Health Care Checkup: April 30, 2021

Health Care Checkup

April 30, 2021

THE BIG PICTURE

On Wednesday evening, President Joe Biden gave his first address to Congress. In his speech, Biden discussed the many initiatives his Administration has taken in its first 100 days. The President advocated for various health provisions, such as lowering the prices of prescription drugs and expanding Medicare coverage and benefits. Additionally, the President advocated for the National Institutes of Health to create an Advanced Research Projects Agency for health. Biden said that the agency could work to develop breakthroughs to “prevent, detect, and treat diseases like Alzheimer’s, diabetes, and cancer.”

Also on Wednesday, President Biden unveiled the American Families Plan (AFP), which would represent a $1.8 trillion investment in jobs, health care, child support, education, nutrition, and other programs. The AFP includes a $200 billion investment to make Affordable Care Act (ACA) premium tax credits from the American Rescue Plan (ARP) permanent. The AFP aims to lower prescription drugs costs by letting Medicare negotiate prices. Additionally, the AFP would create a public insurance option and would lower the Medicare enrollment age from 65 to 60. The Plan proposes the creation of a national family and medical leave program and guarantees twelve weeks of paid parental, family, and personal illness leave by year 10 of the program.

Also on Thursday, the Senate voted by voice to pass a bill (H.R. 2630) that will extend the temporary scheduling of fentanyl-related substances in schedule I of the Controlled Substances Act until October 22, 2021. The order was originally scheduled to expire on May 6, 2021.

The Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that would update Medicare fee-for-service payment rates for inpatient hospitals and long-term care hospitals for fiscal year (FY) 2022. Overall, acute-care hospitals would see a 2.8% increase (an additional $2.5 billion) in Medicare reimbursements for FY22. Long-term care hospitals would receive a 1.4% increase ($52 million). The rule also “requires the distribution of an additional 1,000 new Medicare-funded medical residency positions to train physicians.”

What to Expect Next Week: There will be two hearings next week on lowering the cost of prescription drugs. The first will be held on Tuesday by the House Energy and Commerce Subcommittee on Health and is titled “Negotiating a Better Deal: Legislation to Lower the Cost of Prescription Drugs.” On Wednesday, the House Education and Labor Subcommittee on Health, Employment, Labor, and Pensions will hold a hearing titled, “Lower Drug Costs Now: Expanding Access to Affordable Health Care.”

DEEP DIVE

President Biden Unveils American Families Plan

On Wednesday, President Joe Biden unveiled the American Families Plan (AFP), which would represent a $1.8 trillion investment in jobs, health care, child support, education, nutrition, and other programs. The AFP includes a $200 billion investment to make Affordable Care Act (ACA) premium tax credits from the American Rescue Plan (ARP) permanent. The AFP aims to lower prescription drugs costs by letting Medicare negotiate prices. Additionally, the AFP would create a public insurance option and would lower the Medicare enrollment age from 65 to 60. The Plan proposes the creation of a national family and medical leave program and guarantees twelve weeks of paid parental, family, and personal illness leave by year 10 of the program. The AFP also would extend the Child Tax Credit increases from the ARP through 2025 and makes the Child Tax Credit permanently fully refundable. The proposal will be considered by Congress and is a compendium to the $2.65 trillion American Jobs Plan the President released in late March. MCRT’s summary of the AFP can be found here.

Biden Addresses Joint Session of Congress

On Wednesday evening, President Biden gave his first address to Congress. In his speech, Biden discussed the many initiatives his Administration has taken in its first 100 days. Biden spoke about the successes America has had with administering millions of doses of COVID-19 vaccines. He also spoke about the American Jobs Plan and the American Families Plan. He called on Congress to pass legislation that would raise the minimum wage to $15 per hour and to close gender-related pay gaps. Biden also called on Congress to work in a bipartisan manner to pass criminal justice reform. The President advocated for various health provisions as well, such as lowering the prices of prescription drugs and expanding Medicare coverage and benefits. Additionally, the President advocated for the National Institutes of Health to create an Advanced Research Projects Agency for health. Biden said that the agency could work to develop breakthroughs to “prevent, detect, and treat diseases like Alzheimer’s, diabetes, and cancer.” President Biden’s full speech can be viewed here.

CMS Adopts Rules to Lower Health Care Costs of ACA Marketplace Plans in Year 2022

On Friday, the Centers for Medicare & Medicaid Services (CMS) announced the adoption of new provisions that will lower out-of-pocket costs to Federal Health Insurance Marketplace consumers by $400 in plan year 2022. The second 2022 Notice of Benefit and Payment Parameters final rule (also known as the “2022 payment notice”) finalizes a measure that will make cost-sharing $400 less than what CMS had proposed in November 2020. HHS Secretary, Xavier Becerra, said “Families deserve to have access to health care coverage that doesn’t break the bank. That’s why today we’re acting to lower consumers’ maximum out-of-pocket costs by $400 and why President Biden has a plan to reduce families’ health care costs for the long run.” CMS said that it anticipates additional rulemaking for the 2022 payment notice at the end of this year.

CMS Inpatient Proposed Rule Would Increase Hospital Payments by $2.5 Billion

On Tuesday, CMS issued a proposed rule that would update Medicare fee-for-service payment rates for inpatient hospitals and long-term care hospitals for fiscal year (FY) 2022. Overall, acute-care hospitals would see a 2.8% increase (an additional $2.5 billion) in Medicare reimbursements for FY22. Long-term care hospitals would receive a 1.4% increase ($52 million). The rule also “requires the distribution of an additional 1,000 new Medicare-funded medical residency positions to train physicians.” CMS will distribute the new slots to hospitals in rural areas and those who experience shortages of physicians. HHS Secretary, Xavier Becerra, said “This rule will give hospitals more relief and additional tools to care for COVID-19 patients, and it will also bolster the health care workforce in rural and underserved communities. The Biden Administration is committed to expanding health equity in communities across the country, especially in rural America.” The fact sheet for the proposed rule can be found here.

Six-Month Extension of Ban on Fentanyl Analogues Cleared for Biden’s Signature

On Thursday, the Senate voted by voice to pass a bill (H.R. 2630) that will extend the temporary scheduling of fentanyl-related substances in schedule I of the Controlled Substances Act until October 22, 2021. The order was originally scheduled to expire on May 6, 2021. While many lawmakers have pushed for fentanyl analogues to either be permanently banned or temporarily banned, over 100 organizations, including the American Civil Liberties Union (ACLU), have pushed for restrictions on fentanyl analogues to be lifted, as they claim that continuing the policy will increase drug-related prosecutions. The Biden Administration has supported an extension of the temporary ban while it examines broader drug policy reform.

HHS Releases New Buprenorphine Practice Guidelines

The Department of Health and Human Services (HHS) released new guidelines for the prescribing of buprenorphine to treat opioid use disorder. The new guidelines exempt licensed health practitioners from federal certification requirements needed to prescribe buprenorphine if the practitioner possesses a valid registration from the Drug Enforcement Administration. Health practitioners have long critiqued training requirements tied to prescribing buprenorphine because they claimed it prevented them from effectively treating patients suffering from opioid use disorder. In a statement, Assistant Secretary for Health, Dr. Rachel Levine, said that “Increases in overdose deaths emphasize the need to expand access to evidence-based treatments, including buprenorphine that can be prescribed in office-based settings. These guidelines provide another tool to help communities respond to the evolving overdose crisis, equipping providers to save lives in their communities.” More information can be found here.

Lawmakers Announce Bipartisan Legislative Efforts to Improve the Nation’s Public Health and Medical Preparedness Programs

On Thursday, Senate Health, Education, Labor, and Pensions (HELP) Committee Chair Patty Murray (D-WA) and Ranking Member Richard Burr (R-NC) announced the beginning of bipartisan discussions to consider how to better prepare the country for future public health emergencies in light of the COVID-19 pandemic. Murray and Burr are working on a range of various legislative proposals to achieve this, including strategies for modernizing federal public health response systems, and modernizing medical countermeasures to combat public health threats. Additionally, the Senators are working on proposals that would strengthen and secure the U.S.’s medical supply chain. Ranking Member Burr issued a statement, stating “This pandemic isn’t over yet, but now is the time to take stock of the lessons learned over the last year and to begin preparing for the next potential threat. We need an honest accounting of the successes and shortcomings in our response to the novel coronavirus, so we can accurately fill the gaps in our public health architecture. The insights provided by those who have been on the frontlines of this fight, in both the private and public sector, are uniquely valuable in this process. I look forward to working with Chair Murray to craft effective, bipartisan solutions.”

Texas Lawmakers Write Letters to HHS Regarding State’s Medicaid Waiver

On Tuesday, Representative Lloyd Doggett (D-TX) and other Texas Democrats wrote a letter to HHS and CMS, urging the Biden Administration to renegotiate Texas’ Medicaid Section 1115 waiver to help reduce the high rates of uninsured individuals across the state. The move came about a week after the Administration revoked the extension of Texas’ Medicaid waiver, which had provided billions of dollars to Texas hospitals for uninsured patients’ care. The waiver was granted in the final days of the Trump Administration and did not undergo the typical public notice and comment period. The lawmakers wrote, “While important that Texas hospitals receive necessary funding for uncompensated care, the 1115 waiver should not serve as a replacement for the State’s failure to accept federal funding to expand Medicaid pursuant to the Affordable Care Act.” Texas Republicans, led by Congressman Mike Burgess (R-TX), also wrote a letter to HHS, requesting that the agency reconsider their decision to rescind the Medicaid waiver. The members wrote, "…The time and effort required to renegotiate a new waiver extension will detract from the work that Texas and your agency could be conducting to improve health care for Texans and for Americans. We respectfully request that CMS reconsider the egregious and unprecedented action it has taken to rescind this 1115 Waiver extension. We urge you to work closely with Texas going forward." Senate confirmation of the Biden Administration’s nominee to lead CMS, Chiquita Brooks-LaSure, has been held up for objections by Senator John Cornyn (R-TX) and other Republicans over the Administration’s handling of Texas’ waiver.

SENATE HEARINGS AND EXECUTIVE SESSIONS

N/A

HOUSE HEARINGS AND EXECUTIVE SESSIONS

House Committee on Oversight and Reform - Hearing

Subcommittee on Economic and Consumer Policy Hearing: "The Urgent Need to Reform the Organ Transplantation System to Secure More Organs for Waiting, Ailing, and Dying Patients"

Tuesday, May 4 at 11:00 AM ET

House Committee on Energy and Commerce - Hearing

Subcommittee on Health Hearing: "Negotiating a Better Deal: Legislation to Lower the Cost of Prescription Drugs"

Tuesday, May 4 at 11:30 AM ET

House Committee on Education and Labor - Hearing

Subcommittee on Health, Employment, Labor, and Pensions Hearing: Lower Drug Costs Now: Expanding Access to Affordable Health Care

Wednesday, May 5 at 12:00 PM ET