HEALTH CARE BRIEFING: GOP Stimulus Has Extra $1.3B for Hospitals

Senate Republican leaders want to give hospitals and community health centers billions of dollars to help them fight the novel coronavirus as part of a massive economic stimulus bill unveiled today.

The $1.5 trillion package would give community health centers an added $1.32 billion and would lift Medicare “sequestration” payment cuts this year, among other measures. Those cuts in payments to hospitals and doctors would slash more than $15 billion from Medicare payments, just in fiscal 2020.

Ending the payment cuts was among the top requests made by hospital groups, who argue that U.S. health-care providers are losing as much as $1 million every day due to the coronavirus outbreak.

The measure also proposes that Medicare offer hospitals an added payment for caring after coronavirus patients that amounts to a 15% bonus, and would allow for increasing telehealth services for Medicare patients at certain health centers and rural clinics during the health emergency. It would also waive a requirement for face-to-face visits between dialysis patients and doctors, and it would bolster some Medicare home-care services.

Democratic leaders reiterated their call to increase Medicaid spending and put more federal funding into expand public health programs. “The number one priority is addressing this health crisis, which requires a Marshall Plan to rebuild our health care infrastructure on a continental scale and ensure the resources are there to test and treat everyone who needs it,” said Senate Minority Leader Charles Schumer (N.Y.) and Speaker Nancy Pelosi (Calif.) in a joint statement.

  • Also in the draft stimulus proposal, Senate GOP leaders decided against including a proposal to limit surprise medical bills, according to aides and lobbyists familiar with the talks. The provisions that Republican lawmakers were seeking would have been similar to a package of measures supported by the chairmen of the Senate and House health committees late last year, designed to end “balance billing” practices and limit some out-of-network charges insured patients faced when seeking emergency room care.
  • However, Senate leaders rejected the request from their own ranks to add the provisions in the bill. Senate Majority Leader Mitch McConnell (R-Ky.) said the proposal his caucus unveiled yesterday, which includes over $1 trillion in economic stimulus measures, will need to “beat back this virus” by funding public health programs like health centers. Alex Ruoff has more.
Photographer: Scott Eisen/Bloomberg
A medical tent is used for drive-through testing outside of the Carney Hospital in Boston.

A centerpiece of the stimulus package is tax rebates to individuals of $1,200 and $2,400 for married couples. Rebates are completely phased-out for all taxpayers with incomes exceeding $99,000 for individuals or $198,000 for a couple. It also provides $208 billion worth of loans for businesses hurting due to the outbreak, including $58 billion for the airline sector, and $150 billion for other distressed areas of the economy. Read more about the broader package here.

McConnell’s office last night released the following section summaries that are part of the proposal:

More Congressional Efforts:

  • Sen. Ted Cruz (R-Texas) yesterday introduced two pandemic bills, one that would “allow physician-owned hospitals to expand their facilities, beds, and surgical rooms,” and another that would “expand access to Health Savings Accounts to anyone with a health planfor the duration” of the pandemic, according to a statement. The first is co-sponsored by Sens. John Cornyn (R-Texas), James Lankford (R-Okla.), and Mike Braun (R-Ind.). The second measure is co-sponsored by Sen. Ben Sasse (R-Neb.).
  • House Oversight and Reform Chairwoman Carolyn Maloney (D-N.Y.) yesterday sent a letter seeking a copy of the administration’s plan for coronavirus testing in response to a leaked White House “Response Plan” that said the public health situation “will last 18 months or longer.” But it doesn’t “include a plan to address one of the most significant failings with the response to date—the shortfall in coronavirus testing,” says the letter, signed by Maloney and subcommittee heads, to HHS Secretary Alex Azar and CDC Director Robert Redfield.
  • Sen. Tammy Baldwin (D-Wis.) and Rep. Mark Pocan (D-Wis.) unveiled a measure that would “require the Defense Department to make testing kits for COVID-19 available to all American servicemembers deployed to the Middle East,” according to a statement. The two received “calls from Wisconsin military families” concerned that troops deployed to Afghanistan were in areas with confirmed cases, and did not have testing available, the statement said. The bill would require Secretary of Defense Mark Esper to make kits available for troops in the Middle East “within one week of enactment.”
  • The Congressional Progressive Caucus sent a letter to Pelosi outlining 12 priorities for the third legislative package under negotiation for the coronavirus that would include free testing, treatment and prevention.

Testing, Treatment & Equipment

Emergency Powers for Virus Supplies: House Democrats are starting work on measures to fund manufacturing needs for medical supplies amid the outbreak, even as Trump waits to use his emergency mobilization powers. Trump has said that he’s invoked the Defense Production Act, but he has yet to take action and enter into contracts with private manufacturers to boost production of medical supplies such as ventilators. “We hope we’re not going to need that,” Trump said yesterday, adding that governors should take the lead on such actions.

But House appropriators are already in early stages of considering measures to pay for those provisions, House Appropriations Committee spokesperson Evan Hollander said yesterday. They’re working to include funds in their own “phase 3” bill. Jack Fitzpatrick, Alex Ruoff and Shira Stein have more.

  • Health-care groups called on the federal government to take quick action to ensure a steady supply of essential health equipment. Over a dozen groups representing a wide range of the industry such as hospitals, health insurers, health professionals, drugmakers, and labs sent in a letter to Vice President Mike Pence and congressional leaders, saying “immediate, collective action” is necessary “by the private sector and all levels of government” to address capacity and supply, Sara Hansard reports.
  • Clinical testing laboratories have also asked Congress for funding, seeking $5 billion to cover emergency costs associated with Covid-19 test kits. In a letter to congressional leaders yesterday, the American Clinical Laboratory Association said that the Treasury Department should administer a direct financial fund to help cover the costs of equipment, supplies, and labor to sustain testing capacity for millions of Americans. Read more from David Voreacos and Neil Weinberg.
  • Meanwhile, the 500 million N95 air-filtering respirator masks Trump said the federal government ordered may take 18 months to be delivered, according to the grant application. There’s been a shortage of the masks, and health-care workers are being told to reuse them. The government is expecting the masks to be delivered incrementally, according to the application, but it will allow those deliveries to occur over 18 months. Chinese manufacturers are not able to fulfill the request. Read more from Shira Stein.

Murray Requests Probe Into HHS Testing Delays: Senate Health, Education, Labor, and Pensions Committee ranking member Patty Murray (D-Wash.) asked the HHS watchdog to investigate delays in development and deployment of coronavirus tests. In a letter yesterday, Murray asked the HHS inspector general to launch probe to “understand where HHS has erred in this process and implement lessons learned.”

WHO Adopts Ebola Test Method: The World Health Organization is taking the drug-testing approach that helped curtail Ebola’s latest resurgence and using it against Covid-19. At least 10 countries including France, Spain, and Switzerland agreed to join a trial called “Solidarity” the international agency is coordinating, simultaneously testing four therapies by pitting them against one another. The strategy is designed to speed up a process that can take years as doctors scour laboratories for promising treatments against the new virus.

“It’s an unprecedented opportunity to come together as one against a common enemy,” WHO Director-General Tedros Adhanom Ghebreyesus said in a briefing on Wednesday. In the absence of drugs and vaccines, health officials are urging—or in some cases compelling—people to stay home to avoid infecting others. Finding treatments against a new illness can a painstaking process. Ebola drugs were particularly difficult to identify because the disease often hit quickly, going back undercover before clinicians had the opportunity to finish testing potential treatments. Read more from Thomas Mulier and John Lauerman.

Coverage Without Cost-Sharing: The Trump administration clarified it will not take enforcement actions against health insurers for not imposing cost-sharing for coronavirus care in catastrophic plans that normally require high payments before claims are covered. The Department of Health and Human Services “will not take enforcement action against any health insurance issuer” that “amends its catastrophic plans to provide pre-deductible coverage for services associated with the diagnosis and/or treatment of COVID-19,” the agency said in guidance yesterday. Read more from Sara Hansard.

Trump Touts Malaria Drug: Trump has told the Food and Drug Administration to see if it can expand the use of an experimental malaria drug, chloroquine, to treat patients with symptoms of Covid-19. Trump and the head of the FDA gave apparently conflicting remarks yesterday on the availability of the drug. Trump said chloroquine was approved and that it could be prescribed to patients. But minutes later FDA Commissioner Stephen Hahn said the drug would be used in clinical trials to discover whether or not it works and if so what dose would be safe and effective. Anna Edney has more.

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Research, Prevention & Coordination

Record Coronavirus Trials: A possible Covid-19 vaccine’s record-breaking pace to a clinical trial could become the new normal as researchers begin looking for vaccines even before new infections break out. The potential is there to shatter the decade-long timeline to develop new vaccines, making health professionals more nimble in the face of evolving threats. And it could have happened sooner if the investment in studying SARS and MERS didn’t dry up after those outbreaks went away, scientists said.

The first clinical trial started March 16 for a candidate vaccine to protect against SARS-Cov-2, the virus that causes Covid-19. An actual vaccine won’t be ready for another 12 to 18 months, but the announcement marks a new record in moving to human testing for a disease that nobody knew existed just a few months ago.

National Institutes of Health vaccine researcher Kizzmekia Corbett told National Institute of Allergy and Infectious Diseases Director Anthony Fauci it would take around 100 days to move into a clinical trial once scientists received the genetic sequence from their Chinese counterparts in January. They did it in 66. Jeannie Baumann has more.

FEMA Takes Over Coordination: The Federal Emergency Management Agency is stepping up its role on coordinating the government’s overall response to the pandemic, while the HHS will continue to lead the health and medical response. In a tweet, FEMA said it’s leading the federal coordination on behalf of HHS and the White House in response to Covid-19. FEMA said its coordination center was active and that it was readying more than 50 teams to deploy across the U.S. to activate emergency operations centers. Read more from Cheryl Bolen.

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What Else to Know

LGBTQ Groups Sue HHS: Family Equality, True Colors United Inc. and Services & Advocacy for LGBT Elders are suing HHS Secretary Azar, challenging his agency’s decision not to enforce a nondiscrimination rule against groups that get federal grant money. HHS announced in November 2019 that it won’t take enforcement action against participants in its grant programs for discriminating against those based on their age, disability, sex, race, color, origin, religion, sexual orientation, or gender identity.

This non-enforcement “give recipients of federal funds a license to discriminate in their provision of government-funded services to millions of people,” LGBTQ groups said in their complaint filed on Wednesday in the U.S. District Court for the Southern District of New York. The policy is a substantive rule, and is illegal under the Administrative Procedure Act because it was adopted without notice and the opportunity for the public to comment, the complaint says. Read more from Mary Anne Pazanowski.

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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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