HEALTH CARE BRIEFING: Home Health Groups Look to Revive Agenda

Activists for home health care are asking Democrats to follow through on promises to expand access to the services increasingly in demand as the US population ages.

A coalition of labor unions, disability rights groups, and others have been advocating for legislation to strengthen in-home care for the elderly and disabled, while increasing caregivers’ wages and unionizing opportunities.

Their calls have taken on new urgency as states face a March 31 deadline to apply for money from a pandemic-era program that sought to lay the groundwork to expand Medicaid’s home care offerings.

The House-passed sweeping domestic spending package (HR 5376) included $150 billion for states to improve and expand their home and community-based care programs. But the package has been in limbo in the Senate, awaiting agreement from Sen. Joe Manchin (DW.Va.).

“It’s just a backwards slide for people who need help,” said Lynn Weidner, who works in home care in Allentown, Pa., speaking about the lack of action in Congress. Weidner advocates for expanding home care services. Read more from Alex Ruoff.

Senate to Take Step on Covid Funding

The Senate will meet today and vote on whether to cut off debate on a motion to proceed to legislation (HR 4373) that Democrats want to use as a vehicle for providing more pandemic aid, Nancy Ognanovich reports.

President Biden Wednesday called on Congress to authorize a new round of funding for Covid drugs and vaccines, ratcheting up warnings that US stockpiles are running dry.

Negotiations continued in Congress, after an effort to include all or part of Biden’s $22.5 billion request in an omnibus government spending measure collapsed. “We’re not yet at the finish line, but we will keep working,” Senate Majority Leader Chuck Schumer (DN.Y.) said on Wednesday. Sen. Mitt Romney (R-Utah), who is involved in the talks, said Democrats proposed a new list of offsets. “Their list and our list are different. So we’re going to work through the differences and see if we can reach a meeting of the minds,” Romney said. “We may or may not.”

Biden’s administration has previously pushed back against demands for offsets as part of the new funding package, saying it should be emergency funding and “not something where it would require offsets.” But Biden’s remarks Wednesday made no such push, and a spokesperson said that the White House is deferring to Congress on the details in getting a deal done.

“Just as we’ve reached the critical turning point in this fight, Congress has to provide the funding America needs to continue to fight Covid-19,” Biden said Wednesday.

Biden also unveiled a new website where Americans can find recommendations for mitigating Covid-19 risks that are specific to their area. COVID.gov will offer local guidance for mask-wearing, and tips on where to find free masks, vaccines, tests and antiviral treatments. Read more from Jordan Fabian and Josh Wingrove.

Biden Expected to Lift Pandemic Immigration Restriction: The Biden administration is expected to soon lift a pandemic-related policy allowing authorities to expel most migrants crossing US borders, according to a person familiar with the planning. The policy change is likely to be announced by the Centers for Disease Control and Prevention by week’s end and implemented by the end of May, the person said. As a result, the number of people trying to cross into the US from Mexico is expected to surge, posing both humanitarian and political concerns. Read more from Jordan Fabian.

More on the pandemic:

So happening on the hill

House Takes Up Insulin Bill: The House will vote today on a bill to cap what people pay with insurance for a month’s supply of insulin. The insulin measure (HR 6833) would cap cost-sharing under private health insurance and Medicare for a month’s supply of selected insulin products at $35 or 25% of a plan’s negotiated price, whichever is less, starting in 2023. To offset the cost, Democrats are advancing a modified version that would delay a Trump-era regulation aimed at limiting drug rebates in Medicare that never took effect. That regulation costs money to implement, so any delay would generate savings for the government. The House bill hasn’t garnered any Republican cosponsors, while senators are still trying to find bipartisan agreement on tackling insulin prices.

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Medicare Sequestration Deadline Up Amid Pandemic: Congress will allow the return of the Medicare sequester, starting with a 1% cut in payments effective tomorrow, two senior Democratic aides told Bloomberg Government, Alex Ruoff reports.

Lobbying organizations for hospitals and physicians have been pressing lawmakers for months to again avert the return of the sequester but there’s little sign of support for such a move this week, one senior Democratic aide said. The sequester has been postponed throughout the Covid-19 pandemic as a way to help struggling hospitals and doctors offices. The American Hospital Association estimated hospitals will lose $3 billion by the end of the year due to the 1% reduction in payments that starts April 1, which will grow to 2% starting July 1.

nominations: Senators yesterday in a 54-44 vote confirmed January Contreras to be assistant secretary for family support at the Department of Health and Human Services.

  • The Senate also advanced to the floor the nomination of Alvaro Bedoya as a commissioner to the FTC Wednesday, which had been blocked by Republicans in the Senate Commerce, Science, and Transportation Committee for months. VP Kamala Harris break the tie Brody Ford has more.

House GOP Attacks Unions’ Role in School Covid Guidance: With the pandemic ebbing, the Biden administration shared its school reopening guidance with a national teachers’ union, resulting in key portions of it changing, a House Republican panel claims in a new report. The report, published Wednesday, claims that US Centers for Disease Control and Prevention Director Rochelle Walensky shared the draft guidance with the American Federation of Teachers. After sharing that, the union pressed Walensky to clarify in the guidance that schools should close automatically if Covid positivity rates hit a certain threshold. Read more from Paige Smith.

Marijuana Legalization Bill Is Set for House Vote: The House is poised to in the coming days to vote on a bill to federally decriminalize marijuana, expunge convictions, and levy a tax on sales as Senate Democrats craft their own version of a comprehensive bill. The House is expected to pass its bill, a version of which made it through the chamber in 2020 but didn’t get Senate action. But this time, Democrats hold the narrowest of Senate majorities and Schumer plans to introduce his own legalization bill in April. Read more from Jarrell Dillard.

Wyden Probes Insurers Over Mental Health Care Gaps: Health insurance executives should be held accountable for falling short of insurers’ requirements to cover mental health care, the head of the Senate Finance Committee said Wednesday. Sen. Ron Wyden (D-Ore.) said too many Americans can’t access the mental health providers they want to see, and often are unfairly denied coverage in spite of federal laws in place for over a decade that require insurers to cover mental health as on par with physical health. Read more from Alex Ruoff.

FDA Delay on Device User Fee Deal Scrutinized: House leaders Wednesday blasted the FDA for its delayed agreement with device makers on the fees they pay to the agency, arguing that a lag in the process threatened Congress’ ability to reauthorize programs meant to bring Americans lifesaving products. Members on the House Energy and Commerce Committee’s health panel questioned Jeff Shuren, director of the FDA’s Center for Devices and Radiological Health, on why the FDA went months past a deadline to send its proposal for the next user fee amendments to Congress. Celine Castronuovo has more.

Biden’s Budget Request—BGOV Webinar: Biden released his fiscal 2023 budget request this week, calling for $5.8 trillion in federal spending and a $1.2 trillion deficit. The Bloomberg Government legislative analyst team held a webinar to discuss the budget’s key proposals on spending and revenue, economic assumptions, agency highlights, and next steps in Congress. The president’s budget includes $1.6 trillion in discretionary spending, funding boosts for nearly every agency, and tax bumps for corporations and wealthy households. Find BGOV’s breakdown of the administration’s request here.

What Else to Know Today

Restraints on Abortion Pill Access Tee Up New Fight: State efforts to ban medications that terminate a pregnancy are likely to be the next big legal fight on abortion regardless of what the US Supreme Court decides to do with Roe v. calf. Alabama, Mississippi, Kansas, and 16 others now have laws requiring a clinician to be physically present when abortion-inducing drugs are administered, according to the Guttmacher Institute, a research group that supports abortion rights. These laws prohibit drugs like mifepristone from being prescribed through a telehealth appointment. Lydia Wheeler has more.

IRS Guidance to Protect ACA, Medicaid Wraps Review: The White House’s Office of Management and Budget has finished reviewing Internal Revenue Service guidance that would review all regulatory actions to ensure they are consistent with “the policy to protect and strengthen” the Affordable Care Act. The guidance, which was sent to OMB for review by the IRS March 11, can now be published at any time. Biden in 2021 called for a review of actions to determine if they undermine protections for people with pre-existing conditions. Read more from Sara Hansard.

Biogen to Begin Screening Patients for Aduhelm: Biogen will begin screening patients in May for a four-year study aimed at confirming the effectiveness of Aduhelm, the company’s controversial Alzheimer’s medicine. The drugmaker submitted a final protocol for the global trial to the US Food and Drug Administration and intends to enroll about 1,500 patients, according to a statement Wednesday. Both Biogen and the FDA have been criticized since the regulator gave expedited approval to Aduhelm, despite conflicting results from studies and objections from outside agency advisers. Read more from John Lauerman.

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With assistance from Alex Ruoff other Nancy Ognanovich

To contact the reporter on this story: Brandon Lee in Washington at blee@bgov.com

To contact the editors responsible for this story: Giuseppe Macri at gmacri@bgov.com; Michael Ross at mross@bgov.com

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