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COVID-19: Federal Update (7/16)

Quick Takes

—MCCONNELL EXPECTED TO INTRODUCE NEW COVID-19 RELIEF BILL NEXT WEEK. Senate Republicans' opening offer on the next round of COVID-19 relief legislation could be unveiled as soon as next week as the upper chamber prepares to return from its July 4 district work period.

—TRUMP REINS IN MAJOR ENVIRONMENTAL LAW TO SPEED BIG PROJECTS. President Donald Trump announced Wednesday that he is rolling back a foundational Nixon-era environmental law that he says stifles infrastructure projects.

— PELOSI SIGNALS FLEXIBILITY ON SIZE OF RENEWED UNEMPLOYMENT PAYMENTS. The expanded unemployment benefits are set to expire at the end of the month.

— TRP SPECIAL REPORT: 2020 ELECTION OUTLOOK. Click here to view TRP's newest election outlook slide deck.

— FED EXTENDS PPP-RELATED RULE CHANGE. The Federal Reserve announced an extension of a rule change aimed at bolstering the effectiveness of the Small Business Administration's (SBA) Paycheck Protection Program (PPP).


Capitol Hill Update

—MCCONNELL EXPECTED TO INTRODUCE NEW COVID-19 RELIEF BILL NEXT WEEK.Senate Republicans' opening offer on the next round of COVID-19 relief legislation could be unveiled as soon as next week as the upper chamber prepares to return from its July 4 district work period. Majority Leader Mitch McConnell (R-KY)'s proposal is expected to focus on health care, jobs, and liability protections. Reports suggest that the GOP's bill will also contain $50-$100 billion in education funding, and could either be attached with conditions or incentives for schools to develop concrete reopening plans in the fall. Once the Senate returns next week, GOP Senators, House Democrats, and the Trump administration will begin negotiations on the next round of relief in earnest. 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 COVID-19 bill.


Washington Insider: What We’re Reading


President Donald Trump announced Wednesday that he is rolling back a foundational Nixon-era environmental law that he says stifles infrastructure projects, but that is credited with keeping big construction projects from fouling up the environment and ensuring there is public input on major projects. Trump was in Atlanta to announce changes to National Environmental Policy Act regulations for how and when authorities must conduct environmental reviews, making it easier to build highways, pipelines, chemical and solar plants and other projects.

Speaker Nancy Pelosi (D-Calif.) on Wednesday signaled a willingness to compromise with Republicans on the size of renewed expanded unemployment benefits, which are currently set to expire at the end of the month. During a press conference at the Capitol, Pelosi indicated that the size of the expansion would depend on whether the next coronavirus relief package includes another round of direct stimulus payments to individuals and families.

Amid a nationwide push by activist groups including Black Lives Matter to cut police budgets and redirect the money toward minority communities, some of America’s biggest cities are doing the opposite. Houston, Phoenix and San Diego—the fourth-, fifth- and seventh-biggest cities in the U.S. by population—have all increased their police forces’ funding in budgets passed in the past month as much as 5%. They contrast with a larger number of cities where leaders have cut or said they plan to cut police budgets, including New York, Los Angeles, Portland, Ore., Baltimore and San Francisco.

A coalition of former military officials is urging lawmakers to extend a ban of drilling in the eastern Gulf of Mexico, arguing a lapse in the moratorium will hurt military preparedness. The letter comes as Florida lawmakers are seeking to extend the moratorium, which expires in June 2022, as Congress grapples with the must-pass National Defense Authorization Act (NDAA), a bill that sets military policy for the year.


COVID-19: What We’re Hearing


— 'CARES 2.0' STATE OF PLAY. 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.

  • Unemployment Reform. Congressional Republicans have spearheaded efforts on reforming the enhanced unemployment benefits so that generous payments approved in the CARES Act don’t become an obstacle to rehiring workers. Democrats, on the other hand, have emphasized that the enhanced unemployment insurance benefits must be a part of the next round of relief legislation.

    • Senate Republicans have expressed openness to lowering the unemployment boost from $600 to the $200-$400 range. Another compromise option could be enhancing a tax credit that would give employers a tax break for keeping workers on the payroll.

  • 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. President Trump stated recently that he is open 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.

  • 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…

— FED EXTENDS PPP-RELATED RULE CHANGE. The Federal Reserve announced an extension of a rule change aimed at bolstering the effectiveness of the Small Business Administration's (SBA) Paycheck Protection Program (PPP). The extension will temporarily modify the Board's rules so that certain bank directors and shareholders can apply to their banks for PPP loans for their small businesses.

— CMS PUBLISHES OVERVIEW OF TELEHEALTH UTILIZATION. In a blog post in the Journal Health Affairs, CMS Administrator Verma provides an overview of CMS’ analysis of telehealth utilization among Medicare beneficiaries during the pandemic.


RECENT DEVELOPMENTS…

— HHS CHANGES PROCESS FOR HOSPITALS TO REPORT COVID-19 DATA. The Department of Health and Human Services (HHS) announced changes to its process for collecting daily COVID-19-related data from hospitals, starting today. HHS plans to use this data to inform decisions at the federal level, such as allocation of supplies, treatments, and other resources.

— TRP SPECIAL REPORT: THE PROVIDER RELIEF FUND AND ITS DISTRIBUTIONS. On Jul. 10, 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. Click here to read TRP's updated analysis on the provider relief fund and its distributions.

CMS EXTENDS COMPLIANCE DEADLINE FOR MEDICAID HCBS SETTINGS RULE. The Centers for Medicare & Medicaid Services (CMS) announced it was extending the deadline to March 17, 2023, for ensuring compliance with the Home and Community-Based Settings Regulation, in response to the COVID-19 pandemic.

— CMS ALLOCATES ADDITIONAL RESOURCES FOR NURSING HOMES. 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.

— HHS PLANS TO DISTRIBUTE RAPID POC TESTING EQUIPMENT TO NURSING HOMES. HHS announced a large-scale procurement of U.S. Food and Drug Administration (FDA) -authorized rapid point-of-care diagnostic test instruments and tests to be distributed to nursing homes in COVID-19 hotspot geographic areas.

— HHS, HRSA AWARD NEW FUNDING FOR HEALTH CENTERS. 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. SBA and Treasury Department have officially disclosed the names of more than 650,000 recipients of the PPP. Click here 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 contract with 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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