We hope you had a good Thanksgiving break! Congress is heading back in with just three weeks until the government runs out of money.

• Peter, Victoria and Maya caught up with senators, aides and lobbyists Monday to get an update on our lame duck preview. Here’s our sense of the outlook so far.

A newsy comment from Sen. Richard Burr: He told Peter on Monday that there is "no" chance of action on reforming FDA oversight of dietary supplements before the end of the year.

• A senior Republican HELP Committee aide later added that there is a chance of reforming FDA oversight of cosmetics, and that it is "linked" to the VALID Act reforming diagnostic test oversight (a measure pushed by Burr), where changes are being discussed.
• "If we reach consensus on VALID, then cosmetics can flow with it," the aide said.
• Another candidate is the PREVENT Pandemics Act, which Burr introduced with Sen. Patty Murray.
• "Everything's in conversations right now," Burr said. "Hopefully in the next week to 10 days we should get some read on that. I think VALID's currently on the table, so is the PREVENT Act."

The outlook is better for items with a firm deadline, like averting Medicare PAYGO cuts and at least partly averting a 4.5 percent cut to physician payments.

• As Burr's comments suggest, dietary supplement reform is looking very unlikely, but there is some chance for other FDA items, like cosmetics, VALID, and accelerated-approval reform.
• Public health policies (like the PREVENT Pandemics Act) will be easier to pass than policies that require extensive pay-fors, one former Democratic aide added.
• An extension of the telehealth flexibilities seems very likely, though the specifics on how long the extension will be — and whether permanency is on the table — are still up in the air.
• A House Republican aide said bipartisan negotiations on the FMAP rate and number of years to extend Medicaid funding for Puerto Rico are a lame duck priority. The starting point is a bipartisan 2021 Energy and Commerce bill that extended increased funding at the FMAP rate of 76% for five years.
• Two health care proposals that Republicans oppose — vaccine mandates and paying for abortion travel — could also hold up the annual defense spending bill, which needs to pass in December.

What’s really looking tough: COVID-19 funding. The White House announced another request of about $10 billion for COVID needs, including development of next-generation vaccines that better target new variants.

• But Republicans have been resisting new COVID-19 funds for months, and there’s no sign they are changing their minds.
• We’re also hearing more and more that the $16 billion price-tag associated with Medicare Advantage prior-authorization reforms that passed the House earlier this year is likely to mean it won’t end up in an end-of-year package.

The big picture: There’s definitely uncertainty about what’s going to happen. Negotiations are not very intense yet, and a lot is still to be decided. One big unknown: How much money there even is to spend on the health-related items.

• It’s always a safe bet to say Congress is going to kick the can down the road, at least a little bit, and we’re hearing the funding deadline could be extended from Dec. 16 to Dec. 23. (So don’t book your flights home for the holidays too soon).
• "I don't know if we'll get [the package] done by the 16th. The 16th is the day I'd like to get it done, but we might be here 'til Christmas," Sen. Richard Shelby told reporters Monday evening.

The House Energy and Commerce Committee has seen less turnover than the Ways and Means exodus we told you about — but the next committee slate will still look different from the last time Republicans had a House majority, Maya reports.

The big picture: Just 13 Republicans who have been on the Energy and Commerce Committee since 2018 will still be in the House next year.

• And Rep. Steve Scalise, one of the 13, will leave the committee while he serves as House majority leader, his office confirmed.

Why it matters: Returning members who will rise in seniority next Congress could have more sway over the committee's agenda next year, said James Paluskiewicz, a senior policy adviser at Alston & Bird and former Republican chief health counsel for Energy and Commerce.

• For example, Reps. Buddy Carter and Tim Walberg only joined Energy and Commerce in 2017. Next year, they'll be among the more senior members.
• Other members like Reps. Larry Bucshon and Richard Hudson, who joined in 2015, could benefit from the turnover, too.
• New GOP seats are likely to open up on the committee — though just how many remains to be seen, as incoming House leadership can shrink the committee's size. (McMorris Rodgers looks forward to welcoming new members, spokesperson Chris Krepich said.)

Yes, but: Next year’s committee will work in a different environment than the last time Republicans were in the majority. In 2018, Republicans also had a Senate majority and the White House.