INDUSTRY LOBBYING COMPLICATES DEMOCRATS’ MEDICARE AMBITIONS — Congressional Democrats’ effort to add dental, vision and hearing coverage to Medicare is running into a cash crush and resistance from powerful health industry lobbies — an early sign of the battles facing lawmakers when they return next month to debate a $3.5 trillion social spending package, Alice Miranda Ollstein reports. To make the math work, House and Senate committees now assembling the package are weighing options like a longer phase-in of benefits, skimpier coverage with more cost-sharing, an end date that banks on reauthorization by a future Congress or even means-testing that would restrict new benefits to only the poorest beneficiaries. At stake: The changes could ensure key coverage for millions of Americans and help progressives deliver on a key campaign pledge to expand Medicare. But the provision could cost roughly $350 billion over a decade, eclipsing other health priorities under discussion like an extension of Obamacare subsidies or an expansion of in-home care. Groups like the American Dental Association, worried their members will be paid less in traditional Medicare than in private Medicare plans, are also pushing to limit the new benefits to the poorest Americans. And the insurance industry is warning Congress that mandating the new benefits will hike premiums and diminish other benefits for millions of seniors. Lobbying in the dark: Congress' deliberations are “freaking out” companies who worry that seniors will drop their private plans en masse and migrate to traditional Medicare once the new benefits are in place, one insurance industry source said. But industry is also mindful of the optics of publicly opposing coverage of eyeglasses, dental care and hearing aids, and is largely pushing the message behind the scenes, they said. CBO REPORT LAYS OUT DRUG NEGOTIATION STAKES — Fewer early-stage drugs are expected to come to market if Speaker Nancy Pelosi’s negotiation bill, H.R. 3, goes into effect — but it’s not as bad as people might think, the Congressional Budget Office found in a Thursday report. CBO had already estimated that H.R. 3, which would allow negotiation on a category of drugs, would lead to roughly eight fewer new medicines in the following decade and 30 fewer drugs over the subsequent 10 years. In an updated assessment, the budget analysts say early-stage drugs are most affected but “CBO … now expects more new drugs to be introduced over the next decade under current law.” Why it matters: Critics of the negotiation approach are likely to highlight this analysis as the latest evidence that new, potentially life-saving medicines won’t reach Americans because drug companies can’t reap the revenues from costly development. While nine out of 10 Americans said in a recent Kaiser Family Foundation poll that they support drug price negotiation, opposition to the approach soared to 65 percent when respondents were told negotiation could limit access to new drugs. What CBO says: It isn’t clear what kind of medicines could be affected — after all, if a product is assured a big market because of patients’ needs, pharmaceutical companies are unlikely to abandon its development. Plus “the policy may lead to lower prices and increased usage for drugs already on the market.” NURSE UNION BLAMES HOSPITALS FOR STAFF SHORTAGES — The hospital industry is responsible for some states’ shortages of registered nurses, National Nurses United said Thursday after reports of a building workforce crisis. “The United States is not experiencing a nursing shortage, only a shortage of nurses willing to risk their licenses or the safety of their patients by working under the unsafe conditions the hospital industry has created,” the union, the largest for registered nurses nationwide, clapped back in a statement. “The hospital industry is crying false tears over the lack of nurses willing to stay in direct care when these untenable working conditions are entirely of their own making.” Those conditions, the union argues, are historic under-staffing and unsustainable scheduling practices to maximize profits, low pay, and little cross-training to ensure that nurses can move to other units when needed — like in a pandemic. NNU also contends that “Except for a handful of states, there are sufficient numbers of registered nurses to meet the needs of the country’s patients,” according to a 2017 HHS report that identified an inequitable distribution of nurses across the country, but not a shortage. CHILDREN’S HOSPITALS WARNS OF RISING NEEDS AMID COVID — Pediatric providers need more support as the pandemic continues, mental health needs increase and flu season looms, Children’s Hospital Association CEO Mark Wietecha wrote in a letter to President Joe Biden on Thursday. “With pediatric volumes at or near capacity and the upcoming school season expected to increase demand, there may not be sufficient bed capacity or expert staff to care for children and families in need,” Wietecha said, noting that between school and typical viral seasons like flu, the nation could be heading for “the perfect storm” threatening pediatric hospital capacity. Wietecha pressed for federal support but added “We strongly support and advocate for stronger masking and vaccination guidance.” While it’s still less likely for children to require hospitalization from the virus, Covid-19 cases are increasing among children, he said. | 
