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Presented by Blue Cross Blue Shield Association: Delivered daily by 10 a.m., Pulse examines the latest news in health care politics and policy. | | | | | |  | | By Adam Cancryn and Sarah Owermohle | | | With Alice Miranda Ollstein Editor’s Note: POLITICO Pulse is a free version of POLITICO Pro Health Care's morning newsletter, which is delivered to our s each morning at 6 a.m. The POLITICO Pro platform combines the news you need with tools you can use to take action on the day’s biggest stories. Act on the news with POLITICO Pro.
| | | — Democrats are still haggling over a trio of major provisions that could determine the fate of much of President Joe Biden's health agenda. — A bomb threat shut down HHS headquarters and other federal buildings for hours on Wednesday. — New polling shows most small-business owners support the administration's forthcoming vaccine requirements. WELCOME TO THURSDAY PULSE — where the dark days of March 2020 are (hopefully) gone but Tiger King somehow is not. Send tips to acancryn@politico.com and sowermohle@politico.com. | | | | A message from Blue Cross Blue Shield Association: Everyone should have access to affordable health care, no matter who you are, where you live or what your health condition may be. See how Blue Cross and Blue Shield companies are working to improve health and expand access to high-quality care. | | | | | | INSIDE THE DEM STANDOFF ON HEALTH CARE — As Democrats close in on the deadline for finalizing their social spending package, nearly all the proposal’s major health policies remain unresolved — leaving party leaders struggling to manage the competing ideological forces surrounding each. Here’s the latest on where things stand ahead of a pivotal 24 hours, per POLITICO’s Alice Miranda Ollstein: Medicare expansion: Democrats are mired in an extended impasse over the fate of extending dental, vision and hearing benefits to traditional Medicare, with centrist Sen. Joe Manchin (D-W.Va.) balking at further expanding a program he argues is headed toward insolvency. Senate Budget Chair Bernie Sanders (I-Vt.) has led the progressive charge in favor of the benefits for months, insisting that leaving the provision out of a final bill would be unacceptable. One idea on the table: A cheaper voucher concept, particularly for dental. Lawmakers have also discussed clawing back some savings from Medicare Advantage plans to help cover the added services. Medicaid expansion: Speaker Nancy Pelosi touted “great progress” on the issue Wednesday in a sign that Democrats may be close to a breakthrough on the effort to cover low-income people in states that have refused to expand Medicaid. The movement comes after supporters pitched a scaled-back plan to close the coverage gap through private insurance instead of a new federal program in a bid to allay Manchin’s spending concerns. Prescription drugs: Top Democrats say they’ve hammered out deals to limit the rate of price increases for drugs under Medicare Parts B and D, cap out-of-pocket spending for older Americans and redesign benefits under Medicare Part D to give them catastrophic coverage. Still in progress: discussions over allowing Medicare to negotiate drug prices directly. Both conservative House Democrats who oppose direct negotiation and Senate progressives who favor the provision say a deal is still possible — albeit one that would limit the government’s ability to negotiate to a narrower class of drugs. But with no agreement yet, the key plank of the party’s health agenda is hanging by a thread. Forecast: ¯\_(ツ)_/¯. Liberal Democrats are already balking at planned cutbacks designed to win over the party's centrist holdouts, including the decision Wednesday to scrap a paid leave program. And even if Democrats coalesce behind a framework of the bill by the end of the week, negotiators warned more changes to the health policy provisions could still follow. “The deal is not done until the Senate acts,” Senate Finance Chair Ron Wyden (D.-Ore.) told reporters Wednesday. “I want to be very blunt about it.”
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BOMB SCARE SHUTS DOWN HHS — The health department’s headquarters and surrounding federal buildings were evacuated Wednesday following a bomb threat that targeted the Humphrey Building.
Authorities spent roughly four hours sweeping the area around Independence Ave. S.W. before issuing an all-clear and allowing employees to reenter the offices. HHS didn’t provide specifics on the threat or possible motive but said there was no “reported incident” and the building was evacuated out of “an abundance of caution.” The nearby General Services Administration headquarters and the O’Neill federal building housing both HHS and House offices were also evacuated. HHS Secretary Xavier Becerra wasn’t on-site, having traveled to Baltimore for a previously scheduled event. And the department is still on telework status, meaning most employees were working from home. But the incident underscored the intense scrutiny on the health department, which for months has been at the center of partisan battles and conspiracy theories tied to Covid-19. | | | SMALL-BIZ OWNERS BACK VAX MANDATES — Sixty percent of small-business owners favor requiring employees to get vaccinated against Covid-19 — and more than 40 percent are ready to replace workers who refuse to comply, POLITICO’s Rebecca Rainey reports. Those are the topline findings from a new U.S. Chamber of Commerce poll, in the latest sign of support for the White House–led push to mandate the vaccine. The trend is even more pronounced among manufacturers and retailers, of whom a majority said they’d fire those who buck the vaccination rules. The findings come ahead of new federal regulations requiring companies with more than 100 employees to verify their staff is vaccinated or submit to weekly tests. That rule could be finalized as soon as this week, though GOP lawmakers and several states have already threatened to sue. Even so, roughly 60 percent of small-business owners surveyed said they were likely to implement their own independent vaccine requirements. What remains unclear is the impact the mandates will have on the labor market. While Republicans have warned of massive disruptions, only a small percentage of workers at hospitals and other businesses already implementing mandates have followed through on threats to quit. Still, the Chamber survey found that nearly half of small businesses currently hiring are already having trouble finding suitable job candidates. | | | | A message from Blue Cross Blue Shield Association:   | | | | | | FIRST IN PULSE: GOP SEEKS HEARING ON BIDEN’S COVID RESPONSE — Republicans on the House Energy and Commerce Committee are requesting a hearing focused on the Biden administration’s pandemic response, arguing that the panel has a duty to more closely scrutinize key aspects of the effort to rein in Covid-19. The group, in a letter to House E&C Chair Frank Pallone (D-N.J.), outlined three areas the committee should probe: The administration’s handling of the summer’s Delta surge, CDC decision-making and the attempt to pinpoint Covid-19’s origins. “As the committee of jurisdiction over public health, a hearing on the Biden Administration’s response to the COVID-19 pandemic is long overdue,” the Republicans, led by Ranking Member Cathy McMorris Rodgers (R-Wash.), wrote, adding that the panel should summon top health officials like Anthony Fauci, NIH Director Francis Collins and CDC chief Rochelle Walensky to testify. The GOP lawmakers singled out a series of CDC decisions for criticism, including its back-and-forth over indoor masking and guidelines issues to schools. The group also accused Biden of “flouting FDA process” in prematurely announcing plans for booster shots, and demanded that Fauci and Collins again answer questions about the possibility that Covid-19 could have originated in a lab. | | Inside the Humphrey Building | | HHS OPENS UP TITLE X GRANT FUNDING — The health department is allocating $256 million in grants under the Title X family planning program — a move that comes weeks after it finalized a rollback of Trump-era rules barring abortion providers from receiving the funds. The roughly 90 grants HHS plans to dole out will focus specifically on programs aiding health equity efforts, with a preference given to those that serve low-income clients. The Biden administration Title X rules — which take effect Nov. 8 — would also no longer ban grantees from making abortion referrals. They would also require service sites to offer “culturally and linguistically appropriate, inclusive, trauma-informed” family planning care.
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| | | FIRST IN PULSE: BENNET PITCHES RURAL HOSPITAL INVESTMENT — Sen. Michael Bennet (D-Colo.) is introducing legislation today that would earmark $17 billion to help rural hospitals upgrade and expand their facilities. The proposal — dubbed The Hospital Revitalization Act — would create a grant and loan program at HHS that awards up to $40 million to small rural hospitals facing financial difficulties. In a statement, Bennet said he worked with rural hospitals in Colorado to write the bill. Hospitals eligible for the program would need to have generated less than $50 million of net patient revenue or have fewer than 50 beds. They’d also need to show a negative total margin for two of the last three years before 2020, as well as predominantly serve Medicare and Medicaid patients. | | | Kenneth Westberry is the new senior manager of state government affairs at the Association for Accessible Medicines. He was previously the senior manager of policy and government relations at the National Coalition of STD Directors. | | | In a leaked recording, Epic’s president said the mission of the company’s diversity council shouldn’t be to fight for specific social causes or “any cause, really, other than we come together for work,” Healthcare IT News’ Kat Jercich reports. A review of drug industry campaign contributions by Kaiser Health News’ Victoria Knight, Rachana Pradhan and Elizabeth Lucas found that companies made their biggest donations with “surgical-strike-precision” lawmakers critical to shaping Democrats’ social spending bill. In-N-Out Burger is in an escalating war with California health officials over violations of the state’s Covid-19 rules, The Los Angeles Times’ Gregory Yee reports. | | | | A message from Blue Cross Blue Shield Association: Everyone should have access to affordable health care, no matter who you are, where you live or what your health condition may be.
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