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November 17, 2022 | Volume 26, No. 10| Archives
In This Issue:
  • Election Results: Control of Congress and the Lame Duck Session 
  • MAT Act Update 
  • Candidate Corner 
  • A Closer Look: Ballot Initiatives   
  • Administration: Biden’s agenda and Hepatitis C 
  • Courts: ACA Challenge, Homeless Feeding Lawsuit, Opioid Settlement 
  • News to Know: Substance Use and Harm Reduction 
  • COVID Corner 
  • What We’re Reading 
  • Good News Corner! 
Midterms 2022 had record-breaking turnout!
Control of Congress Is Undecided
The U.S. Capitol building against a bright blue sky
  • Democrats will have a one-seat Senate majority after winning Arizona and Nevada. The Georgia race between Sen. Raphael Warnock and Herschel Walker is headed for a Dec. 6 runoff.

  • Republicans have won control of the House with a slim majority of 218 seats

  • The Republican legislative agenda includes tax cuts and reductions in government spending. Investigations into the Administration and possible impeachment proceedings will likely follow a Republican win of the House. 

  • On Nov. 15, 2022, Republicans voted for Kevin McCarthy for Speaker of the House and Sen. Mitch McConnell for Minority Leader of the Senate. Democrats will hold their leadership elections the week after Thanksgiving.

  • A divided congress will likely see a stalemate on proposed legislation
CONGRESS: Lame Duck Session
  • The current Congress must pass a budget package and raise the debt ceiling before the current continuing resolution (CR) expires on Dec. 16, 2022. Republicans may push for another short-term CR instead of an Omnibus bill, that would fund the government for a year, so they will be able to shape the budget for FY 2023 when the 118th Congress is inaugurated Jan. 3, 2023.
  • NH Sen. Maggie Hassan, longtime champion of the Mainstreaming Addiction Treatment Act, was re-elected, thus ensuring ongoing support for passing this legislation. The senator introduced the bipartisan bill in 2019 in partnership with Alaska Sen. Lisa Murkowski. The MAT Act removes the "X-waiver" regulatory barriers on buprenorphine, the gold standard of care for treatment of opioid use disorder. Buprenorphine is a safe, effective medication that cuts the risk of overdose death in half.

  • Currently the MAT Act has 273 co-sponsors in both the House and Senate. Our coalition is pushing to include the bill in the end-of-year budget package. 
TAKE ACTION: Contact your senators and representatives. We need to keep the MAT Act at the front of the line for inclusion. Here are some important talking points to use. Buprenorphine access also combats systemic racism. Here is a study to reinforce this argument. Organizations can sign on to support the MAT Act here.
Candidate Corner
The 2022 midterm election saw big wins for diversity.
  • In a major win for disability rights activists, Pennsylvania Lt. Gov. John Fetterman was elected to the Senate after suffering a major stroke in May 2022. Fetterman used assistive technologies such as closed captioning during debates, and sometimes had trouble with speech. People with disabilities saw their struggles reflected in the candidate and respected his ability to continue to the fight. PA voters found him capable and ready to tackle the rigors of Congress

  • Fetterman used assistive technologies such as closed captioning during debates, and sometimes had trouble with speech. People with disabilities saw their struggles reflected in the candidate and respected his ability to continue the fight. PA voters found him capable and ready to tackle the rigors of Congress. 

  • For women, a record breaking 12 female candidates won their gubernatorial races. The 2022 midterms saw two firsts: Democratic New York Governor Kathy Hochul will be the first elected female governor of New York, and in Massachusetts, Democrat Maura Healy will be the first female governor.

  • LQBTQ candidates set records by running in all 50 states and the District of Columbia. Not only is Maura Healy the first female to hold the office in Massachusetts, but she will also be its first openly lesbian governor. Oregon’s new governor, Democrat Tina Kotek, is also the first openly lesbian governor to serve. New Hampshire’s Democrat James Rosenor will be the first transgender man to serve in Congress, and Democrat Erick Russell will be the first openly gay Black member of Congress. 

  • BIPOC candidates set records in several midterm races. Democrat Wes Moore will become the first Black governor of Maryland and only the third Black governor to be elected in the USDemocrat Anthony Brown will be Maryland’s first Black Attorney General and Democrat Andrea Campbell will be the first Black woman as Attorney General in Massachusetts. Summer Lee, Democrat, will be the first Black Women in Congress from Pennsylvania. Democrat Stephanie Thomas will be Connecticut’s first Black women to serve as Secretary of State. Democrat Maxwell Frost who is Afro-Latino set records as the first member of Generation Z in Congress.  

  • Election deniers threaten election integrity and won 172 of the 370 races in which they were candidates. Four election deniers won Secretary of State and eight won Governorships. It remains to be seen how this will impact state policy changes and future elections. Among the most prominent election deniers reelected were Senator Rand Paul (KY), Representative Marjorie Taylor Greene (GA), Representative Matt Gaetz (FL), and Governor Ron DeSantis (FL).  
A Closer Look: Ballot Measures
Reproductive Health

Harm Reduction
Health Policy
  • South Dakota voted to expand Medicaid in an outstanding victory for the 40k residents that will be eligible for health insurance starting on July 1, 2023.
  • Oregon’s ballot initiative 111 adds an amendment to the state constitution that would make access to health care a human right. Disappointingly, this is mostly a symbolic gesture.
  • A ballot measure that passed in Arizona targets medical debt collectors who impoverish former patients. Arizona’s Prop. 209 caps the annual interest rate debt collectors can charge at 3% and protects assets like houses, cars, and home furnishings from forced sale. In addition, the percentage of wage garnishment will reduce from 25% of earnings to 10%.



  • Update to the ACA Challenge: Last month, Judge O’Connor’s ruling in Kelley vs. Becerra granted the rights of organizations to deny coverage for preventive services that violate their religious values. Now, the plaintiffs are arguing that coverage for all preventive services should be optional. If this key provision of the ACA is struck down, insurance companies can pick and choose which services to cover and implement cost sharing for benefits begin. 

  • Norma Thornton, a 78 year-old woman, is suing Bullhead City, Arizona, for a law that prohibits serving food in public spaces for “charitable purposes.” The lawsuit points out that family picnics and other social gatherings can serve food in public parks, so the ordinance only applies to people experiencing homelessness

  • CVS and Walgreens have reached a settlement of $10 billion to be paid to states over 10 years for their role in fueling the opioid epidemic.  


Substance Use and Harm Reduction
TAKE ACTION: Educate patients about how to use fentanyl test strips in states with decriminalization laws. Test strips are still illegal in Arkansas, Connecticut, Florida, Idaho, Iowa, Kansas, Louisiana, Maine, Mississippi, Montana, New Jersey, Ohio, South Dakota, Texas, Utah, Washington, and West Virginia. Advocate for your state to decriminalize by contacting your governor or state legislature.
  • On Nov. 4, the CDC issued guidelines relaxing the rules for prescribing opiates for pain. The new guidelines leave the maximum dosage for painkillers up to providers, remove limits on the number of days providers can prescribe opiates for acute pain, and warns against abruptly halting treatment. Some might argue that this will worsen the opioid epidemic, but the CDC’s rules are meant to protect patients with chronic pain and encourage tapering off medication rather than a sudden stop. 

  • Vertex Pharmaceuticals is developing a drug that alleviates pain but is non-addictive. The substance works on sodium channels rather than opiate receptors and could be a major breakthrough in preventing substance use disorder

  • Paramedics in New Jersey are providing buprenorphine on the scene of an overdose. A new study indicates that providing emergency buprenorphine leads to more patients seeking treatment for opioid use disorder.

  • Social workers have been on the frontline of the “war on drugs” for years. A new journal article argues that social workers should be agents of drug policy reform by intervening upstream and reducing or eliminating the role of the criminal justice system among people with substance use disorder. 


Note on the Public Health EmergencyAs of Nov. 14, HHS did not give states 60 days’ notice that the emergency would expire, as many had anticipated. This means the PHE will be extended in mid-January for a specified period of time. Hence, the dates in our Medicaid redetermination issue brief are no longer applicable. However, this information and timeline outline should be used to prepare for the end of the PHE. We will update this document once the PHE end-date is announced. 
NEW PUBLICATION: Check out our latest issue brief:  COVID-19 & the HCH Community: Lessons Learned From the Pandemic. This brief updates our interim lessons learned, published in September 2021. This document is a culmination of the innovation and wisdom learned by the HCH Community during the COVID-19 pandemic. Despite all the challenges, hardships, and morale injury of the past 2.5+ years, the HCH Community found ways to meet the needs of their clients. These Lessons Learned provide valuable guidance and resources for improving the systems that serve people experiencing homelessness moving forward.

What We're Reading
Good News Corner!
We are often sharing bad policy news, but we’re committed to finding good policy news out there! Here are stories we found this month that lifted our spirits:
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Corinne Lovett
Health Policy Manager
National HCH Council
Baltimore, MD
(443) 703-1445

This publication and all HCH advocacy are funded by dues from Organizational Members of the Council and by private donations. Consider joining the Council to support this work.
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