HEALTH CARE BRIEFING: Covid Spending Debate Continues on Offsets

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House members aim to pass a $15.6 billion coronavirus supplemental this week, but more negotiation is needed to clear a path through the Senate.

The Biden administration has said they’ll need funds for early treatment of Covid-19, but lawmakers have stumbled over disagreements on how to offset the bill’s cost. House Democratic leaders pulled a different version of the $15.6 billion bill from the broader $1.5 trillion government funding package after their members opposed a plan to pull $7 billion back from state and local governments appropriated under the March 2021 stimulus.

The supplemental spending bill includes $9.9 billion for the Biomedical Advanced Research and Development Authority to purchase oral antivirals, monoclonal antibodies, pre-exposure prophylaxis, and vaccines. It also would provide $750 million for the development of new vaccines; $4.5 billion for global health efforts, including for vaccines; and $500 million for humanitarian needs including disaster and migration aid.

Democratic leaders are open to adding even more resources, expecting that more will be needed eventually, Speaker Nancy Pelosi (D-Calif.) said Friday. “What the president was asking for in the legislation was a good start,” Pelosi said at a press conference. “It wasn’t everything. So we would have needed to do more anyway. And we will.”

Democrats’ latest version of the bill includes $8.6 billion in offsets after they removed the provision to pull back $7 billion in stimulus funds. That may not be enough for some key Republicans. Senate Appropriations Vice Chairman Richard Shelby (R-Ala.) told reporters last week he wants more information from the administration on what’s needed and how much previously appropriated money is unspent.

“I don’t even know if they need any more,” Shelby said. “There hasn’t been a pure accounting. If they show they really needed the money, we ought to do it, but there’s a lot of ambiguity and vagueness.” Read more from Jack Fitzpatrick.

Also Happening on the Hill

‘Next Pandemic’ Bipartisan Bill Set for Committee Review: A sweeping pandemic preparedness bill will go before the Senate health committee on Tuesday, Jeannie Baumann reports. Sens. Patty Murray (D-Wash.) and Richard Burr (R-N.C.) last week introduced the PREVENT Pandemics Act, which aims to use the lessons learned from the Covid-19 response to improve public health infrastructure and better arm the nation for disease outbreaks. The bipartisan duo serve as chair and ranking member of the Senate Health, Education, Labor and Pensions Committee.

Senator Presses AbbVie on Humira Sales: AbbVie, maker of the blockbuster rheumatoid arthritis medication Humira, is using units in Bermuda and Puerto Rico to shrink its tax bill even though the company generates most of its sales in the U.S., Senate Finance Chairman Ron Wyden (D-Ore.) said. Wyden demanded Friday that the Illinois-based drugmaker explain the tax implications of having a Bermuda unit hold its intellectual property for Humira, the world’s best-selling drug. No manufacturing or packaging of Humira occurs in Bermuda, he said. David Voreacos has more.

Telemedicine Costs for Health Savings Accounts Eased: Employers can resume covering telehealth for workers with health savings accounts before patients meet costly annual deductibles thanks to a provision in the omnibus spending bill approved by Congress. Employer groups have called for Congress to extend and make permanent coronavirus-era legislative provisions that expired at the end of 2021 that allowed them to provide coverage before annual deductibles are met for telehealth for workers with tax-advantaged health savings accounts. Read more from Sara Hansard.

Health Care, Companies Face New Cyber Reporting Law: A range of companies would have to beef up their cybersecurity operations to comply with hack reporting requirements under cybersecurity reporting rules cleared in a government funding bill (H.R. 2471) March 10. The rules would encompass a broad range of businesses in 16 critical infrastructure sectors. Companies would have 72 hours to report a hack, and 24 hours to report a ransomware payment to the government, once rules are in place.

Companies in highly regulated businesses, such as financial services and health care, will be better equipped to handle the new rules, cyber professionals said. Read more from Maria Curi.

Texas Policy on Trans Kids Blocked for Now

Texas Gov. Greg Abbott’s effort to crack down on most health-care practices for transgender children was temporarily blocked statewide by a judge who said Abbott (R) exceeded his authority. Abbott’s Feb. 22 directive to the Texas Department of Family and Protective Services to consider gender-affirming care for minors to be “child abuse” violates the separation of powers because it has the effect of a new law “without new legislation,” Judge Amy Clark Meachum said Friday in Austin.

The judge, at the end of a daylong hearing, issued a temporary injunction that prohibits the state from investigating families whose transgender children get medical care while the lawsuit proceeds—a major setback for Abbott in his latest culture-war fight. A trial was set for July 11. “We are relieved for Texas families who’ve been terrorized by this unlawful directive,” Camilla Taylor, the litigation director for Lambda Legal, one of the groups that filed the suit, said on a call. “It was deeply traumatic for parents and children alike.”

Abbott’s directive triggered a firestorm from critics who said Texas was setting the stage for families to be torn apart for treating children with gender dysphoria. Licensed professionals such as teachers, doctors and nurses were also at risk of liability for failing to report such treatment. Read more from Erik Larson.

  • During the hearing, an employee at the state’s family services agency told the judge she was resigning rather than help enforce Abbott’s order. Randa Mulanax, an investigations officer with Child Protective Services, said the department is stretched thin probing actual child abuse. Read more from Erik Larson.
  • Dozens of big companies including Apple and Google urged Texas to nix Abbott’s order on gender-affirming health-care. The 65 companies, which also include Microsoft, Salesforce and Capital One, signed a full-page ad in Friday’s Dallas Morning News that says in bold letters: “Discrimination Is Bad For Business.” The companies said the policy is “not just wrong, it has an impact on our employees, our customers, our families and our work,” Michael Smith, Nico Grant, and Dina Bass report.

What Else to Know Today

Texas Top Court Blocks Challenge to Abortion Ban: Texas’ Supreme Court shut down a legal challenge to the state’s restrictive abortion law, saying clinics and women’s-rights advocates can’t sue state medical-licensing officials because they don’t enforce the law, leaving advocates without anyone to proactively challenge the law, which allows individuals to sue anyone who “abets” an abortion once cardiac activity is detected, usually around six weeks. The court said state officials were immune because the law exclusively relies on civil suits by private citizens. Read more from Laurel Calkins.

SCOTUS Urged to Deny Review in Nursing Home Rights Case: The U.S. Supreme Court should deny review of a Seventh Circuit ruling that allowed a nursing home resident to proceed in a suit alleging the facility violated his right to be free from unnecessary medication, the resident’s representative told the high court Friday. The appeals court properly held that the Federal Nursing Home Reform Act gives people a private right to sue facilities for violating rights it specifically grants them, Gorgi Talevski’s representative, Ivanka Talevski said. Read more from Mary Anne Pazanowski.

Pfizer’s Covid Pill Unlikely to Reach Much of World for a Year: Agreements to expand global access to Pfizer’s highly effective Covid-19 therapy will be announced shortly, yet parts of the world may wait a year for the drug due to production and regulatory hurdles. The United Nations-backed Medicines Patent Pool plans to name the generic drugmakers that are going to be making the pills next week, four months after reaching a licensing accord with Pfizer. The drug companies may be ready to supply the first Paxlovid pills by December, according to the Geneva-based group. Larger quantities may only reach the market in May 2023, analytics firm Airfinity. estimates. Read more from James Paton.

Employers Turn to ‘High-Performing’ Physicians for Cost Savings: Some of the largest companies in Wisconsin are hoping to save money on health care this year by setting up insurance plans that steer employees to primary care physicians who provide high-quality care for less money. The half-dozen employers in eastern Wisconsin are expected to save more than 15% of $12,000 per employee in annual medical costs—about $10 million this year for the 5,000 employees who enrolled in the plans, Dave Ostendorf, chief actuary of plan administrator Centivo, said. Read more from Sara Hansard.

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To contact the reporter on this story: Brandon Lee in Washington at

To contact the editors responsible for this story: Giuseppe Macri at; Michaela Ross at

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