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.


Becerra Confirmed As HHS Secretary

Xavier Becerra has been sworn in as the 25th Secretary of the U.S. Department of Health and Human Services (HHS). Becerra was confirmed by the Senate in a narrow 50-49 vote on Thursday with the support of only one Republican, Sen. Susan Collins (R-Maine). Collins stated that Becerra’s commitment to rural health care and lowering drug prices was the reason for her support. As Secretary, Becerra has pledged to focus on ensuring that all Americans have health security and access to health care.

Senate Majority Leader Chuck Schumer (D-N.Y.) has filed cloture on the nominations of Vivek H. Murthy to be surgeon general of the Public Health Service and Rachel Levine to be an assistant secretary of health. Murthy and Levine were advanced by the Senate Health, Education, Labor, and Pensions (HELP) Committee with bipartisan support last week – the vote in favor of Murthy was 16-6, and the vote in favor of Levine was 13-9. The Senate is expected to vote to confirm the

House Passes Bill to Avert Medicare Sequester Cuts

The House of Representatives has passed legislation (H.R. 1868) to avert $36 billion in Medicare sequestration cuts triggered by the American Rescue Plan Act and to extend the current moratorium on the 2% Medicare sequester. The bill passed by a vote of 246- 175, with 29 Republicans joining Democrats in support of the legislation. The latest stimulus package triggered statutory pay- as-you-go (PAYGO) requirements that would result in a 4% sequester to the Medicare program in early 2022. H.R. 1868 would waive the PAYGO rules for the recently- passed reconciliation package and extend the temporary pandemic freeze on Medicare reimbursement cuts, set to expire at the end of this month, through the end of the year. The bill will require 60 votes for passage in the Senate. While other PAYGO waivers and the Medicare sequester freeze have previously been accomplished in a bipartisan manner, some Senate Republicans have indicated that they will not support H.R. 1868. Sens. Jeanne Shaheen (D-N.H.) and Susan Collins (R-Maine) have introduced their own legislation (S. 748, the Medicare Sequester Relief Act) to suspend the 2% sequester for the duration of the public health emergency (PHE) while also extending the 2% sequester for an additional calendar year.

Democrats Urge WH to Waive Patent Protections for COVID Vaccine

Congressional Democrats are continuing their effort to push the White House to increase the global availability of vaccine supplies. President Joe Biden has committed $4 billion to COVAX and has offered Mexico and Canada access to the U.S. stockpile of the AstraZeneca vaccine. Some lawmakers, however, are urging the President to support a temporary waiver of patent protections for COVID-19 vaccines. This waiver would allow global manufacturers to replicate vaccine formulas to increase vaccine production across the world. The waiver, which was proposed by India and South Africa through the World Trade Organization (WTO) last year and is supported by 55 other countries, was opposed by the Trump administration. A letter to the President from House Democrats in support of the waiver has been signed by close to 100 members, including Appropriations Chair Rosa DeLauro (D-Conn.) and Ways and Means Trade Subcommittee Chair Earl Blumenauer (D-Ore.). Proponents of the waiver argue that any loss of profit by pharmaceutical companies resulting from the waiver would be offset by the global economic gains that result from pandemic recovery across the rest of the world, while opponents believe that strong intellectual property protections are necessary to incentivize continued innovation. The administration has said that it will make its decision based on its analysis of how effective the waiver would be. The WTO operates by consensus, meaning all 164 members would have to agree to support the waiver in order for it to take effect. A U.S. change of position, however, could carry weight with other opponents of the measure. The issue will next be examined at a WTO meeting in mid-April.

In a related effort, Joint Economic Committee Democrats sent a letter asking the Biden administration to develop a plan to share the nation’s surplus Covid vaccines with low- and middle-income countries and the COVAX initiative.

The Return of Congressional Earmarks

The House Republican Conference has voted to bring back earmarks, following the decision by House and Senate Democrats to do the same. The decade-long ban on congressionally-directed spending was lifted during a closed door vote on Wednesday. Under the resolution adopted by the conference in a 102-84 vote, GOP members will be required to publicly disclose their earmark requests and affirm that they do not have a financial interest in the projects. They will also be required to explain why the earmark is an “appropriate use of taxpayer funds.” Member seniority, committee assignments, and leadership positions will not be taken into consideration in the facilitation of an earmark request. Senate Republicans are still debating whether or not to lift their own ban on earmarks.

HHS Personnel Update

President Joe Biden has announced that he will nominate Dawn O’Connell to serve as Assistant Secretary for Preparedness and Response (ASPR) within the U.S. Department of Health and Human Services (HHS). O’Connell has been working as a senior counselor for COVID response at HHS for the past two months. She previously worked as the director of the U.S. office of the Coalition for Epidemic Preparedness and served in the Obama administration as a senior counselor to the HHS secretary on global health issues. If she receives Senate confirmation, she will lead the federal government’s pandemic preparedness efforts and the Biomedical Advanced Research and Development Authority (BARDA) and oversee the Strategic National Stockpile.

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