Public health legislation in the new Congress


  • Timothy McBride, professor of public health, Washington University in St. Louis
  • Cara Tenenbaum, principal, Strathmore Health Strategy
  • Leann Chilton, vice president, government relations, BJC HealthCare
  • Lottie Joiner, assistant managing editor, Verite News (moderator)

By Anne Marshall-Chalmers

When it comes to the 118th Congress and the likelihood that legislators will pass critical pieces of public health legislation, Timothy McBride isn’t feeling optimistic. “I’ve never seen a Congress more dysfunctional,” he said. 

McBride spoke on a panel that discussed public health bills stuck in Congress, largely due to partisanship. “They will mess around with Medicare, either positively or negatively,” he said. “So pay attention.”

The VALID Act, which would give the Federal Drug Administration greater authority to regulate diagnostic tests, was among many bills panelists urged journalists to follow. Cara Tenenbaum, who worked for the FDA for several years, noted that blood and other diagnostic tests are “regulated the same they were in 1976,” she said. 

As pharmacogenomics is increasingly used, it’s important to ensure the tests that inform drug recommendations are accurate and regulated. “I’ve seen things online that tell you to send us a blood sample, we’ll evaluate your DNA and we’ll tell you which antidepressant or which birth control to take,” she said. “And those things are pretty high stakes.” 

Rural hospital closures, and legislative support to reverse this trend, is “paramount,” McBride said, adding that it is one of the few issues drawing support from both Democrats and Republicans. “Putting money into rural hospitals isn’t partisan,” he said.

Closures, however, are disproportionately impacting regions in the South and Midwest, leaving poor and vulnerable communities without care. McBride said hospital closures stem from struggling rural economies, as well as patient populations that are often uninsured or covered by Medicare or Medicaid, which may not reimburse hospitals at a rate that covers costs. 

McBride said certain rural hospitals can apply for a Rural Emergency Hospital (REH) designation to avert shutting down, a new provider type established by the Consolidated Appropriations Act of 2021. “They would only be able to do emergency services and not inpatient services,” McBride said, a change that reporters should monitor.

Panelists also urged reporters to cover regulation regarding the use of telehealth for physical health treatment, as well as the end of the pandemic’s public health emergency, and how that could end coverage for millions of Medicaid enrollees, potentially leaving vulnerable Americans without health insurance.

Anne Marshall-Chalmers is an independent journalist based in Albany, Ca. She was a 2023 AHCJ-California Health Journalism Fellow.