{"id":2008,"date":"2020-11-17T21:07:08","date_gmt":"2020-11-17T21:07:08","guid":{"rendered":"https:\/\/thornrun.com\/health-policy-report-11-16\/"},"modified":"2023-08-08T21:25:25","modified_gmt":"2023-08-08T21:25:25","slug":"health-policy-report-11-16","status":"publish","type":"post","link":"https:\/\/thornrun.com\/health-policy-report-11-16\/","title":{"rendered":"Health Policy Report (11\/16)"},"content":{"rendered":"\n

Capitol Hill Update<\/strong><\/p>\n\n\n\n

The House will convene for legislative business today as Members look to address key year-end priorities. Fiscal year (FY) 2021 appropriations and the National Defense Authorization Act face hard deadlines in December, and lawmakers will need to navigate several “poison pill” issues before an agreement on these items can be reached. Officials will also look to reach a consensus on another round of COVID-19 relief aid, as calls for additional legislation continue to grow. Speaker Nancy Pelosi (D-CA) is expected to pick up negotiations with Senate Majority Leader Mitch McConnell (R-KY) in the coming days and weeks ahead, as the Trump administration is reportedly stepping back from the pandemic relief negotiations. House Democrats and Senate Republicans still remain far apart on the size and scope of the next bill, and it remains to be seen whether a deal can be clinched prior to the end of the 116th Congress.<\/p>\n\n\n\n\n\n\n\n

On the floor this week, lawmakers are set to consider legislation<\/a> that\nwould reauthorize the National Apprenticeship Act. The $3 billion measure would\namend the existing national apprenticeship program to include\npre-apprenticeships and youth apprenticeships, and would also promote\nadditional labor standards “necessary to safeguard the welfare of\napprentices.” For the balance of the “lame duck” session,\nMajority Leader Steny Hoyer (D-MD) said<\/a> lawmakers will\ntake up a bill<\/a> that would\ndecriminalize cannabis and expunge convictions for non-violent cannabis\nconvictions, as well as a forthcoming conference report that reflects a\nbipartisan, bicameral agreement on the Water Resources Development Act.\nMeanwhile, the Senate is expected to focus primarily on presidential\nnominations until the big-ticket items clear the lower chamber. <\/p>\n\n\n\n

Supreme Court Appears Willing to Uphold Bulk of ACA<\/strong><\/p>\n\n\n\n

The United States Supreme Court heard arguments in the case of California\nv. Texas <\/em>last Tuesday, in which a group of GOP-led states are seeking to\ninvalidate the Affordable Care Act. The case hinges in part on whether the\nindividual mandate, the alternative tax to which Congress reduced to zero in\n2017, is severable from the rest of the law. Two highly-watched justices \u2014\nChief Justice John Roberts and Associate Justice Brett Kavanaugh \u2014 appeared\nunconvinced by the plaintiffs\u2019 arguments that if the mandate were to be struck\ndown, the full law would have to go as well. While their views of\ninseverability appeared clear, there were fewer indications as to whether they\nbelieved that the mandate, absent its alternative tax, was unconstitutional.\nJustice Alito also expressed some skepticism \u2014 though not as much as Chief\nJustice Roberts and Justice Kavanaugh \u2014 that the mandate is necessary for the\noperation of the rest of the law. However, justices\u2019 questions during oral\narguments are not always indicative of how they will ultimately rule. A ruling\nis expected by June 2021. <\/p>\n\n\n\n

Since the ACA\u2019s individual mandate penalty is $0, there would be\nlimited impact on the law even if the Court found the measure to be\nunconstitutional. Justices Sotomayor, Kagan, and Breyer all appear skeptical of\nthe argument that the mandate now constitutes a command rather than a choice.\nIn particular, they do not appear to believe that making a law less coercive \u2014\nby zeroing out a mandate \u2014 can make it more of a command. In general, the\nconservative justices may be sympathetic to the argument that the mandate can\nno longer be a tax, as it can no longer raise revenue. In that case, the $0\npenalty may be unconstitutional.<\/p>\n\n\n\n

The issue of severability has become particularly important as\nother key tenets of the law \u2014 such as the entirety of the law\u2019s insurance\nreforms, or even unrelated provisions like CMMI and the biosimilars pathway \u2014\ncould potentially be struck, as well. Texas\u2019 arguments for inseverability rely\non legislative findings in the original ACA that say that the individual\nmandate is necessary. However, Justice Kavanaugh noted, \u201cCongress knows how to\nwrite an inseverability clause\u201d and that this<\/em> is not that<\/em>. Last\nTuesday\u2019s oral arguments suggest that most disruptive outcome is unlikely. <\/p>\n\n\n\n

Administration Announces Partnership With Pharmacies for\nCOVID-19 Vaccine Distribution <\/strong><\/p>\n\n\n\n

The Trump administration announced<\/a> the federal\ngovernment will partner with large chain pharmacies and networks that represent\nindependent pharmacies and regional chains to increase access to future\nCOVID-19 vaccines. The administration reported that the partnership will\nencompass 60 percent of all pharmacies throughout the 50 states, D.C, Puerto\nRico, and the U.S. Virgin Islands. Department of Health and Human Services\n(HHS) Secretary Alex Azar stated that the \u201cvast majority of Americans live\nwithin five miles of a pharmacy,\u201d and that the new partnership \u201cis a critical\nstep toward making sure all Americans have access to safe and effective\nCOVID-19 vaccines when they are available.\u201d <\/p>\n\n\n\n

The administration explained that the partnership is being\nestablished in anticipation that one or more COVID-19 vaccines will be\nauthorized or approved and recommended for use in the United States before the\nend of 2020. Pfizer announced this past week their vaccine candidate was\nshowing more than 90 percent effectiveness and Moderna is expected to announce\nresults from their vaccine trial by the end of the month. The Centers for\nDisease Control and Prevention (CDC) is also reportedly considering methods for\nhelping Americans remember to receive the second dose of a successful COVID-19\nvaccine with the same brand to ensure full effectiveness. <\/p>\n\n\n\n

Biden Names COVID-19 Transition Advisory Team<\/strong><\/p>\n\n\n\n

President-elect Joe Biden named<\/a> 13 health experts\nto his transition COVID-19 advisory team last Monday. The president-elect has\ndeclared tackling the coronavirus pandemic as one of the \u201cmost important\nbattles\u201d his administration will face and one of his first priorities upon\nentering the White House. Biden has promised that his COVID-19 response will be\n\u201cinformed by science and experts,\u201d and stated \u201cthe advisory board will help\nshape [his] approach to managing the surge in reported infections; ensuring\nvaccines are safe, effective, and distributed efficiently, equitably, and free;\nand protecting at-risk populations.\u201d He explained the advisory board will\nconsult with state and local officials to \u201cdetermine the public health and\neconomic steps necessary to get the virus under control, to deliver immediate relief\nto working families, to address ongoing racial and ethnic disparities, and to\nreopen our schools and businesses safely and effectively.\u201d <\/p>\n\n\n\n

The advisory team will be co-chaired by three experts: (1) Dr.\nDavid Kessler, former Food and Drug Administration Commissioner; (2) Vivek\nMurthy, former Surgeon General; and (3) Dr. Marcella Nunez-Smith, associate\nprofessor of medicine and epidemiology at Yale. Additionally, Beth Cameron,\nformer senior director for global health security and biodefense in the Obama\nadministration, and Rebecca Katz, co-director of the Center for Global Health\nScience and Security at Georgetown University, will serve as advisory to the\ntransition on COVID-19 and will work closely with the advisory board. Also\nserving on the advisory board is: <\/p>\n\n\n\n