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Federal Health Policy Updates for the Week of June 22, 2020

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The Headlines

  1. Read the latest health policy updates on Congress and the Administration.
  2. Duke Health endorses bill to provide emergency relief to federal science agencies.
  3. Help us tell the story of COVID-19's impact on your research or patient care!

Sometimes, words fail; but
No order blurs who we are 
And why we fight on

The Details
1. Federal health updates from Capitol Hill and the Administration
While resuming a more regular schedule, new precautions are being put into place to protect Members and staff. The Office of the Attending Physician, which serves Congress and the U.S. Supreme Court, has warned that pre-COVID-19 normal operations will not be back in place for quite some time.
COVID-19: Connecting Duke Health and Congress for an Energy and Commerce Hearing
This week, Dr. Cameron Wolfe, Associate Professor of Medicine, met virtually with health policy staff from members of the House Energy and Commerce Committee to aid their preparation for a June 23 hearing on “Oversight of the Trump Administration’s Response to the COVID-19 Pandemic.” Dr. Wolfe emphasized that while increased testing is important, it is not a panacea to properly curtailing the spread and impact of the virus. Rather, testing must be met with proper social distancing, other safety protocols, such as wearing masks in public spaces, and robust contact tracing. Dr. Wolfe also spoke to the relative reliability of emerging antibody tests. 
The Energy and Commerce Committee hearing featured testimony from Trump Administration officials, including Anthony Fauci, MD, Director of the National Institute for Allergy and Infectious Diseases, Adm. Brett Giroir, MD, Assistant Secretary for Health for the Department of Health and Human Services, Stephen Hahn, MD, Commissioner of the Food and Drug Administration, and Robert Redfield, MD, Director of the Centers for Disease Control and Prevention. Rep. Richard Hudson (R-NC-08) asked witnesses about antibody testing, specifically how the FDA is working to ensure that serology antibody tests on the market are the most reliable. Rep. GK Butterfield (D-NC-01) focused on the impact on underserved communities and how to best slow the spread, especially in states like North Carolina that are seeing an increase in positive cases.

On June 22, President Trump signed an Executive Order extending green card processing suspensions and adding new restrictions on non-immigrant visas. In addition to extending the suspension of visa processing for permanent residency through December 31, 2020, the order also suspends through December 31 new non-immigrant visas for the following categories: H1-B, H-2B, H-4, J, and L. The order only apples to individuals currently outside of the United States without a valid visa or one in process. According to Duke Visa Services, J-1 Research Scholar Program is not impacted by the order.

Exemptions are provided for certain classifications, including those deemed to be in the “national interest.” A non-exhaustive list of examples in the order suggests that medical workers and researchers responding to COVID-19 may be included for exemption consideration. The order does not make any modifications to the Optional Practical Training (OPT) Program or F-visas. It is subject to review and possible modification every 60 days.

Duke Health Government Relations is working with our Duke University government relations colleagues, professional associations, partners, and others to advocate on behalf of our international students and their contributions to the medical workforce and research enterprise.

Visit our issues page to learn more.
House Democrats Introduce New ACA Enhancement Bill
This week, House Democratic leaders introduced the Patient Protection and Affordable Care Act (ACA) Enhancement Act (H.R. 1425). The bill is designed to make improvements to the current ACA regulatory structure, including lowering health care costs and providing increased protections for those with pre-existing conditions, encouraging Medicaid expansion and strengthening the Medicaid program, and establishing a Fair Price Negotiation Program to negotiate with drug manufacturers in order to obtain a maximum fair price for certain selected drugs.
The House is expected to approve the bill early next week, but it is unlikely it will receive a vote in the Senate.
House Democrats Introduce $1.5 Trillion Infrastructure Package
House Democratic leaders have also introduced The Moving Forward Act (H.R. 2), an estimated $1.5 trillion infrastructure package. The legislation is designed to provide both broad and targeted investments for the nation’s roads and bridges, transit, rail, schools, housing, broadband, drinking and wastewater systems, postal service, clean energy, and health careProposed infrastructure spending for health care includes $10 billion over five years to reestablish the Hill-Burton program for the construction and modernization of hospitals and medical facilities, $10 billion for community health center capital project funding, $4.5 billion to improve laboratory infrastructure, $5 billion for 21st Century Indian Health Program hospitals and outpatient health facilities, and $500 million for a pilot program to improve community-based care.
The House is expected to pass the bill along party lines, and no vote is anticipated in the Senate. While infrastructure spending remains a priority for the White House, it is unclear when Senate Republicans may unveil their proposal.
Price Transparency Rule
On June 23, a federal district court judge upheld the Trump Administration’s mandate for hospitals to publish the non-publicly disclosed rates they negotiate with health insurers. President Trump rolled out the health care price transparency rules in November 2019, requiring hospitals to publish their prices in an effort to drive down health care costs. The hospital rule applies to 300 common procedures and services, including X-rays and lab tests. A similar rule for health insurers is still pending.

While the ruling is a victory for the Administration, an appeal is expected with a possible injunction preventing the transparency rule from going into immediate effect.

House Appropriations Committee Chair Nita Lowey (D-NY) has formally outlined the Committee’s aggressive markup schedule for its version of the twelve annual appropriations bills. The Appropriations subcommittees are expected to begin a three day marathon of subcommittee markups on July 6, with consideration by the full panel on July 9. The Labor-Health and Human Services-Education Subcommittee markup, which will set funding levels for critical research agencies and programs including the National Institutes of Health, is scheduled for July 8.
The Senate Appropriations Committee had initially planned to begin marking up its versions of the appropriations bills this week, but the process has been delayed as attention has turned to policing reform and other matters.
COVID Stimulus and Recovery
There is general agreement that Congress will need to pass a “Phase IV” COVID-19 recovery and stimulus package to provide additional assistance to individuals, businesses, and health systems and providers in response to the national health emergency. There is not yet a definitive plan on how to move forward with negotiations. The House passed its marker, the HEROES Act (H.R. 6800), on May 15, but Senate Republican leaders have indicated that many of its provisions are non-starters. Senate Majority Leader Mitch McConnell (R-KY) has said that the Senate version of “Phase IV” will almost certainly include liability protections for businesses to aid in reopening strategies in addition to any stimulus provisions. Given an increasingly crowded schedule, McConnell signaled that the earliest the Senate would take up “Phase IV” legislation would be the week of July 20. However, emerging priorities and work on appropriations may lead to further delays.
2. Duke Health endorses legislation to provide emergency relief for federal science agencies
Duke Health and Duke University have joined a growing list of organizations in endorsing bipartisan legislation introduced this week by Representatives Diana DeGette (D-CO), Fred Upton (R-MI), Eddie Bernice Johnson (D-TX), Frank Lucas (R-OK), Anna Eshoo (D-CA), and Anthony Gonzalez (R-OH) entitled the “Research Investment to Spark the Economy Act (RISE Act).” The bill would authorize $26 million in emergency relief for federal science agencies and would, among other provisions, provide supplemental funding for research flexibilities to graduate students, post-doctoral researchers, and principal investigators to complete work, training, or employment that was disrupted by COVID-19.
In a joint press statement, sponsors of the bill stated, “These researchers are essential to our nation’s public health, national security, economic growth and international competitiveness… Preserving our scientific infrastructure and protecting our innovation pipeline will help ensure U.S. leadership in the world and help us better respond to future pandemics.”
Securing $26 billion in emergency relief for federal science agencies remains a priority for Duke Health Government Relations. NC Representatives Butterfield (D-NC-01), David Price (D-NC-04), David Rouzer (R-NC-07), George Holding (R-NC-02), and Alma Adams (D-NC-12) previously joined over 180 colleagues in support of $26 billion for research in the next emergency relief package.
3. Are you interested in sharing an example of the impact of COVID-19 on your research or patient care?
Duke Health Government Relations is supporting efforts from the Association of American Medical Colleges to collect and share examples about COVID-19’s impact on young/early stage investigators, the research process, and the potential impact on patients over the long term (including the development of new diagnostics, treatments and cures and the halting of clinical trials). Duke Health Government Relations would also like to share these stories with policymakers to provide real-world examples to illustrate why additional relief is needed during this unprecedented pandemic.
If you would like to share a story, please contact Also, visit our website to read how the pandemic is impacting a Duke PhD candidate’s research on Zika virus infection and a second-year Pulmonary and Critical Care Medicine fellow and future physician-scientist working on chronic lung disease and injury.