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The Health 202

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

Biden didn't share the real reason Medicare premiums are lower

The Health 202

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

Happy hump day, y’all. The Post wants to hear from you: What does aging well mean to you? Send us your thoughts here. 

Today’s edition: An experimental Alzheimer’s drug slowed cognitive decline in a closely watched clinical trial, the companies announced. Abortion rights group NARAL Pro-Choice America is launching its final midterms blitz in battleground states. But first … 

Yes, Medicare Part B premiums are lower. But it's because they were too high last year.

There are just six weeks before the midterm elections, and yesterday President Biden vowed to lower seniors’ health costs in a Rose Garden speech. He pledged to protect Medicare against perceived Republican threats and pointed to Democrats’ new law allowing the federal health program to negotiate drug prices for the first time.

“And this morning, we got even more good news,” Biden said yesterday, pointing to a decrease in Medicare premiums for doctor visits. “For years, that fee has gone up. Now, for the first time in more than a decade, it’s going to go down.” 

But the reality is more complicated than that election-year sound bite. Seniors wound up overpaying their Medicare Part B premiums this year due to uncertainty over a controversial new Alzheimer’s treatment. Now, federal health officials are essentially instituting a correction, reducing monthly premiums by 3 percent for 2023 to make up for last year’s substantial hike.

The rare drop in Medicare premiums isn't due to Democrats' policy proposals for the federal health insurance program, but the notion of lowering costs is a message Democrats want to trot out less than two months before the midterms. Party officials believe they have an advantage over Republicans on health care in the November elections, and are seeking to sell their recently passed health-and-climate bill to voters on the campaign trail.  

  • “I think what the president should have said — and I can understand why he didn't want to — is that this is the result of a very wise policy decision,” said Paul Ginsburg, a professor of the practice of health policy at the University of Southern California, pointing to the Medicare agency’s decision to limit coverage of the divisive Alzheimer’s drug. But that would be a complex message to explain, he said.

Alan Rappeport, of the New York Times:

What happened

Here’s the complex backstory. 

Last year, the Centers for Medicare and Medicaid Services (CMS) announced a roughly 14.5 percent increase to 2022 premiums for Medicare Part B, which covers doctor visits, some preventive care and other outpatient services.

The major reason for the increase? An expensive new Alzheimer’s drug, called Aduhelm, that the Food and Drug Administration approved in June 2021 despite a fierce dispute over whether the drug is safe and effective (there’s another potential treatment in town; more on that later). The drug initially cost a whopping $56,000 annually per patient, and there was uncertainty over whether — and how widely — Medicare would cover the treatment. 

Then, drugmaker Biogen slashed the price of the drug nearly in half. A few months later, CMS decided on a plan in the spring to limit coverage to those enrolled in clinical trials, which sharply restricts the treatment’s use. That meant Medicare wasn’t spending as much cash on the drug as it’d budgeted for.

But reducing the cost of Medicare premiums midyear was “prohibitively complex and highly risky,” CMS determined. And so the federal health department settled on incorporating the savings into the 2023 premium instead.

That was a major driver for premiums decreasing from $170.10 per month in 2022 to $164.90 next year. Other factors include changes in spending patterns partially attributable to the pandemic, a CMS official told The Health 202. 

The price drop was announced earlier than last year’s big price hike, which was released Nov. 12, and many other recent Medicare Part B premium rates. The CMS official said this was due to a strong interest among Medicare enrollees to find out how much their premiums will cost after discussions around Aduhelm. They also pointed to a statutory deadline of releasing such information in September, though the agency doesn’t always hit that deadline.

Ceci Connolly, president of the Alliance of Community Health Plans: 

The reaction

Republicans hit back, slamming the administration for the previous cost spike. 

President Joe Biden is completely out-of-touch and trying to distort reality for American seniors,” Rep. Cathy McMorris Rodgers (Wash.), the top Republican on the House Energy and Commerce Committee, said in a statement, saying that next year’s “‘savings’ are swallowed up by this year’s historic 14.5 percent increase for seniors.” 

Meanwhile, the decision won praise from groups like Democratic-aligned Protect Our Care and Social Security Works, a progressive group.

The price change means that seniors will get to keep their Social Security cost-of-living adjustments, says Nancy Altman, the president of Social Security Works. Such a cost-of-living adjustment hasn’t yet been announced but is expected in the coming weeks. 

More from Rep. Cathy McMorris Rodgers:

What's next

There was some potentially promising news in the world of Alzheimer’s treatments last night. An experimental drug slowed cognitive and functional decline by 27 percent in a much-anticipated clinical trial, the sponsors of the medication announced yesterday. That may increase the therapy’s chance at approval as soon as early next year, our colleague Laurie McGinley writes.

The details: Japanese drugmaker Eisai and its American partner, Biogen, said the drug met the primary and secondary goals of the 18-month late-stage study. 

The trial results, which haven’t been peer reviewed, contrast with the disastrous rollout of Aduhelm, which the two companies also sponsored. The data for the new drug, called lecanemab, tell a more straightforward and encouraging story, Laurie writes.

Daybook

On tap today: The Biden administration will host the White House Conference on Hunger, Nutrition and Health to lay the groundwork for its effort to end hunger and reduce diet-related disease by 2030. 

The first national conference in over 50 years will feature academics, activists and government leaders. The conference will highlight the administration’s 44-page action plan for the campaign as well as more than $8 billion in private-and-public sector commitments announced this morning.

Also of note: Congress is on a glide path to avoid a partial government shutdown, our pals at The Early 202 report. Reminder: The deal didn't include funding for covid or monkeypox after the White House stumped for $26.9 billion. 

Reproductive wars

First in the 202s: NARAL launches final midterms blitz in key states

NARAL Pro-Choice America is planning to beef up its phone banking, canvassing and other efforts to mobilize voters in the final stretch before November’s midterm elections.

The prominent abortion rights group is concentrating its efforts in a handful of states. That includes places where there are battleground races in Congress and for the governor’s office, like in Pennsylvania, Georgia, Nevada and Arizona, as well as California and Michigan where the question of whether to enshrine abortion rights into the state constitution will be put to voters. 

As part of the initiative, the group will roll out a new pilot program in Michigan, where 14 organizers will work to sign up 14,000 voters and recruit 400 volunteers on seven college campuses.  

  • “With six weeks left, we really see this as a ground game and a mobilization moment and a political organizing opportunity,” Mini Timmaraju, the head of NARAL, said in an interview.

The strategy: Abortion rights supporters have little recourse to counteract restrictions on the procedure after the Supreme Court overturned the constitutional right to an abortion. Leaders of the movement are seeking to turn Democratic anger over the Supreme Court’s decision to overturn Roe v. Wade into votes at the ballot box. Planned Parenthood Action Fund, Emily’s List and NARAL previously committed to spend a record $150 million total on this year’s midterm elections.

Meanwhile, in South Carolina …

Republicans likely won’t pass stricter abortion laws. A vote in the state House on Tuesday likely halted the effort to further restrict the procedure, the Associated Press reports.

House Republicans are insisting on a near-total ban on abortion except for in cases of rape, incest or if the life of the mother is threatened. But such a bill didn’t fly in the Senate, where Republicans instead sent over a modified version of a “heartbeat” limit already on the books (though blocked by the state courts). The House rejected the Senate’s version in a 95-11 vote yesterday, though the vote doesn't completely close the door on changing abortion laws this year, the AP’s Jeffrey Collins  writes. 

State scan

Florida hospitals cancel surgeries, transfer patients as Ian approaches

Florida’s hospitals, nursing homes and home health organizations are bracing for the potentially life-threatening effects of Hurricane Ian as the storm churns toward the state’s Gulf Coast, The Post’s Sabrina Malhi reports. 

For instance: AdventHealth’s response to the menacing hurricane began Monday by first discharging low-risk patients, transferring those who aren’t as clinically stable to suitable facilities and canceling non-emergency surgeries. Meanwhile, some providers report working to shore up hospital equipment, testing backup communication systems and mobilizing staff. 

Mary Mayhew, the head of the Florida Hospital Association, said hospitals in the state regularly review their emergency response plans, as well as conduct routine drills to test factors like their surge capacity.

Nursing homes also initiated their emergency response protocols after Gov. Ron DeSantis (R) declared a state of emergency in 24 counties. As of 2018, nursing homes in the state are required to have backup generators that are able to run air conditioning in case of a power outage — a mandate that was put in place after eight elderly patients in South Florida died in the aftermath of Hurricane Irma. 

Some of the preparations for the storm, as reported by Amy Lu of Hearst Television: 

More from President Biden:

In other health news

  • The Food and Drug Administration said yesterday that it would scale back the number of emergency use authorization requests it reviews for new coronavirus tests, focusing only on those that are likely to have a benefit to public health. The announcement comes one week after federal investigators recommended the agency revise its policy for the devices.
  • A Texas judge ruled yesterday that state Attorney General Ken Paxton (R) doesn’t have to appear at a hearing related to an abortion access lawsuit, after an affidavit alleged that he ran away twice from a person who was serving him a subpoena, CNN reports.
  • Unaccompanied migrant children held at a makeshift intake site operated by HHS’s Office of Refugee Resettlement last year spent weeks without updates on their cases, fueling distress, anxiety, and in some cases, panic attacks among the minors, an internal watchdog report released yesterday concluded.

Health reads

Syphilis cases are surging. Should I be worried? (By Teddy Amenabar | The Washington Post)

Pregnancy during Hurricane Sandy linked to kids’ psychiatric disorders, study says (By Caitlin Gibson | The Washington Post)

In 2019, Doug Mastriano said women who violated proposed abortion ban should be charged with murder (By Allan Smith | NBC News)

Sugar rush

Thanks for reading! See y'all tomorrow.

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