The delicate road ahead for Biden’s spending bills — CMS scraps more Medicaid work requirements — CDC extends eviction ban amid rental crisis fears

From: POLITICO Pulse - Friday Jun 25,2021 02:09 pm
Presented by PhRMA: Delivered daily by 10 a.m., Pulse examines the latest news in health care politics and policy.
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Quick Fix

— President Joe Biden’s endorsement of a bipartisan infrastructure deal will kick off a fresh round of high-stakes negotiations.

The Biden administration is scrapping Medicaid work requirements in two more GOP-led states.

A CDC ban on evictions will remain in place for another month, amid worries its expiration could put millions out on the streets.

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Driving the Day

A BIPARTISAN, BIDEN-BACKED BREAKTHROUGHThe president’s endorsement of a bipartisan outline marked a critical step, after weeks of maneuvering over the next pair of spending packages.

But there’s still plenty that will need to fall into place before Congress clinches an infrastructure deal, POLITICO’s Marianne LeVine, Burgess Everett and Natasha Korecki report — and a second party-line bill that could include any of a range of health care provisions could take even longer.

The initial framework would set aside $600 billion in new spending for traditional infrastructure projects. Majority Leader Chuck Schumer has already endorsed the deal, and Biden on Thursday vowed to “fight like the devil” to get it passed.

Still, there are plenty of caveats — and no clear path so far to 60 votes. Senate Minority Leader Mitch McConnell has yet to back the framework, and it remains unclear whether Democrats can peel off all the necessary GOP votes.

Among Democrats, meanwhile, Sen. Chris Murphy (D-Conn.) has already signaled there could be difficulties keeping the party together on the legislation, given that this offer is far smaller than what Biden originally sought.

That Democratic support is likely to hinge on whether Biden can also advance a second, larger package stuffed with key policies that extend beyond traditional infrastructure — and, as progressives have insisted, passed along party lines.

On Thursday, House Speaker Nancy Pelosi committed to pursuing that balancing act, declaring there wouldn’t be an infrastructure bill without a “reconciliation bill.” But the White House and congressional negotiators still face the tough task of fleshing out not just one, but two massive spending packages in the coming weeks.

BIDEN SCRAPS MORE MEDICAID WORK RULES — The administration is revoking Indiana and Arizona’s permission to impose Medicaid work requirements, in Biden’s latest move to unravel one of the most significant Trump-era health policies, POLITICO’s Rachel Roubein reports.

The notices quietly posted by CMS on Thursday conclude that the work rules “are not likely to promote the objectives” of the Medicaid program, with Administrator Chiquita Brooks-LaSure writing that the agency has grave concerns that, left intact, they would strip many people of their coverage.

“Losing health care coverage undoubtedly has negative consequences for affected beneficiaries down the road,” she wrote in a letter to Arizona officials.

Neither state had imposed the work rules as of yet, and both states’ rules were subject to legal challenges. And even as Indiana earlier this year defended the requirements, it promised not to implement them during the pandemic.

But CMS has put several states’ work requirements under review, in what is widely expected to be a rollback of the policy across the country. Health officials have still yet to weigh in on similar policies in GOP strongholds such as Ohio, South Carolina and Utah.

 

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CDC EXTENDS EVICTION BAN AMID RENTAL CRISIS FEARS — The agency’s pandemic-prompted eviction ban will remain in place for another month, as officials grapple with what they fear could be a wave of evictions as soon as the prohibition ends, POLITICO’s Katy O’Donnell reports.

The extension is expected to be the last for Biden’s lengthy moratorium, which was first imposed early in the Covid-19 pandemic as a first wave of cases shut down local economies across the country. Already, the government is fighting a legal challenge from landlords trying to overturn the ban.

But with more than 6 million households behind on rent, officials are hoping to use the additional grace period to speed billions of dollars in aid to struggling tenants.

On Thursday, the Justice Department posted new guidance to help state and local officials distribute $46 billion in federal aid. And the government is also urging state courts to adopt policies that discourage landlords from kicking people out of their homes.

The looming threat of mass evictions has also prompted action on Capitol Hill. The CDC’s extension came after 44 House Democrats called on Biden to keep the eviction ban in place, warning it was an “urgent matter of health, racial and economic justice.”

Democratic Sens. Sherrod Brown of Ohio and Elizabeth Warren of Massachusetts are pressing the Consumer Financial Protection Bureau to take action as well, urging it to impose new protections for distressed homeowners ahead of the expiration of a related program that allows for the suspension of mortgage payments.

On the Hill

FIRST IN PULSE: DEMOCRATS SEEK CRACKDOWN ON MEDICAL DEBT COLLECTION — A half-dozen Democratic senators want the CFPB to take “expansive actions” to rein in medical debt collectors, as the pandemic has vividly illustrated the mounting financial burden on patients.

In a letter to the agency’s acting chief shared with PULSE, the lawmakers sought a series of new policies shielding debtors, including restrictions on reporting medical debt to credit agencies and limits on how many times in a day debt collectors can call someone.

They also pressed for a requirement that debt collectors tell patients about financial assistance programs and a ban on collecting from debtors while they’re appealing a coverage denial, disputing charges or seeking financial aid.

“Medical debt is almost never voluntary and the complexities of medical billing often can take months to resolve,” the senators, led by Murphy and Sen. Chris Van Hollen (D-Md.), wrote. “The CFPB has an opportunity to strengthen protections for and improve the economic wellbeing and health of Americans.”

 

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Health Costs

STUDY: HALF OF EMERGENCY AMBULANCE RIDES LEAD TO OUT-OF-NETWORK CHARGE — An estimated 51 percent of patients who receive an emergency ground ambulance ride could end up receiving a “surprise” medical bill, according to a new analysis from the Kaiser Family Foundation.

The study of claims data also found that nearly 40 percent of all non-emergency ambulance rides resulted in out-of-network charges, with much higher proportions recorded in large states like California and Texas.

Overall, ground ambulances transport roughly 3 million people to the hospital per year — with wide variations in what private insurers will cover the service and to what extent patients can ultimately be billed for the ride.

Congress passed legislation last year banning surprise bills, but excluded costs tied to ambulances. “Taken together, as many as 1.5 million privately insured patients who are brought to an emergency room by an ambulance may be at risk of getting a surprise medical bill each year,” the Kaiser analysts wrote.

 

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Names in the News

The Federation of American Hospitals hired Tilithia McBride as its vice president of quality and Abby Kaericher as vice president of legislation and associate general counsel.

McBride was previously the director of quality payment and delivery reform at GlaxoSmithKline. Kaericher previously served as a health policy advocate and antitrust associate at the law firm Hall, Render, Killian, Heath & Lyman. FAH also promoted Jonathan Jagoda to be its senior vice president of legislative affairs.

Jerry Sheehan is now assistant director for scientific integrity and data access at the White House Office of Science and Technology Policy. He most recently was deputy director of the National Library of Medicine at the National Institutes of Health.

 

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What We're Reading

Nearly all of the Covid-19 deaths and hospitalizations in the U.S. are among people who are not vaccinated, the Associated Press’ Carla Johnson and Mike Stobbe report.

Don’t discount Novavax’s Covid-19 vaccine just because it’s a little late to the party, The Atlantic’s Hilda Bastian writes.

Days after Biogen’s controversial Alzheimer’s drug won FDA approval, Eli Lilly began pushing the agency to greenlight its own experimental Alzheimer’s treatment, Bloomberg Opinion’s Max Nisen writes.

 

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