Policy Updates: Hill Happenings and Administration Activities

By Mike Weir August 6, 2018

Hill Happenings

FY2019 Budget and Appropriations

The Senate is expected to take up the FY2019 Labor, Health and Human Services, Educations and Related Agencies (LHHS)/Defense minibus as soon as this week. NASTAD will continue to monitor the appropriations process and advocate for the highest funding levels on behalf of HIV and hepatitis programs. NASTAD does not expect any major changes to occur when the House and Senate consider their respective bills on the floor. 

340B Drug Pricing Program

Republican leadership on the House Energy and Commerce Committee sent letters to nine contract pharmacies participating in the 340B Drug Pricing Program requesting information about various practices, including “contracting practices, the distance between covered entities and contract pharmacies, to what degree contract pharmacies prevent duplicate discounts or diversion in the program, and whether contract pharmacies ensure low-income uninsured patients do not face high drug costs despite the program’s discount.” The committee requested responses from the nine recipients by August 15, 2018. 

PEPFAR

Representatives Chris Smith (R-NJ-4), Barbara Lee (D-CA-13), Ileana Ros-Lehtinen (R-FL-27), Karen Bass (D-CA-37), Ed Royce (R-CA-39), and Eliot Engel (D-NY-16) have reintroduced the PEPFAR Stewardship and Oversight Act, H.R. 6651--PEPFAR reauthorization legislation. The legislation reauthorizes the program for five years. Currently, there is no companion bill in the Senate.

“For the last 15 years, PEPFAR has been a testament to the bipartisan cooperation on U.S. leadership in global public health. Thanks to PEPFAR, millions of lives have been saved through HIV/AIDS treatment, care, and education. But our work is far from over – we are at a tipping point and Congress must recommit to this fight,” said Congresswoman Lee in a press release. “At this pivotal time, Congress must do the important work to protect and fund programs like PEPFAR and the Global Fund. As an early champion of these initiatives, I am so proud of our work across the aisle, ensuring that PEPFAR can continue to save lives for decades to come.”

Administration Activities

Short-term Plans

The Trump Administration issued a final rule that will allow for the sale of short-term health plans for a maximum duration of up to one year but which can be renewed for a total of three years. The new rule overturns an Obama Administration directive that limited short-term plans to 90 days. The rule will “help increase choices for Americans faced with escalating premiums and dwindling options in the individual market,” said James Parker, a senior adviser to Health and Human Services (HHS) Secretary Alex Azar.

The Administration projects that roughly 200,000 consumers currently purchasing plans on the exchanges would leave that market because of the rule and that a total of roughly 600,000 people are estimated to enroll in the plans next year. By 2021 or 2022, an estimated 1.6 million additional people are projected to enroll in short-term plans, said Randy Pate, the director of the Center for Consumer Information and Insurance Oversight (CCIIO) and deputy administrator of the Centers for Medicare and Medicaid Services (CMS).

Title X

The Federal AIDS Policy Partnership (FAPP) sent a letter, signed by 28 organizations, including NASTAD, to HHS expressing numerous concerns regarding the proposed Title X “domestic gag rule.” NASTAD also submitted an individual letter.

Division of Adolescent and School Health

The Centers for Disease Control and Prevention’s (CDC) Division of Adolescent and School Health (DASH) announced the 86 grant recipients for PS18-1807: Promoting Adolescent Health through School-Based HIV Prevention

2018 National STD Prevention Conference

The 2018 STD Prevention Conference will be held August 27-30, 2018 in Washington, DC. Registration for the conference is still open. 

Ryan White HIV/AIDS Program (RWHAP) 2018 Clinical Conference

The RWHAP Clinical Conference will be held on December 9-11 in Oxon Hill, Maryland. The conference is open to any RWHAP-funded clinical prescriber--Parts A-F.  Registration for the Clinical Conference is now available.

2018 National Ryan White Conference on HIV Care & Treatment

The 2018 Ryan White Conference on HIV Care & Treatment will be held December 11-14, 2018 in Oxon Hill, Maryland. Late registration for the conference is open until September 28, 2018. 

2019 National HIV Prevention Conference

The 2019 National HIV Prevention Conference (NHPC) will be held March 18-21, 2019 in Atlanta, Georgia. Check out the updated website for more information about tracks and to view the tentative conference schedule. 

Resources

MMWR Weekly: Vol. 67, No. 28:HIV Testing, Linkage to HIV Medical Care, and Interviews for Partner Services Among Black Men Who Have Sex with Men — Non–Health Care Facilities, 20 Southern U.S. Jurisdictions, 2016 

News Bulletin

Fair Pricing Coalition Pleased with Steps by Gilead to Increase Access to PrEP, but More Actions Needed

“The Fair Pricing Coalition (FPC) today commended Gilead Sciences for recent improvements to its Advancing Access program for Truvada (tenofovir disoproxil fumarate/emtrictabine) as pre-exposure prophylaxis (PrEP). In a July 24, 2018, letter to advocates, Gilead announced that its copay assistance maximum would be increased from $4,800 to $7,200 a year. This change goes into effect September 1.  Additionally, beginning July 1, people vulnerable to HIV who qualify for the Advancing Access Medication Assistance Program (MAP) – which provides free drug to uninsured or underinsured individuals who meet annual income criteria – will remain eligible for 12 months instead of six months.”

Trump Spurns Medicaid Proposal After Furious White House Debate

“Hoping to head off a full expansion of Medicaid under the Affordable Care Act, some senior officials in the Trump Administration and Republican governors have been pushing hard for a smaller expansion to satisfy a growing political demand in their states. But President Trump decided on Friday to shut down the debate until after the midterm elections, administration officials said.”

States defend family planning program against Trump administration’s threats

“Governors from a growing number of states are fighting back against a proposal by the Trump Administration to bar clinics that provide abortion services or referrals from receiving federal family-planning funds. New York's Andrew M. Cuomo (D) and 13 others have threatened to sue. Washington state's Jay Inslee, Oregon's Kate Brown and Hawaii's David Ige, also Democrats, vowed to pull their states from the program if the changes are implemented. On Monday, 13 attorneys general, all Democrats, added their voices to the opposition, arguing that the changes are unconstitutional.”

Price Of HIV Test Falls, Raising Hopes In Global AIDS Fight

“The Clinton Health Access Initiative, along with several other development agencies, has brokered an agreement to make routine HIV tests more accessible. They're aiming to make HIV viral load tests available for $12 a piece, slashing the price in some markets by more than 50 percent.”

Growing homophobia will fuel the HIV epidemic, experts fear

“Studies have shown that continuously taking antiretroviral drugs can reduce the virus to undetectable levels, but for many LGBT communities -- in Guyana and globally -- access to services is blocked through the homophobia they face.”

CDC Warns: You Should Not Wash Or Reuse Condoms

“A condom is not a complex piece of machinery. It is also not underwear. But apparently enough people don't understand how to use condoms and reuse and wash condoms that the Centers from Disease Control and Prevention (CDC) felt compelled to issue the following warning [via Twitter]: ‘We say it because people do it: Don't wash or reuse #condoms! Use a fresh one for each #sex act. https://go.usa.gov/xU5vh”

Job Opportunities

STD Program Regional Consultant – Tennessee 

The Tennessee Department of Health is hiring for a STD Program Regional Consultant (Disease Investigation Specialist 4) withintheir HIV/STD & Viral Hepatitis Program.