Health Policy Report (3/29)

March 29, 2021

Congress stands adjourned for the spring district work period and will convene for votes during the week of April 12. Looking ahead to the April session, Senate Majority Leader Chuck Schumer (D-NY) outlined the upper chamber’s agenda when senators return in two weeks. The “Dear Colleague” letter notes that the Senate will focus on three main issue areas, including: (1) climate change, economic recovery, and jobs; (2) voting rights and civil rights; and (3) health and gun safety. The upcoming session is expected to include consideration of several House-passed bills that will likely be stonewalled due to the 50-50 split in the Senate. As such, the pressure will be on Democrats to modify or eliminate the filibuster as the Majority seeks to clinch legislative wins on key policy priorities.

Senate Clears Medicare Sequester Bill Ahead of Spring Recess 

Prior to adjourning for its spring state work period, the Senate overwhelmingly passed (90-2legislation that would extend a delay on spending cuts to Medicare. The bipartisan amendment to the House-passed “pay-as-you-go” (PAYGO) waiver would extend the moratorium on a two percent cut to Medicare over the next nine months, kicking the deadline to December 31, 2021 with a spending offset that would take effect after the pandemic. The measure includes several technical fixes to the underlying bill and would also punt the broader PAYGO funding issues as a result of the American Rescue Plan (ARP) to a separate legislative effort. House lawmakers will need to vote on the legislation again before it goes into effect, however, and they are expected to do so when the chamber reconvenes in April. While the two percent cuts are scheduled to go into effect on March 31, it is expected that the Centers for Medicare and Medicaid Services (CMS) will allow providers to hold claims until Members vote on the underlying bill. 

Drug Pricing Measures Could Pay for Health Provisions in Infrastructure Package 

House Speaker Nancy Pelosi (D-CA) explained last week that health care policies included in the upcoming infrastructure package are likely to be paid for through provisions tackling prescription drug prices, noting Congress “would be missing an opportunity” if it did not include drug pricing legislation. Speaker Pelosi said that H.R. 3 could cover $500 billion of the cost of the infrastructure package, which would include “human infrastructure” provisions such as language boosting Affordable Care Act (ACA) tax credits and making ACA coverage more affordable. Additionally, Reps. Frank Pallone (D-NJ) and Jim Clyburn (D-SC) are working to include language that would expand community health centers and improve broadband for telehealth. Republican members have already criticized the potential pay-for addition, pointing to the GOP’s drug pricing measure H.R. 19 as a better alternative. 

Biden Updates Vaccination Goal to 200 Million Shots in First 100 Days 

Last Thursday during his first press conference since taking office, President Biden announced the administration would update its vaccination goal to 200 million COVID-19 vaccine doses within the first 100 days of the Biden presidency. The U.S. easily surpassed the president’s original goal of 100 million shots in the first 100 days and has administered 115 million shots in the first 64 days. At the current vaccination rate of 2.5 million doses per day — as averaged over the last seven days — the U.S. would complete its goal of 200 million shots shortly before the 100-day mark on April 30. President Biden acknowledged that this goal was ambitious but said that “no other country in the world is going to come close…to what we are doing.” Potentially adding to available vaccine supply in the U.S., AstraZeneca reported last Wednesday its vaccine candidate had a 76 percent efficacy rate and would seek Food and Drug Administration Emergency Use Authorization. 

Rachel Levine, Vivek Murthy Confirmed by Senate 

Last week, the Senate confirmed Rachel Levine to serve as Assistant Secretary of Health and Vivek Murthy to be Surgeon General. Republican Senators Susan Collins (ME) and Lisa Murkowski (AK) joined Democrats (52-48) in favor of Assistant Secretary Levine’s confirmation, who previously served as the Pennsylvania Health Secretary. She is the first openly transgender federal official to be confirmed by the Senate. Dr. Murthy was confirmed as Surgeon General on Tuesday by a 57-43 vote, with Republican Sens. Bill Cassidy (LA), Susan Collins (ME), Roger Marshall (KS), Lisa Murkowski (AK), Rob Portman (OH), Mitt Romney (UT), and Dan Sullivan (AK) joining Democrats. He previously served as Surgeon General under former President Obama. 

HHS Urged to Use Moderna Patent to Widen COVID-19 Vaccine Access 

A group of patient advocates and academics wrote to top federal health officials last Wednesday urging the administration to use a soon-to-be-issued patent for technology partially developed with federal support to ensure “rapid, equitable global access” to COVID-19 vaccines. The patent will cover the use of spike proteins in the COVID-19 vaccine developed by Moderna and the National Institute of Allergy and Infectious Diseases. The advocates explain in their letter to HHS Secretary Becerra, NIH Director Collins, and NIAID Director Fauci that the patent could be an “important policy tool” to ensure any licensing agreement fosters greater access to COVID-19 vaccines through boosted manufacturing and distribution of the Moderna vaccine. They advocate that any licensing agreement should include provisions empowering the U.S. government to authorize manufacturing of the Moderna vaccine, require technology sharing with the World Health Organization to help ramp up global production, and require accessible pricing universally. They explain that taxpayers contributed over $2.5 billion in the development of the Moderna vaccine, and that the vaccine should be used to help protect public health at home by expanding global access. 

Those signing the letter include Pre4All, Public Citizen, I-Mak, and HealthGAP, as well as the deans of public health schools at Columbia University, New York University, the City University of New York, and other academics. Moderna has responded to previous similar requests by saying that it would not enforce its patent rights related to its vaccine and will license its intellectual property to any Covid-19 vaccines to others after the pandemic ends.