As negotiations over a COVID-19 relief package between House Speaker Nancy Pelosi (D-CA) and Treasury Secretary Steven Mnuchin drag into another week, the outlook for a deal before Election Day appears to be a long-shot given the remaining significant disagreements as well as resistance among Senate Republicans to a bill ranging from $1.9 trillion to $2.2 trillion. Senate Majority Leader Mitch McConnell (R-KY) has agreed to consider an agreement if it should come together, but he continues to throw cold water at a pre-election, multi-trillion-dollar deal that would split his caucus just before the election.
Instead, Leader McConnell has been laser-focused on the Supreme Court. Today, the Senate is scheduled to vote and confirm the nomination of Judy Amy Coney Barrett to the Supreme Court, solidifying the conservative 6-3 majority. Yesterday, the nomination cleared a procedural hurdle by a rare weekend 51-48 vote, with Sens. Lisa Murkowski (R-AK) and Susan Collins (R-ME) joining Democrats.
While Speaker Pelosi and Secretary Mnuchin have inched closer to a deal, including agreeing for the most part on a national strategy for COVID-19 testing, contact tracing, and surveillance, substantial differences remain. The amount of federal aid to state and local governments as well as liability protections – a red line for Leader McConnell and a nonstarter for Democrats – are among the major points of contention. Mnuchin’s latest offer includes $300 billion for state and localities, relatively close to the $436 billion proposed in House Democrats’ updated Heroes Act. Leader McConnell’s failed $500 billion targeted relief package did not include any state and local aid.
Notably, Speaker Pelosi and Secretary Mnuchin’s discussions have broached the ideas of providing stimulus checks to undocumented immigrants and expanding eligibility for premium tax credits – which are both strongly opposed by Republicans. The updated Heroes Act would allow individuals who have received (or have been approved to receive) unemployment compensation for any week during the applicable period (date of enactment to 60 days after the last day of the public health emergency) to be eligible for premium tax credits, regardless of their income. For individuals with higher income, tax credits would be determined as if their income was 133 percent of the federal poverty level.
Even if Speaker Pelosi and Treasury Secretary Mnuchin reach a deal, the logistical challenges of transforming their agreement into a bill and the timing of a floor vote have also cast doubt on pre-election coronavirus relief. At her weekly press conference last Thursday, Speaker Pelosi noted, “So, I keep saying, it’s just not a question of us agreeing in a room; it’s a question of the CBO weighing in with the score, the legislative counsel writes these things, raising their questions and putting it in legislative order. It takes time.”
In addition, assuming unified Democratic support, it remains unclear whether the at least 13 Republican senators – needed to overcome the 60-vote filibuster – are willing to back the potential Pelosi-Mnuchin deal. However, Republicans facing tough Senate reelections may cross party lines in the hopes for a reelection boost. According to polls, up to eight Republican seats are considered toss-ups or leaning Democratic, while only one Democratic seat held by Sen. Doug Jones (D-AL) appears to be in real danger of flipping.
On Friday (October 30), the Center for Disease Control and Prevention’s (CDC) Advisory Committee on Immunization Practices (ACIP) will discuss COVID-19 vaccines. Agenda items include vaccine allocation, post-licensure safety surveillance protocol and updates from the Food and Drug Administration’s (FDA) Vaccines and Related Biological Products Advisory Committee and COVID-19 vaccine manufacturers. Health and Human Services Secretary Alex Azar remains optimistic that a safe and effective COVID-19 vaccine will be available this year. He recently said, “By the end of January we expect we’d have enough to vaccinate all seniors as well as our health care workers and first responders and by the end of March to early April enough vaccine for all Americans who would want to take a vaccine.” The FDA recently gave AstraZeneca and Johnson & Johnson the green light to resume Phase 3 clinical trials after they were halted over safety concerns. Pfizer and Moderna are also in Phase 3 clinical trials.
Lastly, the Medicaid and CHIP Payment and Access Commission (MACPAC) convenes this week (October 29-30) to discuss various issues, including post-pandemic Medicaid eligibility redetermination policies; dually eligible beneficiaries; access to mental health services and treatment; high-cost drugs; and postpartum coverage. Of note, the House passed the Helping MOMS Act of 2020 (H.R. 4996) at the end of September by a voice vote. The bill would allow states to extend Medicaid coverage for new moms through the entire postpartum period and provide a one-year, five percentage point Federal Medical Assistance Percentage (FMAP) enhancement to incentivize extension. There is no Senate companion bill.