Health Policy Report (2/16)

House Committees wrapped up their markups of reconciliation instructions on the next round of COVID-19 relief legislation last week as Democratic lawmakers look to get the measure onto the floor for a vote. Members on the House Budget Committee will meet this week to combine all of the reconciliation instructions into the final $1.9 trillion virus relief bill, with floor consideration likely to occur the following week of February 22. A formal notice for the Budget panel’s forthcoming meeting has yet to be posted. 

Meanwhile, the Senate completed the impeachment trial of former President Donald J. Trump over the weekend. In a 57-43 vote, Senators fell short of the two-thirds majority required to convict the former President on a charge that he incited the January 6 insurrection on Capitol Hill. No votes are scheduled in the upper chamber this week as the Senate stands adjourned until Monday, February 22. When senators return next week, they are expected to focus on confirming President Joe Biden’s cabinet nominees, as well as COVID-19 relief.

Biden Administration to Rescind Trump Medicaid Work Requirements

The Biden administration last Friday began the process of revoking Medicaid work requirements. The Centers for Medicare and Medicaid Services (CMS) sent letters to states with previously approved Medicaid work requirement waivers informing them that the administration has “preliminarily” determined to revoke the policy and will give states 30 days to submit information contesting the decision. The letters cite the administration’s “serious concerns about testing policies that create a risk of substantial loss of health care coverage in the near term,” as well as the COVID-19 pandemic’s impact on health and accessibility. Administration officials are reportedly planning to rescind the Trump administration’s 2018 letter announcing the work requirement policy, as well as the 2020 letter from former CMS administrator Seema Verma aimed at making it more difficult for the incoming Biden administration to quickly overturn the policy.

President Biden issued an executive order last month directing the review of Medicaid work requirements. The Trump administration had approved work requirements in 13 states, and 10 others were still seeking approval for waivers. No work requirements are currently in effect due to rulings by federal courts, and the policy is up for review by the Supreme Court on March 29. 

White House Purchases 200 Million Additional Vaccine Doses

President Biden announced last Thursday that the administration has purchased an additional 200 million doses of COVID-19 vaccines, bringing the U.S. supply to 600 million doses. During his announcement on Thursday, President Biden criticized the Trump administration for lacking a comprehensive plan for the vaccine rollout. He stated that his predecessor “did not do his job in getting ready for the massive challenge of vaccinating hundreds of millions of Americans.”

The president explained that 100 million doses each were purchased from Pfizer and Moderna, and that the companies will step up their production timelines in order to deliver at least 100 million doses by the end of May. Every American who wants to be vaccinated will be able to do so by the end of July, according to President Biden. The administration paid the same prices for the vaccines as previously, paying $2 billion for the additional Pfizer doses and $1.65 billion for the additional Moderna doses. Additional supply is also expected to come from Johnson & Johnson’s vaccine, which is set to be reviewed by the Food and Drug Administration on February 26. Johnson & Johnson expects to supply 100 million doses by the middle of the year.

The administration also announced last Tuesday that it plans to send vaccine doses directly to community health centers to promote equitable vaccine distribution in traditionally underserved areas. The administration plans to phase in the program by sending doses initially to at least one health center in every jurisdiction across the country, with one million doses divided across 250 clinics as the program ramps up. Administration officials explained they will focus on clinics primarily treating individuals experiencing homelessness, agricultural and migrant workers, public housing residents, and those with limited English proficiency.

Biden Changes Position in ACA Case Before SCOTUS

Last Wednesday, the Department of Justice (DoJ) sent a letter to the Supreme Court reversing the administration’s position in the high-profile case considering the constitutionality of the Affordable Care Act. The DoJ explained that the new administration believes the individual mandate is constitutional, and that the ACA can stand even if the Supreme Court decides to strike down the provision requiring insurance coverage. The letter cites the 2017 decision from Congress to reduce the individual mandate to zero rather than eliminate it entirely. Deputy Solicitor General Edwin Kneedler did not request new oral arguments or additional briefing, but the letter signals the Biden administration’s support for the health law. The move is unlikely to have much impact on the outcome of the case as the Supreme Court previously heard arguments. A decision is expected from the high court by summer.

White House Names Non-Federal Members of COVID-19 Equity Task Force

The White House announced 12 non-federal members of its COVID-19 Health Equity Task Force last Wednesday, some of whom have previous experience working with or advising the federal government. The new members will assist in gathering information on communities disproportionately impacted by COVID-19 and develop recommendations for the administration on how best to combat racial and ethnic disparities in the government’s COVID-19 response. Their work will culminate in a final report to White House COVID-19 Response Coordinator Jeff Zients discussing what drove current, observable COVID-19 disparities and how these disparities might continue to impact those recovered from coronavirus. The members represent immigrants, the LGBTQ community, individuals with disabilities, health care providers, the homeless, children, rural communities, and various racial and ethnic groups. Members include the following individuals:

• Mayra Alvarez, President of The Children’s Partnership
• James Hildreth, President and CEO of Meharry Medical College
• Andrew Imparato, Executive Director of Disability Rights California
• Victor Joseph, tribal member of the Native Village of Tanana
• Joneigh Khaldun, Chief Medical Executive and Chief Deputy Director of the Michigan Department of Health and Human Services
• Octavio Martinez, Executive Director of the Hogg Foundation for Mental Health at The University of Texas at Austin
• Tim Putnam, President and CEO of Margaret Mary Health
• Vincent Toranzo, student from Broward County, FL.
• Mary Turner, ICU nurse at North Memorial Medical Center in Robbinsdale, MN
• Homer Venters, clinical associate professor at New York University College of Global Public Health
• Bobby Watts, CEO of the National Health Care for the Homeless Council
• Haeyoung Yoon, senior policy director at the National Domestic Workers Alliance