HEALTH CARE BRIEFING: House Democrats Set Up Vote on ACA Changes


By Brandon Lee

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The House will vote next week on a bill to bolster the Affordable Care Act and to let the government negotiate the price of some drugs, an election-year move by Democrats to signal their priorities on health care.

Their bill (H.R. 1425) is largely a repeat of measures that the Democratic-controlled House already passed, mostly along party lines. It would expand the Affordable Care Act’s tax credits, pressure states to expand Medicaid programs with the promise of more federal funds, and cap what any person may pay for coverage premiums at 8.5% of their income.

The cost of these measures to the government would be offset by letting federal agencies demand pharmaceutical companies lower the prices of certain drugs, as proposed in a measure (H.R. 3) opposed by nearly all Republicans last December.

House Energy and Commerce Chairman Frank Pallone (D-N.J.) added that it would extend health coverage to 4 million Americans and cut what many pay for insurance. “It’s a win-win all around,” Pallone said at a press conference.

Read more on the bill below:

  • The measure would permanently extend federal funding for the Children’s Health Insurance Program and allow states to cover children whose family incomes exceed eligibility thresholds.
  • The legislation would alter the indexing factor used to determine premium tax credits and out-of-pocket limits each year so that it’s based only on the growth in employer-based insurance premiums. The Trump administration modified the calculation in an April 2019 rule by including individual market premium growth, which increases at a faster rate.
  • The measure would prevent the administration from implementing a 2018 rule that expanded short-term plans, which aren’t subject to ACA coverage requirements such as pre-existing condition protections but are generally cheaper for healthier individuals.
  • A new “Improve Health Insurance Availability Fund” would receive $10 billion annually to help states set up reinsurance programs or provide financial assistance to enrollees in the individual market.
  • The measure would provide $200 million for states to establish insurance exchanges if they don’t have one. The ACA provided initial funding, which expired in 2015, for states to open up marketplaces where individuals and small businesses could buy insurance.

See more in the BGOV Bill Summary: Expanded H.R. 1425, ACA and Drug Changes

After a push by leaders of the House Congressional Progressive Caucus and the Congressional Hispanic Caucus, the legislation is also slated to include coverage for immigrants living in the U.S. under the Deferred Action for Childhood Arrivals program.

The heads of three House committees backed an amendment that would let DACA recipients get access to the Affordable Care Act’s insurance subsidies. Rep. Pramila Jayapal (D-Wash.) is also seeking to eliminate the waiting period for immigrants to qualify for Medicaid, according to an aide from her office.

Briefs in a lawsuit challenging the constitutionality of Obamacare—a challenge supported by the administration—are due at the Supreme Court today, giving Democrats the opportunity to draw a contrast between their legislation and the effort to overturn the health law in the middle of a pandemic.

“It wasn’t right anytime, but now it is beyond stupid,” Speaker Nancy Pelosi (D-Calif.) told reporters yesterday. The House will hold a vote on the bill June 29, Pelosi said. Read more from Alex Ruoff.

Pandemic Rages in the U.S., Spurring Quarantines and Mask Orders

The Covid-19 pandemic is tearing through the U.S. heartland, setting records for hospitalizations and forcing businesses to rethink their plans to reopen as new modeling predicts the virus will kill 180,000 Americans by October.

With the U.S. seeing one of its highest-ever increases in cases Wednesday, some states took drastic measures, imposing face mask orders and internal quarantines. The country recorded more than 34,500 new infections for a second day, rattling markets as numbers neared the peak of 36,188 set April 24, when the virus was coursing through New York.

The resurgence, coming just as the regions first hit by the pandemic start to emerge, reflects the pathogen’s inexorable spread in states that were slow to enforce lockdowns or quick to lift them. It also made clear to places where the disease was late to arrive that there are no magical escapes.

Florida and Texas each hit records for cases Wednesday, with health officials in Houston saying their infrastructure was “overwhelmed.” Arizona, meanwhile, reached a peak in hospitalizations. In California, which also saw an all-time high for new infections, Walt Disney Co. delayed the reopening of its theme parks indefinitely, while Nevada’s governor ordered everyone to wear masks in public as some of Las Vegas’ biggest casinos made them a condition of entry.

New York, New Jersey and Connecticut set quarantines for incoming travelers from the hot zones, and North Carolina put its reopening on ice for three weeks. Read more from Margaret Newkirk, Jonathan Levin and Michelle Fay Cortez.

Virus & Nursing Homes Hearing: The House Ways and Means Health Subcommittee holds a hearing today on Covid-19’s effects on nursing homes.

Senators Ask NCAA to Stop Schools From Requesting Virus Waivers: Sens. Richard Blumenthal (D-Conn.) and Cory Booker (D-N.J.) asked the National Collegiate Athletic Association to prohibit schools from “requiring or coercing” students to sign liability waivers that would exempt institutions from accountability for the spread of the coronavirus, Ben Livesey reports.

U.S. Shifts Virus Testing Support: The Trump administration is shifting support for Covid-19 testing centers to private pharmacies and health centers, causing concern in Texas where the bulk of government-backed sites remain and where virus cases are skyrocketing.

There are 13 federally supported testing sites in five states, seven of which are in Texas, the Health and Human Services Department said. Federal backing for the 13 sites ends June 30, when it will be refocused on 600 pharmacy sites and 1,300 health centers, Brett Giroir, the assistant U.S. health secretary at Health and Human Services, said yesterday. Read more from Anna Edney.

Stockpile Said to Need Clearer Mission From Congress: Congress needs to clarify the Strategic National Stockpile’s mission and role to prevent issues with getting necessary supplies during public health emergencies in the near future, Senate Homeland Security and Governmental Affairs Chairman Ron Johnson (R-Wis.) said at a hearing. The nation is “paying the price for this lack of articulation and clarity during the current pandemic,” Johnson said. Read more from Shira Stein.

Deaths Seen Hitting 180,000 by October, Races Through U.S.: America is on track to lose 180,000 lives to coronavirus by the start of October, according to new data from experts modeling the pandemic at the University of Washington in Seattle, although an embrace of masks could decrease the damage. The forecast from the Institute for Health Metrics and Evaluation is a reduction from a projection of 201,129 deaths from the middle of June, and is predicated on the expectation that the outbreak will start to pick up in late August and intensify further in September, with 179,106 deaths by Oct. 1. Read more from Margaret Newkirk, Jonathan Levin and Michelle Fay Cortez.

Cancer Immune Therapies Tied to Severe Covid-19: Cancer patients treated with medications that unleash the immune system to attack tumors are more likely to be hospitalized with respiratory complications from Covid-19, according to a new study. The findings suggest that while immune therapies or checkpoint inhibitors may increase the risk of developing severe Covid-19 symptoms, other treatments like chemotherapy may not. Read more from James Paton.

Tri-State Area Orders Hot-Spot Visitors to Quarantine: New York, New Jersey and Connecticut will require visitors from Covid-19 hot spots to self-quarantine for 14 days to avoid a resurgence in cases. Any state that has a rate of positive tests for infections above 10% will be subject to the quarantine, New York Gov. Andrew Cuomo (D) said yesterday. The order impacts travelers from Alabama, Arizona, Arkansas, Florida, Texas, Utah, Washington state, and North and South Carolina. Elise Young has more.

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What Else to Know Today

Lawmakers Want $26 Billion for Research: A bipartisan House group unveiled a bill yesterday that would authorize approximately $26 billion in emergency aid to federal science agencies—such as HHS and the National Science Foundation—to distribute to research universities, national laboratories, and independent institutions to continue work on federally funded research projects, lawmakers including Rep. Diana DeGette (D-Colo.) said in a statement. Read text of the bill here.

Humanitarian Innovation Patents: The House today plans to vote on legislation (H.R. 7259) that would modify a federal program that provides accelerated patent reviews for innovations that address global humanitarian needs. The measure was referred to the House Judiciary Committee, which hasn’t considered it. The bill will be considered under expedited procedure that indicates broad support. For more, see the BGOV Bill Summary by Danielle Parnass.

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With assistance from Danielle Parnass and Alex Ruoff

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; Zachary Sherwood at zsherwood@bgov.com; Michaela Ross at mross@bgov.com

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