Hart Health Strategies

POLICY BRIEFINGS

Neal Outlines Agenda for W&M Committee

In a letter to his colleagues in the House of Representatives last week, Ways and Means Committee Chair Richard Neal (D-Mass.) outlined his agenda for the panel for the coming months. In addition to drafting legislation in keeping with the President’s proposed American Jobs Plan, Ways and Means will consider changes to the nation’s caring infrastructure and hidden barriers to workforce participation, starting with the Economic Mobility Act and the Child Care for Economic Recovery Act. Chairman Neal also pledges to give every worker the right to paid family and medical leave.

Lawmakers Ask HHS to Expand Opioid PHE Declaration

Reps. Ann Kuster (D-N.H.), David Trone (D-Md.), Nanette Barragan (D-Calif.), and Katie Porter (D-Calif.) have sent a letter to the U.S. Department of Health and Human Services (HHS) urging Secretary Xavier Becerra to extend and broaden the declaration of the opioid crisis as a public health emergency (PHE). The lawmakers cite the significant increase in overdose deaths during the pandemic as a justification for extending the declaration and broadening it to include not just opioids but the entire drug epidemic. The existing emergency declaration is set to expire on Wednesday.

Democrats Push for New SEP for the Unemployed

Democratic committee leaders have sent a letter to U.S. Department of Health and Human Services (HHS) Secretary Xavier Becerra encouraging the department to open an Affordable Care Act (ACA) marketplace special enrollment period (SEP) for individuals who remain unemployed beyond the expiration of the American Rescue Plan Act’s COBRA subsidies. The letter was signed by House Education and Labor Chair Bobby Scott (Va.), Senate Health, Education, Labor, and Pensions (HELP) Committee Chair Patty Murray (Wash.), House Ways and Means Committee Chair Richard Neal (Mass.), Senate Finance Committee Chair Ron Wyden (Ore.), and House Energy and Commerce Chair Frank Pallone (N.J.). The lawmakers express concerns that certain people currently using the expanded benefits provided through the American Rescue Plan Act could be locked out of coverage until 2022 following the conclusion of the law’s premium support program for job-based coverage.

Upton, Dingell Request More Vaccines for MI

Reps. Fred Upton (R-Mich.) and Debbie Dingell (D-Mich.) are asking the White House to increase the amount of COVID-19 vaccine being sent to their state. Michigan is currently experiencing a surge in coronavirus cases. While current federal vaccine allocation is population-based, Upton and Dingell argue that taking COVID-19 case count into consideration for hard-hit areas like Michigan is consistent with public health guidance.

Sen. Tillis Undergoes Surgery to Treat Prostate Cancer

Sen. Thom Tillis (R-N.C.) announced that he is recovering from surgery to treat prostate cancer. Sen. Tillis underwent surgery last week. He stated that he plans to return to the Senate soon and is expected to make a full recovery. Sen. Tillis has previously emphasized the importance of routine screenings, as his cancer was detected during an annual physical when he was not experiencing symptoms.

CBO Releases Reports on 2020 Enacted Legislation, Public Option, and Drug R&D

The Congressional Budget Office (CBO) has released a report summarizing the agency’s estimates of the effects on mandatory spending or revenues of authorizing legislation that was enacted during the second session of the 116th Congress. CBO estimates that laws enacted in 2020 will add $2.8 trillion to the cumulative deficit between 2020 and 2030 as a result of a $634 billion reduction in revenues and a $2.2 trillion increase in outlays. The Coronavirus Aid, Relief, and Economic Security (CARES) Act and the Consolidated Appropriations Act, 2021 account for $2.3 trillion (or roughly 80%) of the estimated increase in deficits over the 2020–2030 period.

In its Research and Development in the Pharmaceutical Industry report, CBO details the amount of money spent by the pharmaceutical industry on research and development. The industry spent $83 billion on R&D in 2019, approximately 10 times the amount spent per year in the 1980s after taking inflation into account. The average number of new drugs released per year from 2010 to 2019 reached 38, a 60 percent increase compared to the previous decade. CBO found that R&D spending is dependent on anticipated revenues from a new drug, expected development costs, and how the policy environment impacts the supply and demand for prescription drugs. CBO also concludes that the price of new drugs are not influenced by R&D costs, but that new drugs are instead priced in an attempt to maximize future revenues net manufacturing and distribution costs.

CBO also released a new report that explores key design considerations and implications of the creation of a public health insurance option, including potential impacts on provider pay rates and participation. The report also outlines decisions policymakers would need to make related to prescription drugs, including negotiation, contracting with a pharmacy benefit manager, and price setting. While CBO acknowledges that the impact of a public option would depend on its design, the agency notes that Affordable Care Act (ACA) marketplace and employer health plans pay approximately twice as much as Medicare for hospital care, and 25% more to physicians. The report cautions that a public option could be disruptive to the market and reduce coverage options, and would likely reduce the revenues of both providers and prescription drug manufacturers.

CDC Declares Racism a Public Health Threat

Centers for Disease Control and Prevention (CDC) Director Rochelle Walensky issued a statement last week declaring racism a serious public health threat and detailing the steps CDC is taking to address the impact of racism on public health. Amongst other actions, the agency is currently studying the impact of social determinants on health outcomes, making new and expanded investments in racial and ethnic minority communities and other disproportionately affected communities around the country, and expanding internal agency efforts to foster greater diversity. The CDC also launched a new web portal “Racism and Health” as an educational resource and to spur public and scientific discourse around racism and health.

HHS Personnel Update

The Senate Finance Committee will hold a hearing on Thursday to consider the nominations of Andrea Joan Palm to be Deputy Secretary of Health and Human Services and Chiquita Brooks-LaSure to be Administrator of the Centers for Medicare and Medicaid Services. 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 U.S. Department of Health and Human Services (HHS) Secretary Xavier Becerra, who served on the panel during his time in Congress. Andrea Palm most recently led the Wisconsin Department of Health Services. She previously served as a senior counselor at HHS under former President Barack Obama.

Amy Abernethy resigned as the number two official at the Food and Drug Administration (FDA) and will leave the agency by the end of the month. She joined the agency two years ago with the goal of furthering how the FDA uses information technology and real world evidence and data.

Stakeholders Urge CMS to Reconsider Prior Authorization Rule

Agroup of 40 organizations including the American College of Surgeons,, American Medical Association, Federation of American Hospitals, and Medical Device Manufacturers Association have sent a letter to the Centers for Medicare and Medicaid Services (CMS) urging the administration to reconsider a regulation scheduled to go into effect on July 1 expanding the use of prior authorization for certain medical procedures. The letter expresses serious concerns that beneficiaries will experience significant barriers to access to medically necessary procedures as a direct result of the policy. The organizations request that the rule by delayed and that CMS withhold action on any further expansion of prior authorization requirements until it has established specific criteria, to guide its decision-making related to the use of prior authorization.