HEALTH CARE BRIEFING: Drug-Price Allies See Fight With Centrists

By Brandon Lee and Alex Ruoff

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House Democrats who want to empower the government to demand lower prices from drugmakers are concerned that centrists in their party are now emboldened to blunt their ambitious drug-pricing agenda.

Lawmakers pushing to fulfill their party’s longtime call to allow the government to negotiate with the pharmaceutical industry on the price of medicines watched with unease this week as a group of 10 moderate Democrats postponed a procedural vote for the party’s reconciliation bill, the vehicle for their $3.5 trillion economic expansion plan. Their fear is that some of these same centrist lawmakers may again band together to blunt the drug-pricing provisions going into the reconciliation package.

“Now is the time to act and get something done on pharmaceutical pricing,” Rep. Lloyd Doggett (D-Texas) told reporters yesterday. “There may never be a moment just like this, which is why this current dispute is troubling. There’s still the opportunity for those who made this argument of doing one bill instead of another to still have influence over the final bill.”

After over a day of negotiations and delayed votes, House leaders agreed to a resolution saying they will vote late next month on a $550 billion bipartisan infrastructure bill, which moderates want to send to President Joe Biden’s desk before Congress takes up the large economic package. In exchange for having a date certain for a vote, moderate Democrats agreed to vote to proceed on the vehicle for the $3.5 trillion economic package.

  • The House adopted the resolution last night after a White House pressure campaign and assurances from Speaker Nancy Pelosi (D-Calif.) helped unify fractious Democrats to move ahead on the core of Biden’s economic agenda. The 220-212 vote tables an intra-party rift between progressives and centrists that threatened to derail Pelosi’s strategy for pushing the budget framework and the bipartisan infrastructure bill through Congress, Billy House and Erik Wasson report.

Some of the same lawmakers demanding action on the bipartisan infrastructure bill ahead of the reconciliation package have also expressed misgivings with taking on drug-pricing changes without GOP support. Ten Democrats wrote to Pelosi in May, asking her to first “garner bipartisan, bicameral support” before advancing any drug-pricing bill.

Some lawmakers signing that letter, such as Rep. Jake Auchincloss (D-Mass.), have since endorsed Democrats’ signature drug pricing bill (H.R. 3), which would direct the government to negotiate lower prices from drugmakers. Others are already saying H.R. 3 needs to change before they sign off. For example, Rep. Scott Peters (D-Calif.) opposes how H.R. 3 uses the prices paid by other countries to set what the U.S. pays for drugs, a spokesperson said.

House Democrats’ majority in the House is so slim they can only afford to lose three of their members to pass bills that don’t have Republican support. Read more from Alex Ruoff.

House Panel to Begin Health Work on Sept. 6: Following the budget resolution adoption, the House Ways and Means Committee will start marking up a package of health care and tax legislation the week of Sept. 6, Chair Richard Neal (D-Mass.) said yesterday. Neal’s committee is responsible for crafting Democrats’ proposal for widening Medicare benefits to include hearing, dental, and vision services, and extending the temporary expansion of Obamacare’s tax credits, Neal said. That process is likely to take up several days of mark ups.

Right now, Neal said, committee members are debating how long they can extend Obamacare’s larger premium assistance, set to expire in 2022. That’s determined by how much money Democrats can save through changes to the U.S. tax code and drug pricing legislation. “That depends on what the amount of total savings you have to work with,” he said.

Rep. Doggett said the panel is also discussing its role in extending coverage to people in 12 states that have declined to expand their Medicaid programs under Obamacare, such as his. The Energy and Commerce Committee is working on its proposal, one that’s expected to create a type of federally-run Medicaid program, but Ways and Means staffers are looking into ways to bring people into Affordable Care Act plans, he said. “We are looking at alternatives that could be considered,” he said, Ruoff reports.

The Coronavirus Pandemic

Vaccine Efficacy Diminished as Delta Rose, CDC Says: The effectiveness of Covid-19 vaccines among front-line workers declined to 66% after the delta variant became dominant, compare to 91% before it arose, an analysis from the Centers for Disease Control and Prevention shows. The vaccines are still protective, it added. The observational study published in the agency’s Morbidity and Mortality Weekly Report followed thousands of workers in eight U.S. sites from December 2020 to August 2021, John Tozzi reports.

  • Biden’s chief medical adviser, Anthony Fauci, said yesterday a Covid-19 booster shot may not be needed “indefinitely” as the third dose could lead to lasting levels of protection against the virus. Fauci told MSNBC “it’s entirely conceivable” the booster dose of the Pfizer-BioNTech or Moderna vaccine “very well may allow for a rather prolonged period of protection.” Catherine Larkin and Justin Sink have more.

Vaccine Mandates at Hospitals to Soar After FDA Approval: Covid-19 vaccination mandates for health-care workers will take off now that the FDA has fully approved a vaccine, hospital leaders say. Mandates were already poised to “spread like wildfire” before the Pfizer-BioNTech shot approval as hospitals and states gained confidence in their legality, said Steven Michaud, president of the Maine Hospital Association. The approval will make hospitals even more comfortable in requiring the vaccine. Allie Reed has more.

  • As regulatory approval of Pfizer’s vaccine paves the way for companies to get more aggressive with inoculations, American workers are increasingly supportive of punitive measures for unvaccinated colleagues. A new survey released yesterday by Eagle Hill showed that 41% of workers agreed non-vaccinated employees should pay higher insurance premiums, and two-thirds said that unvaccinated people shouldn’t get special allowances to work from home. Read more from Matthew Boyle.
  • Meanwhile, full FDA approval of Pfizer’s Covid-19 vaccine may ease the path to booster shots in the U.S., a plan that’s received mixed reactions amid spiking infections from the delta variant and global inequity in immunization access. The FDA’s action on Aug. 23 now makes it easier for the CDC to recommend a booster because it would be endorsing an extra dose of a vaccine that’s already approved, said Lawrence Gostin, director of the O’Neill Institute for National and Global Health Law at Georgetown University. Read more from Ian Lopez.

USDA Launches Pandemic Warning System: The U.S. Agriculture Department will spend $300 million to expand surveillance for Covid-19 and other diseases in animals, as well as establish an early warning system to better avoid future pandemics. The funds stem from the American Rescue Plan Act. The department estimates it will require multiple years to build. Up to 75% of emerging diseases in humans “can also impact the health of animals,” Agriculture Secretary Tom Vilsack said, Megan Boyanton reports.

Troubling Data on Virus in Kids Stir School Masking Fight: South Carolina’s second-largest school system inserted itself in the center of a nationwide debate last week when it voted by a landslide to mandate face masks, defying the state’s ban on any such measures as delta’s spread continues in the South. The Medical University of South Carolina cited data showing positive Covid-19 cases in students last month were on track to surpass those of the entirety of the 2020 fall semester. Read more from Anna Edney.

Related:

Covid-19 Hit Seniors in Nursing Homes Harder: Medicare’s 1.4 million beneficiaries who lived in nursing homes last year had higher rates of Covid-19 infections, hospitalizations, and deaths compared with enrollees living outside the facilities. New Medicare claims data shows the 2% of beneficiaries who reside in nursing homes accounted for 22% of Medicare’s 3 million-plus Covid infections and 19% of Covid hospitalizations from March to December 2020. Read more from Tony Pugh.

More Headlines:

What Else to Know Today

Anti-Abortion Centers Appeal Block on Counseling Law: Two crisis pregnancy centers and officials in South Dakota will urge a federal appeals court to reverse a ruling that upheld an order blocking a pre-abortion counseling mandate, they told the issuing trial court. Gov. Kristi Noem (R), Alpha Center, and Black Hills Crisis Pregnancy Center told the District of South Dakota that they will appeal its refusal to dissolve a 2011 injunction against the rule to the Eighth Circuit. Read more from Mary Anne Pazanowski.

Illumina Fights U.S. Bid to Unwind $8 Billion Grail Takeover: U.S. antitrust officials kicked off their effort to unwind Illumina’s $8 billion acquisition of Grail, saying the deal will impede the development of life-saving cancer-detection tests. The deal, a combination of gene-sequencing giant Illumina and its former spinout, will mean less innovation and fewer choices for patients, the Federal Trade Commission argued as its lawsuit against the purchase went to trial in its in-house administrative court yesterday. Read more from David McLaughlin.

Harris Trip Delayed by ‘Health Incident’ in Hanoi: Vice President Kamala Harris departed Singapore over three hours late yesterday, amid concerns about “an anomalous health incident” in Hanoi, her next destination, the Department of State said. The department has frequently used the phrase “anomalous health incidents” to describe so-called Havana Syndrome, which has afflicted dozens of U.S. intelligence and diplomatic officials who mysteriously fell ill after hearing sounds. Jenny Leonard has more.

More Headlines:

To contact the reporters on this story: Brandon Lee in Washington at blee@bgov.com; Alex Ruoff in Washington at aruoff@bgov.com

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

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