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This Week (February 21-25)

Congress is out this week. The next This Week in Health Policy will be Friday, March 4.

Last Week (February 14-18)

Health Care Highlights

Biden calls for more pandemic funding. The Biden administration this week asked Congress for another $30 billion in pandemic response funding in conjunction with the government funding package lawmakers hope to complete by March 11. Department of Health and Human Services (HHS) officials made the information pitch to lawmakers this week, with a formal White House request expected at a later date. According to initial reports, the request includes $17.9 billion for antiviral treatments and other medical supplies, $4.9 billion for testing, and $2.7 billion to fight future variants. "While we continue to have sufficient funds to respond to the current omicron surge in the coming weeks, our goal has always been to ensure that we are well-prepared to stay ahead of the virus," White House press secretary Jen Psaki told reporters. "So we've been in these ongoing conversations about what those needs might look like and this was a part of that effort." Sen. Roy Blunt (R-MO), the top Republican on the health appropriations subcommittee, said he talked to HHS Secretary Xavier Becerra about the request and indicated he could support a $30 billion supplemental, saying that "in the categories they are asking for money, the other money has all been spent or committed to other purposes." Senate Appropriations Chairman Patrick Leahy (D-VT), however, told reporters he wasn't interested in dealing with the request as part of the omnibus spending package and would rather move it as a separate bill.

Senate confirms Califf as FDA chief. On Tuesday (Feb. 15), the Senate voted 50-46 to confirm Robert Califf as commissioner of the Food and Drug Administration (FDA). Dr. Janet Woodcock, who served as acting commissioner for more than a year, will become the FDA's second-in-command. Five republicans voted in Califf's favor, while four Democrats and Sen. Bernie Sanders (I-VT) opposed him and several other lawmakers sat out the vote. Califf, who was sworn in Thursday, laid out his priorities for the agency via tweet thread. He said he looks forward to being able to "hit the ground running" and noted that a primary focus of their work would continue to be their response to the pandemic. Other priorities he outlined included accelerating the development of new treatments and devices, strengthening the response to the opioid crisis, lessening harm from tobacco products, and more. He also said it would be key for the FDA to combat misinformation about science "that has become increasingly prevalent" and that core to all of their work is "the fundamental need to enhance our ability to collect and analyze data."

Republicans call on Biden to end PHE while hospitals call for extension. More than 70 Republican lawmakers this week asked the Biden administration to end the federal public health emergency (PHE) for COVID-19, saying in a letter that "our country is now in a much different situation than we were when the PHE was originally enacted" given the availability of vaccines and treatments. They asked the administration to submit a plan to Congress by March 15 to unwind the emergency declaration, which is currently set to expire on April 15. Read their letter here. Meanwhile, hospital groups including the Federation of American Hospitals (FAH) are calling for the PHE to be extended past its current expiration date in April. In a letter to HHS Secretary Becerra, the FAH requested a minimum 60-day notice before the Biden administration ends the PHE designation and cited COVID-19's "sustained damage, unpredictable nature, and the threat of new variants that can quickly emerge." Read the letter here.

HHS awards $55 million to health centers for virtual care. On Monday (Feb. 14) HHS, through the Health Resources and Services Administration (HRSA), awarded nearly $55 million to 29 HRSA-funded health centers to increase health care access and quality for underserved populations through virtual care such as telehealth, remote patient monitoring, digital patient tools, and health information technology platforms. "Virtual care has been a game-changer for patients, especially during the pandemic," said HHS Secretary Becerra. "This funding will help health centers leverage the latest technology and innovations to expand access to quality primary care for underserved communities." According to the announcement, health centers quickly expanded their use of virtual care to maintain access to essential primary care services throughout the pandemic, reporting a 6,000 percent increase in the number of virtual visits between 2019 and 2020. In total, the number of health centers offering virtual visits grew from 592 in 2019 to 1,362 in 2022, an increase of 130 percent. The awards aim to enable health centers to sustain an expanded level of virtual care and identify and implement new digital strategies.

Warnock unveils insulin cap legislation. This week, Sen. Raphael Warnock (D-GA) unveiled a bill, the Affordable Insulin Now Act, mimicking a popular provision in Democrat's stalled Build Back Better (BBB) plan to require Medicare plans and private group or individual plans to cap patients' out-of-pocket costs for insulin at $35 per month. While Senate Majority Leader Chuck Schumer (D-NY) called the legislation a priority for the caucus, other Senate Democrats aren't ready to move on from other key pieces of the BBB. Senate Finance Committee Chairman Ron Wyden (D-OR) told reporters he thinks the party could unite around the legislation's broader health care provisions, which includes the insulin cap as well as empowering the government to negotiate with drugmakers and extending bolstered premium subsidies for people who purchased coverage on the Affordable Care Act's (ACA) exchanges.

FTC decides not to go after PBM competition. By a 2-2 party-line vote, the Federal Trade Commission (FTC) failed to reach consensus on opening a probe into pharmacy benefit managers (PBMs) and whether their drug price setting practices unfairly favor PBM-affiliated pharmacies at the expense of independent ones. The vote comes in spite of demands for scrutiny of the industry and anger from pharmacy groups over the decision, which say PBMs hurt local competition and impose opaque fees that inflate drug prices.

Hearings

Education and Labor Subcommittee Hearing on Pathways to Affordable, Universal Health Coverage. On Thursday (Feb. 17), the House Education and Labor Subcommittee on Health, Employment, Labor, and Pensions held a hearing entitled, "Exploring Pathways to Affordable, Universal Health Coverage." Democrats on the committee, along with Democratic witnesses, used the hearing to express concern with increased health care spending coupled with the underperformance of the health care system in comparison to lower-spending peer countries. They touted several options for reducing the cost of care and enhancing access to affordable coverage such as extending enhanced ACA subsidies advanced during the pandemic, bolstering ACA protections around non-comprehensive coverage, and making other changes such as fixing the so-called "family glitch." Several members and witnesses expressed support for establishing a public option and/or moving to a single-payer, "Medicare for All" system, which they said could reduce waste and costs while increasing access to quality health care for all. The Republican witness, Brian Blase, echoed concern with high prices but said they are driven by government involvement, excessive third-party payments, and consolidated health care markets. He also expressed support for policies advanced by the Trump administration including expanded coverage through Association Health Plans (AHPs), individual coverage health reimbursement arrangements (ICHRAs), price transparency and other policies aimed at enhancing options for employers and consumers without new federal spending. Republicans on the committee echoed support for these policies and condemned the inflationary nature of expanded subsidies and other government spending, while expressing support for employer-provided coverage.

• More information available here.

House Energy & Commerce Committee Hearing on the National Mental Health Crisis. On Thursday (Feb. 17), the House Energy & Commerce Committee held a hearing entitled "Americans in Need: Responding to the National Mental Health Crisis." During the hearing, committee members discussed the impact of the COVID-19 pandemic and related public health efforts on mental health for children, health care workers, and the country at large. Committee members discussed a range of topics related to mental health and substance misuse, including barriers to services, mental health parity and pending regulations, and the committee's efforts to reauthorize various mental health programs set to expire in September. Committee members discussed the need for the Department of Labor to release regulations implementing mental health parity laws and ways to encourage payers to ensure parity. Witness testimony included policies to address access issues, such as telehealth flexibilities related to in-person requirements, site of service and geographic telehealth restrictions, and bolstering the mental health workforce. Witnesses also emphasized the need for equitable mental health care and ensuring 9-8-8 is fully funded and supported.

Reports, Studies, and Journals

NIH Director's Blog: Analysis of Death Records Shows Growing Disparities in Opioid Epidemic.Based on the most recent data, about 100,000 people now die in the United States from drug overdoses over the course of a year, about half of them from synthetic opioids and primarily fentanyl. That's more than a 30 percent increase over 2019 levels, and a reminder that the exact causes of these tragic overdoses continue to evolve over time, including from changes in how people use drugs.

National Bureau of Economic Research: From Anti-vax Intentions to Vaccination: Panel and Experimental Evidence from Nine Countries. Vaccinations were more likely among individuals aged 50+, exposed to COVID-19, compliant with public restrictions, more informed on traditional media, trusting scientists, and less concerned about vaccines' side effects.

Centers for Disease Control and Prevention: Effectiveness of Maternal Vaccination with mRNA COVID-19 Vaccine During Pregnancy Against COVID-19-Associated Hospitalization in Infants Aged <6 Months — 17 States, July 2021-January 2022. Effectiveness of maternal completion of a 2-dose primary mRNA COVID-19 vaccination series during pregnancy against COVID-19 hospitalization among infants aged <6 months was 61%. Effectiveness of completion of the primary COVID-19 vaccine series early and later in pregnancy was 32% and 80%, respectively.

Health Affairs: The Effectiveness Of Government Masking Mandates On COVID-19 County-Level Case Incidence Across The United States, 2020. On average, the daily case incidence per 100,000 people in masked counties compared with unmasked counties declined by 23 percent at four weeks, 33 percent at six weeks, and 16 percent across six weeks post-intervention.

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