POLICY BRIEFINGS


House Passes Another COVID Relief Bill Without GOP Support


The House of Representatives has passed another coronavirus stimulus bill without full support of Republican lawmakers. The $2.2 trillion measure, a reduction from the $3.4 trillion bill passed by the House in May, was intended to be a compromise deal, but it was unable to garner any bipartisan support. It would restore the $600 per week increase in jobless benefits, provide another round of direct stimulus checks to Americans, and provide $436 billion in funding for state and local governments. It also includes $75 billion for COVID testing, contact tracing, and isolation measures, $50 billion for the Provider Relief Fund, and $20 billion for the Biomedical Advanced Research and Development Authority (BARDA) for the development and procurement of vaccines and therapeutics. The Centers for Disease Control and Prevention (CDC) would receive $7 billion for its vaccination campaign and $1 billion for a vaccination public awareness campaign. It includes $3.5 billion for the Substance Abuse and Prevention Treatment block grant, $4 billion for the Mental Health Services block grant, and $50 million for suicide prevention. The bill would allow uninsured Americans to sign up for coverage on the Affordable Care Act (ACA) marketplace during a two-month special enrollment period, and unemployed Americans would qualify for enhanced subsidies to purchase coverage. States would also receive money to increase their ACA outreach and enrollment. The bill instructs insurers to cover COVID-19 tests for anyone who wants one.

The legislation passed by a vote of 214-207, with 17 Democrats joining Republicans in voting no. House Speaker Nancy Pelosi (D-Calif.) and Treasury Secretary Steven Mnuchin continue to negotiate a bipartisan deal but have yet to reach a breakthrough. The two sides remain at odds about the expansion of the earned income and child tax credits and the paring back of net operating loss (NOL) provisions passed by Congress in March, both of which Democrats support but Republicans oppose. Republicans also oppose the scale of proposed aid to state and local authorities, while President Trump over the weekend tweeted his support for a new package noting that saying the country “wants and needs” fiscal stimulus. Pelosi is facing pressure from the centrist wing of her party, with two dozen Democrats urging her to accept the White House’s offer of a $1.6 trillion bill. Democratic leaders have said the chamber will remain on-call in October should a compromise be reached.


Candidates Spar at First Presidential Debate


The first presidential debate between President Donald Trump and former Vice President Joe Biden took place last week. The two sparred on a number of health care related issues, including COVID-19 and the president’s response to the pandemic and the impact that the President’s Supreme Court Justice nominee Amy Coney Barrett could have on the future of the Affordable Care Act. The next Presidential debate is scheduled for October 15th, while the Vice-Presidential debate will take place on October 7th.


Lawmakers Consider Supreme Court Nominee’s Record Ahead of Confirmation Hearing


The President’s nominee to the Supreme Court Amy Coney Barrett began meeting with members of the Senate last week. While she has not participated in any cases that dealt with the Affordable Care Act (ACA), Barrett’s academic writing and other public actions indicate disagreement with past Supreme Court decisions to uphold the 2010 health care law. She has opposed the law’s provisions dealing with birth control and has criticized Chief Justice John Roberts’ majority opinion in upholding the law for pushing the ACA “beyond its plausible meaning to save the statute.” The Supreme Court is scheduled to hear oral arguments a week after the November elections in a case challenging the law’s constitutionality. Barrett could participate in the case if she is confirmed in time for oral arguments. During her time as an appeals judge, she has not participated in any cases involving the question of severability – or whether a law can stand if parts of it are struck down, and her writings do not indicate where she would stand on the issue. The current lawsuit centers on the constitutionality of the ACA’s individual mandate. The mandate’s penalty was zeroed out by Congress, which a collection of Republican-led states are arguing make the mandate unconstitutional since it can no longer be considered a tax. It remains unclear which parts of the law, such as Medicaid expansion or provisions which support the transition from Medicare fee-for-service to value-based care – would survive if the ACA is found to be unconstitutional by the Supreme Court. The 2010 health care law created the Medicare Shared Savings Program (MSSP), funded the Center for Medicare and Medicaid Innovation (CMMI), and established a pathway for the approval of biosimilars, among other things.


Senate Leaders Spar on Health Care Bill


The Senate blocked legislation last week that would prohibit the Department of Justice (DOJ) from supporting a legal challenge to the Affordable Care Act (ACA) by a vote of 51-43. The vote on S. 4653 was forced by Minority Leader Chuck Schumer (D-N.Y.). Republican senators Susan Collins (Maine), Joni Ernst (Iowa), Cory Gardner (Colo.), Martha McSally (Ariz.), Dan Sullivan (Alaska), and Lisa Murkowski (Alaska) joined Senate Democrats in support of the measure. The Supreme Court is scheduled to hear a Trump administration-backed lawsuit against the 2010 health care law shortly following the November 3 elections.

In a move to counter Schumer’s attempt to make health care a focus in the weeks leading up to the election, Majority Leader Mitch McConnell (R-Ky.) called a vote on Sen. Thom Tillis’ (R-N.C.) legislation to guarantee that individuals with pre-existing conditions can obtain health coverage even if the ACA is overturned in court. The bill, however, would have permitted the use of lifetime caps by insurers. The measure stalled following a 47-47 vote, with Republican Sens. Ted Cruz (Texas), Rand Paul (Ky.), and Mike Lee (Utah) breaking ranks to vote against it.


Lawmakers Probe Private Equity Receipt of COVID Funds


Reps. Katie Porter (D-Calif.), Bill Pascrell (D-N.J.), and Rosa DeLauro (D-Conn.) sent a letter to U.S. Department of Health and Human Services (HHS) Secretary Alex Azar requesting information regarding coronavirus relief payments made to private equity-backed health care companies. The lawmakers ask for details on how the relief loans have been allocated and which providers have been denied aid. They also seek a breakdown of funding by provider type and ownership. The letter expresses concern that smaller hospitals may be at a disadvantage, arguing that “it is egregious that HHS has prioritized money for private equity-owned hospitals with no transparency and seemingly no regard for hospitals that do not have financial support from Wall Street.”


W&M Leaders Request More Info on Planned Drug Discount Cards


Reps. Bill Pascrell (D-N.J.) and Lloyd Doggett (D-Texas) are asking U.S. Department of Health and Human Services (HHS) Secretary Alex Azar for more details about the Trump administration’s plan to send prescription drug discount cards to seniors in the coming weeks. “It appears that the Trump Administration may seek to rely on existing waiver authority and claim imaginary ‘savings’ from a separate plan that has not even gone into effect yet,” the letter states. “In reality, and in keeping with past dubious actions by this administration to try and abuse taxpayer money, senior citizens and taxpayers will likely be left on the hook to pay for this scam, should it ever be effectuated,” Pascrell and Doggett write.



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