Policy Corner: July 10, 2020

House Passes ACA Enhancement Act

The House of Representatives passed the Patient Protection and Affordable Care Enhancement Act, H.R. 1425, to establish and provide funding for the Improve Health Insurance Affordability Fund. The bill requires states to use allocated funds to (1) issue reinsurance payments to health insurers (i.e., reimbursements to protect insurers against exceedingly high claims) for individual health insurance coverage or (2) provide other assistance to reduce out-of-pocket costs (e.g., copayments, coinsurance, and deductibles) for qualified health plans offered in the individual market through an exchange.

The bill appropriates $10 billion per year for the fund, which the Centers for Medicare and Medicaid Services (CMS) must distribute to states in accordance with a specified methodology based on the estimated amount of reinsurance payments for individuals in a state during the given year, subject to specified deductions. Additionally, states must submit applications explaining how they will use such funds. In the event that a state does not submit an application, the bill directs CMS to allocate the calculated funding amount to reinsurance programs in that state.

The legislation is in a response to President Trump asking the U.S. Supreme Court to completely strike down the Patient Protection and Affordable Care Act (ACA), which, among other provisions, prohibits insurance companies from refusing to cover Americans with preexisting conditions or from imposing caps for coverage; established procedures through which applicants would receive subsidies that would lower their premiums; and provided a significant increase in funding to states for the Medicaid programs.

House Appropriations Subcommittee Marks Up Appropriations Bill

The House Appropriations’ Subcommittee on Labor, Health and Human Services (HHS), Education, and Related Agencies marked up the fiscal year 2021 funding bill for those federal agencies this week. Specifics have yet to be determined. Overall, the subcommittee recommended increased discretionary funding by $2.4 billion above the FY 2020 level for education, health care, medical research, and job training programs. Among the recommendations, the subcommittee provides $96.4 billion for HHS, an increase of $1.5 billion above the FY 2020 enacted level and $11.1 billion above the president’s budget request. This includes funding for:

• The Administration for Community Living (ACL) – The bill funds ACL at $2.3 billion, an increase of $56 million above the FY 2020 enacted level and $171 million above the president’s budget request. This amount includes:
  • $957 million for Senior Nutrition programs, an increase of $20 million above the FY 2020 enacted level;
  • $400 million for Home and Community-Based Services, an increase of $10 million above the FY 2020 enacted level; and
  • $206 million for Family and Native American Caregivers Services, an increase of $10 million above the FY 2020 enacted level.
• Centers for Disease Control and Prevention (CDC) – The bill includes $8 billion for the CDC, an increase of $232 million above the FY 2020 enacted level and $925 million above the president’s budget request. This includes $856 million in transfers from the Prevention and Public Health Fund. In addition, the bill includes $9 billion in emergency supplemental appropriations for the CDC to improve the nation’s preparedness for public health emergencies.
  • $25 million to specifically support firearm injury and mortality prevention research, an increase of $12.5 million above the FY 2020 enacted level;
  • $7.5 million for domestic violence prevention, , an increase of $2 million above the FY 2020 enacted level.
• National Institutes of Health (NIH) – The bill increases funding for each Institute and Center by no less than 7% to support a wide range of critical research on diseases and conditions that affect individuals and families all over the world.
  • Recommends $25 million for firearm injury and mortality prevention research, an increase of $12.5 million above the FY 2020 enacted level;
  • Continued robust investments in initiatives such as the Cancer Moonshot, All of Us Precision Medicine Initiative, BRAIN Initiative, opioids research, combating antibiotic-resistant bacteria, and Clinical and Translational Science Awards.

Illinois Representative Introduces Telehealth Study Legislation

Rep. Robin Kelly (D-Ill.) introduced the Evaluating Disparities and Outcomes of Telehealth During the COVID-19 Emergency Act of 2020 (EDOT Act), H.R. 7078, which would direct HHS to conduct a study of telehealth utilization under the new COVID-19 flexibilities as Congress considers permanently expanding some telehealth authorities.

Lawmakers Introduce Assisted Living Facility Reporting Bill

Sens. Elizabeth Warren (D-Mass.), Ed Markey (D-Mass.), and Rep. Carolyn Maloney (D-N.Y.) introduced the Assisted Living Facility Coronavirus Reporting Act, S. 4184/H.R. 7463, which would institute national data collection and reporting standards for assisted living facilities around COVID-19 infections among residents. The legislation includes a requirement for each assisted living facility to report to the CDC weekly on COVID-19 cases and testing among residents and staff, disaggregated by demographic characteristics including disability status.

Senators Push Funding for Child Care and Education Relief

Sen. Patty Murray (D-Wash.), Ranking Member of the Senate Health, Education, Labor, and Pensions (HELP) Committee, and Senate Democratic Leader Chuck Schumer (D-N.Y)., introduced the Coronavirus Child Care and Education Relief Act (CCCERA), a $430 billion bill to address the national child care and education crises and provide relief to students, families, schools, and educators across the country during this pandemic. The bill will provide a massive investment to ensure that child care providers can remain open, and that K-12 schools and colleges can address a variety of issues including implementing public health measures, addressing learning loss among students, and providing emergency financial assistance to post-secondary students during the pandemic. The bill will also address the growing inequities in our education system by providing services for those disproportionately impacted by the coronavirus crisis, including students of color, students from low-income families, students experiencing homelessness, English learners, students with disabilities, and more.  Additionally, the bill will reverse Secretary DeVos’ recent attempts to circumvent Congressional intent when implementing the CARES Act, such as using funds meant for public schools for private schools.

In addition to Sens. Murray and Schumer, the bill is cosponsored by Sens. Patrick Leahy (D-Vt.), Jacky Rosen (D-Nev.), Tim Kaine (D-Va.), Tammy Baldwin (D-Wis.), Jeff Merkley (D-Ore.), Chris Van Hollen (D-Md.), Bernie Sanders (I-Vt.), Chris Murphy (D-Conn.), Tina Smith (D-Minn.), Bob Casey (D-Pa.), Debbie Stabenow (D-Mich.), Ed Markey (D-Mass.), Elizabeth Warren (D-Mass.), Jack Reed (D-R.I.), Maggie Hassan (D-N.H.), and Dianne Feinstein (D-Calif.).

BIAA gratefully acknowledges the Centre for Neuro Skills and Avanir Pharmaceuticals for their support for legislative action.