3.19.21 Weekly Public Policy Update

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The slow churn of state legislating continued to turn this week and we’re starting to see some of the butter separate from the buttermilk. We’ve now had three bills enrolled and ready for some signatures. That said, we want to make sure that we don’t put buttermilk on our toast or butter in our fried-chicken brine. That’s where the TDC family comes in – while we may not control what’s in the churn, we can certainly influence how we use what comes out. I’ll send you witty, incisive and insightful weekly policy updates, and you, dear reader, along with the rest of our beautiful TDC family, apply the butter. Convoluted metaphors aside, thank you for reading and thank you for doing the hard work of the mission. 

TDC Priority Bill Updates

  • ID Death Penalty Bill – this bill modernizes the definition of “intellectual disability” by aligning it with current medical and legal criteria, and provides a pathway for individuals sentenced to death to be evaluated under this modern definition.
  • Text-to-911 – this bill requires Tennessee to establish a statewide text-to-911 system
    • This bill is great – it has so many benefits and puts Tennessee on the leading edge of this growing nationwide movement. 
    • The bill passed unanimously and without discussion on the Senate floor on Thursday morning. The House version was rolled to March 23rd in the State Government Committee.
    • The bill hasn’t encountered many hiccups on its steady march through several committees – the bill was rolled this week because Rep. Mannis, the House sponsor, was meeting with the governor and not present in committee when the bill came up. There’s no reason to think it should slow down at this point.
  • 340B Discrimination Prohibition – this bill prohibits pharmacy benefit managers from reimbursing 340B prescription entities at a lesser rate than others, from using fees or chargebacks that increase cost or exclude 340B entities from their pharmacy networks.
    • The fiscal note is not significant, there is national energy for drug pricing reform and the intent is simply good, people-first protections for a vulnerable population – there is no good reason this bill shouldn’t move forward quickly.
    • Earlier this week, this bill passed through the House Insurance Subcommittee with very little discussion and no objections. It’s up in the full House Insurance Committee on Tuesday the 23rd. 
  • Health Benefit Plan Network Access and Adequacy Act – This bill establishes minimum standards for creation and maintenance of health networks. 
    • Healthcare network providers must ensure that covered persons have access to all sorts of vital care in their network, or else allow folks to use “out-of-network” services at their in-network rate (among other fun, complicated insurance stuff). 
    • This bill seems fantastic – it should ensure the availability of care. However, the bill has a big “if” – it allows for the Commissioner of Commerce and Insurance to establish the standard of what “available” means
      • That said, we’d like to see this bill continue to move forward and worry about the adequacy of that adequacy standard when we cross that road.
    • The Insurance Subcommittee ran out of time on Tuesday to hear the bill, they’ll try again on Tuesday the 23rd. 

Other stuff for next week:

Federal Updates

  • This one is a bit complicated (and frankly, way over my head), but nonetheless, let’s try to talk about it:
    • Congress is debating (several) bills that would prevent a 2 percent Medicare sequester cut from occurring April 1st. 
      • The cuts are a function of the 2011 Budget Control Act, which aims to cut federal spending by $1 trillion by 2021 
    • At the same time, these bills are aiming to exempt the $1.9 trillion American Rescue Plan Act from “pay-as-you-go” aka PAYGO rules
      • PAYGO means that any new legislation that affects revenue and spending on entitlement programs, like Medicare, don’t add to the federal budget deficit.
      • Because some components of the stimulus bill affected Medicare, co-occurring cuts to Medicare services would have to be made under PAYGO
    •  The House passed H.R. 1868 this week, which would prevent both cuts to Medicare funding
      • The bill also aligns healthcare-related aid income from the first CARES Act with the tax structure of CHIP and Medicaid
      • It also helps rural hospitals who are seeking Medicare eligibility and disproportionate-share hospitals from seeing funding cuts.
      • The bill doesn’t end the cuts completely, it just extends the moratorium on making the cuts for 9 more months
    • Senate Republicans don’t like the bill and are planning to push back – can Senate Democrats win 10 GOP votes and avoid cuts to Medicare?

Media Highlights

  • Commercial Appeal – the TN Department of Health announced Friday that counties may begin to progress through the vaccine eligibility phases as their supply allows. This is big news, because it means that the rate of vaccine uptake has accelerated quickly and the supply is approaching the demand. 
  • The Tennessean – the American Rescue Plan is set to distribut almost $2.5 billion to Tennessee for K-12 education. School districts will on average receive $15.3 million. Notably, $4.7 million will be set aside for hiring school nurses, which is nice. 
  • Yahoo – today is the first day of the NCAA Tournament AKA MARCH MADNESS. Who did bettors in Vegas lay down the most money on? The Vols. Enjoy the madness with some notable March buzzer beaters because who doesn’t love a good buzzer beater? 

Thanks for reading and have the most wonderful and restful weekend.