HEALTH CARE BRIEFING: Democrats Seek $3T Aid With Testing Funds

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House Democrats proposed a $3 trillion coronavirus relief bill yesterday, combining aid to state and local governments with direct cash payments, expanded unemployment insurance, nationwide testing and contact tracing systems, and health insurance subsidies.

While there’s little chance of the aid package (H.R. 6800) gaining Senate approval and the president’s signature as written, passage in the Democratic-led House would give Speaker Nancy Pelosi (D-Calif.) a marker to set down in negotiations with the Trump administration and Senate Republicans. “Not acting is the most expensive course,” Pelosi said at the Capitol. “We face the biggest catastrophe in our nation’s history.”

Among its key provisions, the bill would create a contact tracing and disease surveillance workforce and bump billions more dollars into states’ Medicaid programs. It would give $75 billion to public health departments and workforce agencies to support expanding Covid-19 testing and create a contact tracing and surveillance system across the country. It would also increase Federal Medical Assistance Percentage payments to state Medicaid programs by 14% starting July 1 through June 30, 2021.

Other highlights include:

$100 billion to the federal fund for health-care providers;
Slashing interest rates to 1% for providers who took Medicare advance payments;
Eliminating cost sharing for Covid-19 treatments for people in Medicare, Medicaid and private insurance, TRICARE and at Veterans Affairs facilities;
Full subsidies for COBRA premiums for furloughed workers;
Special enrollment periods for Obamacare and Medicare;
A temporarily increase by 2.5% of Medicaid disproportionate share hospital allotments;
Regular reporting to Congress on requests by states to the Strategic National Stockpile; and
A requirement for drug manufacturers to report foreign drug manufacturing sites.

The bill is a follow-up to the $3 trillion Congress has already spent on four bills in response to the crisis caused by the coronavirus pandemic, which has ground the world’s biggest economy to a halt.

Republicans aren’t the only hurdle for Pelosi. Majority Leader Steny Hoyer (D-Md.) announced plans to have the House vote on the legislation on Friday, but members of the party’s liberal wing want to delay that because the bill may not go far enough to address their priorities.

House Progressive Caucus Co-Chairs Pramila Jayapal (D-Wash.) and Mark Pocan (D-Wis.) asked Pelosi in a letter yesterday for a meeting about “any amendments that might be needed to ensure that it truly reflects the priorities and the work of the entire caucus.” Read more from Erik Wasson and Laura Davison.

Congressional Virus Efforts

Coronavirus Oversight Panel to Focus on Reopening: A new House panel created to oversee coronavirus relief spending will focus its first briefing on requirements to safely reopen the American economy during the coronavirus pandemic. Among participants at the hearing today will be former FDA Commissioner Scott Gottlieb, one of the authors of a report released in late March by the conservative American Enterprise Institute, “National Coronavirus Response: A Road Map to Reopening.” Gottlieb served as head of the FDA under Trump until April of last year.

The 12-member committee is led by Rep. Jim Clyburn (D-S.C.), the No. 3 House Democrat. It was created on a party-line vote when lawmakers were in Washington last month to pass the most recent coronavirus aid package. There are seven Democrats and five Republicans on the panel. Republicans have warned they believe Democrats will use the committee for partisan attacks on Trump and his administration. Read more from Billy House.

Progressive Caucus Hearing on Testing, Tracing: The Congressional Progressive Caucus holds a virtual hearing at 2 p.m. on the need to scale up Covid-19 testing and contact tracing. Reps. Jamie Raskin (D-Md.) and Ayanna Pressley (D-Mass.) will lead the meeting, which will be livestreamed here.

Nursing Homes Against Seniors’ Groups: Nursing homes are taking on the nation’s senior citizens’ groups over whether to extend new liability protections to long-term facilities. Senate Republicans, with the backing of industry groups, want new liability shields to cover a host of health-care businesses, including hospitals, doctors’ practices, and nursing homes, as a way to encourage them to reopen their doors. The AARP, the nation’s largest nonprofit for seniors, pushed back on new liability shields in a letter to the Senate Judiciary Committee. Read more from Alex Ruoff.

Meanwhile, health industry experts want more details about how nursing homes under lockdown to outsiders will be reopened, even as outbreaks continue to ravage the facilities. Reports that the Centers for Medicare & Medicaid Services is crafting guidelines and regulatory criteria that could let nursing homes allow visitors enter the facilities have prompted concerns about putting vulnerable residents in more danger. Read more from Tony Pugh.

Senate Panel Advances Virus Relief Spending Nominee: The Senate Banking Committee advanced the nomination of Brian Miller to be the special inspector general for pandemic recovery. The job is responsible for overseeing trillions of loans and grants that the Treasury Department and Federal Reserve will issue to airlines, defense companies and other corporations seeking liquidity following the economic fallout from the coronavirus. Democrats have questioned Miller’s ability to serve in the role, in light of his current post—as a White House lawyer during Trump’s impeachment, Laura Davison reports.

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Vaccine Research, Testing & Reopening

Trump’s Own Experts Shrug Off His ‘We’ve Prevailed’ Claim: A day after said “we’ve prevailed” in expanding testing enough to start reopening the U.S. economy, the president’s top health experts offered a more cautionary assessment as they warned about the perils of moving too quickly. “We’re not out of the woods yet,” Robert Redfield, director of the Centers for Disease Control and Prevention, said yesterday at a Senate Health, Education, Labor and Pensions Committee hearing, warning that Americans “need to stay vigilant with social distancing.”

That need was underscored by the fact that all of the witnesses and many of the lawmakers appeared by remote video from their homes or offices, in some cases in modified self-quarantine after exposure to the virus. Most of the discussion was about testing that still falls short and a vaccine that’s unlikely to arrive before 2021. Read more from Laura Litvan and Anna Edney.

Fauci Warns That Early Reopening May Kill More: Anthony Fauci, the nation’s top infectious disease official, yesterday warned against reopening the economy too soon, telling the HELP Committee that communities doing so risk new coronavirus outbreaks.

Fauci said at the committee hearing yesterday that he’s concerned about cities and states reopening without reaching “checkpoints” set by the White House in guidelines to help them decide when it’s safe. “I feel if that occurs, there is a real risk that you will trigger an outbreak that you might not be able to control,” he said. “In fact, paradoxically, it will set you back.”

Fauci’s call for caution would put him in conflict with Trump‘s race to reopen the country for business and ease restrictions that have crushed the economy. The checkpoints that Fauci cited call for a succession of steps toward a more gradual reopening, including a “downward trajectory” of documented cases and positive Covid-19 tests “within a 14-day period.” Laura Litvan and Justin Sink have more.

Vaccine Trial for Children Mulled: Children may be included in clinical trials to determine if an experimental vaccine works, FDA Commissioner Stephen Hahn told the Senate panel yesterday. But any potential vaccine should only be tested on children once a candidate has shown promise in healthy adult volunteers, bioethicists say. Talk of a potential decision to test the unapproved vaccine in children comes as some Republicans, such as Sen. Rand Paul (R-Ky.) called for reopening schools in the fall.

There are 125 vaccine candidates in development, including one developed by scientists at the National Institute of Allergy and Infectious Diseases under the National institutes of Health that went to human trials in March. But this study, known as a phase I trial, only involves healthy, adult volunteers because it’s the first time scientists have introduced the experimental vaccine into the human body. Testing in children would only occur in future larger studies to determine if the vaccine meets the FDA’s approval standards. Jeannie Baumann has more.

Fauci, Redfield, Hahn Can Be at White House: Three top U.S. health officials will rejoin White House meetings, ending a period of isolation after an adviser to Vice President Mike Pence tested positive for coronavirus last week. Redfield, Hahn, and Fauci will participate in meetings as long as they remain asymptomatic and are wearing face masks, according to a joint statement issued yesterday. Read more from Josh Wingrove.

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Treatment Efforts & Coordination

HHS Spends $645 Million on Face Coverings: The HHS is buying over half a billion dollars’ worth of cloth face coverings to “mitigate” the transmission of the coronavirus as stay-at-home orders are lifted, according to the contracts, which were awarded May 8. Contracts were awarded to HanesBrands for $322 million; San Mar for $217 million; Parkdale Advanced Materials for $60 million; Beverly Knits for $43 million; America Knits for $1.68 million; and American Giant for $1.27 million. Read more from Shira Stein.

Drug Trials Miss Groups Hardest Hit: Black and Hispanic populations bearing the brunt of the pandemic are also woefully underrepresented in clinical trials for drugs, a new study found. The FDA has warned the lack of diversity in the large studies drug companies need to win approval means that research may miss how medications can affect some populations differently. Research released yesterday by the Tufts Center for the Study of Drug Development found that women, blacks, and Hispanics participate in trials at rates below their share of the total U.S. population, Jeannie Baumann reports.

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What Else to Know

Premium Prices May Leave Millions Without Coverage: Nearly 6 million people who lost their jobs in recent months may have to pay the full cost of health coverage and could end up uninsured. That finding, released today by the Kaiser Family Foundation, the San Francisco-based health-care research organization, was based on unemployment figures of more than 31 million people who have filed claims between March 1 and May 20 as employers shut down and cut back hours due to the Covid-19 pandemic.

The finding highlights the difficulty that many people will face keeping coverage. Democrats have called for the administration to fully reopen enrollment in the the federal HealthCare.gov exchange to allow uninsured people to sign up for coverage, while the Trump administration is using emergency funding for hospitals to cover the uninsured. Read more from Sara Hansard.

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To contact the reporters on this story: Alex Ruoff in Washington at aruoff@bgov.com; 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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