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Federal Health Policy Updates for the Week of March 2, 2020

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The Headlines

  1. Congress approved emergency funding to address the COVID-19 virus. 
  2. Super Tuesday results are in, and North Carolina's races are set.
  3. The appropriations cycle has begun!
  4. Several congressional hearings focused on substance use disorder and the novel coronavirus.
  5. The Supreme Court is set to consider a challenge to the ACA.

The Details

1. Congress passes emergency spending package
This week, Congress approved and the president signed into law a bipartisan measure that would provide $8.3 billion in emergency aid spending to combat the COVID-19 virus, including:

  • $2.2 billionavailable through September 2022, for the Centers for Disease Control and Prevention (CDC), including:
    • $950 million in grants and cooperative agreements for state/local surveillance, epidemiology, laboratory capacity, infection control, mitigation, communications, and other preparedness and response (including $475 million that would be available within 30 days of enactment).
    • At least $300 million for global disease detection and emergency response.
    • $300 million for the Infectious Diseases Rapid Response Reserve Fund.
    • The ability for CDC to use such funds to support grants for construction, alteration, or renovation of non-Federally owned facilities to improve state/local preparedness and response capability.
  • $836 million, available through September 2024, for the National Institutes of Health, including:
    • $826 million for the National Institute of Allergy and Infectious Diseases (NIAID) to prevent, prepare for, and respond to coronavirus domestically or internationally.
    • $10 million transferred from NIAID to the National Institute of Environmental Health Sciences for worker-based training to prevent and reduce exposure of hospital employees and other first responders.
  • $3.1 billion, available through September 2024, for the Public Health and Social Services Emergency Fund to support, among other activities:
    • Development and purchase of necessary countermeasures and vaccines. Purchase of vaccines, therapeutics, diagnostics, and necessary medical supplies, including for potential deposit in the Strategic National Stockpile (with an additional $300 million in contingency funding to purchase additional products if needed).
    • Grants for construction, alteration, or renovation of non-Federally owned facilities to improve state/local preparedness and response capability.
  • $61 million, available until expended, for the Food and Drug Administration to support:
    • Development of medical countermeasures and vaccines. Advanced manufacturing for medical products.
    • Monitoring of medical supply chains.
  • Authority for the Secretary of Health and Human Services to waive, under the public health emergency declaration for the novel coronavirus, certain current telehealth requirements by the Centers for Medicare and Medicaid Services.


2. North Carolina primary results
North Carolina's statewide primary elections were Tuesday, with the ballot including contested party races for President, U.S. Senate, congressional seats, Governor, Council of State, state legislative positions, and county board membership. North Carolina Senator Thom Tillis will face Democratic candidate Cal Cunningham, while seats for the 2nd and 6th Districts will be filled with new faces following the retirements of Reps. George Holding (R-NC) and Mark Walker (R-NC), respectively. Alan Swain (R) and Deborah Ross (D) will vie for the 2nd District, and Lee Haywood (R) and Kathy Manning (D) will vie for the 6th District.

3. The congressional FY 2021 appropriations season begins
Since last month's release of the president's FY 2021 annual budget request, our office has been working to submit Duke Health's priority list of federally funded programs to our congressional offices, together with a requested spending level for each one. The list includes the National Institutes of Health (NIH), the CDC, health professions and nursing workforce development programs, and a Department of Defense health research program, among others.

At the request of Duke Health, Reps. GK Butterfield (D-NC-01) and David Price (D-NC-04) signed onto a letter to House appropriators urging $44.7 billion for the NIH in FY 2021. Rep. Butterfield also signed onto letters in support of increased funding for Title VII health professions programs and Title VIII nursing workforce development programs.

4. Congressional hearings this week
On Tuesday, the House Energy and Commerce Health Subcommittee held a hearing on 14 bills to further expand access to substance use disorder treatment, including a bipartisan bill supported by Duke Health. The Opioid Workforce Act (H.R. 3414/S.2892) would add 1,000 Medicare-funded training positions to approved residency programs in addiction medicine, addiction psychiatry or pain management over a five-year period. The bill, which Rep. Butterfield cosponsored at the request of Duke Health, awaits action by the full Committee. The Ways and Means Committee, which also has jurisdiction over the bill, approved it last summer.

This week also included House and Senate hearings on the US response to the novel coronavirus COVID-19. Witnesses from the NIH, CDC, and FDA provided updates on current efforts to combat the emerging outbreak. Staff for Senator Richard Burr (R-NC), who serves on the Health, Education, Labor and Pensions Committee, are in regular contact with Duke Health experts on the health system's preparedness plans.

5. Supreme Court to take up ACA challenge
The Supreme Court on Monday said it will take up a Republican challenge to the Affordable Care Act, likely later this year. More than a dozen Republican-led states brought the suit in 2018 after Congress eliminated the law's tax penalty for not having health insurance while leaving the rest of the individual mandate in law. The states argued that the rest of the law was unconstitutional, since the Supreme Court previously upheld the mandate on the basis of Congress' taxing power.

In December, a panel of federal appeals court judges found the law unconstitutional. Instead of ruling on the entire law, the appellate panel sent the challenge back to a federal judge in Texas who previously invalidated the entire law.