Hart Health Strategies provides a comprehensive policy briefing on a weekly basis. This in-depth health policy briefing is sent out at the beginning of each week. The health policy briefing recaps the previous week and previews the week ahead. It alerts clients to upcoming congressional hearings, newly introduced bills, regulatory announcements, and implementation activity related to the Patient Protection and Affordable Care Act (PPACA) and other health laws.


Democrats Move Ahead with Budget Reconciliation for COVID Relief

Congressional Democrats and the White House have decided to move forward in advancing the next coronavirus stimulus bill through reconciliation. A fiscal 2021 budget resolution was filed by Senate Majority Leader Chuck Schumer (D-N.Y.) and House Speaker Nancy Pelosi (D-Calif.) last week, the first step in the budget reconciliation process that could allow President Joe Biden’s nearly $2 trillion COVID relief package to pass both chambers with simple majorities. The resolution contains instructions to congressional committees to draft the portions of the stimulus bill within their jurisdictions and submit them to their respective Budget Committee by February 16. The final bill is required to total less than $1.9 trillion and adhere to the Senate’s Byrd Rule. The 2021 budget blueprint (S. Con. Res. 5) was passed by the Senate on Friday after an all-night session, with Vice President Kamala Harris casting her first tie-breaking vote. Senators ultimately adopted 19 non-binding amendments during the vote-a- rama, including a measure supporting legislation in favor of a coronavirus vaccine awareness campaign. The House of Representatives had already agreed to its own budget resolution (H. Con. Res. 11) earlier in the week and later approved the Senate’s language. House Majority Leader Steny Hoyer (D-Md.) expects the House will vote on the stimulus package the week of February 22, though he noted that there is a chance the chamber could return from recess early to consider the legislation. To achieve passage, all 50 Senate Democrats would have to approve the plan put forth under the budget reconciliation process, and Democrats in the House could only afford four objections.

Several groups of moderate lawmakers continue to push leadership to immediately pass standalone funding to support vaccine development and distribution. The Blue Dog Coalition of House Democrats sent a letter to Speaker Pelosi urging her to take up a bill to support the nation’s vaccination effort, warning that the reconciliation process could take months to complete. “Our preferred legislative approach,” the lawmakers state, “is to swiftly vote on the portion of the administration’s proposal focused on vaccine development and distribution,” while other elements of the relief plan be passed on a separate track. The bipartisan House Problem Solvers Caucus has also called for an immediate vote on $160 billion in funding for vaccines, testing, tracing, and health providers as negotiations on wider pandemic-related issues continue. The Biden administration, however, has rejected any “piecemeal” approach to COVID relief.

No Republicans are on the record in support of the comprehensive package sought by President Biden. A group of 10 Republican senators discussed their own $618 billion stimulus plan with Biden officials on Monday, and said they still have significant questions and concerns about the size and scope of the President’s plan. President Biden has characterized the GOP bill as too slim and has maintained that his $1.9 trillion proposal is a floor and not a ceiling.

A breakdown of the President’s request for $160 billion in direct pandemic relief within the broader American Rescue Plan was released last week. More than half that funding - $83 billion – would be used to increase development of and access to vaccines, testing and therapeutics, and critical supplies. Of this $83 billion, $10 billion would be invested in domestic manufacturing, including through the use of the Defense Production Act (DPA) and the Biomedical Advanced Research and Development Authority (BARDA). Four billion would be used to build two manufacturing facilities with the ability to produce 100 million COVID vaccine doses per month; $1 billion would be put toward the creation of a stockpile of essential materials and supplies; $3 billion for the expansion of additional supply manufacturing; and $2 billion for the onshoring of test kits and related supplies. The President proposes that $50 billion be spent on U.S. testing efforts, with $3.5 billion being invested in laboratory capacity and the construction of high-through put labs. Another $20 billion would be spent on vaccine development and distribution efforts, funding vaccination clinics and mobile units for underserved communities, boosting vaccine manufacturing, and launching a vaccine awareness campaign. Three billion would be put toward research and development of COVID therapeutics, including through funding for BARDA. The plan also includes $340 million to strengthen the nation’s work on genomic sequencing of emerging COVID variants.

Biden to Issue E.O. on Critical Supply Chains

President Joe Biden plans to order a government-wide review of critical supply chains, with the goal of reducing the nation’s reliance on other countries for medical supplies and other essential materials. According to White House officials, the administration plans to work with U.S. allies to ensure a collective approach. The executive order (E.O.) is expected to direct analyses of critical sectors of the economy.

Brooks-LaSure Frontrunner for CMS Post

Chiquita Brooks-LaSure appears to be the top name on President Joe Biden’s short list to head the Centers for Medicare and Medicaid Services (CMS). Brooks-LaSure is a former Obama administration health official who helped implement the Affordable Care Act (ACA) while serving as deputy director for policy at the Center for Consumer Information and Insurance Oversight (CCIIO). She chaired President Joe Biden’s health transition team and currently works as a managing director of the consulting firm Manatt Health. Earlier in her career, she was a staffer for the House Ways and Means Committee where she helped to draft the ACA while working with nominee for U.S. Department of Health and Human Services (HHS) Secretary Xavier Becerra, who served on the panel during his time in Congress. North Carolina Health Secretary Mandy Cohen is the other leading candidate for CMS Administrator. Cohen also served at the agency during the Obama administration, as CMS chief operating officer and chief of staff. Biden’s other health care nominees, including Becerra and Surgeon General nominee Vivek Murthy, are still awaiting their confirmation hearings. The Senate confirmed Alejandro Mayorkas to be Secretary of Homeland Security and Pete Buttigieg as Secretary of Transportation last week.

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