Health Care Checkup: January 28, 2022

Health Care Checkup

January 28, 2022

THE BIG PICTURE

Justice Stephen Breyer plans to retire from the Supreme Court, after serving for more than 27 years, at the end of the Court’s current term later this year. Breyer formally announced his retirement alongside President Joe Biden at the White House on Thursday. Breyer’s announcement will enable President Biden to nominate his replacement, which he said he will do by the end of February. During his Presidential campaign, Biden pledged to nominate a black woman to the Court and early speculation has focused on a handful of candidates including D.C. Circuit Judge Ketanji Brown Jackson, California Supreme Court Justice Leondra Kruger, and South Carolina U.S. District Court Judge J. Michelle Childs. Senate Majority Leader Schumer (D-NY) reportedly has indicated that he hopes to move expeditiously, as Republicans did when they confirmed Justice Amy Coney Barrett in just over one month after Justice Ruth Bader Ginsburg died in 2020. We do expect discussions among Democrats in the Senate on other matters, including the “Build Back Better” legislation, government funding, and China competitiveness issues to continue simultaneously.

A new report issued by the Government Accountability Office (GAO) found “persistent deficiencies in HHS’s preparedness and response efforts” to the COVID-19 pandemic, as well as in other public health emergencies. Specifically, GAO found that HHS has struggled with establishing clear roles and responsibilities for key partners, collecting and analyzing data, providing consistent communication, establishing transparency and accountability, and understanding its partners’ capabilities and limitations.

Senate Health, Education, Labor, and Pensions (HELP) Committee Chair, Senator Patty Murray (D-WA), and Ranking Member, Senator Richard Burr (R-NC), released a discussion draft of the Prepare for and Respond to Existing Viruses, Emerging New Threats, and Pandemics Act. They are accepting feedback on the draft by February 4, 2022. The legislation is aimed at strengthening U.S. public health response systems in light of the coronavirus pandemic. The Senators said that the ongoing pandemic has “put a harsh spotlight” on some of the many challenges the nation’s public health system faces, including “broken supply chains and inadequate stockpiles.” The new legislation focuses on improving these challenges, including improving coordination among public health preparedness agencies, strengthening the supply chain, and improving public health messaging. A section-by-section summary of the legislation is available here and the legislative text is available here.

House Representatives Bill Pascrell (D-NJ-09) and Scott Peters (D-CA-52) wrote a letter to President Joe Biden, urging his Administration to provide Medicare beneficiaries with full reimbursement for at-home COVID-19 tests. In mid-January the Biden Administration began requiring commercial insurers to cover the cost of over-the-counter, at-home COVID-19 tests. Pascrell and Peters urged the Administration to take “immediate action to ensure that those covered by Medicare have the same ready, cost-free access to COVID-19 diagnostic tests.” The full letter can be found here.

CMS announced that it will begin posting staff turnover rates and weekend staff levels for nursing homes on its Medicare.gov Care Compare website. Beginning in July, this information will be included in the Nursing Home Five Star Quality Rating System, which consumers can use to help compare nursing homes. The announcement from CMS can be found here.

What to Expect Next Week: Next week, both the House and Senate will be in session and will hold a slew of health-related hearings. On Tuesday, the Senate HELP Committee will hold a hearing titled, “Mental Health and Substance Use Disorders: Responding to the Growing Crisis.” Also on Tuesday, the Senate Commerce, Science and Transportation Committee will hold a hearing titled, "Stopping COVID-19 Fraud and Price Gouging." On Wednesday, the House Ways and Means Committee will hold a hearing on “America’s Mental Health Crisis.” On Thursday, the House Energy and Commerce Subcommittee on Health will hold a hearing titled, "FDA User Fee Reauthorization: Ensuring Safe and Effective Drugs and Biologics."

DEEP DIVE

Justice Stephen Breyer Announces Retirement from Supreme Court

Justice Stephen Breyer plans to retire from the Supreme Court, after serving for more than 27 years, at the end of the Court’s current term later this year. Breyer formally announced his retirement alongside President Joe Biden at the White House on Thursday. Breyer’s announcement will enable President Biden to nominate his replacement, which he said he will do by the end of February. During his Presidential campaign, Biden pledged to nominate a black woman to the Court and early speculation has focused on a handful of candidates including D.C. Circuit Judge Ketanji Brown Jackson, California Supreme Court Justice Leondra Kruger, and South Carolina U.S. District Court Judge J. Michelle Childs. The direct impact of Justice Breyer’s retirement on health care policy is still unknown, as President Biden has not yet announced his replacement. Senate Majority Leader Schumer (D-NY) reportedly has indicated that he hopes to move expeditiously, as Republicans did when they confirmed Justice Amy Coney Barrett in just over one month after Justice Ruth Bader Ginsburg died in 2020. We do expect discussions among Democrats in the Senate on other matters, including the “Build Back Better” legislation, government funding, and China competitiveness issues to continue simultaneously.

HHS to Distribute Additional $2 Billion in Provider Relief Fund Payments

The Department of Health and Human Services (HHS) announced that it will release $2 billion in Provider Relief Fund (PRF) Phase 4 payments to more than 7,600 providers who have been negatively impacted by the COVID-19 pandemic. Provider relief payments have been distributed throughout the pandemic to help health care providers prevent and respond to the virus. In response to the additional funds being disbursed, HHS Secretary Xavier Becerra said, “Provider Relief Fund payments have served as a lifeline for our nation’s heroic health care providers throughout the pandemic, helping them to continue to recruit and retain staff and deliver care to their communities.” Additional information can be found here.

CMS Announces 14.5M Americans Have Signed Up for ACA Health Coverage During “Historic” Open Enrollment Period

On Thursday, the Centers for Medicare and Medicaid Services (CMS) announced that a “record-breaking” 14.5 million people signed up for Marketplace health coverage during the 2022 open enrollment period (OEP), which includes 5.8 million new enrollees. The OEP ran from November 1, 2021 through January 15, 2022. 10.3 million people enrolled through HealthCare.gov and 4.2 million people enrolled through State-based Marketplaces. HealthCare.gov consumers saw their monthly premium decrease by an average of 23% compared to the 2021 enrollment period. CMS attributes this decrease from subsidies provided by the American Rescue Plan. More information can be found here.

Members of Congress Urge Medicare to Cover At-Home COVID-19 Tests

GAO Says Oversight of COVID-19 Relief Funds and Responses to Public Health Emergencies are in Need of “Significant Improvements”

Democrats Remain Optimistic that Build Back Better Legislation Will Move Forward

Despite the bumpy road that the Build Back Better (BBB) social spending bill has encountered in the Senate so far, top Democrats expressed optimism this week that most of the provisions in the House-passed version of the BBB bill will pass the Senate. House Majority Leader Steny Hoyer (D-MD) said on Tuesday that he predicts the legislation will be passed and signed into law before the midterm elections. He said, “I’m of the belief that Build Back Better is going to pass. It won’t pass as we sent it to the Senate, obviously. It will be changed, but that’s the legislative process.” Senate Finance Chairman Ron Wyden (D-OR) also expressed optimism on Tuesday and told reporters that, “The reality is there is a lot of common ground right now.” Wyden said that most Democrats agree upon expanding health care, allowing Medicare to negotiate drug prices with drug manufacturers, and providing tax incentives for clean energy. Senator Joe Manchin (D-WV), a pivotal vote, has cited rising inflation rates as the reason that he will not support BBB, but Senator Wyden said that Democrats are working to take Manchin’s concerns into account in reshaping the legislation.

Senators Murray and Burr Release Draft of Bipartisan Public Health Preparedness and Response Bill

On Tuesday, Senate Health, Education, Labor, and Pensions (HELP) Committee Chair, Senator Patty Murray (D-WA), and Ranking Member, Senator Richard Burr (R-NC), released a discussion draft of the Prepare for and Respond to Existing Viruses, Emerging New Threats, and Pandemics Act. The legislation is aimed at strengthening U.S. public health response systems in light of the coronavirus pandemic. The Senators said that the ongoing pandemic has “put a harsh spotlight” on some of the many challenges the nation’s public health system faces, including “broken supply chains and inadequate stockpiles.” The new legislation focuses on improving these challenges, including improving coordination among public health preparedness agencies, strengthening the supply chain, and improving public health messaging. A section-by-section summary of the legislation is available here and the legislative text is available here.

Departments of Labor, HHS, and Treasury Issue Report to Congress on Mental Health Parity and Addiction Equity Act

The Departments of Labor, Health and Human Services and the Treasury issued a report to Congress on the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA). The MHPAEA requires that the Secretary of Labor submit a report to Congress every two years to evaluate how well group health plans are adhering to the requirements of the legislation. The 2022 report found that health insurance plans are failing to ensure parity for mental health and substance-use disorder benefits. An example HHS cited is that a “health insurance issuer covered nutritional counseling for medical conditions like diabetes, but not for mental health conditions such as anorexia nervosa, bulimia nervosa and binge-eating disorder.” In response to the report, Labor Secretary Marty Walsh said, “The report's findings clearly indicate that health plans and insurance companies are falling short of providing parity in mental health and substance-use disorder benefits, at a time when those benefits are needed like never before.” The report made recommendations on how to improve compliance of the MHPAEA, which include enhancing enforcement and ensuring coverage of benefits for beneficiaries. Find more here.

CMS Announces that it will Begin Posting Nursing Home Staff Turnover Rates and Weekend Staff Levels on its “Care Compare” Website

On Wednesday, CMS announced that it will begin posting staff turnover rates and weekend staff levels for nursing homes on its Medicare.gov Care Compare website. Beginning in July, this information will be included in the Nursing Home Five Star Quality Rating System, which consumers can use to help compare nursing homes. Under these new requirements, nursing homes will have to report the number of administrators who stopped working at the nursing home in the past year, as well as the percentage of registered nurses who left. Nursing homes will also have to report the weekend staffing levels for registered nurses, licensed practical and vocational nurses, and certified nurse aides. The announcement from CMS can be found here.