Hart Health Strategies provides a comprehensive policy briefing on a weekly basis. This in-depth health policy briefing is sent out at the beginning of each week. The health policy briefing recaps the previous week and previews the week ahead. It alerts clients to upcoming congressional hearings, newly introduced bills, regulatory announcements, and implementation activity related to the Patient Protection and Affordable Care Act (PPACA) and other health laws.


House Passes Heroes Act to Spur Negotiations with Senate Republicans

The House of Representatives passed a $3 trillion stimulus bill (H.R.6800, the Health and Economic Recovery Omnibus Emergency Solutions Act or the HEROES Act) last week by a vote of 208-199. The HEROES Act included nearly $1 trillion in aid for state and local governments, rent and mortgage relief, expanded unemployment benefits and food assistance, and provided funding for voting by mail and the U.S. Postal Service. It would also make another round of direct cash payments of up to $1,200 to individuals. The legislation, which was passed largely along party lines, is opposed by most Republicans, who have characterized the bill as a Democratic wish-list that is dead on arrival in the Senate. The White House has also issued a veto threat.

With respect to insurance coverage, the HEROES Act would provide a two-year federal backstop of subsidies to support health plans and coverage of job-based insurance premiums between March and next January for workers who have been laid off or furloughed. It would reopen the HealthCare.gov enrollment period and provide an additional increase to federal Medicaid payments. It would also restore Medicaid coverage for Pacific Islanders.

With respect to testing and treatment for COVID-19, $75 billion is included for testing and surveillance. Labs would be required to send daily testing reports to the U.S. Department of Health and Human Services (HHS) and to make data public about where tests have been distributed and the results being recorded. The bill would end cost sharing for coronavirus-related treatments, and includes a provision to crack down on price-gouging for supplies amid the pandemic, giving the Federal Trade Commission (FTC) the authority to prevent “unconscionably excessive” price increases.

To address drug shortages, the bill would require pharmaceutical manufacturers to issue quarterly reports on the volume of drugs made overseas and expand the Food and Drug Administration’s (FDA) authority to enforce timely notification requirements and risk management plans for drug shortages. It directs the FDA to designate National Centers of Excellence in Continuous Pharmaceutical Manufacturing to work with the agency to build a national framework for continuous drug manufacturing. The bill also gives FDA the authority to destroy imported medical devices that the agency believes they are adulterated, misbranded, or unapproved and may pose a threat to public health. Device manufacturers would also be required to provide information on extending medical device shelf life dates.

Key employment provisions within the HEROES Act include a “Heroes Fund” to provide $200 billion in hazard pay to essential workers. Essential work employers would be eligible for grants of $10,000 per essential worker to cover the entire cost of premium pay. The bill would also allow a greater array of non-profits to access funds under the Paycheck Protection Program (PPP), lengthen the required period for spending the money to 24 weeks, nix a requirement that at least 75 percent of the money be spent on payroll, and set aside funding specifically for firms with 10 or fewer employees. The bill would permit loans to be spent on personal protective equipment (PPE) or other supplies necessary for protecting employee health and safety.

Although the legislation is understood as a symbolic messaging bill, Democrats will use it as an opening bid during eventual negotiations with the Republican Senate and White House. Republicans have stressed that there is no need to rush the passage of an additional stimulus until the effects of previously passed coronavirus legislation become apparent. Any deal on the next package is still likely weeks away. It has been reported that Majority Leader Mitch McConnell (R-Ky.) does not plan to move the next relief package until June at the earliest. McConnell is insisting that the next COVID-19 bill create a legal safe harbor for businesses, nonprofits, governments, workers, and schools as the economy begins to reopens, and House Speaker Nancy Pelosi (D-Calif.) has indicated that she is open to a conversation about legal protections as a part of the next stimulus deal.

President Trump has expressed support for infrastructure spending in the next stimulus. He is also pushing to include a measure to increase transparency into the prices for medical services negotiated by hospitals and insurers. The White House believes that passing such a measure through legislation would end its current legal battle with the industry over two 2019 regulations that would require hospitals and insurers to make their prices public. The President also continues to urge the inclusion of a payroll and capital gains tax cut in the next stimulus package as well. Democrats have expressed opposition to this idea.

House Adopts Historic Rules for Proxy Voting, Remote Committee Work

The House of Representatives adopted a resolution (H.Res.965) last week that will provide for the use of proxy voting during the COVID-19 pandemic. The change will allow lawmakers to serve as proxies for their colleagues who are not able to be on Capitol Hill during votes. The resolution also includes procedures to implement remote committee work and eventually remote floor votes. The temporary changes will enable committees to engage in fully virtual hearings and markups during the coronavirus pandemic. Committees will be required to use software platforms approved by the Chief Administrative Officer (CAO) for remote participation to help guard against cybersecurity issues. The changes will be in place for 45 days and can be extended or renewed if the public health emergency persists or if there is a resurgence.

House May Consider Additional COVID Legislation Next Week

Majority Leader Steny Hoyer (D-Md.) announced that no votes are expected in the House of Representatives this week to allow the chamber time to determine how the new rules for remote work will be implemented. Tom Tiffany (R-Wis.) and Mike Garcia (R-Calif.), who won in special elections, will be sworn in during Tuesday’s pro forma session. The House will be in session May 27 and 28 and is expected to consider H.R. 6172, the USA FREEDOM Reauthorization Act of 2020 (FISA Reauthorization). In addition, Leader Hoyer told members that negotiations regarding additional legislation addressing the COVID-19 pandemic are ongoing and it is possible that the House could vote on COVID-19-related bills when they return.

CDC Issues Additional Reopening Guidances

The Centers for Disease Control and Prevention (CDC) released six checklists last week to help schools, workplaces, restaurants and bars, youth programs and camps, childcare programs, and mass transit decide when to reopen during the coronavirus pandemic. The guidances are shorter and less specific than previous drafts from the agency. Sen. Mike Braun (R-Ind.) blocked an attempt by Minority Leader Chuck Schumer (D-N.Y.) last week to pass a resolution supporting the release of the more comprehensive guidelines, which were shelved by the White House for being overly prescriptive.

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