HEALTH CARE BRIEFING: Senate to Tee Up Vote on Becerra for HHS

By Alex Ruoff and Brandon Lee

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Lawmakers will tee up the nomination of Xavier Becerra to lead the Department of Health and Human Services today, a Senate Democratic source said. The nomination has, so far, seen only Democratic support, making him likely to be President Joe Biden’s first cabinet pick to be confirmed along party-line votes.

The Senate is set to vote on discharging his nomination from committee today, a precursor to the confirmation vote. Confirming Becerra means Biden can move forward more aggressively with his health agenda: tackling the Covid-19 pandemic; reversing some of the changes made under the Trump administration; and building on the Affordable Care Act.

Becerra’s nomination will need four hours of debate and a majority vote for the chamber to bring it up for a final vote after gaining no Republican support during a committee vote last week. Republicans have opposed Becerra’s nomination largely due to his long-time support for abortion rights. Conservatives have also questioned his lack of medical expertise, though only a minority of recent HHS secretaries have been doctors.

Democrats have touted Becerra’s work in helping to create the Affordable Care Act during his time in the House and his defense of the signature health law as California’s attorney general.

Democrats hold the thinnest-possible majority in the Senate, so any Republican opposition to Becerra’s nomination will require Democrats to stay unified in support. Anti-abortion groups have targeted Sen. Joe Manchin (D-W.Va.), who has supported abortion restrictions, as a possible swing vote for their crusade to sink Becerra’s nomination. Read more from Alex Ruoff and Laura Litvan.

Also Happening on the Hill

Lawmakers Eye Delay on Medicare Cuts: Congress will follow up on the passage of the $1.9 trillion Covid-19 relief package (H.R. 1319) with a measure to delay billions of dollars in cuts to Medicare, a problem exacerbated by the package, according to a senior Democratic aide. The House is set to tackle the Medicare sequester moratorium in the coming weeks, according to the aide, who spoke on condition of anonymity to discuss plans that haven’t been announced publicly.

Health-care provider groups want lawmakers to quickly address the end to a moratorium on the 2% Medicare sequester, coming next month, and a 4% Medicare sequester amounting to $36 billion in cuts coming in early 2022. The groups warn that medical practices in particular have been stressed by the pandemic and should not have to face lower Medicare reimbursements. “Now’s not the time for Congress to forget the sacrifices our providers have made during the pandemic,” Jerry Penso, president of the American Medical Group Association, said yesterday.

The upcoming cuts come from Democratic priorities: the $1.9 trillion aid package, which was applauded by the American Medical Association and AMGA, triggers a 2010 “Pay-As-You-Go” law passed in 2010 by Democrats that requires anything that adds to the federal deficit to be offset by spending reductions. Democratic leaders expect to have bipartisan backing to waive the PAYGO rules, as they did for Republicans’ 2017 tax cuts, the aide said, Alex Ruoff reports.

Clinical Labs Don’t Get Medicare Vows: Clinical laboratories got no assurance from two key lawmakers they’d be spared from Medicare cuts in coming years. Rep. Brett Guthrie (R-Ky.), the lead Republican of the House Energy and Commerce Health Subcommittee, told the American Clinical Laboratory Association yesterday at the group’s annual meeting that its members may see their Medicare payments reduced next year, Ruoff reports.

“After you have done so much and continue to do so much during the Covid-19 public health emergency, labs may see a steep cut to Medicare reimbursement” due to a 2014 law, Guthrie said. Guthrie said he’s waiting on a congressional advisory group’s ruling on overhauling the Protecting Access to Medicare Act. PAMA was aimed at cutting payment rates for lab tests to help reduce Medicare, but results have been mixed. Medicare spending for tests increased in 2018 by $459 million, a 6% increase over the previous year even though rates were decreased.

Murray Seeks $4.5 Billion for Health Infrastructure: Senate Health, Education, Labor, and Pensions Chair Patty Murray (D-Wash.) and other Democrats introduced a bill that seeks to establish “a new core public health infrastructure program which ramps up to $4.5 billion in annual funding to bolster the nation’s efforts to fight the COVID-19 pandemic, and strengthen its ability to respond to other public health challenges going forward,” according to a statement. Read the legislation here.

Alston & Bird Nabs Two Hill Staffers: James Paluskiewicz, former chief health counsel for the House Energy and Commerce Health Subcommittee’s Republicans, and Neleen Rubin, former Senate Finance Committee Democratic health policy staffer, have joined Alston & Bird’s health care practice, the firm announced yesterday. Rubin helped develop the Affordable Care Act as a staffer on the Senate Finance Committee, according to a statement. Read it here.

Hearings Today:

The Coronavirus Pandemic

Biden Boosts J&J Vaccine Order: Biden said doubling the U.S. order of Johnson & Johnson’s single-shot vaccine will help build a stockpile larger than the country’s population, providing backup doses to meet unexpected needs as novel variants of the virus emerge. After the U.S. is satisfied that it has sufficient supply to meet contingencies, it will provide vaccines to other countries, he said. “We are not going to be ultimately safe until the world is safe,” Biden said.

Biden made the public remarks after an event at the White House yesterday with J&J CEO Alex Gorsky and Merck CEO Ken Frazier. The companies last week reached a collaboration to boost production of J&J’s recently authorized Covid-19 vaccine. The U.S. had previously ordered 100 million doses, which the company has said would be delivered before the end of June. J&J and the government will finalize the new order in coming weeks, U.S. officials said. “I’m doing this because during this wartime effort we need maximum flexibility,” Biden said. Read more from Josh Wingrove and Riley Griffin.

  • But nearly two weeks after being cleared by regulators, Johnson & Johnson’s single-shot coronavirus vaccine is not yet providing a visible jolt to the U.S. immunization campaign. Almost 3.6 million doses of the J&J vaccine have been distributed since the shot received emergency authorization on Feb. 27, yet only 440,000 have been put in people’s arms. In California, which received 440,000 doses across all providers in the state, only 2,200 shots have been injected, federal data show. Read more from Angelica LaVito and Jill Shah.

Nursing Homes Face Task in Upping Staff Shots: Nursing homes will have to get creative—and a little lucky—to reach their goal of increasing employees’ vaccination rates from 40% to 75% by the end of June. The task will get much more difficult in the coming weeks after CVS’s and Walgreens’ pharmacies finish the last of their three on-site vaccine clinics at each facility. After that, nursing homes will have to fend for themselves. Tony Pugh has more.

Shots Slow in Some States, Opening Way for Policy Shift: The pace of Covid-19 vaccinations appears to be slowing in some parts of the U.S., possibly signaling that more states may need to follow Alaska in dramatically broadening access. Alaska, an outperformer in the inoculation race, said on Tuesday it’d become the first state to open up shots to everyone over age 16. It’s not the only jurisdiction that has seen the pace of shots administered sputter recently. Others include Arkansas, Tennessee and Mississippi. Read more from Jonathan Levin.

  • Meanwhile, a highly infectious Covid-19 variant is likely the dominant strain in Florida, Texas and Georgia, and gaining a foothold across the country, according to new data from testing company Helix. In the states, over 50% of the latest samples exhibited S gene target failure, a key characteristic of the variant first identified in the U.K., called “B.1.1.7.” The variant has stirred warnings of a possible resurgence.

More Headlines:

What Else to Know Today

Biden Drops Defense of Trump ‘Public Charge’ Rule: The Justice Department told courts it will no longer defend a Trump administration rule that sought to withhold legal status from most immigrants who rely on government benefits. The “public charge” rule sought to deny green cards to migrants who used Medicaid, food stamps, housing vouchers, or other forms of government help. Groups that sued in 2019 said the rule effectively imposed a wealth test on immigrants, Bob Van Voris reports.

NIH Chief Wants to Keep ‘Shark Tank’ Testing Program: Developers of promising medical technologies could get a boost from the NIH under a “Shark Tank”-like program the agency’s director wants to keep once the pandemic subsides. The initiative, called RADx, responded to Covid-19 testing shortfalls last spring by setting up a venture capital-like fund within the NIH that focused on the most promising technologies. RADx is one of several initiatives created in response to Covid-19 that NIH Director Francis Collins said yesterday he’s likely to keep. Read more from Jeannie Baumann.

More Headlines:

With assistance from Shira Stein

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

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