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.


American Rescue Plan Act Signed into Law

The House of Representatives approved the $1.9 trillion American Rescue Plan Act (H.R. 1319) with a 220-211 vote last week, sending the measure to President Joe Biden for his signature. No Republicans supported the legislation, and Jared Golden (D-Maine) was the only Democrat to oppose it. The bill, which was previously amended by the Senate and advanced via the budget reconciliation process, restricts eligibility for the $1,400 stimulus checks and extends unemployment benefits at a lower level than that contained in the version of the bill initially passed by the House. The legislation includes $48 billion for COVID-19 testing and tracing and $7.5 billion for the Centers for Disease Control and Prevention’s (CDC) vaccine distribution efforts. It does not include a measure to increase the minimum wage, after the Senate’s parliamentarian ruled that the provision did not qualify for the fast-track budget reconciliation process, but it does include an expansion of the child tax credit and health insurance premium subsidies. Please see the included Appendix for a summary of health provisions in the law, as prepared by Hart Health Strategies Inc.

House to Consider Medicare Sequester, PPP Extension This Week

The House of Representatives is planning to consider a legislative measure that would delay billions of dollars in automatic cuts to the Medicare program this week. The current moratorium on the 2% Medicare sequester expires on March 31, while the latest stimulus package triggers statutory pay-as-you-go requirements that would result in a 4%, or $36 billion, sequester to the program in early 2022. The 2010 Pay-As-You-Go (PAYGO) statute requires any addition to the federal deficit be offset by spending reductions, with the Office of Management and Budget (OMB) responsible for issuing a report at the end of the calendar year that would trigger the sequestration to mandatory programs. Lawmakers are expected to advance the legislation (H.R. 1868), which was introduced on Friday by House Budget Chair John Yarmuth (D-Ky.), to waive and reset the PAYGO amounts and delay the 2% sequestration cuts for a period of nine months, through December 31. The House Rules Committee is scheduled to meet March 16 to set the terms for floor debate for the measure. There has historically been bipartisan support for waiving the PAYGO rules to avoid Medicare cuts, even with partisan opposition to the triggering legislation, as was the case with the GOP’s 2017 tax cut.

The House is also expected to vote this week to extend the Paycheck Protection Program (PPP) for two months beyond its current expiration on March 31. The bill (H.R. 1799) would extend the program’s funding authorization through June 30 and require the Small Business Administration (SBA) to spend the final 30 days completing applications that were submitted prior to June 1. The bill has been listed for floor consideration this week under suspension of the rules. The measure is expected to have Republican support. The budget reconciliation package signed into law on March 11 added $7.2 billion to the program, for a total lending authority of $813.7 billion. About $120 billion remained in the program as of March 7.

President Marks One Year of COVID With Announcements to Speed Vaccinations

President Joe Biden hosted executives from Johnson & Johnson (J&J) and Merck at the White House last week, following the announcement that the companies had reached a deal facilitated by the administration to speed production of J&J’s COVID vaccine. The agreement that will result in the production of 100 million more doses of the single-dose, easily stored J&J vaccine. According to the administration, this doubling of the country’s order will help build a stockpile larger than the U.S. population, which could support the eventual vaccination of people under the age of 16 or any unexpected needs for doses as new variants of the virus emerge. The new J&J doses will be available in the second half of the year.

The President also addressed the nation for the first time since his inauguration on Thursday evening to mark the one- year anniversary of the start of the pandemic. During his speech, the President announced that he will direct states to make all U.S. adults eligible for vaccinations by May 1, and that his administration would reach its goal of 100 millions shots during the first 100 days of his presidency by his 60th day in office. He also announced that the administration will start distributing vaccines to an additional 700 community health centers and will double the number of retail pharmacies receiving shots from the federal government. The administration will also double the number of mass-vaccination sites and has moved to authorize dentists, EMTs, paramedics, veterinarians, medical students, and other health professionals to administer shots through an expanded liability shield under the Public Readiness and Emergency Preparedness (PREP) Act of 2005.

The President previously said that he expects to have enough vaccine available by the end of May to vaccinate all U.S. adults, although more time will be necessary to administer the shots. The federal government plans to launch websites and a call center to help Americans locate available vaccination appointments by May 1. During his address, the President offered the Fourth of July as a goal for the nation to begin returning to normalcy.

Sen. Roy Blunt Announces Plans to Retire

Sen. Roy Blunt (R-Mo.) announced that he does not plan to run for reelection next year. Sen. Blunt is the no. 4 Senate Republican leader who has spent 24 years in the House of Representatives and Senate combined. For the past six years he has been the top Republican on the Labor, Health and Human Services, and Education Appropriations Subcommittee, where he has been a strong advocate for strengthening research funding at the National Institutes of Health (NIH); federal spending on biomedical research has increased 42.7% since 2015. Senate Minority Leader Mitch McConnell (R-Ky.) called Blunt’s decision to retire “a loss for the Republican conference and the entire Senate.” Blunt joins Republican Sens. Richard Burr (N.C.), Rob Portman (Ohio), Richard Shelby (Ala.) and Patrick Toomey (Pa.) who already have said they will not seek another term.

Senate Expected to Advance HHS Nominees

The Senate voted to discharge the nomination of California Attorney General Xavier Becerra to be Secretary of Health and Human Services on Thursday by a vote of 51-48. The Senate Finance Committee deadlocked on Becerra’s nomination along party lines earlier this month, necessitating the procedural vote. Sen. Susan Collins (R-Maine) joined Democrats in voting to bring the nomination for a vote. Collins stated that she received assurances from Becerra that he would work with her on drug pricing legislation. During his confirmation hearings, Republican panel members raised concerns about Becerra’s stance on abortion and his qualifications to lead the large health department.

The Senate Health, Education, Labor, and Pensions (HELP) Committee will hold a March 17 vote on the nominations of Vivek Murthy to serve as Surgeon General and Rachel Levine to serve as Assistant Secretary of Health and Human Services. Both individuals are expected to be confirmed in the coming weeks.

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