The Hill gears up to debate health spending

The Hill gears up to debate health spending

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With Megan. R. Wilson

Driving the Week

 HHS Secretary Xavier Becerra testifies.

HHS Secretary Xavier Becerra heads to the hill this week to defend Biden’s budget proposal. | Kevin Dietsch/Getty Images

PLAYING DEFENSE — HHS Secretary Xavier Becerra will be on the Hill this week defending President Joe Biden’s budget proposal, Daniel writes.

What to watch: The Wednesday hearing with the Senate Finance Committee (and a hearing next week with the House Energy and Commerce Committee) is likely to feature a heavy dose of Republican criticism over the administration’s response to the pandemic, the opioid overdose crisis and a proposed payment model that Republicans believe will stifle innovation. Republicans have also recently criticized what they see as Becerra’s decision to weaken religious freedom protections for some health care professionals.

Why it matters: The imminent attack on Biden’s requests for health spending is part of a bigger battle, with many in the GOP calling for steep cuts in discretionary spending, including to programs Democrats hold dear, like Medicaid.

“President Biden’s reckless spending is forcing Americans to deal with record levels of inflation,” E&C committee leadership said in its announcement about the hearing. “It has made it more difficult to purchase healthy foods, caused greater stresses on families, and driven up health care costs across the board.”

— Dems will get their turn, too. Also on Wednesday, Democrats on the HELP committee will have a chance to go after a favorite boogeyman: the pharmaceutical industry.

Moderna CEO Stéphane Bancel is expected to take a grilling from HELP Chair Bernie Sanders (I-Vt.) on the price of the company’s Covid-19 vaccine. If you want to know how Sanders feels, look no further than the title of the hearing: “Taxpayers Paid Billions For It: So Why Would Moderna Consider Quadrupling the Price of the COVID Vaccine?”

Look for Bancel to make the case that Sanders’ rhetoric jeopardizes future public-private partnerships. He’ll likely argue that drug companies may be less willing to help during future emergencies if their reward is a Congressional tongue-lashing.

— And more is on the way. Sanders plans to target insulin pricing — even as several companies pledged lower prices — in a future hearing.

WELCOME TO MONDAY PULSE — In honor of the new Ted Lasso season, we’ll start this Monday with a shoutout to the Sacramento professional soccer team that has put the “988” hotline on its jerseys, raising awareness about the national suicide and crisis hotline. Send your news and tips to [email protected] and [email protected].

TODAY ON OUR PULSE CHECK PODCAST, host Katherine Ellen Foley talks with Megan Messerly about the states where GOP lawmakers are making a play to head off abortion ballot measures by using bills that make it harder for voters to undo the abortion restrictions that lawmakers put in place after 50 years under Roe v. Wade.

A message from PhRMA:

What’s a pharmacy benefit manager (PBM)? They decide if medicines get covered and what people pay for them, regardless of what your doctor prescribes. These middlemen are putting their profits before your medicines. And getting between you and your doctor. You need to see what’s going on.

At the Agencies

MEANWHILE, HEALTH SPENDING IS SLOWING — While the lawmakers on the Hill duke it out, the Congressional Budget Office said Friday that it overestimated projections for federal health care spending between 2010 and 2020 and costs will likely remain lower than expected for at least another decade, POLITICO’s Ben Leonard reports.

The agency said the government spent less money per beneficiary than CBO had foreseen, to the tune of $1.1 trillion.

Why it matters: Slower growth in spending per beneficiary could help preserve the solvency of Medicare’s trust funds and keep Medicaid costs, already a big part of state budgets, from spiraling. It could also affect how both parties tackle the nation’s debt, which CBO projects to rise as a percentage of the economy because, in large part, of spending on Medicare and Social Security. If Medicare spending growth slows, national debt could be lower than forecasted.

Lobby Watch

A nurse takes a patient's blood pressure.

Action Now Initiative is launching a six-figure ad campaign supporting the Biden administration’s proposed changes to Medicare Advantage payment policy. | David McNew/Getty Images

BREWING BATTLE OVER MEDICARE ADVANTAGE Action Now Initiative, the Arnold Ventures advocacy organization that works on health care reform and other issues, is launching a six-figure digital and TV ad campaign supporting the Biden administration’s proposed changes to Medicare Advantage payment policy, Megan reports.

The ad takes aim at insurance companies, which critics say have overcharged the government when administering MA plans. Last month, the Centers for Medicare and Medicaid Services proposed a slew of changes to how much insurance companies are paid, which could result in a $3 billion cut to the industry.

This rule, the ad says, will “crack down on Medicare Advantage fraud and abuse and protect the benefits seniors are owed,” urging Congress to “protect our seniors and their benefits.”

— But insurance companies, and some provider groups, have pushed back on the proposed payment changes, saying they’ll have a negative impact on care and could harm vulnerable populations. They’ve put millions into their own advertising campaigns, including a prominent spot during the Super Bowl.

Arnold Ventures is also talking to policymakers on Capitol Hill about the issue and their view on the changes’ implications.

Mark Miller, former executive director of the Medicare Payment Advisory Commission now working at Arnold Ventures, told Megan “this is a step” toward putting the Medicare program on stable footing.

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STATES’ ABORTION BALLOT STRATEGIES — Legislatures in several states are debating bills this session that would limit voters’ power to override abortion restrictions Republicans imposed, which took effect after the Supreme Court overturned Roe v. Wade last year, POLITICO’s Alice Miranda Ollstein and Megan Messerly report.

After watching the pro-abortion rights side win all six ballot initiative fights related to abortion in 2022, conservatives are mobilizing to avoid a repeat.

Lawmakers in Arkansas, Florida, Idaho, Missouri, North Dakota, Ohio and Oklahoma are considering bills that would prevent voters from restoring abortion access by popular vote through a series of different mechanisms.

They include hiking filing fees, raising the number of signatures required to get on the ballot, restricting who can collect signatures, mandating broader geographic distribution of signatures and raising the vote threshold to pass an amendment from a majority to a supermajority.

Why it matters: Many abortion-rights advocates see citizen-led ballot measures as their best chance at restoring access in conservative-controlled states. Meanwhile, this latest legislative push comes as the nation awaits a ruling from a federal judge in Texas, which could take the abortion pill mifepristone off the market, dramatically narrowing access to abortion across the country.

A message from PhRMA:

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Global Health

THE LONG ARM OF WAR — Last August, Biden signed the PACT Act, increasing VA coverage for troops exposed to toxic smoke from burn pits, which the U.S. military routinely used for decades to get rid of waste at bases in Iraq and other countries.

Americans, of course, weren’t the only ones exposed.

In Iraq, residents near burn pits were also sick and dying, but the U.S. government hasn’t assessed the burn pits’ impact there or treated or compensated Iraqis who fell ill as a result of them, The Washington Post reported over the weekend.

At the largest U.S. base in the country, a burn pit where “batteries, human waste, plastic ration packs, even refrigerators” were incinerated stretched 10 acres, at times burning 150 tons of waste a day.

Names in the News

America’s Health Insurance Plans has hired Sean Dickson, formerly of West Health Policy Center, as its senior vice president of pharmaceutical policy and strategy.

STEP INSIDE THE WEST WING: What’s really happening in West Wing offices? Find out who’s up, who’s down, and who really has the president’s ear in our West Wing Playbook newsletter, the insider’s guide to the Biden White House and Cabinet. For buzzy nuggets and details that you won’t find anywhere else, subscribe today.

What We're Reading

In the third installment of its series on obesity, STAT reports on the controversy over the American Academy of Pediatrics’s January guidance for treating obesity in children.

ProPublica reports on the Georgia county that spent $1 million to avoid covering costs for one employee’s gender-affirming care.

Josh Rogin argues in The Washington Post that U.S. companies must stop supporting DNA collection in Tibet.

Mother Jones reports on how a hospital in Sarasota became the target of a wide array of right-wing groups.

A message from PhRMA:

Insurers and their PBMs don’t want you to see that you could be paying more than they are for your medicines. Rebates and discounts can significantly lower what insurers and PBMs pay for medicines. These savings can reduce the cost of some brand medicines by 50% or more. But insurers and PBMs aren’t required to share those savings with you at the pharmacy counter.

They don’t want you to see that they use deductibles, coinsurance and other tactics to shift more costs on to you. Or that the three largest PBMs control 80% of the prescription drug market. Or that last year they blocked access to more than 1,150 medicines, including medicines that could have lowered costs for you at the pharmacy. 

PBMs and insurance practices are shrouded in secrecy,  they need to be held accountable.  

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