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The Senate voted in the wee hours of Tuesday morning to repeal insurers' federal antitrust enforcement immunity, sending the bill to the president's desk. The Competitive Health Insurance Reform Act would amend the 1945 McCarran-Ferguson Act, which gave insurers federal immunity from antitrust enforcement and delegated primary authority to regulate consolidation in the insurance industry. The bill allows the Justice Department and the Federal Trade Commission to regulate health insurance markets. (Cohrs, 12/22)

Hefty fines, the suspension of Medicare payments and other new measures to increase oversight and transparency in the fast-growing hospice industry are set to become law as part of the omnibus spending bill approved by Congress this week. The reforms had been included in the bipartisan HOSPICE Act co-sponsored by U.S. Reps. Jimmy Panetta (D-Carmel Valley) and Tom Reed (R-N.Y.). That bill was passed by the House earlier this month and then folded into the $1.4-trillion spending package sent to President Trump for his signature. (Christensen and Poston, 12/23)

With an unusual burst of bipartisan end-of-the-year goodwill, Congress nearly passed, after a 20-year hiatus, a State Department authorization bill this month. But then something happened to torpedo the effort in the final days. The torpedo was Ivanka Trump. ... However, a push by anti-abortion groups, with Trump’s support, to include language that Democrats said would undermine the role of reproductive health in the work already underway by the Global Women’s office ultimately caused Pelosi and Shaheen to withdraw their support for codifying the W-GDP initiative. (Oswald, 12/23)

Senate Majority Leader Mitch McConnell vowed in a new interview to bring all of President-elect Joe Biden’s Cabinet nominees to the Senate floor for votes by the full chamber — a pledge that comes ahead of what both Democrats and Republicans are expecting to be a series of bitter confirmation fights early next year. “They (Biden’s nominees) aren’t all going to pass on a voice vote, and they aren’t all going to make it, but I will put them on the floor,” McConnell told Republican strategist Scott Jennings for a column in the Louisville Courier-Journal published Monday. (Forgey, 12/22)

The next Congress will begin in a haze of uncertainty — and that has consequences for President-elect Joe Biden. With the Senate majority unknown until the Jan. 5 Georgia runoffs, much of the chamber’s business remains up in the air — potentially for days or weeks after if the elections are tight and certification is postponed. And that could mean more delay for staffing Biden’s cabinet and implementing his agenda. Sen. Richard Burr (R-N.C.), who could chair the Senate HELP Committee in the next Congress, said that the current state of limbo renders the confirmation process “moot” until control of the Senate is clear. (Levin and Everett, 12/22)