HEALTH CARE BRIEFING: Democrats Seek Unity on Medicare Expansion

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Democratic leaders are moving ahead with plans to expand the two massive U.S. public health insurance programs even as their rank and file have yet to unite over how to do so.

House Budget Chair John Yarmuth (D-Ky.) told reporters he isn’t sure there’s widespread support in his own party for lowering the age to qualify for Medicare, the federal health insurance program for the disabled and those aged 65 years or older. Democrats are considering that provision as part of major legislation designed to ride on a budget bill this year.

“That has about 75% support in the caucus,” he said, adding he’s readying a budget reconciliation package for the coming weeks.

Democratic leaders are eyeing the budget bill as a vehicle to pass their party’s major priorities without depending on support from Republicans. Failing to find agreement on health priorities could leave Democrats without major wins to bring to their constituents ahead of next year’s midterms.

House Energy and Commerce Chair Frank Pallone (D-N.J.) said his panel is crafting a bill aimed at extending “guaranteed coverage” to people in the 12 states that have not decided to expand their Medicaid programs under the Affordable Care Act. “I want to provide coverage for those people that are in red states that have not expanded,” Pallone said about coverage for Medicaid, the federal health insurance for low-income people.

Pallone declined to offer details. Some Democrats in the 12 holdout states are proposing a new tier of the ACA marketplace plan, or federal government-run insurance, available to people who make too much to qualify for Medicaid—but too little to qualify for subsidies for private insurance. Others are suggesting allowing counties or cities to widen access within their boundaries, a move that could help major population centers.

One major concern with using the budget process to extend insurance to those in this “Medicaid gap” is a potential limit on how long the coverage may last, Rep. Colin Allred (D-Texas) said. “I don’t know how we could get something long-term, but we’re trying to get creative,” Allred said. “This pandemic has highlighted the need to give people coverage.” Alex Ruoff has more.

The Coronavirus Pandemic

U.S. Sends Response Teams to Fight Delta Strain: The Biden administration is sending response teams to unvaccinated pockets of the U.S. in an attempt to combat the spread of the highly transmissible delta coronavirus variant. U.S. health officials will boost testing, provide therapeutics and deploy federal personnel where needed and requested, said Jeffrey Zients, Biden’s Covid-19 czar. Staff will come from the Centers for Disease Control and Prevention and the Federal Emergency Management Agency. Read more from Fiona Rutherford.

J&J Covid Shot Neutralizes Delta Variant: Johnson & Johnson said that its single-shot coronavirus vaccine neutralizes the fast-spreading delta variant and provides durable protection against infection more broadly. The company said in a statement yesterday that recipients of its vaccine produced strong neutralizing antibodies over the course of at least eight months against all variants including delta, which was first seen in India and has been spreading around the globe. Read more from Riley Griffin.

CureVac Vaccine Trails Rivals in Efficacy at 48%: CureVac said its mRNA-based Covid-19 vaccine provided full protection against hospitalization and death for people under age 60, although its overall efficacy trailed that of similar shots already in use around the world. The German drugmaker said late Wednesday that the vaccine was 48% effective at preventing disease of any severity, well behind the efficacy rates of more than 90% shown by Pfizer and Moderna’s mRNA shots, Timothy Annett and Tim Loh report.

Wuhan Virus Center Targeted in House Funding Bill: The House Appropriations Committee voted 32-25 yesterday to advance its fiscal 2022 State and Foreign Operations bill. Appropriators agreed by voice vote to add a measure to prohibit federal funds to the Wuhan Institute of Virology, which studies coronaviruses and which some experts have said may have had a role in the origin of the pandemic. It was added to the manager’s amendment including a series of measures considered bipartisan. Rep. Guy Reschenthaler (R-Pa.) took credit for the proposal being added to the manager’s amendment. Read more from Jack Fitzpatrick.

  • The Senate passed a similar provision in May with its bill addressing U.S. competitiveness with China (S. 1260). The National Institutes of Health has awarded grants in the past to researchers who did work with the Wuhan institute, but not the institute itself. National Institute of Allergy and Infectious Diseases Director Anthony Fauci told senators earlier this year that they conduct research in China because that’s where these diseases often originate, Alex Ruoff reports.

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What Else to Know

First Rule on ‘Surprise’ Billing Lays Out How Hospitals Get Paid: The first regulation to implement a law that prohibits hospitals and doctors from billing sending patients high bills in emergencies and other situations was released yesterday by the Biden administration.The interim final rule specifies how rates will be calculated to determine what providers should be paid.

The No Surprises Act, passed as part of appropriations legislation (Public Law 116-260) in December 2020, bars health providers from billing patients more than would be paid for in-network services in emergencies or other circumstances when out-of-network clinicians are used. Read more from Sara Hansard.

Drug Pricing Group Drops Ads Targeting Bennet: Patients for Affordable Drugs Now, an advocacy group pushing for permitting Medicare to negotiate drug prices, announced it’s pulling ads in Colorado meant to pressure Sen. Michael Bennet (D) to support legislation in the Finance Committee. The group said it spoke with Bennet’s office and “clarified his position on drug price legislation.” It is still playing ads against three others on the panel: Sens. Bob Casey (D-Pa.), Robert Menendez (D-N.J.), and Tom Carper (D-Del.).

Health IT Agency Mulls Sharing Patient Data With Social Services: Federal regulators are taking aim at the information walls between health-care providers and the social services sector as part of their effort to reduce health disparities, Micky Tripathi, the nation’s top Health IT official, said yesterday. Linking health care providers with social services organizations through health information technology will allow patients to receive more holistic care and enable better interventions to address social problems that can lead to poor health outcomes, said Tripathi, head of the Office of National Coordinator for Health Information Technology, or ONC, which is part of HHS. Read more from Christopher Brown.

Carcinogens Still Confound Drug Industry After Recalls: Years after millions of blood-pressure pills were recalled for containing potentially cancer-causing chemicals, U.S. regulators are still grappling with curbing contaminants that keep turning up in tainted drugs. A group of Food and Drug Administration chemists, toxicologists and analytical lab staff have been meeting regularly since 2018 to learn how nitrosamines get into drugs and how to eliminate them. But that target has proved elusive, Anna Edney reports.

Dialysis Centers to See Slim Boost in Medicare Payments: Medicare payments to freestanding dialysis centers will increase 1.2% in 2022, while hospital-based facilities will see a 1.3% payment bump, according to a proposed payment rule from the Centers for Medicare & Medicaid Services. Collectively, the pay hikes will add about $140 million to Medicare’s total dialysis expenditures, the CMS estimates. Read more from Tony Pugh.

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Publishing Note: Bloomberg Government’s Health Care Briefing will not publish Monday, July 5 in observance of the Independence Day federal holiday. We’ll resume publication Tuesday, July 6.

With assistance from Alex Ruoff

To contact the reporter on this story: Brandon Lee in Washington at

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

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