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Democrats’ economic package may have just turned into a health-care bill

Democrats’ economic package may have just turned into a health-care bill


Good morning — and TGIF. 

Today’s edition: The national suicide hotline number is changing to 988 tomorrow, and HHS Secretary Xavier Becerra told us governor buy-in is key to its long-term success. The House will vote on two bills aimed at protecting access to abortion. But first … 

The economic bill is a shadow of its former self – but health care is still part of it

There’s been another seismic shift in the negotiations over Democrats’ long-stalled economic package. 

The climate change and tax increase provisions appear out. What’s left is a health care bill — and one that’s much smaller than the once-in-a-decade remake of the system Democrats had originally envisioned.

The latest: Sen. Joe Manchin (D-W.Va.) told Democratic leaders yesterday that he wouldn’t support an economic package with new climate spending or new tax increases targeting wealthy individuals and corporations, The Post’s Tony Romm and Jeff Stein scooped last night. 

But Manchin is open to provisions that aim to lower prescription drug costs for seniors, as well as a two-year extension of enhanced Obamacare subsidies set to expire at the end of the year. 

The marked shift comes after weeks of seemingly promising negotiations between Senate Majority Leader Chuck Schumer (D-N.Y.) and Manchin. And it comes as Democrats have been seeking a win to bring back to voters before the midterm elections. 

Key quote: “Political headlines are of no value to the millions of Americans struggling to afford groceries and gas as inflation soars to 9.1 percent,” Sam Runyon, a spokeswoman for Manchin, told our colleagues. “Senator Manchin believes it’s time for leaders to put political agendas aside, reevaluate and adjust to the economic realities the country faces to avoid taking steps that add fuel to the inflation fire.”

For over a year, Democrats have attempted to find a path forward on a sweeping social spending deal to overhaul federal health care, education, climate, immigration and tax laws. 

Last summer, there was a broad swath of health care policies prime for potential inclusion.

  • Allowing Medicare to cover vision, dental and hearing services
  • Closing the Medicaid coverage gap, which would extend the safety net program to 2.2 million poor adults
  • Infusing hundreds of billions into home care for seniors and those with disabilities
  • Letting Medicare negotiate drug prices for the first time
  • Extending the beefed up Obamacare subsidies set to expire in December

Some of those policies have been on the cutting room floor for months. But now, all non-health related spending seems excluded from the party’s economic package, and what’s left is a health-care package whittled down to two main policies.

Advocates for closing the coverage gap have ramped up their efforts in recent days — and will be furious if Democrats with their majorities in Congress and President Biden in the White House ultimately fail to expand Medicaid in the dozen states refusing Obamacare’s expansion. 

  • “It’s egregious that Senate Democrats would even consider passing a bill giving premium assistance to wealthy individuals while leaving behind the poorest Americans,” Jane Adams, campaign director of Alabama Arise, said in a statement.

Yet … “People shouldn’t underestimate how historic a drug pricing deal in and of itself would be,” Larry Levitt, an executive vice president at the Kaiser Family Foundation, wrote in an email. For one, taking on the drug industry is no easy task. Its multimillion-dollar lobbying machine had waged a campaign against the Democrats’ drug-pricing proposal, which includes allowing Medicare to negotiate prices.

Extending the Obamacare subsidies could save Democrats a major midterms headache. Roughly 13 million people were set to learn their health insurance costs would substantially increase just before the midterm elections. 

But if the tax credits are extended for just two more years — a proposal Manchin has endorsed, per Tony and Jeff — then Americans could get notices of spikes in their health-care costs weeks before the 2024 presidential election.

Sen. Ed Markey (D-Mass.):

A new 911 for mental health launches this weekend

Starting Saturday, Americans experiencing a crisis can dial 988 and reach the hotline for mental health emergencies. The transition is expected to bring millions more calls, chats and texts into a system where readiness to handle the surge varies from place to place, our colleague Lenny Bernstein reports. 

“Ultimately, this is a network of call centers that will be operated principally by the states,” Health and Human Services Secretary Xavier Becerra told The Health 202. “We have helped stand them up, but long-term if we’re going to have success, governors have to buy in.”

The call centers are funded by local, state and federal dollars — and that creates a variation in each center’s ability to handle its call volume.

Becerra said one of the biggest challenges of the new effort is to get the word out about the new easy-to-use number, as well as ensuring that state and local officials are committed to making investments to help transform the country’s crisis-care system.

It’s a dramatic revamp of a system that builds on the current national suicide prevention hotline, where Americans can call, text or online chat call centers and receive counseling. Ultimately, the goal is to be able to dispatch mobile crisis teams immediately to those in need, wherever they live — though officials and advocates acknowledge that will take time to stand up across the country. 

  • The overall network’s capacity was able to address roughly 85 percent of calls, 56 percent of texts and 30 percent of chats, per a report from the federal government last year, which cited a December 2020 analysis.
  • But HHS officials said they have seen significant improvements with response rates since then due to an infusion of funds into the system.

House Democrats tee up votes on abortion rights

House lawmakers today are expected to pass a bill that would codify the right to an abortion less than a month after the Supreme Court overturned Roe v. Wade. The largely symbolic vote comes as Democrats move to signal their commitment to abortion rights following the court’s ruling.

The Women’s Health Protection Act, an updated version of a bill the House passed in September, would also prohibit states from imposing restrictions that would make abortions more difficult to obtain. It is almost certain to die in the Senate, where it would need the support of 10 Republicans to pass or all Democrats on board with scrapping the filibuster.

“There is tremendous fear and anxiety,” Rep. Judy Chu (D-Calif.), the bill’s sponsor, told The Health 202. “And not a lot of people remember that we passed this bill in September, so we felt it was really important to put the bill on the floor.”

The chamber is slated to vote on another piece of legislation to protect patients’ right to travel to receive an abortion if their state bans the procedure and shield the people who help them to do so from legal ramifications. 

Republicans in the Senate yesterday stymied Democrats’ attempt to pass similar legislation through unanimous consent. As of now, no states have moved to penalize providers or others for performing abortions on women coming in from out of state, though some major groups are actively working on legislation to do so.

Our colleague Caroline Kitchener broke down those plans:

Texas sues Biden administration over rule requiring abortions in medical emergencies

Texas Attorney General Ken Paxton (R) asked a federal court yesterday to block new guidance from the Biden administration reminding doctors that they must terminate a pregnancy if doing so is necessary to stabilize a patient in an emergency medical situation, The Post’s Katie Shepherd reports. 

The lawsuit comes just days after the Department of Health and Human Services sent a memo to hospitals asserting that federal law requiring emergency medical treatment preempts any conflicting state restrictions. The agency warned physicians and hospitals that refusing to treat women who need an abortion could result in fines or being booted from the Medicare program.

The lawsuit challenges the administration guideline on the grounds that it uses federal funds — since it ties compliance to Medicare and because funding for the Justice Department would go toward enforcing the law — in violation of the Hyde Amendment, which bars federal spending to facilitate an abortion except in most cases.

Texas Attorney General Ken Paxton (R):

The Indiana doctor who provided abortion services to a 10-year-old Ohio girl who was raped disclosed the procedure to state authorities, according to documents obtained by the IndyStar through a public records request. The Post also obtained the records.

The latest news follows comments made by the state’s Republican Attorney General, Todd Rokita, this week, who said his office would investigate whether Caitlin Bernard, an Indianapolis-based OB/GYN who performed the procedure, reported the minor’s sexual abuse and abortion as required by Indiana law. Despite the newly disclosed forms, Rokita said he plans to continue with his investigation, IndyStar‘s Tony Cook reports. 

Caitlin Bernard, Indiana physician at the center of the case:

A post-Roe surge could reshape this Illinois steel mill town

In a post-Roe world, the conservative leaning community of Granite City in southern Illinois offers the closest abortion services for many patients across the South and Midwest. It’s a shift that has the potential to reshape the steel mill town, but not everyone’s happy about it, our colleague Caroline Kitchener reports. 

As many as 14,000 women are expected to travel to the region for abortions this year, mostly from neighboring states where the procedure is largely restricted. And while the area leans conservative, abortion rights in the state are largely protected by Illinois’ blue government. 

Read Caroline’s full dispatch here.

  • Nearly 20 senators yesterday sent a letter to President Biden and Becerra pressing the White House to declare national and public health emergencies over abortion access.
  • A federal judge in Cincinnati temporarily blocked the Biden administration from enforcing its coronavirus-vaccine mandate on military service members who requested religious exemption, Cincinnati’s Fox19 reports.
  • The bipartisan bill to lower insulin costs from Sens. Susan Collins (R-Maine) and Jeanne Shaheen (D-N.H.) would cost the federal government roughly $23 billion over the next decade, according to an estimate by the Congressional Budget Office.

Rural Hospital Rescue Program Is Met With Skepticism From Administrators (By Sarah Jane Tribble and Tony Leys | Kaiser Health News)

Polish abortion activist’s trial hints at a post-Roe future in U.S. (By Claire Parker, Karolina Jeznach and Loveday Morris | The Washington Post)

A Twitter ‘rando’ named a new coronavirus variant Centaurus and it stuck (By Ellen Francis | The Washington Post)

Thanks for reading! See y’all Monday.