POLICY BRIEFINGS


Senate Acquits Donald Trump in Second Impeachment Trial


Former President Donald Trump was acquitted over the weekend in his second impeachment trial. Fifty-seven senators voted to convict Trump for the role he played in the incitement of a riot at the Capitol on January 6, and 43 senators voted to acquit. No witnesses were called to testify during the trial, but written testimony from Rep. Jaime Herrera Beutler (R-Wash.) was admitted into evidence in place of calling her as a witness. Seven GOP senators – Sens. Mitt Romney (Utah), Susan Collins (Maine), Lisa Murkowski (Alaska), Ben Sasse (Neb.), Bill Cassidy (La.), Richard Burr (N.C.), and Pat Toomey (Pa.) – joined Democrats in voting the former president guilty of “incitement of insurrection.” Two-thirds of the Senate were necessary to convict, leaving the vote 10 members short.


Biden Administration Personnel Update


Elizabeth Fowler appears to be on the top of the short list of individuals under consideration to lead the Center for Medicare and Medicaid Innovation (CMMI). Fowler previously served in the Obama administration as a special assistant on health care and economic policy at the National Economic Council, as deputy director for policy at the Centers for Medicare and Medicaid Services’ (CMS) Consumer Information and Insurance Oversight (CIIO) and was chief health counsel to former Senate Finance Committee Chairman Max Baucus. In these capacities, she was responsible for both drafting and implementing the ACA. She has since worked at the Commonwealth Fund as executive vice president for programs and at Johnson & Johnson as its vice president for global health policy.

The Senate confirmed Denis McDonough as Secretary of Veterans Affairs last week by a vote of 87-7. The President’s nominee for Secretary of the U.S. Department of Health and Human Services (HHS) Xavier Becerra is still awaiting his confirmation hearings before the Senate Health, Education, Labor, and Pensions (HELP) Committee and the Senate Finance Committee. The hearings are expected to take place the week of February 22, though planning reportedly remains fluid. Other key health posts – including Surgeon General nominee Vivek Murthy and HHS Assistant Secretary for Health Rachel Levine – appear to be on hold until Becerra is confirmed.


COVID-19 Health Equity Task Force Announced


President Joe Biden announced the members of the administration’s COVID-19 Health Equity Task Force last week. Dr. Marcella Nunez-Smith, associate professor of medicine and epidemiology at the Yale School of Medicine, Associate Dean for Health Equity Research, and founding director of Yale’s Equity Research and Innovation Center, will chair the 12-member panel. The Task Force will work to provide recommendations for addressing health inequities caused by the COVID-19 pandemic and for preventing such inequities in the future. The Task Force’s first meeting is scheduled for February 26.


Lawmakers Urge Administration to Increase Access to MAT


Sens. Maggie Hassan (D-N.H.) and Lisa Murkowski (R-Alaska) and Reps. Paul Tonko (D-N.Y.) and Anthony Gonzalez (R-Ohio) have sent a letter to President Joe Biden asking the administration to work with Congress to increase access to medication-assisted treatment (MAT) for substance abuse disorder. The lawmakers ask the White House to eliminate the buprenorphine waiver – also known as the X-waiver – requirement which they argue limits access to addiction treatment providers. They invite the administration to support the Mainstreaming Addiction Treatment (MAT) Act to accomplish this goal.


Clyburn to Continue Probes into Trump Administration Actions


House Select Subcommittee on the Coronavirus Crisis Chair Jim Clyburn (D-S.C.) sent a letter to White House Chief of Staff Ron Klain and acting U.S. Department of Health and Human Services (HHS) Secretary Norris Cochran to announce that his panel will renew its investigation into political meddling by the Trump administration during its response to the COVID-19 pandemic. Rep. Clyburn requests the new administration’s assistance in obtaining documents and information to help improve the nation’s response to the ongoing public health crisis. In response, Ranking Member Steve Scalise (R-La.) called for a probe into President Joe Biden’s conflicting statements with the Centers for Disease Control and Prevention (CDC) regarding school re-openings.


Bipartisan Lawmakers Push Bill to Increase Research Funding


Abipartisan, bicameral group of lawmakers have introduced legislation that would authorize funding to restart research and clinical trials that have been derailed by the COVID-19 pandemic. The Research Investment to Spark the Economy (RISE) Act (H.R. 869) would provide $26 billion in emergency relief for federal science agencies to repair damage caused by the coronavirus to the research ecosystem. At least $10 billion would be allocated to the National Institutes of Health (NIH) for research recovery. The legislation was introduced by Sens. Ed Markey (D-Mass.) and Thom Tillis (R-N.C.) and Reps. Diana DeGette (D-Colo.) and Fred Upton (R-Mich.).


Texas Representative Dies Following COVID Diagnosis


Rep. Ron Wright (R-Texas), who was first elected to Congress in 2019, passed away last week after a battle with cancer and COVID-19. Wright was a member of the Foreign Affairs and Education and Labor committees. He is the first sitting member of Congress to have died after testing positive for COVID-19. His seat will be filled in a special election.


CBO Releases Latest Budget Forecast


The CBO has released its latest budget forecast, predicting a wider budget deficit in 2021 due to the latest COVID stimulus package, followed by smaller budget gaps over the next decade due to stronger economic growth. CBO projects a $2.26 trillion deficit in the fiscal year ending in September 2021, an increase over its September 2020 projection of $1.81 trillion. The cumulative budget gap from 2021 to 2030 is expected to be $345 billion smaller than previously estimated. The deficit forecast is based on an estimated government revenue of $3.51 trillion, an increase of $250 billion over the previous CBO outlook. The forecast deficit would total 10.3% of gross domestic product (GDP) in fiscal 2021 and 4.6% next year, compared with 14.9% in 2020. Debt will increase to about 107% of GDP in 2031; the previous CBO projection released in September saw that figure at a higher level in 2030.


White House Moves to Reverse Medicaid Work Requirements, Prior Authorization Regulation


The White House has begun to unwind Medicaid work requirements approved under the Trump administration. Acting administrator of the Centers for Medicare and Medicaid Services (CMS) Elizabeth Richter sent letters to Arkansas, Georgia, Ohio, Nebraska, Indiana, Arizona, Wisconsin, South Carolina, and Utah last week informing them that the agency has commenced a process to determine whether to withdraw the waivers under which the work rules were approved. CMS also sent separate letters to rescind a letter from former Administrator Seema Verma asking states to sign on to an agreement that would provide for a nine-month process if the agency would decide to terminate, amend, or withdraw a Medicaid waiver in the future. The Biden administration has argued that the COVID-19 pandemic has greatly increased the risk that work requirements in the Medicaid program will lead to unintended loss of coverage for many individuals.

The administration has also removed a Trump-era rule aimed at reducing regulations surrounding prior authorization in the Medicare program from the CMS website. The final rule, which was announced on January 15 but was never published in the Federal Register, fell under the regulatory freeze enacted when President Joe Biden took office.


Latest Information on How to Handle Provider Relief Fund Payments For Second Draw Paycheck Protection Program Loans


The Small Business Administration’s (SBA) Paycheck Protection Program (PPP) second draw loans are only available to entities that can demonstrate a 25% reduction in revenue. The SBA’s Interim Final Rule (IFR) notes that the key calculation related to revenue loss is a comparison of gross receipts, defined broadly to include “all revenue in whatever form received or accrued . . . from whatever source.” Thus, funds from the Provider Relief Fund (PRF) program would likely be revenue received from a source and may be used to calculate eligibility for second draw loans. The SBA’s only explicit exception is first draw PPP loans, which do not “count” for purposes of showing the required revenue loss for a second draw PPP loan. By contrast, the PRF funds are not explicitly exempted. Given that tax documentation is likely required for this determination and that the PRF funds are taxable, that revenue will likely be evident as part of the application process. While it is possible that SBA might exclude PRF funds at a later time via guidance or IFR, for now it would be cautious to count these funds for purposes of calculating the 25% revenue loss required to quality for a second draw PPP loan.



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BRIEFING ARCHIVE


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