DEMOCRATS SCALE BACK THEIR HEALTH AMBITIONS — Democrats are taking a cautious approach on the health care components of Biden’s infrastructure package, amid concerns about keeping the party united behind far-reaching legislation that could ultimately cost $2 trillion or more, POLITICO’s Alice Miranda Ollstein and Susannah Luthi report. Democratic leaders crafting the bill are so far sold only on modest expansions of coverage for poor adults and making permanent the Obamacare subsidies they built out on a temporary basis earlier this year. Those moves would be paid for by drug pricing reforms — but not the more ambitious ones that progressives want. Already, centrist Democrats have signaled they would prefer to sanction drug companies for hiking prices faster than inflation, rather than grant the government power to directly negotiate lower prices. The upshot is that Biden’s biggest campaign pledges could be on ice until after the midterms, when the question of Democrats’ razor-thin Senate majority will be settled one way or another. Though Biden has backed lowering Medicare’s eligibility age and aggressively slashing drug prices, he will only have a few opportunities to push through big health reforms before then — and passing this one up would substantially lower their odds of ever implementing that kind of change. DEMS’ OTHER BIG DILEMMA: WHETHER TO WORK WITH THE GOP — Plans for a two-part infrastructure package have Democrats gaming out whether — and for how long — to negotiate with Republicans, POLITICO’s Marianne LeVine, Burgess Everett and Sarah Ferris report. Some Democrats have floated negotiating a smaller, bipartisan bill, just enough to show that Congress can still successfully legislate, before passing a second measure stuffed with Democratic priorities through the filibuster-free reconciliation process. Yet there remain doubts about whether the parties can come to any agreement at all about how to pay for the new spending. As of Thursday, not even a bipartisan group of moderate senators could make progress, and had to table the issue until next week. And in the White House, officials are wary of getting bogged down in weeks of fruitless discussions, with chief of staff Ron Klain signaling that while there’s still time to court Republicans, the clock will eventually run out. BIDEN RESTORES FDA OVERSIGHT OF MEDICAL DEVICES — The administration is scrapping a Trump-era policy that would have stripped the FDA of its ability to review more than 80 types of medical devices, POLITICO’s David Lim reports. HHS Secretary Xavier Becerra and acting FDA Commissioner Janet Woodcock wrote Thursday that they’d concluded the change was made “without adequate scientific support,” and that the policy itself “contained numerous errors and ambiguities.” “We did not find any evidence that HHS consulted with, otherwise involved, or even notified FDA before issuing the Notice,” the two wrote. — The effort to strip FDA’s oversight authority was one of several last-minute policies that then-HHS Secretary Alex Azar approved in his final months in the job, amid an escalating feud between the health department and the FDA. This change would have affected products ranging from sleep assessment devices to surgical isolation gowns.
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