HEALTH CARE BRIEFING: Pallone Eyes ACA Boost as Relief Follow-Up

Bloomberg Government subscribers get the stories like this first. Act now and gain unlimited access to everything you need to know. Learn more.

Democrats plan to try to keep building on the Affordable Care Act in the coming weeks with bills to give the Biden administration more outreach funds and to roll back insurance rules from the Trump administration.

Rep. Frank Pallone (D-N.J.), chair of the House Energy and Commerce Committee, told reporters yesterday that his panel next week will take up ACA legislation and discuss a permanent funding mechanism for CHIP, the public health insurance program for children that’s currently bankrolled by regular extensions.

Later in the day, the committee’s health panel announced it would hold a hearing March 23 on legislation that Pallone and Subcommittee Chair Anna Eshoo (D-Calif.) said will strengthen Obamacare as a follow-up to the Biden administration’s $1.9 trillion coronavirus relief package. Members will consider bills that “build on that progress by expanding access to quality, affordable health care for the people,” they said in a statement.

Democrats, for the first time since its enactment, expanded the ACA as part of the aid package signed into law last Thursday (Public Law 117-2). Pallone called the aid bill a “down payment” for what’s coming next. “We want to continue to address access and affordability and address the damage done by the previous administration,” he said.

Pallone said the House will also take up a drug pricing bill in coming months “similar” to the sweeping Medicare negotiation bill (H.R. 3) passed by the chamber last session. He added that he hoped to work with Republicans on drug pricing, but he didn’t rule out using budget reconciliation to pass it by a party line vote.

“We all would like to see bills done with Republicans, if possible, but we certainly don’t rule out reconciliation,” Pallone said, Alex Ruoff reports.

Obamacare Insurers Inflate Claims to Reduce Refunds, Study Says: Obamacare insurers have short-changed their consumers by hundreds of millions of dollars, according to a study released yesterday by university researchers.

Fourteen percent of health insurers, particularly publicly traded insurers, are inflating the medical claims they report paying in order to avoid rebates required under the Affordable Care Act, according to a paper to be published in the Accounting Review. The paper is by Andrew Van Buskirk of Ohio State University, Evan Eastman of Florida State University, and David Eckles of the University of Georgia.

Under the ACA, health insurers are required to spend at least 80% of premium revenue on benefits, and they must refund the difference to policyholders if they don’t. Read more from Sara Hansard.

Happening on the Hill

Becerra Nomination: The Senate today plans to hold a procedural vote on whether limit debate on the nomination of Xavier Becerra to serve as secretary of Health and Human Services. Senate Majority Leader Charles Schumer (D-N.Y.) said Becerra will be confirmed later this week, Nancy Ognanovich reports.

Fauci Calls Variants Worrying Element of Crisis: Current evidence shows that vaccines with emergency use approval from the Food and Drug Administration are effective against genetic variants of the coronavirus, but “we must remain vigilant,” President Joe Biden’s top medical adviser Anthony Fauci plans to tell House Energy and Commerce Oversight and Investigations Subcommittee members. Fauci, the director of the National Institute of Allergy and Infectious Diseases, released prepared remarks ahead of today’s hearing on the pandemic. Read it here.

Other Hearings Today:

The Senate Health, Education, Labor and Pensions Committee will vote on the nominations of Vivek Murthy to be the U.S. surgeon general and Rachel Levine to serve as assistant secretary of Health and Human Services.
The Senate Finance Committee will hold a hearing that aims to explore how Covid-19 impacted nursing homes in the U.S. The hearing, announced by Chair Ron Wyden (D-Ore.), will feature testimony from John Dicken, director of health care at the U.S. Accountability Office, among others, according to a notice.
The House Energy and Commerce Subcommittee on Health plans a hearing on health-care access in U.S. territories.

Sanders’ Panel to Hold Drug Pricing Hearing: The Senate Health, Education, Labor, and Pensions Committee’s Primary Health and Retirement Security Subcommittee, led by Sen. Bernie Sanders (I-Vt.), announced it will hold a hearing on drug prices March 23. The event is titled, “Why Does the U.S. Pay the Highest Prices in the World for Prescription Drugs?” Find the hearing page here.

The Coronavirus Pandemic

Moderna Says Dosing Started in Pediatric Study: Moderna said the first children have been dosed in a clinical trial of its Covid-19 vaccine for kids ages six months to less than 12 years old. The phase 2-3 trial is being conducted in conjunction with the National Institute of Allergy and Infectious Diseases, the company said yesterday. The study is expected to enroll around 6,750 participants in the U.S. and Canada and will weigh three dose levels in young children and two dose levels in older kids in its first phase. Read more from Robert Langreth.

‘Vaccine Day’ Offers Promise of Finish Line: In the past week, the U.S. Covid-19 vaccination rate accelerated to 2.43 million doses a day, according to Bloomberg’s vaccine tracker. More than 100 million Americans have received vaccine doses, and over 30 million people have been fully vaccinated. The Biden administration is aiming to ramp up vaccine distribution and broaden eligibility to all adults by no later than May 1. Read more from Andrew Zaleski.

Still, with no federal website to help out, frustrated private individuals are increasingly creating Facebook groups and Twitter accounts to help friends and neighbors navigate a bewildering, disjointed maze of sites offering limited appointments for Covid-19 vaccines. Meanwhile, others are taking it a step further, launching private websites that share data nationally, as the Biden administration works to create a site in May. Read more from Jill R. Shah.
Former President Donald Trump said he would urge his supporters and others wary of the coronavirus vaccine to get it, while also saying that personal freedoms must be respected. Fauci on Sunday had said that reluctance among Republicans to receiving a vaccine is one of the biggest risks to controlling the coronavirus pandemic and that he’d like to see Trump publicly urge his supporters to get the vaccine, Mark Niquette reports.

More U.S. Headlines:

France, Italy Hint at Reversal on AstraZeneca: European Union governments sought to put another chaotic vaccine saga behind them as the EU’s drug regulator signaled AstraZeneca’s Covid-19 shot was safe and as France and Italy hinted that they were ready to lift suspensions. In a sign that the latest crisis may soon start to calm, Italian Prime Minister Mario Draghi and French President Emmanuel Macron said yesterday they’ll likely resume using AstraZeneca’s shot if the European Medicines Agency says it’s safe. Ian Wishart and John Follain have more.

Nationalism Threatens WHO’s Vaccine Goal: Vaccine nationalism in countries including the U.S. and India will probably derail efforts by the World Health Organization to deliver 2 billion doses to poorer and middle-income countries by the end of the year, according to the head of the world’s biggest vaccine maker. Countries are holding tight to their supplies and restricting access to materials, said Adar Poonawalla, CEO of the Indian company responsible for offering over half of doses used in the Covax program. Chris Kay and Haslinda Amin have more.

Russia yesterday condemned the U.S. for applying diplomatic pressure on Brazil to reject its Sputnik V vaccine, arguing that attempts at political interference in vaccination efforts will cost lives. The Health and Human Services Department said in a report that its Office of Global Affairs sought to persuade Brazil not to allow the Russian vaccine, accusing the Kremlin of aiming to expand its influence in the Americas to the “detriment of U.S. safety and security.” Jake Rudnitsky and Ilya Arkhipov have more.

More Global Headlines:

What Else to Know Today

HHS Retracts Part of Insurer Drug Coverage Model: The HHS yesterday withdrew a piece of a voluntary payment model introduced by the Trump administration allowing insurers to cut back the types of drugs they’re required to cover in Medicare. The Centers for Medicare & Medicaid Services said that based on stakeholder feedback, it won’t move forward with providing flexibility for Medicare plans to treat five of the six protected classes of drugs the same as they would for other drug types.

The Trump administration first announced the model in January 2019. Plans had until March 1 of this year to submit their notice that they intend to apply to participate in the model. Read more from Jacquie Lee.

Purdue Moves to Unload Opioid Settlements: Purdue Pharma has floated a settlement plan calling for members of the billionaire Sackler family to pay over $4.2 billion to help resolve the thousands of lawsuits that drove the maker of OxyContin, the opioid painkiller, to bankruptcy. Court papers filed late Monday by Purdue call for the drugmaker to hand over the company’s assets to trusts for the benefit of states, cities and counties suing to recoup the billions spent dealing with the nation’s opioid crisis.

Combined with the cash payment by the Sackler family—the company’s current owners— the Chapter 11 reorganization plan may be worth more than $10 billion, according to court filings. In exchange for the company and the funds, slated to be paid out over nine years, Purdue and the Sacklers would be legally insulated from existing and future opioid lawsuits. Certain states and cities that sued the drugmaker oppose that proposal, saying it doesn’t do enough to hold Purdue’s owners accountable. Read more from Jeremy Hill and Jef Feeley.

USDA Names Senior Officials on Food Safety: The Agriculture Department named Sandra Eskin as its new deputy undersecretary for food safety yesterday, where she will help lead a USDA division focused on certifying the safety of the country’s supply of meat, poultry, and egg products, as well as humane animal handling. Eyang Garrison was named chief of staff under the deputy secretary’s office. Megan U. Boyanton has more.

Trade Group Lobbies for Cannabis Oversight Model: A wine and spirits industry trade association is seeking to be at the forefront of federal cannabis oversight with its model regulatory framework released today. Wine & Spirits Wholesalers of America based its proposed system for adult-use cannabis production, testing, distribution across state lines, tax collection, and public safety measures on existing federal law over the alcohol industry, the group said.

The organization, which represents almost 400 member companies, also considers social equity measures in its model. It aims to help lower barriers to business permitting, benefiting individuals with past non-violent, cannabis-related offenses. A large segment of the population, “when you look at the war on drugs in the U.S., has been disproportionately affected,” said Michael Bilello, WSWA spokesman, Megan U. Boyanton reports.

More Headlines:

With assistance from Megan U. Boyanton and Nancy Ognanovich

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

Stay informed with more news like this – from the largest team of reporters on Capitol Hill – subscribe to Bloomberg Government today. Learn more.