Health Care Checkup: January 8, 2021

Health Care Checkup

January 8, 2021

THE BIG PICTURE

What Happened This Week

Congress ratified Joe Biden’s election win in the wee hours of Thursday morning. The electoral count was halted on Wednesday afternoon due to a violent group of Trump supporters who overtook the U.S. Capitol building. Once the Capitol building was able to safely reopen, Congress reconvened to finish the ratification process. Despite continued false claims from President Trump that the election was riddled with widespread fraud, he released a statement early Thursday morning stating that there will be an “orderly transition of power” on January 20.

Also on Wednesday, it was declared that the Democratic party had gained control over the Senate as the winners from the Georgia runoff races were announced. Democrat Raphael Warnock defeated his Republican opponent, incumbent Kelly Loeffler who was appointed to fill the expiring term of long-serving Senator Johnny Isakson who retired last year. Jon Ossoff defeated his Republican opponent as well, incumbent David Perdue. Ossoff will be the first Jewish senator from Georgia and the youngest in the Senate at age 33. Warnock will also make history as Georgia’s first Black senator. The duo will be the first Democrats in Georgia to gain Senate seats in 20 years.

On Thursday, as anticipated by many policy and public health watchers, HHS Secretary Alex Azar extended COVID-19 national public health emergency declaration, and thus, also extended the regulatory flexibilities and authorities tied to it. The renewal is effective January 21, 2021 and lasts 90 days. Secretary Azar first declared a public health emergency due to COVID on January 31, 2020.

Also on Thursday, the Centers for Medicare and Medicaid Services (CMS) issued guidance to states in order to encourage them to adopt strategies to address social determinants of health (SDOH) in Medicaid and the Children’s Health Insurance Program (CHIP). The guidance describes how states can utilize existing flexibilities available to them under federal law – various care delivery approaches, benefits, and reimbursement methodologies – to address the negative outcomes that can be impacted by SDOH.

Earlier in the week on Sunday, the 117^th Congress convened, and House Speaker Nancy Pelosi was re-elected to lead the chamber. Speaker Pelosi has stated that the chamber’s “most urgent priority” will continue to be fighting the coronavirus pandemic and helping those hit hardest by it.

What to Expect Next Week: After the riots on Wednesday that overtook the Capitol, there have been increasing calls for President Trump to resign from office in the waning days of his Presidency. While this is unlikely to happen, several lawmakers have said that Congress will move forward with impeachment if he does not. Both the House and Senate will not be in session next week, so it should be a quieter week on the Hill.

DEEP DIVE

Congress Certifies Joe Biden as 46^th President of the United States

In the wee hours of Thursday morning, both the House and Senate ratified Joe Biden’s election win. The electoral count was halted on Wednesday afternoon due to a violent group of Trump supporters who overtook the U.S. Capitol building. Once the Capitol building was able to safely reopen, Congress reconvened to finish the ratification process. Despite continued false claims from President Trump that the election was riddled with widespread fraud, he released a statement early Thursday morning stating that there will be an “orderly transition of power” on January 20.

Democrats Gain Control of Senate After Ossoff and Warnock Win Georgia Races; Pelosi Selected Again as House Leader

On Wednesday, it was declared that the Democratic party had gained control over the Senate as the winners from the Georgia runoff races were announced. Democrat Raphael Warnock defeated his Republican opponent, incumbent Kelly Loeffler who was appointed to fill the expiring term of long-serving Senator Johnny Isakson who retired last year. Jon Ossoff defeated his Republican opponent as well, incumbent David Perdue. Ossoff will be the first Jewish senator from Georgia and the youngest in the Senate at age 33. Warnock will also make history as Georgia’s first Black senator. The duo will be the first Democrats in Georgia to gain Senate seats in 20 years. The Democrat’s control of the Senate could help further President-elect Biden’s health care agenda, which includes initiatives such as lowering the prices of prescription drugs, expanding the Affordable Care Act (ACA), and giving additional funding to states to help in the fight against the pandemic. The Biden Administration will also be able to more easily get confirmation for its cabinet nominees. While the Senate will be split evenly between Democrats and Republicans, Vice President-elect Kalama Harris will be able to break ties when she is sworn in on January 20^th.

On Sunday, the 117^th Congress convened, and House Speaker Nancy Pelosi was re-elected to lead the chamber. Speaker Pelosi has stated that the chamber’s “most urgent priority” will continue to be fighting the coronavirus pandemic and helping those hit hardest by it.

End of 2020 Congressional Omnibus Deal Recap

After much anticipation and partisan back-and-forth, Congress passed a $2.3 trillion COVID relief and government funding bill on December 21, 2020. President Donald Trump signed it into law one week later on December 27. $900 billion from the package went to COVID relief, which includes a second round of $600 stimulus checks per adult and child, an 11-week extension of enhanced unemployment benefits, and an additional $300 per week in unemployment benefits. The stimulus package also includes housing supports, such as $25 billion in rental assistance and extends eviction moratorium through the end of January. The bill also contains aid for small businesses, with $284 billion for the Paycheck Protection Program, additional PPP loans, grants for live venues, and grants for the Emergency Economic Injury Disaster Loan program. Some of the other measures include $45 billion for the transportation industry, $13 billion for the Supplemental Nutrition Assistance Program (SNAP), and $82 billion for schools and colleges. $20 billion was allocated for purchasing vaccines, $8 billion for vaccine distribution, $20 billion for states’ testing, and $20 billion for health care providers.

President Trump first refused to sign the bill into law because he stated that he wanted the stimulus check amounts increased from $600 to $2,000. In response to the President’s request, the House passed the CASH Act, which would have raised the $600 checks to $2,000. However, the Act was dead on arrival in the Senate. $2,000 stimulus checks may still be delivered to the American people though, as Democrats have promised $2,000 checks if they gained control over the Senate. Now that they have, additional stimulus aid for the public is more than likely.

Rollout of COVID Vaccine Slower Than Expected

While millions of Americans have been receiving both Pfizer’s and Moderna’s COVID vaccines for several weeks, rollout of the vaccine has been slower than promised by Operation Warp Speed. The Trump Administration had promised that 20 million people would be vaccinated by the end of 2020. However, as of Thursday morning, only 5.9 million have been inoculated. Health and Human Services (HHS) Secretary Alex Azar has attributed the slow rollout to the holidays and the states’ adherence to the Centers for Disease Control and Prevention’s (CDC) guidelines to first administer the vaccine to essential health care workers and long-term care residents. States have grappled with logistical challenges for distributing the vaccine, as supplies are still scarce, and they have also been struggling with a lack of resources for distribution. The U.S. Food and Drug Administration (FDA) has faced increasing pressures to alter the dosing regimens for one of the vaccines to speed up vaccination efforts. However, in a press release on Monday, the FDA stated that “[They] have committed time and time again to make decisions based on data and science. Until vaccine manufacturers have data and science supporting a change, we continue to strongly recommend that health care providers follow the FDA-authorized dosing schedule for each COVID-19 vaccine.”

Biden-Harris Transition Announces Members of COVID-19 Response Team

On December 29, 2020 President-elect Joe Biden and Vice President-elect Kamala Harris announced the members of their COVID-19 response team. The team is made up of physicians, health experts, and policy advisors. There will be a supply coordinator, a vaccinations coordinator, and a testing coordinator. In a statement, President-elect Biden said “This accomplished and experienced team will work to get the pandemic under control so that the American people can get back to their lives and to their loved ones. To recover from this pandemic, we must take aggressive action to manufacture, distribute, and administer vaccines, testing, and personal protective equipment in an equitable way. These individuals are deeply qualified and will restore public trust in the pandemic response by leading with facts, science, and integrity.” The full list of members can be found here.

CMS Issues New Roadmap for States to Address Social Determinants of Health

On Thursday, the Centers for Medicare and Medicaid Services (CMS) issued guidance to states in order to encourage them to adopt strategies to address social determinants of health (SDOH) in Medicaid and the Children’s Health Insurance Program (CHIP). The guidance describes how states can utilize existing flexibilities available to them under federal law – various care delivery approaches, benefits, and reimbursement methodologies – to address the negative outcomes that can be impacted by SDOH. The guidance is geared toward SDOH benefits that states can cover now under current law, including housing-related services and supports, non-medical transportation, home-delivered meals, educational services, and employment supports. In a press release, CMS Administrator Seema Verma said, “The evidence is clear: social determinants of health, such as access to stable housing or gainful employment, may not be strictly medical, but they nevertheless have a profound impact on people’s wellbeing….Today’s letter to state health officials highlights strategies by which states can promote a value-based system that fosters treatment of the whole person and lowers healthcare costs.”

SBA Issues New PPP Guidance

The U.S. Small Business Administration (SBA) and Treasury issued guidance on Wednesday for the reconstituted Paycheck Protection Program (PPP). The guidance included two interim final rules (IFRs). The first IFR, “Business Loan Program Temporary Changes; Paycheck Protection Program as Amended,” consolidates the rules for PPP forgivable loans for first-time borrowers and outlines changes made by the Economic Aid to Hard-Hit Small Businesses, Nonprofits, and Venues Act, P.L. 116-260. The second IFR, “Business Loan Program Temporary Changes; Paycheck Protection Program Second Draw Loans,” lays out the guidelines for new PPP loans to businesses that previously received a PPP loan.