HEALTH CARE BRIEFING: Mental Health Coverage Flaw Fines Targeted

Democrats want to beef up enforcement of rules meant to make it easier to access mental health services using insurance. Business groups say the move won’t work and is a ploy to pay for Democrats’ wide-reaching social spending agenda.

Tucked into a once-$3.5 trillion domestic spending package is a provision empowering the government to fine health plans and employers that violate federal laws requiring access to mental health care that’s on par with other medical care. Health plans now get cited for violating the law and agree to come into compliance and reimburse beneficiaries.

Supporters of the new fines say they’ll give the Labor Department an effective tool to expand mental health coverage. Parity between mental health and other health services has been lacking for decades, often leaving people without adequate coverage for the help they need.

Lawmakers on both sides of the aisle say improving mental health parity in insurance plans is a key to tackling the ongoing opioid overdose crisis in the U.S. Americans are struggling to find mental health and substance use treatment services they can afford since so many services are out of network.

“A crucial part of this mission is ensuring that our mental health and substance use disorder parity laws are being enforced,” Rep. Brian Fitzpatrick (R-Pa.) said recently. Read more from Alex Ruoff.

Happening on the Hill

Moderna’s Tech Should Be Shared, Lawmakers Say: A bicameral group of 12 Democratic lawmakers including Sen. Elizabeth Warren (Mass.) said Moderna’s contract with the U.S. may allow the government to access and share the company’s Covid-19 vaccine technology. Lawmakers urged the Biden administration “to take bold steps to dramatically expand global COVID-19 vaccine access and manufacturing capabilities” in a letter. Read more from Daniela Sirtori-Cortina.

Democrats Target Unaccompanied Child Migrant Shelters: Democratic senators are calling on the Department of Health and Human Services to swiftly shut down unlicensed emergency intake shelters the agency has relied on to house large numbers of unaccompanied migrant children picked up at the U.S.-Mexico border this year, Ellen M. Gilmer reports.

“While much of this reliance arose as a result of the former administration’s intentional decimation of the asylum process, we urge you to shape a different legacy for the Biden administration,” Sens. Jeff Merkley (Ore.), Richard Blumenthal (Conn.), and others said in a letter to HHS’s Office of Refugee Resettlement.

The Biden administration requested $2.5 billion in continuing resolution funding for the care of unaccompanied children. The government should use the funding to expand a network of care providers to handle fluctuations, improve the quality of children’s care, and release them quickly to vetted sponsors, the senators said.

Hearings Next Week:

• The Senate Finance Committee announced an Oct. 19 panel entitled “Health Insurance Coverage in America: Current and Future Role of Federal Programs.”
• The House Energy and Commerce Health Subcommittee scheduled an Oct. 20 hearing on enhancing public health for children and families, especially amid the pandemic.

The Coronavirus Pandemic

Vaccine Mix Bolsters Antibodies: Mixing Covid-19 vaccines produces as much or more antibodies as using the same shot as a booster, according to preliminary results of a widely awaited U.S. government-sponsored trial. The trial is the first major U.S. study to compare the effects of using different vaccines—including Moderna, Pfizer-BioNTech or Johnson & Johnson—as boosters from the initial shot or shots. Read more from Bloomberg News.

No Recommendation From FDA Staff on J&J Booster: U.S. regulators didn’t make a recommendation on whether recipients of the Johnson & Johnson Covid-19 vaccine should receive a booster, ahead of a closely watched meeting where scientific experts will weigh whether study data supports giving the additional dose.

Tomorrow, the Food and Drug Administration’s advisers will convene to guide the agency on J&J’s request for an emergency-use authorization of a second shot. The staff also declined to make a recommendation regarding booster shots from both Moderna and Pfizer. Read more from Riley Griffin and Robert Langreth.

WHO’s New Origin Study: The World Health Organization proposed a fresh team of scientists to lead an investigation into the origins of Covid-19 and other diseases after the last effort was wracked by controversy. The 26 proposed members of the group have expertise in a range of areas from epidemiology to biosecurity, the WHO said. Read more from Thomas Mulier.

Vaccine Mandate Enforcement in Question: Biden has tasked OSHA with creation of a rule requiring every U.S. company with more than 100 employees to require its workers be inoculated against Covid-19, or subjected to weekly testing. But the agency has has been virtually mum about what enforcement will look like and how it will deploy its limited resources on a massive nationwide mandate. Read more from Fatima Hussein.

• Workplace Covid-19 vaccination mandates have largely survived a first wave of legal challenges even as the number of lawsuits over them has soared with their expanded use. Workers and advocacy groups have filed at least 39 federal cases this year, contesting vaccination requirements imposed by employers or governments, with 85% of them arriving after Aug. 1, according to a Bloomberg Law review. Read more from Robert Iafolla.
• In New York, the state’s vaccine mandates for health-care workers have led to only a small reduction in staff. Gov. Kathy Hochul (D) said at a briefing yesterday that the state is seeing a 3% reduction in its health-care workforce, including staff at nursing homes and hospitals, as a result of the vaccine requirement. Read more from Bloomberg News.
• A federal judge barred United Airlines from placing unvaccinated workers with a religious or medical exemption on unpaid leave, as part of its mandatory Covid-19 vaccination program for employees. U.S. District Judge Mark Pittman issued a 2-page temporary restraining order Tuesday, noting that the two sides in the dispute agreed last month that the airline would refrain for now from placing exempted workers on leave for failure to comply with the vaccine mandate. Read more from Peter Jeffrey.

BGOV OnPoint: Vaccine Mandates Spur Pushback

More Vaccine Mandate Headlines:

• Arkansas Governor Allows Vaccine Opt-Out Law, Voices Hesitation
• N.Y. Vaccine Mandate Appeal Delayed as Hospitals Seek Clarity
• Health Worker Vaccine Mandate Survives Court Challenge in Maine
• Texas Ban on Vaccine Mandates Shows Pressure From Far Right
• ConocoPhillips to Defy Texas Prohibition on Vaccine Mandates
• AFL-CIO President Hedges Support for Employer Vaccine Mandates
• Teamsters Lose Bid for Arbitration of Employer’s Vaccine Mandate
• Covid Quickens GOP Populism Tilt From Old Pro-Business Brand
• Vaccine Mandates Withstand Challenges as Lawsuits Proliferate

Long Covid Doubles Burden of Mystery Illness Few Doctors Treat: Doctors estimate there were 1 million to 2 million people living with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) before the coronavirus pandemic hit. With the advent of long Covid, there may be twice that many now.

ME/CFS may well explain the symptoms described by many people who are still ill months after having Covid-19. The condition, which can leave its victims bedridden, can be triggered by or follow an infectious disease. But most doctors don’t know what ME/CFS is, in part, because routine lab tests show nothing wrong. Read more from Lydia Wheeler.

More Headlines:

• Ivermectin Is Unproven for Covid-19, But Drugmakers Are Cashing In
• Bill Gates Says World Must Increase Vaccine-Making Capacity
• L.A. Lakers Suit Over Covid Damage to Staples Center Gets Reboot

What Else to Know

GOP-led States Call U.S. Attack on Texas Abortion Law a Threat: A group of Republican-led states criticized the U.S. Justice Department for suing to overturn a Texas ban on most abortions, telling a judge that the federal government needs to be reined in. If a temporary injunction blocking the law is revived while the lawsuit proceeds, the Justice Department will be emboldened to file similar suits in the future, the 18 states said in a filing at the federal appeals court in New Orleans yesterday. Read more from Laurel Brubaker Calkins and Erik Larson.

Toxic Impurities Detected in Some Heart Pills in U.S.: Over the past three years, millions of blood pressure pills that contain a probable carcinogen have been recalled around the world. As pharmaceutical companies have worked on finding a fix, they’ve discovered an entirely new problem: Another potentially dangerous chemical is showing up in the same drugs. The new chemicals are called azido impurities and regulatory authorities say they’re mutagenic, meaning they can change someone’s DNA and potentially increase cancer risk. Read more from Anna Edney.

Holmes Faked Pharma Backing to Lure Walgreens, U.S. Says: Studies by Pfizer and Schering-Plough touted by Theranos to pitch its blood-testing technology shared a common flaw: they weren’t real, according to U.S. prosecutors. In a bid to get the Walgreens drug-store chain to use her cutting-edge machines, Elizabeth Holmes sent documents she described as “independent due diligence reports” on Theranos from some of the leading pharmaceutical companies. Read more from Joel Rosenblatt.

HHS Sued Over Alleged Anti-LGBT Bias in Refugee Program: The Department of Health and Human Services was sued by a lesbian woman yesterday who says she was discriminated against due to her sexual orientation by organizations that receive government funding to provide foster services for refugee children. Kelly Easter, who said she attempted to apply to be a foster parent in a federally funded child-welfare program, filed suit in the U.S. District Court for the District of Columbia. David McAfee has more.

More Headlines:

• Anti-Abortion Group Sues to Lift California Vax Site Buffer Zone
• Progenity Jumps on Patents for Needle-Free Drug Delivery
• EPA Settles With Health Groups Over Asbestos Analysis
• Health Plan Operator Sharity Can Solicit Bankruptcy Plan Votes
• Tobacco Settlement Money Fraud Claims Proceed Against Hospital
• UnitedHealthcare’s Liposuction Class Deal Rejected as ‘Cosmetic’

With assistance from Ellen M. Gilmer

To contact the reporter on this story: Michaela Ross in Washington at mross@bgov.com

To contact the editors responsible for this story: Zachary Sherwood at zsherwood@bgov.com; Giuseppe Macri at gmacri@bgov.com; Brandon Lee at blee@bgov.com