HEALTH CARE BRIEFING: Trump Tees Up Health-Care Orders This Week

By Brandon Lee

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The White House is planning to roll out executive orders to protect Americans from surprise medical bills and require insurers to cover pre-existing conditions, according to two people familiar with the planning.

The executive orders would let President Donald Trump claim he’s tackling major health-care issues, but their immediate effect will be limited because they will likely just provide directions to federal agencies. It’s unclear how the administration could substantially address either issue without Congress, one congressional source said.

Trump is expected to announce the moves tomorrow, when he’s set to host an event in Charlotte, N.C., which the White House has billed as an opportunity for him to lay out his health-care vision, the people said.

White House officials haven’t completed the orders and are still wrapping up some details, one administration aide cautioned. Politico first reported the plans for executive orders.

The Trump administration proposed a simple ban on balance billing this year, which would prohibit health-care providers from charging patients for services their insurers won’t cover. Lawmakers opted instead to back a more comprehensive approach to address how those charges are eventually settled, but haven’t been able to get it through Congress. Read more from Alex Ruoff.

Congressional Virus Efforts

Today’s Hearings:

House Passes Stopgap Funding Measure: The House passed a stopgap funding bill to keep the government operating through Dec. 11 after both parties in Congress and officials at the White House struck a deal to provide aid to farmers and food assistance for low-income families. The 359-57 vote now sends the temporary spending bill to the Senate for a vote before the fiscal year ends on Sept. 30. Final passage would avert a government shutdown just before the Nov. 3 general election, Erik Wasson and Jack Fitzpatrick report.

  • The bill includes $8 billion for child and family nutrition programs, as well as funds to replenish the Commodity Credit Corporation. The legislation would extend and modify a program that allows families to receive food aid via electronic benefit transfer when schools are closed. Waivers that give nutrition programs flexibility to operate during the pandemic would also be extended, Megan Boyanton and Sarah Babbage report.
  • BGOV Bill Summary: H.R. 8337, Stopgap Funds & Program Extensions

Lawmakers Seek $3 Billion for NSF: Reps. David McKinley (R-W.Va.) and G.K Butterfield (D-N.C.) urged colleagues in a letter yesterday to support providing the National Science Foundation $3 billion in emergency aid. The organization conducts research, including for Covid-19. “While our nation’s scientists and research institutions have risen to the challenge of the pandemic, they are facing enormous strains to their operations and infrastructure,” the lawmakers wrote. Read the letter here.

OSHA Called ‘Feckless’ on Meat Plant Virus Cases: A faster and more forceful response by U.S. officials could have prevented the large outbreaks of Covid-19 at meat plants that sickened thousands and killed dozens of workers, according to a letter from Sens. Elizabeth Warren (D-Mass.) and Cory Booker (D-N.J.). The pair slammed the “feckless” response by the Occupational Safety and Health Administration, which this month had fined Smithfield Foods $13,494 and JBS Foods $15,615 for not protecting workers at two meat plants in South Dakota and Colorado. Michael Hirtzer has more.

Lawmaker-Doctors Target Medicare Cuts: Surgeons, specialty care providers, and leading physician activists facing cuts in their Medicare payment rates next year are looking at federal intervention. A bipartisan group of House lawmakers, several of whom are physicians, are working to add such a provision in the next pandemic relief bill. Read more from Tony Pugh.

Senators Say Some Still Paying for Tests: Sens. Maggie Hassan (D-N.H.), Ron Wyden (D-Ore.) and Health, Education, Labor, and Pensions top Democrat Patty Murray (D-Wash), among others, raised concern yesterday about individuals still being charged for coronavirus diagnostic tests despite the CARES Act requiring health insurers to cover testing costs. The nine senators urged Aetna President Karen Lynch to affirm that customers wouldn’t need to pay out of pocket for a Covid test. Read the letter here.

House Legislation: The House yesterday passed by voice vote:

  • Global Health Security: The Global Health Security Agenda Interagency Review Council to facilitate and review the federal response to global infectious disease threats would be codified by H.R. 2166. It was established in a 2016 executive order signed by former President Barack Obama. The measure also would direct the president to appoint a coordinator to lead U.S. strategy on global health emergencies. The House Foreign Affairs Committee amended and approved the bill by voice vote on March 4. For more, see the BGOV Bill Summary by Naoreen Chowdhury.
  • Global Childhood Development: The U.S. Agency for International Development (USAID) would be authorized to promote early childhood development programming abroad under H.R. 4864. The House Foreign Affairs Committee amended and approved the bill by voice vote on Dec. 18, 2019. For more, see the BGOV Bill Summary by Naoreen Chowdhury.

More on the Pandemic

Trump Redirects Testing, Mask Funds to Boost Vaccine War Chest: The Trump administration has shifted billions of dollars previously allocated to public-health programs into its Operation Warp Speed vaccine push, reflecting the U.S. government’s increasing focus on a medical solution to ease the Covid-19 pandemic. The transfers, disclosed in a government audit, reported by Bloomberg News and described by congressional aides, have grown the budget of the Warp Speed program to as large as $18 billion, much larger than the $10 billion figure the administration has routinely cited in public.

One of the biggest transfers came in August, with $6 billion pulled from $16.7 billion that had been allocated to the U.S. Strategic National Stockpile, which buys, holds and distributes crucial medical supplies in times of national crisis. The money had originally been meant to replenish stocks of medical protective gear, ventilators, and Covid-19 testing supplies, all of which have experienced shortages at points during the pandemic. Read more from John Tozzi, Riley Griffin and Shira Stein.

U.S. Deaths Top 200,000: The U.S. death toll from the novel coronavirus exceeded 200,000, a grim milestone that comes eight months after the pathogen was first confirmed on American soil, Bloomberg News reports.

Smartphone Tracking Planned for First Vaccines: Americans that get the first Covid vaccines will be closely monitored by the Centers for Disease Control and Prevention with daily text messages and emails, according to a federal advisory group. Essential workers who are expected to be the first recipients will get daily texts on their phones inquiring about side effects in the first week after they get the shot, Tom Shimabukuro, a CDC immunization specialist, said at a meeting of the CDC Advisory Committee on Immunization Practices. Anna Edney has more.

Where Does a Person’s Data on Vaccine Status Go? Another hurdle to gaining the public’s trust on a vaccine is knowing where one’s vaccination status data is sent. Patching together state immunization databases with information held by pharmacies like Walgreens, CVS, and Walmart to track coronavirus vaccinations opens the door for misusing patient data, lawyers have warned. Read more from Jacquie Lee.

Pence Aide Says He Fired Staffer Who Criticized Trump: Vice President Mike Pence’s national security adviser told reporters that he had fired a former aide to Pence who filmed an ad last week criticizing Trump’s response to Covid-19. “I fired her,” Keith Kellogg, an ex-general who advises Pence, said of Olivia Troye, who formerly worked on Pence’s coronavirus task force. “The reason I fired her is because her performance started to drop,” he said. Justin Sink, Mario Parker, and Jennifer Jacobs have more.

CDC Recommends Changes to Holiday Celebrations: New guidance from the CDC for the upcoming holiday season warns that hosts and attendees at holiday celebrations will need to take steps to limit the risk of contracting and spreading the coronavirus. Virtual events or those that involve one’s immediate household are low risk, the agency said in a posting. If people do gather in person, the CDC recommends doing it outdoors, keeping groups small, and taking measures like mask-wearing. Emma Court has more.

Stockpile Adds $65 Million in Drugs: Fresenius Kabi and Baxter Healthcare will supply almost $65 million in medicines to the national medical stockpile to treat patients with Covid-19 and prepare for future health emergencies. The Strategic National Stockpile is buying the pharmaceuticals as part of a plan to restructure and resupply, known as “SNS 2.0,” so that there are enough in the case of future Covid-19 flare-ups. Read more from Shira Stein.

More Headlines:

What Else to Know

Panel to Probe Drug Prices: House Oversight Chairwoman Carolyn Maloney (D-N.Y.) announced two days of hearings on Sept. 30 and Oct. 1 with pharmaceutical executives to examine “some of the costliest drugs” in the U.S., according to a statement. The chief executives from Bristol-Myers Squibb and Teva Pharmaceuticals, as well as Celgene’s former CEO, will testify on Sept. 30. Amgen, Mallinckrodt Pharmaceuticals and Novartis executives will appear Oct. 1, Jameelah Robinson reports.

Purdue’s Bonus Plan Called ‘Inappropriate’: Purdue Pharma‘s proposed $9.9 million executive bonus plan is “an affront” to thousands harmed by the opioid crisis, five senators told a U.S. bankruptcy judge. “Bonus payments as outlined in Purdue’s proposal should not be made while these families continue to wait for justice,” the lawmakers, led by Sen. Tammy Baldwin (D-Wis.), told Judge Robert D. Drain in a letter. Read more from Leslie A. Pappas.

Prior Approval for Medicare Non-Emergency Ambulances: Medicare patients in all states who take ambulances to routine non-emergency appointments—usually dialysis—will need prior authorization for those rides on most occasions. The Centers for Medicare & Medicaid Services announced yesterday the expansion of an ambulance transport payment mechanism that’s been tested in eight states and the District of Columbia for several years. It’s expected to save taxpayers money without compromising patient care. Read more from Fawn Johnson.

More Headlines:

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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