Summary
Infrastructure and Budget Reconciliation
House Democrats will soon face a hard deadline to pass the bipartisan Infrastructure Investment and Jobs Act. The 30-day surface transportation funding extension (P.L. 117-44) expires on October 31. Absent congressional action, the Department of Transportation would be forced to furlough thousands of workers. House Speaker Nancy Pelosi (D-CA) plans to hold a vote of the bipartisan infrastructure package this Wednesday or Thursday.
Whether the House holds a vote and passes the package is contingent on congressional Democrats (i.e., moderates and progressives) reaching a deal on a trimmed down budget reconciliation package. Lawmakers have not yet agreed on a price tag, though it seems likely to land around $2 trillion. Expanding Medicare to cover dental, vision, and hearing benefits is at risk of getting cut completely. Democrats are considering temporary solutions for the Medicaid expansion coverage gap and ACA premium tax credits (possibly covering people in the Medicaid gap for three or four years and extending premium tax credits for three years). As for prescription drug pricing, a narrower version of Medicare drug price negotiation may be included (WHG summary of the most pertinent drug pricing proposal provisions).
Caregiver and Workforce Legislation
Tomorrow, the House Energy and Commerce Subcommittee on Health will convene a hearing to discuss a slate of bills aimed at bolstering the health care workforce through new grant programs. They focus on the following: caregivers of people living with Alzheimer’s disease and other dementias, allied health professions (e.g., physical therapy, occupational therapy), behavioral health professionals, community health workers, public health professionals, and infectious disease specialists. The bills have bipartisan support, unless otherwise noted.
- Alzheimer’s Caregiver Support Act (H.R. 1474)
- Dr. Lorna Breen Health Care Provider Protection Act (H.R. 1667)
- Public Health Workforce Loan Repayment Act of 2021 (H.R. 3297)
- Allied Health Workforce Diversity Act of 2021 (H.R. 3320)
- Helping Enable Access to Lifesaving Services (HEALS) Act (H.R. 5583) (Republican-support only)
- Enhancing Community Health Workforce Act (H.R. 5594) (Republican-support only)
- Bolstering Infectious Outbreaks (BIO) Preparedness Workforce Act of 2021 (H.R. 5602)
COVID-19 Vaccine
Tomorrow, the Food and Drug Administration’s (FDA) Vaccines and Related Biological Products Advisory Committee will review a request from Pfizer to amend its emergency use authorization to all the use of its COVID-19 vaccine in children 5 through 11 years of age. Pfizer’s COVID-19 vaccine appears safe and over 90 percent effective in young kids, according to the company’s briefing document. The Center for Disease Control and Prevention’s (CDC) Advisory Committee on Immunization Practices (ACIP) is scheduled to meet on November 2 and 3 to make recommendations on the use of the Pfizer vaccine in children ages 5 through 11.
In anticipation of the vaccines, the White House unveiled its plan for ensuring newly eligible kids are able to quickly receive the COVID-19 vaccination. The Administration says this plan will ensure convenient and equitable access for children and would “rely heavily” on the coordination of states, Tribes, and territories. The CDC also released a Pediatric COVID-19 Vaccination Operational Planning Guide to help with ordering supplies, enrolling an adequate network of providers, reporting and monitoring, and communications.
As for COVID-19 vaccinations among adults, the Occupational Safety and Health Administration (OSHA) may issue the emergency temporary standard (ETS) requiring large employers (with 100+ employees) to mandate COVID-19 vaccinations or weekly testing as soon as this week. The ETS has been under review at the Office of Management and Budget (OMB) since October 12. Tomorrow, the House Education and Labor Committee will convene a joint subcommittee hearing on vaccine requirements and employee accommodations.
MACPAC
Later this week, the Medicaid and CHIP Payment and Access Commission will meet to discuss various priorities for their upcoming reports, including:
- Recommendations aimed at increasing vaccine coverage for Medicaid-enrolled adults; and
- Additional recommendations to improve integration of care for dually eligible beneficiaries (as a follow-up to design consideration for a unified program and strategies for state contracts with dual eligible special needs plans).
Commissioners will also discuss disproportionate share hospital allotments to states, workforce for home-and community-based services, and their response to the Senate Finance Committee (SFC) request for information on behavioral priorities, among other topics. Last month, SFC Chairman Ron Wyden (D-OR) and Ranking Member Mike Crapo (R-WY) issued a bipartisan request for information on legislative proposals to improve access to behavioral health services. Comments are due November 1.