HEALTH CARE BRIEFING: Relief Plan Could Trigger Medicare Cuts

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Democrats’ $1.9 trillion coronavirus relief package would trigger cuts to Medicare and other programs early next year unless Republicans agree to a waiver — a hurdle that could give the GOP leverage.

The Congressional Budget Office said in a letter yesterday to House Minority Leader Kevin McCarthy (R-Calif.) that Medicare would face a $36 billion cut, and as much as $90 billion in other programs would be slashed.

The spending cliff is entirely of the Democrats’ making. Under the 2010 Pay-As-You-Go law passed by Democrats and signed by then-President Barack Obama, spending increases and tax cuts that add to the deficit — like Biden’s plan — trigger automatic cuts the following calendar year. It takes 60 votes in the Senate to declare the new outlays an emergency and avoid the cuts, which means Democrats would need 10 Republicans.

Democrats are already plotting ways to turn off the Paygo trigger, according to a Senate Democratic aide who said the most likely scenario would be to attach a waiver to a future must-pass spending bill. That would effectively dare Republicans to shut down the government or go along. Read more from Steven T. Dennis.

House Vote Today: The House is poised to pass the $1.9 trillion Covid-19 stimulus, but a ruling late yesterday by a Senate official dealt a major blow to prospects that the final legislation will include a hike in the U.S. minimum wage to $15 per hour. Today’s vote in the House will bring most Americans one step closer to receiving $1,400 relief payments and move action to the Senate, where disagreements among Democrats over the minimum wage had been the biggest obstacle to turning the pandemic relief plan into law. Erik Wasson has the latest.

BGOV Bill Summary: Democrats’ Modified Reconciliation Package

Happening on the Hill

Surgeon General Pick Vows Clear Scientific Messaging: Two top HHS nominees pledged to focus on science and public health yesterday as a way to clear up U.S. confusion about Covid-19 vaccines and other pandemic issues. The Senate’s Health, Education, Labor, and Pensions Committee heard testimony from Vivek Murthy, Biden’s pick for surgeon general, and Rachel Levine, the White House nominee for assistant secretary of health.

Sen. Richard Burr (R-N.C.), the committee’s top Republican, stopped short of saying he will support the nominees. “The question before us today is, ‘Are both of you prepared and qualified to take on the roles and responsibilities required?’” Burr said. “I hope that you’ll use today’s hearing to address those concerns to earn my support.”

The committee’s chair, Sen. Patty Murray (D-Wash.), said, “Given the urgency of this moment, I’ll be pushing to get both of these nominees confirmed quickly.” Sen. Mitt Romney (R-Utah) told reporters he would back Murthy’s nomination.

Murthy was surgeon general during the Obama administration and has led Biden’s Covid-19 efforts in recent months. He said his top priority would be “to make sure we’re clear on what the science says, to go out to where people are, and to communicate that information clearly, including communicating why we change our recommendations if we do make changes.”

Meanwhile, Levine was unanimously confirmed three times by the GOP-led Pennsylvania state senate to serve as the the commonwealth’s secretary of health and physician general. During her career as secretary of health, Levine also led the Association of State and Territorial Health Officials, where she was an occasional critic of the Trump White House’s handling of the virus. Read more from Shira Stein.

Bill Targets Eating Disorders in Veterans: Reps. John Katko (R-N.Y.), Seth Moulton (D-Mass.) and Veronica Escobar (D-Texas) introduced a measure that aims to ensure TRICARE, the military’s health insurance program, provides members of the military and their families “with comprehensive treatment for eating disorders.” The bill would “clarify that under TRICARE, eating disorders treatment shall be provided to beneficiaries without age limitations when medically necessary.” Read a statement here.

Bipartisan Bill Tackles Disparities on Mental Health: Sens. Bill Cassidy (R-La.) and Brian Schatz (D-Hawaii) unveiled a bill yesterday that aims to “increase investments in schools conducting critical research into minority health disparities.” The bill, first offered in the 116th Congress by Rep. John Lewis (D-Ga.) before his death, allows the National Institute on Minority Health and Health Disparities to resume providing grants for research on minority health disparities. Read a statement here.

The Coronavirus Pandemic

Biden Says U.S. Will Distribute J&J Vaccine Rapidly: Biden said the federal government will distribute Johnson & Johnson’s coronavirus vaccine as fast as the company can produce it, if the shot is approved by the Food and Drug Administration. “If—if—the FDA approves the use of this new vaccine, we have a plan to roll it out as quickly as Johnson & Johnson can make it,” Biden said yesterday at an event celebrating the injection of 50 million doses of coronavirus vaccines since he took office.

The event was intended to highlight the administration’s effort to curb the pandemic, Biden’s top campaign pledge, which depends largely on accelerating vaccinations. The administration has also sought to increase coronavirus testing and re-open schools—while more contagious, new variants of the virus have begun to circulate, threatening progress. “The more people get vaccinated, the faster we’re going to beat this pandemic,” Biden said.

The administration has said it will immediately allocate between 3 and 4 million doses of the J&J vaccine upon its approval, with just over two million going directly to states. The company has said it will deliver 20 million doses by the end of March. It’s long seemed likely that Biden would easily surpass his goal of 100 million doses in 100 days, as the pace was approaching 1 million a day even before Jan. 20. The U.S. hit the halfway mark 36 days later. Read more from Nancy Cook and Josh Wingrove.

Johnson & Johnson’s vaccine is set for vetting by a panel of outside advisers to the FDA today, one of the final steps toward potential authorization of the country’s first one-dose immunization against Covid-19. If the panel votes that the vaccine’s benefits outweigh its risks, as expected, the agency could grant emergency clearance within days. While the committee’s decision is non-binding, the FDA usually follows its advisers’ recommendations. Read more from Robert Langreth.

Hospital Admissions Fall 72%, Led by Elderly: Covid-19 hospital admissions plummeted 72% in a month in the U.S. as the virus ebbed and the vaccination push accelerated. Americans 85 years old and over saw the most pronounced drop, down 81% from January to February, data from the Centers for Disease Control and Prevention show. The rate was 23.4 hospitalizations per 100,000 residents 85 and over for the week of Feb. 7-13, the latest data available. That was down from 120.3 per 100,000 four weeks earlier. Read more from Jonathan Levin.

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What Else to Know Today

Ex-Senator Joins Firm Serving PhRMA: Former Sen. Pat Roberts (R-Kan.), who left Congress in January, has joined top lobby shop Capitol Counsel. Roberts will serve as a senior counselor to the firm’s clients, offering “his insights and advice about legislative strategy and his deep understanding of the executive branch,” the firm said in a release. Capitol Counsel is a top firm by revenue, earning $19 million in 2020 from clients including the American Health Care Association and the Pharmaceutical Research and Manufacturers of America. Read more from Megan R. Wilson.

Opioids to Leave Mark Long After Pandemic: With opioid deaths soaring under the veil of Covid-19, health workers expect the rate of infants born dependent on drugs are also rising alongside them, creating huge financial and societal costs that will last decades beyond the pandemic. The national rate of babies born with neonatal abstinence syndrome was already rising prior to the coronavirus—82% from 2010 to 2017. Health workers say the problem has worsened during the pandemic. Read more from Valerie Bauman and Ian Lopez.

Insurers Urge SCOTUS to Review Damages in ACA Pay Case: The federal government must repay health insurers in full for money they lost by decreasing members’ deductibles, copays, and coinsurance under an Obamacare program designed to make plans more affordable, two health insurers said to the Supreme Court. The insurers are seeking review of a court decision that they argue “allows the government to escape billions of dollars in binding commitments” owed to those who participated in the Affordable Care Act’s cost-sharing reduction initiatives. Mary Anne Pazanowski has more.

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With assistance from Jack Fitzpatrick

To contact the reporter on this story: 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

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