This is the legislative update for March 1, 2021. View all updates here.
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The House passed the American Rescue Plan, which provides COVID-19 relief and expanded access to various programs.
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Health and Human Services Secretary-designate Xavier Becerra appears to be on a smooth path to Senate confirmation.
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The Nebraska Economic Forecasting Advisory Board increased their October forecast for state Medicaid funding by $462 million.
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Kevin Bagely (Nebraska Medicaid’s newest director) sat before two legislative committees, including the Appropriations Committee and the committee for his own formal appointment as Director of Nebraska Medicaid and Long-Term Care Services.
The March 1, 2021 legislative update includes highlights from both federal and state legislatures.
Federal Updates
Congress
Both the House and Senate are in session this week.
Over the weekend, the House passed the $1.9 trillion American Rescue Plan (ARP), containing proposals from several House committees. Overall, the package provides funds to expand access to:
Mental Healthcare and Substance Use Disorder Treatment
- $10 million for the National Childhood Traumatic Stress Network
- $30 million for Project AWARE, which supports youth mental health wellness and resiliency
- $20 for existing grant programs that support youth suicide prevention efforts
- Support for workforce training, allocating $200 million to training and education of mental and behavioral health professionals
Extended Health Coverage Through Medicaid
- Mandatory vaccine coverage
- $15 million grant to establish a mobile crisis intervention service
- States have the option to extend postpartum coverage through Medicaid and the Children’s Health Insurance Program (CHIP)
Private Insurance
- Increases and expands Affordable Care Act subsidies
- Provides no premium coverage for people whose income is at 100-150% of the federal poverty level
- Subsidizes 85% of Consolidated Omnibus Budget Reconciliation Act (COBRA) continuation coverage for workers who are laid off or have reduced hours
Telehealth
- $500 million to establish grants to support telehealth/broadband expansion
Promote Covid-19 Vaccine Distribution, Testing, and Public Health Infrastructure
- $7.5 billion to the Centers for Disease Control and Prevention (CDC) to plan, prepare, and distribute vaccines
- $1 billion for vaccine education
- $5.2 billion for research, development, and manufacturing of vaccines and medical products
- $500 million to the Food and Drug Administration (FDA) to evaluate the performance and safety of vaccines and therapeutics
- $46 billion to Health and Human Services (HHS) for COVID-19 testing and contact tracing
- $1.75 billion to the CDC for genomic sequencing
- $750 million to combat COVID-19 nationally
- $1.8 billion to HHS to purchase and distribute testing, personal protective equipment (PPE), vaccines, and more
- $500 million to the CDC for public health data surveillance
- $7.6 billion to community health centers
Schools/Child Care
- $40 billion in childcare stabilization grants
- $128.5 billion for the Elementary and Secondary School Emergency Relief Fund
- $1 billion to Head Start programs
- $7.6 billion to expand broadband, in order to increase connectivity for students
Nutrition
- Boosts the cash value voucher in the Supplemental Nutrition Program for Women, Infants, and Children (WIC) to $35 per month
- $390 million for outreach to WIC
Child Welfare
- $250 million for child abuse and neglect programs
- $100 million for the child abuse and neglect treatment and response state grant program
Tax Credits
- Expands the Child Tax Credit to $3,000 per child ($3,600 for children under age 6)
The Senate is likely to make changes to the House version, which only garnered support from Democrats. They are expected to have a proposal back to the House by March 15.
Senate Confirmation: Health and Human Services
After two full days of hearings before the Senate HELP and Finance committees, it became clear how lawmakers hope to see the Biden administration adapt to a new reality post-pandemic. For instance, both Republicans and Democrats want to see the cost of insurance, prescription drugs, and medical procedures reduced.
Health and Human Services Secretary-designate Xavier Becerra appears to be on a smooth path to Senate confirmation. Becerra is favorable to the Trump administration’s policy requiring hospitals to disclose negotiated rates with insurers and efforts to lower the cost of insulin.
It appears that Becerra is no longer passionate about Medicare for All, which President Biden opposes. Instead, like President Biden, he wants to build upon the Affordable Care Act. He has not offered specific details at this time.
When it comes to schools reopening, Becerra feels that the threat of COVID-19 spreading in schools is greater than the challenges or fallout resulting from remote learning. He plans to defer to local officials to make the decision whether or not to send children back to school.
Senator Ben Sasse (R-Neb), who sits on the Finance Committee, was one of several Republicans to elevate the issue of abortion. This resulted in a heated exchange about Becerra’s lawsuit to enforce the ACA’s contraception mandate (Translation: The requirement that all plans in the Health Insurance Marketplace® cover contraception and counseling for all women, as prescribed by their provider. Plans must not charge a copay or coinsurance when these services are provided by an in-network provider, even if the patient hasn’t met their deductible yet).
Hearings on the Hill this week include:
Monday, Mar. 1 | Tuesday, Mar. 2 | Wednesday, Mar. 3 | Thursday, Mar. 4 | Friday, Mar. 5 |
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House E& C Committee Hearing - “The Future of Telehealth: How COVID-19 is Changing the Delivery of Virtual Care.” | House Appropriations Hearing - “FDA'S Foreign Drug Inspections Program” | |||
The Medicaid and CHIP Payment and Access Commission (MACPAC) Virtual Meeting |
State Updates
Nebraska Legislature
Monday, March 1 marks Day 35 of the 90-day legislative session, and a celebrated final week of committee hearings (with the exception of the Judiciary Committee). As hearings come to an end, senators will begin to vote bills out of committee to the floor for three rounds of debate.
Throughout the week of March 15, senators will begin full-day debate and will be required to submit their priority legislation to Speaker Hilgers.
Medicaid
Across the country, children’s hospitals rely heavily on a robust Medicaid program. In Nebraska, Children’s Hospital & Medical Center is the largest Medicaid provider, which, at times, is nearly 50% of our billable charges.
To maintain a healthy Medicaid, states must dedicate a significant percentage (over 20%) of state funding, which can end up complicating funding for other agencies and initiatives.
Last week, we received great news when the Nebraska Economic Forecasting Advisory Board met and increased their October forecast by $462 million.
While all board members and Appropriations Committee members welcome the optimistic news, the excess funding is likely going to be prioritized to additional property tax relief and replenishing the state’s cash reserve or rainy day fund.
Also last week, Kevin Bagely (Nebraska Medicaid’s newest director) sat before two legislative committees:
- 1. Formal Agency 25 (HHS) hearing before the Appropriations Committee (budget-setting committee).
- Bagely welcomed the idea of a 2% provider rate increase each year of the biennium (the next two years), should the Legislature pass legislation to support an increase.
- Two weeks ago, President Joe Biden announced work requirements were not permitted under any Medicaid expansion proposal, radically altering the two-tiered benefits Governor Ricketts and former Medicaid Director Matthew Van Patton designed.
- Bagely was asked by senators to determine the cost and timeline to fully expand Medicaid to those eligible adults to guarantee they have access to all services — dental, vision, and pharmacy — under a traditional Medicaid plan. A lawsuit was recently filed by Nebraska Appleseed to implement the full expansion.
- 2. HHS Committee for Bagely’s formal appointment as Director of Nebraska Medicaid and Long-Term Care Services.
- Bagely presented his robust work history to committee members and the public, specifically mentioning the medically complex children waiver he implemented in Utah.
- Children’s will be meeting with Bagely as he investigates future opportunities for Nebraska Medicaid to adapt to the needs of children. He was complimentary of our established Katie Beckett Program, which aids families with complex children who are transitioning home with home health support.
- The committee discussed provider rate increases, especially to support long-term care facilities across the state that are closing due to low reimbursement with Medicaid.
This week’s hearings include, but are not limited to:
Monday, Mar. 1 | Tuesday, Mar. 2 | Wednesday, Mar. 3 | Thursday, Mar. 4 | Friday, Mar. 5 -- RECESS DAY |
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LB30 (Wayne): Limit the amount an insured pays for prescription insulin drugs | LB270 (Morfeld): Adopt the Pharmacy Benefit Manager Regulation Act and require an audit under the Medical Assistance Act | LB417 (Halloran): Authorize possession of a firearm on school grounds by a full-time, off-duty law enforcement officer | LB540 (Walz): Change terminology related to disability in civil rights provisions | |
LB20 (Blood): Provide for insurance coverage of and Medicaid access to contraceptives | LB375 (Kolterman): Adopt the Pharmacy Benefit Manager Regulation and Transparency Act | LB459 (M. Cavanaugh): Change provisions relating to the cigarette tax and the Tobacco Products Tax Act and distribute tax proceeds as prescribed | LB49 (M. Hansen): Change penalty for use of tobacco or nicotine products by a person under twenty-one years of age | |
LB441 (M. Hansen) Change provisions relating to compensation for individuals affected by COVID-19 under the Nebraska Workers' Compensation Act | LB87 (Morfeld): Provide for mental health first aid training for school districts and change provisions relating to the use of lottery funds | LB458 (McCollister): Change provisions of the Sex Offender Registration Act | ||
LB480 (McKinney): Change the minimum wage as prescribed | LB432( Revenue): Change income tax rates | |||
LB639 (Day): Adopt the Seizure Safe Schools Act | LB433 (Revenue): Change the sales and use tax rate | |||
LB630 (Bostar): Provide for a study of the efficacy of commercial air filters in classrooms |
If you personally are aware of a bill and would like to add your expertise, feedback, or questions, please contact Liz Lyons at [email protected].
Key Dates
Monday, January 25th | First Day of Public Hearings – 9:00 a.m. start |
Tuesday, February 16th | Nebraska Forecasting Advisory Board Meeting |
Thursday, March 4th | Appropriations Budget due to the Legislature |
Tuesday, March 16th | Deadline for committee and senator priority bill designations |
Thursday, April 29th | Budget bills must be on General File |
Wednesday, May 19th | Budget bills must be passed |
Thursday, June 10th | Last Day of Legislative Session – Sine Die (Day 90)(tentative) |
Sunday, June 13 - June 18th | Children’s Hospital Association (CHA) Family Advocacy Day |
Child Health Champion Advocacy Team
Please join the Children’s Child Health Champion Advocacy Team every Thursday at 7:30 a.m. for a 30-minute call.
Advocating for children is extremely important at all stages. This internal group of stakeholders — comprised of providers and experts across the continuum of care at Children’s — meets weekly to ensure we are leading the discussion on child advocacy in the region.
Learn more about our advocacy and legislative work in our community.
Advocacy & Outreach
If you are interested in joining the movement, contact Liz Lyons at [email protected] for more information.