The Washington PostDemocracy Dies in Darkness

The Health 202: Congressional Democrats are trying to jump-start action on health care

with Alexandra Ellerbeck

Democrats are trying to signal they’re still serious about advancing new health-care policies, even as the White House increasingly sidelines the issue.

Two top congressional Democrats have announced they’ll write a bill to create a government-run, “public option” plan — something President Biden promised on the campaign trail to do but is now expected to leave out of his budget proposal being released tomorrow.

The effort by Rep. Frank Pallone Jr. (D-N.J.) and Sen. Patty Murray (D-Wash.) still faces the same political obstacles to passing a public option plan that were always there: intense industry opposition and Democrats’ narrow majorities in the House and Senate.

But it gives Democrats an easier answer when asked whether they’re working toward their oft-repeated 2020 campaign promises for a new wave of action on improving insurance options and lowering health-care costs in the United States.

“This buys time for a process and is something for leadership and committees to point to on ‘action’ on public option,” a GOP health lobbyist wrote me.

Pallone and Murray are soliciting feedback on how to design a public option plan.

“As we work to craft legislation, our priority is to establish a federally administered public option that provides quality, affordable health coverage throughout the United States,” they wrote in a letter to “all interested parties” released yesterday.

They specifically requested feedback by July 31 on a number of questions, including:

  • Who should be eligible for the public option.
  • Whether the plan should be available to everyone or limited to certain categories of people, such as those eligible for individual marketplace coverage.
  • How Congress should ensure enough medical providers participate in the plan.
  • How to determine prices for health-care items and services, and how to structure the plan’s benefit package.
As expected, the industry pushback started instantly.

Doctors and hospitals hate the idea of a public option plan, because through it the government could insist upon lower payments for medical services. Private insurers dislike it because of the competitive threat posed by a government-backed plan that could offer lower premiums.

The news releases started flooding in, starting with one from industry-funded group called Partnership for America’s Health Care Future, which was formed several years ago to counter growing calls for a single-payer health-care system. 

“A large and growing body of research shows that the public option would come with unaffordable new costs, take coverage choices away from consumers and threaten access to the quality care Americans need,” the group’s executive director, Lauren Crawford Shaver, wrote. 

The American Hospital Association wrote that “we do not support the introduction of a public option plan that could increase the strain covid-19 has placed on our health care system.”

Realistically speaking, industry doesn’t have much to worry about at this very moment.

The move by Murray and Pallone is significant and signals that Democrats are serious about doing a public option after the idea was scuttled during the 2010 debate over the Affordable Care Act.

But the White House has been signaling that it plans on using its political capital for initiatives other than health care this year.

Biden didn't include a measure to lower prescription drug prices one hated by the pharmaceutical industry in his “human infrastructure” spending plan. Similarly, the financial projections in his impending budget request are expected to exclude any mention of drug pricing or public option measures, my colleagues Jeff Stein and Tyler Pager reported.

Jeff Stein, White House reporter for The Post:

Ahh, oof and ouch

AHH: Biden could face a tough choice on elder care if a bipartisan infrastructure deal emerges.

“In multiple rounds of talks, Republican lawmakers have held firm in opposition against key White House plans to address the changing climate, add $400 billion in funding for elder care, and a slew of other domestic priorities the administration is pushing for families and children,” The Post’s Jeff Stein and Tony Romm report. Biden’s jobs and infrastructure proposal called for a major investment in expanded access to home or community-based care covered by Medicaid.

A group of lawmakers led by Sen. Shelley Moore Capito (R-W.Va.) is expected to present a Republican counter-offer to Biden today. Meanwhile, a second bipartisan group is preparing a backup proposal that is also expected to jettison some key climate and elder-care priorities pushed by the White House.

“If centrists in both parties strike a deal, Biden probably would be forced to choose between accepting a compromise that leaves out these proposals, or rejecting a bipartisan infrastructure deal aides have long sought as a political triumph,” Jeff and Tony write. “If they choose to embrace a narrower package, senior Democrats have said they would come back after the bipartisan deal and pass an additional package with the remaining priorities. But concerns have grown among some allies of the White House that doing so will prove difficult in a narrowly divided Congress.”

OOF: Democratic support in Congress for a probe into the coronavirus origins is growing.

“It’s not yet clear what form the congressional inquiry would take, particularly whether the Covid origin question would be part of a broader review of the global crisis and the U.S. response. But the ongoing discussions on Capitol Hill represent a remarkable bipartisan agreement that Congress should investigate the origins of a virus that has killed 3.5 million people worldwide, including nearly 600,000 Americans,” Politico’s Andrew Desiderio and Erin Banco report.

Democrats had previously dismissed theories that the coronavirus could have escaped from a lab in Wuhan, China, but are now giving the hypothesis serious consideration.

White House press secretary Jen Psaki on May 25 said President Biden supported an international independent investigation into the origins of covid-19. (Video: The Washington Post, Photo: Demetrius Freeman/The Washington Post)

“The talks, which center on the Senate’s intelligence and health committees, are likely to ramp up pressure on the White House to address building frustration with its broader China strategy,” Andrew and Erin write. “For the first time, Democrats are open to entertaining their argument that the Biden administration needs to exert diplomatic pressure on Beijing to release data from the Wuhan lab.”

Biden said Wednesday that he has asked intelligence agencies to double down on efforts to investigate the origins of the pandemic.

OUCH: A New York law firm is involved in multiple legal cases against vaccine mandates.

The law firm Siri & Glimstad has done millions of dollars of legal work for the Informed Consent Action Network, a Texas nonprofit group and one of the nation’s foremost anti-vaccination groups. Now they are involved in efforts to combat employer vaccine mandates. The law firm has helped a sheriff’s deputy in North Carolina, nursing home employees in Wisconsin and students at the largest university in New Jersey lodge complaints against vaccine requirements.

“The legal salvos show that a groundswell against compulsory immunization is being coordinated, at least in part, from a law office on Park Avenue in midtown Manhattan. And they offer a window into a wide-ranging and well-resourced effort to contest vaccine requirements in workplaces and other settings critical to the country’s reopening — a dispute with sweeping implications for public health, state authority and individual rights,” The Post’s Isaac Stanley-Becker reports.

At the center of the legal challenges is the fact that the vaccines have been authorized only for emergency use. It's a relatively uncharted area of law, and experts disagree on whether the regulations around emergency use could limit mandates. Even legal experts who think that employers have a strong case say that legal threats could lead some businesses and institutions to forgo mandates. 

Pfizer/BioNTech and Moderna could soon receive full authorization for their vaccines, after which the legal case against employer vaccine requirements could become harder.

Elsewhere in health care

A state-backed health insurance option is nearing approval in Colorado.

The Colorado Senate voted 19 to 16 to advance a standardized health plan on the individual and small-group markets. Originally pitched as “public option” that would have an insurance plan sold by the state government, the latest iteration of the bill adopts a hybrid model, in which private insurers sell a heavily regulated plan.

“The state House has already approved the legislation. But the latest milestone came after rapid-fire negotiations as the sponsors tried to balance the interests of patients, health insurers, hospitals and doctors. A new deal with one side, the doctors, prompted fresh outrage from the insurance companies — but it also may have cemented votes from wavering Democrats,” Colorado Public Radio’s Andrew Kenney reports.

Amendments introduced on Tuesday removed penalties for doctors who refuse to accept the Colorado option — a move that was welcomed by major doctors’ groups in the state. 

New guidelines may allow scientists to grow human embryos past 14 days.

“For decades, scientists around the world have followed the ‘14-day rule,’ which stipulates that they should let human embryos develop in the lab for only up to two weeks after fertilization. The rule — which some countries (though not the United States) have codified into law — was meant to allow researchers to conduct inquiries into the early days of embryonic development, but not without limits,” Stat’s Andrew Joseph reports.

But an influential scientific panel may have opened the door to longer cultivation of embryos. The International Society for Stem Cell Research has said that in certain circumstances it may be permissible if the research meets certain conditions and has a strong scientific rationale. 

Some researchers say that studying embryos longer could shed light on a critical stage of development between 14 and 28 days, a point at which many miscarriages occur, and some congenital abnormalities are thought to form.

Experts say that the original 14-day limit was arbitrary but also served to reassure the public.

“The rule has served a really important function for assuring the public that there are significant limits on scientists, especially around growing early human life forms in the lab,” Josephine Johnston, a bioethicist at the Hastings Center, told STAT.

Sugar rush

Ohio announced the first winners in its vaccine lottery.