HEALTH CARE BRIEFING: Democrats at Odds as Committees Start Work

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The fissures in Democrats’ ambitious health agenda are growing starker as congressional committees begin voting on bills that will make up the party’s $3.5 trillion social spending and tax package.

Leaders have started to whittle down their more than $1 trillion list of health priorities but face the daunting task of unifying around thorny issues such as how to get health coverage to millions of Americans in Republican-controlled states that refused to expand their Medicaid programs.

They also face industry groups demanding changes and pharmaceutical companies working to halt policies that will cut into their bottom lines.

“Our goal is to have a joint proposal that the president, House Dems and Senate Dems can all pass and support,” Senate Majority Leader Chuck Schumer (D-N.Y.) told reporters yesterday. “We’re working towards that goal.”

Those fights will be on stage starting today when the House Ways and Means Committee begins considering legislation to expand Medicare to include vision, hearing, and dental benefits, as well as to improve oversight of nursing homes. The panel is slated to vote on other health legislation next week.

  • The Ways and Means panel will also mark up provisions outlining nationwide paid family and medical leave, with the starting point of a comprehensive program offering 12 weeks of benefits available beginning in July 2023. Read more from Chris Marr.

The House Energy and Commerce Committee will follow suit next week, marking up their legislation to lower drug prices and extend a temporary expansion of Obamacare.

House leaders will then package the measures together with proposals from other committees into a massive domestic policy bill set to pass along party lines. Read more from Alex Ruoff.

Education, Childcare Bill Unveiled: House Democrats want to spend $450 billion to make child care more affordable and pre-kindergarten univeral. The package, proposed yesterday, also includes tens of billions in new spending for free community college, school infrastructure, child nutrition, and worker training. The House Education and Labor Committee plans to to begin marking up the more than $700 billion package today. Read more from Andrew Kreighbaum.

  • The measure would also add civil monetary penalties for mental health parity violations. Health plan sponsors and administrators would be liable for penalties for violating the federal mental health parity law under the Education and Labor Committee’s portion of the bill. Mental health proponents have long been frustrated that health plans haven’t complied with the Mental Health Parity and Addiction Equity Act, and they have called for civil penalties to add teeth to the law. Sarah Hansard has more.

The Coronavirus Pandemic

Biden to Call for Vaccine Conference at UN: President Joe Biden plans to call for a meeting on global vaccine supply to be held at the United Nations General Assembly later this month, as wealthy nations face pressure to do more to bolster inoculations for developing countries, according to people familiar with the matter. Biden intends to host a session during the UN meetings, though the scope and the attendees aren’t yet clear. While the U.S. has been reaching out to other countries about participating in the session, it hasn’t finalized its plans, the people said. Read more from Josh Wingrove and David Wainer.

Florida Judge Allows School Mask Rules: Florida schools can start legally requiring masks, a state court judge ordered in what he called an uncommon ruling, even as Gov. Ron DeSantis (R) appeals an earlier decision against his ban on mask mandates. It’s highly unusual to lift an automatic hold on a decision such as the one that kicked in when DeSantis filed his appeal, Leon County Circuit Court Judge John C. Cooper said at a hearing held over Zoom yesterday. But “we’re not in normal times—we’re in a pandemic,” he said. “We have children who can’t be protected by a vaccination.” Read more from Jonathan Levin.

Covax Cuts 2021 Supply Forecast: The global program set up to immunize the world against Covid-19 cut its 2021 supply forecast by more than a quarter, hampered by delays in acquiring life-saving vaccines. Covax expects to have about 1.4 billion doses by the end of the year, the organizations coordinating the initiative said yesterday. In June, Covax had forecast that about 1.9 billion doses would be available by the end of 2021. Some manufacturers and countries have prioritized bilateral deals, while export bans and challenges in scaling up production are among other factors hindering the rollout, they said. Read more from James Paton.

  • The WHO said yesterday that director general Tedros Adhanom Ghebreyesus had called for an extension of a moratorium on Covid-19 booster shots until at least the end of 2021. “A month ago, I called for a global moratorium on #COVID19 booster doses at least until the end of September, to prioritise vaccinating the most at-risk people around the world who are yet to receive their first dose,” the WHO cited Tedros as saying, Nathan Crooks reports.

‘Buy American’ Waivers Largely Pandemic-Related: A surge in government demand for medical supplies led to a record $2.3 billion in foreign goods purchases that qualified for Buy American Act waivers, according to Bloomberg Government analysis. Medical supply and equipment purchases overall—covering 78 NAICS categories—accounted for 70% of waivers buys in fiscal year 2020. Agencies bought $1.6 billion of those goods, more than 10 times the $152 million spent on them in fiscal 2019. Read more from Paul Murphy.

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What Else to Know

Abortion Brush-Off Contrasts With Move in Church Case: The Supreme Court never mentioned the impact on Texas women when it cleared the way for the state last week to ban almost all abortions after six weeks, before many women know they are pregnant. The court’s silence stands in contrast to its concern for New York City worshipers affected by capacity restrictions on churches and synagogues during the height of the pandemic. In a November order, the court said adherents would suffer if they couldn’t attend services in person. “Catholics who watch a Mass at home cannot receive communion, and there are important religious traditions in the Orthodox Jewish faith that require personal attendance,” the court said in its unsigned opinion.

The two late-night orders underscore just how far out of favor abortion rights have fallen at a Supreme Court now under conservative control. Read more from Greg Stohr.

  • Abortion providers in Texas are seeing some success in state-court lawsuits brought to derail a law giving private citizens a right to sue for alleged violations of its ban on abortions after about six weeks. Three Planned Parenthood affiliates in Texas won a temporary restraining order blocking Texas Right to Life, its legislative director John Seago, and several unnamed defendants from suing them to enforce S.B. 8’s ban on abortions after fetal cardiac activity is detected. Read more from Mary Anne Pazanowski.
  • Meanwhile, Indiana can enforce a set of laws that narrow access to abortion in the state after a federal appeals court overturned an injunction against the restrictions yesterday. A lawsuit filed in the U.S. District Court for the Southern District of Indiana challenged a law requiring that abortion-inducing drugs be dispensed only by physicians, as well as laws requiring in-person counseling and examinations, second-trimester hospitalization, and a ban on telemedicine. Read more from Maeve Allsup.
  • The House is preparing to consider legislation (H.R. 3755) as early as next week that would ban restrictions on abortion, other than those that are medically necessary. The measure would specify that health-care providers have the right to provide abortion services without limitations, and would bar other restrictions. For more on the measure, read the BGOV Bill Summary by Christina Banoub.
  • Related: Biden Administration Prepares to Sue Texas Over Abortion Law: DJ

FDA Looks at Opioid Safety Program: The FDA is exploring ways to bring consistency to the opioid safety training that drugmakers must provide for prescribers as the opioid overdose epidemic continues to ravage the nation. The FDA announced yesterday plans to hold a two-day public workshop next month to reconsider its drug safety program known as Risk Evaluation and Mitigation Strategy for opioids. Under the REMS program for opioids, companies that make these painkillers must provide unrestricted grants to continuing education providers. Read more from Jeannie Baumann.

Ida’s Toll Spurs Calls for Food Relief: The Biden administration and food banks, responding to Hurricane Ida’s devastation, are pressing Congress for more assistance to help communities hit by both the storm and the coronavirus pandemic. The Federal Emergency Management Agency and the Agriculture Department coordinated aid for Louisiana when Ida struck on Aug. 29. The government moved meals, water, generators, and other equipment to the region in advance. Then USDA sent food and approved waivers to help more easily feed residents on the Supplemental Nutrition Assistance Program (SNAP), formerly known as food stamps. Read more from Megan U. Boyanton.

Affordable Drug Group to Run Ads on Drug Pricing Efforts: Patients for Affordable Drugs Now, a group supporting legislation to allow the government to negotiate prices with drugmakers, is launching an ad campaign in the beltway trying to build support for Democrats’ drug pricing plans, Alex Ruoff reports. “Don’t listen to the lies. Don’t listen to the threats. Don’t listen to the lobbyists. Listen to patients,” P4ADNow’s TV ad, slated to run during September, will say, according to a release.

California Senate OKs Bill on Genetic Information: California’s Senate approved yesterday a bill that expands the definition of personal information to include genetic data. The bill, AB 825, was approved 30-0 and now heads to Gov. Gavin Newsom’s (D) desk for approval. The Information Practices Act of 1977 requires agencies to disclose breaches of systems that handle personal information to residents whose unencrypted data was compromised. Read more from Jake Holland.

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With assistance from Alex Ruoff

To contact the reporter on this story: Zachary Sherwood in Washington at

To contact the editors responsible for this story: Giuseppe Macri at; Michaela Ross at

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