Week Ending 2.19.2021

Weekly Policy Updates

Friday, February 19, 2021


Snapshot: What’s Happening in Washington This Week

With impeachment behind them, both the House and Senate now turn towards competing priorities to pass a $1.9 billion COVID relief bill and begin advancing Biden’s nominees for appointed positions. The House version of the COVID relief package should receive a vote by the end of next week, then the Senate can take it up to pass under a likely razor-thin margin. Senators Bennet and Kaine’s public option bill will aim to be included in the next reconciliation package this summer, although it will still have to gather 51 votes in the Senate.

FEHB, OPM & Federal Employees

OPM Will Hold a Virtual Carrier Conference: OPM’s annual carrier conference will be held virtually from April 20th-22nd. A detailed agenda is not yet available.

OPM Releases the Annual Call Letter: This year’s call letter, which outlines priorities for plan year 2022, discusses many expected and familiar topics including the COVID-19 pandemic, mental health and SUD, prior authorizations for prescription drugs, and transparency efforts. Two new topics were coverage for certain medically-necessary foods and fertility preservation for individuals with possible iatrogenic infertility issues.

Why it matters: OPM’s annual call letter lays out their priorities for the upcoming plan year and we expect to see many of these topics covered at this year’s Carrier Conference.

Some Agencies Tell Employees They Should Be Prioritized for COVID-19 Vaccine, But Offer Little Other Help: Federal agencies, such as the Postal Service and USDA, has communicated to their employees that they should be eligible for COVID-19 vaccine during phase 1B as essential employees, but States (who are responsible for the vaccine rollout) aren’t all aligned. Many Federal employees are left worried that they won’t have access to the vaccine in a timely fashion.

Why it matters: As reported previously, FEHB carriers will likely have a role in facilitating access to the COVID-19 vaccine for the federal employees they serve and should understanding the access issues they are facing.

Policy Updates

House Aims to Vote on Covid Relief Bill by the End of Next Week: Speaker of the House Nancy Pelosi (D-CA) said Thursday that the House will try to vote on its $1.9 trillion COVID-19 relief bill by the end of next week. Currently included in the bill is subsidies for COBRA and ACA coverage and billions in funding for public health investments, vaccines, testing, and COVID tracing. The House Budget Committee will meet Monday to combine the separate bills each House Committee has passed into one large piece of legislation for consideration in the full chamber.


Why It Matters: Democrats are under pressure to make the COVID relief legislation law before March 14th, when federal unemployment supplements and expanded insurance eligibility expires. While a bipartisan deal in either chamber is not strictly off the table, it’s extraordinarily unlikely as Democrats move aggressively to meet the deadline. However, the timely process of passing a bill under reconciliation (which only requires 51 votes in the Senate) could also be held up by any single Democratic member of the Senate. This means that more controversial provisions may be abandoned to get a bill all Democrats can agree on before the deadline.


Senate Democrats Unveil Health Care Proposal With Public Option: Democratic Senators Michael Bennet (CO) and Tim Kaine (VA) unveiled a bill creating a public option health care plan on the Affordable Care Act marketplaces. The plan would include similar benefits to Medicare, but with additional benefits such as covering primary care services without cost-sharing requirements or copays. Initially, the public option would only be available in areas with an insurer shortage on the individual market, and then it would expand to be available to all by 2025. Biden campaigned on creating a public option this fall.


Congressional Budget Office Scores Medicare-For-All: Universal Coverage for Less Spending: The CBO recently released an economic analysis of Medicare for All finding that the program would achieve universal coverage and decrease healthcare spending.

Why It Matters: A public option could expand choices and access to health insurance coverage. Kaine said he would push for the proposal to be passed via reconciliation, which likely would mean the Senate won’t consider it until the Summer or Fall. Any version of a public option will face pushback from both the health industry and more liberal Democrats who prefer a single-payer “Medicare for All” model. However, Bennet believes his proposal would be easier for colleagues to support, suggesting he thinks he can either convert Republicans to back the plan or convince liberal Democrats to remain on board.


Senate Committee to Hold Confirmation Hearing for Biden's HHS Nominee Next Week: Xavier Becerra, President Joe Biden’s nominee to lead the Department of Health and Human Services, will appear before the Senate Health, Education, Labor and Pensions committee (HELP) on Tuesday for his confirmation hearing. Becerra will likely be asked about his stances on managing the government’s pandemic response, expanding the Affordable Care Act, and whether his background as California’s Attorney General qualifies him for the position.


Why It Matters: President Biden has over two dozen nominees waiting to be confirmed by the cabinet. Becerra’s confirmation will be a crucial step in ramping up the activities of HHS to lead the pandemic response. However, critics say Becerra’s background as a litigator while Attorney General is unsuitable to lead the Health agency. While his nomination will likely pass both the committee and the Senate, the stances he takes during his hearing will point towards the direction of the agency during his term.


Industry Updates

Mental Health Startup Modern Health Valued at $1.17B After Series D Funding Round: Modern Health offers a variety of mental health solutions including digital programming, virtual coaching, and clinical therapy in 35 languages. The company, which was founded by women, has raised over $170 million in less than 2 years and now provided services to over 220 employers.

Why it matters: the COVID-19 pandemic has led to dramatic changes in how Americans access healthcare. It appears that virtual care is here to stay, especially in the mental health arena. The company highlighted above is just one example of the many startups that have grown exponentially. We are curious to see how OPM and FEHB carriers will respond to these changes in consumer behavior and expectations.

One-Third of US Adults Postponed Care During Pandemic: About 36% of adults and 29% of children have delayed or forgone accessing care because of concerns about the COVID-19 pandemic, according to the Urban Institute and Robert Wood Johnson Foundation. While most of the delayed care was routine in nature—dental, checkups, screenings—over ¾ of those who delayed care have a chronic condition and indicated that condition had worsened.

Payer Profits Nosedived in Q4 on Increased COVID-19 Expenses: Healthcare Dive provides a summary of insurer performance in Q4.

COVID-19

Average of Daily New Coronavirus Cases Below 90K for First Time Since November: The seven-day average of COVID-19 cases has dropped below 90,000 for the first time since November. According to the World Health Organization, global cases are also on the decline. Experts note that this could be due to increased vaccinations but could also simply be a seasonal pattern.

US COVID-10 Deaths, Explained in 8 Charts and Maps: Vox recently released a suite of visualizations that show trends in deaths in location, race, and age. This is a must-see, striking visuals and quick, easy to digest analysis. One key takeaway: almost 90% of the people who have died in the US from COVID-19 are over the age of 60. On a related note, NIHCM recently released an infographic about the impacts of COVID-19, including social isolation, mental health, and vaccine hesitancy, on individuals aged 65 and older.

Why it matters: Approximately ½ of FEHB enrollees are annuitants. Understanding trends impacting the aging and elderly will be important for FEHB carriers as you continue to address the COVID-19 pandemic and educate enrollees on the availability of the vaccine.

#COVID, #Vaccine, #HHSLeadership, #PublicOption, #CallLetter, #CarrierConference

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