Health Care Checkup
December 23, 2021
THE BIG PICTURE
[Please note: This is a revision.]

While Senate Democrats had hoped to pass the Build Back Better social spending bill before they left for the holidays, work was still underway in the caucus to come to a consensus. On December 19, Senator Joe Manchin said he would not support the legislation: “I cannot vote to continue with this piece of legislation, I just can’t,” said Manchin on FOX News. Soon after, the White House issued a statement on Manchin’s comments, with White House Press Secretary Jen Psaki saying Manchin’s comments on FOX News “represent a sudden and inexplicable reversal in his position, and a breach of his commitments to the president and the senator’s colleagues in the House and Senate.” Democratic leaders in the House and Senate have indicated they will still pursue a path forward despite Manchin’s comments, with Senate Majority Leader Chuck Schumer issuing a Dear Colleague indicating that “[T]he Senate will, in fact, consider the Build Back Better Act, very early in the new year so that every Member of this body has the opportunity to make their position known on the Senate floor, not just on television. We are going to vote on a revised version of the House-passed BBB – and we will keep voting on it until we get something done.” Expect Senate action on BBB in early January as Democrats try to chart a path forward on the President’s agenda. 
 
On Tuesday, the White House announced a new set of measures to help combat the spread of the Omicron coronavirus variant. The highly contagious variant has been rapidly spreading across the country, causing a major uptick in the number of new cases. The Biden Administration will deploy an additional 1,000 service members to hospitals burdened by COVID-19 in January and February. Additionally, President Biden will direct the Federal Emergency Management Agency (FEMA) to help states ramp up their hospital capacity. The Administration’s fact sheet can be found here.

On Wednesday, the U.S. Supreme Court announced that it will hold a special hearing on January 7 to consider challenges to the Occupational Safety and Health Administration’s (OSHA) testing and vaccine mandate, as well as the CMS health care worker vaccine mandate. As a reminder, OSHA’s mandate requires that companies with 100 or more employees require their personnel to either get fully vaccinated against COVID-19 or submit to weekly testing. The CMS mandate requires that workers at health care facilities participating in Medicare or Medicaid be fully vaccinated against COVID-19 by January 4. Earlier this month, HHS appealed a federal court decision that halted CMS’s rule. The OSHA mandate has faced several legal challenges, and most recently on December 17, the U.S. Court of Appeals for the Sixth Circuit lifted the Fifth Circuit’s stay on the mandate, and OSHA set a deadline of January 10 for employers to comply with the mandate.
 
Also on Wednesday, HHS announced that this year's Open Enrollment Period through HealthCare.gov and State-based Marketplaces (SBMs) is outpacing all previous years, with a current historic enrollment high of 13.6 million people. The American Rescue Plan (ARP) provided premium tax credits to help make ACA coverage more affordable. So far, 92% of people enrolled in federal Marketplace plans will receive premium tax credits. The Open Enrollment Period will stay open until January 15, 2022. Additional information can be found here.
 
The Department of Health and Human Services announced that the Substance Abuse and Mental Health Services Administration (SAMHSA) will invest $282 million to help transition the National Suicide Prevention Lifeline from the current 10-digit number to a three-digit number, 988. In 2020, Congress designated 988 as the new dialing code for the National Suicide Prevention Lifeline. Additional information can be found here.

Additionally, HHS issued new guidance to help clarify how the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy Rule “permits covered health care providers to disclose protected health information to support applications for extreme risk protection orders that temporarily prevent a person in crisis, who poses a danger to themselves or others, from accessing firearms.” The announcement from HHS can be found here, and the guidance from HHS can be found here.
What to Expect Next Week: Both the House and Senate will be out of session for the holidays. We will resume distribution of our Health Care Checkup the week of January 3. In the meantime, please see our key dates to watch in 2022 here. The MCRT team wishes you and yours a wonderful and safe holiday season!
DEEP DIVE
Build Back Better Social Spending Bill Punted to 2022
 
While Senate Democrats had hoped to pass the Build Back Better social spending bill before they left for the holidays, work was still underway in the caucus to come to a consensus. On December 19, Senator Joe Manchin said he would not support the legislation: “I cannot vote to continue with this piece of legislation, I just can’t,” said Manchin on FOX News. Soon after, the White House issued a statement on Manchin’s comments, with White House Press Secretary Jen Psaki saying Manchin’s comments on FOX News “represent a sudden and inexplicable reversal in his position, and a breach of his commitments to the president and the senator’s colleagues in the House and Senate.” Democratic leaders in the House and Senate have indicated they will still pursue a path forward despite Manchin’s comments, with Senate Majority Leader Chuck Schumer issuing a Dear Colleague indicating that “[T]he Senate will, in fact, consider the Build Back Better Act, very early in the new year so that every Member of this body has the opportunity to make their position known on the Senate floor, not just on television. We are going to vote on a revised version of the House-passed BBB – and we will keep voting on it until we get something done.” Expect Senate action on BBB in early January as Democrats try to chart a path forward on the President’s agenda. 
 
HHS Announces Historic ACA Enrollment Numbers
 
On Wednesday, HHS announced that this year's Open Enrollment Period through HealthCare.gov and State-based Marketplaces (SBMs) is outpacing all previous years, with a current historic enrollment high of 13.6 million people. The American Rescue Plan (ARP) provided premium tax credits to help make ACA coverage more affordable. So far, 92% of people enrolled in federal Marketplace plans will receive premium tax credits. The Open Enrollment Period will stay open until January 15, 2022. Additional information can be found here.

Supreme Court Announces it will Hold Special Hearing in January to Consider Challenges to OSHA and CMS’s Vaccine Mandates
 
On Wednesday, the U.S. Supreme Court announced that it will hold a special hearing on January 7 to consider challenges to the Occupational Safety and Health Administration’s (OSHA) testing and vaccine mandate, as well as the CMS health care worker vaccine mandate. As a reminder, OSHA’s mandate requires that companies with 100 or more employees require their personnel to either get fully vaccinated against COVID-19 or submit to weekly testing. The CMS mandate requires that workers at health care facilities participating in Medicare or Medicaid be fully vaccinated against COVID-19 by January 4. Earlier this month, HHS appealed a federal court decision that halted CMS’s rule. The OSHA mandate has faced several legal challenges, and most recently on December 17, the U.S. Court of Appeals for the Sixth Circuit lifted the Fifth Circuit’s stay on the mandate, and OSHA set a deadline of January 10 for employers to comply with the mandate. The following day, OSHA released a press release, which stated, “To provide employers with sufficient time to come into compliance, OSHA will not issue citations for noncompliance with any requirements of the ETS before January 10 and will not issue citations for noncompliance with the standard’s testing requirements before February 9, so long as an employer is exercising reasonable, good faith efforts to come into compliance with the standard.” We will continue to monitor this situation as it unfolds. 
 
President Biden Announces New Actions to Protect Americans and Help Communities and Hospitals Battle Omicron
 
On Tuesday, the White House announced a new set of measures to help combat the spread of the Omicron coronavirus variant. The highly contagious variant has been rapidly spreading across the country, causing a major uptick in the number of new cases. The Biden Administration will deploy an additional 1,000 service members to hospitals burdened by COVID-19 in January and February. Additionally, President Biden will direct the Federal Emergency Management Agency (FEMA) to help states ramp up their hospital capacity. FEMA is also prepared to deploy hundreds of ambulances and emergency medical teams to help transport patients to hospitals. The Administration is also preparing to send millions of N-95 masks, billions of gloves, tens of millions of gowns, and over 100,000 ventilators to states that are in need. Further, the Administration is working to ensure that COVID-19 vaccines and testing are readily available. There will also be a new website launched through the White House in January, where Americans can order free rapid tests to their homes. The Administration’s fact sheet can be found here.
 
HHS Announces Investments to Help Implement the 988 Dialing Code for the National Suicide Prevention Lifeline
 
The Department of Health and Human Services announced that the Substance Abuse and Mental Health Services Administration (SAMHSA) will invest $282 million to help transition the National Suicide Prevention Lifeline from the current 10-digit number to a three-digit number, 988. In 2020, Congress designated 988 as the new dialing code for the National Suicide Prevention Lifeline. $177 million will be devoted to strengthening and expanding the existing Lifeline infrastructure, and $105 million will go toward increasing staffing nationwide at crisis call centers. Additional information can be found here.
 
HHS Issues Guidance on HIPAA for Extreme Risk Protection Orders
 
On Monday, HHS issued new guidance to help clarify how the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy Rule “permits covered health care providers to disclose protected health information to support applications for extreme risk protection orders that temporarily prevent a person in crisis, who poses a danger to themselves or others, from accessing firearms.” This guidance further implements the U.S. Department of Justice's model extreme risk protection order legislation, which provides a framework for concerned parties to intervene in crisis situations. The announcement from HHS can be found here, and the guidance from HHS can be found here
SENATE HEARINGS AND EXECUTIVE SESSIONS
N/A
HOUSE HEARINGS AND EXECUTIVE SESSIONS
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ADMINISTRATION ANNOUNCEMENTS
Centers for Medicare & Medicaid Services
 
Food and Drug Administration
 
Guidance Documents from the Centers for Disease Control and Prevention

National Institutes of Health
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