Sanders’ provider plan

May 17, 2023

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By Megan R. Wilson and Daniel Payne

Presented by

With Alice Miranda Ollstein, Megan Messerly, Erin Schumaker and Daniel Lippman

Driving The Day

Senate HELP Chair Sen. Bernie Sanders, ranking member Sen. Bill Cassidy and Sen. Rand Paul listen during a committee hearing.

HELP chair Bernie Sanders (r.), pictured here with committee member Sen. Rand Paul (l.) and ranking member John Cassidy, is proposing a nearly $200 billion health package. | Carolyn Kaster/AP Photo

SANDERS GOES BIG IN NEW HEALTH PACKAGE — Senate HELP Committee Chair Bernie Sanders (I-Vt.) has a new plan for health care — but the nearly $200 billion price tag is scaring off Republicans.

Sanders told Daniel and our Burgess Everett about a package he’s proposing that would, over five years, provide $130 billion for community health centers and $60 billion to help expand the workforce. Within the workforce funding, $15 billion would be for graduate medical education programs, with an emphasis on boosting primary care access.

It’s among the first major packages Sanders has proposed as leader of the Senate Health, Education, Labor and Pensions Committee — and shows he’s trying to walk a line between remaining faithful to his progressive ideas and guiding legislation to a bipartisan consensus to pass.

“This is an issue where the American people desperately want us to act,” Sanders said in an interview. “I think there is support across the political spectrum, and I intend to do everything that I can to substantially increase the healthcare workforce.”

Partisan problems: The panel has been discussing those issues for months, and there is some indication that Democrats and Republicans are working on bipartisan legislation.

Senate HELP ranking member Bill Cassidy ","url":"https://directory.politicopro.com/member/66858","personId":"66858","linkText":"Bill Cassidy","link":{"target":"NEW","attributes":[{"name":"data-person-id","value":"66858","_id":"00000188-2a03-dc13-a5fc-2b57fb6b0000","_type":"f601356c-0e4b-3847-a646-21bd958d59ca"}],"url":"https://directory.politicopro.com/member/66858","_id":"00000188-2a03-dc13-a5fc-2b57fb6b0001","_type":"33ac701a-72c1-316a-a3a5-13918cf384df"},"_id":"00000188-27a2-d79a-af9d-77ab14d70000","_type":"353fe80b-e1b5-3663-85ca-add066ecafc0"}">Bill Cassidy (R-La.) told POLITICO in a statement that their teams have worked toward “a reasonable solution” but implied that Sanders’ plan is a departure from what had been discussed.

“This proposal to increase funding for health centers by 550 percent at a time when Congress is deadlocked trying to negotiate spending and a debt ceiling increase is not setting up a path for success for legislation that can pass the Senate with 60 votes, and make it through the House to be signed into law,” he said. “Let’s just be realistic.”

What’s at stake: Community health center funding would end in September should Congress fail to reauthorize the program.

But discussions about increasing funding — and boosting the health workforce — come amid historic challenges, largely connected to the Covid-19 pandemic, on both fronts.

WELCOME TO WEDNESDAY PULSE. It’s Megan Wilson, the POLITICO health team’s lobbying reporter filling in this morning. I’m happy to help, but you must know I work for tips: mwilson@politico.com. And don’t forget Daniel Payne, who runs the ship: dpayne@politico.com.

TODAY ON OUR PULSE CHECK PODCAST, host Carmen Paun talks with Megan Messerly, who reports on the division among Democrats over whether minors should be able to have abortions without telling their parents, which some lawmakers see as a political liability, particularly as conservatives push “parents’ rights” to win popular support in other areas.

Listen to today’s Pulse Check podcast

A message from PhRMA:

Pharmacy benefit managers (PBMs) decide if medicines get covered and what you pay, regardless of what your doctor prescribes. They say they want lower prices, yet they often deny or limit coverage of lower-cost generics and biosimilars, instead covering medicines with higher prices so they make more money. What else are they hiding?

Abortion

Abortion rights protesters are removed from the North Carolina state capital.

Abortion rights protesters are removed from the North Carolina State Capitol after House members voted to override Gov. Roy Cooper's veto of an abortion bill. | Chris Seward/AP Photo

NC OVERRIDES ABORTION VETO — North Carolina’s GOP supermajority legislature voted Tuesday to override Democratic Gov. Roy Cooper’s veto and ban abortion after 12 weeks of pregnancy, Megan Messerly reports — handing a significant victory to Republican legislative leaders.

The override needed the unanimous support of GOP lawmakers to override Cooper’s veto — the governor spent the last week traveling across the state hoping to persuade at least one Republican to oppose the override.

“This is compromise legislation — a sentiment that has been shared with me by Republicans, independent voters and whispered to me by moderate Democrats,” Republican North Carolina state Sen. Vickie Sawyer said on the Senate floor shortly before the vote.

North Carolina was the last state south of Virginia and east of New Mexico that hadn’t implemented or passed new abortion restrictions since the Supreme Court overturned Roe v. Wade last June.

Ninety-three percent of abortions are performed during the first trimester, according to the CDC — meaning the procedure will remain accessible in most circumstances when the new law takes effect on July 1. The bill also contains exceptions for rape and incest, fatal fetal abnormalities and to save the life of the pregnant person.

THE ABORTION RESTRICTION MOST PARENTS LOVE — While Democratic-controlled legislatures have moved to make their states havens for abortion access in the post-Roe era, Megan Messerly and Alice report that Democratic lawmakers appear to be wary of altering one policy: parental notification.

Some Democrats see repealing state laws requiring children and teenagers to tell their parents before getting an abortion as a political liability, with national polling showing overwhelming support for keeping parental involvement laws in place.

“Broadly, every person in our caucus is pro-reproductive freedom. It’s always when you get into the details that things become negotiable,” Minnesota state Sen. Erin Maye Quade told Megan.

Their reluctance is frustrating some progressive lawmakers and abortion-rights groups. Even progressive states like Colorado, Maryland and Massachusetts have laws that require either parental permission or notification.

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At the Agencies

GAO: HEALTH WORKER NONCOMPETES ABOUND — Fifty-seven percent of health care and social assistance employers surveyed by the Government Accountability Office reported requiring new hires to sign agreements that restrict the workers from taking jobs with rivals, Erin reports.

“This report underscores how non-compete agreements suppress wages, particularly for low-income workers, and hinder our economic growth,” Tim Kaine (D-Va.), one of a bipartisan group of senators who requested the GAO investigation, said in a statement.

The Federal Trade Commission is also paying attention: The agency proposed a rule in January to ban noncompete agreements.

A message from PhRMA:

Lobby Watch

PHYSICIAN-OWNED HOSPITALS FLY-IN — Members of the Physician-Led Healthcare for America, an industry group representing doctor-owned hospitals, have flown into Washington to meet with lawmakers.

They’ve got nearly two dozen meetings on Capitol Hill today, including with Reps. Brendan Boyle (D-Pa.), Kevin Hern (R-Okla.) and John Joyce (R-Pa.) and Sen. Roger Marshall (R-Kan.).

The group is trying to drum up support from policymakers for a bipartisan measure that would repeal a provision stemming from the Affordable Care Act, which bans new physician-owned hospitals. Reps. Larry Bucshon (R-Ind.) and Henry Cuellar (D-Texas), with whom the group is also meeting, are key sponsors of the House version.

HEALTH TECH GROUP WINDING DOWN — Executives for Health Innovation, an advocacy group that promotes the adoption of health technology, is winding down after two decades, the organization said Tuesday.

CEO Jen Covich Bordenick said in a statement that the group and its members “created a new reality in healthcare” since its creation — adding they had helped usher in e-prescribing and the use of electronic health records and telehealth platforms.

Formerly known as the eHealth Initiative, its membership includes CVS Health, Fitbit, the American Heart Association, the Mayo Clinic and the American Academy of Family Physicians.

The organization said its board is forming “a committee to distribute EHI’s current assets to other nonprofits that align with its mission.”

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On the Move

Nahid Bhadelia has returned to Boston University, where she leads the Center for Emerging Infectious Diseases Policy and Research. She was formerly senior policy adviser for the White House Covid-19 response team.

What We're Reading

POLITICO New York’s Maya Kaufman writes about how Mount Sinai Hospital was hit with an unprecedented six-figure penalty for a “persistent pattern” of understaffing its neonatal intensive care unit.

Top Republicans on the House Energy and Commerce Committee wrote to Cigna’s CEO, asking the insurance giant to explain its use of an automated system to deny medical claims without reading them — a process outlined in a story from ProPublica that Cigna called “biased and incomplete.”

Reuters analyzes the circumstances around bat-borne viruses to better predict future outbreaks.

A message from PhRMA:

Middlemen say they want lower prices, yet they often deny or limit coverage of lower-cost generics and biosimilars while giving preferential coverage to medicines with higher prices. This might be good for PBM’s bottom line, but it can lead to higher costs for patients. What else are they hiding?