Health Care Checkup: September 17, 2021

Health Care Checkup

September 17, 2021

THE BIG PICTURE

The E&C Committee also approved further measures that would make the Children’s Health Insurance Program (CHIP) permanent and that would extend Medicaid postpartum coverage from 60 days to one year. Additionally, the E&C Committee authorized a plan that would invest $190 billion into home and community-based services (HCBS). Also on Wednesday, the Ways and Means (W&M) Committee approved legislation that would make temporary enhanced ACA tax credits permanent and that would extend the child tax credit until 2025. Late last week, the W&M Committee also authorized the first part of its bill, which would add hearing, vision, and dental coverage to Medicare. The E&C Committee also approved these Medicare coverage provisions.

House Democrats are aiming to include drug-pricing language in the Build Back Better Act that would allow Medicare to negotiate the prices of prescription drugs. However, Representatives Kurt Schrader (D-OR), Kathleen Rice (D-NY), and Scott Peters (D-CA) declared that they will not support such a measure and instead introduced their own bill, which is narrower in scope and only allows Medicare to negotiate the drugs in Medicare Part B. On Wednesday, all three Representatives voted against the E&C Committee’s drug-pricing proposal, leaving the measure in a tie of 29-29. However, the drug-pricing legislation did advance in the W&M Committee with a vote of 24-19. Meanwhile, the Pharmaceutical Research and Manufacturers of America (PhRMA) wrote an open letter on Wednesday, stating that the drug-pricing proposals would “sacrifice future medical advances” and that the pharmaceutical industry’s ability to innovate is “under attack.”

The U.S. Food and Drug Administration’s (FDA) vaccine advisory panel met Friday to discuss Pfizer’s application for administration of a third “booster” dose of its COVID-19 vaccine. The panel voted 16-2 to reject Pfizer's proposal to offer a third dose of its COVID vaccine to vaccinated individuals 16 and older. However, the panelists are debating whether a third dose is indicated for older adults and vulnerable populations. The Biden Administration had originally planned to begin offering booster shots to vaccinated adults next week. However, given the FDA panel's vote, that timeline is uncertain.

What to Expect Next Week: Next week, the House is expected to take action to fund the government through a continuing resolution, address the debt ceiling, consider the National Defense Authorization Act, and consider H.R. 3755, the Women’s Health Protection Act. There will also be several health-related Congressional hearings. On Wednesday, the House Energy and Commerce Subcommittee on Oversight and Investigations will hold a hearing titled, "Putting Kids First: Addressing COVID-19's Impacts on Children." On Thursday, the Senate Special Committee on Aging will hold a hearing titled, "Frauds, Scams and COVID-19: How Con Artists Have Targeted Older Americans During the Pandemic."

DEEP DIVE

House Committees Continue Build Back Better Markup

This week, House committees continued to mark up their individual portions of the $3.5 trillion Build Back Better Act. On Wednesday, the House Energy and Commerce (E&C) Committee voted 30-27 to advance legislation that would create a federally run Medicaid program. The program is intended to provide Medicaid coverage to residents in states that have not expanded their Medicaid programs under the Affordable Care Act (ACA). The proposal would expand Medicaid eligibility in states that have not yet done so by expanding the ACA’s premium tax credits to people who made below 100% of the federal poverty level from 2022 through 2024. Then, the proposal would develop a federal Medicaid program to serve those people beginning in 2025. The E&C Committee also approved further measures that would make the Children’s Health Insurance Program (CHIP) permanent and that would extend Medicaid postpartum coverage from 60 days to one year. Additionally, the E&C Committee authorized a plan that would invest $190 billion into home and community-based services (HCBS). Also on Wednesday, the Ways and Means (W&M) Committee approved legislation that would make temporary enhanced ACA tax credits permanent and that would extend the child tax credit until 2025. Late last week, the W&M Committee also authorized the first part of its bill, which would add hearing, vision, and dental coverage to Medicare. The E&C Committee also approved these Medicare coverage provisions.

Democratic Legislators Disagreement Over Rx Pricing Puts Final Details of Reconciliation Offsets in Flux

FDA Vaccine Advisory Panel Debates COVID-19 Booster Shots

HHS Announces $350 Million to Promote Maternal and Child Health

On Friday, the Department of Health and Human Services (HHS) announced approximately $350 million in awards will be disbursed among every state in the country to help improve maternal and child health. According to HHS, the funding will “expand home visiting services to families most in need, increase access to doulas, address health disparities in infant deaths, and improve data reporting on maternal mortality.” America continues to have one of the highest rates of maternal mortality in the developed world. HHS will carry out the funding through the Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Program, the Healthy Start Initiative, and the State Systems Developmental Initiative (SSDI). A list of MIECHV awardees can be found here; a list of the Healthy Start awardees can be found here; and the of the SSDI awardees can be found here.

CMS Proposes Repeal of Trump-era Medicare Device Coverage Rule

On Monday, the Centers for Medicare and Medicaid Services (CMS) issued a Notice of Proposed Rulemaking that proposes to void the Medicare Coverage of Innovative Technology (MCIT) final rule, which was slated to go into effect on December 15, 2021. The MCIT rule, which was finalized in the waning days of the Trump Administration, was created to make a new, accelerated pathway to Medicare coverage for “innovative products” that the U.S. Food and Drug Administration (FDA) deemed “breakthrough.” The Biden Administration is concerned that the rule could pose potential safety risks to Medicare beneficiaries and is looking to create a new rule that would account for those concerns. CMS Chief Medical Officer and Director of the Center for Clinical Standards and Quality Lee Fleisher said, “We believe it is important to evaluate how a device works for Medicare patients. This includes a potential decision to cover a device under Medicare in the context of collecting additional evidence before broadly covering the device in the Medicare program.” More information can be found here.

More than 70 Bipartisan House Members Ask CMS to Rescind Proposed Medicare Pay Cuts

More than 70 bipartisan House members signed off on a letter to Deputy Administrator and Director of CMS Meena Seshamani, asking that the agency not finalize the 2022 Physician Fee Schedule (PFS) Final Rule’s clinical labor policy. The lawmakers say that the proposed cuts in the 2022 Medicare PFS would have “profoundly negative effects on health equity.” The proposal would reduce reimbursement rates by up to 23% for physicians who treat patients with diseases such as cancer, end-stage renal disease, and heart disease. The lawmakers urged CMS to work with Congress to fundamentally reform the PFS. The letter can be viewed here.

SAMHSA Awards $123 Million in Grants to Fight the Nation’s Overdose Epidemic

The Substance Abuse and Mental Health Services Administration (SAMHSA) announced that it is issuing $123 million in grants to six grant programs across the nation to help combat the overdose epidemic in the country. The awards were disbursed among six grant programs: 1) the Medication Assisted Treatment for Prescription Drug and Opioid Addiction program; 2) the Tribal Opioid Response Grants; 3) the Screening, Brief, Intervention, and Referral to Treatment program; 4) the Strategic Prevention Framework for Prescription Drugs program; 5) the First Responders-Comprehensive Addiction and Recovery Act Grants program; and 6) the Providers Clinical Support System program. HHS Assistant Secretary for Mental Health and Substance Use Miriam Delphin-Rittmon said, “This funding will strengthen the full continuum of care for those battling addiction and enhance health care providers’ depth of knowledge and best practices.”