Democrats’ economic package, by the health-care numbers

Democrats' economic package, by the health-care numbers
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Good morning, and happy belated International Cat Day to all who celebrated. Here’s our sweet girl, who sometimes likes to attack my feet. Have cat photos or tips? Send them to rachel.roubein@washpost.com.

Today’s edition: Biden administration officials are slated to announce a new plan to stretch the limited supply of monkeypox vaccine. Inside a key decision President Biden made that ultimately helped senators forge a reconciliation deal. But first…

1.5 million seniors, 3.3 million diabetics, 13 million Obamacare enrollees

Congressional Democrats are gearing up to pass the most significant health-care package in more than a decade, amounting to a major win for President Biden, who has made tackling the high costs of care a centerpiece of his domestic agenda.

If signed into law, the party’s long-delayed spending package would prevent huge spikes in the price some people pay for health insurance; limit seniors’ drugs costs to $2,000 per year; and cap insulin at $35 per month for diabetic Americans enrolled in Medicare.

“When you sit down at that kitchen table at the end of the month, you’re going to be able to pay a whole hell of a lot more bills because you’re paying less in medical bills,” Biden told reporters yesterday.

Here at The Health 202, we’ve focused on the legislation’s tumultuous political path. Today, we’re bringing you a by-the-numbers look at the consumer impact of the bill.

That’s how many people enrolled in Medicare could see their annual out-of-pocket costs for medication decrease substantially, particularly those who take pricey drugs for diseases like cancer or multiple sclerosis.

Democrats’ economic package imposed on $2,000 per year limit on how much those enrolled in Medicare’s voluntary prescription drug benefit pay for medications starting in 2025. About 1.4 million seniors and those with disabilities spent $2,000 or more on drugs in 2020, according to the Kaiser Family Foundation. But that’s probably an undercount, since the estimate didn’t account for expected increases in average out-of-pocket costs in more recent or future years.

One centerpiece of Democrats’ bill: Allowing Medicare to negotiate the price of prescription drugs for the first time. The government would begin negotiating the price of 10 drugs by 2026with that number growing to up to 20 medications by 2029.

But how many Medicare beneficiaries will the policy help? And how much will seniors save? It’s not yet clear. The answers to those questions will depend on which drugs are subject to negotiation and the price reductions the government achieves.

“It’s difficult to say with certainty which drugs will be negotiated or what the level of savings will be for patients who take those drugs,” said Tricia Neuman, a senior vice president at KFF. “But for patients who do take those drugs, there will be savings that come into being starting in 2026.”

3.3 million diabetic patients

The economic package creates a $35 monthly cap on the price of insulin for patients on Medicare — a policy that will affect about 3.3 million people.

The number of Americans with Medicare using insulin has more than doubled in recent years, from 1.6 million in 2007 to 3.3 million in 2020. Many seniors spend an average of $54 per prescription across all insulin products, meaning many will see lower costs with the new cap. (Read my deep dive on insulin with Rachel Panett here.)

13 million Obamacare enrolled

If the package passes, Democrats will avoid increasing health premiums for about 13 million Americans who buy coverage through the Affordable Care Act’s exchanges.

Last year, lawmakers included enhanced financial help for Obamacare enrollees in their coronavirus aid package — a policy set to expire at the end of this year. But the party’s health-and-climate bill extends the beefed-up tax credits through 2025.

Health-care costs would rise substantially without that assistance, and Democrats wanted to avoid the specter of skyrocketing health prices weeks before the midterms. Here’s what the impact would be if Democrats didn’t secure a deal on an extension (or if the legislation isn’t ultimately passed), per the Department of Health and Human Services:

  • About 3 million people potentially would have become uninsured.
  • Nearly 9 million Americans staying on the exchanges could have lost hundreds of dollars in financial help per year.
  • An estimated 1.5 million might have lost tax credits entirely but remained insured.

For more info, check out our story published this morning.

Limited monkeypox vaccine supply would be stretched under FDA plan

We tap today: Biden administration officials are set to announce a new strategy to split monkeypox vaccine doses in hopes of vaccinating up to five times as many people against the virus while stretching the limited supply, our colleague Dan Diamond reports.

The strategy, first described publicly by Food and Drug Administration Commissioner Robert Califf last weekwould change how the shots are administered while still maximizing the immune reaction generated by the vaccine.

The planned change in vaccine dosing would be a large-scale, real-time experiment as officials try to curb a record monkeypox outbreak. While Califf has emphasized that the approach would not compromise safety, the change isn’t without risk.

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  • People who receive the pared-down version of the vaccine, which is intended as a two-dose regimen, may wind up needing additional shots if the plan leads to an insufficient level of protection against the virus.
  • Local officials may also struggle to carry out the new strategy, which may require additional training and supplies.

To change how the shots are administered, HHS Secretary Xavier Becerra would need to issue a second declaration over the outbreak that would allow for “emergency use” of the existing vaccines to change how the shots are administered.

White House prescriptions

Inside Biden’s hot streak, from poolside to the Capitol

President Biden is on a winning streak.

The Senate’s passage of Democrats’ economic package capped a three-week stretch of political wins for the president, a starting victory that was partly won because of his decision to take himself out of the conversationThe Post’s Yasmeen Abutaleb and Tyler Pager write.

The turnaround on the budget bill was the result of a presidential decision to let senators negotiate among themselves, rather than Biden playing a leading role. After negotiations crumbled with Sen. Joe Manchin III (DW.Va.) in December, Biden directed his staff not to disclose the details of any interactions with members of Congress to take himself out of the public picture.

But in the hours before the Inflation Reduction Act appeared poised to pass the Senate, Biden wasn’t leaving anything to chance. He sat poolside at the White House on Saturday phoning Democratic Sens. Mark R. Warner (Go.), Amy Klobuchar (Min.) and Tina Smith (Minn.), among others. As lawmakers labored through a “vote-a-rama,” Steve Richettione of Biden’s closest aides, and White House chief of staff Ron Klein spoke with Biden about every half an hour.

  • “One of the lessons learned — a big lesson learned — was that letting the negotiations with senators dominate the public conversation was a mistake,” said Jen Psaki, Biden’s former White House press secretary. “Disagreements about minutiae became what the public consumed, instead of how pieces of legislation were going to impact people’s lives.”

Now, Biden’s challenge will be to keep the momentum up in order to turn around a presidency plagued by low approval ratings and cascading crises, Yasmeen and Tyler note. That means motivating Democratic voters and convincing them these wins matter not just to Biden but to them as well.

Post Roe, some in GOP wage uphill battle to offer families more support

There’s a small coalition of conservatives pushing to expand financial support for families now that abortion rights are no longer guaranteed nationwide. But their calls are largely being met with the usual buzzsaw of GOP opposition to social spending, our colleagues Jeff Stein and Leigh Ann Caldwell report.

  • Republicans have roundly rejected Biden’s bids to expand child care, prekindergarten and national paid family leave.
  • Senate Minority Leader Mitch McConnell (R-Ky.) has made clear that dwindling access to abortion has done nothing to change his view that new federal social programs are unnecessary.
  • GOP aides and conservative policy analysts say they’re skeptical that the Supreme Court decision will produce a meaningful shift in the party’s stance.

Yet, a handful of conservative lawmakers are pressing the case. Republican Sens. Mitt Romney (Utah) and Marco Rubio (Fla.) have emerged at the forefront of the uphill battle, with Romney currently pitching legislation to cut monthly checks for $250 per child to millions of American parents.

Meanwhile, the Supreme Court ruling overturning Roe v. wade has energized conservative advocates of more generous family policies. Some influential anti-abortion and religious groups, like Susan B. Anthony Pro-Life Americahave backed proposals like Romney’s, arguing that the government now has a greater obligation to provide support to families.

This comes as Democrats believe the GOP’s resistance to change its stance on the issue could be a political liability for Republicans come November — and an opportunity for Democrats.

  • On tap Wednesday: Tea House Rules Committee will meet to tee up the Inflation Reduction Act for debate and votes on Friday, our Post Politics Now colleagues report.
  • A legal advocacy group for students filed a federal petition yesterday urgent the agency that oversees the National Health Service Corps to change its rules to address the penalties facing health-care workers who involuntarily violates contracts to help with student debt, the wall street journal‘s Rebecca Ballhaus writes.
  • A group of 23 states led by Florida told a federal court that the Centers for Disease Control and Prevention lacks the power to mandate masks on transportation, Reuters reports.
  • Extreme weather connected to climate change has worsened more than half of infectious diseases that people come in contact with worldwide, according to a study out yesterday in Nature Climate Change.

America has a maternal mortality crisis. Biden push aims to change that. (By Akilah Johnson l Washington Post)

Newsom Pins Political Rise on Abortion, Guns, and Health Care (By Angela Hart | Kaiser Health News)

A look at some medications under increased scrutiny amid abortion bans (By Frances Stead Sellers | The Washington Post)

Thanks for reading! See y’all tomorrow.

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