HealthCare Roundtable e-News – March 2, 2021

U.S. House Passes Biden’s $1.9T COVID-19 Relief Plan

In a near party-line vote early Saturday, the House approved President Joe Biden’s promised $1.9 trillion COVID-19 relief plan. The package, titled the American Rescue Plan, includes $1,400 stimulus payments to qualifying Americans, enhanced vaccine distribution, and additional unemployment aid. The bill passed 219-212, with the House GOP and two Democrats voting against it, and will head to the Senate for review.

“It’s a great day for us to take a vote to reduce the spread of this virus…put vaccinations in the arms of the American people, money into the pockets, children into the schools, workers back into their jobs, so that we can go forward,” House Speaker Nancy Pelosi (D-Calif.), said prior to the House vote. Biden commented on the win for his bill in the House, thanking Pelosi for her “extraordinary leadership.”

Where Democrats have a marginal majority in both the House and the Senate, legislators opted to pass the stimulus package through a process known as budget reconciliation, which enables a party to pass legislation with a small majority vote but limits what can be included in the bill to those items that have a significant impact on the federal deficit.

The package faces significantly more scrutiny in the Senate; last Thursday, Senate Parliamentarian Elizabeth MacDonough decided that an increase of the minimum wage, a key component of the package, cannot be included in any bill under reconciliation. Other Democrats in the Senate also oppose elements of the package, including Joe Manchin (W. Va.), who said earlier this year that he would oppose another round of stimulus payments.

Several Senate leaders are considering changes to the relief package, but some warn that any changes will likely delay relief because the measure would have to go back to the House.

Becerra Confirmation Hearing Focuses on Biden’s Health Care Agenda, the COVID-19 Pandemic, Provider Relief Funds

Last Tuesday, Senate Health Committee members held a confirmation hearing for Health and Human Services Secretary nominee Xavier Becerra, during which Becerra was questioned on his past support for Medicare for All, the extending circumstances of the COVID-19 pandemic, and his experience with various health care systems and current obstacles.

When questioned on coverage expansion to undocumented immigrants and public health care options, Becerra cited that his role at HHS will be to “implement the president’s agenda” and ensure more Americans have access to coverage whether it is through their employer, Medicaid, or the ACA exchanges, though Becerra did confirm that where the law does not allow coverage for undocumented immigrants, it would be his job to enforce the law as it stands.” (InsideHealthPolicy)

On the COVID-19 pandemic, Becerra did not confirm how long he thinks the public health emergency should last but emphasized that working with governors and states will be critical when the data confirmed a declaration of emergency is no longer needed. Becerra was also questioned by Sen. Susan Collins (R-Maine) on the lack of additional funding in President Joe Biden’s $1.9 trillion COVID-19 relief plan, to which Becerra said he believed that the president would “provide support” for long-term care facilities and hospitals. He expressed to committee members that support would come either through the provider relief fund or by overseeing the allocations of current resources to ensure they’re being utilized to “make sure that we’re working closely with those facilities that have been hit the hardest.” (InsideHealthPolicy)

Becerra was also questioned on his experience working in larger, more urban health care systems, stating that this would not distract him from allocating funds and resources to smaller, rural communities. Becerra acknowledged that patients and health care workers in rural communities “face a different challenge” than their counterparts in dense cities and reiterated his commitment to working with legislators. (InsideHealthPolicy)

Grassley Sees New Path for Drug Pricing Bill with Schumer as Majority Leader, Becerra’s HHS Nomination

Former Senate Finance Committee Chair Chuck Grassley (R-Iowa) commented last week on the status of the drug pricing legislation his committee passed in 2019 but fell short of receiving support from then-Senate majority leader Mitch McConnell (R-Ky.). Grassley said it might be possible to pass the bipartisan bill with the help of HHS Secretary-nominee Xavier Becerra and said he would look to the Biden administration’s support for the plan.

Grassley had previously negotiated the bill with the current Finance Committee Chair Ron Wyden (D-Ore.), who sought to link a floor vote on the bill to a vote on letting Medicare negotiate drug prices. McConnell shot down the proposal, even after Grassley had onboarded several other Republican co-sponsors for the bill, but Grassley is optimistic that the bill “will be a lot easier to get up under a Schumer majority leader position than it was under McConnell.” (InsideHealthPolicy)

In Becerra’s Senate confirmation hearings last week, Wyden kicked his session off by listing drug pricing policy first when emphasizing his committee’s focus on righting inequality in health care. Similar to questions raised in the Senate Health Committee hearings, Becerra was questioned on topics ranging from insulin prices to the 340B hospital drug discount program. Prior to the hearing, Senate Finance Chair Ron Wyden (D-Ore.) told reporters that he’s not aware of a single member of his caucus who has raised concerns about Becerra.

Appeals Court Panel Reconsiders Generic-Drug Labeling in Teva-Glaxo Case

Last Tuesday, a U.S. Court of Appeals heard arguments on a case over the copy use of Teva Pharmaceutical Industries Ltd.’s Coreg heart drug. This is the second time the three-judge panel is reviewing a $235 million verdict won by GlaxoSmithKline Plc in October last year after the jury found Teva’s label encouraged doctors to prescribe a generic version for a newer patented indication.

Questioning in the case indicated the panel may be split once again over the results, but the judges would make it clear that the questioning is a fact-specific issue that wouldn’t limit the use of so-called skinny labels in other cases. One of the judges who sided with GlaxoSmithKline last year, Circuit Judge Kimberly Moore, could potentially be the swing vote in the latest round. Moore had previously said that just saying a copycat drug is interchangeable with a branded medicine “doesn’t prove the generic-drug maker encouraged doctors to prescribe it for a new patented use.”