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April 26, 2021

This Week in Health Policy for April 26

This Week (April 26 - 30)

The Senate Health, Education, Labor and Pensions Committee holds a hearing on "Examining Our COVID-19 Response: Using Lessons Learned to Address Mental Health and Substance Use Disorders."

  • Details: 10:00 AM EDT on 04/28/2021
  • More information available here.

The House Energy and Commerce Health Subcommittee holds a hearing on "The Long Haul: Forging a Path through the Lingering Effects of COVID-19."

  • Details 11:00 AM EDT on 04/28/2021
  • More information available here.

The House Ways and Means Health Subcommittee holds a hearing on "Charting the Path Forward for Telehealth."

  • Details 2:00 PM EDT on 04/28/2021
  • More information available here.

Last Week (April 19 - 23)

Health Care Highlights

House leadership reintroduces dueling drug pricing packages. This week, House Democrat and Republican leaders from committees of jurisdiction on drug pricing released proposals to address the cost of prescription drugs, closely reflecting proposals from last Congress. Yesterday (April 22), Energy and Commerce Committee Chairman Frank Pallone Jr. (D-NJ), Ways and Means Committee Chairman Richard E. Neal (D-MA), and Education and Labor Committee Chairman Bobby Scott (D-VA) reintroduced H.R. 3, the Elijah E. Cummings Lower Drug Costs Now Act, which passed out of the House of Representatives in 2019. The legislation would empower the Secretary of Health and Human Services (HHS) to negotiate the cost of certain high-priced single source drugs; impose inflationary rebates on Medicare Part B and D drugs; and redesign the Medicare part D benefit, including capping out-of-pocket costs at $2,000 per year. In 2019, the Congressional Budget Office (CBO) estimated that the price negotiation provisions in the bill would save the federal government about $456 billion over 10 years. Unlike the 2019 version, the bill excludes the addition of Medicare benefits for vision, dental, and hearing.

On Wednesday (April 22), Energy and Commerce Committee Ranking Member Cathy McMorris Rodgers (R-WA), Ways and Means Committee Ranking Member Kevin Brady (R-TX), and Education and Labor and Committee Ranking Member Virginia Foxx (R-NC) released their Lower Costs, More Cures Act (H.R. 19). The legislation remains largely unchanged from the 2019 version and includes dozens of bipartisan drug pricing measures. Among these, the bill would also revamp the Medicare Part D benefit, including capping out-of-pocket costs at $3,100 per year, in addition to capping monthly insulin costs at $50 post-deductible. The bill also includes several transparency measures that apply to Medicare Parts D and B, along with measures directed at Medicaid, would ban “pay-for-delay” settlements between brand and generic manufacturers, and more.

Democrats urge White House to include health policy in infrastructure push. Congressional Democrats are urging the White House to include health policy in President Biden’s planned “American Families Plan,” expected to be detailed next week. House Speaker Nancy Pelosi said in a statement Thursday (April 22), that “lowering health costs and prescription drug prices will be a top priority for House Democrats to be included in the American Families Plan.” The Biden Administration, however, has declined to specify if it intends to include health care in the plan, with Press Secretary Jen Psaki saying during a press conference that Biden is working with advisers “to finalize the details of the package, including the investments in areas like child care, education and other areas that are big priorities to him,” notably leaving out health care. In addition to the reintroduction of Democrat’s drug pricing bill this week (H.R. 3), which proponents hope will serve as a “pay for” for the infrastructure package, Sens. Debbie Stabenow (D-MI), Tammy Baldwin (D-WI), and Sherrod Brown (D-OH) introduced a bill this week that would let Americans beginning at age 50 buy into Medicare. Biden supported both Medicare drug negotiation and expanding Medicaid to age 60 during his campaign, but has not indicated his support for either proposal as President. Pelosi and a group of centrist House Democrats also expressed support for permanently extending ACA subsidy enhancements included in the latest coronavirus stimulus bill for a two-year period, which President Biden has also expressed support for in the past.

Senate Finance advances CMS/HHS nominations, subject to hold. On Thursday (April 22), the Senate Finance Committee voted to advance the nominations of Chiquita Brooks-LaSure, President Joe Biden's pick to lead the Centers for Medicare and Medicaid Services (CMS), and Andrea Palm, who would be deputy secretary of the Department of Health and Human Services (HHS). The committee voted 20-8 to advance Palm's nomination, but were split 14-14 along party lines on Brooks-LaSure's. The nominations can now move to a Senate vote, but that process is likely to be slowed due to a hold put on Brooks-LaSure’s nomination by Sen. John Cornyn (R-TX). The hold is due to a recent Biden administration decision to revoke a 10-year extension for Texas’s Medicaid waiver, which would have provided federal funding for the state’s uncompensated care funding pool. The 1115 waiver, which was approved in the final days of the Trump Administration, was revoked on procedural grounds, with Biden’s CMS saying in a letter that Trump’s CMS “materially erred” in allowing the state to bypass the normal notice and comment process. Medicaid advocates have previously criticized the waiver for serving as poor substitute for Medicaid expansion, which the state has not adopted.

HHS announces historic navigator funding. On Wednesday (April 21), the Biden administration announced the CMS will make $80 million available in grants to navigators in Federal Marketplaces for the 2022 plan year. The funding, which will be used for outreach and education efforts, is the largest allocation CMS has made available for navigator grants to date and represents an eight-fold increase in funding from the previous year. The department also released the 2021 Marketplace Open Enrollment report, which shows over 12 million consumers nationally selected a Marketplace plan during the 2021 Open Enrollment Period (OEP), a 5% increase from the 2020 OEP.


HELP Committee Hearing on U.S. Biomedical Research. On Thursday (April 22) the Senate Committee on Health, Education, Labor & Pensions (HELP) held a hearing entitled, “Protecting U.S. Biomedical Research: Efforts to Prevent Undue Foreign Influence,” where the committee heard testimony from officials at the National Institutes of Health (NIH) and Government Accountability Office (GAO) around their efforts to prevent and act against grant fraud and other activities to prevent, identify and address threats from foreign entities. The panel discussed processes in place to collaborate with and educate stakeholders at NIH grant recipient organizations to detect and prevent grant fraud, in addition to extramural awareness programs that include broader education about potential threats and identification of bad actors. They also discussed processes in place to ward off threats, including an extensive process for approval of data sharing requests, updated grant guidance, and intra-agency efforts to improve information sharing and develop more comprehensive training programs. Several committee members noted the need to balance the importance of global sharing of scientific data, such as with the sequencing of COVID-19, with the importance of mitigating national security threats. Several committee members also brought up other concerns that were not specific to NIH, such as the potential for misuse of sensitive genetic data, given some third-party genetic testing is done abroad; vulnerabilities inherent in the expansion of network-connected technologies and increased potential for cyber-attacks; and recent attempts by North Korea to hack COVID-19 vaccination data.

Reports, Studies, and Journals

JAMA Pediatrics: Maternal and Neonatal Morbidity and Mortality Among Pregnant Women With and Without COVID-19 Infection. This study indicates a consistent association between pregnant individuals with COVID-19 diagnosis and higher rates of adverse outcomes, including maternal mortality, preeclampsia, and preterm birth compared with pregnant individuals without COVID-19 diagnosis.

Health Affairs: US Public Health Neglected: Flat Or Declining Spending Left States Ill Equipped To Respond To COVID-19. This study presents state spending trends in eight categories of public health activity from 2008 through 2018. Although overall national health expenditures grew by 4.3 percent in this period, state governmental public health spending saw no statistically significant growth between 2008 and 2018 except in injury prevention. Moreover, state spending levels on public health were not restored after cuts experienced during the Great Recession, leaving states ill equipped to respond to COVID-19 and other emerging health needs.

Health Affairs: Social Determinants Matter For Hospital Readmission Policy: Insights From New York City. This study assessed the impact of individual social risk factor variables and social determinants of health (SDOH) measures on hospital readmission rates and penalties used in the Centers for Medicare and Medicaid Services (CMS) Hospital Readmissions Reduction Program (HRRP). 

Kaiser Family Foundation: Are Health Centers Facilitating Equitable Access to COVID-19 Vaccinations? An April 2021 Update. People of color made up the majority of people who received vaccinations at community health centers, including 59% of those receiving the first dose and 54% of those receiving the second dose of the vaccine.


Contact Information
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