HEALTH CARE BRIEFING: Manchin Deal Extends ACA Subsidies to 2025

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Sen. Joe Manchin (D-W.Va.) and Senate Majority Leader Chuck Schumer (D-N.Y.) struck a deal on a tax, health-care, tax, and energy policy bill, breaking a deadlock on Democrats’ long-sought legislation to enact major parts of President Joe Biden’s domestic agenda.

The bill would direct the government to negotiate with drugmakers for lower prices on certain medicines, and cap what seniors on Medicare pay for drugs each year at $2,000. The measure also requires pharmaceutical companies to rebate Medicare if they raise the prices of their drugs more than just account for inflation, Laura Davison, Ari Natter and Alexander Ruoff report.

Manchin’s and Schumer’s agreement would also extend federal subsidies for Affordable Care Act premiums, first enacted by the American Rescue Plan (Public Law 117-2) in 2021, for three years.

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Wednesday’s announcement came just hours after Speaker Nancy Pelosi (D-Calif.) said she’s planning for the House to reconvene in mid-August to vote on the earlier reconciliation bill, which would have only addressed drug prices and the looming expiration of Obamacare subsidies.

The framework’s ACA subsidy extension comes as the share of Americans who rely on the ACA continues to grow. A new report the CDC published this morning shows the share of Americans without health coverage continued to fall in the first quarter to 8%, or 26.4 million people— down from 9.5%, or 30.8 million, in the first quarter of 2021. In April, HHS reported that total enrollment for Medicaid expansion, ACA marketplace coverage, and the Basic Health Program reached an all-time high of over 35 million people in early 2022, Sara Hansard reports.

Monkeypox Funding Plans at Risk

A potential White House request for billions of dollars in monkeypox funding could find itself ensnared in an impasse on Capitol Hill over additional Covid-19 dollars.

Lawmakers have been struggling for most of this year to agree on new funding for Covid-19 pandemic programs that the White House has warned are running low on money. Turning their attention to a new health threat could prove even trickier.

A Democratic aide and key senators said they haven’t received a request from the White House, a formal step that typically kicks funding requests into gear. This means there likely won’t be action until at least September, after the congressional summer recess. Read more from Jeannie Baumann and Alex Ruoff.

US to Make More Monkeypox Shots Available: Another 786,000 doses of Bavarian Nordic’s monkeypox vaccine will be made available to states Thursday as the country grapples with strained vaccine supply amid a growing outbreak, federal regulators said. Madison Muller has more.

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Also Happening on the Hill


  • Lead’s Health Effects: The House Oversight and Reform Committee holds a Thursday hearing on the impacts that lead in aviation fuel could have on children’s health.

House Passes Medicare Telehealth Extension: The House passed a bill H.R. 4040 from Rep. Liz Cheney (R-Wyo.) would extend Medicare telehealth waivers through Dec. 31, 2024, regardless of whether the Covid public health emergency is lifted. Tony Pugh has more.

  • Medicare Advantage Bill: House lawmakers also moved a step closer Wednesday to requiring more transparent coverage decisions by Medicare managed care plans. The House Ways and Means Committee adopted an amendment that changes the language of H.R. 8487, which now goes to the floor, Pugh reports.

Ernst Blocks Contraception Bill Vote: Sens. Mazie Hirono (D-Hawaii) and Ed Markey (D-Mass.) tried to clear by voice vote a House-passed bill (H.R. 8373) to guarantee contraception rights. Sen. Joni Ernst (R-Iowa) objected to the move, saying it “goes far beyond the scope of contraception” and would guarantee funding for abortion, Alex Ruoff reports.

Wyden Says Merck, Abbott Stonewalling Probe: Senate Finance Chairman Ron Wyden (D-Ore.) accused Merck and Abbott Laboratories of stonewalling his committee and its investigation into big pharmaceutical companies’ tax practices, and demanded the firms comply with requests for information, Se Young Lee reports.

AOC, Crenshaw Team Up on Psychedelics: Reps. Alexandria Ocasio-Cortez (D-N.Y.) and Dan Crenshaw (R-Texas) are unlikely allies in supporting an expansion of psychedelic research studies for active-duty service members. The duo filed separate amendments on such research that successfully made it into the fiscal 2023 National Defense Authorization Act (H.R. 7900). But the measures’ fate in the Senate remains unclear. Read more from Mia McCarthy.


  • DHS Fentanyl Bill: Senate Homeland Security Chairman Gary Peters (D-Mich.) unveiled legislation to ensure the Homeland Security is “expanding available tools” to stop the flow drugs like fentanyl into the US, according to a statement.
  • Students’ Free Lunch: A House panel approved a bill that would raise reimbursement rates for school meal programs and expand eligibility for free lunch. The bill (H.R. 8450) from House Education and Labor Chair Bobby Scott (D-Va.) would automatically certify free meals for kids if they’re covered by Medicaid. Maeve Sheehey has more.
  • Heat Protections Bill: A House Education and Labor Committee voted 27-19 Wednesday to advance a bill (H.R. 2193) mandating the Labor Department’s workplace safety arm create a heat stress standard—a step meant to protect workers in agriculture and other occupations. Paige Smith has more.

Around the Administration

Biden Says His Recovery Shows Pandemic Progress: President Joe Biden cast his own mild bout with Covid as evidence of the strides the US has made under his watch, contrasting his experience with that of his predecessor, who—when diagnosed in 2020—was airlifted to a hospital and received supplemental oxygen. Read more from Josh Wingrove.

Hospices to Get $825 Million Boost From Medicare: Hospice providers will receive a $825 million hike in Medicare payments in fiscal 2023 under a rule published by the Biden administration Wednesday. The increase represents a 3.8% boost in the payment rate, CMS’ final rule says. Allie Reed and Tony Pugh have more.


  • Georgia Abortion Law: Abortion advocates are suing Georgia in state court to stop enforcement of a law that criminalizes most abortions at around six weeks, Mary Anne Pazanowski reports.
  • Pfizer Copay Ruling: A ruling barring Pfizer’s proposal to help middle-income Medicare beneficiaries afford an expensive heart drug could end an effort by drugmakers to boost sales by eliminating copays for many patients. The Second Circuit upheld HHS’s opinion that Pfizer’s proposal would violate the Anti-Kickback Statute. Christopher Brown has more.
  • LGBTQ Health Bias: A Biden administration effort to shore up health-care nondiscrimination protections for LGBTQ people is all but certain to wind up in court, but could be protected from being overturned due to its process to allow for religious conscience exemptions, according to attorneys. Read more from Shira Stein.

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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: Giuseppe Macri at; Michaela Ross at

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