contaminants reported, suggesting the water there might be less polluted than in Biscayne Bay. 

“Biscayne Bay could be so contaminated, the oysters are bombarded with such high concentrations they accumulate contaminants more quickly,” explained researcher Leila Lemos in a press release. 

PFAS and PAES could also be hindering oysters’ growth, as analyses showed higher levels of PFAS in water were associated with thinner shells.

Researchers said the health risks for humans consuming the oysters are low, although they only studied a small group of PFAS and PAES compounds. 

“It’s important to also remember that there’s so many other exposure paths for both PFAS and PAEs compounds, like drinking water,” Lemos continued. 

One recent analysis of U.S. drinking water found levels of PFAS are likely higher than tests conducted by the Environmental Protection Agency are designed to show. PFAS can impact reproduction and human development, along with immune system functioning, and have been shown to interfere with vaccine efficacy. 

PAES have also been linked with diabetes, allergies, asthma and obesity. 

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Michigan gubernatorial candidate Ryan Kelley pleads not guilty to Jan. 6 charges

Michigan Republican gubernatorial candidate Ryan Kelley pleaded not guilty on Thursday to four misdemeanor charges connected with his alleged involvement in the Jan. 6, 2021 attack on the Capitol.

The FBI arrested Kelley last month, alleging that he was among the crowd on Capitol grounds for roughly two hours on Jan. 6 but had no evidence Kelley had entered the Capitol building.

At times, he allegedly filmed crowds attacking police officers and pulled a covering off a temporary structure, according to authorities.

Kelley is charged with knowingly entering a restricted area without lawful authority, disorderly conduct, knowingly engaging in physical violence in a restricted area and willfully injuring or committing depredation against federal government property. 

He pleaded not guilty to all of those charges during a virtual federal court hearing on Thursday morning.

Kelley remains the leading candidate in the state’s Republican primary scheduled for Aug. 2, according to recent polling conducted after his arrest.

Kelley received the support of 17 percent of survey respondents, with chiropractor Garrett Soldano trailing in second with 13 percent, according to an EPIC-MRA poll.

The winner will take on incumbent Gov. Gretchen Whitmer (D) in November.

Kelley has made no secret of his involvement on Jan. 6, saying he remains a supporter of former President Trump.

“January 6, 2021, back when gas was under two dollars a gallon, those were good times,” Kelley said at a primary debate on Wednesday night.

During the debate, Kelley later said he was in Washington, D.C. on Jan. 6 but claimed his actions that day were protected by the First Amendment.

“We were there protesting the government because we don’t like the results of the 2020 election, the process of how it happened, and we have that First Amendment right,” he said. “And that’s what 99 percent of the people were there for that day.”

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13 million cases and counting: Immigration backlog result of rewarding inefficiency

United States Citizenship and Immigration Services (USCIS) has a backlog of around 5.2 million immigration benefit requests, with an additional 8.5 million pending requests that are not in the backlog yet because they aren’t ready for adjudication. This means that USCIS has 13.7 million benefit requests to do — in addition to the new applications it is receiving.

USCIS plans to hire 4,000 additional employees by the end of this calendar year, but the agency has been overwhelmed by a backlog crisis that wasn’t caused entirely by an employee shortage, and its backlog won’t be brought under control just by adding more employees. 

The Office of Citizenship and Immigration Services Ombudsman describes systemic problems in USCIS’s application-fee-based funding system that are preventing it from fully utilizing its personnel and resources and suggests ways to improve the situation in recommendations submitted to USCIS on June 15, 2022.  

The Ombudsman seems to have overlooked a systemic problem that I think should have been addressed.

The application-fee-based system USCIS is using rewards inefficiency.

USIS requests for an increase in application fees are based to a great extent on how much time is being spent on processing the various applications it adjudicates. The more time it takes to adjudicate the applications, the higher the fees USCIS can charge. The higher the fees, the more money the agency will have to meet its budgetary needs.

Conversely, if USCIS reduces the time it takes to do the applications by becoming more efficient, the fees will be lower and the agency will have less money for meeting its budgetary needs.

This is a problem for all of the applications USCIS processes — new, backlogged, and pending.

USCIS isn’t going to be able to keep up with its caseload and get its background under control until all of these problems have been eliminated.

Highlights from the recommendations

Approximately 97 percent of the USCIS’s budget is funded by the filing fees it collects, but the agency is not permitted to charge fees for all of the applications it has to process. For instance, fees cannot be collected when the applications are for specified types of humanitarian relief, such as affirmative asylum applications. With some exceptions, the cost of paying for these applications is borne by USCIS’ fee-paying customers.

The agency’s funding model was developed to be consistent with the Chief Financial Officers Act (CFO Act) and Circular No. A-25 from the Office of Management and Budget (OMB).  

This requires USCIS to (1) review their user fee rates every two years; (2) determine the full costs of providing services; (3) review new programs to identify potential new user fees; and (4) report the results of these reviews in their annual CFO reports.

USCIS uses the Activity-Based Cost (ABC) methodology to assign costs to specific benefit requests in a manner consistent with OMB guidance (Circular A-25). The main ABC considerations are employee staffing, workload volume, adjudication completion rates, and utilization rates for each of the immigration benefits services it provides.

Completion rates are based on the number of hours it takes to fully process a specific application. The more time spent adjudicating a request, the higher the fee that USCIS can charge to recover the cost of processing it.

Procedural requirements

The agency’s fee-for-service funding model requires it to comply with the Administrative Procedure Act’s (APA) rule making procedures to adjust the amounts of the fees. This includes extensive fact gathering, analysis, negotiations, and navigating through multiple reviews conducted by various offices in USCIS, DHS, and OMB. Then it must provide notice and a meaningful opportunity for the public to offer comments on proposed fee changes. When the public comment period closes, the agency must consider and draft responses to the unique comments.  

Then, except for the initial fact-gathering phase, the review process is repeated, with the final rule similarly requiring the USCIS director, DHS, and OMB to review and approve it.

This takes a long time.

It took approximately two and a half years to move the Aug. 3, 2020, rule through the entire process, from the initial fact-gathering to publication of the final version in the Federal Register.

By the time USCIS issued that final rule, the data on which it was based was outdated.   

What’s more, the backlog is not considered. USCIS staffing models reflect the cost of adjudicating future benefit applications. They do not include the costs of the additional staffing and associated resources the agency needs to reduce its backlogs, or its pending caseload.

USCIS’s almost exclusive reliance on a fee-for-service funding model has left it chronically underfunded and unable to keep up with its caseload.

Conclusions

The Ombudsman says USCIS should:

• Re-engineer the agency’s biennial fee review process and associated staffing models to ensure that they proactively project the amounts needed to meet targeted processing time goals for future processing and backlog adjudications;

• Seek public appropriations to cover the cost of delivering humanitarian-based immigration benefits;

• Consider seeking congressional authority to establish a new financing stream through the Federal Financing Bank or through some other mechanism to provide funds as needed at its discretion;

• Request annual appropriations specifically earmarked for eliminating backlogs; and

• Resume the use of its authority to adjust fees annually on the basis of the salary/inflation factor calculated by OMB under Circular A-76.

These recommendations would improve USCIS’s funding system, but it would make more sense to fund the agency with congressional appropriations instead of trying to make its application-fee-based system work.

That said, the people who use USCIS’s services should continue to contribute to the cost of providing them by paying application fees. 

Also, I don’t think USCIS should have to go through a time-consuming labyrinth of procedural steps to justify fee increases. It would make more sense to make annual fee adjustments on the basis of the U.S. Bureau of Labor Statistics’ Consumer Price Index.

Nolan Rappaport was detailed to the House Judiciary Committee as an Executive Branch Immigration Law Expert for three years. He subsequently served as an immigration counsel for the Subcommittee on Immigration, Border Security and Claims for four years. Prior to working on the Judiciary Committee, he wrote decisions for the Board of Immigration Appeals for 20 years. Follow him at https://www.blogger.com/blog/posts/2306123393080132994

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CNN's Kaitlan Collins elected 2024 president of White House Corespondents' Association

Kaitlan Collins, CNN’s Chief White House reporter, has been elected by her peers to serve as the president of the White House Correspondents’ Association in 2024.

Collins’s election marks a bit of history for the organization, which has now elected a woman as president three years in a row for the first time ever.

Collins was elected to a three year term and she’ll serve as president in the final year of that term, along with NBC’s Kelly O’Donnell and NPR’s Tamara Keith.

“A huge thanks to my fellow members of the White House Correspondents’ Association for this vote of confidence,” Collins wrote in a tweet on Wednesday. “I am honored, humbled and ready to get to work!”

CNN hired Collins as its top White House reporter early in 2021. She joined several of the nation’s largest news networks that currently have women serving as their chief White House correspondents.

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Who is Larry the Cat and how does he keep outlasting UK leaders?

British Prime Minister Boris Johnson is out, resigning after less than three years on the job Thursday. Larry the Cat, a mainstay at 10 Downing Street, is not going anywhere.

The brown and white tabby, whose official title is Chief Mouser to the Cabinet Office of the United Kingdom, has been living in the country’s executive office since 2011.

With Johnson’s resignation, Larry has now outlasted three British prime ministers, having seen the ends of David Cameron’s and Theresa May’s terms at 10 Downing.

Larry was initially brought to Downing Street by Cameron to handle a rat issue near the prime minister’s official residence. He was a former stray adopted from London’s Battersea Dogs and Cats Home and was the first cat to take over the unofficial rat-catching post since the retirement of Humphrey in 1997.

The Chief Mouser is well-versed in interacting with world leaders. He appeared to have warmed up to former President Obama but took a nap under former President Trump’s armored vehicle during his visit in 2019.

Now it seems that Larry has garnered enough respect from British politicians in his lengthy tenure as Chief Mouser that some are facetiously floating him for a potential prime minister bid himself.

“Well at some basic level, almost anybody in Parliament would be a better prime minister than Boris Johnson. Larry the Downing Street Cat would be a better prime minister,” Rory Stewart, a former conservative member of parliament said in an interview with CNN’s Christiane Amanpour.

Following Johnson’s election to the office in December 2019, it was rumored that Larry may be headed for the door since Johnson is inclined toward dogs.

However, even after Johnson’s Jack Russell Dilyn moved into Downing Street, Larry has remained in his post and can now add Johnson to the list of prime ministers he has outlasted.

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