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February 15, 2021

House Energy & Commerce Committee approves $188.5 billion in Reconciliation Bill provisions to combat COVID-19

Bill includes funding to ramp up vaccinations, testing, treatment, and tracing along with other public health investments and supports for vulnerable and underserved populations

The House Energy and Commerce Committee on February 12, approved on party lines the committee's reconciliation directives from S. Con. Res. 5, the fiscal 2021 concurrent budget resolution. The committee's provisions, which Chairman Frank Pallone (D-NJ) said will "provide the resources and support needed to bring an end to the COVID-19 pandemic," include $14 billion to speed up the distribution of vaccines, $46 billion for a national testing strategy, $7 billion for the mobilization of a public health jobs program, $25 billion for addressing health disparities and protecting vulnerable populations, $5 billion for utility assistance programs, and $7.6 billion to expand internet connectivity, among other items. The bill also mandates coverage for COVID-19 vaccines and treatment in Medicaid and the Children's Health Insurance Program (CHIP). Ranking member Cathy McMorris Rodgers (R-WA) criticized the bill and "hyper-partisan process," adding that "The Majority has shared no information about how many jobs this will create, how many vaccines it will get into people's arms, or how quickly we can reopen schools."

The package mostly resembles the stimulus plan outlined by President Biden, however it also includes several Medicaid expansion provisions which were not included, in addition to a provision to eliminate the cap on Medicaid inflation rebates. Currently, Medicaid requires a minimum 23% rebate on brand drugs, and companies pay an additional rebate when they increase prices faster than inflation, which is capped at 100%. The bill would eliminate the cap starting in 2023 in part to pay for other Medicaid provisions such as a two-year, five percent bump in the federal Medicaid match to states that newly expand Medicaid along with enhanced coverage for postpartum women and for home- and community-based services. Upon consideration of the Medicaid provisions, Rep. Larry Bucshon (R-IN) requested confirmation that the rebate changes would not be imposed on drugs or biologics that are currently exempt from providing rebates, and Chairman Pallone agreed to get back to him with that information.

Republicans offered a slew of amendments throughout the markup, none of which were agreed to, some due to policy differences and others due to their inability to fit into budget reconciliation rules, according to committee Democrats. Lawmakers, for example, voiced support but did not approve amendments for additional funding for the National Institutes of Health (NIH), added transparency into how the government dispenses vaccines to states, permanent expansion of enhanced Medicaid coverage for postpartum women, and a provision to increase access to telehealth for children. An amendment by Rep. Brett Guthrie (R-KY) to add an additional $35 billion to the Provider Relief Fund (PRF) also failed on party lines, with the Chairman stating that he would work with HHS to distribute $24 billion in unobligated PRF funds still remaining and they could revisit adding additional dollars once the fund is depleted.

The Committee's Memorandum includes a section-by-section for each of the four Committee Prints on 1) Public Health, 2) Medicaid, 3) the Children's Health Insurance Program, and 4) Other Provisions. Additional markup documents such as amendments can be found here.

Details of the committee's approved bill can be found in the attached Alert.


Contact Information
For additional information concerning this Alert, please contact:
Washington Council Ernst & Young
   •  Any member of the group at (202) 293-7474.


Full text of the Alert