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.


Senate to Vote on Slimmed-Down COVID Legislation This Week

Majority Leader Mitch McConnell (R-Ky.) announced that the Senate will vote on a targeted COVID relief bill as well as additional funding for the Paycheck Protection Program (PPP) when the chamber returns this week. The half-trillion-dollar measure is similar to the bill that Republicans previously tried to pass in September. It includes $300 in enhanced unemployment benefits through the end of December and money for testing and reopening of schools. Lending authority for the PPP expired on August 8 with approximately $134 billion unspent. The Senate will vote on additional PPP money on Tuesday, and the rest of the package on Wednesday. McConnell plans to vote on the measure before proceeding to the pending Supreme Court nomination of Amy Coney Barrett. Democrats have characterized the bill as inadequate and are not expected to support it. In the House, negotiations are ongoing between Speaker Nancy Pelosi (D-Calif.) and Treasury Secretary Steven Mnuchin on a more comprehensive stimulus package. Staff continue to exchange language on several areas of disagreement, but Mnuchin stated that the President will personally lobby any Senate Republicans who are reluctant to support an eventual deal.

Judiciary Committee Vote on Supreme Court Nominee Set for Oct. 22

The Senate Judiciary Committee completed its confirmation hearings on the President’s nominee to the Supreme Court Amy Coney Barrett last week. During the proceedings, Democrats raised concerns about the nominee’s position on a number of health care related issues, including her stance on the constitutionality of the Affordable Care Act (ACA), abortion, gun restrictions, and consumer rights. Democratic panel members focused on the potential consequences for Americans if the ACA is rolled back during the pandemic, citing a law review article authored by Barrett that critiqued the court’s previous reasoning for upholding the 2010 health care law. While Democrats stated that her confirmation would likely guarantee a vote against the ACA in a hearing on the law’s future scheduled for November 10, Republicans argued that the current lawsuit against the ACA has little chance of succeeding. Democrats also vocally opposed the decision to hold the hearings in the midst of the pandemic, with two Republican members of the panel having tested positive for COVID-19.

Barrett stated that she would put her personal preferences aside if appointed to the Supreme Court and characterized herself as someone who will interpret the Constitution and laws as they are written. She expressed support for a limited role for federal judges who do not try to resolve policy disputes or make value judgements. Barrett said that she is “not hostile” to the ACA, stating that her previous writings on the law were focused on the majority’s reasoning and not the law itself, and that she had made no “deal” with the President to rule in a particular way on the case. She offered no indication of how she would vote on an abortion-rights case but declined to characterize Roe v. Wade or contraception rights as super-precedents that could not be overturned. She stated that the constitutional right to bear arms is not absolute and leaves room for gun regulations. Barrett appears to have avoided any slips that would derail her confirmation by the Senate. The Judiciary Committee will vote to advance her nomination to the full Senate on October 22. Democrats have acknowledged that there is nothing they can do to prevent Barrett’s confirmation. Majority Leader Mitch McConnell (RKy.) stated last week that Barrett has the votes to be confirmed, and that he expects to bring her nomination to the floor on October 23.

Democrats Request Details on Drug Discount Cards

Democratic leadership of several congressional health panels have sent letters to the U.S. Department of Health and Human Services (HHS) and the Government Accountability Office (GAO) requesting details about the Trump administration’s plan to send $200 drug discount cards to Medicare beneficiaries in the weeks leading up to the November presidential elections. The letters were signed by House Energy and Commerce Chairman Frank Pallone (D-N.J.), House Ways and Means Chairman Richard Neal (D-Ma.), and Senate Finance Ranking Member Ron Wyden (D-Ore.). The lawmakers question the motive and legality of the White House plan, expressing concerns about the “propriety of these actions, particularly in light of recent press reports indicating that the timing of this project is being driven by the upcoming presidential election.” They argue that current law does not provide the Administration authority to proceed with the drug card demonstration.

Ways and Means Leadership Continues Work on Health Equity

House Ways and Means Committee Chair Richard Neal (D-Mass.) is following up on his series of inquiries regarding racial health equity, asking the Centers for Medicare and Medicaid Services (CMS) to examine the issue of the misuse of race in clinical decision-making. He urged the agency to take his questions as “an opportunity to immediately evaluate the unintended consequences of clinical decision tools, including algorithms developed by specific professional societies, along with their uses and relevance to CMS initiatives related to quality and safety for Medicare and Medicaid beneficiaries.” He also requests a briefing from CMS on the current use of racial bias in such clinical decision-making tools by October 30.

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