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The Health 202

A newsletter briefing on the health-care policy debate in Washington.

Biden touts insulin savings in plea for his social spending package

The Health 202

A newsletter briefing on the health-care policy debate in Washington.

Welcome to Tuesday's Health 202, where today we're sending well wishes to 14-year-old and 41-year-old hippos who tested positive for covid-19 in Belgium. (The two appear to be doing well except for runny noses.)

Sen. Bernie Sanders (I-Vt.) has concerns with Biden's pick to lead the FDA, and nurses are making more money traveling to short-staffed hospitals around the country. But first: 

Affordable insulin is one of Biden's top plugs for his economic package

President Biden is capitalizing on a politically popular idea — curbing the high cost of drugs — to push the Senate to pass his roughly $2 trillion social spending bill. 

In a speech at the White House yesterday, Biden underscored the drug pricing policies included in the legislation, urging Congress “to finish the job” and send the bill to his desk. 

Biden’s speech centered around the high cost of insulin — and a plan Democrats have to place a $35 limit on how much consumers pay each month for the lifesaving medication. (Notable: The cap only extends to those on Medicare or who have private insurance, and not to the uninsured.)

  • Pleading the case: “We’re closer than ever to passing my Build Back Better bill and providing people suffering from diabetes and so many other diseases the medicine they need and the dignity they deserve — being able to afford them,” Biden said.
Where we're at

This comes at a pinnacle moment for Democrats’ economic ambitions. 

Senate Majority Leader Chuck Schumer is sticking with an aggressive timeline of passing the social spending bill before Christmas. But that’s less than three weeks away, and Congress still needs to authorize nearly $778 billion in defense spending and address the debt ceiling — both of which have been mired in political disputes.

Meanwhile, Democrats will wrap up their health-focused meetings today with the Senate parliamentarian, who referees what policies can pass in the economic package without GOP votes. 

This comes ahead of the bipartisan meetings, where Republicans and Democrats will argue over what they think can be included — and several health-care lobbyists said they expect challenges on drug pricing provisions.

Josh Wingrove, Bloomberg News:

Drug pricing plan

The drug pricing plan was significantly scaled back from earlier versions, but still embraces key Democratic priorities that the party wants to take to voters in the midterms. This includes: 

  • Allowing Medicare to negotiate the price of prescription drugs for the first time
  • Capping how much seniors and Americans with private insurance pay for insulin to $35 per month
  • Limiting out-of-pocket spending for seniors to $2,000 annually
  • Requiring drugmakers pay rebates when they increase prices faster than inflation in Medicare and the commercial market
Stay or go?

But there could be questions over whether several provisions — particularly those extending to the private market — impact government spending or revenue. If not, then it’s technically not allowed under the process Democrats are using to pass the legislation. 

Multiple Republicans didn’t comment on whether they planned to challenge the drug pricing provisions. Such decisions are usually kept pretty close to the vest, though lobbyists are anticipating that they’ll likely be contested. 

  • One health policy consultant, Chris Condeluci, said it’s possible the parliamentarian could rule in Democrats' favor on extending the inflation rebate to the commercial market. That’s because the drugmakers are required to pay the dollars to the Medicare Trust Fund, which could possibly strengthen that fund.
  • But Condeluci, a former Republican aide, said he’s skeptical that the $35 cap on insulin could pass muster.

Democrats believe they’re in the right. 

  • On extending the inflation rebate: “It's this almost philosophical disagreement between what policy is … Our contention is you can't bifurcate the policy because you can't effectively control prices without covering both public and private markets,” Sen. Chris Murphy (D-Conn.) said.
Industry reax

The pharmaceutical industry has waged an all-out war against Democrats’ drug pricing plan. Shortly after Biden’s speech yesterday, the major drug lobby — Pharmaceutical Research and Manufacturers of America — criticized the bill as “damaging.”

  • PhRMA says it has supported fixed-dollar co-pays in the past. However, the trade group says “a partisan reconciliation process is the wrong way to make significant changes to our health-care system,” according to Brian Newell, a spokesperson for the trade group.

The insurance industry could end up being on the hook for more of the cost of insulin. AHIP, the major insurer lobby, argues that drugmakers should “be held accountable for the prices that they, and they alone, set and raise year after year.”

  • “If there is no action on the problem of the price, the consumer ends up paying for the cost of the cap through higher premiums,” according to Kristine Grow, a spokesperson for the group.

Larry Levitt, Kaiser Family Foundation:

From our notebook

Sen. Bernie Sanders (I-Vt.) has concerns over Biden’s pick to lead the FDA. They’re similar to the reservations the senator had years ago, when Robert Califf was nominated to lead the agency under then-President Obama.

  • Pharmaceutical ties: Sanders confirmed to reporters yesterday that he still has concerns over Califf’s ties to the pharmaceutical industry. Califf has consulted for pharmaceutical companies, as well as served on their board.
  • Issues with the FDA: Sanders cited unease with certain agency decisions, such as its recent approval of the controversial Alzheimer’s drug though some experts said there’s scant evidence it worked.
  • Sanders said he wants to give him an opportunity to answer questions when he testifies before the Senate HELP Committee.

Califf, who Biden nominated last month, is already facing resistance from a handful of Democrats. Yet, he’s still expected to get through the Senate relatively easily, since he was confirmed in an 89-to-4 vote back in 2016. (While Sanders vocally opposed Califf’s nomination the first time around, he missed the vote.)


Nurses are leaving their staff jobs to earn more money as travel nurses

Nurses can triple their salaries by leaving staff jobs to travel around the country and help short-staffed hospitals The Post’s Lenny Bernstein reports.

Travel nursing has taken off during the pandemic: Last year saw 35 percent growth in the industry compared with the pre-pandemic year 2019. And this year, an additional 40 percent growth is expected.

The context: The surge in travel nursing comes as hospitals are struggling with staffing shortages, exacerbated by an aging, burned-out and retiring workforce. The pandemic shut down foreign recruits and there are not enough nursing students to replace those leaving the profession. 

Hospitals are frustrated: Some hospitals accuse the travel companies of price gouging. Nurse unions, on the other hand, say there would not be shortages if pay and working conditions were better.

The CDC released guidance on when to use at-home coronavirus tests

The Centers for Disease Control and Prevention (CDC) released additional information on the use of at-home tests. The move comes as public health experts and consumers have clamored for more guidance on how to use the increasingly popular rapid tests, The Post's Lena H. Sun reports.

  • The CDC suggests that people consider taking a test before indoor gatherings with people outside their households — especially those who might be at higher risk of infection or severe disease. The agency also says the tests can be used regardless of vaccination status or whether a person has symptoms of covid-19.

Here's what else you need to know:

New York City Mayor Bill de Blasio announced on Dec. 6 that a vaccine mandate for private-sector employers will go into effect on Dec. 27. (Video: Reuters)
  • New York City is expanding its vaccine mandate to all private employers amid rising coronavirus cases and concerns over the omicron variant, The Post’s Paulina Villegas reports. Democratic Mayor Bill de Blasio described the measure as a “preemptive strike”  and the first-of-its-kind in the nation.
  • The CDC warned Monday against travel to several European countries, as well as Jordan and Tanzania, amid fears of the omicron variant, The Post’s Hannah Knowles reports. The warning includes Andorra, Cyprus, France, Liechtenstein and Portugal.
  • Cities around the world are canceling end-of-year celebrations as the omicron variant spreads, Paulina writes.
  • A Norwegian Cruise Line ship docked in New Orleans over the weekend with at least 17 passengers and crew members infected with the coronavirus, including at least one probable case of the omicron variant, per our colleague Rachel Pannett.
  • The United States has pledged to commit $400 million more to help other countries vaccinate and to support their health-care systems, Hannah reports.

In other health news

A group of Democratic lawmakers facing tough reelection battles want to prevent Medicare cuts. Rep. Susan Wild (D-Pa.), Rep. Cindy Axne (D-Iowa) and over 15 other Democrats sent a letter to Biden and congressional leaders urging them to prevent cuts to the government health program that are scheduled to go into effect early next year.

Female doctors earn $2 million less than men over the course of their careers. A survey of more than 80,000 physicians published in the journal Health Affairs found that women make on average 25 percent less than men over the course of their careers — a difference that adds up to a whopping $2 million. The researchers controlled for hours worked, practice type and specialty.

Vice President Harris will host a summit at the White House today focused on improving maternal health outcomes in the United States. The administration is announcing actions, like a new “birthing-friendly” designation for hospitals that participate in a program to improve maternal outcomes.

Sugar rush

Thanks for reading! See y'all tomorrow.