With help from Megan R. Wilson

PROGRAMMING NOTE: We’ll be off next week for the holidays but back to our normal schedule on Tuesday, Jan. 3.

OMNIBUS ON THE WAY — A year-end package that would bring new policy (and money) across health sectors is expected to pass in Congress today.

The bill, if signed into law, would avert a government shutdown. Read more about what’s in the bill here — and implications for global health, family planning, the VALID Act, cosmetics regulations, accelerated approval, hospital at-home waivers, artificial intelligence in health, the Advanced Research Projects Agency for Health and providers (more on that below) (Pros only).

Senators had been expected to vote on the bill Wednesday night, but it hit a roadblock when Republican Sen. Mike Lee of Utah offered a proposed amendment that ties funding for the Office of the Executive Secretary at the Department of Homeland Security to the Biden administration keeping Title 42, or Trump-era border restrictions tied to the pandemic.

WELCOME TO THURSDAY PULSE. A recent American Psychiatric Association poll found more Americans (37 percent) rate their mental health as only fair or poor compared to last year (31 percent).

Have tips that helped you improve your mental health in the new year? What about tips for what we should cover next? Drop us a line at [email protected] and [email protected].

TODAY ON OUR PULSE CHECK PODCAST, Carmen Paun talks with Daniel Payne about the trajectory of the mpox outbreak in 2022 and what lessons we can learn from it.

FINAL PLEAS — A coalition of 20 physicians’ groups was among those to blast congressional leaders for not stopping the full Medicare cuts to doctors in the omnibus package released early Tuesday morning.

In a Tuesday letter obtained by Pulse, the group pleaded for last-minute changes to the bill before it passes to eliminate reimbursement cuts entirely, not partially as in the package.

The group told congressional and committee leaders that the move would put further financial stress on its members, a final push in a long stretch of lobbying.

In the bill, doctors get partial relief from the scheduled 4.47 percent cut, which would effectively cut rates by 2 percent in 2023, then 3.25 percent in 2024.

The group’s disappointment is shared both publicly and privately.

The American Medical Association wasted no time expressing dismay with the deal — sending a statement before the final text was released.

The Medical Group Management Association was “deeply dismayed” by the deal, and the Surgical Care Coalition said Congress was showing “a lack of commitment to our nation’s seniors.”

But not all provider groups expressed disappointment in Congress’ package. Hospital groups like the American Hospital Association and the Children’s Hospital Association celebrated wins like the waiving of the full pay-as-you-go, or PAYGO, cuts and the investment in medical education programs and rural care.

The AHA’s approach to partial relief was a far cry from clinician groups, saying its members “appreciate Congress giving partial relief to physicians by rolling back Medicare payment cuts.”

Some value-based care groups were more middling in their response. The 5 percent bonus for alternative payment models scheduled to end next year was instead bumped down to 3.5 percent.

The National Association of Accountable Care Organizations, which comprises groups of providers who coordinate care for increased efficiency, said it “greatly appreciated” Congress’ bill while acknowledging it’s still less than the bonus they’ve been getting.

ANOTHER PROVIDER ITEM THAT MADE THE CUT — Two programs to boost Medicare reimbursements in rural hospitals were extended in the omnibus package.

The Medicare-Dependent Hospital program offered reimbursement boosts for small hospitals that see mostly Medicare patients. And, a decadeslong program that provides extra funds to low-volume hospitals, which have relatively few discharges, was also extended.

The programs, initially set to expire before year’s end, were extended to Dec. 23 through a continuing resolution passed last week.

BACK TO THE STOCKPILE — HHS is distributing Tamiflu, an antiviral to treat the flu, from the nation’s Strategic National Stockpile, the agency said in a statement Wednesday, emphasizing the severity of this year’s influenza wave.

The stockpile has been held for a flu pandemic, but elevated demand has pushed leaders to increase the available supply.

The manufacturers are working 24/7 to produce more of the drug, the agency said, urging people to buy only what they need — and to get vaccinated to reduce burdens on the health system.

REDUCING MEDICAID CHURN — A provision in the omnibus package could mean fewer children are taken off Medicaid, according to a new analysis from KFF.

The bill would require states to provide children continuous eligibility for Medicaid and the Children’s Health Insurance Program. This change could keep kids from being withdrawn from the programs and re-enrolling within 12 months.

Continuous eligibility lets a child stay in the program for a set period unless they age out, move states, withdraw or, sometimes, don’t pay their premiums. States with those policies have fewer kids entering and exiting the system in rapid succession, the report found.

The policy being considered is an extension of a pandemic policy that would, if passed, no longer be tied to a public health emergency.

FIRST IN PULSE: 'HEALTH UNDERWRITERS' REBRANDS — Starting Jan. 1, the National Association of Health Underwriters will be known as the National Association of Benefits and Insurance Professionals, Megan reports.

Megan chatted with CEO Janet Trautwein, who has led the organization for more than 25 years and noted the outdated name goes back to the association’s inception about a century ago.

Over the years, the association has worked to expand its membership to include people in many roles involved in health insurance and benefit plans, including agents, brokers, consultants, administrators and technology platforms. It now represents more than 100,000 people.

“We had to make some changes to better describe ourselves,” Trautwein said. “For a long time — at least the last 15 years — we’ve had to explain to people, what is a health underwriter? And you could spend the first five or 10 minutes talking to someone, trying to explain what it is — when, really, it’s just health plan professionals, employee benefits professionals.”

The rebranding also comes with a new slogan, “Shaping the future of health care,” which Trautwein says reflects its advocacy interests: “We look a lot at what can we do to make sure that health care is accessible and affordable for people moving into the future so that it’s available to everyone, regardless of what their income level is,” she said.

CHINA’S NEXT STEPS — On Wednesday, global health leaders expressed concerns about a severe Covid wave in China after leaders abandoned their strictest regulations to stop the spread, POLITICO’s Carmen Paun reports.

“One in seven people on the planet live in China, and the acceleration of vaccination, the protection of the health system during this period is in the interest of seven out of seven people on this planet,” said Mike Ryan, the World Health Organization’s emergency boss.

Speaking about the situation to reporters today, WHO officials avoided criticizing China for the fast policy U-turn, praising its focus on vaccination instead.

But in reopening, the country doesn’t have the same protection from vaccines that some other countries had when working to return to normal.

But that could be changing, with the first shipment of foreign vaccines — made by BioNTech in Germany — to China announced Wednesday.

The shots will initially be for German nationals in China, though Berlin is pushing for wider use.

Chris DeRienzo is now senior vice president and chief physician executive for the American Hospital Association. He was most recently system chief medical officer and senior vice president of quality at WakeMed Health and Hospitals in North Carolina.

The New York Times’ Megan Specia reports on the rising frustrations with Britain’s ambulance services.

Kaiser Health News’ Noam N. Levey writes that hundreds of hospitals sue patients and threaten their credit.

Anthony Almojera writes for The New York Times’ opinion section about the growing mental health crisis he's witnessing as a paramedic.