Health Policy Report (6/14)

June 14, 2021

House lawmakers will begin their floor activity for the month of June later this afternoon. On the floor this week, Members will take up a package of Environmental, Social, and Corporate Governance (ESG) bills out of the Financial Services Committee, as well as legislation that would repeal the 2002 Authorization for Use of Military Force (AUMF) in Iraq. In the month ahead, the House will consider a series of Senate-passed Congressional Review Act (CRA) resolutions that would overturn Trump-era regulations pertaining to: (1) the Equal Employment Opportunity Commission (EEOC) (S.J.Res.13); (2) a rollback of methane protections at the Environmental Protection Agency (EPA) (S.J.Res.14); and (3) the Office of the Comptroller of Currency’s rule relating to “National Banks and Federal Savings Associations as Lenders” (S.J.Res.15). Additionally, lawmakers will take up the House Transportation and Infrastructure Committee’s surface transportation reauthorization measure prior to adjourning for the Independence Day district work period.

On the Senate side, floor activity is expected to focus primarily on confirming President Joe Biden’s pending nominations, starting with Kentanji Brown Jackson to be a Circuit Judge for the DC Circuit. Senators will also vote on Lina Khan’s nomination to be a Commissioner on the Federal Trade Commission (FTC). The noted tech critic and antitrust hawk cleared the Senate Commerce Committee on a bipartisan basis last month and could be sworn in after confirmation as early as this week. Once she takes her post, that could free the Senate to approve current FTC Commissioner Rohit Chopra’s nomination to be Director of the Consumer Financial Protection Bureau (CFPB).

HHS Reports Record Number of Americans Insured Under ACA

Last week, the Department of Health and Human Services (HHS) reported that a record 31 million Americans have health insurance through the Affordable Care Act (ACA). The administration also announced that uninsurance rates have been reduced in every state in the country since coverage was expanded, and those served by the ACA Exchanges and Medicaid expansion have reached record highs. HHS Secretary Xavier Becerra stated that the report speaks to the success of the ACA and the country’s need for quality, affordable health care. Additionally, Centers for Medicare and Medicaid Services (CMS) Administrator Chiquita Brooks-LaSure said the administration would work to protect and build on the ACA to ensure Americans can access the care they need.

Specifically, the HHS report showed 11.3 million individuals enrolled in ACA plans as of February 2021, and 14.8 million newly-eligible individuals enrolled in Medicaid through expansion as of December 2020. Furthermore, one million people are enrolled in the ACA’s Basic Health Program, and almost four million previously-Medicaid-eligible individuals gained coverage under expansion due to enhanced outreach and streamlined applications. Notably, the administration reported that the number of nonelderly uninsured adults was reduced by 41 percent between 2010 and 2016 — from 48.2 million to 28.2 million.

Administration Releases Findings from American Supply Chain Review

Last Tuesday, the administration released a report detailing the findings of a 100-day review of American supply chain vulnerabilities. The review was ordered by President Biden in February, and tasked the administration with examining the supply chains for pharmaceuticals and active pharmaceutical ingredients, critical minerals, and more. The administration noted that decades of underinvestment and public policy choices led to a fragile supply chain, and “unfair” trade practices by competitor nations and prioritization of low-cost labor, just-in-time production, consolidation, and more led to these vulnerabilities. The report details immediate actions the administration will take to strengthen these supply chains, including the establishment of a task force to focus on supply chain disruptions led by Commerce Secretary Gina Raimondo, Transportation Secretary Pete Buttigieg, and Agriculture Secretary Tom Vilsack.

In order to immediately address supply chain vulnerabilities for critical medicines, the Department of Health and Human Services (HHS) under the Defense Production Act (DPA) will establish a public-private consortium for advanced manufacturing and onshoring of domestic essential medicines in addition to selecting 50-100 critical drugs drawn from the Food and Drug Administration’s (FDA) essential medicines list to be the focus of efforts. HHS will also make an initial commitment of $60 million to develop novel platform technologies to increase domestic manufacturing capacity for API. The administration also acknowledges that the FDA needs additional authority to collect information about drugs and APIs moving through the U.S. supply chain in order to anticipate and respond to drug shortages, as well as the need for the FDA to move forward with creating a quality rating system for drug manufacturers to encourage sponsors to update manufacturing processes and increase quality transparency. 

CMS Boosts Payments for At-Home COVID-19 Vaccinations

The Centers for Medicare and Medicaid Services (CMS) announced that it will increase payment rates for administering COVID-19 vaccines in-home to hard-to-reach Medicare beneficiaries. The administration noted that the increase in payment rates continues the administration’s efforts to meet individuals where they are and make it as easy as possible for all the get vaccinated. They reported approximately 1.6 million adults older than 65 may have trouble accessing COVID-19 vaccinations because they have difficulty leaving home and could be reached by this effort. Medicare will pay an additional $35 per dose for COVID-19 vaccine administration in a beneficiary’s home, increasing the total payment amount for at-home vaccination from approximately $40 to approximately $75 per vaccine dose. For a two-dose vaccine, this results in a total payment of approximately $150 for the administration of both doses (or approximately $70 more than the current rate.)

Administration to Donate 500 Million Pfizer Vaccines to Lowest-Income Nations

President Biden announced last Thursday that the administration will purchase and donate 500 million doses of Pfizer’s COVID-19 vaccine to be distributed to the world’s lowest-income nations. The vaccine doses will be delivered by June 2022 to 92 nations, although 200 million will be delivered by the end of this year. Vaccine doses will begin shipping in August 2021. The president noted that the donation is the largest-ever purchase and donation of vaccines by a single country and will serve as the foundation for a coordinated effort between countries to vaccinate all around the world. Other G-7 leaders announced Thursday that they will provide an additional 500 million vaccine doses to be shared with the rest of the world. Nations receiving vaccines will be defined by Gavi’s (the Vaccine Alliance) COVAX Advance Market Commitment and the African Union, and the U.S. will work with COVAX to deliver the vaccines.