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Washington DC Update 2/2/2021
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The Centers for Disease Control and Prevention (CDC) has created a new webpage for coping with stress in the difficult times resulting from the COVID-19 pandemic.

Greetings from Washington, DC. The major issues covered in this Update are:
 Read about these topics and more in this week’s Update. But first, check out:

COVID-19 Vaccine Information

Mask Information
See the “Other News...” section below for information about mask types and usage, and warnings about counterfeit N95 masks.
Special Announcements
President Biden issued an Executive Order on January 28 that does two significant things of relevance to the families of children and youth with special health care needs:
  1. It creates a new Special Enrollment Period (SEP) -- from February 15 through May 15 -- for the 36 states using the healthcare.gov exchange or platform. Other states may choose to open their enrollment periods. As explained in this CMS Fact Sheet (01/28/21), the administration will undertake outreach and marketing efforts to ensure that consumers are aware of this opportunity.
  2. It directs federal agencies “to reconsider rules and other policies that limit Americans’ access to health care, and consider actions that will protect and strengthen that access.” A White House fact sheet explains that these restrictive policies may include:
  • Demonstrations and waivers under Medicaid and the ACA, including work requirements;
  • Policies that undermine health-insurance marketplaces/exchanges;
  • Policies that make it more difficult to enroll in Medicaid and the ACA; and
  • Policies that reduce affordability of coverage or financial assistance, including for dependents.

These are policies that advocates have been concerned about for some time and have urged the new administration to address.
Plan to Address COVID Pandemic
The White House has provided a broad outline of the administration’s plan to address the health aspects of the COVID pandemic, and the more detailed (200-page) National Strategy for the COVID-19 Response and Pandemic Preparedness (01/21/21). See Biden Pandemic Strategy Puts Focus On People With Disabilities (Disability Scoop, 01/25/21). In addition, President Biden has proposed the “American Rescue Plan” to address the economic (and health) problems caused by the COVID pandemic (see the “Congress” section, below)

Continuation of Public Health Emergency at Least through 2021
As explained in a January 24, 2021, blog post from the Georgetown Center for Children and Families, Acting Health and Human Services Secretary Norris Cochran recently sent a letter to Governors to assure states that the current declaration of a Public Health Emergency (PHE) “will likely remain in place for the entirety of 2021,” and that HHS will provide 60 days’ notice when it decides to terminate the PHE or let it expire. This is significant because the PHE declaration is the basis for the temporary increase the federal matching rates for Medicaid and CHIP; the continuous Medicaid coverage (maintenance-of-effort) requirements; and other temporary authorities, including “Appendix K,” that give states flexibility in telehealth benefits and other Medicaid and Medicare services.

Temporary Freeze on Regulations, Pending Reviews
The president’s chief of staff issued a memorandum to federal departments asking them to halt the promulgation of regulatory actions, with some exceptions, until the president’s appointees or designees have had the opportunity to review them. For rules that have been finalized but are not yet in effect, the department “should consider postponing the rules’ effective dates for 60 days” in order to review them, and to open a 30-day public comment period. Biden Seeks to Halt or Delay Trump’s ‘Midnight Regulations (Government Executive, 01/20/21).

See also an article from WKYC (01/27/21) explaining that this freeze does not, as rumored, delay a significant patient discount for insulin.
Executive Orders
The president has issued a number of Executive Orders to address the health and economic consequences of the pandemic, some of which are explained in these fact sheets:

Pandemic-Relief Bill
As noted above, the administration has proposed legislation, the “American Rescue Plan,” to address the economic (and health) problems caused by the COVID pandemic. Among other things, he proposes another round of stimulus checks, increased childcare and child tax credits, restoration of emergency paid leave, and increased subsidies for health insurance premiums. 

The president has expressed his hope that the legislation will pass with bipartisan support, but it takes 60 votes to advance most legislation in the Senate and it does not seem likely that ten Republicans will support a bill of the magnitude envisioned by the administration and congressional Democrats. Failing a bipartisan agreement, the Senate can use the “budget reconciliation” process to pass a bill with a simple majority -- all 50 Senate Democrats plus Vice-President Harris. All provisions in a reconciliation bill must be budgetary in nature, however, which will limit its scope to some extent.

Senate Report on Insulin Prices
After a two-year investigation, the Republican and Democratic leaders of the Senate Finance Committee released a staff report on insulin pricing practices on January 14. The report describes practices of manufacturers and pharmacy benefit managers that have caused significant price increases in insulin. See the Committee Press Release, 01/14/21).
Medicaid & CHIP
Affordable Care Act/Private Insurance
CMS Releases Partial Final NBPP
The Trump administration released some of the final 2022 Notice of Benefit and Payment Parameters (NBPP), a complex rule that sets forth ACA-implementation rules for states and insurers. Health care advocates and insurers had concerns about certain aspects of the rule as proposed. It is possible that the Biden administration will make changes to the final rule through another formal rule-making process. For more information, see:
Specialized Vaccine Resources

Vaccine Misinformation Alerts and Resources, from the Public Health Communications Collaborative:
Other News & Resources
Implementation of the New Surprise Billing Law
The December 2020 COVID-19 relief package and government funding law includes the “No Surprises Act” to protect consumers from surprise medical bills from out-of-network providers in states without balance billing laws and in federally regulated self-insured (ERISA) plans.

See The No Surprises Act: Implications for States to learn more about how this new law will be implemented (State Health and Value Strategies blog, 01/12/21). 
 Mask Information

For more information, including a sketch of the way a genuine NIOSH-approved N95 mask is marked, see Respirator Trusted-Source Information, from The National Personal Protective Technology Laboratory (NPPTL) and ADA [American Dental Association] Tips to Avoid Counterfeits.

Pandemic Could Hurt Home-Based Care for Kids With 24/7 Needs (Pew Stateline, 01/07/21; about waiting lists for Katie Beckett waiver, including experiences of Family Voices staffer Cara Coleman and her daughter).

Outgoing NPR Health Policy Correspondent Reflects On Her Favorite Story (NPR, 01/15/21; about a young wheelchair-using woman who helped convince the state of Georgia to get a Medicaid home and community-based waiver in 1992).
TRICARE and Military Health System
Tricare updates since the last Washington update:

To keep up with TRICARE and COVID-19 updates, sign up for email alerts.
Download the latest TRICARE East Region or TRICARE West Region newsletter at www.tricare.mil/publications.
Due March 4, 2021, 5:00 pm ET -- Solicitation of Nominations for Appointment to the Advisory Committee on Minority Health (Federal Register, 12/04/20).
Wednesday, Feb. 3, 3:00-4:30 ET
SOAR = Supplemental Security Income (SSI) program Outreach, Access, and Recovery (SOAR), a program designed to increase access to SSI/SSDI for eligible adults and children who are experiencing or at risk of homelessness.
Wednesday, February 10, 12:00 ET
Robert Wood Johnson Foundation Systems for Action Research Program

Thursday, February 11, 1:30 ET
Hosted by American Muslim Health Professionals
Wednesday, February 24, 1:00-2:00 ET
Public Health Communications Collaborative

Wednesday, March 10, 12:00 ET
Robert Wood Johnson Foundation Systems for Action Research Program
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Family Voices is a national organization and grassroots network of families and friends of children and youth with special health care needs and disabilities that promotes partnership with families--including those of cultural, linguistic and geographic diversity--in order to improve healthcare services and policies for children.