HEALTH CARE BRIEFING: Democrats Release Plans to Expand Medicare

House Democrats yesterday unveiled key parts of their planned $3.5 trillion bill enacting the bulk of President Joe Biden’s economic agenda and scheduled committee votes on it for the end of the week.

The Ways and Means Committee has proposed a massive expansion of the social safety net, including the coverage of dental, hearing and vision benefits by Medicare. Vision benefits would start in 2022, with hearing benefits beginning in 2023 and dental coverage in 2028.

The legislation also would mandate universal paid family leave, according to text of the bill. Committee votes are expected Thursday and Friday on the draft plan.

The measure would be one of the largest expansions of Medicare benefits since its prescription drug program was created almost 20 years ago.

“This is our historic opportunity to support working families and ensure our economy is stronger, more inclusive, and more resilient for generations to come,” Rep. Richard Neal (D-Mass.), chair of the House Ways and Means Committee, said in a statement.

Dental coverage is by far the most expensive of the three programs for Medicare: the nonpartisan Congressional Budget Office previously estimated that such coverage would cost $238 billion over 10 years, compared with $30 billion for vision and $89 billion for hearing coverage.

The Ways and Means Committee is set to start considering the legislation tomorrow. Democrats plan to advance the package using reconciliation, a procedure that bypasses the need for Republican votes in the Senate. The Ways and Means markup will also include legislation to fund physician training, bolster elder justice programs, and address staffing shortages in long-term care facilities. Its hearing coverage wouldn’t include over-the-counter devices. Alex Ruoff has more.

More Details of Paid Leave Plan: A new national paid medical and family leave plan would begin July 2023 under the Ways and Means Committee’s bill. The plan would provide up to 12 weeks of federal benefits to replace lost wages because time off for medical or caregiving for an ill family member. Benefits would be awarded on a sliding scale based on a worker’s annual income. Eligible employees can apply for benefits if they have or anticipate having at least four caregiving hours in a week. Read more from Andrew Kreighbaum.

Also Happening on the Hill

DOJ Pressed to Counter Texas Abortion Law: The Justice Department is facing mounting pressure to counter the Texas anti-abortion law that has infuriated Democrats and put Biden on the defensive, but there appears to be little the agency can do. Attorney General Merrick Garland should “use the full power of the Department of Justice to defend a woman’s constitutional right to choose an abortion,” more than 20 Democrats on the House Judiciary Committee wrote in a letter yesterday. In the letter, Democrats led by Chair Jerrold Nadler (D-N.Y.) said the department should consider criminally prosecuting citizens who take action under the law. Read more from Chris Strohm and Greg Stohr.

  • Meanwhile, Mexico’s Supreme Court yesterday unanimously declared that criminalizing early-term abortion is unconstitutional, a historic decision that loosens limits on the procedure in a region where few countries offer access without restriction. Mexico, a largely Catholic and conservative country of about 130 million people, is following Argentina, where elective abortion was declared legal late last year. Read more from Andrea Navarro and Dale Quinn.
  • Related: Texas Startup to Open Out-of-State Office, Citing Abortion Ban

Employer Groups Press Democrats on Drug Price Bill: Employer groups say Democrats must include private insurance plans in their drug pricing legislation or they’ll try to sink the legislation, Alex Ruoff reports. The groups want private plans to be able to take advantage of lower rates negotiated by the government for Medicare, something Democrats have backed in the past, and a cap on drug price increases pegged to inflation.

“If these two provisions protect employer sponsor coverage we will support the drug bill, if not we will oppose it,” James Gelfand, executive vice president of public affairs for ERIC, which represents large employers, said. Gelfand said the expectation is drugmakers will raise prices for private plans if a drug pricing plan only applies to Medicare. The group estimates cutting out employer-sponsored plans will cost them $125 billion over 10 years.

We’ve seen this playbook before,” said Elizabeth Mitchell, chief executive officer for the Purchaser Business Group on Health, said. “If price protections aren’t extended to employers and employees, the cost balloon will be pushed down for Medicare and everyone else will pay for it.”

Warren Calls to Publicly Manufacture Drugs: Sen. Elizabeth Warren (D-Mass.) urged Biden to publicly manufacture key drugs like insulin, naloxone, and EpiPens. “Let’s send a message to Big Pharma: You can’t just keep jacking up prices forever,” Warren said in a tweet, Megan Howard reports. Warren has previously introduced legislation that would give the Health Secretary authority to manufacture generic drugs in cases “where the market has failed and strengthen the generic market for the long term by jump-starting competition.”

The Coronavirus Pandemic

U.S. Hits 75% of Adults With at Least One Vaccine Dose: Three-quarters of U.S. adults have received at least one dose of a Covid-19 vaccine as of yesterday, according to a White House official, setting a new milestone in the country’s fight against the pandemic. Data to be reported by the Centers for Disease Control and Prevention will reflect the new threshold, the official said. The U.S. hit 70% of adults with at least one dose in early August, four weeks after Biden’s July 4th target for the achievement, Josh Wingrove reports.

Biden will discuss plans to stop the spread of the Delta variant and boost vaccinations tomorrow, a White House official said, Wingrove reports. Biden will lay out a six pronged strategy working across the public and private sectors.

Israel’s Covid-19 Surge Shows What’s Coming Next: Israel, once a front-runner in the global race to move on from Covid-19, is now one of the world’s biggest pandemic hot spots. The country that was once predicted to be the first to vaccinate its entire population had the highest per-capita caseload of anywhere in the week through Sept. 4, according to figures compiled by Johns Hopkins University. Its world-beating inoculation rate, meanwhile, has tumbled down the league table.

Infections jumped because of the prevalence of cases among the unvaccinated, especially children. The highest rate of new cases in recent weeks is among children under the age of 12, according to Ran Balicer, chair of the expert advisory panel to the government. There were also so-called breakthrough infections in those who have been vaccinated, and the drop in efficacy of vaccines. About 61% of Israelis have been given two doses. Read more from Daniel Avis.

J&J Study Shows Infections Halved in Health Workers: Johnson & Johnson’s Covid-19 vaccine cuts the risk of getting infected with the disease by about half, according to the latest results of a trial involving almost half a million health workers in South Africa. The vast majority of the breakthrough infections were mild, Glenda Gray, co-leader of the study known as Sisonke, said in an interview, citing unpublished data from the trial, which had earlier shown the shot’s effectiveness against severe illness. Read more from Janice Kew and Antony Sguazzin.

More Headlines:

What Else to Know

Telehealth Audits to Shape Its Post-Pandemic Future: Federal watchdogs are investigating whether the expansion of telehealth services during the pandemic opened the door to fraud and abuse, a move that policy experts say could help determine the future of the practice. U.S. health-care providers embraced telemedicine over the past year as a way of providing continuing care to patients who would otherwise have lost access because of Covid-19 restrictions or their own fear of visiting the doctor’s office. Federal regulators removed barriers to telehealth in Medicare and Medicaid, and many providers want those changes to be made permanent.

But the Justice Department and the Office of Inspector General of the Department of Health and Human Services complicated the picture by announcing a $4.5 billion health-care fraud “takedown” of telemarketers and telemedicine companies. The OIG is auditing telehealth providers, and the results could help give policy makers a clearer view of the risks and rewards, industry insiders say. Read more from Christopher Brown.

Anthem, Blue Cross Hit With Antitrust Claims: A group of large employers, including Alaska Air and FedEx, sued the Blue Cross Blue Shield Association, Anthem and other insurance companies, alleging the defendants conspired to create “exclusive service areas” to limit competition over health insurance services. The lawsuit, filed Sept. 4 in the U.S. District Court for the Northern District of Alabama, said the alleged conspiracy resulted in higher costs for employers’ self-funded health insurance. Read more from Siri Bulusu.

More Headlines:

With assistance from Alex Ruoff

To contact the reporter on this story: Zachary Sherwood in Washington at zsherwood@bgov.com

To contact the editors responsible for this story: Giuseppe Macri at gmacri@bgov.com; Michaela Ross at mross@bgov.com

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