Summary
Infrastructure
The White House continues to push for a bipartisan deal on infrastructure. To gain Republican support, however, such a modified approach would likely represent a dramatic departure from President Joe Biden’s $2 trillion American Jobs Plan to such a degree that he would risk losing the support of congressional Democrats.
A group of Republicans are preparing a counterproposal focused on what they consider to be traditional infrastructure (i.e., transportation, drinking water, and broadband) with a price tag of $600 billion to $800 billion – just shy of the $832 billion investment Biden proposed for those elements. Republicans’ plan would leave out Biden’s investments in home and community-based services, public health preparedness, and workforce development and protections, among others. If they prove viable, it is unclear what implications these negotiations will have on Democrats’ broader infrastructure ambitions.
Meanwhile, committees in both chambers will hold several hearings this week that address various elements of Biden’s plan. Tomorrow, Transportation Secretary Pete Buttigieg, Commerce Secretary Gina Raimondo, Housing Secretary Marcia Fudge, and Environmental Protection Agency (EPA) Administrator Michael Regan will discuss the American Jobs Plan with the Senate Appropriations Committee. As noted in our calendar below, congressional committees will also examine broadband, workforce development, and taxes. On Wednesday, the House Ways and Means Committee will convene a hearing on paid leave and child care, which are expected to be focal points of Biden’s forthcoming American Family Plan along with health care reforms.
COVID-19 Vaccine
On Friday, the CDC’s Advisory Committee on Immunization Practices (ACIP) will hold an emergency meeting to further review data involving six reported U.S. cases of patients developing a rare blood-clotting disorder after receiving Johnson & Johnson’s (J&J) single dose vaccine. ACIP may rule on whether to end the pause and provide additional recommendations (e.g., restrictions, warnings). Last week, Jeff Zients, White House COVID-19 Response Coordinator, gave assurances that the pause in the use of the J&J vaccine will not deter the U.S. from achieving the President’s goal of 200 million shots by his 100th day in office (i.e., by the end of April).
Regulatory Update
Though the Centers for Medicare & Medicaid Services (CMS) has released proposed rules for nearly all of its fiscal year (FY) 2022 Medicare payment updates, the proposed changes for its FY 2022 inpatient prospective payment system (IPPS) remain under review at the White House Office of Management and Budget (OMB). The proposal is due by the end of April and so its release is expected in the coming days. Like the other proposed Medicare regulations issued thus far, the proposed FY 2022 IPPS will also likely include a request from CMS for feedback on how to better leverage data collection and quality measurement to advance the Biden Administration’s aims around health equity and reducing disparities.
Of additional note, part two of the finalized Notice of Benefit and Payment Parameters for coverage year 2022 also remains under review at OMB. The final rule was received at the end of March and its release was expectedly shortly thereafter, though the finalized provisions are still yet to se be seen. As a reminder, the set of provisions that could be finalized in this rule includes policies on risk adjustment, medical loss ratio, and pharmacy benefit manager transparency in the commercial market.