Health Policy Report (3/7)

Capitol Hill Update

House and Senate appropriators are pushing to finalize an omnibus spending deal for fiscal year (FY) 2022, but they may need beyond next Friday’s deadline to complete their work. While the “four corners” leaders are reportedly on the cusp of completing the 12-bill spending package, a last-minute White House request for supplemental funding to support Ukraine and address pandemic-related areas of need has complicated the appropriations talks. Specifically, GOP senators have been opposed to additional COVID-19 relief money, instead pushing for a review of how much unspent pandemic relief funds remain.

If appropriations leaders can iron out an agreement, House lawmakers could unveil the omnibus text as soon as today, followed by a vote on final passage tomorrow. This timeline could also apply to a potential continuing resolution (CR) if appropriators need additional time to finalize a deal, however. The bulk of the floor activities in the House will occur in the early part of the week to accommodate an upcoming Democratic members’ issues conference.

In addition to a vote on government funding, senators are poised to pass legislation that would implement a series of reforms to the U.S. Postal Service (USPS). Specifically, the Postal Service Reform Act (H.R. 3076) would, among other things: (1) provide USPS with $50 billion in additional funding over 10 years; (2) require future retirees to enroll in Medicare; and (3) establish a Postal Service Health Benefits program for USPS employees and retirees. The Senate is also set to resume consideration of pending presidential nominees this week, starting with the nominations of Maria Pagan to be Deputy United States Trade Representative (USTR) and Ed Gonzalez to be Assistant Secretary of Homeland Security. 

Key House Committee Discusses Impact of COVID-19 on Health Care System

On March 2, the House Energy and Commerce Subcommittee on Oversight and Investigations held a hearing (TRP analysis) to discuss the impact the COVID-19 pandemic has had on the health care system. During the hearing, members questioned health care provider witnesses on the effects the pandemic has had on their lives, as well as the lives of their patients. Members focused on policy actions that would address future pandemic preparedness, health care workforce shortages, and behavioral health issues. While Democrats supported the current administration’s investments and policies to support those affected by the pandemic and the health care workforce, Republicans focused on the effect of pandemic guidance strategies and mandates on the health care system.

During the hearing, witnesses advocated for increased investments to bolster the health care workforce, such as residency programs, loan repayment programs, fair and adequate compensation, and minimum standard nurse-to-patient ratios. Members and witnesses also supported increasing and extending telehealth capabilities to improve and expand access to care for all patients, especially those in rural and underserved settings. 

CMS Releases Updated PHE Guidance to States

On Thursday, the Centers for Medicare and Medicaid Services (CMS) released new guidance providing states 14 months to process Medicaid and Children’s Health Insurance Plan (CHIP) renewals after the public health emergency (PHE) comes to a close. Previously, the Biden administration had given states twelve months to resume the redetermination process. The updated guidance also notes that states can begin the redetermination process up to two months before the PHE ends, which is roughly the same amount of time that the Biden administration expects to provide before bringing an end to the PHE.

Additionally, CMS issued data reporting requirements that instruct states to submit baseline Medicaid data and include additional data for the preceding 14 months. States will also have to submit supplementary data if CMS raises concerns about data compliance or if the state in question is not meeting reporting timelines. The guidance includes a provision that states have the authority to treat enrollees who are deemed ineligible for Medicaid or CHIP as eligible for marketplace coverage unless the ineligibility determination is due to a procedural reason.

President Biden Announces Mental Health Strategy

Ahead of Tuesday night’s State of the Union (SOTU) address, President Biden announced a strategy to address mental health challenges in the U.S. This plan will include policies to: (1) strengthen provider capacity; (2) help connect people to mental health services; and (3) foster healthier communities. Notably, this plan previews several initiatives that will be included in the President’s fiscal year (FY) 2023 budget request. The plan also focuses on behavioral health care for children and treatment for substance use disorder (SUD).

The president is calling Congress to execute legislation to enact several of his proposals to bolster mental health care, as well as directing federal agencies to support and supplement numerous programs. In the wake of the stalled effort to pass the Build Back Better Agenda (BBBA), President Biden is now pushing mental health policy to the forefront of his health care agenda. This effort coincides with Congressional activity on several committees — notably the Senate Health, Education, Labor, and Pension (HELP) and Finance Committees, and House Ways and Means and Energy and Commerce Committees — to piece together a mental health package. This new focus is partly as a response to the COVID-19 pandemic, which increased the number of individuals reporting high rates of anxiety and depression.

CMMI Launches Health Equity Initiative

On Thursday, the Centers for Medicare and Medicaid Services (CMS) Innovation Center (CMMI) announced that it will launch a health equity initiative. CMMI says that it will imbed health equity in its models in four ways. Specifically, CMMI notes that it will promote and incentivize equitable care in new and existing models by focusing recruitment on underserved populations, reexamining quality metrics, enhancing benefits, and considering changes to payment incentives. CMMI will also work to increase model participation of safety net providers, the agency says, such as federally qualified health centers (FQHC), certified community behavioral health clinics (CCBHC), and rural health clinics. Additionally, CMMI assures stakeholders that it will improve data efforts by increasing data collection and stratifying race and ethnicity data. In the long term, CMMI plans to require model participants to collect self-reported data.