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.


Appeals Court Weighs Fate of ACA’s Preventive Services Mandate

The 5th U.S. Circuit Court of Appeals in New Orleans heard arguments last week regarding a lower court’s March decision on the Affordable Care Act’s (ACA) preventive services coverage mandate. The plaintiffs argued in support of the nationwide suspension of the law’s requirements for no-cost coverage of certain preventive services, while the Biden administration characterized the March decision as a “legal error.” The Department of Justice argued that while no harm would be done to the plaintiffs by putting the nationwide injunction on hold, great harm would be done to the millions of individuals with employer-sponsored insurance or coverage through the individual market should the court fail to do so. The attorney for the parties challenging the law asserted that because members of the U.S. Preventive Services Task Force are not Senate confirmed or overseen by Senate confirmed federal employees, their recommendations for what services must be covered by insurers at no cost to the beneficiary cannot be enforced, stating that “agency actions must be set aside if they are unlawful.” While the appeals court panel agreed that the individual Texas businesses involved in the litigation should be shielded from the requirements while the case is being decided, they appeared split on whether the current coverage rules should be kept intact for the rest of the country. The panel of judges seemed unconvinced by the plaintiff ’s assertion that a nationwide injunction would not cause harm because insurers would be unlikely to end coverage of preventive services while the case is still ongoing.

Ways and Means Advances Telehealth Legislation

The House Ways and Means Committee advanced legislation (H.R. 1843) last week that would permit high-deductible health plans to cover telehealth services before enrollees meet their deductible. The Telehealth Expansion Act was agreed to in a 30-12 vote, with five Democrats joining panel Republicans in support of the measure. Current statute allows these plans to cover telehealth pre-deductible through the end of 2024. Lawmakers argued that making this COVID-era flexibility permanent will save money and improve and expand access to care, especially for individuals in rural areas of the country.

Judiciary Republicans Probe FTC Review of Illumina-GRAIL Merger

House Judiciary Committee Chairman Jim Jordan (R-Ohio) has sent a letter to the Federal Trade Commission (FTC) regarding the agency’s review of the biotechnology company Illumina’s acquisition of GRAIL, a cancer startup. Jordan and other GOP lawmakers assert that the Commission’s approach to the merger “departs from the FTC’s normal processes and raises questions about the Commission’s reliance on foreign jurisdictions to enforce U.S. laws.” The letter was co- signed by Reps. Darrell Issa (R-Calif.) and Thomas Massie (R-Ky.). They request materials related to the FTC’s review of the Illumina-GRAIL merger.

House Lawmakers Expected to Markup FDA Funding Bill This Week

Appropriators in the House of Representatives are expected to hold a full committee markup of the fiscal year (FY) 2024 Agriculture-Rural Development-Food and Drug Administration spending bill on Wednesday. The panel delayed a previously scheduled markup of the legislation amidst negotiations on the debt limit. The recently enacted debt ceiling agreement set caps on discretionary spending for FY 2024.

COVID Czar to Depart Administration

COVID-19 Czar Ashish Jha plans to leave his post at the White House on June 15 and return to his prior position as dean of the Brown University School of Public Health. Jha’s departure has been expected given the Biden administration’s decision to not renew the public health emergency (PHE) declaration which ended on May 11. Jha took over as the White House’s COVID-19 Response Coordinator in April 2022, succeeding Jeff Zients and making him the second official to lead the nation’s coronavirus response. The White House does not plan to replace Jha as it continues to unwind the coronavirus PHE and search for a director of the new Office of Pandemic Preparedness and Response Policy. This person will advise the President and work to coordinate federal responses to biological and pandemic threats.

Experts Consider Benefits of Telehealth at Politico Event

Experts agreed that the benefits of telehealth will outweigh the costs during a summit on health care convened by Politico last week. The panel, which included Colorado Lt. Gov. Dianne Primavera and Stanford Health Clinic President Luis Garcia, discussed digital health care and the increased use of telemedicine following the adoption of certain flexibilities in response to the COVID-19 pandemic. The speakers agreed that telehealth saves money for both patients and health systems by shortening hospital stays, eliminating travel expenses, and reducing stigmas around mental health. They also explored how telehealth has supported health systems in reaching underserved and rural populations of patients and addressing gaps in prenatal and maternal health care. U.S. Department of Health and Human Services Deputy National Coordinator for Health Information Technology Steven Posnack suggested that increased telehealth adoption could lead to the creation of new payment models for providers. A recording of the session can be found here.

Upcoming Congressional Hearings and Markups

House Appropriations Committee markup of Fiscal Year 2024 Military Construction, Veterans Affairs, and Related Agencies Bill; 10:00 a.m.; June 13

House Education and the Workforce Committee markup of H.R. 824, Telehealth Benefit Expansion for Workers Act and H.R. 3941, Schools Not Shelters Act; 10:15 a.m.; June 13

House Education and Workforce hearing “Examining the Policies and Priorities of the Department of Health and Human Services;” 10:15 a.m.; June 13

House Energy and Commerce Subcommittee on Health legislative hearing “Legislative Solutions to Bolster Preparedness and Response for All Hazards and Public Health Security Threats;” 10:30 a.m.; June 13

House Oversight and Accountability Select Subcommittee on the Coronavirus Pandemic hearing “Oversight of CDC Policies and Decisions During the COVID-19 Pandemic;” 10:30 a.m.; June 13

House Veterans’ Affairs Subcommittee on Health “Care Coordination: Assessing Veteran Needs and Improving Outcomes;” 1:00 p.m.; June 13

House Oversight and Accountability Committee hearing “Death by a Thousand Regulations: The Biden Administration’s Campaign to Bury America in Red Tape;” 10:00 a.m.; June 14

House Energy and Commerce Subcommittee on Health legislative hearing “Examining Proposals that Provide Access to Care for Patients and Support Research for Rare Diseases;” 10:30 a.m.; June 14

Senate Committee on Veterans’ Affairs hearing “Connections to Care: Improving Substance Use Disorder Care for Veterans in Rural America and Beyond;” 3:00 p.m.; June 14

Senate Special Committee on Aging hearing “Before Disaster Strikes: Planning for Older Americans and People with Disabilities in All Phases of Emergencies;” the witness list can be found here; 9:30 a.m.; June 15

Senate Health, Education, Labor, and Pensions Committee executive session to consider S. 133, NAPA Reauthorization Act; S. 134, Alzheimer’s Accountability and Investment Act; S. 265, SIREN Reauthorization Act; S. 1844, Animal Drug and Animal Generic Drug User Fee Amendments of 2023; S. 1852, Sickle Cell Disease and Other Heritable Blood Disorders Research, Surveillance, Prevention, and Treatment Act of 2023; and S. 1855, Special Diabetes Program Reauthorization Act of 2023; 10:00 a.m.; June 15

House Veterans’ Affairs Subcommittee on Health hearing on H.R. 3520, Veterans Care Improvement Act; H.R. 1182, Veterans Serving Veterans Act; H.R. 1774, VA Emergency Transportation Act; H.R. 2683, VA Flood Preparedness Act; H.R. 2768, PFC Joseph P. Dwyer Peer Support Program Act; H.R. 2818, Autonomy for Disabled Veterans Act; H.R. 3581, Caregiver Outreach and Program Enhancement (COPE) Act; H.R. 1278, DRIVE Act; H.R. 1639, VA Zero Suicide Demonstration Project Act; and H.R. 1815, Expanding Veterans’ Options for Long Term Care Act; 10:30 a.m.; June 21

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