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Inside Congress’ health care policy breakdown
Lawmakers are headed toward passage of a stopgap spending bill that funds the same health programs as the last one — but things were almost different, I scooped last night.
Republicans and Democrats swapped offers on policies, including a monthslong renewal of pandemic-era bumps to doctors’ Medicare payments, a couple behavioral health programs, and increasing funding for community health centers, but the talks ultimately broke down late last week.
This breakdown isn’t the end, but does offer some signals about how more substantive negotiations could go in the weeks ahead. Get the full report here.
Biden’s coverage crackdown
The Biden administration took action yesterday to make insurers give specific reasons for coverage denials and speed up pre-approvals for health care services, my colleague Brittany Trang reports.
The new rule is wide-reaching, and applies to Medicare, Medicaid, CHIP, and Obamacare plans. Several provider groups lauded the rule. But faster prior authorization decisions aren’t always better, she explains in the full story.
Drug copay coupons count
The Biden administration has stopped defending a Trump-era rule that tried to lower drug prices at the expense of patients’ pocketbooks, my colleague John Wilkerson reports.
At issue is the copay accumulator, a head-scratching term that describes the insurance industry practice of collecting money that drug companies give patients to help them afford drugs but not counting that financial assistance toward those patients’ deductibles and spending caps.
The Trump administration instituted the rule. Patients sued over it and won. The Biden administration initially appealed that court ruling, but on Tuesday dropped its appeal. Now insurers will have to count copay coupons toward patient cost sharing obligations, as long as the financial assistance is for drugs without generic competition. More from John here.
Dems try for Roe reckoning
Senate Democrats on Wednesday hosted abortion rights advocates and doctors for a nearly three-hour discussion on the patchwork of state abortion laws in the wake of Roe’s overturn, my co-author Sarah Owermohle reports.
The briefing comes amid a broader Democratic push to put the issue front-and-center on Roe’s anniversary next week and ahead of the 2024 presidential elections. Vice President Kamala Harris hits the road this Monday for a “Reproductive Freedoms Tour,” while HHS Sec. Xavier Becerra hosted lawmakers at HHS Wednesday as part of a just-launched reproductive health series.
Even with safe-haven states enshrining abortion rights, health systems’ staff and resources can’t keep up, nor can the lowest-income and most vulnerable people make those trips, said Planned Parenthood D.C.’s chief medical officer Selina Floyd. Austin Dennard, an OB/GYN in Texas, detailed her own trip out of state to receive an abortion in 2022 after her fetus was diagnosed with fatal anencephaly. Dennard has since joined a lawsuit against the state’s ban.
“I remember thinking, ‘what do you pack when you’re traveling for an abortion?’ I can’t believe I’m even having to ask this question,” she said in tears Wednesday.
What we’re reading
- More patients are getting their meds online. Pharma wants in on the action, STAT
- Majority of debtors to US hospitals now people with health insurance, The Guardian
- Pumping breastmilk in bathrooms is a common, albeit unspoken, practice at health care conferences, STAT
- Republican governors in 15 states reject summer food money for kids, Washington Post