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.


American Rescue Plan Passes Senate, Heads Back to House

The Senate passed the American Rescue Plan Act on Saturday following more than 25 hours of amendment votes. The legislation advanced along party lines 50-49. Vice President Kamala Harris was not required to cast the tie-breaking vote because Sen. Dan Sullivan (R-Alaska) had returned home for the funeral of his late father-in-law. The $1.9 trillion COVID relief bill now heads back to the House of Representatives. The House will consider the Senate’s amended version of the bill on Tuesday. Democrats aim to send the measure to the President’s desk ahead of the March 14 expiration of supplemental jobless benefits.

The Senate measure restricts eligibility for the $1,400 stimulus checks and extends unemployment benefits at a lower level than that contained in the House version of the bill. Like the House bill, the Senate bill includes $160 billion for vaccine and testing programs and $350 billion for state and local governments, with added measures governing how the state and local aid can be spent. The bill does not include a measure to increase the minimum wage, after the Senate’s parliamentarian ruled that the provision did not qualify for the fast-track budget reconciliation process, but it does include an expansion of the child tax credit. The Senate’s measure would increase to 100% the premium subsidy for COBRA health insurance coverage for laid-off workers through the end of September. It also ends the cap on Medicaid’s drug rebate program in 2024, a year later than put forth in the House-passed bill. The bill also would provide $8.5 billion for rural providers impacted by the pandemic. Hart Health Strategies Inc. has prepared a more detailed comparison of the health provisions in the House- and Senate-passed American Rescue Plan which can be found as an appendix to this newsletter.

The Congressional Budget Office (CBO) estimated that the 10-year cost of the Senate bill was $1.863 trillion, within the $1.889 trillion limit set by the budget resolution passed by Congress last month to kickstart the reconciliation process. Most of the spending would come this year, with most remaining outlays coming in 2022. CBO also released its analysis of the estimated budgetary effects of H.R. 1319, the American Rescue Plan Act of 2021, as engrossed by the House of Representatives. The House-passed bill was estimated to exceed the budget resolution limit.

President Extends COVID National Emergency

President Joe Biden has acted to extend the national emergency first declared on March 13, 2020 due to the COVID-19 pandemic and set to expire after one year. “The COVID-19 pandemic continues to cause significant risk to the public health and safety of the Nation,” the declaration states, “It is essential to continue to combat and respond to COVID-19 with the full capacity and capability of the Federal Government.” This extension, which relates to the national disaster declaration, is separate and distinct from the public health emergency declaration.

House Democratic Plan to Restore Earmarks

Democrats in the House of Representatives have unveiled a plan to restore earmarks, now termed “Community Project Funding,” ending a decade-long ban on the practice. The proposal, which was released by Appropriations Chairwoman Rosa DeLauro (D-Conn.), would allow the inclusion of money in annual spending bills to benefit specific projects. The amount of money spent on earmarks would be capped at one percent of discretionary spending, lawmakers would only be permitted to submit 10 project requests, at most, along with evidence to justify their requests from their communities, and funds cannot flow to for-profit recipients. All requests would be posted online, with earmarks to be audited by a federal watchdog. The House Transportation and Infrastructure Committee has already announced that lawmakers will be allowed to include earmarks in the next highway bill. A hearing will be held in April for panel members to discuss their policy priorities, ahead of the Sept. 30 deadline to pass surface transportation reauthorization legislation. The Senate is still working on its own plan to revive congressionally-directed spending.

Select COVID Subcommittee to Investigate One Medical

The Select Subcommittee on the Coronavirus Crisis has launched an investigation into One Medical following allegations that the company intentionally distributed coronavirus vaccines to ineligible individuals. Chairman Jim Clyburn (D-S.C.) stated that he is “deeply concerned that medical providers’ refusal to adhere to vaccination prioritization guidelines and the intentional diversion of doses to individuals in lower priority groups may cost more American lives and delay or even derail containment of the virus across the country.” He requests documents and information from the company by March 15, 2021.

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