HEALTH CARE BRIEFING: HHS Responds to GOP Testing Funds Inquiry

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The Biden administration told Republican senators it had $18 billion in unobligated funds for coronavirus testing, mitigation, and contact tracing, according to a summary obtained by Bloomberg Government, a pool of unused money that will likely factor into negotiations on a coronavirus relief bill, Jack Fitzpatrick reports.

Health and Human Services officials told Sens. Roy Blunt (R-Mo.) and Richard Burr (R-N.C.) the agency had $18 billion in unobligated funds for those purposes late last week, though only $4.6 billion of those funds haven’t been allocated for a specific purpose, according to the response. Most of the unobligated funds, $16.6 billion, were appropriated in the American Rescue Plan Act of 2021 (Public Law 117-2).

Blunt and Burr requested details on coronavirus test funding in a letter this month, as the Biden administration raced to provide more testing to the public amid a surge in coronavirus cases due to the omicron variant. Any legislation providing further funds for coronavirus relief will “need to have stronger reporting provisions,” Blunt said in a Wednesday hallway interview. He said he appreciated the administration’s response to his questions.

HHS had $97 billion for testing, mitigation, and contact tracing from 2020 legislation and the March 2021 American Rescue Plan, officials said. While officials didn’t provide a comprehensive list of how those funds were spent, they provided examples of major expenditures. Some of the funds were routed to programs outside their original purpose; $2.3 billion of testing funds were used for coronavirus-related expenses for unaccompanied children entering the U.S. or to backfill funds used for the same purpose. Another $155 million was used as part of the Biden administration’s program to resettle some Afghans into the U.S.

The funds included:

$29.4 billion to states testing, contact tracing, and mitigation programs;
$10 billion to states for school testing programs;
$9 billion for community testing sites;
$5 billion for procurement of tests and supplies; and
$4.5 billion to purchase and distribute 500 million tests.

Biden’s pledge to provide 1 billion free rapid Covid-19 tests to Americans is set to be a boon for test makers, as the omicron variant has left pharmacies and clinics scrambling to find supplies. The federal government has committed to spend at least $4.2 billion to develop, manufacture and produce rapid antigen tests since the start of the pandemic in 2020, according to a review of BGOV’s contracts database. And that’s before fulfilling Biden’s latest pledge for free tests. Supplying the first 500 million will cost $4 billion, a top U.S. official said. Kristen V. Brown and Paul Murphy have more.

ALSO HAPPENING ON THE HILL

Sen. Bernie Sanders said it’s time for Democrats to change course on Joe Biden’s agenda and have senators vote on portions of the president’s key economic bill, then seek to pass what remains as a package. Sanders (I-Vt.) argued for forcing senators of both parties to take a stand on portions of the bill that are popular among broad swaths of Americans such as negotiating the cost of prescription drugs, which has attracted bipartisan interest. Read more from Emma Kinery.

The Coronavirus Pandemic

Health Care Strike Risk Runs High as Hundreds of Labor Deals End: Hundreds of union contracts will expire in 2022 at health-care facilities from Boston to Sacramento, setting up fights over staff-to-patient ratios, pay, and other safety concerns as beleaguered workers continue to battle the Covid-19 pandemic. The cluster of expiring labor agreements will force health-care management to reckon with the physical and mental toll the pandemic has had on workers during the worst staffing shortage in memory.

At least 207,000 health-care workers are covered by the more than 400 labor agreements set to expire this year, according to an analysis of federal disclosures and contract settlement data compiled by Bloomberg Law. That figure is a conservative estimate that will only grow throughout the year as more companies report information on expiring contracts to the federal government. Read more from Andrew Wallender, Ian Kullgren, and Allie Reed.

Biden’s Shot Mandate for Federal Workers Blocked: The Justice Department will appeal a federal judge’s national preliminary injunction against Biden’s executive order mandating that all federal workers consent to be vaccinated against Covid-19 or else face termination. The order poses a threat of irreparable harm to the “liberty interests of employees who must choose between violating a mandate of doubtful validity or consenting to an unwanted medical procedure that cannot be undone,” Judge Jeffrey V. Brown of the U.S. District Court for the Southern District of Texas said. Read more from Kathleen Dailey.

The rise of the omicron variant has led to a threefold increase in worker complaints and referrals to OSHA from other agencies. That surge comes at the same time the Supreme Court halted enforcement of the OSHA shot-or-test mandate for large employers and the office’s withdrawal of the White House’s emergency temporary standard for health-care workers. The jump in cases and lack of virus-specific rules to prevent infections has led to calls for OSHA to boost enforcement with other laws. Bruce Rolfsen has more.
Meanwhile, a new OSHA standard to protect health-care workers should be finalized in six to nine months, the agency said Friday. James Frederick, deputy assistant secretary of labor for occupational safety and health, offered the timeline in a statement that’s part of the agency’s legal defense of its Dec. 27 decision to cancel the health-care Covid-19 emergency temporary standard. The claim was made in response to a lawsuit filed Jan. 5 by some labor unions asking the U.S. Court of Appeals for the District of Columbia Circuit to revive the emergency standard. Read more from Bruce Rolfsen.

Omicron Nears Peaks in U.S. as Some Regions Still Face Struggle: The omicron variant is starting to loosen its grip on the Northeast, but experts warn that it will take more time for the latest wave of Covid-19 to recede nationwide. The shape of the omicron wave may look different in various parts of the country, depending on vaccination rates and hospital capacity in those areas. Nationally, the omicron wave could peak as early as this week, projections from the Institute of Health Metrics and Evaluation at the University of Washington say. “We are going to go through a couple more weeks that are very difficult on our hospitals, but come mid-February, March, we should be in a very good position,” said Ali Mokdad, a professor at IHME and chief strategy officer for population health at the University of Washington. Read more from Madison Muller

It’s also extremely unlikely that a person can be reinfected with omicron, at least in the short-term, Anthony Fauci said amid the sharp declines in cases. “There are reinfections, but it is unlikely that—if you mounted a good immune response—at least over a period of several months, it is extremely unlikely that you will be reinfected with the same variant,” Fauci, the director of the National Institute of Allergy and Infectious Diseases, said in a press briefing. Read more from Josh Wingrove.
Booster doses of Covid-19 vaccines increased protection against both delta and omicron in three studies that looked at infections, hospitalizations and deaths in thousands of U.S. patients. A third dose of mRNA vaccines made by Moderna and Pfizer-BioNTech was at least 90% effective in preventing hospitalizations in both the delta and omicron surges, an analysis of hundreds of thousands of hospitalizations and clinical visits showed. Fiona Rutherford has more.
In just over one month after omicron reached the U.S., the number of Americans who said they’d been diagnosed with Covid-19 jumped by more than one quarter, according to Census data. Self-reports of Covid-19 rose to 57 million in the period from Dec. 29 through Jan. 10 from 45 million from Dec. 1 to Dec. 13, according to the U.S. Census Bureau’s Household Pulse Survey. Another 2.7 million said they may have been infected based on symptoms but weren’t sure. Alex Tanzi has more.
Related: Fauci Says U.S. Omicron Outbreak ‘Going in the Right Direction’

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What Else to Know Today

Georgia Sues HHS Over Repeal of Medicaid Work Rule: Georgia is suing the HHS over its withdrawal of the state’s authority to require work as a condition of Medicaid eligibility. The Friday lawsuit comes around a month after HHS informed Georgia it can’t impose work requirements on beneficiaries or charge premiums beyond those allowed in the Medicaid statute. Work requirements were a policy priority under the Trump administration, which approved proposals to impose them on adult beneficiaries in 12 states. Read more from Christopher Brown.

Judge in Planned Parenthood Case Defends Abortion Laws: A federal appeals court judge on the panel hearing a Louisiana abortion case involving Planned Parenthood assailed the organization for accusing the state of a “sham investigation” into its fetal disposal practices, offering a strident defense of abortion restrictions. Judge James Ho slammed Planned Parenthood in a concurring opinion he added Thursday to a previous ruling from the Fifth Circuit, which said in July that the group could move forward with part of its abortion rights lawsuit against Louisiana health officials. Read more from Mike Leonard.

Input on Streamlining Drug Payment Approvals Sought: The HHS is seeking input on how to use information technology to make it easier for health insurers to get approval of a prescription drug before they pay for it. The request for information seeks to improve the prior authorization process, which private insurers and other payers use to ensure that a drug or treatment gets covered by the patient’s health plan. The HHS Office of the National Coordinator for Health Information Technology released the request on Friday. Read more from Christopher Brown.

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To contact the reporters on this story: Brandon Lee in Washington at blee@bgov.com; Jack Fitzpatrick in Washington at jfitzpatrick@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

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