HEALTH CARE BRIEFING: U.S. Said to Pay for Uninsured Patients

By Brandon Lee and Alex Ruoff

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Some of the $100 billion in federal funds earmarked to help hospitals cope with the coronavirus pandemic will cover bills for the uninsured, Vice President Mike Pence said yesterday.

“We don’t want any Americans to worry about the cost of getting a test, the cost of getting treatment,” Pence told reporters yesterday at the White House.

The Trump administration is working on a proposal for the president to direct some of the funds targeted to hospitals to cover expenses for the uninsured. The funds would go directly to the medical facilities, Pence said. Officials expect to have an announcement today. Justin Sink and Mario Parker report.

Around 3.5 million American workers probably lost their employer-provided health insurance policies in the past two weeks as the epidemic triggered an unprecedented wave of layoffs, according to research published yesterday by the Economic Policy Institute.

The “very rough estimate” is based on industry-specific unemployment claims filed in Washington state, which had the earliest U.S. outbreak.

It’s hard to be precise because some laid-off workers will be able to get insurance via Obamacare exchanges or a family member who still has a job, or will qualify for government coverage under Medicaid, the EPI said. On the other hand, the 3.5 million doesn’t include spouses or children of the newly unemployed who may now be without coverage.

States Order Health Insurers to Keep Covering Workers: States including California, Ohio, Colorado, Wisconsin, and Maine are moving to require or encourage insurers to let employers continue covering employees under group policies—even if employees would normally lose eligibility due to layoffs or reduced hours. The move comes after employers have asked health insurers to continue to cover employees forced into furloughs. Read more from Sara Hansard.

Exchange Enrollment Holds Steady for 2020: Meanwhile, about the same number of people enrolled in Obamacare plans for 2020 as in 2019, the Department of Health and Human Services reported late Wednesday, Hansard reports.

Hospitals Press Insurers for Faster Payments: The hospital industry is asking major health insurers to follow Medicare’s lead and allow providers to receive their payments faster or more frequently during the Covid-19 emergency. Doing so would “make a significant difference in whether a hospital or health system keeps their doors open during this critical time,” said Richard Pollack, president and CEO of the American Hospital Association, in an letter Wednesday to insurance industry executives.

But Kristine Grow, a spokesperson with America’s Health Insurance Plans, said in a statement that decisions about payments should be made on a case-by-case basis. “Not every hospital is in need of advance payments, and not every plan is able to make them,” Grow said. Read more from Tony Pugh.

Combating an Equipment Shortage

White House Likely to Urge Face Cover: The White House is likely to recommend that people living in areas hardest hit by the coronavirus cover their faces in public, according to a person familiar with the matter, as new research shows that the pathogen may hang in the air after people sneeze, cough or even talk. The administration won’t urge Americans to buy commercial medical-grade masks, which are in short supply at hospitals. The recommendation from the U.S. Centers for Disease Control and Prevention would apply to areas with high levels of community transmission of the virus, the person said.

Officials in New York City, the epicenter of the outbreak in the U.S., and in California’s Bay Area yesterday told residents they should cover their faces when they are outside. Read more from Jennifer Jacobs and Michelle Fay Cortez.

Demand for Gear Outstrips FEMA’s Supply: A surging demand for protective equipment such as masks, gloves, face shields and even body bags from states to help deal with the pandemic far outstrips the federal government’s ability to respond, according to documents released by the House Oversight and Reform Committee yesterday. Five states and D.C., composing a regional group for the Federal Emergency Management Agency, asked for 5 million masks but got less than 500,000 by the end of March, documents show.

Masks are in high demand and short supply. FEMA officials told the committee on an April 1 call that trying to purchase face masks on the open market would be like “chasing rabbits in an open field,” because many domestic suppliers are not able to locate available supplies, according to a readout of the call from the oversight committee. FEMA also told members that the majority of the 100,000 ventilators Trump vowed will not be available until at least late June. Read more from Daniel Flatley.

  • The Strategic National Stockpile holds 9,500 ventilators and federal officials expect about 3,200 more in the next two weeks, according to a readout of a briefing by federal health and Federal Emergency Management Agency officials given to House Oversight staff. In comparison, New York state has about 2,200 in its state stockpile, Alex Ruoff and Jennifer Kay report.
  • At the same time, the administration is expected to put FEMA in charge of obtaining medical supplies like masks and gloves for the Strategic National Stockpile, including deciding who gets federal contracts, according to two people familiar with the discussions. The method that the White House is looking to use is an “interagency agreement” in which one federal agency does work for another. Typically, such arrangements are used when one agency lacks a certain capability. Read more from Shira Stein.

Trump Speeds Up Ventilator Production: Trump issued an order under the Defense Production Act to speed production of ventilators after state officials raised alarms that supplies are inadequate for Covid-19 patients. Trump signed an executive order directing HHS to ensure supplies for General Electric, Hill-Rom Holdings, Medtronic, ResMed, Royal Philips, and Vyaire Medical. The order doesn’t name the suppliers to companies manufacturing the ventilators. Read more from Jordan Fabian.

FDA Urged to Ease Sanitizer Production: A bipartisan Senate group urged FDA Commissioner Stephen Hahn in a letter yesterday to “remove another government roadblock hindering Americans’ response to the novel coronavirus pandemic” by lifting federal guidance that “effectively limits distillers to using denatured (non-food-grade) alcohol, despite the World Health Organization (WHO) recognizing the use of undenatured (food-grade) alcohol as an acceptable ingredient in hand sanitizer,” according to a statement from Sen. Rand Paul (R-Ky.), one of the letter’s authors. Read the letter here.

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Treatment, Coordination & Response

Commerce Schedules “Paper Hearing”: The Senate Commerce, Science, and Transportation Committee announced a hearing for April 9 on the use of big data to track and treat the coronavirus outbreak. The “paper hearing” will allow witnesses to answer lawmaker questions remotely with testimony posted online amid social distancing measures, according to a committee email statement.

Pelosi Wants Special Virus Committee: Speaker Nancy Pelosi (D-Calif.) said yesterday her chamber will create a special committee to oversee the government’s response to the pandemic, including how the $2 trillion from last week’s stimulus plan is spent. Pelosi told reporters yesterday the bipartisan committee, to be led by House Majority Whip James Clyburn (D-S.C.), will also aim to make sure that efforts are based on science and to protect against price gouging of essential materials in the broader economy. Billy House and Erik Wasson have more.

FDA Eases Gay Blood Donor Rules: Federal regulators eased restrictions that severely limit blood donations by men who have sex with men as supplies run short amid the pandemic. The FDA released revised guidelines yesterday that would allow gay men to donate blood after refraining from sexual contact for three months instead of a year. The FDA said that the experience in other countries, such as the U.K., with a three-month deferral and improved testing led the agency to make the change. Anna Edney has more.

Adjustments for Health Workers With Conditions: Doctors and nurses on the front lines of the coronavirus pandemic with health conditions of their own may seek out “reasonable accommodations” through the Americans with Disabilities Act, and employers must consider them despite the pandemic, according to the Equal Employment Opportunity Commission. Hospitals may not evade the law’s requirements by citing the crisis, the EEOC said in updated guidance. Read more from Paige Smith.

HHS Loosens Patient Privacy Laws: HHS won’t penalize business associates of the health-care industry for sharing patient information if it’s aimed at assisting the government in combating the pandemic, the agency said yesterday. HHS relaxed regulations under federal health privacy laws for business partners of hospitals, doctors and other health-care providers as long as they are acting in good faith, such as assisting the CDC, the Centers for Medicare and Medicaid Services, and other state health authorities in combating Covid-19, Ayanna Alexander reports.

Funding for Smaller Localities: A bipartisan lawmaker group asked Pelosi to ensure future coroanvirus relief bills “include stabilization funding specifically for localities with populations under 500,000,” according to a statement, saying that the latest stimulus didn’t allow for localities with populations under 500,000 to receive stabilization funds directly. “These smaller counties, cities, and towns have faced enormous costs while responding to the COVID-19 pandemic,” they said in a letter.

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Testing, Research & Development Efforts

Pence Touts 100,000 Daily Tests: Pence said more than 100,000 Americans are now being tested daily for coronavirus, as the government tries to ramp up its lagging response to tracking the outbreak. “We literally are tracking every single day the number of cases, where they’re coming out,” Pence said yesterday in an interview with Bloomberg Television. The availability and speed of testing across the U.S. has increased in recent days, but health professionals have warned that they aren’t able to test all patients who could have the virus. That has hampered efforts to prevent the disease from spreading into parts of the country that are relatively untouched.

Pence cited Abbott Laboratories, saying a weekend breakthrough on point-of-care testing will make an additional 50,000 tests available each day that take as few as five minutes to process. U.S. testing for the coronavirus was delayed because the CDC was slow to manufacture and distribute a reliable test kit. That’s prompted governors to warn that they don’t have the information to track the full scope of Covid-19. Justin Sink has more.

PhRMA Urged to Commit to Cheap Vaccine: House Oversight and Reform Chairwoman Carolyn Maloney (D-N.Y.) urged members of the Pharmaceutical Research and Manufacturers of America, the largest drugmakers’ industry group, to “commit to setting affordable prices for any medications that are or may be used to prevent or treat coronavirus, including vaccines,” according to a statement. “In order to end the ongoing coronavirus crisis, every American—regardless of income or insurance status—must be able to afford any drug that is effective in preventing or treating the virus,” Maloney said in a letter.

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What Else to Know

Fight Over Virus Shutdown of Abortion: An Alabama emergency order that’s been interpreted to require abortion providers to temporarily cease business is a good faith attempt to protect scarce medical resources during the coronavirus pandemic and should be allowed to take effect, Alabama told a federal district court. The state asked the U.S. District Court for the Middle District of Alabama this week to lift a March 30 temporary restraining order that blocked the policy’s enforcement and reinstate the emergency order.

The temporary order, issued by Judge Myron H. Thompson, prohibits Alabama from shutting down abortion clinics until he can rule on a preliminary injunction being sought by providers, who say that the ban is unconstitutional. There are three reasons for dissolving the temporary restraining order and denying the providers’ preliminary injunction motion, the state said in a brief. Read more from Mary Anne Pazanowski.

Birth Control Opt Outs Argued Invalid: Trump administration rules exempting employers with religious or moral objections from complying with Obamacare’s birth control coverage rules are invalid, two states told the U.S. Supreme Court. Three agencies violated normal administrative procedures when adopting rules that let employers offer their employees health insurance plans that don’t cover contraceptives and related services, Pennsylvania and New Jersey told the court, arguing the Affordable Care Act doesn’t authorize the administration to broadly release employers from their obligation to provide plans that cover women’s preventive services at no cost to employees, Mary Anne Pazanowski reports.

Cleary Rejoins Akin Gump: Akin Gump Strauss Hauer & Feld re-signed a prominent HHS attorney two months after the firm lost a health-care legal team to Ropes & Gray. Kelly Cleary, who is joining the firm’s health-care and life sciences practice in Washington, until recently served three years as deputy general counsel at HHS, and as chief legal officer for the Centers for Medicare & Medicaid Services. Read more from Sam Skolnik.

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

To contact the editors responsible for this story: Giuseppe Macri at gmacri@bgov.com; Zachary Sherwood at zsherwood@bgov.com; Michaela Ross at mross@bgov.com

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