with Alexandra Ellerbeck

Senate Democrats are exploring ways to send seniors vouchers worth hundreds of dollars to quickly afford hearing, vision and dental services.

It would be a stopgap way to get the new benefits to seniors quickly while the potential new piece of Medicare is being implemented.

The notion of vouchers, which is still very much in flux, underscores the challenges Democrats face in giving Americans tangible new benefits from President Biden's massive social spending bill — particularly before the midterms. As I reported last week with my colleague Jeff Stein, federal health officials estimate it could take three to five years to formally stand up a new dental benefit which Democrats are seeking to include in the $3.5 trillion bill.

These new benefits are complicated and take time to implement, and there's enormous political pressure to get help to people quickly, especially with the midterm elections coming up, Larry Levitt, executive vice president at nonpartisan group the Kaiser Family Foundation, told Jeff.

First, Democrats would need to pass the social spending bill. 

Assuming that happens, Senate Democrats are toying with the idea of then sending some form of financial help for hearing, vision and dental services to Medicare enrollees, four people with knowledge of the situation tell Jeff and me. Discussions range from roughly $600 to $1,000, though sources cautioned details are still very much in flux.

But vouchers are a markedly different approach than a key House committee took yesterday, showcasing a split between the two chambers on a critical plank of the Democrats’ health agenda. 

Here’s the latest on that effort. 

The Senate is hashing out an interim way of providing seniors with financial assistance while the permanent programs are set up. Sources stress negotiations are still underway, but the stopgap measure may come in the form of a debit card or a program similar to a voucher. The amount of cash sent per year hasn’t yet been finalized, sources tell Jeff and me. 

A Senate Democratic aide said there’s a recognition that seniors are in need of overdue care, so it’s important to have access to services as soon as possible.   

Kaiser Family Foundation

The House Ways and Means Committee released its Medicare expansion bill yesterday — and it doesn’t include a mechanism to give all three benefits to millions of seniors next year. Instead, the legislation starts vision coverage in 2022, then hearing in 2023 and phases in dental care beginning in 2028. 

  • The House panel released the text without sign-off from Senate Democrats, according to a person close to negotiations. It also didn't have approval from the White House, per another person familiar. 
  • A Ways and Means Committee aide said Chairman Richard Neal (D-Mass.) plans to “advance this language while continuing to coordinate with the White House and counterparts in the Senate.”

Per Jeff

Meanwhile, the White House is aiming to shorten projections from federal health officials that it could take years to stand up the program, we reported last week, though officials haven’t commented specifically on the temporary measure. 

“Ways & Means is doing strong and valuable work, but this is one of many elements of a large process and negotiations are ongoing,” a source familiar with the White House’s thinking told Jeff.

Some advocates — such as Melissa Burroughs, of the consumer group Families USA — are pushing congressional negotiators to strengthen the benefits the new dental program would provide. For instance, the current House bill covers only half the cost of major services, such as bridges, crowns and root canals.

Vox's Dylan Scott

It all comes down to money. 

Congressional leaders are wrestling with how much to spend on each new health program, many of which likely come with high price tags, such as extending Medicaid to 2.2 million poor adults or boosting in-home care for seniors. And giving out cash before new Medicare benefits are permanent costs. 

"It's expensive, and there's already a lot of competition for scarce dollars,” according to one senior Democratic aide.

This comes as uncertainty swirls around the negotiations, with any Senate Democrat having the power to tank the package the party aims to pass without any GOP votes. Sen. Joe Manchin (D-W.Va.) has privately warned the Biden administration and congressional leaders that he may back as little as $1 trillion of the plan, Axios scooped last night. 

And shelling out federal help may not be easy. 

Congress has approved trillions of dollars of new spending over the course of the pandemic that were hard to disburse or remain unspent due to bureaucratic hurdles. Some advocates close to senior Democrats are pushing them to use the covid stimulus checks — sent twice under President Trump and once under Biden — as a template for sending Medicare benefits to seniors, Jeff writes. 

  • Alex Lawson, executive director of the liberal group Social Security Works, said he is arguing that lawmakers follow the example of the relief checks, which the Internal Revenue Service distributed to tens of millions of Americans in a matter of weeks.

Ahh, oof and ouch

AHH: Three-quarters of adults in the United States have gotten at least one coronavirus vaccine.

As the country headed into Labor Day, 74.9 percent of people 18 and older had received at least their first shot, according to data from The Washington Post. The White House announced Tuesday that an additional 1.5 million doses were administered over the holiday weekend, pushing the share of adults at least partially vaccinated to 75 percent.

“The figure marks a milestone in the country’s efforts to stop the spread of the virus and its highly infectious delta variant, which has caused infections to surge nationwide, but it masks some broad disparities in state vaccination rates,” The Post’s Derek Hawkins reports.

Northeastern states lead the country in vaccination rates, while many Southern states lag behind. In Massachusetts, over 75 percent of the adult population is fully vaccinated. In Alabama, less than half of adults are fully vaccinated.

Still, the pace of vaccinations appears to be increasing, spurred by fears of the delta variant. More than 900,000 shots were administered a day on average last week, up from a low of about half a million shots a day in mid-July. Polling from The Post and ABC News finds younger Republicans and Republican-leaning independents have become more willing to get vaccinated since this spring.

OOF: Biden will outline a plan to stop the spread of the delta variant.

Biden will give a speech Thursday outlining the next phase of his administration’s response as the nation continues to grapple with a surge in cases driven by the more transmissible delta variant. 

“As he has said since Day One, his administration will pull every lever to get the pandemic under control,” White House press secretary Jen Psaki said Monday aboard Air Force One. “And on Thursday, he will lay out a six-prong strategy that will help us to do just that.”

“The number of covid-19 patients in U.S. hospitals this Labor Day was nearly twice the number recorded last Labor Day. And the rise in covid-19 hospitalizations is straining medical resources in many states,” The Post’s Eugene Scott reports.

OUCH: Booster shots can generate confusion.

“Booster confusion appears to have reached epidemic proportions amid a flood of new scientific studies that are not always consistent with one another,” The Post’s Joel Achenbach writes. “ 'Fully vaccinated’ is suddenly a squishy concept. People who felt relatively bulletproof after two shots have been forced to rethink what’s safe, what’s risky and whether they’re truly protected from the coronavirus.”

The Biden administration wants to roll out booster shots Sept. 20. Some experts say that’s too soon, and the additional shots are unnecessary. Others say it’s not soon enough. There's confusion over whether boosters should even be called boosters, or if they should be considered part of the initial vaccination series. 

Amid the confusion, some patients are charting their own path. “People are just doing what they want,” Kavita Patel, a primary care physician at Mary’s Center in the Washington area, told The Post. “I know of patients who have gotten a booster four months after their second dose.”

Drug pricing

First in The Health 202: Nearly 400 investors and leaders of small biotechnology companies, as well as patients and researchers, are laying out their case against drug price negotiation. The group — which says it collectively invests roughly $17 billion per year on trying to find breakthrough drugs — argued that such policies would “immediately halt private funding of drug discovery and development” in a letter sent Wednesday to congressional leaders, Biden and HHS Secretary Xavier Becerra. Instead, they’re pitching a different idea: Making all drugs go generic “without undue delay.” 

Get ready for the drug price jockeying to intensify. 

The letter comes as the Senate Finance Committee chairman is in the midst of hammering out his companion to the House’s drug price negotiation bill. The legislation’s savings are key to helping pay for Democrats’ $3.5 trillion economic package.

More in coronavirus news

  • Surgeon General Vivek H. Murthy told Politico's Joanne Kenen that success with covid “does not equal no cases.” Instead, he makes the case that success will be achieved when there are very few people hospitalized or dying from the disease. He added that vaccinated people may be overestimating their risk from the delta variant.
  • Idaho has started to ration health care amid a surge in covid hospitalizations, The Post’s Derek Hawkins reports
  • Pressure is increasing on the FDA to quickly authorize vaccines for kids, but the regulators want more safety data. Health officials say it may be late fall or winter before vaccines are approved for 5- to 11-year-olds, Politico’s Lauren Gardner reports.
  • The Post takes a deep-dive into the history of China’s high-security lab at the Wuhan Institute of Virology, which has found itself at the center of controversy over the origins of the coronavirus pandemic and bereft of international collaboration.

Environment and health

Medical journals call for action on climate change.

More than 200 medical journals are carrying an editorial warning that a 1.5-degree-Celsius rise in global temperatures is the “greatest threat to global public health.” It’s the first time publication of an editorial has run at this scale, the New York Times reports.

The editorial cites a 50 percent increase in heat-related mortality among the elderly over the past 20 years and a series of global health harms that climate change will exacerbate, including the spread of tropical infections, pregnancy complications and crop failures that lead to undernutrition.

The battle over abortion

Whitmer urges the repeal of a decades-old abortion prohibition.

Michigan Gov. Gretchen Whitmer (D) called on the state legislature to repeal a state law criminalizing abortion that dates back to 1931. The law has not been enforced in decades because of the Supreme Court’s decision on Roe v. Wade, but that could change if the conservative-led Supreme Court overturns the landmark abortion ruling. Republicans control both houses of the state legislature, however, and may block efforts to repeal the law.

Sugar rush