| Happy Tuesday, where today we want to know: Have you ever bought a health plan through the Affordable Care Act's exchanges? How was it? Send your thoughts over to rachel.roubein@washpost.com. Today's jam-packed edition: The CDC announces plans to revamp the agency, including conducting a one-month review. The director of the National Cancer Institute is stepping down. But first … | Biden is taking executive action on Obamacare, with his legislative agenda stalled |  Former president Barack Obama will join President Biden at the White House for an Affordable Care Act announcement today. (Demetrius Freeman/The Washington Post) | | | There are two big storylines we're following today: | - President Biden will announce a tweak to Obamacare long sought by advocates.
- And on Capitol Hill, Senate negotiators announced a covid funding deal yesterday that excluded global aid — and we're tracking its status in both chambers.
| | Let's start with the "family glitch." In the company of former president Barack Obama, Biden will propose a change today allowing millions more families to buy health coverage through the Affordable Care Act's insurance marketplaces, our colleague Amy Goldstein writes in a story out this morning. Context: This is an action Biden can take on his own, with his legislative agenda stalled on Capitol Hill. The details: Financial assistance to buy Obamacare plans is generally meant for people who can't get coverage through their job or a government-run program. But financial assistance is available for those whose employer plans are particularly pricey, requiring them to spend roughly 10 percent or more of their household income on their health insurance premiums. But here's the catch. This threshold is based on the price of an individual's insurance plan — and doesn't include how much it'd also cost to cover a workers' spouse or children. Sometimes, that cost far exceeds 10 percent of the family's income. | | More than 5 million people fall into the so-called family glitch. The Treasury Department is planning to propose a rule to address this gap in the health law. If the regulations are finalized, such a change could start Jan. 1, Amy notes. Under the proposed fix, the White House estimates 1 million Americans would switch to ACA plans and 200,000 uninsured people would obtain health coverage. | - "Fixing the family glitch is the most significant thing they can do" in terms of changing the Affordable Care Act, Katie Keith, director of the Health Policy and the Law Initiative at Georgetown Law's O'Neill Institute, told The Health 202.
| | Biden is also planning to announce an executive order directing federal agencies to do what they can to expand affordable health insurance — the second such measure since he took office. | | The Post's James Hohmann: |  | | | | | Meanwhile at the Capitol … global funding is out of a new deal to provide $10 billion in aid for the nation's pandemic response, per a dispatch Dan Diamond and I wrote yesterday. The decision set off alarms among health experts, who said the country needed to treat the potential for new variants to emerge overseas and spread as a serious threat. But lawmakers were unable to agree on how to pay for aid to help vaccinate the rest of the world, people familiar with the package told Dan and me. That move is an issue for some in the House. Several Democrats expressed reservations about legislation that cut global aid after the White House had sought roughly $5 billion in international assistance. | - "Folks need to be really cognizant that there are a lot of folks here that are very concerned about this issue," Rep. Raja Krishnamoorthi (D-Ill.) told reporters yesterday evening.
| | House Speaker Nancy Pelosi issued a statement late last night urging the package "be enacted as quickly as possible," saying it'd help fulfill immediate needs to secure more treatments and vaccines. The White House appeared to take the same tack with press secretary Jen Psaki urging Congress to "move promptly." | - "You take what you can get and live to fight another day for the rest," a senior House Democratic aide, who spoke on the condition of anonymity, told The Health 202.
| | Could global aid come later? Democrats said they'd pursue a separate package for the international response "later this spring." Sen. Mitt Romney (R-Utah) — a key negotiator on the covid package — said he was willing to explore such an effort. The other key question is when the Senate could send an aid bill to the House. The chamber's calendar is also pretty busy this week with confirming Ketanji Brown Jackson to the Supreme Court. Congress is out for two weeks beginning April 9. More from House Democrats: | | Rep. Jake Auchincloss (D-Mass.): |  | | | | | Erik Wasson, Bloomberg News: |  | | | | | |  | Agency alert | | CDC to undergo review following pandemic criticism |  Centers for Disease Control and Prevention Director Rochelle Walensky announced plans to revamp the agency Monday. (Shawn Thew/EPA-EFE) | | | Centers for Disease Control and Prevention Director Rochelle Walensky announced plans Monday to revamp the agency following intense criticism of its performance leading the country's coronavirus pandemic response, our colleague Lena H. Sun reports. Jim Macrae, an associate administrator at the Health Resources and Services Administration, will conduct a one-month review of the agency's "structure, systems and processes" starting April 11. Walensky also tapped three senior officials to gather feedback and suggestions for "strategic change" within the CDC. The agency's revamp will focus on its "core capabilities," including beefing up the nation's public health workforce, health equity and preparedness for disease outbreaks worldwide. | - "At the conclusion of this collective effort, we will develop new systems and processes to deliver our science and program to the American people, along with a plan for how CDC should be structured," Walensky wrote in an agency-wide email shared with Lena.
| | But one outside adviser to the administration said the CDC needed to do far more than hire an outside adviser to review its protocols. Since the early days of the pandemic, the agency's response has been criticized, including delays in developing coronavirus tests, unclear guidance on masking and quarantining, and a failure to analyze and release real-time data to the public. | | More from The Post's Lena H. Sun: |  | | | | America's top cancer doctor is stepping down | | National Cancer Institute Director Norman "Ned" Sharpless announced he will step down from his position at the end of the month, our colleague Laurie McGinley reports. Sharpless played a large role in validating coronavirus diagnostic tests in the early days of the pandemic, in addition to ramping up the agency's research into pediatric cancers and the new field of immunotherapies. The announcement from Sharpless — who also led the Food and Drug Administration for a brief stint — is the latest in a series of departures and job changes by senior health and science officials. | | NCI Director Ned Sharpless: |  | | | | | |  | Coronavirus | | Medicare to start covering the cost of at-home coronavirus tests |  Medicare says millions of enrollees will finally have access to free over-the-counter coronavirus tests at drugstores. (Ted S. Warren/AP) | | | More than 59 million Americans enrolled in Medicare can now get up to eight at-home coronavirus tests per month for free, the Centers for Medicare and Medicaid Services announced Monday. | - Medicare will pay pharmacies and providers participating in the initiative for the tests directly.
- This is the first time Medicare has covered an over-the-counter self-administered test at no cost to beneficiaries.
| | Flashback: The initiative comes months after the Biden administration launched a similar program requiring private insurers and group health plans to cover the cost of rapid tests for their enrollees — which left out people on Medicare, many of whom are among the most vulnerable to the virus. | | |  | On the Hill | | Wyden presses Merck on the drugmaker's tax practices |  Sen. Ron Wyden (D-Ore.) has led the charge in investigating the tax practices of Big Pharma. (Drew Angerer/Getty Images) | | | In his latest probe into tax practices of multinational pharmaceutical companies, Senate Finance Committee Chair Ron Wyden (D-Ore.) sent a letter to Merck on Monday pressing the drugmaker to reveal details about the taxes it recently paid. | - U.S. sales account for 46 percent of Merck's global sales, though the company reported 14 percent of pretax income in the country, according to Wyden.
- "It appears that the company has minimized profits in the United States while reporting substantial foreign profits to avoid paying U.S. corporate income taxes," Wyden wrote in his letter.
| | Merck confirmed for The Health 202 that it received the letter and would be complying with Wyden's requests, which include a country-by-country breakdown of the company's pretax earnings from 2019-2021. Wyden previously sent letters to AbbVie and Bristol Myers Squibb as a part of his ongoing investigation into the 2017 Republican tax reform. | | |  | In other health news | | - Almost the entire global population is breathing poor quality air, resulting in millions of preventable deaths each year, according to a report from the World Health Organization.
- The BA.2 omicron subvariant now accounts for nearly 3 out of every 4 new coronavirus cases across the United States, the CDC said Monday.
- An antiabortion activist who had five fetuses removed from the Washington, D.C., home where she had been staying pleaded not guilty Monday for violating the federal Freedom of Access to Clinic Entrances Act in 2020, which prohibits threats intended to interfere with reproductive health-care services, The Post's Peter Hermann, Tom Jackman and Michelle Boorstein report.
| | |  | Health reads | | By Bram Sable-Smith and Rachana Pradhan | Kaiser Health News ● Read more » | | | | | |  | Sugar rush | | | Thanks for reading! See y'all tomorrow. | |
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