409: Data Landscape, Deeper in Debt Ceiling Debate

ROBERT JOHNSON: 

This is Public Health Review Morning Edition for Friday, April 28, 2023. I'm Robert Johnson.

Now, today's news from the Association of State and Territorial Health Officials.

CRAIG BEHM: 

I think we can and should think bigger as we think about architecture and design and funding for monetization updates.

JOHNSON: 

Craig Behm is president and CEO of CRISP, Maryland's designated health information exchange. He's on the agenda next month at ASTHO's TechXpo and Futures Forum in Chicago.

BEHM: 

We have survived the pandemic and seen that when we all focus on creative solutions and rapid responses, we can do some really neat and exciting things.

JOHNSON: 

Behm says the advancements made in technology during the pandemic are nothing compared to what's possible.

BEHM: 

I think technology has finally caught up with maybe the dreams of all these different policymakers and stakeholders. And so, instead of having gaps in what technology is able to do, we're really asking kind of what are the big goals of public health and these officials. And more or less, if the data exists somewhere, we can provide something useful to satisfy those goals.

ROBERT JOHNSON: 

You can hear Behm and other innovators discussed the latest in the public health technology space. Online seats to the TechXpo in late May are still available. Sign up using the link in the show notes.

Data sharing gets more complicated next month. That's when the public health emergency ends and along with it requirements that local health agencies and departments give some of their data to the federal government. ASTHO's chief medical officer Dr. Marcus Plescia says most agencies are willing to share their data, but legal hurdles often get in the way. The CDC is currently trying to negotiate agreements with jurisdictions. CNN covered the story. You can read it using the link in the show notes.

Lawmakers and advocates spent another week debating the debt ceiling here in Washington. ASTHO's Carolyn Mullen is engaged in the back and forth. She has this update in her latest view from Washington, D.C. report.

Good morning.

CAROLYN MULLEN: 

Good morning, Robert. What a great and beautiful morning we're having here. I have my cup of coffee and ready to chat with you about everything that happened in D.C. this week.

JOHNSON: 

Well, so are we.

You know, another week is behind us and the debate over the debt ceiling is ramping up. What is the latest regarding those discussions?

MULLEN: 

So, a major development this week was the House approved Speaker McCarthy's legislation to raise the debt ceiling for one year. This bill also sets in place caps on discretionary spending through FY23 and reduces the overall amount of funding for fiscal year 24 by 22%. It also establishes some work requirements for entitlement programs and rescinds all unobligated COVID-19 funding.

This bill now moves to the Senate, where it faces a very uncertain future and we're expecting it to not pass the Senate.

JOHNSON: 

Let's talk about the strategy, then. What is ASTHO's approach to the bill?

MULLEN: 

So, we are uniting with our partners in the Coalition for Health Funding and an organization called NDD United. And we'll be sending a letter up to the Hill saying that these caps on discretionary spending really have significant negative consequences for public health and for the entire ecosystem, and impacting the populations that we care about. So that letter will be sent in a couple of weeks or so.

We're also getting a better understanding of what will be rescinded as part of the COVID funding that's part of this legislation and taking a look at the accounts that Congress may be targeting for clawbacks of funds. The good news is, is that the funding that has gone out the door to states is safe. But we are looking at the federal accounts and more to come on that. We do know there's about $4 billion of unobligated funds at CDC, for example. We know there's about $2.5 billion for the Strategic National Stockpile. So we're concerned about that. And we'll be getting a better understanding of Congress's intention there and if there's a way to get those funds obligated as soon as possible.

JOHNSON: 

So where do you see all of this going next week?

MULLEN: 

So the House is in recess next week, so they've done their job. So you're going to hear a lot of rhetoric in the media with Speaker McCarthy saying, "Look, we've done our part, we've passed our bill, it's now up to President Biden and the Senate to do their job to raise the debt ceiling." Economic analysts are saying the X date, or the date by which the debt ceiling needs to be raised, is around July, so there is some time.

What I'm really looking for is when we start to see momentum of the Gang of Eight, or the problem-solving caucus kind of coming together to solve this. And that's where the real negotiation's going to be. That, as of right now, President Biden has made it very clear that he would like a clean debt ceiling and the House has made made it clear on their priorities for the next phase of these negotiations. So we have time, but not a whole lot of time, for Congress to get their act together.

JOHNSON: 

We'll look forward to that. Carolyn Mullen, as always, it's great to see you.

MULLEN: 

Thanks so much. Have a great weekend.

JOHNSON: 

You too.

That'll do it for today's newscast. We're back Monday morning with more ASTHO news and information.

I'm Robert Johnson. You're listening to Public Health Review Morning Edition. Have a great weekend.