HEALTH CARE BRIEFING: Stopgap Keeps Power on Fentanyl-Adjacents

The House released a short-term government funding bill and plans to vote on it today to stave off a federal shutdown after Feb. 18. The bill would keep the government running through March 11 to allow time for more negotiations between Republicans and Democrats on a complete $1.5 trillion appropriations package.

The U.S. government has been running on temporary spending measures since the Oct. 1 start of fiscal year 2022. Republicans and Democrats are haggling over the topline spending level, with Democrats seeking a 13% boost to domestic social spending. The GOP wants any such hike to be matched by an equal increase for the defense budget, and for Democrats to drop a slew of policy changes, including those related to tax-payer funded abortion services.

The measure would extend several health-related authorities through March 11:

• The temporary scheduling of fentanyl-like substances as a Schedule I substance under the Controlled Substances Act, the most strictly controlled drug category.
• A temporary increase in the Federal Medical Assistance Percentage for U.S. territories. The measure would reduce amounts available in the Medicare Improvement Fund to $99 million from $101 million to offset the cost of the extension.
• The Health and Human Services Department’s authority to make direct personnel appointments to the National Disaster Medical System in response to a public health emergency. Read more in a BGOV Bill Summary.

“We are close to reaching a framework government funding agreement, but we will need additional time to complete the legislation in full,” House Appropriations Chair Rosa DeLauro (D-Conn.) said in a statement.

The overdue spending bills have gotten renewed attention in recent weeks as President Joe Biden’s larger economic agenda has largely stalled in the Senate. The spending bills are separate from the $2 trillion Build Back Better measure, which would have directed funds from tax increases toward new climate change, health and childcare initiatives while seeking to cut prescription drug costs.

A 2022 spending package could be attached to new extra funding to fight the Covid-19 pandemic, but the White House has not yet submitted a request to Congress. Read more from Erik Wasson.

Lawmakers Seek Telehealth Expansion in Stopgap: A bipartisan, bicameral group of lawmakers are calling for the permanent extension of expanded coverage of telehealth services to be included in the stopgap legislation. “Throughout this pandemic we have seen how telecommunications systems can help triage and assess ill patients remotely,” and reduce exposure to Covid-19 “for our most vulnerable,” the 44 lawmakers including Sen. Marsha Blackburn (R-Tenn.) and Brian Schatz (D-Hawaii) said in a letter to congressional leaders. Read it here.

• The letter comes the same day a bipartisan Senate duo introduced a bill to extend Medicare policies allowing for easier telehealth access. The measure introduced by Sens. Catherine Cortez Masto (D-N.M.) and Todd Young (R-Ind.) has the backing of telehealth groups. The Alliance for Connected Care sent a letter yesterday calling for passage of the bill. The legislation would allow the U.S. Centers for Medicare and Medicaid Services to extend for two years Medicare payments for a range of telehealth services, including for substance abuse treatment. Read bill text here.

Also on Lawmakers’ Radars

Testimony Yanked as Embattled White House Science Aide Resigns: Embattled White House science adviser Eric Lander will resign from his post effective by Feb. 18, and will no longer testify before a House panel today. Rep. Anna Eshoo (D-Calif.), chairwoman of the House Energy and Commerce health subcommittee, confirmed the hearing will proceed with the second panel of witnesses.

Lander, the first science aide to hold a Cabinet-level position, was slated to appear before the health panel for a hearing on the Advanced Research Projects Agency for Health, which is Biden’s proposal to launch an entity to speed medical discoveries.

“I believe it is not possible to continue effectively in my role, and the work of this office is far too important to be hindered,” Lander said yesterday in his resignation letter. A White House investigation revealed yesterday found Lander, director of the Office of Science and Technology Policy, bullied subordinates and created a hostile work environment for members of his team. Read more from Jeannie Baumann.

Lawmakers Say Drug Czar Job Should Be Cabinet-Level: The nation’s drug czar should be elevated to a Cabinet-level position, putting the effort to combat addiction and overdose deaths at the top of the White House’s agenda, according to a report today from the Commission on Combating Synthetic Opioid Trafficking. The panel, led by Sen. Tom Cotton (R-Ark.) and Rep. David Trone (D-Md.), found that manufacturing synthetic opioids has recently become easier for Mexican drug cartels to conceal and that “geopolitical issues” between the U.S., Mexico and China hurt efforts disrupt the flow of opioids into the U.S.

The report recommended the government reduce demand for opioids domestically and work with other countries to reduce the supply. Find the report here.

What Else to Know Today

Schools’ Mask Mandates Ease as Governors See ‘Inflection Point’: Some U.S. governors are taking broad steps to discontinue school masking, saying the pandemic precaution is outweighed by widespread vaccinations, lower transmission and the need for unimpeded instruction. Connecticut Gov. Ned Lamont (D) yesterday recommended his state end mask mandates for schools and daycares on Feb. 28. New Jersey, where more than 1-in-9 residents is a public-school student, will end its order next month for 1.3 million in kindergarten through high school. Similar moves may come soon in New York.

Masking in schools have been among the most politically charged Covid-19 policy issues as officials attempt to balance public health with growing cries for normalcy. Challenges from mask foes are spawning legal rulings that have some districts puzzling over how to conduct lessons. In Virginia, the state’s highest court yesterday backed Gov. Glenn Youngkin (R) in his order to allow parents to ignore classroom mask mandates. Read more from Elise Young and Nic Querolo.

Covid-19 Adds to Pregnancy Risk, Notably in Unvaccinated: Covid-19 seems to increase the risk of pregnancy complications, and women infected with the virus were more likely to lose their pregnancy, an NIH-funded study found. The report, which appeared yesterday in the Journal of the American Medical Association, adds to a growing body of evidence showing the benefits of vaccines against Covid-19 during pregnancy. But a survey last year found people hoping to become pregnant in the next six months were less likely to get vaccinated out of fears of birth defects. Read more from Jeannie Baumann.

ACA Insurers Use Tech to Keep Customers on Board: Obamacare insurers, flush with a record 14.5 million plan members after a successful sign-up period, are facing a new challenge: how to keep the new enrollees from dropping their coverage. Each year, about 10% of marketplace plan members have their coverage terminated for nonpayment or other reasons. To maintain the new bumper crop of enrollees, some insurers will use A.I., advanced analytics, and machine learning to identify members most likely to let their policies lapse. Read more from Tony Pugh.

More Headlines:

• Kentucky Abortion Law Should Be Revived, State Tells Federal Court
• N.J. Nursing Home Operator in Covid Death Case Denied Rehearing
• Covid-19 Paid Leave Boost for California Workers Goes to Newsom
• Vaccine Protests Close Ambassador Bridge, Top U.S.-Canada Link

With assistance from 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: Zachary Sherwood at zsherwood@bgov.com; Giuseppe Macri at gmacri@bgov.com; Michaela Ross at mross@bgov.com