The Health 202: The infrastructure deal bodes well for Democrats' health policy goals

Now they could use a budget reconciliation bill later this... | Presented by Humana ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌  ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌  ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌  ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌  ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌  ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌  ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌  ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌  ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌  ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌

Sign up for this newsletter Read online Your health policy appointment. Presented by Humana       By Paige Winfield Cunningham with Alexandra Ellerbeck  Email Health policies aren't part of the bipartisan infrastructure agreement President Biden and a group of senators announced yesterday. But the deal did move the ball forward for Democrats on their quest to further expand health coverage and lower drug prices: Now they can push top health priorities in a separate, partisan package later this year. Congress can save budget reconciliation for health care and other stuff. Until yesterday, it was unclear whether Democrats would need to use a budget reconciliation bill to pass their infrastructure priorities on a partisan basis (budget reconciliation requires just a simple Senate majority to pass). But Biden has signed off on a bipartisan agreement crafted by five Democratic and five Republican senators — meaning Democrats can save a reconciliation bill for later. The bipartisan measure "would pump hundreds of billions of dollars in new spending into infrastructure projects across the country — handing him, if it survives congressional approval, a significant cross-party achievement," The Post's Seung Min Kim, Mike DeBonis and Jeff Stein report. President Biden and senators speak after a meeting regarding infrastructure negations at the White House on Thursday. (Demetrius Freeman/The Washington Post) "We have a deal," Biden said alongside the senators who had negotiated for weeks on a package to revitalize the nation's road and transit systems, while upgrading broadband and investing in other public-works projects. "Biden spoke during an impromptu appearance on the driveway outside of the West Wing of the White House after a shorter-than-expected meeting with senators, in which he delivered his formal endorsement of the proposal crafted by Sens. Rob Portman (R-Ohio), Kyrsten Sinema (D-Ariz.) and eight others in the Senate," our colleagues write. "The new agreement is nowhere near as expansive as the $2.2 trillion American Jobs Plan, Biden's own infrastructure measure that he detailed in April," they add. "But Democratic leaders have made it clear that they hope to push through, potentially with only Democratic votes, a separate package encompassing priorities such as climate initiatives, paid leave and expanded education." The senators return to the Capitol after meeting with Biden. (Alex Brandon/AP) ADVERTISEMENT Content from Humana Medicare Advantage: Better health outcomes, lower costs The Medicare program has evolved for over 50 years to meet seniors' needs. Today, Medicare Advantage plans are reducing ER visits and saving enrollees an average of $1,640/year in out-of-pocket costs.   There's a laundry list of health policies Democrats probably will try to fold in, too. Some of the items were already outlined by Biden in his previous spending proposals, including $200 billion for permanently expanding the federal subsidies that make private insurance plans sold on HealthCare.gov and state-run marketplaces more affordable. Congress already expanded the subsidies, but only temporarily. Biden has also proposed $225 billion to create a new paid family leave program, administered by the Social Security Administration, and $400 billion on long-term care. There's drug pricing legislation, too. Earlier this month, House Energy and Commerce Chairman Frank Pallone Jr. (D-N.J.) said he's aiming to get H.R. 3 attached to a spending package this year. The measure allows the federal government to directly negotiate lower drug prices and caps out of pocket spending for prescription drugs in the Medicare program. And then there's legislation to get more people enrolled in Medicare and Medicaid. Sen. Bernie Sanders (I-Vt.) has been floating legislation to lower the Medicare eligibility age to 60 and expand its coverage to include vision and dental. In the House, Democrats have been working on ways to get Medicaid expansion to people in states where GOP policymakers still refuse to expand it themselves. Share The Health 202    Ahh, oof and ouch AHH: Hospital stocks are up, reflecting post-covid growth. Hospitals were hit hard by covid-19 as patient volumes plummeted in the early days of the pandemic and elective procedures were suspended. But following an influx of government assistance, rebounding patient volumes and long-term initiatives to boost profits, their financial fortunes are looking up. Shares of big hospital operators such as Tenet Healthcare and Community Health Systems have significantly outperformed the market. HCA Healthcare is also up. An ambulance arrives at a Texas hospital. (Callaghan O'Hare/Reuters) "What began as a recovery rally for hospital stocks could now prove to be longer lasting, say analysts and industry investors. Rebounding patient volumes are combining with longer-term initiatives to squeeze more profits out of hospitals," the Wall Street Journal's Brian Spegele reports. The pandemic added urgency to long-term initiatives to boost profits, including selling off less profitable assets and shifting services to lower-cost outpatient treatment. Another factor in investors' optimistic outlook: the Biden administration's support for the Affordable Care Act, which helps cover patients who otherwise might not be able to pay. OOF: Nearly all covid deaths are now among the unvaccinated. "An Associated Press analysis of available government data from May shows that 'breakthrough' infections in fully vaccinated people accounted for fewer than 1,200 of more than 853,000 COVID-19 hospitalizations. That's about 0.1%. And only about 150 of the more than 18,000 COVID-19 deaths in May were in fully vaccinated people. That translates to about 0.8%, or five deaths per day on average," the Associated Press's Carla K. Johnson and Mike Stobbe report. The United States is currently recording about 300 deaths from covid-19 a day, but that number could go down to almost zero if everyone were vaccinated, according to the AP's analysis of data from the Centers for Disease Control and Prevention. The CDC itself has not estimated hospitalizations and deaths among the fully vaccinated, citing limitations in the data, including the fact that only 45 states report breakthrough infections and some are less aggressive in documenting them. "Still, the overall trend that emerges from the data echoes what many health care authorities are seeing around the country and what top experts are saying," Carla and Mike report. Earlier this month, Andy Slavitt, a former coronavirus adviser to the Biden administration, suggested that 98 to 99 percent of deaths from covid-19 are among the unvaccinated. And CDC Director Rochelle Walensky recently touted the effectiveness of the vaccines, saying "nearly every death, especially among adults, due to COVID-19, is, at this point, entirely preventable." OUCH: The World Health Organization is predicting the most vulnerable will need annual coronavirus boosters. An internal document reported on by Reuters forecasts that those most vulnerable to covid-19, such as the elderly, will need an annual booster shot, while the general population will need a booster shot every two years, Reuters's Francesco Guarascio reports. The estimate is part of a report that is being discussed this week at a board meeting of Gavi, a vaccine alliance that co-leads the WHO's Covax coronavirus vaccine program. The report does not say how the WHO reached its forecast for booster shots, but it shows that health officials expect new variants to continue to emerge.   More in coronavirus news Post reporters documented the inside story of the effort to save Trump from covid-19. The Post's Damian Paletta and Yasmeen Abutaleb detail the extraordinary effort to save President Trump when he fell ill with covid-19 in October 2020.  In an excerpt from their forthcoming book, "Nightmare Scenario," our colleagues document the race by White House officials to ensure that the president would have access to lifesaving treatments that were then only in clinical trials. For months, Trump had flouted public health protocols, but his illness caught officials by surprise. The president became sick enough with covid-19 that some close advisers questioned whether he would make it, even as White House officials at the time painted a far rosier picture of his health. "Trump's brush with severe illness and the prospect of death caught the White House so unprepared that they had not even briefed Vice President Mike Pence's team on a plan to swear him in if Trump became incapacitated," Damian and Yasmeen write. Some medical advisers hoped the president's bout with covid-19 would lead him to take the virus and public health precautions more seriously. Then-CDC Director Robert Redfield spent the weekend of Trump's illness praying for his recovery and for him to emerge with a change of heart. "Instead, Trump emerged from the experience triumphant and ever more defiant. He urged people not to be afraid of the virus or let it dominate their lives, disregarding that he had had access to health care and treatments unavailable to other Americans," our colleagues write.   Elsewhere in health care Some experts are pushing CMS to launch a trial to study an unproven Alzheimer's treatment. The Food and Drug Administration's decision to grant accelerated approval to Aduhelm, a costly new Alzheimer's treatment, has sparked backlash from some experts who say the drug's benefits are unproven. With a list price of $56,000 a year and the potential to be used by millions of patients, the drug could cost taxpayers billions. "Focus has now shifted to the Centers for Medicare and Medicaid Services, which needs to determine whether and how to cover an unproven drug at a cost capable of bankrupting the Medicare program. The drug has major implications as well for the Medicaid program, which has less authority to exclude coverage," Roll Call's Lauren Clason reports. A vial and packaging for the drug Aduhelm. (Biogen/AP) "A few influential experts are now backing an idea to test both the cost and treatment implications through a payment pilot under the Center for Medicare and Medicaid Innovation. The office has sweeping authority to force providers to participate in experiments that waive provisions under federal law," she writes. Peter Bach, director of Memorial Sloan Kettering's Center for Health Policy and Outcomes, and Craig Garthwaite endorsed the idea in a recent op-ed, which called for CMS to pay full price for the drug in some regions while paying nothing in others. By largely limiting the use of the drug to covered areas, CMS would gain more data to judge whether it actually works.   Sugar rush   We think you'll like this newsletter Check out Power Up for all the Washington news you need — fast — from the White House to the Hill and other power centers. In your inbox pre-dawn, Monday through Friday. Sign up »

Manage my email newsletters and alerts | Unsubscribe from The Health 202 | Privacy Policy | Help You received this email because you signed up for The Health 202 or because it is included in your subscription. ©2021 The Washington Post | 1301 K St NW, Washington DC 20071