HEALTH CARE BRIEFING: Obamacare Surge Boosts State Exchanges

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Surging Obamacare enrollment during the pandemic will likely be a boon for states that are launching their own health insurance marketplaces.

Obamacare sign-ups spiked after millions of people lost their jobs and work-related coverage due to Covid-19. An increase in enrollees will likely reduce per-person costs for insurers, particularly as more healthy people look to get covered. That in turn could draw more insurers to the exchanges, leading to increased competition and reduced premiums, state health officials and analysts said.

Insurers may be especially drawn to state-based exchanges since states typically spend more money on outreach and marketing and may combine their exchanges with reinsurance programs that lower premiums, as Pennsylvania has done.

The Health and Human Services Department reported that almost a half-million people enrolled in the federal exchanges through May after losing their jobs, a 46% increase from the same time period last year. Almost 263,000 people newly signed up for coverage in state-based exchanges since March, according to a report by health-care consulting firm Avalere Health. Only eight of the 12 existing state exchanges that reopened, however, publicly released enrollment numbers, according to the report.

“There could be actually more than 1 million new enrollees to the exchanges currently in 2020″ due to the impact of Covid-19, said Chad Brooker, associate principal of Avalere.

The increase comes as more than a half dozen more states, including Pennsylvania and Virginia, move to create their own Affordable Care Act exchanges for residents to shop for plans. Read more from Sara Hansard.

HHS Faulted for Not Opening ACA Markets: The HHS’s refusal to open a special enrollment period for Americans to buy health insurance on federally run Obamacare exchanges during the pandemic must be set aside, Chicago told a federal court in Washington. HHS didn’t try to estimate how many people may benefit from reopening the enrollment period or determine how an SEP could help them, health-care providers, or the public, the city said. Read more from Mary Anne Pazanowski.

Happening on the Hill

Redfield, DeVos Probed on Schools: Sen. Elizabeth Warren (D-Mass.) and Rep. Andy Levin (D-Mich.) asked Centers for Disease Control and Prevention Director Robert Redfield and Education Secretary Betsy DeVos for all correspondence between their agencies and the White House over guidance on opening schools to determine if any proposals were influenced by politics. Read more from Elizabeth Elkin.

GAO Probe Sought on Remdesivir: House Oversight and Reform Chairwoman Carolyn Maloney (D-N.Y.) along with Sen. Debbie Stabenow (D-Mich.) asked a federal watchdog agency to investigate the discovery and development of Gilead’s Covid-19 treatment remdesivir. Gilead announced it’d charge federal programs $390 per vial, or $2,340 for a five-day treatment of the drug. “Because of the high price,” the lawmakers want the Government Accountability Office to also examine what rights U.S. agencies have tied to their contributions to remdesivir’s development, they said in a statement. Kim Chipman has more.

Data on Food Inspectors Overdue, Democrats Say: Congressional Democrats are pressing the Department of Agriculture to publish the number of confirmed Covid-19 cases and deaths among food safety inspectors, citing a congressional requirement made earlier this month. “I call upon the department to rectify this immediately,” House Appropriations Agriculture-FDA Subcommittee Chairman Sanford Bishop (D-Ga.) wrote in a statement. “The public is entitled to this information.” Read more from Megan U. Boyanton.

Stimulus Update: Negotiators made little progress yesterday, when Treasury Secretary Steven Mnuchin and White House Chief of Staff Mark Meadows met with Speaker Nancy Pelosi (D-Calif.) and Senate Minority Leader Chuck Schumer (D-N.Y.) to discuss the next stimulus bill.

“I don’t know that I would characterize it as getting closer,” Meadows told reporters.

Senate Majority Leader Mitch McConnell (R-Ky.) has insisted on measures shielding companies, schools and other organizations from lawsuits. President Donald Trump also said yesterday there are some measures in the bill he doesn’t like, without specifying which provisions. Read more from Erik Wasson and Laura Litvan.

Rule for Second Appropriations Package: The House today will consider the rule providing consideration of the second fiscal 2021 appropriations package (H.R. 7617) which includes Defense, Commerce-Justice-Science, Energy and Water, Financial Services, Labor-HHS-Education, and Transportation-HUD funding. A manager’s amendment to the appropriations measure would remove the Homeland Security measure, Jack Fitzpatrick reports.

Yesterday at the House Rules Committee hearing on the measure, lawmakers made 340 amendments in order, including a provision by Rep. Jason Smith (R-Mo.) that would push the secretary of Health and Human Services and others to annually update a list of 300 to 400 medications for which availability is important in the event of a public health emergency.

BGOV Bill Summary: H.R. 7614, Fiscal 2021 Labor-HHS-Education Funding

Child Care Bills on House Flour: House will also vote on two measures today under a closed rule:

  • Child Care Provider Grants: A $50 billion stabilization fund would be created to support child care providers affected by the coronavirus pandemic under a modified version of H.R. 7027. The measure would provide the funding through the Child Care and Development Block Grant (CCDBG) program as an emergency appropriation. Funding would be used to provide grants to child care providers to sustain their operations during pandemic-related closures and as they reopen. The measure was referred to the House Appropriations and Budget committees, which haven’t acted. For more, see the BGOV Bill Summary by Danielle Parnass.
  • Child and Family Care Assistance: Dependent care and payroll tax credits would be expanded to support caregivers and child care providers affected by the coronavirus pandemic under H.R. 7327. The bill would also provide $10 billion in emergency funding to the Child Care Development Fund for grants to enhance child care facility safety and infrastructure. The funding wouldn’t count against discretionary spending caps. The measure would also provide $10 billion annually through fiscal 2024 for general child care entitlement to states. The measure was referred to the House Appropriations, Budget, and Ways and Means committees, which haven’t acted. For more, see the BGOV Bill Summary by Naoreen Chowdhury.

Today’s Hearings:

Other Letters & Legislation:

  • Rep. Ro Khanna (D-Calif.), Sen. Bernie Sanders (I-Vt.), and others unveiled a measure to help manufacture and distribute “high-quality, reusable masks to everyone in America,” they said in a statement yesterday. The bill seeks to distribute three free, reusable masks to every person in the country. The measure would use “all available authorities,” such as the Defense Production Act, to achieve this, the statement claims. Read text of the bill here.
  • Sens. Chuck Grassley (R-Iowa) and Martha McSally (R-Ariz.), in an op-ed published by Fox News yesterday, said the coronavirus pandemic has highlighted and accelerated the need to cut drug prices in the U.S. “The mandate to lower drug costs is more important than ever,” they wrote. “COVID-19 arguably lends even more urgency to our efforts.” Grassley unveiled a Senate bill on drug pricing (S. 4199) earlier this year and Trump signed executive orders last week targeting drug pricing. Read the op-ed here.
  • Sen. Mark Warner (D-Va.), along 12 other lawmakers, wrote yesterday to Senate leadership urging them to include the Public Health Emergency Privacy Act (S. 3749) in the next Senate Covid-19 stimulus package. The privacy bill would limit the use of data collected in Covid-19 screening tools, among other provisions.

Research & Treatment Efforts

Medicare Data Show Impact on Minorities: American Indian and indigenous Alaskan Medicare beneficiaries have the second highest hospitalization rate for the novel coronavirus among all racial and ethnic cohorts in the program, new federal data show. Only Black beneficiaries have a higher rate. The finding adds to the growing body of research that shows the pandemic is taking a disparate toll on communities of color.

Black beneficiaries on Medicare saw the highest hospitalization rates at 670 per 100,000, according to claims data. American Indians and Alaskan Natives had a rate of 505 hospitalizations per 100,000. Hispanics, who can be of any race, had a hospitalization rate of 401. They were followed by Asians at 207 and Whites at 175 hospitalizations per 100,000. Read more from Tony Pugh.

Supercomputer Enlisted in Virus Fight: A new interagency partnership will use the fastest supercomputer in the nation to find and enhance potential Covid-19 therapeutics and vaccines, the HHS said in a statement. The initiative will let federal agencies share health data, research and expertise as they continue the fight against the coronavirus, Shira Stein reports.

Trump Says Anti-Malaria Drug Warnings Political: Trump said the medical community’s widespread warnings against using the anti-malaria drug hydroxychloroquine to treat Covid-19 patients were politically motivated to damage him. Read more from Jordan Fabian and Mario Parker.

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What Else to Know

3M Trial Over PFAS Contamination Pushed to 2021, CEO Says: 3M’s earliest trial related to PFAS chemicals is likely to be in 2021 instead of this year, the company’s chief executive officer, Mike Roman, said during a quarterly earnings call yesterday. The company, which made chemicals that are part of the family of PFAS, or per- and polyfluoroalkyl substances, is facing multiple lawsuits related to the chemicals’ presence in the environment, especially in drinking water. Read more from Sylvia Carignan.

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To contact the reporter on this story: Brandon Lee in Washington at

To contact the editors responsible for this story: Giuseppe Macri at; Zachary Sherwood at; Michaela Ross at

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