POLICY BRIEFINGS

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.


THIS WEEK'S BRIEFING - JULY 25, 2022

HHS Renews COVID-19 PHE/House to Consider Telehealth Extensions


U.S. Department of Health and Human Services (HHS) Secretary Xavier Becerra has renewed the COVID-19 public health emergency (PHE) through October 13. In addition to ensuring free COVID-19 vaccines, therapeutics, and testing, the PHE declaration provides added flexibility for the provision of telehealth and Medicaid enrollment. HHS has committed to giving 60-days’ notice before allowing the PHE declaration to expire.

The House of Representatives is scheduled to consider the Advancing Telehealth Beyond COVID-19 Act (H.R. 4040) this week. The bill would further expand telehealth flexibilities beyond the COVID-19 PHE and includes measures to remove geographic requirements, expand originating sites of telehealth services, allow for the furnishing of audio-only telehealth services, and permit telehealth face-to-face hospice recertification encounters. Congress previously passed legislation to extend such authorities for 151 days after the PHE expires. The legislation is offset by reducing funds in the Medicare Improvement Fund.


President, Lawmakers Test Positive for COVID-19


President Joe Biden tested positive for COVID-19 on Thursday. The President was experiencing mild symptoms and is being treated with Pfizer Inc.’s Paxlovid. According to White House physician Kevin O’Conner, he is responding to the therapy as expected. Preliminary sequencing results indicated that Biden was probably infected with the BA.5 variant that is currently prevalent in the U.S. He has been isolating at the White House and maintaining a virtual work schedule. Biden is fully vaccinated and has received two booster shots.

Several lawmakers also announced that they tested positive for COVID-19 in breakthrough cases of the virus last week, including Sen. Tom Carper (D-Del.) and Sen. Tina Smith (D-Minn.). Rep. Bennie Thompson (D-Miss.), chair of the House Select Committee investigating the January 6 riot at the Capitol, also announced that he has tested positive for COVID-19. The lawmakers were experiencing mild symptoms and planned to isolate.


House to Vote on Health Legislation This Week


Several health-related pieces of legislation have been placed on the House of Representative’s calendar for this week, including the Medical Marijuana and Cannabidiol Research Expansion Act (H.R. 8454), the Gabriella Miller Kids First Research Act 2.0 (H.R. 623), and the South Asian Heart Health Awareness and Research Act of 2022 (H.R. 3771), in addition to the Advancing Telehealth Beyond COVID-19 Act (discussed above). The House is currently scheduled to adjourn for August recess at the end of this week, while the Senate is scheduled to be in session until August 5. However, House Speaker Pelosi (D-Calif.) previously extended the ability for House members to vote remotely through August 12 – a nod that the House could be called back for votes as necessary.


Six-Bill Minibus Advanced by House


The House of Representatives passed six of the 12 annual appropriations bills last week. The package (H.R. 8294) – which included Agriculture-Food and Drug Administration, Energy-Water, Financial Services, Interior-Environment, Military Construction-VA, and Transportation-Housing and Urban Development programs—passed by a 220-207 party-line vote. It totals just over $400 billion, one-fourth of the discretionary funds for fiscal year (FY) 2023. Republican lawmakers expressed opposition to the overall funding levels and the omission of certain policy riders. It remains unclear whether the six remaining FY 2023 spending bills can be advanced before the congressional August recess. Majority Leader Steny Hoyer (D-Md.) has suggested that the Commerce-Justice-Science, Labor-Health and Human Services- Education, and State-Foreign Operations have the most potential for movement, but they are not on the House calendar for consideration this week. While Senate appropriators are expected to release their spending bills before the recess, no mark ups have been scheduled, increasing the likelihood of lawmakers relying on a continuing resolution to fund the federal government beyond the end of the fiscal year on September 30.


House Passes Bill Codifying Access to Contraception


The House of Representatives passed legislation (H.R. 8373) to codify access to contraceptives last week. Eight Republicans voted in support of the measure. The vote was a part of a series of bills put forth by Democratic leadership to put lawmakers on the record on issues related to pregnancy and abortion following the Supreme Court’s overturning of Roe v. Wade. Many Republicans criticized the legislation for being overly broad, making Senate passage of the bill unlikely. Sens. Tim Kaine (D-Va.) and Susan Collins (R-Maine), however, are working to draft legislation to codify the right to contraception as secured by Griswold v. Connecticut.


CBO Releases ACA Subsidy, UFA Estimates


The Congressional Budget Office (CBO) has released its projections for several measures currently being debated on Capitol Hill. CBO estimates that permanently extending enhanced Affordable Care Act (ACA) subsidies will cost an average of $25 billion per year. The subsidies are set to expire this year if Congress does not act to extend them. Democrats have proposed including a two-year extension in the current reconciliation package being negotiated by Senate Majority Leader Chuck Schumer (D-N.Y.) and Sen. Joe Manchin (D-W.Va.). CBO predicts that making the expanded subsidies permanent would increase the federal deficit by $247.9 billion over the next decade and result in 4.8 million new enrollees in the marketplace. Approximately 2.2 million fewer people would be uninsured each year, compared to the current law. Permanently extending the enhanced ACA plan subsidies would also increase enrollment in both Medicaid and the Children’s Health Insurance Program by a combined 200,000 each year and result in a 2.3 million decrease in enrollment in employer-based coverage. CBO also released its projections for the FDA Safety and Landmark Advancements (FDASLA) Act (S. 4348) to reauthorize medical product user fee programs at the Food and Drug Administration. The agency estimates that the bill, as reported out of committee, would save $1.4 billion over the next decade.


Lawmakers Debate R&D Tax Break in Scaled-Back USICA


The bipartisan group of lawmakers working to negotiate a scaled-back version of the U.S. Innovation and Competition Act (USICA) are considering the addition of a one-year extension of a tax break for corporate research and development costs that expired at the end of 2021. The provision would allow companies to deduct research expenses in the year they are incurred rather than a multi-annual period – five years for domestic expenses and 15 years for foreign costs. The measure is valued at an estimated $2 billion. Sens. Mark Warner (D-Va.), Jon Tester (D-Va.), and Shelley Moore Capito (R-W.Va.) are on the record in support of the addition. Sen. Todd Young (R-Ind.), who is the Republican lead on negotiations, is also pushing to include a provision to establish a directorate for technology and innovation within the National Science Foundation. Conference negotiations have been ongoing for months as lawmakers work to reconcile the differences between the House- and Senate-passed versions of the China competition bill.


Senate Panel Examines Implementation of VA’s New EHR System


During a hearing before the Senate Veterans’ Affairs (VA) Committee last week, lawmakers committed to additional oversight of the VA’s new electronic health records system being implemented by its contractor Oracle. The VA signed a deal with Cerner to implement the modernized records management system in 2018, and Oracle bought Cerner last month. The cost of the system, which is in place at just five of the VA’s 171 medical centers, has increased from $10 billion over 10 years to $50.8 billion over 28 years. Lawmakers expressed concern with the ballooning total cost of the project and the VA’s failure to mitigate lost productivity caused by the system’s rollout. A report from the VA’s inspector general found 60 safety issues at the medical center where the system was first rolled out by Cerner. Deputy Inspector General David Case testified that Oracle has not explained how it would fix the current problems and move the rollout forward.



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