Policy Updates: Hill Happenings and Administration Activities

By Julio Contreras February 16, 2021

Hill Happenings 

Democrats Trigger Budget Reconciliation Process to Pass COVID-19 Relief  

Congressional Democrats are working in lockstep with the Biden Administration to quickly pass the President’s proposed $1.9 trillion pandemic relief legislative package. After early negotiations failed to offer a clear, bipartisan path forward, Democrats are leveraging the budget reconciliation process to avoid the Senate filibuster and pass the legislative 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. After early rounds of voting on amendments, both chambers of Congress approved the concurrent budget resolutions (H.Con.R. 11 ; S.Con.Res. 5), officially triggering the budget reconciliation process by directing House and Senate committees to start drafting the bill text for the COVID-19 relief package and providing instructions for handling the reconciliation process. 

On February 11, the House Energy & Commerce Committee conducted a full committee markup of the COVID-19 relief budget reconciliation legislation, advancing certain benefits and healthcare provisions included in the legislative package. Notably, the bill text proposes to allocate $30 million in Substance Abuse and Mental Health Services Administration (SAMHSA) funds to be used to support community-based overdose prevention and harm-reduction services, including syringe service providers (SSPs), to help stem the drug misuse crisis that is made worse by the COVID-19 pandemic. The bill also included proposed language that would lift the Medicaid drug rebate cap. The marked-up bill text is now heading to the House Budget Committee for review.  

Additionally, NASTAD joined a coalition of over 100 organizations and urged Congress to pass the broad stimulus and COVID-19 relief proposals included in President Biden’s legislative relief package, the American Rescue Plan. The coalition of health advocates calls on Congress to back the President’s legislative proposal without cutting down the relief aid, arguing that a federal response commensurate with the outsized impact of the pandemic is long overdue. The coalition calls on lawmakers to prioritize the well-being of communities of color, uphold unemployment benefits and social safety-net programs like Medicaid, and distribute relief dollars to states and local jurisdictions.  

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.  

Senate Appropriations Committee Leaders Announce Subcommittee Rosters and Leadership for 117th Congress 

On February 12, Senate Appropriations Committee Chairman Patrick Leahy (D-VT) and Vice Chairman Richard Shelby (R-AL) announced the majority and minority Chairmen, Ranking Members, and subcommittee rosters for the 117th Congress. With the Senate Appropriations Subcommittee structures in place, Democrats in the upper chamber can continue to push forward their legislative agenda, including marking up COVID-19 relief through budget reconciliation and scheduling confirmation hearings for President Biden’s Cabinet nominees. 

Administrative Activity 

Biden Administration Withdraws Support for Legal Challenge to the Affordable Care Act 

On February 10, the U.S. Department of Justice (DOJ) formally withdrew its support for legal challenges to the Affordable Care Act (ACA) that were put in place by the Trump Administration and made their way to the Supreme Court of the United States. Deputy Solicitor Edwin Kneedler argues that, after the change in administration, the U.S. DOJ has reconsidered its position and no longer concludes that certain provisions of the healthcare law are unconstitutional. Although the withdrawal of support signals the administration’s commitment to upholding the ACA, the legal move may not impact the high court’s ruling, which is likely already being drafted. 

CDC Announces Funding Opportunity to Deliver HIV Prevention Messages to Priority Populations 

The Centers for Disease Control and Prevention (CDC) has issued a notice of funding opportunity (NOFO) that seeks to engage strategic partners from across a variety of sectors to support the dissemination of messages and resources from the Let’s Stop HIV Together campaign to the populations and communities most impacted by HIV. The Partnering and Communicating Together funding opportunity is part of CDC’s efforts to increase HIV awareness and promote HIV prevention and testing under the Ending the HIV Epidemic (EHE) initiative. This program will help organizations expand the reach and dissemination of campaign resources using a variety of vehicles, including publications, meetings, conferences, digital and social media, and other mechanisms. Recipients will prioritize health communication and mobilization efforts among populations highly impacted by HIV and in the jurisdictions where HIV is most prevalent, prioritizing the 57 jurisdictions in Phase I of the Ending the HIV Epidemic initiative. 

CDC HIV/AIDS Prevention Research Synthesis (PRS) Project Adds PrEP Intervention Resources 

The CDC HIV/AIDS Prevention Research Synthesis (PRS) Project recently added a new chapter on Pre-Exposure Prophylaxis (PrEP) interventions to the Compendium of Evidence-Based Interventions and Best Practices for HIV Prevention. The new resource identifies effective interventions for PrEP use and persistence, and helps HIV prevention planners and providers in the US select interventions most appropriate for their communities. Following consultations with CDC and National Institutes of Health (NIH) subject matter experts, two sets of evaluation criteria were developed for the new PrEP chapter. Evidence-based criteria evaluate intervention studies that have a comparison group whereas evidence-informed criteria evaluate intervention studies have a pre-post comparison only. Evidence-based criteria provide the strongest evidence of efficacy whereas evidence-informed criteria identify interventions with modest evidence of efficacy. 

NASTAD Joins Coalition Calling on CMS to Ease Medicare Enrollment During COVID-19 Pandemic 

NASTAD joined a coalition of 50 organizations urging the Centers for Medicare & Medicaid Services (CMS) to reinstate two policies to help people sign up for Medicare amid the COVID-19 pandemic: a Special Enrollment Period (SEP) for Part C and Part D and Equitable Relief for Premium Part A and Part B. CMS established these enrollment pathways last May to promote access to coverage and care during the COVID-19 public health crisis. However, the enrollment flexibilities were allowed to lapse shortly thereafter, despite clear and ongoing needs. The coalition is asking CMS to help by renewing and strengthening the SEP and Equitable Relief flexibilities. These policies should remain in effect through the calendar year in which the emergency period ends, at a minimum, and coverage should begin as soon as possible—no later than the first day of the month following enrollment.  

President Biden Announces Members of the Biden-Harris Administration COVID-19 Health Equity Task Force 

On February 10, President Biden announced the remaining members of the COVID-19 Health Equity Task Force, underscoring the administration’s interest in addressing health equity during the pandemic. On January 21, in one of his first actions as President, President Biden signed an executive order that created a task force to address COVID-19 related health and social inequities. The task force, chaired by Dr. Marcella Nunez-Smith, addresses disparities in COVID-19 testing, cases, hospitalizations, and mortality that are that determined by race, ethnicity, geography, disability, sexual orientation, gender identity, and other factors. 

Resources 

Webinar: Expanding Harm Reduction Access using Online and Mail-Based Services 

Date & Time: Wednesday, February 24 | 3:00 – 4:15 pm ET 

Please join NASTAD Drug User Health for a webinar with Next Distro on Wednesday, February 24, 3:00 - 4:15 PM ET. The popularity of distributing harm reduction materials including safer use supplies by mail has grown significantly since COVID-19. Join NASTAD and NEXT Distro for a discussion about values, opportunities, and challenges related to mail-based harm reduction. Members of the NEXT Distro team will provide an overview of program operations, opportunities to collaborate, and discuss how to expand mail-based harm reduction access in local communities. Additionally, Corey Davis from the Network for Public Health Law will be available to provide an overview of the legality of mail-based syringe and naloxone access. 

The Southern Syringe Services Program (SSP) Institute 

Date & Time: March 3-4 | 12:00 – 4:30 PM ET 

NASTAD invites you to attend a virtual two-day, regional gathering on harm reduction, syringe services programs, and drug user health. The Southern Syringe Services Programs (SSP) and Drug User Health Institute will be held virtually via Zoom and occur on the afternoons of March 3-4, 2021 from 12:00 - 4:30 PM ET.  This convening will bring together health department staff, community-based groups, content experts, national stakeholders, and state and local service providers who work on issues related to the drug use/overdose crisis and reducing associated harms in their respective jurisdictions and communities. Health department staff, SSPs/harm reduction programs, and other community-based organizations and local service providers in southern states are encouraged to attend.   

Registration for AIDSWatch 2021 is Now Open 

Registration is now open for AIDSWatch. AIDSWatch, to be held March 22-24, 2021, will bring together HIV advocates from across the country – virtually – to speak truth to power to members of the 117th Congress and the new Biden-Harris administration. We will gather as a community to sustain our advocacy around ending the HIV epidemic in the United States, even amid more than a year of navigating the COVID-19 pandemic. Presented by AIDS United, the US PLHIV Caucus and the Treatment Access Expansion Project, AIDSWatch is the largest, national, constituent-based HIV advocacy event. While typically held in person in Washington, D.C., AIDSWatch continues to be held virtually due to the COVID-19 pandemic.  

Job Postings 

Communicable Disease Epidemiologist – Cheyenne, Wyoming 

This position will serve as the Communicable Disease AIDS Drug Assistance Program (ADAP) Coordinator, Wyoming TB Controller, and Disease Intervention Specialist (DIS) for the Communicable Disease (CD) Treatment Program.  Assist in outbreak response to ensure the safety of Wyoming residents; by interviewing cases for exposure information, updating news outlets on the progress of outbreak control, analyzing exposure data utilizing epidemiological and statistical methods. 

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 

Biden moving to withdraw Trump-approved Medicaid work rules 

“The Biden administration on Friday will notify states it plans to revoke Medicaid work requirements, starting the process of dismantling one of the Trump administration's signature health policies. The move is one of several steps that Biden’s health department is expected to take this week to unravel the contentious work rules long criticized by Democrats, according to internal documents obtained by POLITICO. The documents — which were labeled “close hold” — do not make clear how quickly Biden will cut off work rules the previous administration approved in a number of states, which for the first time were allowed to mandate that some people work or volunteer as a condition of enrollment in the low-income health care program.” 

Housing Trumps Insurance in Keeping People With HIV in Care 

“For a group of Washington, DC, residents, access to health insurance and general satisfaction with their providers weren’t enough to overcome barriers to HIV care thrown up by a lack of housing, jobs and money. These are the findings of a survey and in-depth interviews published in the journal AIDS and Behavior. The findings are significant because models show that engaging people with HIV in care could cut new cases by 94% by 2027—but only if it’s possible to engage everyone living with the virus. Getting people into treatment and supporting them to stay in treatment is a key tenet of the federal government’s Ending the HIV Epidemic: A Plan for America.” 

Pandemic-Fueled Alcohol Abuse Creates Wave of Hospitalizations for Liver Disease 

“As the pandemic sends thousands of recovering alcoholics into relapse, hospitals across the country have reported dramatic increases in alcohol-related admissions for critical diseases like alcoholic hepatitis and liver failure. Alcoholism-related liver disease was a growing problem even before the pandemic, with 15 million people diagnosed with the condition around the country, and with hospitalizations doubling over the past decade. But the pandemic has dramatically added to the toll. Although national figures are not available, admissions for alcoholic liver disease at Keck Hospital of the University of Southern California were up 30% in 2020 compared with 2019, said Dr. Brian Lee, a transplant hepatologist who treats the condition in alcoholics.” 

Assessing Global HIV Targets in PEPFAR Countries: A Dashboard 

“A new KFF analysis finds that across 46 PEPFAR countries and among six different indicators of progress, the majority (40) has met at least one target, 17 countries have met at least half of the targets, and one country has met five targets. No country has met all targets and six have not met any target.”