May 17, 2021
This Week in Health Policy for May 17
This Week (May 17 - 21)
The Senate Appropriations Labor, Health and Human Services, Education and Related Agencies Subcommittee holds a hearing on "Review of the FY2022 Budget Blueprint for the Centers for Disease Control and Prevention."
The Special Committee on Aging hearing on "Taking Aim at Alzheimer's: Frontline Perspectives and Caregiver Challenges."
The Senate Health, Education, Labor and Pensions Primary Health and Retirement Security Subcommittee holds a hearing on "A Dire Shortage and Getting Worse: Solving the Crisis in the Health Care Workforce."
Last Week (May 10 - 14)
Health Care Highlights
Bipartisan effort to address maternal mortality. This week, House Ways and Means Committee Chairman Richard Neal (D-MA) and Ranking Member Kevin Brady (R-TX) announced the release of a U.S. Government Accountability Office (GAO) report entitled “Maternal Mortality and Morbidity: Additional Efforts Needed to Assess Program Data for Rural and Underserved Areas,” which was requested by the committee leaders two years ago. In a joint statement, Reps. Neal and Brady said: “We strongly encourage the relevant agencies to adopt GAO’s recommendations, and in Congress, we will continue working to address the lack of consistent, nationwide data on maternal mortality, so that we can improve maternal health equity and outcomes in our nation and put an end to this terrible crisis.” Improving maternal mortality and morbidity, especially in areas disproportionately impacted by access and equity issues, is a rare area of bipartisan focus in the 117th Congress.
Moderate Democrats push for bipartisan drug pricing bill. A group of 10 moderate Democrats, are urging House Speaker Nancy Pelosi (D-CA) to pursue drug pricing reform that has “bipartisan, bicameral support, with buy-in from a majority of American and stakeholders in the public and private sectors,” according to a May 3 letter to the Speaker. The letter, spearheaded by Reps. Scott Peters (D-CA) and Jake Auchincloss (D-MA), calls into question whether Pelosi has the votes to pass her signature drug pricing bill, H.R. 3, which would let Medicare negotiate the price of prescription drugs and impose huge fines on drug companies that do not comply. The lawmakers write that any bill must “preserve our invaluable innovation ecosystem so that it can continue to prevent and treat disease,” hinting at a key criticism of Medicare negotiation by industry and Republican Congressmen. They also note that Congress should work with industry to determine “ways to better serve patients in an efficient and affordable fashion with an eye toward improving health equity.”
Pfizer gets vaccine clearance for younger teens. This week, the Food and Drug Administration (FDA) authorized the emergency use of Pfizer’s COVID-19 vaccine for children ages 12 to 15 and an advisory panel for the Centers for Disease Control (CDC) voted to recommend that the vaccine be used for the new age group, paving the way for states to start vaccinate adolescents. The vaccine was found to develop a strong immune response with no signs of new or worrisome side effects in the population. President Biden said “The bottom line is this: A vaccine for kids between the ages of 12 and 15 is safe, effective, easy, fast and free,” adding that more 15,000 pharmacies would be prepared to start vaccinating children in the new age group immediately.
CDC says vaccinated people can unmask. On Thursday, the CDC came out with new guidance for fully vaccinated people, saying they no longer need to wear masks or physically distance in most indoor and outdoor situations, although the new recommendations don't apply in health care settings; on airplanes, trains and public transportation; or where state or local restrictions still require masks or distancing. President Biden called the country’s vaccination effort an “historical logistical achievement,” noting that “the rule is very simple: Get vaccinated or wear a mask until you do.” Following the announcement, Speaker Nancy Pelosi (D-CA) said masks will still be required for members of Congress and staff on the House floor because it is not known how many House members and their staffs are vaccinated.
Senate confirms Palm, advances Brooks-LaSure. This week, the Senate this week voted 61-37 to confirm Andrea Palm to serve as deputy secretary of HHS, the number two role at the agency. The Senate also voted 51-48 to discharge the nomination of Chiquita Brooks-LaSure to lead the Centers for Medicare and Medicaid Services (CMS), bringing her one step closer to confirmation after her nomination was delayed by Sen. John Cornyn (R-TX) and others over the recent withdrawal of Texas’s 1115 Medicaid waiver, which had previously been approved under the Trump administration. A final vote could come as early as next week.
HHS reinstates protections for sexual orientation and gender identify. On Monday (May 10), the Biden administration announced it will provide protections against discrimination in health care based on gender identity and sexual orientation, reversing a Trump-era policy that civil rights groups said would allow health care workers and institutions, as well as insurers, to deny services to transgender individuals. HHS Secretary Becerra said that “The Supreme Court has made clear that people have a right not to be discriminated against on the basis of sex and receive equal treatment under the law, no matter their gender identity or sexual orientation” and that HHS “will act on related reports of discrimination.”
Biden administration offers $7.4 billion for state public health workforces. This week, the Biden administration announced it will provide $7.4 billion of funding from the $1.9 trillion pandemic relief measure passed earlier this year to hire and train public health workers to respond to COVID-19 and future crises. According to the announcement, the funding “will allow the United States to expand its public health workforce, creating tens of thousands of jobs to support vaccinations, testing, contact tracing, and community outreach, and strengthen America’s future public health infrastructure.”
Congress passes mental health bills. This week, the House passedseveral bills to improve the nation’s mental health system. Five measures (H.R. 433, H.R. 721, H.R. 1260, H.R. 1205 and H.R. 1324) authorize grants that support those struggling with substance use disorder (SUD), create school-based mental health services, authorize funding for research on race-based health disparities, and fund training programs to help health-care providers tackle them, among other items. The Senate also passed the “Improving Mental Health Access for Students Act,” which would require colleges to place on student identification cards the contact information for the National Suicide Prevention Lifeline, Crisis Text Line, and campus mental health centers. The bill now heads to the House.
Missouri Governor says it will not implement Medicaid expansion. Missouri Gov. Mike Parson (R) said the state will not implement Medicaid expansion, which voters approved in a ballot measure last year, after Republican state lawmakers refused to appropriate funds to do so in the state budget bill passed last week. Parson sent a letter to the CMS this week formally withdrawing plans to expand MO HealthNet, the state’s Medicaid program, due to concerns over the program’s fiscal solvency. The expanded coverage had been set to take effect July 1.
Energy and Commerce Health Subcommittee Hearing FY 2022 Health and Human Services Budget. On Wednesday (May 12), the Subcommittee on Health of the Committee on Energy and Commerce held a hearing entitled “The Fiscal Year 2022 HHS Budget,” featuring testimony from Health and Human Services (HHS) Secretary Xavier Becerra. Democrats on the committee applauded the administration’s budget request, including its focus on building up public health infrastructure, investing in mental health and substance use disorder (SUD) treatment, advancing translational research, focusing on issues of equity and social determinants of health (SDOH), and committing to addressing climate change as a public health issue, among other items. Democrats also applauded the administration’s efforts to make permanent enhanced subsidies on the individual market and review policies that undermine patient protections, urged Becerra to ensure drug manufacturers and pharmacies were following the law under the 340B program, discussed the need to remove additional barriers to SUD treatment, and more. Republicans on the committee expressed concern about the size of the proposal, pushed back on the administration’s support of H.R. 3, criticized recent movements by the administration to support waiving intellectual property (IP) protections for the COVID-19 vaccine, expressed concern about the influx of children at the border in Office of Refugee Resettlement (ORR) facilities and their treatment, and urged the Secretary to comply with statutory protections against partial birth abortion, among other items.
Secretary Becerra also expressed his commitment to an “all-hand-on-deck” approach to addressing the COVID-19 pandemic, said the administration is committed to buy American when it comes to personal protective equipment (PPE), committed to follow Congressional intent in creating regulations for addressing surprise medical billing, and noted support for removing barriers to telehealth. He also told the committee that there is an estimated $25 billion remaining in the Provider Relief Fund (PRF), in addition to $8 billion in funding for rural providers, and said they will ensure providers who need the funding will get it in a transparent process.
Reports, Studies, and Journals
National Bureau of Economic Research: Adverse Selection in Medicaid: Evidence from Discontinuous Program Rules. These results suggest healthier low-income individuals may be sensitive to even modest health insurance premiums, and that premiums may induce adverse selection in Medicaid plans.
Health Affairs: Racial/Ethnic Disparities In COVID-19 Exposure Risk, Testing, And Cases At The Subcounty Level In California. Latino people in California are 8.1 times more likely than white people to live in households at high risk of exposure to COVID-19, are overrepresented in cumulative cases and are underrepresented in cumulative testing, researchers found.
Centers for Disease Control and Prevention: Demographic and Social Factors Associated with COVID-19 Vaccination Initiation Among Adults Aged ≥65 Years - United States, December 14, 2020-April 10, 2021. After the first 3.5 months of the U.S. COVID-19 vaccination program, 79.1% of adults aged ≥65 years had received ≥1 dose, with higher vaccination initiation among men. Counties with lower vaccination initiation rates had higher percentages of older adults with social vulnerabilities.