Policy Updates: Hill Happenings and Administration Activities

By Garrett Eberhardt December 16, 2019

Hill Happenings

House and Senate Appropriators Reach Deal on FY2020 Appropriations

After meeting last Thursday, House and Senate appropriators, Congressional leadership, and the Trump administration announced that all sides came to an agreement over funding for all 12 outstanding fiscal year (FY) 2020 appropriations. Appropriators agreed to flat funding of $1.375 billion for a wall at the southern border, as well as an agreement not to interfere with President Trump's ability to divert Pentagon funding to the wall. The 12 appropriations bills will be sent to the Congressional floor in two separate packages for votes tomorrow. The first package will include the Defense, Homeland Security, Commerce-Justice-Science, and Financial Services bills while the other bills will be included in a second minibus. The agreement will allow for the Ending the HIV Epidemic initiative to be implemented in full as intended, but full details of the deal are expected to be released sometime later today.

House Passes Bill on Prescription Drug Plan

Last Thursday, the House of Representatives passed HR 3, the Elijah E. Cummings Lower Drug Costs Now Act, amid pushback from both progressives and conservatives. The bill requires the Centers for Medicare & Medicaid Services (CMS) to negotiate maximum prices for insulin products and at least 25 single source, brand-name drugs that do not have generic competition and are among the 125 drugs that account for the greatest national spending or the 125 drugs that account for the greatest spending under the Medicare prescription drug benefit and Medicare Advantage (MA). The negotiated prices cannot exceed 120 percent of the average international price or 85 percent of the U.S. average manufacturer price and must be offered under Medicare and MA and private health insurance unless the insurer opts out. Senate Majority Leader Mitch McConnell (R-KY) has already stated that the Senate will not take up the bill and the White House has announced it would veto it. The Senate plans to take up its own more moderate drug pricing bill in the coming months. Despite the opposition, the bill passed the House chamber in a 230-192 vote, partly signaling to voters a vision for how Democrats would like to remake prescription drug pricing in this country prior to next year’s elections. NASTAD, along with the National Coalition of STD Directors, sent a letter to House Democrats last week in support of the bill and its efforts to reduce the high cost of drugs, improving the ability of health departments and other healthcare providers to address the HIV, hepatitis, and STD epidemics. Two weeks ago, the Senate Finance Committee updated its own bipartisan Prescription Drug Pricing Reduction Act of 2019, but it is unclear if the update will convince skeptical Republican Senators.

Rep. Jenniffer González Colón Announced as New Co-Chair of Congressional HIV/AIDS Caucus

Last week, Rep. Jenniffer González Colón (R-PR) was announced as the new co-chair of the Congressional HIV/AIDS Caucus. Rep. González Colón will lead the bipartisan and bicameral caucus with Rep. Barbara Lee (D-CA) to continue to monitor developments related to global and domestic HIV/AIDS. “We have made incredible progress in our fight for an AIDS-free generation, and Congress must continue to work together to support programs we know are working,” said Congresswoman Barbara Lee. “I look forward to working with Rep. González-Colón to address the needs of communities disproportionately impacted by HIV – including African Americans and Latinx Americans – as we continue working towards an AIDS-free generation. I am delighted to partner with her in leading the Congressional HIV/AIDS Caucus.”

Congress Introduces World AIDS Day Resolutions

Last week, World AIDS Day resolutions were introduced in both the House of Representatives and Senate. The resolutions reiterated Congress’ support of the goals and ideals of World AIDS Day, recognizing its 29th anniversary and commended the President, State governments, and local governments, including State and local public health agencies, for recognizing the day as well and for encouraging individuals to undergo testing for HIV, and for their other ongoing efforts strengthened by the Ending the HIV Epidemic initiative. Congress also commended national, State, and local media organizations for carrying messages in support of World AIDS Day and stated its support for the implementation of the National HIV/AIDS Strategy for the United States, continued funding for PEPFAR and the Global Fund to Fight AIDS, the Ryan White HIV/AIDS Treatment Extension Act, the Minority HIV/AIDS Initiative, and all federal health agencies that work toward prevention, care, treatment services, and research programs for persons living with HIV/AIDS in the United States.

Administration Activities

Stephen Hahn Confirmed as FDA Commissioner

The Senate confirmed the Trump administration’s nominee for Food and Drug Administration (FDA) commissioner Stephen Hahn, an oncologist and hospital administrator, late last week. Hahn was approved by the chamber in a 72-18 vote following his endorsement by numerous patient advocacy and healthcare provider groups as well as five former FDA commissioners. Hahn will replace acting FDA commissioner ADM Brett Giroir who also acts as the Assistant Secretary of Health in the Department of Health and Human Services.

Nine States Join OIDP’s 2020 Hepatitis C Medicaid Affinity Group

The Department of Health and Human Services’ Office of Infectious Disease and HIV/AIDS Policy announced last week that Arkansas, Idaho, Indiana, Kentucky, Michigan, New Hampshire, Washington, West Virginia, and Wisconsin will participate in its third year of the Hepatitis C Medicaid Affinity Group. The states will work to improve hepatitis C outcomes for Medicaid beneficiaries by working collaboratively across Medicaid, public health, behavioral, and correctional health agencies to learn about and share innovative strategies to improve HCV cure.

Office on Women’s Health Distributes $3 Million in Support of Intimate Partner Violence and HIV Screening

The Department of Health and Human Services’ Office on Women’s Health announced last week that it has awarded over $3 million to community-level programs in Texas, Kentucky, and Louisiana to reduce the negative health impacts of intimate partner violence (IPV) and HIV. The award was given through the Preventing HIV Infection in Women through Expanded Intimate Partner Violence Prevention, Screening, and Response Services initiative and seeks to address the link between IPV and HIV by protecting women through violence-prevention efforts and providing services in communities where women are most at risk. The four organizations receiving funding, the University of Texas Southwestern Medical Center, University of North Texas Health Science Center, The Center for Women and Families, Inc. in Louisville, KY, and Institute of Women and Ethnic Studies in New Orleans are in one of the prioritized jurisdictions of the Ending the HIV Epidemic: A Plan for America initiative.

Ending the Epidemic

NASTAD Piece on Ending the Epidemic Published in American Journal of Public Health

A piece authored by Amy Killelea, Natalie O. Cramer, and Michael Weir of NASTAD will be published in the January 2020 edition of the American Journal of Public Health outlining the importance of the Ending the HIV Epidemic: A Plan for America initiative. The article highlights the potential of EHE to increase HIV prevention and treatment options by building on important work already happening in jurisdictions across the United States and utilizing the increased funding detailed in the president’s budget and congressional appropriations bills. NASTAD also emphasizes the importance of urging federal partners to ensure that the initiative is used to harness momentum and resources to end new HIV infections nationwide and meaningfully engage jurisdictions with low and moderate HIV prevalence at all stages to ensure that innovation is encouraged and supported through existing funding mechanisms.

Resources

NASTAD recently released a set of nine drug pricing and access principles to further support its mission to ending the HIV and hepatitis epidemics. These principles covering issues such as increased competition, insurance formularies, and cost sharing, will work to advance NASTAD’s health legislative and policy priorities and help address the health disparities fueling disproportionate access to healthcare. NASTAD and the Building Healthy Online Communities Coalition will host a webinar on Tuesday, December 17 from 2:00 PM – 3:00 PM ET titled Understanding Digital Campaign Execution – How to Use Online Media in Your Ending the HIV Epidemic Work. The webinar will provide expert tips and lessons learned on how to use social media and other online platforms to promote health literacy among the public in the HIV response, including how to best spend your recruitment budget and ad purchasing on dating/hook-up apps.

NASTAD, as part of the Partnership to End the HIV, STD, and Hepatitis Epidemics, wrote a letter to Assistant Secretary for Health ADM Brett Giroir MD advocating that STDs, hepatitis, and housing programming in the Ending the HIV Epidemic: A Plan for America (EHE). The letter argues that by not integrating these programs into EHE, diagnosing, treating, and preventing new HIV cases is made harder and that the federal government should work to ensure that jurisdictions are including STD, hepatitis, and housing programs in their EHE plans.

Job Opportunities

Public Health Program Manager – New Hampshire

The State of New Hampshire’s Department of Health and Human Services’ Division of Public Health Services is seeking a Public Health Program Manager to supervise and monitor the NH Ryan White HIV CARE Program (NH CARE Program) and the NH Tuberculosis Financial Assistance (TBFA) Programs. The position will have the responsibility of coordinating all aspects of program services and developing goals, objectives and performance improvement measures for a statewide continuum of TB and HIV care.

Senior Director of Legal and Regulatory Affairs – Baltimore

The Baltimore City Health Department (BCHD) is seeking candidates for a Senior Director of Legal and Regulatory Affairs position. The position will serve as general counsel and principal legal advisor to BCHD's senior leadership team and will provide support throughout the agency on a wide range of legal matters including health law and regulatory compliance, health-related transactional matters, risk assessment, and affirmative litigation efforts with the City's Law Department.

Director of Policy – Illinois

The AIDS Foundation of Chicago (AFC) is seeking a Director of Policy with content expertise to stay abreast of critical healthcare delivery systems including Medicaid, Housing, Ryan White, and the Affordable Care Act (ACA) and influence health policy. The position will serve as the lead for policy development and work on identifying and resolving policy-related issues across the agency with other departments.

Director of Government Relations – Illinois

The AIDS Foundation of Chicago (AFC) is seeking a Director of Government Relations to develop and manage AFC’s federal, state and local government relations activities. The position will be the point person for HIV-related state legislative matters regarding appropriation, health care reform, and policy issues impacting the social determinants of health and health disparities.

HIV Transitional Specialist – Washington State

The Department of Corrections’ Health Services Division in Washington State is hiring an HIV Transitional Specialist. The position supports the department’s vision of maintaining safe communities by providing support for and developing comprehensive release plans for people living with HIV. The position will also provide technical assistance to correctional health care staff upon initial screening or admission and prior to the release of any patient living with HIV.

News Bulletin

Facebook ads push misinformation about HIV prevention drugs, LGBT activists say, ‘harming public health’

“Facebook users have been bombarded with misleading ads about medication meant to prevent the transmission of HIV, according to lesbian, gay, bisexual and transgender advocates, who say the tech giant’s refusal to remove the content has created a public-health crisis.

In response, GLAAD plans to step up its efforts on Monday, joining the Human Rights Campaign, The Trevor Project, NASTAD, and 49 other prominent LGBT groups in publicly calling out the tech giant for a policy that puts ‘real people’s lives in imminent danger.’”

Governor Andrew M. Cuomo Calls on Facebook to Remove Deceptive Ads on HIV Prevention Drug Truvada

"I am deeply troubled by reports of deceptive advertisements on Facebook questioning the safety and effectiveness of the HIV-prevention drug Truvada. The ads are unwarranted and unacceptable, and Facebook should remove them immediately.”