Washington Watch for the Week of February 22, 2021

Carter L. Alleman, J.D.

Democrats Move Ahead with Budget Reconciliation for COVID Relief
Congressional Democrats and the White House have decided to move forward in advancing the next coronavirus stimulus bill through reconciliation. A fiscal 2021 budget resolution was filed by Senate Majority Leader Chuck Schumer (D-N.Y.) and House Speaker Nancy Pelosi (D-Calif.) last week, the first step in the budget reconciliation process that could allow President Joe Biden’s nearly $2 trillion COVID relief package to pass both chambers with simple majorities. The resolution contains instructions to congressional committees to draft the portions of the stimulus bill within their jurisdictions and submit them to their respective Budget Committee by February 16.

House committees completed their work in translating President Joe Biden’s American Rescue Plan into legislative text. The individual pieces of legislation will be included as a part of the $1.9 trillion coronavirus relief package that is expected to be voted on by the House of Representatives during the week of February 22, after the House Budget Committee assembles the individual measures into a single reconciliation bill and all the Congressional Budget Office (CBO) scores are available. Democratic leadership have promised to enact the package prior to the March 14 expiration of enhanced unemployment benefits.

The House Energy and Commerce Committee approved their legislation on Friday by a vote of 30-25. The bill includes more than $46 billion for COVID-19 national testing efforts and $20 billion to improve vaccine distribution. The measure includes funding to incentivize states to expand their Medicaid programs, would permit new mothers to stay on the program for up to a year, and eliminate a cap on Medicaid drug rebates beginning in 2023. The measure also includes funding to support research and the public health workforce. The Congressional Budget Office’s (CBO) cost estimate for the reconciliation recommendations of the Energy and Commerce Committee can be found here.

The House Ways and Means Committee measure was passed by a 24-18 party-line vote on Thursday. It contains a provision to subsidize 85% of insurance premiums for individuals currently eligible for COBRA and provide employers with a payroll tax credit to help extend COBRA coverage. The legislation also aims to cap the cost of coverage in the individual health insurance market through increasing Affordable Care Act (ACA) tax credits for 2021 and 2022. ACA plans would be free for people making up to 150% of the federal poverty level and for people collecting unemployment insurance. People making up to 400 percent of the federal poverty level would be eligible to receive subsidies; their premiums would be capped at 8.5% of their income. The bill also includes additional direct payments of $1,400 to individuals and an extension of temporary federal unemployment benefits.

The House Veterans’ Affairs Committee approved legislation along a 17-2 party line vote containing $13.5 billion for veteran’s health care services in response to the increased number of individuals seeking care previously delayed because of the pandemic. The bill includes $272 million for processing backlogged benefits claims, $750 million for state home facilities, $100 million for upgrades to VA information technology, and $400 million for veteran retraining programs.

The House Oversight and Reform Committee also completed its work on its component of the package last week, and the CBO cost estimate for that package can be found here. The bill contains $350 billion in aid for state and local governments, split between states receiving 60% of funding and localities receiving 40% of funding. The money would be distributed within 60 days to locations based on revenue lost as a result of the pandemic.

The legislation reported by the House Small Business Committee, with the CBO cost estimate here, would increase funding for the Paycheck Protection Program (PPP) by $7.25 billion. The committee’s legislation would also create a new program to support the restaurant industry and includes additional funding for the Targeted Economic Injury Disaster Loan Advance program.

The House Education and Labor bill (CBO cost estimate here), passed by a 27-21 party line vote, would raise the federal minimum wage to $15 an hour, though it remains to be seen whether this provision will qualify for the reconciliation process under the Senate’s Byrd rule. The bill also includes funding to reopen schools and expand access to health insurance.

The House Transportation and Infrastructure (CBO cost estimate here) and Agriculture committees (CBO cost estimate here) also advanced their components of the administration’s COVID relief proposal. The Transportation Committee voted 39-25 in support of a bill containing more than $40 billion in aid, while the Agriculture Committee approved by a vote of 25-23 a $16 billion bill aimed at food purchases, nutrition aid, and supply chain assistance.

Trump Impeachment Trial to Begin This Week
Opening arguments in former President Donald Trump’s Senate impeachment trial began on February 9. The proceedings did not take as long as Trump’s first impeachment trial, which lasted three weeks, as the case against the former president relies in large part on public events and the personal experiences of lawmakers themselves.

Former President Donald Trump was acquitted in his second impeachment trial. Fifty-seven senators voted to convict Trump for the role he played in the incitement of a riot at the Capitol on January 6, and 43 senators voted to acquit. No witnesses were called to testify during the trial, but written testimony from Representative Jaime Herrera Beutler (R-Wash.) was admitted into evidence in place of calling her as a witness. Seven GOP senators – Senators Mitt Romney (Utah), Susan Collins (Maine), Lisa Murkowski (Alaska), Ben Sasse (Neb.), Bill Cassidy (La.), Richard Burr (N.C.), and Pat Toomey (Pa.) – joined Democrats in voting the former president guilty of “incitement of insurrection.” Two-thirds of the Senate were necessary to convict, leaving the vote 10 members short.

White House Moves to Reverse Medicaid Work Requirements, Prior Authorization Regulation
The White House has begun to unwind Medicaid work requirements approved under the Trump administration. Acting administrator of the Centers for Medicare and Medicaid Services (CMS) Elizabeth Richter sent letters to Arkansas, Georgia, Ohio, Nebraska, Indiana, Arizona, Wisconsin, South Carolina, and Utah last week informing them that the agency has commenced a process to determine whether to withdraw the waivers under which the work rules were approved. CMS also sent separate letters to rescind a letter from former Administrator Seema Verma asking states to sign on to an agreement that would provide for a nine-month process if the agency would decide to terminate, amend, or withdraw a Medicaid waiver in the future. The Biden administration has argued that the COVID-19 pandemic has greatly increased the risk that work requirements in the Medicaid program will lead to unintended loss of coverage for many individuals.

The Administration has also removed a Trump-era rule aimed at reducing regulations surrounding prior authorization in the Medicare program from the CMS website. The final rule, which was announced on January 15 but was never published in the Federal Register, fell under the regulatory freeze enacted when President Joe Biden took office.

Bipartisan Lawmakers Push Bill to Increase Research Funding
A bipartisan, bicameral group of lawmakers have introduced legislation that would authorize funding to restart research and clinical trials that have been derailed by the COVID-19 pandemic. The Research Investment to Spark the Economy (RISE) Act (H.R. 869) would provide $26 billion in emergency relief for federal science agencies to repair damage caused by the coronavirus to the research ecosystem. At least $10 billion would be allocated to the National Institutes of Health (NIH) for research recovery. The legislation was introduced by Senators Ed Markey (D-Mass.) and Thom Tillis (R-N.C.) and Representatives Diana DeGette (D-Colo.) and Fred Upton (R-Mich.)

Biden to Issue E.O. on Critical Supply Chains
President Joe Biden plans to order a government-wide review of critical supply chains, with the goal of reducing the nation’s reliance on other countries for medical supplies and other essential materials. According to White House officials, the administration plans to work with U.S. allies to ensure a collective approach. The executive order (E.O.) is expected to direct analyses of critical sectors of the economy.

PREP Act Expanded to Increase Vaccine Administration
HHS has broadened the use of the Public Readiness and Emergency Preparedness (PREP) Act to increase the number of health care providers authorized to administer the COVID-19 vaccine. The amendment authorizes any health care provider licensed or certified in a state to prescribe, dispense, or administer COVID-19 vaccines in any other state or U.S. territory, and authorizes any physician, registered nurse, or practical nurse whose license or certification expired within the past five years to prescribe, dispense or administer COVID-19 vaccines in any state or U.S. territory so long as the license or certification was active and in good standing prior to the date it went inactive.