Health Policy Report (3/8)

March 8, 2021

Senators passed (50-49) President Joe Biden’s “American Rescue Plan” over the weekend following a marathon “vote-a-rama” debate on amendments. The process was delayed for nearly 12 hours on Saturday as Senators deliberated changes to the unemployment benefits portion. Ultimately, a compromise was reached that pared back the weekly boost to $300 per week until September 6, up to $10,200 of which is to be excluded from taxable income for unemployed workers. Given the changes to the underlying bill, the House now needs to vote on the virus relief package again before it gets placed on the President’s desk for signature.

House lawmakers will convene for legislative business this afternoon. In addition to a forthcoming vote on the revised COVID-19 relief bill tomorrow, Members will continue their push to clear key Democratic priorities pertaining to labor rights and gun control. On the labor front, the lower chamber will consider a sweeping measure that would, among other things: (1) allow the National Labor Relations Board (NLRB) to levy fines against businesses that violate certain workers’ rights rules; (2) broaden the scope of individuals covered by fair labor standards to include independent contractors; and (3) permit labor organizations to encourage the participation of union members in strikes. Lawmakers will also take up a pair of measures (H.R. 8H.R 1446) that seek to strengthen background check requirements for gun purchases.

Finance Committee Sends Becerra Nomination to Senate Floor

Last Wednesday, the Senate Finance Committee voted along party lines to advance the nomination of California Attorney General Xavier Becerra to be Secretary of Health and Human Services (HHS) to the Senate floor. Every Democrat on the Committee voted in favor of Becerra’s nomination. No GOP member broke ranks on the vote, however. With the Committee roster evenly divided, Chairman Ron Wyden (D-OR) must notify the Secretary of the Senate of a tie vote, after which Senate Majority Leader Chuck Schumer (D-NY) will move to discharge the nomination from the Committee, bringing it to the Senate floor. This will require one additional procedural vote in the full Senate.

Becerra has proven to be among President Biden’s more controversial cabinet picks. Senate Minority Leader Mitch McConnell (R-KY) has declared Becerra to be “radical” and “underqualified,” despite two degrees from Stanford, a long career in public service, and having previously served as Chairman of the Congressional Hispanic Caucus. McConnell specifically criticized Becerra’s opposition to religious exemptions with regard to employer coverage of birth control. Prior to Wednesday’s vote, Ranking Member Mike Crapo (R-ID) said that while he does not support Becerra’s nomination, he will work to find bipartisan solutions should Becerra be confirmed as Secretary. Sen. Bill Cassidy (R-LA) pointed to Becerra’s performance in his confirmation hearing as a reason to oppose him; specifically, Becerra’s dodge of questions about the statutory definition of contract pharmacies with regard to the 340B program. Senate leadership will move to schedule a vote on Becerra’s nomination in the full Senate. Confirmation could come as early as this week.

Trump Administration Directed Provider Relief Funds Toward Operation Warp Speed

An investigation by STAT News revealed last week that the Trump administration redirected around $10 billion from the Provider Relief Fund intended to assist hospitals and providers through the pandemic towards Operation Warp Speed contracts. Trump’s Department of Health and Human Services (HHS) used a loophole allowing them to redirect the money without informing Congress — a move approved by the HHS Office of the General Counsel. The Biden administration has not yet commented on whether the redirected funding will impact total funds available to assist providers with pandemic-related expenses such as staffing, personal protective equipment, care for uninsured patients, and vaccine distribution. Former White House budget office director Russ Vought, who was involved in the decision-making, stated that the expenditure was necessary to ensure the successful development and purchase of COVID-19 vaccines and therapies and that the administration had the authority to redirect the funds.

Former HHS officials explained that because Operation Warp Speed was created by the administration, it had to pull funding from existing pools of money. They revealed that the funding available for the program was running out at the end of last summer, and officials were forced to look elsewhere for money to ensure progress on vaccines and therapeutics did not slow down. While Congress gave HHS the authority to transfer money between the accounts to respond to the pandemic, it clarified that HHS was required to notify Congress and Appropriations Committees at least ten days before the money was moved. Spokespeople from the committees stated they were not made aware of any transfer of funds. In order to avoid reporting the funding change, officials spent the money directly out of the Provider Relief Fund account. Former HHS officials said that the redirected funds were initially intended to be a loan backfilled after additional funding was provided by Congress. The Health Resources and Services Administration reported that the funding has not been repaid.

ACA Exchange Signups Off to Solid Start Under Special Enrollment Period

The Centers for Medicare & Medicaid Services (CMS) reported last week that more than 200,000 individuals signed up for insurance plans on the Affordable Care Act (ACA) Exchanges in the first two weeks of the special enrollment period implemented as part of President Biden’s COVID-19 response. The initial reporting is partial as it only covers the 36 states served by the federal ACA Exchange, and National enrollment is expected to be higher. The special enrollment period will run until May 15, about twice as long as the regular annual open enrollment period, and the administration has allocated $50 million in advertising to encourage individuals to seek coverage. The Biden administration also announced last Monday that $2.3 million in funding will be available to bolster ACA signups in underserved communities through navigators.

Biden Announces U.S. Will Have Vaccines for All Adults By May

Last Tuesday, President Biden announced that the U.S. will have enough vaccines by the end of May in order to vaccinate all eligible adults, bumping up the administration’s timeline by two months. The president credited his administration’s “stepped up response,” as well as Merck and Johnson & Johnson’s partnership to produce the latter’s vaccine. President Biden noted he had invoked the Defense Production Act to adequately equip Merch manufacturing facilities to safely and effectively produce the Johnson & Johnson vaccine, and all facilities will operate 24 hours a day, seven days a week to help increase U.S. supply. Additionally, last week, analysis from The New York Times revealed the U.S. is administering an average of two million doses of COVID-19 vaccines per day, up from 1.3 million one month ago. At this pace, the Biden administration is on track to reach its goal of administering 100 million vaccine doses within the first 100 days of the new presidency.