What a Senate infrastructure deal means for the Trump-era rebate rule
July 23, 2021Presented by Humana
With Alice Miranda Ollstein
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— The Senate's infrastructure package will likely delay a Trump-era drug pricing regulation.
— Democrats aren't all that excited about the forthcoming infrastructure deal, but they're preparing to vote for it anyway.
— Mississippi is asking the Supreme Court to overturn Roe v. Wade when it considers a case on the state's 15-week abortion ban.
WELCOME TO FRIDAY PULSE — and a fond farewell to POLITICO health care editor Jason Millman, whose tireless work made our coverage sharper, our stories smarter, and our newsroom that much more enjoyable. Tips and tributes to [email protected] and sowermohle[email protected].
INFRASTRUCTURE BILL WOULD DELAY TRUMP-ERA REBATE RULE — Senators negotiating the bipartisan infrastructure deal will lean on a Trump-era drug pricing provision to generate savings for the package — though they’re still unsure exactly how much, POLITICO’s Alice Miranda Ollstein reports.
Sen. Joe Manchin, who has been central to the effort, confirmed Thursday that the group plans to further delay the Medicare rebate rule, telling reporters that “the pay-fors are pretty much lined up.” But they’re still waiting on a score from the Congressional Budget Office — a process that’s likely to run into next week.
The delay isn’t expected to save a ton. Sens. Ron Wyden and Chuck Grassley — who have spent the past few years working on a drug pricing proposal — both downplayed the prospect it would generate huge savings. “When it comes to the Trump proposal, there wasn’t much there,” Wyden said.
The Biden administration had already delayed the rebate rule until 2023, following a court order.
But it could affect how Dems structure their bigger partisan plan. Democrats had originally planned to repeal the rebate rule to help finance their own $3.5 trillion spending package. They’ll lose that option now if the infrastructure bill makes it over the finish line.
DEMS’ INFRASTRUCTURE VERDICT: DON’T LOVE IT, BUT WILL TAKE IT — Democratic senators are begrudgingly embracing the broader infrastructure plan, even if they’re disappointed about many of the details that make up the compromise bill, POLITICO’s Marianne LeVine, Burgess Everett and Laura Barrón López report.
Party leaders expect all 50 Democrats to eventually sign onto the final product when it’s unveiled next week, with some lawmakers banking on passing the bill as a path to a larger spending proposal that will include their top priorities.
The infrastructure package’s success would be a big win for a White House that’s worked hard to strike a bipartisan deal. And while Biden might be able to spare a few Democratic votes, there is still a risk that some of the 11 Senate Republicans who have worked most directly on the bill could ultimately pull their support.
Among the remaining sticking points: How to use unspent Covid-19 relief money to finance the deal. But even as some Democrats grumble about the specifics, there’s little sign of a rebellion on the horizon. “There are a lot of things that are happening that I’m unhappy about,” said Sen. Ben Cardin (D-Md.). “But I’m going to support the package.”
CAPITOL WEIGHS REVIVING MASK RECOMMENDATION — The Capitol’s physician may bring back a recommendation that people wear masks inside the House and Senate, amid a nationwide surge in the Delta variant, POLITICO’s Heather Caygle, Katherine Tully-McManus and Burgess Everett report.
The possibility comes as more staffers and lawmakers have already begun wearing masks in response to news that several fully vaccinated people in the Capitol tested positive for Covid-19. The Capitol attending physician, Brian Monahan, also sent Hill officers a letter Tuesday warning them that the Delta variant poses “a dire health risk to unvaccinated individuals.”
MISSISSIPPI TO SCOTUS: OVERTURN ROE V. WADE — The state’s attorney general filed a brief on Thursday defending Mississippi’s 15-week abortion ban and asking the Supreme Court to overturn Roe v. Wade when it hears arguments on the case this fall, Alice and POLITICO's Josh Gerstein report.
“The national fever on abortion can break only when this Court returns abortion policy to the states,” Attorney General Lynn Fitch wrote, arguing that the nation has changed so much since the 1973 ruing that it needs to be reopened.
That prompted a rebuke from the Center for Reproductive Rights, which is challenging the 15-week ban and called the state’s argument “extreme and regressive.”
CDC ADVISERS: KEEP GIVING J&J SHOTS — A CDC vaccine advisory panel agreed Thursday that the benefits of Johnson & Johnson’s Covid-19 vaccine still outweigh the risks of rare but serious side effects, POLITICO’s Lauren Gardner reports.
The decision came after cases of Guillain-Barré syndrome were linked to the shots, prompting the FDA to add a warning to the vaccine. Most of the advisory panel’s members nevertheless said they were comfortable continuing to give it to adults, with the hospitalizations and deaths avoided as a result of the J&J vaccine far outpacing the few cases of Guillain-Barré or blood clotting – the other side effect tied to the shot.
But there was one caveat: Two of the panel’s 15 members suggested that those administering the vaccine ensure patients are aware of its risks. “I have no problem continuing to have the Janssen product available, but I think that those risks have got to be stated up front,” said Pablo Sanchez, an Ohio State University pediatrics professor.
— The panel also punted on booster shots. Whether immunocompromised people should get Covid-19 booster shots is a decision the committee is leaving up to the FDA, POLITICO’s Katherine Ellen Foley reports. Some members acknowledged that it may not stop some from getting boosters anyway, but concluded that there was not yet enough data to determine who will actually need one.
MISSOURI’s MEDICAID EXPANSION IS A GO — The voter-approved Medicaid expansion is back on track after the Missouri Supreme Court overturned a lower court ruling that found the ballot measure invalid, POLITICO’s Dan Goldberg reports.
The ruling is the latest development in a dispute over the expansion that dates back to last year, when Republican lawmakers refused to fund the program. Advocates eventually sued Gov. Mike Parson over his attempt to withdraw the state’s federal application to expand Medicaid. A county circuit judge sided with Parson before being overruled by the Supreme Court.
It will now fall to that same county circuit judge to figure out how Missouri should implement the expansion.
FIRST IN PULSE: HOUSE DEMS PITCH MEDICARE DENTAL BENEFITS — Two House Democrats are reintroducing legislation that would permanently expand Medicare Part B’s benefits to cover dental services for roughly 37 million enrollees, Alice writes.
Under the bill from Reps. Robin Kelly (D-Ill.) and Steven Horsford (D-Nev.), patients would be responsible for 20 percent of the cost of preventive dental care and screenings. The cost of major services would be phased in over time, with Medicare ultimately covering 50 percent by 2029. Enrollees would also be eligible for a full or partial set of dentures once every five years.
The proposal comes as Democrats have sought to expand Medicare’s benefits as part of their planned party-line spending bill. But it could serve as a backstop if that expansion ends up being limited, with one House Democratic aide predicting lawmakers may not have enough money to add dental, vision and hearing benefits all at once.
FDA UNDER PRESSURE OVER INSPECTION BACKLOG — The leaders of the House Energy and Commerce Committee are seeking details on the FDA’s backlog of foreign inspections, writing Thursday that they’re concerned the pandemic-driven bottleneck could slow the agency’s ability to finalize drug approvals.
“One year into the pandemic, the strategy for resuming all inspections and addressing the backlog of delayed inspections remains unclear,” the lawmakers including E&C Chair Frank Pallone (D-N.J.) and Ranking Member Cathy McMorris Rodgers (R-Wash.) wrote.
The FDA paused all non-critical in-person foreign expansions after Covid-19 hit, POLITICO’s David Lim reports. But while the agency is beginning to resume normal domestic inspections, it is still relying on record reviews and remote evaluations of foreign facilities.
Indonesia’s president sided with business groups rather than his own health advisers in rejecting a full Covid-19 lockdown, days before the country became the epicenter for the virus in Asia, Bloomberg’s Arys Aditya and Philip Heijmans report.
NFL teams could be forced to forfeit if they suffer a Covid-19 outbreak that postpones a game, POLITICO’s Nick Niedzwiadek writes.
Of the almost 9,000 coronavirus-related deaths in Texas since February, all but 43 of the patients were unvaccinated, the Texas Tribune’s Colleen Deguzman reports.
Source: https://www.politico.com/