June 1, 2021 This Week in Health Policy for June 1 This Week (May 31 - June 4) Congress is on recess next week and there will not be a This Week In Health Policy. Last Week (May 24 - 28) Democratic health leaders announce public option plans. On Wednesday (May 26), Senator Patty Murray (D-WA), Chair of the Senate Health, Education, Labor, and Pensions (HELP) Committee and Congressman Frank Pallone, Jr. (D-NJ), Chairman of the House Energy and Commerce Committee, announced their plans to develop legislation to establish a public option proposal to lower health care costs. The Chairs issued a Request for Information (RFI) asking colleagues for input on new legislation, such as who should be eligible to join a government-run plan, how to structure its benefits, and how prices for items and services should be determined, among other questions. "We believe we must take bold steps to lower health care costs and move toward universal coverage by creating a federal public option available to everyone … A federal public option will help guarantee that no matter where you live, who you are, or what your income — if you live in America, you can get the quality health care you need without worrying about cost," said Murray and Pallone in a joint press release. The Committee leaders requested responses by July 31st, 2021 and are aiming to have a bill together by the end of the year. A public insurance option was a major plank of President Joe Biden's health agenda during the campaign, but Biden has not put forward a formal proposal. House Democrats call on Biden to expand and improve Medicare. On Thursday (May 27), more than 150 House Democrats, led by Reps. Pramila Jayapal (D-WA), Jared Golden (D-XX), Joe Neguse (D-CO), and Conor Lamb (D-PA), called on Biden in a letter to expand and improve Medicare as part of the American Families Plan, according to a statement. The letter specifically asks for inclusion of provisions to "expand Medicare by lowering the eligibility age," "improve Medicare benefits to include dental, vision, hearing, and an out-of-pocket cap," and "empower Medicare to negotiate drug prices for all Americans." Brooks-LaSure confirmed as CMS Administrator. On Tuesday (May 25), Chiquita Brooks-LaSure was confirmed 55-44 by the Senate to lead the Centers for Medicare and Medicaid Services (CMS), a $1 trillion agency that will be responsible for carrying out President Biden's vision of expanding access to health care and strengthening the ACA. Brooks-LaSure previously worked in the Health and Human Services Department (HHS) during the Obama administration to implement the Affordable Care Act (ACA) and as a staff member for the House Ways and Means Committee during the law's passage. Her nomination was widely opposed by Republicans due to the Biden administration's decision to rescind a 10-year extension for Texas's 1115 Medicaid waiver over concerns that the waiver did not meet public comment and other administrative requirements in its approval. HHS to deliver $4.8 billion for testing uninsured. On Tuesday (May 25), HHS announced they will be providing $4.8 billion from American Rescue Plan funding to community health centers and other health care providers to test uninsured people for COVID-19. In a statement announcing the funding, HHS Secretary Xavier Becerra said "As we vaccinate the country, let's continue taking the preventive measures necessary to keep the virus under control and prevent it from spreading. Testing remains critical and now it's available at no cost to those who need it." As of May 19, the HRSA Uninsured Program had provided $4 billion in reimbursements to providers across the nation for COVID-19 testing services. The program also provides reimbursements for COVID-19 vaccinations and treatment for the uninsured. Moderate House Democrats drafting alternative drug pricing plan. Two Moderate Democrats — Scott Peters (D-CA) and Jake Auchincloss (D-MA) — say they are preparing drug pricing bills aimed at garnering more support than H.R. 3, the legislation being pushed by Speaker Nancy Pelosi (D-CA) and other House leaders, which would enable Medicare to negotiate the price or prescription drugs by leveraging international reference prices. H.R. 3 is widely opposed by Republicans in Congress as well as some Democrats, however it is key to Democrats' larger legislative priorities due to an estimate $456 billion in savings for the bill. Rep. Peters is reported to be considering a bill similar to the Grassley-Wyden legislation from last Congress, which did not include Medicare negotiation but did include inflationary rebates. Rep. Jake Auchincloss (D-MA) is reported to want a bill focusing more on lowering what seniors pay for their Medications as well as cracking down on pharmacy benefit managers and coding intensity in Medicare Advantage. Biden orders report on virus origin. This week, the Biden administration ordered the U.S. intelligence community to "redouble" its efforts to determine where COVID-19 came from, after conflicting assessments from the intelligence community of whether its origins are natural or a lab leak, asking intelligence officials to disclose new information within 90 days. HHS Secretary Xavier Becerra said in a video message during a World Health Organization meeting that international experts should be allowed to "fully assess the source of the virus and the early days of the outbreak." The Senate also passed this week a measure from Senators Josh Hawley (R-MO) and Mike Braun (R-IN) that would require the Biden administration to declassify intelligence related to any potential links between the lab in question — the Wuhan Institute of Virology, and the origins of the pandemic. The Senate also agreed to an amendment by Senate Rand Paul (R-KY) that would ban federal funds for certain virus research in China and an amendment by Sen. Joni Ernst (R-IA) to prohibit federal funding for the Wuhan Institute of Virology as part of legislation to increase the U.S.'s competitive edge with the country (S. 1260). CMMI ends Next Gen ACO model. Late last week, the Center for Medicare and Medicaid Innovation (CMMI) announced that announced that the Next Generation Accountable Care Organization (Next Gen ACO) Model will not be extended beyond the end of the current performance year. Simultaneously, CMMI announced they will be reopening the application portal for the Direct Contracting Model for current Next Gen ACOs for the second cohort for beginning in January 2022. Interested ACOs must submit all application materials to CMMI by June 14, 2021 to be considered. Hearings and Mark-ups Senate HELP Committee Advances Six Bipartisan Health Care Bills on Maternal Health other issues. On Tuesday (May 25), the Senate Committee Health, Education, Labor and Pensions (HELP) advanced six bipartisan health care bills out of committee, all by voice vote. Committee Chairwoman Patty Murray (D-WA) called for the bills to be passed into law as soon as possible, and Ranking Member Richard Burr (R-NC) applauded the "meaningful, bipartisan progress" on the legislation and said it is a lesson on the importance of working through regular order. Both Murray and Burr highlighted the importance of legislation targeted at improving maternal health outcomes and access — the Maternal Health Quality Improvement Act (S. 1675) and the Rural Maternal and Obstetric Modernization of Services Act (S. 1491), with Sen. Murray saying that "it is not just a tragedy; it is an outrage" that the U.S. has the highest rate of maternal mortality in the developed world. Regarding the Providing Urgent Maternal Protections for Nursing Mothers Act (S. 1658), Sen. Murray added that it will close loopholes that currently leave 9 million working mothers uncovered by federal protections to ensure they have enough break time and a private place to pump. Both Murray and Burr also expressed strong support for the Dr. Lorna Breen Health Care Provider Protection Act (S. 610), aimed at improving the mental and behavioral health of health care providers. Sen. Murray noted that while burnout has long been an issue, there is an urgent need to act following the trauma experienced by health care providers throughout the pandemic. Sen. Burr also expressed his strong support and said the bill will help "health care providers get the support they need." They also both applauded the Supporting the Foundation for the National Institutes of Health and the Reagan-Udall Foundation for the Food and Drug Administration Act (S. 1662), which Sen. Burr said will "allow the agencies to be better partners in research," and the Promoting Physical Activity for Americans Act (S. 1301) to help Americans improve their health through physical activity. Reports, Studies, and Journals Kaiser Family Foundation: KFF COVID-19 Vaccine Monitor: May 2021. The latest KFF COVID-19 Vaccine Monitor shows continued steady progress in vaccine uptake, with 62% of U.S. adults saying they've gotten at least one dose of a vaccine (up from 56% in April) and the share saying they will "wait and see" down slightly from 15% to 12%. Centers for Disease Control and Prevention: Mask Use and Ventilation Improvements to Reduce COVID-19 Incidence in Elementary Schools - Georgia, November 16-December 11, 2020. COVID-19 incidence was 37% lower in schools that required teachers and staff members to use masks and 39% lower in schools that improved ventilation. Centers for Disease Control and Prevention: COVID-19 Vaccine Breakthrough Infections Reported to CDC - United States, January 1-April 30, 2021. A total of 10,262 COVID-19 vaccine breakthrough infections had been reported from 46 U.S. states and territories as of April 30, 2021. Based on preliminary data, 27 percent of breakthrough infections were asymptomatic, while 10 percent of patients were known to be hospitalized and 2 percent died. ———————————————
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