Health Care Checkup: February 19, 2021

Health Care Checkup

February 19, 2021

THE BIG PICTURE

The COVID-19 stimulus package is on track for a House vote next week. Last week, nine House committees marked up and passed their versions of the COVID-19 relief package. It is expected that next week the Budget Committee will combine all the committees’ versions into one bill, which will then head to the Rules Committee. A vote on the House floor for the $1.9 trillion stimulus plan is expected on February 26. The bill is expected to pass; it will head to the Senate, where all 50 Senate Democrats must vote in favor of the legislation for it to pass.

On Friday, President Biden announced that Chiquita Brooks-LaSure will serve as the Administrator of the Centers for Medicare and Medicaid (CMS) and Richard Sauber will be the General Counsel of the U.S. Department of Veterans Affairs. Additionally, it has been reported that President Biden has tapped Liz Fowler to lead the Center for Medicare & Medicaid Innovation (CMMI) at CMS.

On Wednesday, President Biden announced new actions that are geared toward expanding COVID-19 testing, improving the availability of tests, and better preparing for the threat of variants. To expand COVID-19 testing for schools and underserved populations, HHS, in partnership with the Department of Defense (DOD), will invest $650 million to establish regional coordinating centers that will organize the distribution of COVID-19 testing supplies and partner with laboratories to conduct COVID-19 testing and reporting. Additionally, the agencies will invest $815 million to increase domestic manufacturing of testing supplies and materials that have been scarce during the pandemic.

Also on Wednesday, Senators Michael Bennet (D-CO) and Tim Kaine (D-VA) announced the reintroduction of their legislation, the Medicare-X Choice Act. The Act would create a public option by expanding on the Affordable Care Act (ACA) and Medicare. According to the Senators, the Medicare Exchange (Medicare-X) plan would “offer families, individuals, and small businesses low-cost health insurance, decrease the number of uninsured Americans, control the cost of health care, and increase competition in the health insurance market."

What to Expect Next Week: The House is expected to vote on the Budget Reconciliation bill that includes COVID-19 stimulus aid next Friday. Both the House and the Senate are slated to hold a wide array of health and COVID-19 related hearings. On Tuesday, the Senate Health, Education, Labor and Pensions (HELP) Committee and the Senate Finance Committee will each hold hearings on the nomination of Xavier Becerra for Secretary of the Department of Health and Human Services. Also on Tuesday, the House Energy and Commerce Subcommittee on Oversight and Investigations will hold a hearing titled, "Pathway to Protection: Expanding Availability of COVID-19 Vaccines." On Thursday, the Senate HELP Committee will hold nomination hearings for Vivek Murthy for Medical Director in the Regular Corps of the Public Health Service and Surgeon General of the Public Health Service, and for Rachel Levine, who was nominated to serve as Assistant Secretary of Health and Human Services. On Friday, the House Ways and Means Subcommittee on Health will hold a hearing titled, “Path Forward on COVID-19 Immunizations.”

DEEP DIVE

COVID-19 Stimulus Plan on Track for House Vote

Last week, nine House committees marked up and passed their versions of the COVID-19 relief package. Next week, it is expected that the Budget Committee will combine all the committees’ versions into one bill, which will then head to the Rules Committee. A vote on the House floor for the $1.9 trillion stimulus plan is expected on February 26. The bill is expected to pass, and it will head to the Senate, where all 50 Senate Democrats must vote in favor of the legislation for it to pass. Gaining the support of all 50 Democrats in the Senate will likely require changes to the $15 minimum wage provision, as both Kyrsten Sinema (D-AZ) and Joe Manchin (D-WV) have both said they will not support the measure. It is also unclear whether that provision can stay in the bill, given the Byrd rule. Senate committees are not expected to mark up the bill in order to expedite passage before enhanced federal unemployment benefits expire on March 14. The final stimulus package is expected to include provisions to expand Medicaid benefits, bolster COVID-19 response efforts, extend housing and unemployment assistance, and grant much needed aid to schools.

Key Members of Biden’s Health Teams Announced

On February 19, President Biden announced that Chiquita Brooks-LaSure will serve as the Administrator of the Centers for Medicare and Medicaid (CMS) and Richard Sauber will be the General Counsel of the U.S. Department of Veterans Affairs. Brooks-LaSure served as a senior CMS official during the Obama Administration and helped carry out the Affordable Care Act’s expansion of coverage and market reforms. She also spent time on the Hill, where she worked as a Democratic staff member for the House Ways and Means Committee. Mr. Sauber is a private practice attorney who was previously appointed by President Reagan to “form and lead the first multi-agency task force to concentrate on pursuing fraud in government contracts.” Additionally, it has been reported that President Biden has tapped Liz Fowler to lead the Center for Medicare & Medicaid Innovation (CMMI) at CMS. Ms. Fowler is an Obama administration veteran who served as a special assistant to the former President on healthcare and economic policy.

President Biden Announces Plan to Expand and Strengthen COVID-19 Testing

On February 17, President Biden announced new actions that are geared toward expanding COVID-19 testing, improving the availability of tests, and better preparing for the threat of variants. To expand COVID-19 testing for schools and underserved populations, HHS, in partnership with the Department of Defense (DOD), will invest $650 million to establish regional coordinating centers that will organize the distribution of COVID-19 testing supplies and partner with laboratories to conduct COVID-19 testing and reporting. Additionally, the agencies will invest $815 million to increase domestic manufacturing of testing supplies and materials that have been scarce during the pandemic. These materials include filter pipette tips, nitrocellulose used in antigen point-of-care tests, and molded plastics that are needed to house testing reagents. Lastly, the Centers for Disease Control and Prevention (CDC) will invest approximately $200 million to “identify, track, and mitigate emerging strains of SARS-CoV-2 through genome sequencing.” The investment is expected to increase the CDC’s sequencing from about 7,000 samples per week to nearly 25,000 per week. The increase will enable better detection of emerging virus variants and more accurate understandings of how they spread.

President Biden Announces Members of his Health Equity Task Force

On Wednesday, President Biden announced the members of his COVID-19 Health Equity Task Force. The Task Force is made up of 12 diverse experts who have experience working with a wide array of populations. The team will issue recommendations to help inform COVID-19 response and recovery efforts. This will include recommendations on the “equitable allocation of COVID-19 resources and relief funds, effective outreach and communication to underserved and minority populations, and improving cultural proficiency within the Federal Government.” Additionally, the Task Force will make recommendations to improve data collection and long-term plans to address data shortfalls regarding minority populations. The team’s work will conclude after they issue a final report to the COVID-19 Response Coordinator that describes the “drivers of observed COVID-19 inequities, the potential for ongoing disparities faced by COVID-19 survivors, and actions to ensure that future pandemic responses do not ignore or exacerbate health inequities.”

COVID-19 Vaccine Updates

The unprecedented winter storms that have left thousands without power and water this week have also delayed COVID vaccine shipments. Two of the major vaccine hubs that supply multiple states with the vaccine were affected by the storms. Additionally, various states, including Colorado and Illinois, are expected to experience shipment delays for several days and have closed vaccination sites due to the inclement weather.

At Tuesday night’s town hall in Wisconsin, President Biden said that the U.S. should have more than 600 million COVID vaccine doses by the end of July, which should be enough to vaccinate “every single American.” The President said that, based on current herd immunity predictions, “by next Christmas...we’ll be in a very different circumstance...than we are today.”

U.S. public health officials are continuing to weigh the option to extend the dosing interval between the first and second dose, which would help to increase the amount of vaccine that could be used administer first doses. The CDC’s Advisory Committee on Immunization Practices (ACIP) has debated the idea, but it has not yet been decided if the committee will convene to address the option and issue official guidance. Health officials have previously rejected the U.K.’s dosing strategy, which allows for the second dose to be given up to twelve weeks after the first.

The Biden Administration has made a $54.2 million contract with Retractable Technologies Inc. to help in COVID-19 vaccination efforts. The contract also includes the option for the federal government to purchase up to $147 million in syringes and needles. Specifically, the government has purchased low dead space syringes, which allow medical professionals to obtain as much vaccine as possible from syringes to minimize waste. The contract will help to ensure that the U.S. has enough of the supplies needed to vaccinate the country.

U.S. Department of Health and Human Services Announces Biden-Harris Administration Staff Appointments

On February 16, HHS announced a range of Biden-Harris Administration staff appointments. The Administration has said that the appointments “represent both an experienced and diverse team committed to President Biden’s mission to end the COVID-19 pandemic, expand affordable health care and reduce costs, and advance equity.” Several notable appointments include Sean McCluskie, who will be the Chief of Staff to the HHS Secretary; and Arielle Woronoff, who will be the Director of the Office of Legislation at CMS. In a statement, Sean McCluskie said, “Together, in the Biden-Harris Administration, we will tackle the COVID-19 pandemic, protect and strengthen the Affordable Care Act, expand access to quality, affordable health care, and advance health equity in communities across the country.” To view the full list of appointments, click here.

Life Expectancy in United States Takes Hit from COVID-19 Pandemic

Life expectancy in the U.S. has increased at a steady pace since the middle of the 20th century. However, life expectancy declined by a full year during the first half of 2020 due to the COVID-19 pandemic. Deaths from the virus, as well as deaths related to the pandemic, including drug overdose deaths, attributed to the decline. The last time life expectancy declined more rapidly was World War II. Black and Latino Americans have been disproportionately affected by coronavirus and saw a sharper decline in the life expectancy than Whites. While White life expectancy fell by 0.8 years, Black life expectancy fell by 2.7 years, and Latino life expectancy fell by 1.9 years.

Senators Michael Bennet and Tim Kaine Announce Introduction of Medicare-X Choice Act

On February 17, Senators Michael Bennet (D-CO) and Tim Kaine (D-VA) announced the reintroduction of their legislation, the Medicare-X Choice Act. The Act would create a public option by expanding on the Affordable Care Act (ACA) and Medicare. According to the Senators, the Medicare Exchange (Medicare-X) plan would “offer families, individuals, and small businesses low-cost health insurance, decrease the number of uninsured Americans, control the cost of health care, and increase competition in the health insurance market.” Among various provisions in the bill, the legislation would expand essential health benefits under the ACA and provide primary care services with no cost-sharing for plan holders, and make premiums more affordable for low-income Americans by providing a larger tax premium subsidy for Americans living below 400% of the Federal Poverty Level (FPL). The bill text is available here and a summary is available here.

SENATE HEARINGS AND EXECUTIVE SESSIONS

Senate Health, Education, Labor and Pensions Committee - Hearing

Full Committee Hearing: "Nomination of Xavier Becerra to serve as Secretary of Health and Human Services."

Tuesday, February 23 at 10:00 AM ET

Senate Veterans' Affairs Committee - Hearing

Full Committee Hearing: "Vaccines for Vets: Our Best Shot at Ending the COVID-19 Pandemic."

Wednesday, February 24 at 3:00 PM ET

Senate Health, Education, Labor and Pensions Committee - Hearing

Full Committee Hearing: "Nominations of Vivek Murthy to serve as Medical Director in the Regular Corps of the Public Health Service and Surgeon General of the Public Health Service, and Rachel Levine to serve as Assistant Secretary of Health and Human Services."

Thursday, February 25 at 10:00 AM ET

Senate Armed Services Committee - Hearing

Senate Armed Services Committee Hearing: "Department of Defense Support to the COVID-19 Response."

Thursday, February 25 at 9:30 AM ET

HOUSE HEARINGS AND EXECUTIVE SESSIONS

House Committee on Energy and Commerce - Hearing

Subcommittee on Oversight and Investigations Hearing: "Pathway to Protection: Expanding Availability of COVID-19 Vaccines."

Tuesday, February 23 at 10:30 AM ET

House Committee on Appropriations - Hearing

Subcommittee on the Departments of Labor, Health and Human Services, Education, and Related Agencies Hearing: "Ready or Not: U.S. Public Health Infrastructure."

Wednesday, February 24 at 10:00 AM ET

House Committee on Homeland Security - Hearing

House Committee on Homeland Security Hearing: "Confronting the Coronavirus: Perspectives on the COVID-19 Pandemic One Year Later."

Wednesday, February 24 at 9:30 AM ET

House Committee on Appropriations - Hearing

Subcommittee on Legislative Branch Hearing: "Health and Wellness of Employees and State of Damage and Preservation as a Result of the January 6 Insurrection."

Wednesday, February 24 at 10:00 AM ET

House Committee on Science, Space, and Technology - Hearing

House Committee on Science, Space, and Technology Hearing: “Building Back the U.S. Research Enterprise: COVID Impacts and Recovery.”

Thursday, February 25 at 10:00 AM ET

House Ways and Means Committee – Hearing

Health Subcommittee Hearing: “Path Forward on COVID-19 Immunizations.”

Friday, February 26 at 2:00 PM ET