KHN’s ‘What the Health?’: The Senate Acts

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The Senate has set the stage for a busy fall that will include debate on a broad array of health issues, such as prescription drug prices, Medicare expansion and further expansion of the Affordable Care Act. Before leaving for a delayed August break, the chamber passed a bipartisan infrastructure bill and budget resolution with an outline of a $3.5 trillion measure to be crafted when lawmakers return. Whether any of those health issues can make it across the legislative finish line remains to be seen, and the path to success is a narrow one.

Meanwhile, covid’s delta variant is spreading rapidly around the U.S., particularly in states with large swaths of unvaccinated people. And the spike is happening just as schools around the country are opening, with children under 12 still unvaccinated.

This week’s panelists are Julie Rovner of KHN, Joanne Kenen of Politico, Mary Ellen McIntire of CQ Roll Call and Yasmeen Abutaleb of The Washington Post.

Among the takeaways from this week’s episode:

• One funding mechanism senators used to pay for the bipartisan infrastructure bill was a temporary rollback of a Trump administration rule on prescription drug pricing designed to take money from the drug industry middlemen who broker prices for insurers and give consumers a discount. The rule has not yet been implemented, but federal auditors determined it would drive up insurance premiums and cost the government money. So, by rolling the rule back, senators say they are saving the government billions of dollars that they would now spend on bridges, mass transit and other projects.
• After the Senate passed its infrastructure bill this week, it moved immediately to pass a budget resolution that could give Democrats just about everything on their social agenda wish list, including an expansion of Medicare benefits, a lower eligibility age for Medicare, extension of the tax credits that fund premium subsidies for plans purchased on the Affordable Care Act’s marketplaces, an expansion of home health care, lower drug prices and coverage for low-income people who live in states that did not expand Medicaid to adults. But wishing and receiving are very different things, and most observers think many of these items will not make it into the final spending bills.
• The Senate’s budget resolution calls for those spending bills to be written and voted on by committees by Sept. 15. That seems highly unlikely.
• President Joe Biden on Thursday reiterated his concerns about the high cost of prescription drugs. That is a potent political issue: Drug expenses generate a lot of consumer concerns, yet efforts to lower prices have run into trouble before on Capitol Hill because of drugmakers’ influence. Despite Biden’s speech, the White House has not shown any indication it is willing to expend serious political capital in trying to get a Medicare drug-pricing proposal through Congress.
• Concerns about the effects of the delta variant on children has the potential to shake up current politics. Southern governors, especially Republican Govs. Ron DeSantis of Florida and Greg Abbott of Texas, have vowed to oppose any mandates on masks or covid vaccines. But some school districts in their states are defying the governors, saying they need masks to help keep kids — many of whom can’t be vaccinated because of their age — safe. The issue will likely play out in the courts.
• While big-name employers are delaying the date for workers to return to the office, schools appear set to resume classes on time. Parents, doctors and educators have said that children need to be back in school and that last year’s widespread lockdowns were harmful, but the delta variant is causing concerns. It appears to be a bigger threat to students than last year’s version of the covid virus.
• Vaccine mandates are still a hot topic, too. A Florida court said this week that DeSantis could not stop a cruise line from requiring that passengers be vaccinated. More employers are also requiring workers to get a shot before coming back to work. And as places like restaurants, theaters and gyms set vaccine requirements, people who have been reluctant to be inoculated might feel pressured to get a shot.

Plus, for extra credit, the panelists recommend their favorite health policy stories of the week they think you should read, too:

Julie Rovner: The Washington Post’s “Covid Killed Her Husband. Now It’s Taking the Only Home Her Kids Have Ever Known,” by William Wan

Joanne Kenen: Stat’s “A Snort or a Jab? Scientists Debate Potential Benefits of Intranasal Covid-19 Vaccines,” by Helen Branswell

Mary Ellen McIntire: Journal of the American Medical Association’s “Gun Violence Researchers Are Making Up for 20 Years of Lost Time,” by Alicia Ault

Yasmeen Abutaleb: The Atlantic’s “The Vaccine Cards Are the Wrong Size,” by Amanda Mull

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KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.

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