WASHINGTON – The giant spending bill passed by Congress last month kept the government open. But it also quietly rewrote huge areas of health policy: Hundreds of pages of legislation were devoted to new health care programs.
The legislation included major policy areas that committees had been hammering away at all year behind the scenes – such as a big package designed to improve the nation's readiness for the next big pandemic. It also included items that Republicans had been championing during the election season – such as an extension of telemedicine coverage in Medicare. And it included small policy measures that some legislators have wanted to pass for years, such as requiring Medicare to cover compression garments for patients with lymphedema.
Although the bill was primarily designed to fund existing government programs, a lot of health policy hitched a ride.
Big, "must-pass" bills such as the $1.7 trillion omnibus often attract unrelated policy measures that would be hard to pass alone. But the scope of the health care legislation in last month's bill is unusual. At the end of 2022, congressional leaders decided to do something that staff members call "clearing the decks," adding all the potentially bipartisan health policy legislation that was ready and written. There turned out to be a lot to clear.
The midterm election also played a role. Many lawmakers saw that the incoming Republican House majority would be far less likely to pass another big spending bill, and so the omnibus was widely viewed as a last legislative hurrah. In fact, the new House leadership has pledged to avoid this sort of omnibus legislation in the future. House Speaker Kevin McCarthy, R-Calif., has agreed to move smaller spending bills one at a time, and to allow lawmakers to propose amendments to each on the House floor. That process would make it much more difficult to combine future spending bills with unrelated policy measures, like a package in the bill that aims to modernize the country's mental health system.
The coming change made the omnibus bill a critical opportunity to pass pieces of legislation that might have withered in the new Congress. Many of the health measures weren't controversial enough to stop the omnibus from passing as one big bill. They might not have all succeeded on their own, however. Several retiring senators were eager to use the bill to pass favored measures and cement their legacies. Among departing senior Republicans were Richard Burr of North Carolina, who was the ranking member of the Senate Health, Education, Labor and Pensions Committee; Roy Blunt of Missouri, who was ranking member on the Senate Appropriations health subcommittee; and Richard Shelby of Alabama, vice chair of the Senate Appropriations Committee. Legacies were also meaningful for the retiring Patrick Leahy, D-Vt., who was the chair of Appropriations, as well as Nancy Pelosi, who was giving up her position as the top House Democrat.
Burr had been working all year with his Democratic counterpart to develop a pandemic preparedness package known as the Prevent Pandemics Act. That legislation passed as part of the spending bill.
Sen. Mitch McConnell, R-Ky., the minority leader, had signaled earlier in the year that he hoped for a relatively modest spending bill. But he did not stand in the way of the giant bill in the end.
"Probably a lot of the driver was, 'Let's resolve it and accept the reality of a lot of stagnation we'll see in the next Congress,' " said Drew Keyes, a senior policy analyst at the Paragon Health Institute and a former staff member on the Republican Study Committee. He was critical of the size and scope of the bill, especially given the limited debate on many of its provisions. But he said he understood why it came together: "We saw a lot of pieces that felt like this is the last opportunity."
Some convoluted budget math made it possible for lawmakers to pass expansions of Medicaid without appearing to cost much money, an opportunity that was likely to disappear over time. By scheduling an end date for an expensive pandemic policy, Congress could then use the projected savings to pay for expanded Medicaid benefits for children, postpartum mothers and residents of U.S. territories.
The bill requires states to keep children signed up for at least a year at a time, and extends funding for the Children's Health Insurance Program. It also sets up a series of policies meant to discourage states from automatically dumping large numbers of adult enrollees after the end of an emergency policy that protected enrollments during the pandemic. The provisions reflected a long-standing interest by Pelosi in broadening health coverage through the Affordable Care Act and other means.
In addition to the expiring funding sources, there was a "time-limited coalition behind some of those policies," said Matthew Fiedler, a senior fellow at the Brookings Institution, who was tracking the Medicaid provisions.
Crucially, most of the bill's health measures had bipartisan support in Congress. Even though Democrats held majorities in both the House and Senate, the bill needed 10 Republican Senate votes to overcome a legislative filibuster. It got far more – the omnibus passed the Senate by a 68-29 margin. (In the House, where Republicans were less involved in negotiations over the bill since their votes were not needed, a greater share voted against it. The final vote was 225-201.) The consequence of all this deck clearing is that it may be a quiet Congress for new health legislation. There are a few health funding programs that will need to be renewed, including funding for programs to combat opioid addiction and overdoses, and one to subsidize hospitals that treat uninsured patients. But beyond those must-pass items (which may or may not pass in the end), don't expect too much.
Democrats already achieved much of their health care agenda earlier in the year, when they passed legislation to allow Medicare to limit the prices of some prescription drugs, expanded subsidies for Americans who buy their own insurance, and added new health benefits for veterans.
McCarthy did have some plans for modest health care measures with a chance of becoming law, including extended Medicare coverage for telemedicine. But that passed in the omnibus, leaving him without a lot of concrete health policy goals beyond over sight into the performance of pandemic programs.
The remaining wish list for Democrats includes measures to broaden Medicare benefits and to expand abortion rights – things they could not pass even when they controlled the House. As part of concessions with right-wing lawmakers to secure the speakership, McCarthy has promised Republicans in the House will propose substantial spending cuts to balance the budget in a decade, a goal that would be impossible without cuts to some or all of the major health programs – Medicare, Medicaid and Obamacare. But those would never advance with Democrats controlling the Senate and White House.
That means the omnibus was an unexpectedly meaty health care bill. There may not be another one for a while.
ALBANY – When Gov. Kathy Hochul's administration used emergency authority to buy $637 million in coronavirus tests through a company owned by a major Hochul campaign donor, critics and political opponents pounced.
Pay to play, they said of the late 2021 state purchase orders. Conflict of interest.
For months, Hochul and her allies have insisted the governor did not have any direct involvement in the deal. Hochul stated her "only involvement" was directing her team to purchase as many tests as possible from any available sources.
But an email written 13 months ago by the company's owner, Charlie Tebele, suggested he may have directly discussed Covid-19 tests with Hochul – at a campaign fundraiser Tebele had thrown for the governor.
Tebele's email, written to a top Hochul aide, was seeking a follow-up conversation about several topics, including "Covid-19 tests." Four days after the email, Hochul's administration approved spending $338 million for Covid-19 tests procured through his company. The email was obtained by The Buffalo News through the Freedom of Information Law.
Hochul's press secretary, Hazel Crampton-Hays, said Hochul did not recall the conversation with Tebele.
Echoing past statements, Crampton-Hays said Hochul did not oversee the procurement process "and was not involved in the day-to-day procurement decisions."
"She simply instructed her team to purchase as many available tests as possible to meet the tremendous need across the state, and they did exactly that to keep New Yorkers safe," Crampton-Hays said. "As we have always said, campaign donations do not have any influence on government decisions and we reject any implication otherwise."
Like her predecessor Andrew Cuomo, Hochul has faced criticism for her handling of the pandemic on issues as varied as masking mandates and virtual learning. But Hochul also has been dogged by questions about whether she used emergency powers during the public health emergency to benefit herself politically.
The $637 million paid to Tebele's company, Digital Gadgets LLC, is among her administration's largest discretionary expenditures, and the tests were purchased at a price much higher than what other states paid around the same time, without competitive bidding. More recently, the relationship between the state and the company has soured to the point that the two sides are now on opposite sides of a lawsuit related to competitive bidding and Covid-19 tests.
Tebele's email did not explicitly say he and Hochul discussed Covid tests at the November 2021 fundraiser he threw in the New York City area. And Tebele has for months publicly denied ever speaking directly to the governor about selling tests to her administration. A Tebele spokesman reiterated that such a conversation never occurred.
The Tebele spokesman did confirm the email's referenced discussion about "community matters" occurred at the November 2021 fundraiser, something never directly stated in the email exchange.
'I was asked to reach out to you'
The email from Tebele was sent to Micah Lasher, Hochul's director of policy, on Dec. 16, 2021, and was titled "Gov Hochul visit." Tebele described a discussion he had had with Hochul at the fundraising event on Nov. 22, 2021.
"We had a conversation with the Governor regarding some community matters when we had her in for a meeting, and I was asked to reach out to you for follow up," Tebele wrote to Lasher. "Is there a way we can schedule a brief call to discuss?" Tebele then listed three matters he wished to discuss: a pre-K reimbursement program; the licensing process for an eating disorder clinic; and "COVID tests."
"We have a community company that has available supply," Tebele wrote.
From the email, it's not clear whether Hochul – or someone from Hochul's campaign – told Tebele to follow up with Lasher on the government-related matters following the fundraiser. Tebele spokesman John Gallagher refused to say who directed Tebele to contact Lasher.
According to Gallagher, some topics listed in the email were indeed "community matters" that Tebele had discussed with Hochul at the fundraiser. But selling Covid tests was a new topic Tebele was broaching, he said.
Gallagher also noted a follow-up email Tebele wrote in the early evening of Dec. 16, 2021, more than six hours after his initial email, headlined "URGENT INFO ADDED."
In that email, Tebele wrote that he had just read Hochul wanted to mail "instant COVID tests" to peoples' homes, and that his company had such a capability. That day, the New York Times had reported on the plan.
"Digital Gadgets only learned of the state's testing needs from New York Times reporting on December 16th, 2021, which is the date of the first time that Digital Gadgets' ability to sell tests was communicated to the state," Gallagher said.
But the first email to Lasher on the morning of Dec. 16, 2021 – written before the New York Times article was published – had also broached selling Covid tests to the state. As for Hochul's administration, the state Department of Health for months had sought to buy Covid tests, striking a deal with another company in September 2021. The state's need intensified after Thanksgiving 2021, when infection fueled by a new variant, surged.
Indeed, other aspects of the timeline suggest that, at the time of the fundraiser, obtaining tests might not have been a top Hochul priority. The World Health Organization did not label Omicron a "variant of concern" until four days after Tebele's event.
That same day, Nov. 26, 2021, Hochul issued an executive order suspending normal competitive bidding rules for COVID-19-related supplies, a suspension that soon would enable the $637 million in no-bid purchase orders.
Business at fundraisers
The Tebele family threw financial support behind Hochul's quest to become the first woman elected governor in New York, a campaign she started following Cuomo's resignation in August 2021.
In total, various members of the extended Tebele family would give Hochul nearly $300,000 during the campaign; ahead of Election Day in November, Nancy and Charlie Tebele gave a combined $235,000 more to the state Democratic Party.
In other instances during her campaign, Hochul proved willing to discuss governmental matters at campaign fundraisers. Donors cut checks to Hochul's campaign, attended the often-intimate, high-dollar events, then were allowed to speak directly to the state's most powerful official about matters before her administration.
And following such conversations, donors in multiple instances were directed by Hochul campaign staff to contact Lasher, emails have shown. Like Tebele, other donors referenced having held a private conversation with Hochul, while writing follow-up emails seeking Lasher's attention.
Hochul built a massive campaign war chest, $60 million raised in 15 months, and pulled out a victory in November over Republican nominee Lee Zeldin.
On Dec. 16, 2021 – the same day as Charlie Tebele's email to Lasher – a member of Tebele's family listing the same home address in Manhattan, Leon Tebele, gave Hochul a $20,000 campaign donation.
On Dec. 20, 2021, Hochul's office approved a purchase order for an initial $338 million in rapid, at-home Covid tests bought from Digital Gadgets.
The deal for 26 million tests came together quickly: Hochul's administration received an offer to buy the tests from Tebele on Dec. 20 for $13 apiece. The same day, Hochul's office signed off on the deal at that price. The no-bid purchase order was enabled by the executive order Hochul had signed the previous month.
By January 2022, the state had struck a second, $299 million purchase order with Digital Gadgets to buy 26millionmore tests.
Lasher does not appear to have facilitated the Tebele deals: He did not respond to Tebele's Dec. 16, 2021, email until five days later.
By that time, the Hochul administration had already agreed to the first purchase order with Digital Gadgets. According to other emails written by Tebele, he finalized that deal through Jackie Bray, commissioner of the State Division of Homeland Security and Emergency Services. From the emails, it's not clear how Tebele gained access to Bray.
The state paid Digital Gadgets an average of $12.25 per test – significantly more than any other test vendor charged New York State, and nearly double what California paid for the same tests. Unlike New York, California bought the tests directly through the manufacturer, rather than through Digital Gadgets, a third-party distributor that took a significant cut in the deal struck with Hochul's administration.
Digital Gadgets, based in New Jersey, purchased the tests for an undisclosed amount from a medical product developer called Access Bio. In exchange for its payment from New York, Digital Gadgets says it provided logistical support, enabling rapid acquisition of scarce tests when the Omicron variant was surging.
Hochul says she simply told her team to acquire as many tests as possible to ensure children could return to school in early January 2022 – and that Digital Gadgets was the only company with a significant, ready supply.
In July, Hochul said that when the deals were struck, she was "not aware" Digital Gadgets had been supportive of her campaign.
Hochul's statement was called into question by the revelation that Tebele threw the in-person, November 2021 fundraiser for Hochul, a month before the first deal was struck between Tebele and Hochul's administration.
After the initial 52 million tests were delivered by Digital Gadgets as promised, Tebele hosted a second campaign fundraiser for Hochul on April 10, 2022. It was the beginning of a more intense period of campaign giving by the Tebele family, at a time Hochul's office was considering another nine-figure purchase order. That deal never came to fruition and has now resulted in litigation.
A falling out
The Hochul administration's consideration of an additional deal with the company was disclosed in a lawsuit Digital Gadgets recently filed against the Hochul administration. About two weeks after the second Tebele campaign fundraiser, Digital Gadgets met with Bray and and her chief of staff, Peter Cichetti, to hear a proposal from the company, according to the lawsuit. On June 10, according to the lawsuit, Cichetti confirmed an order of 24 million more tests through Digital Gadgets at a cost of $8.50 each.
On June 24, five members of the extended Tebele family donated a total of $104,000 to Hochul.
But on July 12, the state Department of Health "abruptly" reversed course, posting a request for competitive bids for Covid tests, breaking its promise to Digital Gadgets, according to the company's lawsuit.
With the process now competitive, Digital Gadgets submitted a bid offering to sell the tests for $2.75 each, far lower than the $8.50 figure the state allegedly agreed to less than two months earlier.
But in late August, the Hochul administration informed Digital Gadgets that it was awarding the contracts to three other bidders.
Yet when Digital Gadgets formally challenged those awards this fall, the company was told competitive bidding had not, in fact, been conducted in awarding the contracts. Hochul's administration now maintains the awards were issued through the2021 executive order allowing no-bid procurement of supplies.
It was the same Hochul order that had once allowed the initial, $637 million in payments to Digital Gadgets.
"If the facts in this lawsuit are correct, the taxpayers dodged a bullet when the Hochul administration belatedly decided to seek competitive bids," said Bill Hammond, senior fellow for health policy at the Empire Center for Public Policy. "If they had taken that simple precaution earlier, the state could have saved hundreds of millions of dollars."
In July, Hochul said at a news briefing that when the deals were struck, she was "not aware" Digital Gadgets had been supportive of her campaign.
Matthew Nasca, Patrick Borrusso and James Brady were 12-year-old kids looking for fun and adventure on a Sunday afternoon.
Nasca and his buddies, who were all altar boys,began walking on March 13, 1966,from Grant Street along Scajaquada Creek toward their favorite hangout, Delaware Park.
They were scanning the murky water for carp or other big fish. As they reached a spot about 200 yards south of Assumption of the Blessed Virgin Mary Church, the boys spotted something big in the water, just a few feet from shore.
It looked like a department store mannequin, floating facedown.
Nasca remembers that they grabbed an arm, pulled it toward them and spotted a gold watch on the wrist.
"Dummies don't wear watches!" Nasca told his friends.
The boys turned over the body and realized they were looking into the face of a large dead man, wearing black pants and a red, plaid hunting jacket.
"His face was all red, with nasty cuts around one of his eyes," Nasca said in an interview 56 years later. "It looked like he had been bludgeoned or punched. It scared the hell out of me."
The boys ran to the nearby Polish Cadets Hall, a popular gathering place on Grant Street, and told the people working there what they had found. A worker took them to a nearby firehouse, and the boys led firefighters back to the creek, where they pointed out the body.
Buffalo police reports show that officers from the Colvin Station arrived to investigate "a floater" in the creek.
Nasca said a pair of eyeglasses and plaid cap were found neatly folded on top of a Scajaquada Expressway guardrail near the body.
Police Lt. James Fremming notified the Erie County Medical Examiner's office and detectives from the Homicide Squad, a routine procedure.
At first, according to police reports, officers considered the possibility of suicide. But this would be no routine case, police quickly learned.
The dead man's wallet was missing, but officers discovered he was Monsignor Francis J. O'Connor, 44, one of the most prominent priests in the Buffalo Catholic Diocese.
Several priests who were his closest friends had been frantically searching for O'Connor for hours. He had failed to show up to celebrate his weekly 7 a.m. Mass at the Sisters of St. Joseph Motherhouse, where where the monsignor served as chaplain.
O'Connor's bed in the motherhouse had not been slept in. No one there had seen him since Saturday night. A leader of the motherhouse had called police late that morning to file a missing persons report.
Back in Black Rock, word had spread quickly that a body had been found in the creek and a crowd soon gathered as police removed the body, according to Buffalo attorney Mark J. Peszko, who recalled going there as a boy with his mother.
When Rev. Charles Meister and Rev. Arnold Schneider, who had been trying to find their missing friend, got word that a body had been found in the creek, about 2 miles from the motherhouse, they drove to the location.
The body was already on its way to the morgue on Grider Street, so they headed there.
Their worst fears were confirmed. It was the monsignor.
His Impala is found, and police zero in on homicide
About the series
Buffalo police homicide files in the unsolved1966 murder of one of Buffalo's most respected Catholic priests were never intended to see the light of day.
But on Feb. 2, 2022, the veil of secrecy was pulled back. Two Buffalo News reporters and their editor were granted access to the files in response to a Freedom of Information request.
Revealed in the 56-year-old reports on the murder of Monsignor Francis J. O'Connor were shocking secrets – a priest and a diocese journalist had been suspects– and a cache of other never before released details.
The reports show the investigation suddenly ended, without any explanation, shortly after a priest was questioned and fingerprinted.
Most of the people who knew O'Connor are now dead, along with the detectives and prosecutors who investigated the crime.
But some people still want to know who murdered the monsignor.
–Lou Michel and Dan Herbeck
How we reported this series
Watchdog reporter Lou Michel filed a Free-dom of Information Law request in January2022 for Buffalo Police records on the unsolved 1966murder of Buffalo Diocese Monsignor Francis J. O'Connor.
He and reporter Dan Herbeck were given access to the Police Department's box of approximately 100 reports on the case. In addition, they interviewed more than 120 people, including retired police officers who worked on the case, people who talked with the Buffalo Police homicide chief who oversaw the investigation, and relatives and acquaintances of O'Connor and of three diocesan employees who were once suspects.
This is the second in an 18-part serial on the unsolved murder.
Read the rest of the series in upcoming issues of The Buffalo News.