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Medicare fund buys time with pandemic and inflation

Presented by PhRMA: Delivered daily by 10 a.m., Pulse examines the latest news in health care politics and policy.
Jun 03, 2022 View in browser
 
POLITICO's Pulse newsletter logo

By Sarah Owermohle and Krista Mahr

Presented by

PhRMA

With help from Ben Leonard

Editor's Note: POLITICO Pulse is a free version of POLITICO Pro Health Care's morning newsletter, which is delivered to our subscribers each morning at 6 a.m. The POLITICO Pro platform combines the news you need with tools you can use to take action on the day's biggest stories.  Act on the news with POLITICO Pro.

QUICK FIX

— Medicare's trust is projected to last until 2028, reflecting economic trends that nevertheless don't relieve pressure on dwindling funds.

— Grappling with the latest mass shooting, health workers amplify calls for gun control.

— The youngest kids could get Covid shots this month as the administration preps to review Pfizer and BioNTech's submission.

WELCOME TO FRIDAY PULSE — Another pandemic bailout that didn't need to happen. Send news and tips to sowermohle@politico.com and kmahr@politico.com

 

A message from PhRMA:

New data show that 35% of insured Americans spent more on out-of-pocket costs than they could afford in the past month. Read more about how insurance is leaving patients exposed to deepening inequities.

 
Driving the Day

Two people walk inside a Medicare Services office.

Medicare is solvent until 2028 because of current economic trends, trustees project. | Spencer Platt/Getty Images

MEDICARE'S TRUST HAS A LITTLE MORE TIME — Medicare appears to be solvent until at least 2028, according to a report released Thursday by the U.S. Treasury Department that extends its projected fiscal cliff by two years.

Covid-19 was net neutral? Medicare's board of trustees, who estimate program costs and peoples' use of various medical devices annually, said the Covid-19 pandemic isn't expected to have a long-term impact on cost projections, though they admitted that much uncertainty still remains around the virus.

While Covid-19 treatment increased some costs, they were offset by an overall drop in other health services as people stayed home and delayed other care, a senior administration official told reporters on a Thursday call. The expectation is that coronavirus treatments will become part of Medicare's standard of care and not add-on payments, the official added.

The same official nodded to the possibility that long Covid could drive up costs in the future but said they haven't seen data to that effect yet.

But some uncertainty exists. The trustees set their assumptions for the report in February. Officials acknowledged in a call with reporters that some data points, such as inflation and its impact on the cost of living, may have since shifted. In particular, CMS in April released a restrictive national coverage determination for Aduhelm, a pricey new Alzheimer's medicine, and said on Friday that expected premium cuts would not happen this year.

The reactions roll in. "This is encouraging news," said Rep. Lloyd Doggett (D-Texas), chair of the Ways and Means Health Subcommittee, in a statement. He added that to "extend the solvency," Congress should pass his legislation that would close loopholes for Medicare tax contributions.

Others were less convinced by the two-year extension. "The Medicare Trustees are warning us that Medicare remains on the brink of insolvency within the next 6 years," House Energy and Commerce Committee ranking member Cathy McMorris Rodgers (R-Wash.) and Health Subcommittee ranking member Brett Guthrie (R-Ky.) said in a joint statement.

Medicare beneficiaries are already being hurt by "historic Part B premium increases," they added, in a nod to last week's news that premiums wouldn't drop this year after a bump to account for Aduhelm.

HEALTH GROUPS RALLY FOR GUN CONTROL AFTER TULSA — The latest mass shooting hit Tulsa, Okla., on Wednesday, with local police reporting that the man who killed four people — including his surgeon — at a local medical center was motivated by disappointment with a recent back surgery.

The Tulsa tragedy comes within a week of the Uvalde, Texas, shooting that killed 19 children and two teachers and the Buffalo supermarket shooting a week prior.

Provider groups are speaking out, again. Gun violence is "out of control in the United States, and, without real-world, common-sense federal actions, it will not abate," American Medical Association President Gerald Harmon said in a statement. Harmon endorsed the Protecting Our Kids Act, debated by the House Judiciary Committee in a hearing Thursday.

The American Hospital Association and Federation of American Hospitals also issued statements calling on Congress to pass bipartisan legislation targeting gun violence. "Enough is enough," said FAH President and CEO Chip Kahn. "Hospitals are pillars of our communities — the places people rush to when they need help; they shouldn't be crime scenes."

The National Medical Association mourned Preston Phillips, the surgeon killed in the violence. "The grief we feel over his loss is overwhelming," NMA President Rachel Villanueva said in a statement. "There is not enough time in between tragedies to complete the stages of grief before we are hurtled back to denial. But we, as a society, cannot resign to this endless cycle of grief and violence. Gun violence can be prevented. Military-grade weapons have no place on the streets. Individuals under the age of 21 should not be allowed to buy weapons. Requiring background checks and eliminating ghost guns are the very least we could do."

SET YOUR CLOCKS: KID VACCINES THIS MONTH — Covid-19 vaccinations for the nation's youngest children could begin as early as June 21, Ashish Jha, the White House's Covid-19 response coordinator, said Thursday.

States can start ordering children's vaccines today, Jha said during a White House press briefing, but orders won't ship until the Food and Drug Administration authorizes the shots for kids between 6 months and 5 years old.

The FDA's vaccine advisory committee is set to discuss Pfizer's and Moderna's applications — which both call for a smaller dose than adults receive — in two weeks, POLITICO's Carmen Paun writes. That'll be followed by a CDC meeting to recommend the shot.

The federal government will make 10 million vaccine doses of both Pfizer and Moderna available to states.

"It's been a long two years," Jha said. "This is the last group of Americans who have not yet been eligible to get a vaccine, too."

 

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In Congress

Rep. Sara Jacobs (D-Calif.) on Capitol Hill July 31, 2021.

Rep. Sara Jacob's proposed bill would protect data shared on reproductive health apps. | Francis Chung/E&E News

'MY BODY, MY DATA' — Rep. Sara Jacobs (D-Calif.) introduced legislation Wednesday aimed at protecting the privacy of data that could be used to target people having abortions, Ben reports.

The My Body, My Data Act — backed by Planned Parenthood and NARAL Pro-Choice America — would enlist the FTC to enforce regulations limiting reproductive health data collection to "only what is needed to deliver a product or service." It would also include a private right of action, allowing individuals to file lawsuits against violators. A non-preemption clause in the legislation would allow states to go further to protect data.

Privacy organizations, legal groups and abortion rights advocates fear state law enforcement could use digital footprints to target people seeking abortions in a post-Roe nation.

"It's unconscionable that information could be turned over to the government or sold to the highest bidder and weaponized against us," Jacobs said in a release.

 

DON'T MISS DIGITAL FUTURE DAILY - OUR TECHNOLOGY NEWSLETTER, RE-IMAGINED:  Technology is always evolving, and our new tech-obsessed newsletter is too! Digital Future Daily unlocks the most important stories determining the future of technology, from Washington to Silicon Valley and innovation power centers around the world. Readers get an in-depth look at how the next wave of tech will reshape civic and political life, including activism, fundraising, lobbying and legislating. Go inside the minds of the biggest tech players, policymakers and regulators to learn how their decisions affect our lives. Don't miss out, subscribe today.

 
 
Around the Nation

NY LAWMAKER LAUNCHED ABORTION PILL BILL — New York City Council Member Carlina Rivera introduced legislation Thursday that would guarantee access to medication abortion, POLITICO NY's Amanda Eisenberg reports.

The bill, Intro. 507, would require every city-run health care site to offer mifepristone and misoprostol at no cost. The pill is usually given to people who are up to 12 weeks pregnant, though the legislation specifies New Yorkers could receive it for free up to 11 weeks and with informed patient consent.

Questions abound: Rivera's office couldn't answer several questions about the bill, including how much the initiative would cost, which agency would be tasked with buying the pills and what contingency plan is in place if it can't obtain them if Roe v. Wade is overturned. Her team also didn't know how many medication abortions could be expected in a given year and whether the city would have a stockpile of the drugs on hand.

Names in the News

— Humana has retained Adam Buckalew to lobby on health care payment policy "including Medicare Advantage, Medicare Part D and other payer policy matters," POLITICO Influence first reported. The former congressional staffer, who worked for former Senate HELP Chair Lamar Alexander and former House Energy and Commerce Chair Greg Walden, helped craft surprise billing legislation.

Buckalew's other clients include Blue Cross Blue Shield Association, Anthem, CVS Health, Novavax and Boehringer Ingelheim.

— Kate Meyer joins Waxman Strategies as a director in the health policy practice. Meyer, whose experience includes working with Girls Gotta Run Foundation, the National Council for Mental Wellbeing, the EMAA Project and Planned Parenthood, will focus on drug pricing, health coverage and equity at Waxman.

— Tom Inglesby is leaving the White House Covid-19 response team , where he served as a senior adviser on coronavirus tests and treatments. Inglesby, director of the Johns Hopkins Center for Health Security at the Bloomberg School of Public Health, will be replaced by Thomas Tsai. 

Tsai is a surgeon and health policy researcher at Brigham and Women's Hospital and Harvard T.H. Chan School of Public Health.

 

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

Florida Gov. Ron DeSantis on Thursday killed a plan crafted by Republican state lawmakers to punish schools that defied loosened pandemic rules and required masks in schools, breaking from his earlier pandemic approach, writesPOLITICO Florida's Andrew Atterbury.

Nearly 70 percent of Covid-19 deaths in the U.S. have been among adults in low socioeconomic positions largely working in labor, service and retail jobs, according to a new study by the University of South Florida, covered by WJLA's Sam Sachs.

Monkeypox's quiet spread beyond endemic areas exposes gaps in our understanding of the virus, virologists tell CNN's Jacqueline Howard and Michael Nedelman.

 

A message from PhRMA:

According to data just released, insurance isn't working for too many patients. Despite paying premiums each month, Americans continue to face insurmountable affordability and access issues:

  • Roughly half (49%) of insured patients who take prescription medicines report facing insurance barriers like prior authorization and "fail first" when trying to access their medicines.
  • More than a third (35%) of insured Americans report spending more in out-of-pocket costs in the last 30 days than they could afford.
Americans need better coverage that puts patients first. Read more in PhRMA's latest Patient Experience Survey.

 
 

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