Policy Updates: Hill Happenings and Administration Activities

By Julio Contreras February 8, 2021

Hill Happenings 

Senate Leaders Reach Power-Sharing Agreement, Announce Committee Leaders 

On February 3, Senate Majority Leader Chuck Schumer (D-NY) and Minority Leader Mitch McConnell (R-KY) reached a deal on a power-sharing agreement for presiding over the evenly split Senate (50-50). Following tense negotiations over preserving the Senate filibuster and apportioning committee representation between parties, the top Senators agreed to staff committees in equal parts Democrat to Republican, closely modeling the 2001 agreement for presiding over the last evenly divided Senate. With the Senate filibuster in place, it will be more difficult for Democrats to pass legislative priorities that Republicans oppose without resorting to the budget reconciliation process.  

With the power-sharing agreement in place, Senate Democrats are now able to assume committee leadership and manage the chamber’s procedural calendar. The prolonged handover of committee leadership obstructed Democrats’ legislative agenda, most notably causing significant delays for the Biden administration to confirm its cabinet nominees. On February 3, Senate Leader Chuck Schumer (D-NY) and Minority Leader Mitch McConnell (R-KY) announced committee assignments for the 117th Congress: 

  • Senate Appropriations Committee 

  • Chair – Patrick Leahy (D-VT) 

  • Ranking Member – Richard Shelby (R-AL) 

  • Health, Education, Labor and Pensions Committee 

  • Chair – Patty Murray (D-WA) 

  • Ranking Member – Richard Burr (R-NC) 

  • Committee on the Budget 

  • Chair – Bernie Sanders (D-VT) 

  • Ranking Member – Lindsey Graham (R-SC) 

  • Committee on Finance 

  • Chair - Ron Wyden (D-OR) 

  • Ranking Member – Mike Crapo (R-ID) 

Democrats Trigger Budget Reconciliation Process to Pass COVID-19 Relief  

Democrats are preparing to leverage the budget reconciliation process in order to avoid the Senate filibuster and push through key policy priorities included in Biden’s proposed $1.9 trillion legislative pandemic relief package with a simple majority, which Democrats command using Vice President Harris’ tie-breaking vote. On February 1, Senate Majority Leader Chuck Schumer (D-NY) and House Speaker Nancy Pelosi (D-CA-12) introduced a concurrent budget resolution, the first step required to enact a Budget Reconciliation bill. On February 3, the House approved the concurrent resolution (H.Con.R. 11), officially triggering the budget reconciliation process in the lower chamber. The concurrent resolution directs House committees to start drafting the bill text for the COVID-19 relief package and provides instructions for handling the reconciliation process. On February 4, the Senate took up its version of the concurrent budget resolution (S.Con.Res. 5), setting up a lengthy process for voting on amendments known as a “vote-a-rama.” The Senate passed the budget resolution early Friday morning after an all-nighter voting on the vote-a-rama amendments, and the House promptly approved the Senate-amended budget resolution. 

NASTAD will continue to monitor stimulus negotiations in the 117th Congress and the appropriations process under a Biden Administration to advocate for the highest funding levels on behalf of HIV and hepatitis programs.  

Administrative Activity 

Biden Administration to Confirm Nominees, Appoint Remaining Officials 

President Biden continues to rely on an "acting" cabinet to facilitate his administration’s regulatory agenda while the Cabinet nominees await Senate confirmation. HHS Secretary-designate Xavier Becerra still does not a date for his Senate confirmation hearings. However, with Democrats now in charge of committee leadership in the Senate, Cabinet confirmation hearings are expected to be scheduled quickly in the coming days, starting with the hearing for Biden’s nominee for the Director of the Office of Management and Budget (OMB), Neera Tanden, on February 9. 

Biden Signs Executive Order Halting Public Charge Rule 

On February 2, President Biden issued a series of executive actions that are intended to undo harmful immigration policies that were put in place by the Trump Administration. The Executive Order (EO) on Restoring Faith in Our Legal Immigration Systems and Strengthening Integration and Inclusion Efforts for New Americans directs federal agencies to review immigration policies, both recently issued and long-standing, that harm the wellbeing and health of immigrants and impose barriers to naturalization. Notably, the EO directs the chiefs of HHS, the Department of State, Department of Justice, and the Department of Homeland Security to review all agency actions related to the implementation of the Trump-era Public Charge rule. Health advocates and immigrant rights activists panned the rule, which amounts to a wealth test on immigrants as a precondition for naturalization, and applauded the new administration for taking steps to remove the harmful policy. Click here to read NASTAD’s statement on the release of the finalized Public Charge rule. 

Biden Administration Halts Trump-Era Drug Pricing Rules 

The Biden administration is delaying implementation of a Final Rule issued by HHS that effectively strips back-end rebates received from drug manufacturers by pharmacy benefit managers (PBMs) of safe harbor protections under the Anti-Kickback Statute and creates new safe harbors to incentivize point-of-sale discounts that accrue to patients. The rulemaking was to go into effect in January 2022 but will now be postponed until January 2023. On January 12, the Pharmaceutical Care Management Association, representing PBMs, filed a lawsuit challenging the Final Rule. The Biden Administration has until April 1 to determine whether it wishes to defend the policy in U.S. District Count.  

Resources 

National Black HIV/AIDS Awareness Day  

February 7 is National Black HIV/AIDS Awareness Day (NBHAAD), a day to celebrate progress in HIV prevention, reduce HIV stigma, and encourage HIV testing and treatment among African American people. This year’s theme, We’re In This Together, emphasizes the role we each play in ending HIV. As part of the HHS Ending the HIV Epidemic: A Plan for America (EHE) initiative, CDC is working with health departments and community-based organizations to address service challenges and help meet the HIV prevention and care needs of their communities. This includes improving access to HIV testing (including self-testing), increasing the use of pre-exposure prophylaxis (PrEP) for people who do not have HIV, and linking or re-engaging people with HIV to care and treatment.  

For NBHAAD, the CDC encourages you to use a new set of prevention materials from the Let’s Stop HIV Together campaign that builds on the existing HIV prevention, testing, treatment, and stigma resources. Help raise awareness by sharing social media content from CDC’s digital toolkit using the #NBHAAD and #StopHIVTogether hashtags.  

SAMHSA Releases HIV Prevention Tool for People Living with SUD or Mental Illness 

The HHS Substance Abuse and Mental Health Services Administration (SAMHSA) has released Prevention and Treatment of HIV Among People Living with Substance Use and/or Mental Disorders, a guidebook that addresses the co-occurrence of HIV and mental illness and/or substance use disorder (SUD) and reviews effective programs and practices to prevent HIV and, for those with HIV, to increase linkage and retention to care in order to improve health outcomes. This free guide includes a variety of modules with information to improve health outcomes for people at risk for developing, living with, or recovering from mental illness and/or SUD and resources for program evaluation. It is part of SAMHSA’s ongoing efforts to implement Ending the HIV Epidemic: A Plan for America (EHE) initiative, which aims to reduce new HIV infections in the United States by 90 percent by the year 2030, and implement the HIV National Strategic Plan. 

Report: Effect of Medicaid Expansions on HIV Diagnoses and Pre-Exposure Prophylaxis Use 

Increased insurance coverage and access to health care can increase identification of undiagnosed HIV infection and use of HIV prevention services such as pre-exposure prophylaxis. This study investigates whether the Medicaid expansions facilitated by the Affordable Care Act had these effects. The results of the study suggest that the changes in new HIV diagnoses, awareness of HIV status, and pre-exposure prophylaxis were not simply because of a higher incidence or an increase in infection risk. Medicaid expansions were associated with increases in the percentage of people living with HIV who are aware of their status and pre-exposure prophylaxis use. Expanding public health insurance may be an avenue for curbing the HIV epidemic. 

Job Postings 

Department of State Health Services, Program Informatics and Evaluation Group – Austin, TX 

  • Program Specialist V - performs advanced (senior-level) consultative services for the Program Informatics and Evaluation Group within the integrated HIV/STD/TB Surveillance and Prevention unit of DSHS 

  • Research Specialist V - conducts highly advanced (senior-level) research and analysis of program evaluation and epidemiologic data associated with HIV, particularly routine testing for HIV in clinical settings 

  • Program Specialist IV - performs highly complex and advanced technical activities related to HIV, STD, and Tuberculosis data management and processing of HIV, STD, and TB laboratory reports 

  • Epidemiologist III - designs and implements statistical analyses appropriate for epidemiologic and programmatic data with a focus on HIV prevention programming. 

Director of Operations, Bureau of Infectious Disease and Laboratory Sciences – Boston, MA 

The Bureau of Infectious Disease and Laboratory Sciences (BIDLS) at the Department of Public Health (DPH) is seeking an experienced leader who is eager to join a mission-driven and fast-paced team in effectively and efficiently supporting the day-to-day operational needs of BIDLS.  The selected candidate will provide direct and indirect supervision to a total of 55 staff, including 4 Managers, and will oversee an annual budget in excess of $500M. To be successful, the incumbent of this position must be detail-oriented and also must understand the complexities of systems change and implementation in government systems, with the ability to ensure alignment with the Bureau’s and Department’s mission, goals, and objectives. 

Open Positions – New York State 

The New York State Department of Health, in partnership with Health Research, Inc, has various job openings, including some within the AIDS Institute. Please visit this link to learn about their current opportunities.  

News Bulletin 

A Drug is 90 Percent Effective at Preventing HIV. It Costs Up to $1,800 Per Month. 

“Nearly a decade after the U.S. approved a drug to prevent HIV, tens of thousands can’t access the medicine, in part because of its cost. Under pressure to offer a more affordable alternative, Gilead released its exclusivity in a settlement agreement, allowing a generic version to come to market — but the drug is almost as expensive as the brand-name version. The U.S. government has now stepped in, in a legal case heralded as a game-changer in drug pricing reform.” 

The Most Important Health Concerns of Black LGBTQ Americans 

“A survey of LGBTQ African Americans offers an array of insights into this community, ranging from relationship status and education to discrimination and acceptance. A section on health concerns, for example, found that depression and anxiety, HIV/AIDS, a healthy body weight, COVID-19 and high blood pressure were cited as the main issues of concern along with the “physical and/or mental health effects resulting from racial discrimination.” Released to coincide with Black History Month, observed each February, the Black LGBTQ Community Survey 2020–2021 was spearheaded by the Center for Black Equity (CBE) and Community Marketing & Insights (CMI), an LGBTQ market research firm. According to a press release on the findings, 1,815 LGBTQ African Americans took the survey between September 21 and October 30, 2020.” 

Frontrunner emerges for Biden’s Medicare and Medicaid chief 

“Chiquita Brooks-LaSure, a longtime Democratic health policy expert, has emerged as the leading candidate to run President Joe Biden’s Medicare and Medicaid agency, according to three sources familiar with the Biden team’s discussions. The eventual head of the trillion-dollar agency will be charged with overseeing Biden’s pledge to expand Obamacare and reverse Trump-era restrictions on the health care safety net.” 

New combination therapy offers chance of healing hepatitis B 

“Scientists at the German Center for Infection Research (DZIF) and the University Hospital Eppendorf (UKE) have now investigated a new combination therapy that has proven highly effective in their infection model. The new therapeutic approach is based on shutting down the viral hepatitis B genome located in the nucleus of infected liver cells.” 

How Covid-19 Has Hurt the Effort to Track STDs 

“As gonorrhea, syphilis and chlamydia have hit their highest marks in decades, many STD contact tracers have shifted to work on the pandemic.”