Democrats go big on health spending — Overdose deaths hit record high — Gun violence-related health costs top $1B

From: POLITICO Pulse - Thursday Jul 15,2021 02:08 pm

Jul 15, 2021

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With Alice Miranda Ollstein

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Quick Fix

— Senate Democrats would expand Medicare benefits and pass other health priorities under their spending plan.

— Drug overdose deaths hit a record high in 2020, upping pressure on President Joe Biden to step up prevention efforts.

— Gun violence costs the U.S. health system more than $1 billion annually, a watchdog agency found.

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Driving the Day

DEMS GO BIG ON HEALTH SPENDING — Senate Democrats’ massive spending package would fund a slew of health care priorities, highlighted by a major expansion of Medicare benefits, POLITICO’s Caitlin Emma, Sarah Ferris and Anthony Adragna report.

The $3.5 trillion plan laid out Wednesday aims to give Medicare beneficiaries dental, vision and hearing services – fulfilling a top goal for Budget Chairman Bernie Sanders and other progressives.

The bill also sets aside money for expanding coverage to the roughly 2 million people in red states that haven’t expanded Medicaid, though Democrats have yet to settle on the specifics of that policy. Nutrition assistance, paid family, medical leave and child care subsidies are included in the package as well.

Democratic leaders are still filling out the details, and pushing the bill through Congress could take some time. They must first release a budget resolution to kick off the reconciliation process Democrats plan to use to pass the package along party lines.

They’ll also need to pay for it. The blueprint would finance the bill’s spending through a combination of approaches, including cuts to prescription drug costs — but it’s unclear what those specific provisions will be.

That leaves plenty of time for negotiations to get dicey. Several moderates are privately skeptical of the overall price tag, and areas like drug pricing have long been contentious.

Yet at least for a day, Biden and Hill Democrats presented a (mostly) united front. During a closed-door lunch on Wednesday, the president encouraged lawmakers to embrace the bill’s ambitions, receiving a series of ovations in the process. And he avoided singling out moderates like Sens. Joe Manchin and Kyrsten Sinema, who he has previously rapped over their spending concerns.

“We have a chance,” said Sen. Chris Murphy (D-Conn.). “I don’t think we have a choice to fail here.”

DRUG PRICING TROUBLES AROUND THE BEND? — In a sign of the obstacles awaiting the spending bill, 15 swing-district Democrats wrote to Speaker Nancy Pelosi and Senate Majority Leader Chuck Schumer urging them to include a provision empowering Medicare to negotiate drug prices.

The measure could offset hundreds of billions of dollars in spending and has long been a centerpiece of Democrats’ drug pricing ambitions. “Empowering Medicare in this way and making these negotiated prices available to the private sector will bring down the cost of prescription drugs not just for seniors, but also for individuals and families across America,” the group’s letter read.

But the idea will likely draw resistance from Democratic centrists who have warned Pelosi they won’t support Medicare negotiation. It would also have to face down a lobbying blitz from the deep-pocketed pharmaceutical industry, which has remained staunchly opposed.

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OVERDOSE DEATHS HIT RECORD HIGH — More than 93,000 people died from drug overdoses in 2020, marking the largest annual increase in at least a half-century, according to the CDC.

The preliminary numbers are the latest and starkest evidence of Covid-19’s toll on drug abuse prevention efforts, and the worsening epidemic that Biden will confront as the U.S. emerges from its separate pandemic, POLITICO’s Dan Goldberg reports.

“That is just an astounding number,” said Obama-era drug czar Michael Botticelli.

Nearly three-quarters of those overdoses were due to opioids, up from roughly 70 percent in 2019. Cocaine and methamphetamine deaths also continued to rise. This is now the third consecutive year that drug overdose fatalities have risen, after a dip in 2018.

Health experts had expected a jump in overdose deaths as a result of the social and economic disruption created by Covid-19. Still, there is concern that after the pandemic, there will be little appetite for addressing yet another public health emergency and too little resources at the state and local levels.

That’s a challenge that will now likely fall to Rahul Gupta, the former West Virginia health commissioner who Biden nominated earlier this week to be the nation’s drug czar.

Public Health

GUN VIOLENCE-RELATED HEALTH COSTS TOP $1B — The U.S. spends more than $1 billion a year treating firearm-related injuries , with government programs like Medicaid picking up much of the cost, POLITICO’s Alice Miranda Ollstein and Nicholas Wu report.

The estimate calculated by the Government Accountability Office accounts for about 30,000 hospital stays and 50,000 emergency room visits, including readmissions for more than 15 percent of firearm injury survivors. A majority of those victims are poor, meaning safety-net programs like Medicaid cover much of the expense.

The $1 billion price tag also does not include costs tied to ambulance rides or long-term treatment, meaning the true expense is likely much higher.

It’s a first-of-its kind study from the GAO, which was requested by House and Senate Democrats who have advocated for treating gun violence as a public health issue and sought to expand firearm oversight. House appropriators are slated to mark up legislation Thursday that would double the NIH’s budget for researching gun violence to $25 million.

Yet there’s been little movement from Republicans opposed to additional gun control measures, who argue that framing firearm injuries as a health issue risks derailing otherwise bipartisan support for public health funding.

NATSEC GROUP: DECLARE FENTANYL A WMD — A bipartisan group of former senior national security officials, retired generals and diplomats are urging Biden to declare fentanyl and its chemical analogues weapons of mass destruction, POLITICO’s Bryan Bender writes.

“Fentanyls are terrifyingly lethal,” they wrote in a Wednesday letter to Biden. “A quantity of fentanyl equal in mass to a single packet of sweetener (1 gram) can kill 500 people. A similar amount of carfentanil can kill 50,000.”

The group added that designating them weapons of mass destruction would help the federal government better coordinate its efforts with state and local authorities to combat fentanyl.

Around the Agencies

FDA CHIEF: POSSIBLE MISSTEPS WITH ADUHELM APPROVAL — Acting Commissioner Janet Woodcock acknowledged on Wednesday the potential that the agency could have better handled its accelerated approval of the Alzheimer’s drug Aduhelm, POLITICO’s Katherine Ellen Foley writes.

“Was the process done exactly the best that it could be? Possibly not,” she said during an interview at the STAT Breakthrough Science Summit.

Woodcock’s comments follow weeks of criticism over the FDA’s decision to greenlight the treatment despite thin evidence – a firestorm that prompted Woodcock herself to call for an independent probe into the agency’s relationship with Aduhelm manufacturer Biogen. Two congressional committees are also investigating the drug’s approval process.

CDC VAX PANEL TO EXAMINE J&J SIDE EFFECTS — The CDC’s vaccine advisory panel will discuss reports of Guillain-Barré syndrome in Johnson & Johnson vaccine recipients next week, after the FDA added a warning to the shot’s fact sheet, POLITICO’s Lauren Gardner reports.

The committee will review the 100 preliminary reports of the rare neurological condition and weigh how the administration should proceed. It’s also scheduled to talk about the possibility of giving immunocompromised people additional vaccine doses.

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What We're Reading

The White House plans to take a more aggressive stance against Covid-19 vaccine disinformation, as conservatives ramp up criticism of the inoculation campaign, CNN’s Kevin Liptak, Kaitlan Collins and Jeff Zeleny report.

Johnson & Johnson is recalling some of its spray sunscreens after finding some samples contained a potentially cancer-causing chemical, The Wall Street Journal’s Felicia Schwartz reports.

In a STAT op-ed, former Biden transition Covid-19 advisor Ezekiel Emanuel and researchers Matthew Guido and Patricia Hong argue health care workers should be required to get vaccinated.

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