KHN’s ‘What the Health?’: Dems Agree to Agree, But Not on What to Agree On

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Negotiations over what to include in — and cut from — the domestic spending package on Capitol Hill are reportedly making progress, but so far all Democrats have to show for their efforts to enact President Biden’s health and other social spending agenda is a continuing promise to keep trying.

Meanwhile, Biden administration officials unveil plans to provide covid-19 vaccines to younger children without looking like they are prejudging the science, in an attempt to avoid the mixed messaging that presaged the rollout of booster doses for adults.

This week’s panelists are Julie Rovner of Kaiser Health News, Joanne Kenen of Politico and Johns Hopkins, Tami Luhby of CNN and Rachel Cohrs of Stat.

Among the takeaways from this week’s episode:

• While there is a different feeling among Democrats on Capitol Hill right now, meeting the goal of both the House and Senate passing the social spending legislation by the end of October still seems very unlikely. What might be possible is that negotiators could agree on a framework by that deadline that would allow Congress to go back to pass an infrastructure bill while they continue fleshing out the social spending bill. Also, things are likely to fall apart a few more times before anything is finally accomplished.
• The Congressional Budget Office this week estimated the effect on health insurance that the House Committee version of the bill would produce. It found a big boost in insurance coverage but a decrease in employer-provided coverage. The CBO also predicted a big loss in employer coverage when the Affordable Care Act passed, but that did not happen.
• Neither the House nor the Senate version of the annual spending bill (not the same as the social spending bill) for the Department of Health and Human Services includes the Hyde Amendment language that bans federal funding for most abortions. But the bill cannot pass the Senate without the language, as it would need 60 votes. This is really an example of virtue signaling for progressives, though it is hard to predict how the abortion debate will continue to play out if the Supreme Court, as expected, overrules Roe v. Wade this term.
• The Biden administration has until Nov. 15 to name someone to run the FDA. The leading candidate is reportedly Robert Califf, who led the agency during the last year of President Barack Obama’s administration. Yet he has baggage similar to that of Janet Woodcock, the current acting commissioner, whom the Biden administration had first eyed for the job. Some Senate Democrats oppose Woodcock for her permissive attitude toward the approval of opioids in years past.
• Speaking of the FDA, the agency released long-awaited regulations this week to allow for the over-the-counter sale of hearing aids. The idea has had bipartisan support and the OTC sale will make a big difference in affordability and accessibility. Without these regulations, people in many states needed to see an audiologist to get hearing aids. Some places simply have no audiologists.
• On covid, the White House seems to be a bit more careful this time on messaging its plans for vaccinating children under 12 than they were in unveiling their plans for boosters. Officials made a mess of communications surrounding boosters for adults. This time they are emphasizing they won’t prejudge the science and will leave the actual medical decisions up to the FDA and Centers for Disease Control and Prevention.
• With a few exceptions, vaccine mandates seem to be working. Some of the places that initially offered their workers a testing option — including New York City — are now taking that away. Ultimately, though, the vaccine mandates are again causing fissures in the nation’s social fabric.
• Nurses are a big part of the “Great Resignation.” They are also leaving traditional staff positions to make much more money as travel nurses. This contributes to health care cost inflation and disrupts continuity of care. It’s a huge issue.

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Plus, for extra credit, the panelists recommend their favorite health policy stories of the week they think you should read too:

Julie Rovner: KHN’s “Hygienists Brace for Pitched Battles With Dentists in Fights Over Practice Laws,” by Giles Bruce.

Tami Luhby: Modern Healthcare’s “Rural Reckoning: COVID-19 Highlights Long-Standing Challenges Facing Rural Hospitals. Will It Create Momentum for Change?” by Jessie Hellmann.

Joanne Kenen: The Atlantic’s “‘I Don’t Know That I Would Even Call It Meth Anymore,’” by Sam Quinones.

Rachel Cohrs: U.S. News & World Report’s “Debt After Death: The Painful Blow of Medicaid Estate Recovery,” by Sarah True.

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