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COVID-19: Federal Update (7/13)


Quick Takes


— HOUSE APPROPRIATORS SET TO MARK UP ENERGY-WATER, L-HHS SPENDING BILLS. The House Appropriations Committee will look to wrap up full committee markups of FY 2021 spending bills this week.


— EPA TO RETAIN OZONE STANDARD BY OBAMA ADMINISTRATION. EPA administrator Andrew Wheeler plans to announce the decision to retain the existing standard today.


— HHS ANNOUNCES NEW PROVIDER FUNDING ALLOCATION. $4 billion in additional COVID-19 relief funding will be sent to safety-net and rural health providers.


— CMS ALLOCATES ADDITIONAL RESOURCES FOR NURSING HOMES. The agency plans to deploy Quality Improvement Organizations (QIOs) across the country to provide immediate assistance to nursing homes in the hotspot areas.


Capitol Hill Update


— HOUSE APPROPRIATORS SET TO MARK UP ENERGY-WATER, L-HHS SPENDING BILLS.No votes are currently scheduled in Congress this week, but Members on the House Appropriations Committee are set to resume their full committee markups of fiscal year (FY) 2021 spending bills. Appropriators will take up the spending bills for: (1) Energy-Water Development (report) and Labor-HHSEducation (reporttoday (2) Defense(report)Commerce-Justice-Science (CJS) (report), and Transportation-HUD (report)tomorrow; and (3) Homeland Security and Financial Services and General Government (FSGG) on Wednesday. House floor action on the funding bills that clear the full committee is expected to occur prior to the end of the month. Meanwhile, the Senate's appropriations process remains gridlocked over certain poison pill amendments, and immediate next steps remain unclear. 


Washington Insider: What We’re Reading


The Trump administration plans to retain a national limit of 70 parts per billion for the pollutant ozone, the standard set by the Obama administration five years ago after business groups fought tougher standards. The Clean Air Act requires the Environmental Protection Agency to review ozone, soot and a handful of other named pollutants every five years, with a mandate to consider only the latest science on public health and not the cost of implementation. EPA administrator Andrew Wheeler plans to announce the decision to retain the existing standard on Monday.


A coalition of major companies and trade groups that represent more than half of American private sector workers wrote to President Trump on Saturday urging him to leave the Deferred Action for Childhood Arrivals (DACA) program in place.More than 140 companies and trade associations signed on to the letter, including Apple, Microsoft, Facebook, Google, Marriott, Target, Uber, Lyft, the National Retail Federation and the U.S. Chamber of Commerce. The groups are members of the Coalition for the American Dream, which organized the letter.


Disagreements between leaders at the Federal Reserve and Treasury Department in recent months slowed the start of their flagship lending initiative for small and midsize businesses, according to current and former government officials. The differences centered on how to craft the loan terms of their $600 billion Main Street Lending Program to help support businesses through the early stages of the coronavirus pandemic. Fed officials generally favored easier terms that would increase the risk of the government losing money, while Treasury officials preferred a more conservative approach, people familiar with the process said.


The House Appropriations Committee on Friday voted to block a controversial Trump Administration transparency rule that the Environmental Protection Agency’s (EPA) own independent board of science advisers criticized. "This rule would place new crippling limits on what studies can be utilized when EPA crafts new regulation," said the amendment's sponsor, Rep. David Price (D-N.C.), citing a slew of experts and scientific associations.


COVID-19: What We’re Hearing


— 'CARES 2.0' STATE OF PLAY. Senate Majority Leader Mitch McConnell (R-KY) provided more details on the GOP priorities for the next round of COVID-19 relief legislation in a sign that another bill could be on the horizon toward the end of this month. Leader McConnell stated that he will be unveiling legislation in the forthcoming weeks that prioritizes health care, jobs, reopening schools and universities, and liability protections. Treasury Secretary Steven Mnuchin noted last week that he expects negotiations between Senate Republicans, House Democrats, and the White House to begin in earnest when the upper chamber returns from its July 4 district work period the week of Jul. 20. However, it remains to be seen whether the parties can clinch a bipartisan agreement given the deep policy divides over the size and scope of the next round of relief. Lawmakers are mulling over several policy options for the next round of legislation, including:

  • Liability. Leader McConnell and Sen. John Cornyn (R-TX) are working on legislation that would limit the liabilities of health care workers, business owners, and employees from lawsuits pertaining to the COVID-19 outbreak. Leader McConnell stated that the GOP's liability provision would insulate stakeholders from lawsuits retroactive to Dec. 2019 through 2024, unless these entities are "grossly negligent or intentionally engaged in harmful behavior. He has continuously emphasized that any future COVID-19 relief efforts must include these protections in order for the Senate to consider additional relief legislation.

    • House Democratic leadership appears open to negotiating a deal on liability protections. House Majority Leader Steny Hoyer (D-MD) emphasized that these protections must not undermine the health and rights of workers, but indicated that the issue is open for further discussion and negotiation.

  • Health Care Priorities. Reports out of the Trump administration suggest that the White House is prioritizing action on surprise medical billing in the next round of relief legislation. It is also looking to address price transparency for pharmaceuticals, as well as an adjustment in the reimbursement rate for telemedicine.

    • During the CARES Act negotiations, Chairman Frank Pallone (D-NJ) and Senate Health, Education, Labor, and Pensions (HELP) Chairman Lamar Alexander (R-TN) were actively trying to tack their surprise billing legislation onto the package. 

  • Stimulus Payments. In a recent interview, President Trump expressed openness to another round of direct economic impact payments, saying that he wants “larger numbers than the Democrats” have offered. Leader McConnell has also expressed openness for another round of stimulus payments that would be targeted toward individuals making $40,000 a year or less.

  • PPP. The Paycheck Protection Program (PPP) application process has officially been reopened thanks to swift action by Congress. House and Senate lawmakers were able to clinch unanimous consent agreements on a bill that would reopen the application process for the roughly $134 billion remaining in the signature small business rescue program, pushing the application deadline from June 30 to August 18. lawmakers are already eyeing additional PPP reforms in the next round of COVID-19 relief legislation. 

    • Small Business Committee Chairman Marco Rubio (R-FL) is drafting additional PPP legislation that would create new programs to expand the use of the remaining funds within the program, including a $25 billion set-aside for businesses with fewer than 10 employees.

    • Ranking Member Ben Cardin (D-MD) and Sen. Jeanne Shaheen (D-NH) have introduced a bill that would extend the PPP application deadline by six months and authorize new lending for businesses with fewer than 100 employees.

    • Additionally, there has been a bipartisan push in Congress to expand PPP eligibility to 501(c)6 organizations and other currently ineligible nonprofits in the next round of COVID-19 relief legislation. 

  • Unemployment Reform. Senate Republicans are spearheading efforts on reforming the enhanced unemployment benefits so that generous payments approved in the CARES Act don’t become an obstacle to rehiring workers.

    • A key option on the table includes enhancing a tax credit that would give employers a tax break for keeping workers on the payroll.

  • State and Local Governments. Funding for state and local governments is a key pillar of the Democrats' next stimulus bill. While there is bipartisan agreement that more needs to be done to help stymie economic hardships for these entities, allocating additional funding has become a divisive issue within the Republican conference.

    • It appears likely that some Senate Republicans — particularly those who are up for re-election — would coalesce behind a bipartisan proposal that would provide additional funding and flexibility to address needs at the state and local level.

  • Budget Reform. A bipartisan group of House lawmakers penned a letter to Speaker Nancy Pelosi (D-CA) and Minority Leader Kevin McCarthy (R-CA) calling for provisions that address the federal debt and trust funds for Medicare and Social Security to be included in the next round of COVID-19 relief legislation.

COVID-19 Legislative & Regulatory Trackers


NEW TODAY...

— HHS ANNOUNCES NEW PROVIDER FUNDING ALLOCATION. The Department of Health and Human Services (HHS) announced $4 billion in additional COVID-19 relief funding for providers that serve a high number of Medicaid patients and provide large amounts of uncompensated care, including to rural populations.


— CMS ALLOCATES ADDITIONAL RESOURCES FOR NURSING HOMES. The Centers for Medicare and Medicaid Services (CMS) announced plans to provide additional resources to nursing homes COVID-19 hotspots. 

  • Specifically, the agency plans to deploy Quality Improvement Organizations (QIOs) across the country to provide immediate assistance to nursing homes in the hotspot areas as identified by the White House Coronavirus Task Force. 

RECENT DEVELOPMENTS…

— HHS, HRSA AWARD NEW FUNDING FOR HEALTH CENTERS. The Department of Health and Human Services (HHS) and the Health Resources and Services Administration (HRSA) awarded $21 million to support health centers' COVID-19 response efforts.

  • This includes $17 million to support 78 Health Center Program look-alikes (LALs) with funding to expand capacity for COVID-19 testing.


— TREASURY UPDATES CORONAVIRUS RELIEF FUND FAQS. The Treasury Department updated its list of frequently asked questions on the state, local, and tribal Coronavirus Relief Fund.


— NIH LAUNCHES NEW COVID-19 CLINICAL TRIALS NETWORK. The National Institutes of Health (NIH) has launched a new clinical trials network to test COVID-19 vaccines and other prevention tools.


— HRSA POSTS FACT SHEET ON PROVIDER RELIEF FUND FOR MEDICAID AND CHIP PROVIDERS. HRSA has published a new fact sheet for Medicaid and CHIP providers on the Provider Relief Fund.


— SBA, TREASURY OFFICIALLY DISCLOSE PPP RECIPIENTS. The Small Business Administration (SBA) and Treasury Department have officially disclosed the names of more than 650,000 recipients of the Paycheck Protection Program (PPP). Clickhere to access the database.


— TRUMP ADMINISTRATION ANNOUNCES NEW 'OPERATION WARP SPEED' INITIATIVES. HHS and Department of Defense announced two new investments into COVID-19 vaccines and treatments as a part of the Trump administration's "Operation Warp Speed" initiative. This includes a $450 million contractwith Regeneron Pharmaceuticals to manufacture an investigational anti-viral antibody treatment, as well as a $1.6 billion deal with Novavax to ramp up production of a potential vaccine.


—TRP SPECIAL REPORT: THE VIABILITY OF DRUG PRICING REFORMS DURING THE COVID-19 PANDEMIC. TRP's newest Special Report examines recent legislation tackling drug pricing reform or price controls for COVID-19 therapies and vaccines, provides a state-of-play on the larger debate on the Hill and within the administration, and explores perspectives on ensuring the affordability of coronavirus-targeted products from the biopharmaceutical industry and health stakeholders.


— TRP SPECIAL REPORT: COVID-19 EMERGENCY DECLARATIONS AND HEALTH POLICY. TRP has published a Special Report describing how emergencies are declared, how they end, the health-related flexibilities that were enabled by the declarations, and what will happen when the emergencies expire.

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