HEALTH CARE BRIEFING: Democrats Eye Hospital Funds in Loan Boost

By Brandon Lee and Nancy Ognanovich

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Senate Majority Leader Mitch McConnell (R-Ky.) is pressing ahead with a plan for a quick vote today on a $250 billion boost to a small business loan program, putting him at odds with the top Democrats in Congress who want to double the size of an interim stimulus package.

McConnell has offered an amendment to the $2.2 trillion coronavirus response package signed into law last month to boost the total available to the Paycheck Protection Program for small businesses to $600 billion.

His plan for quick Senate approval by unanimous consent rests on no objections being raised by Democrats after both Minority Leader Chuck Schumer (D-N.Y.) and Speaker Nancy Pelosi (D-Calif.) proposed another $100 billion for hospitals and $150 billion for state and local governments.

The next package “must provide transformational relief as the American people weather this assault on their lives and livelihoods,” the Democratic leaders said.

Pelosi said yesterday that McConnell’s plan would not win quick passage in her chamber. “The bill that they put forth doesn’t have, will not get unanimous support in the House. It just won’t,” she told NPR.

Pelosi in the same interview said the last stimulus package was similar in size to Republican corporate tax cuts made in 2017. Of the $250 billion being proposed for small businesses, $60 billion should go to community banks and a $50 billion piece to go to disaster loans, she said.

Treasury Secretary Steven Mnuchin said yesterday the administration opposes Schumer’s and Pelosi’s more expansive plan. Additional rescue funds including for hospitals can be dealt with later on, Mnuchin said. “We can do a phase four, and a phase four would be later.” Read more from Laura Litvan, Billy House and Erik Wasson.

Aid to States Said Falls Short: The Democrats’ latest agenda item comes as the House Oversight and Reform Committee released a report yesterday saying that the federal government has failed to distribute enough personal protective gear and other medical supplies to states. President Donald Trump’s administration is leaving states “to fend for themselves, to scour the open market for these scarce supplies, and to compete with each other,” Oversight Chairwoman Carolyn Maloney (D-N.Y.) said in a statement. Read more from Polly Mosendz, Margaret Newkirk and Vincent Del Giudice.

  • Meanwhile, HHS staff told lawmakers that the agency won’t be shipping any more personal protective equipment from the Strategic National Stockpile to states, according to the statement from the House Oversight Committee, reports Shira Stein. Agency staff told the committee on Tuesday that they have dispersed 90% of the stockpile’s PPE inventory. The remaining 10% would be kept for federal workers, the staff said.

Mandatory Cuts to Pay for Stimulus: Congress must start looking at potential cuts to mandatory programs including Social Security and Medicare to help pay for the rising debt the nation is taking on as it responds to the coronavirus, Sen. Kevin Cramer (R-N.D.) said. Cramer told CNBC that the crisis is adding to urgency for Congress to look at the mandatory side of the budget for savings to reduce rising debt. “We just have to be willing to bite that bullet and have the adult conversation that a lot of us have been trying to have for a long time.”

Cramer suggested that discussions about changes in mandatory spending may come after the Nov. 3 election. “When you start talking about the insolvency of Social Security, Medicare, or the funding for Medicaid, it becomes very difficult at election time,” he said, Nancy Ognanovich reports.

Revisions to Medicare Interest Rates: Sens. Bill Cassidy (R-La.) and Jeanne Shaheen (D-N.H.) urged the Centers for Medicare & Medicaid Services in a bipartisan letter dated yesterday to revise interest rates for health-care providers seeking financial relief during the coronavirus outbreak through Medicare’s Accelerated and Advance Payments Program. “Hospitals, physicians and other health-care providers have significant concerns” about the currently 10.25% interest rate, the lawmakers wrote in their letter to CMS Administrator Seema Verma and HHS Secretary Alex Azar. Read the letter here.

Combating Shortages at Hospitals

Trump Urged to Limit Patent Rights on Ventilators, Treatments: Medical device makers and scientists around the world are waiving their intellectual property rights to encourage companies to restore depleted stockpiles of emergency equipment and develop new tests and treatments for the Covid-19 pandemic. But it might not be enough. Some researchers and lawmakers are calling on President Donald Trump to follow the lead of Germany and Israel in restricting patent rights for work on coronavirus treatments.

“When the lives of a significant population of a country are at stake, it is the inherent sovereign right of a government to override private property rights to protect the lives and health of its citizens,” said Fred Abbott, a Florida State University professor who’s advised the World Health Organization and United Nations on patents and drugs. Trump has asked companies to start producing ventilators and respirators, but his administration has stopped short of taking steps that would give some level of protection from patent lawsuits. Read more from Susan Decker and Malathi Nayak.

Export Ban on Gear Takes Effect Tomorrow: The Trump administration’s ban on exports of some personal protective equipment to fight the pandemic in the U.S. will take effect tomorrow and will be in place for four months, according to the Federal Register, which published the rule yesterday. The U.S. is following a number of other countries that have temporarily halted exports of critical PPE recently. Among them are China, a significant source of the materials, and the European Union. The rule covers five types of protective equipment, including N95 masks, surgical masks and gloves. Read more from Jenny Leonard.

Startups Are 3D-Printing Scarce Ventilator and Test Kit Parts: As the U.S. and other countries warn of a dire shortage of ventilators, testing kits, and protective equipment to deal with the pandemic, an unlikely hero is coming to the rescue: the 3D printing community. 3D tech startups, equipment manufacturers, and even home hobbyists are sharing designs and working with local hospitals and health agencies to provide lifesaving equipment and medical supplies that can be quickly created on gear from the $15 billion niche printing industry. Meanwhile, government regulators, including the U.S. Food and Drug Administration, are invoking emergency policies to get the equipment to front-line medical staff. Read more from K Oanh Ha.

Anti-Price Gouging Bill: House Energy and Commerce Democrats introduced a bill yesterday to help protect consumers from price gouging amid the outbreak. The legislation, sponsored by Consumer Protection Subcommittee Chairwoman Jan Schakowsky (D-Ill.) and co-sponsored by full committee Chairman Frank Pallone (D-N.J.), would bar the sale of goods at “unconscionably excessive” prices and authorize the Federal Trade Commission to go after price-gougers, Rebecca Kern reports. Read the bill here.

  • Also yesterday, Sens. Chuck Grassley (R-Iowa) and Amy Klobuchar (D-Minn.) urged the Justice Department to take “vigorous action to protect consumers from price gouging” during the coronavirus outbreak in a letter to Attorney General William Barr. The two senators urged DOJ to aggressively enforce an executive order Trump signed on March 23 to help prevent price gouging conduct. Read their letter here.

DeGette Warns Against Chloroquine Hoarding: House Energy and Commerce Oversight Subcommittee Chairwoman Diana DeGette (D-Colo.) called on the FDA chief in a letter to “take immediate actions to address the dangerous hoarding” of hydroxychloroquine- and chloroquine-based medications normally prescribed to treat lupus and rheumatoid arthritis. Trump has touted the drugs as possible treatments for Covid-19, though they haven’t been approved by the FDA for such use. Read her letter here.

2 Million Suits Eyed for Hospitals: Millions of protective coverall suits will soon head to hospitals to shield workers from the virus, the HHS said yesterday. HHS announced a deal with DuPont for expedited delivery of 450,000 protective suits for health-care workers from its manufacturing site in Hanoi, Vietnam. DuPont’s Tyvek suits create a barrier between its wearer and fine particles and chemicals. The department expects to receive a total of 2.25 million of the Tyvek suits over the next five weeks with an option to continue buying up to a total of 4.5 million suits. Read more from Ayanna Alexander.

More Headlines:

Research, Treatment & Coordination

Coronavirus May ‘Reactivate’ in Cured Patients, Korean CDC Says: The coronavirus may be “reactivating” in people who have been cured of the illness, according to Korea’s Centers for Disease Control and Prevention. About 51 patients classed as having been cured in South Korea have tested positive again, the CDC said in a briefing on Monday. Rather than being infected again, the virus may have been reactivated in these people, given they tested positive again shortly after being released from quarantine, said Jeong Eun-kyeong, director-general of the Korean CDC. Read more from Kyunghee Park.

Plan to Re-Open Economy: Trump’s top health advisers are developing medical criteria for safely opening the U.S. economy in coming weeks if trends showing a crest in cases hold steady. Deborah Birx, the immunologist who coordinates the White House’s pandemic task force, met into the night on Tuesday with Anthony Fauci, the country’s top infectious diseases expert, CDC Director Robert Redfield, and FDA Commissioner Stephen Hahn. Absent from the meeting were economic and political advisers to the president, a deliberate signal that the White House’s aim is to prioritize health considerations over economic ones, according to three people, Jennifer Jacobs and Justin Sink report.

CDC Issues Critical Worker Protection Guidance: The Centers for Disease Control and Prevention is changing its guidance for workers in critical industries to say that the people exposed to the coronavirus should return to work if they don’t have symptoms of the illness instead of self-quarantining for 14 days. Workers can return as long as they have no symptoms of the disease, wear a face mask, practice social distancing and monitor their body temperature for fever. There’s no standard, national definition of what constitutes essential work, leaving states and local governments to make those decisions. Read more from Mario Parker.

Fauci ‘Cautiously Optimistic’ Virus Could Plateau Next Week: Covid-19 cases in the U.S. could plateau in the next week, marking a turnaround in the nation’s fight with the coronavirus pandemic, the NIH’s Anthony Fauci said at a White House press briefing yesterday. Fauci made his remarks as the rate of new infections and hospitalizations has slowed in hard-hit New York. More than 6,000 of the nation’s nearly 14,000 deaths have occurred in New York, Bloomberg data show, but the rate of infections is now doubling about every 10 days, down from a peak of every two days. Read more from Jeannie Baumann.

FDA Warns of False Advertising for Tests: Dozens of companies making false claims about Covid-19 products meant to test if someone who’s had the virus is now potentially immune to it face enforcement, including potential seizures, the FDA said yesterday. More than 70 test developers have told the FDA they have these types of products, called serological tests, available. However, the agency has approved only one manufacturer, Cellex, through its emergency regulatory channel to use the tests in clinical labs. Read more from Jacquie Lee.

  • Also yesterday, Senate Health, Education, Labor, and Pensions Committee Chairman Lamar Alexander (R-Tenn.) and Senate Appropriations HHS Subcommittee Chairman Roy Blunt (R-Mo.) urged Azar in a letter to affirm that Americans who have recovered from Covid-19 can get free antibody testing, which they say would help restart the U.S. economy sooner. Read their letter here.

HHS Awards $1.3 Billion to Health Centers: Community health centers, which provide primary care to 28 million Americans, will receive $1.3 billion to prevent and treat Covid-19, the HHS announced yesterday. Funds will be divided among 1,387 centers and will help them maintain or increase capacity and staffing, the Department of Health and Human Services said. HHS secured the funding from the latest stimulus measure. Read more from Shira Stein.

Health Insurers Say Virus Costs Could Surpass $500 Billion: Health insurers’ costs for testing and treating Covid-19 could be as high as $556 billion in 2020 and 2021, a trade association for health insurers said yesterday. America’s Health Insurance Plans commissioned Wakely Consulting Group to study Covid-19 costs to U.S. health insurers. Wakely came up with a wide range: $56 billion to $556 billion over the next two years. Read more from Sara Hansard.

Pharmacists OK’d to Test for Covid-19: Pharmacists can administer Covid-19 tests, the HHS announced yesterday, expanding the workforce needed for rapid virus testing and cutting commute times to testing sites. Serology testing is included in pharmacists’ new authority, which will be crucial to quickly reopen the economy and test patients who might be eligible to donate plasma for Covid-19 treatments. Read more from Jacquie Lee.

More Headlines:

What Else to Know Today

More Disapprove of Trump’s Virus Agenda: Americans are beginning to sour on Trump’s handling of the coronavirus crisis, according to a poll by Monmouth University released yesterday. Forty-nine percent of survey respondents say Trump was doing a bad job with the pandemic, while 46% said he has done a good job. That is down from a Monmouth University poll two weeks ago finding that 45% of Americans disapproved of Trump’s handling of the crisis, and 50% approved.

Trump’s overall performance rating has stayed largely the same. The poll found that 49% disapproved of his job as president, while last month the number was 48%, well within the poll’s 3.4 point margin of error. Some 44% approved of the job he’s doing now, down slightly from 46% in March. And more respondents—43%—said they trusted their governor more than the president on coronavirus information. Fifteen percent say they trust Trump more, Emma Kinery reports.

Altria Vape Exit Before Juul Deal Draws Suit: Altria Group and Juul Labs were hit with antitrust claims in a Los Angeles federal court over Altria’s exit from the tobacco vaping market—as part of its $12.8 billion agreement to acquire 35% of Juul. The suit comes just a few days after the Federal Trade Commission sued to unwind the deal. The proposed consumer class action concerns Juul’s “stunning” climb between 2015 and 2018, by which time it dominated three-quarters of the vaping industry, displacing many of the e-cigarette products sold by traditional tobacco companies. Read more from Mike Leonard.

Probe Into Treatment of Pregnant Migrants Sought: Sen. Richard Blumenthal (D-Conn.) and 12 other senators called on the Homeland Security Department Office of Inspector General to “immediately investigate continued disturbing reports that pregnant detainees are severely mistreated” under U.S. Customs and Border Protection custody. The members urged DHS’s inspector general Joseph Cuffari to investigate complaints of border agents “delaying or denying medical care to pregnant people,” among other alleged abuses. Read their letter here.

States Ask Court to Reconsider Abortion ‘Gag Rule’ Decision: States suing the federal government over restrictions on taxpayer-funded family planning services want an appeals court to reconsider its decision upholding the policy. The lawsuit was filed by multiple states, cities, and private organizations seeking to roll back a HHS rule that forbids family planning clinics from performing abortions or referring patients elsewhere for the procedure. Providers that want to offer abortion services must do so in facilities that are physically and financially separate from the tax-funded clinic, which they say is tantamount to being gagged. Read more from Lydia Wheeler.

More Headlines:

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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