HEALTH CARE BRIEFING: Impasse Halts Lobbying on Surprise Billing

By Brandon Lee, Alex Ruoff and Jeannie Baumann

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Groups that spent millions of dollars opposing legislation to bring an end to the practice of “surprise” medical billing have largely closed their pocketbooks and gone silent as Congress declines to act.

Since May, two groups that have each bankrolled competing pricey advertising campaigns aimed at swaying lawmakers in opposite directions on surprise bills have stopped airing television ads. Both Doctor Patient Unity, a group created by private equity firms, and the Coalition Against Surprise Medical Billing, made up of insurers and employers, haven’t bought airtime in June or July, according to groups that monitor advertising purchases.

Lobbying spending by industry groups seeking to influence the debate has also dried up, federal lobbying disclosures released Monday show. The slowdown in spending signals that the groups aren’t expecting Congress to act anytime soon, Travis Ridout, who analyzes political advertising as co-director of the Wesleyan Media Project, said. “It’s a strategic calculation on their part,” he said.

The groups themselves say they’re watching lawmakers closely and warned they could resume their campaigns if the issue regains momentum in Congress. But congressional aides and lobbyists don’t expect the next pandemic stimulus bill to include any major provisions tackling surprise medical billing.

Lawmakers leading the effort say they haven’t given up on passing a surprise medical billing package this year, but they missed a prime opportunity late in 2019 to do so. Read more from Alex Ruoff.

Also in lobbying news, several companies developing Covid-19 vaccines or treatments are upping their spending, even as discussions around pricing controls for government-backed cures cools off:

  • Takeda, which is looking into using blood from people who’ve recovered from Covid-19 to fight the coronavirus, spent $1.3 million in quarter two, more than double its lobbying spending from the same timespan a year ago. AstraZeneca spent $780,000 in quarter two, up from $480,000 from the same time in 2019.
  • Some drugmakers aren’t spending more but made recent hires. Novavax, which is trying to develop a vaccine to create antibodies to fight the virus, hired Sara-Lloyd Stevenson, a former policy adviser at HHS, and Vincent Giglierano, a former legislative assistant for Rep. Glenn Grothman (R-Wis.). Both now work as lobbyists for Faegre Drinker Biddle & Reath.
  • Some of the biggest companies developing Covid-19 medicines and vaccines have been spending less on lobbying: Pfizer, Sanofi and Johnson & Johnson all spent slightly less between April and June of 2020 than they did the same time in 2019, Alex Ruoff reports.

Happening on the Hill

GOP Plan With Testing Money Takes Shape: Senate Republicans crafting their own plan for a new coronavirus stimulus bill are broadly endorsing more funds for testing, some child-care assistance, and funding for a vaccine. Details remained in flux yesterday as GOP senators hashed out their opening bid in negotiations with Democrats on legislation to prop up a straggling economy. Both sides said they aim to have a deal worked out by the end of next week, with final passage likely slipping into August.

Senate Majority Leader Mitch McConnell (R-Ky.) said the GOP plan will also include funding to reimburse businesses for the costs of “safe workplaces,” including personal protective equipment, testing, cleaning, and remodeling, “to protect workers and entice customers.”

White House press secretary Kayleigh McEnany said the administration would support funds for “targeted testing,” an apparent shift from over the weekend, when the administration had balked at providing additional money for testing and contact tracing. McEnany said there’s $10 billion left over from the prior stimulus law for testing and the White House simply wants to ensure any new funds are spent wisely. Laura Litvan, Billy House, and Erik Wasson have more.

  • McConnell on the Senate floor yesterday said the Republican stimulus plan would “dedicate even more resources to the fastest race for a new vaccine in human history along with diagnostics and treatments.”
  • Also on the floor, McConnell said that the bill “will also protect seniors from a potential spike in premiums and the federal government will continue to support hospitals, providers and testing.” A senior Republican aide said the amount of funding is still being debated. Senate Republicans agree that the package shouldn’t exceed $1 trillion, Sen. Mike Braun (R-Ind.) said after a policy luncheon.
  • Some Democrats say that’s far too small. Rep. Pramila Jayapal (D-Wash.), one of the chairs of the Congressional Progressive Caucus, said the “needs are much too great” to limit the scope of the bill. She said demand for testing funding and other issues will likely mean it costs over $1 trillion. “I really believe they will be forced by the circumstances to be moved,” she said, Alex Ruoff and Erik Wasson report.

Pediatricians say $200 Billion Needed for K-12 Education: The American Academy of Pediatrics and 30 other national health organizations told Congressional leaders in a letter yesterday that Congress should provide $200 billion in the next coronavirus relief package for K-12 schools “regardless of their timeline for reopening,” Andrew Kreighbaum reports. The White House had cited a report from the pediatricians group in a recent push for schools to physically reopen. But the academy publicly split with President Donald Trump over threats to withhold federal aid from K-12 schools that do not reopen for face-to-face classes.

Two Vaccine Makers Say They Will Sell at Cost: Executives from drugmakers AstraZeneca and Johnson & Johnson told lawmakers on the House Energy and Commerce Oversight and Investigations Subcommittee yesterday that they don’t intend to profit off their Covid-19 vaccines during the pandemic. But executives from Moderna, Pfizer and Merck said they do intend on it.

Rep. Jan Schakowsky (D-Ill.), who posed the question about vaccine pricing, said the responses from companies with the leading Covid-19 vaccine candidates left her worried that there could be price gouging once a vaccine is ready. “It’s clear to me that at this point there’s nothing preventing them from charging what they want to charge,” Schakowsky said yesterday. “If everyone doesn’t have access to the vaccine, then there is no use to it.”

Schakowsky introduced a bill (H.R. 7296) with other House progressives that would require companies to make their Covid vaccines affordable and to eliminate exclusivity if they took government money to develop their vaccine, Bloomberg Law’s Jeannie Baumann reports.

Hearings on the Hill:

  • The Senate Homeland Security and Governmental Affairs Committee plans to mark up 29 bills including: S. 4204 to establish an interagency task force to analyze preparedness for national pandemics; and S. 4210 to authorize transfers of certain equipment during a public health emergency.
  • The House Homeland Security Committee will hear testimony from Federal Emergency Management Agency Administrator Peter Gaynor for a hearing on the national Covid-19 response. Separately, House and Senate Democratic panel leaders sent a letter yesterday to Gaynor “expressing concerns over longstanding senior leadership vacancies at the Agency, including both Deputy Administrator roles, which have each been without permanent appointees for six months” that could make the agency “ill prepared to fulfill its responsibilities.”
  • The House Natural Resources Indigenous Peoples Subcommittee is set to discuss four bills related to indigenous peoples’ health services and child safety during a hearing.
  • The Senate Environment and Public Works Committee holds a hearing on zoonotic disease risks from illegal wildlife trafficking.

Virus Research & Treatment

Trump Restarts Briefings, Endorses Masks: Trump restarted his coronavirus briefings yesterday by warning about a surge in cases while seeking to reassure the public that his White House has the crisis under control. He took a notably more reserved tone than in prior briefings, warning that the situation will likely get worse. “We will defeat the virus,” Trump said yesterday before adding: “It’ll probably, unfortunately, get worse before it gets better.” Justin Sink has more.

Trump also told Americans to wear a mask. “Whether you like the mask or not, they have an impact,” Trump said at the White House. “We’re asking everybody when you are not able to socially distance, wear a mask.” Masks became highly politicized after Trump resisted wearing one in public, until posting on Monday that “it is patriotic” to wear one. Jordan Fabian and Olivia Raimonde have more.

Infections Far Exceed Reported Cases, CDC Says: Far more people have been infected with the coronavirus than previously reported in several corners of the U.S., according to data published yesterday by the Centers for Disease Control and Prevention. The CDC conducted a survey analyzing antibodies for the virus in 10 regions in the U.S. It found prevalence was highly variable from one area to the next, but far higher than the reported number of cases across the board. Read more from Kristen V. Brown.

Antibodies Fade Rapidly, Study Shows: Recovering from Covid-19 might not offer much protection from future infections, particularly for those with only a mild case, researchers said in the New England Journal of Medicine. The study scanned antibodies from the blood of 34 people who recovered from Covid-19 after they suffered primarily mild symptoms that didn’t require intensive care, according to the report.

The first analysis was done on antibodies extracted an average of 37 days after symptoms started, with a second after about 86 days—less than three months. The researchers determined the antibody levels had fallen precipitously, with a half-life of 73 days between the two timespans. The loss of antibodies occurred more quickly than with SARS, an earlier type of coronavirus infection. It is likely that the decline will slow with additional time, the report said. Read more from Michelle Fay Cortez.

Months Into Pandemic, U.S. Still Can’t Get Speedy Testing Right: With coronavirus cases surging across the U.S., the country is again facing an issue that plagued it in the pandemic’s early days: Overwhelming demand at labs has led to longer and longer wait times for test results. Hospitals are still finding themselves short on supplies and even major labs, like Quest Diagnostics, are so bogged down that the turnaround times can exceed a week. “Unless we get test times down, we’re not going to get ahead of the virus,” said former Centers of Disease Control and Prevention Director Tom Frieden, who runs the nonprofit Resolve to Save Lives. Read more from Aysha Diallo, Olivia Raimonde and Emma Court.

More Headlines:

What Else to Know Today

DOJ Says Special ACA Enrollment Not Needed: Courts can’t force the Trump administration to reopen Affordable Care Act enrollments even in the face of a pandemic, the Justice Department argued yesterday. The department is defending HHS against a suit from Chicago in the U.S. District Court for the District of Columbia last month fighting the agency’s refusal to open a special enrollment period for the health insurance exchange. Read more from Lydia Wheeler.

‘Two-Bill’ Abortion Insurance Rule Struck Down: A Trump administration rule that requires insurers selling health plans on state and federal exchanges to bill policyholders separately for abortion coverage is arbitrary, a federal judge in the Northern District of California said yesterday. The rule imposes “substantial and immediate” transactional costs that aren’t balanced by any transactional benefit identified by the agency, Judge Laurel Beeler said. Read more from Jacklyn Wille.

More Headlines:

With assistance from Andrew Kreighbaum and Erik Wasson

To contact the reporters on this story: Brandon Lee in Washington at blee@bgov.com; Alex Ruoff in Washington at aruoff@bgov.com; Jeannie Baumann in Washington at jbaumann@bloomberglaw.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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