Medicare eligibility is tripping up the GOP presidential candidates

You’re reading the web edition of D.C. Diagnosis, STAT’s twice-weekly newsletter about the politics and policy of health and medicine. Sign up here to receive it in your inbox on Tuesdays and Thursdays.

And then there were five (well, six)

A pared-back field of five GOP presidential candidates sparred Wednesday night, touching on health issues ranging from hot-button election topics, to wonky budget math. My co-author Sarah Owermohle and I bring you the three big ideas on health care.

advertisement

  • Medicare solvency: Candidates split on whether they would tighten eligibility requirements. Former President Trump’s stance is that the GOP shouldn’t cut entitlements
  • Abortion: Following electoral losses this week, candidates again reiterated their variety of stances on abortion politics, and whether decisions should be made at the state or national level
  • Fentanyl: While most candidates continued to frame the country’s opioid crisis as a border security issue, more compassionate rhetoric emerged from some candidates about treating addiction as a disease

The next frontier for surprise billing reform

Congress protected patients from a lot of medical bills when lawmakers passed surprise billing reform in 2020, but they kicked the can down the road in one big arena: ground ambulances.

The commission that lawmakers created because they couldn’t agree on an actual policy finally has agreed on some policy recommendations for future action, including limiting patients’ out-of-pocket costs to $100 for an emergency ambulance ride.

My colleagues Bob Herman and Tara Bannow break down the proposals in a collaboration with the awesome health policy podcast Tradeoffs. Give it a read and a listen.

advertisement

Panel passes precisely portioned PBM package

The Senate Finance Committee proceeded like a well-oiled machine on Wednesday when it approved its package of Medicare and Medicaid extenders paired with some new patient cost-sharing regulations for prescription drugs and measures to protect pharmacies.

Other than Sen. Ron Johnson (R-Wis.), every member of the panel voted to advance the package in a markup that lasted less than two hours and saw no amendments added. The package was neatly offset, making it an easy add to a government funding measure down the road. A couple modest behavioral health measures made the cut, too.

Here’s a rundown of all the action.

How do you solve a problem like paying for Ozempic?

With Novo Nordisk’s Wegovy and Ozempic making massive profits and a new FDA approval for Eli Lilly’s Zepbound to treat obesity yesterday, everyone in Washington is scratching their heads as to how the health care system is going to pay for it all.

Sen. Bill Cassidy (R-La.) decried the idea of negotiating the drugs’ prices at the Milken Future of Health Summit, and instead suggested that the government should research ways to get people off of the drugs eventually, like healthy meal deliveries, my colleague Sarah Owermohle reports.

As the debate over the drug’s cost-effectiveness rages, we’re sure there will be no shortage of creative ideas about how to pay for them. If you’re working on something, we’d love to hear about it.

Help wanted: White House edition

The White House is rolling out a new program today calling on companies to hire, train and retain people in recovery from addiction amid the opioid crisis, my colleague Lev Facher reports.

The White House can’t do much of the implementation itself, so the program includes a toolkit for employers and touts a model state law to create incentives for hiring people in recovery and even get certifications as “recovery-friendly” workplaces.

What we’re reading

  • Pulse oximeters’ inaccuracies in darker-skinned people require urgent action, AGs tell FDA, STAT
  • How Ozempic maker Novo Nordisk’s very Danish capitalism fueled its success, and its stumbles, Wall Street Journal
  • FDA’s Woodcock, other experts highlight persistent issues plaguing pharma, biotech in the wake of Covid-19, STAT
  • Big Insurance met its match when it turned down a top trial lawyer’s request for cancer treatment, ProPublica