Democrats look to include insulin provisions in Manchin-Schumer deal

Democrats look to include insulin provisions in Manchin-Schumer deal


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Today’s edition: Democrats are seeking $21 trillion in emergency aid to battle the coronavirus and prepare for other infectious diseases. The Biden administration expects to offer retooled booster shots in September. But first…

Democrats look to include insulin provisions in Manchin-Schumer deal

Senate Democrats are readying another push to curb the cost of insulin — a politically popular provision the party excluded from a deal on an economic package released earlier this week.

The last-minute scramble to add insulin policies back into the legislation has the support of a key Democrat, Sen. Jeanne Shaheen (NH), who until yesterday had instead been pursuing a vote on a bipartisan bill she authored with Sen. Susan Collins (R-Maine). And Senate Majority Leader chuck schumer (DN.Y.) confirmed the plan, which was first reported by The Health 202.

Discussions are still in flux, and it wasn’t immediately clear which insulin policies Democrats would seek to include. The jockeying comes less than 24 hours after Schumer and Sen. Joe Manchin III (DW.Va.) clinch a deal on legislation that aims to lower health-care costs, combat climate change and reduce the federal deficit.

Legislative text released wednesday night included drug-pricing provisions, such as allowing Medicare to negotiate the price of prescription drugs. But it didn’t contain any measures specifically related to insulin, which is used by diabetics to manage their blood sugar levels, to the ire of some drug pricing advocates. Party leaders are now seeking to tweak the bill once again, but have no room for error as they aim to put the package up for a vote next week.

President Biden on July 28 explained how the Inflation Reduction Act of 2022 will be beneficial to climate change and reducing the deficit. (Video: The Washington Post, Photo: Demetrius Freeman/The Washington Post)

Last month, Shaheen and Collins unveiled a proposal to target the high cost of insulin after months of work to forge has compromised. At the time, Schumer pledged to put the legislation on the Senate floor “very soon.”

Meanwhile, the insulin provisions weren’t included in a new version of Democrats’ go-at-it-alone drug pricing plan. Previous iterations of the bill included several insulin-related policies, such as …

  • Imposing a $35 monthly cap on the cost of insulin for patients with private insurance and those enrolled in Medicare
  • Requiring Medicare to negotiate the price of all insulin products

But on Thursday, Shaheen’s office confirmed her insulin bill with Collins wouldn’t get a vote this work period. It had faced daunting political odds in a quest to obtain 10 Republican votes, as some lawmakers expressed unease about the policy and its cost.

“I think that [Collins is] persuasive, and she’s determined,” a Senate GOP aide told The Health 202 earlier this week, “but I think that there’s a lot of concern.”

Now, Shaheen is throwing her support behind adding measures to reduce the cost of the lifesaving drug into Democrats’ economic package. In a statement, Shaheen said that while she believes her bipartisan legislation is “the most effective mechanism” to address insulin’s cost, she believes “the Senate has an opportunity to take action next week to reduce costs — that is a critical window Congress cannot allow to close.”

It’s not yet decided which insulin provisions Democrats will attempt to include in their party-line package, but their success may depend on arcane Senate rules.

The party is seeking to pass its economic package through a fast-track budget maneuver called reconciliation. It allows Democrats to circumvent Republican votes, but all policies must adhere to strict rules. Each provision is required to impact government spending or revenue—and if not, it may get nixed from the bill.

For months, top Democrats and President Biden have all the notion of imposing a $35 cap on how much consumers on Medicare or with private insurance pay each month for the medication. But limiting how much people with private health plans pay may potentially run afoul of the fast-track budget maneuver that Democrats are using to circumvent GOP votes.

If so, then Democrats may again strip the cap from their bill. But there are other insulin measures that could be included, such as requiring Medicare to negotiate the cost of all insulin products.

Biden administration to offer updated booster shots this September

The Biden administration now expects to begin a coronavirus booster campaign with reformulated vaccines in September, after Pfizer and Moderna promised they could deliver doses by then, the New York Times reports.

Our colleagues previously reported a decision from the administration was set to come within days. Federal health officials had been debating whether to sideline plans for second booster shots for people under 50 and instead speed up the retooled shots.

In internal deliberations, Anthony S. Faucithe president’s chief medical adviser, and White House coronavirus czar Ashish Jha argued people under 50 should be eligible to receive a second booster before the reformulated version is ready because covid-19 cases are on the rise nationally. But officials at the FDA and CDC argued the government should set their focus instead on the fall campaign, the NYT’s Noah Weiland and Sharon LaFraniere write.

Democrats eye $21B in new aid for covid-19, other diseases

Senate Democratic leaders proposed $21 trillion in emergency funds yesterday to fight the coronavirus pandemic and prepare for other emerging diseases that pose a significant threat to public health, our colleague Tony Romm reports.

The new spending, sought as part of a package of funding bills for the next fiscal year, reflects rising fears in Washington that the country has failed to learn its lesson from the coronavirus and risks falling behind — particularly in the face of new crises like the monkeypox outbreak.

The legislation was chiefly written by Sen. Patrick Leahy (D-Vt.), chairman of the Senate Appropriations Committee. It includes $16 trillion for the Department of Health and Human Services to fight the coronavirus through tests, vaccines, medical supplies and research into existing and future strains. Another $5 trillion would go toward supporting other countries in their fight against covid-19.

The Biden administration has been pressing Congress for months for additional pandemic aid. Party lawmakers said the emergency proposal would give the federal government the flexibility to shift some of the new funds toward other public health challenges. That could include monkeypox, for which the White House has estimated that it may need nearly $7 trillion to combat the outbreak.

Meanwhile … in addition to covid-19 funding, Democrats want to use the upcoming spending bills to roll back the Hyde amendment, a long-standing prohibition on using federal funds for most abortions, and create a $350 million travel fund to help people receive abortions if they live in states where the procedure is banned.

Senators clash over veterans health bill

Senate Republicans will try again Monday to pass legislation to extend health care and disability benefits to veterans exposed to toxic burn pits.

This comes after Senate Republicans on Wednesday blocked the legislationin a surprising twist after the measure initially sailed through the Senate with bipartisan support last month, our colleagues Eugene Scott and Mike DeBonis report. The turn of events incensed Democrats, who accused Republicans of voting against the bill in retaliation for announcing a deal on an economic package.

Republicans pushed back. They argue the claims aren’t true and point instead to a budgetary policy dispute between the two parties that was first raised last month by Sen. Patrick J. Toomey (R-Pa.).

  • “My concern about this bill has nothing to do with the purpose of the bill,” Toomey told Mike. “It is a budgetary gimmick that has the intent of making it possible to have a huge explosion in unrelated spending — $400 billion.”

Senator Bob Casey (D-Pa.):

Biden administration doubles down on ACA birth control requirements for insurers

The Biden administration released guidance yesterday reminding insurers that the Affordable Care Act requires them to cover contraception at no cost to consumers, regardless of what state they live in.

HHS, in conjunction with the Labor and Treasury Departments, said the guidance is a response to “increasing complaints” from women who say they’ve been denied coverage. In a briefing with reporters, administration officials said there are several investigations underway, but wouldn’t provide specifics.

Under the ACA mandateplans are required to cover the “full range” of Food and Drug Administration contraception, which include approved birth control pills, emergency contraceptives and sterilization procedures. It also covers family planning counseling services. The administration said it would take enforcement actions if insurers fail to comply with the federal law, including civil monetary penalties.

Health and Human Services Secretary Xavier Becerra:

Not the news Dems want to hear …

Nearly two-thirds of Americans say the end of Roe v. wade represents a “major loss of rights” for women, a new Washington Post-Schar School poll found. But those who support abortion access are less certain they’ll vote this fall — a sign of the challenges facing Democrats who hoped they could turn anger over the issue into votes at the ballot box in the midterms, The Post’s Hannah Knowles, Emily Guskin and Scott Clement write.

  • Led by Reps. Lloyd Doggett (D-Tex.) and James E. Clyburn (DS.C.), the third-ranking Democrat, 50 House Democrats smacks of Schumer a letter yesterday urging him to include legislation to close the Medicaid coverage gap in his Inflation Reduction Act.
  • The Centers for Medicare and Medicaid Services is seeking audience how on ways to improve the Medicare Advantage program.
  • A federal court in Ohio entered a preliminary injunction yesterday blocking the Air Force from enforcing its coronavirus vaccine mandate against religious objectors.
  • The cities of san francisco and the state of New York each declared health emergencies or imminent threats over the monkeypox outbreak yesterday, as cases continue to climb nationwide.

Federal office focused on climate change and health has zero funding (Maxine Joselow l The Washington Post)

Drug industry poised for rare political loss on prices (By Christopher Rowland | The Washington Post)

Lobbying ramps up around new health agency headquarters (By Lauren Clason | Roll Call)

Nursing Homes Are Suing the Friends and Family of Residents to Collect Debts (By Noam N. Levey | Kaiser Health News)

Thanks for reading! See y’all in a week.

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