HealthCare Roundtable e-News – April 7, 2021


  • Democrats Consider Medicare Enhancements, Additional Health Care Policies in Next Legislative Package
  • Non-Partisan Parliamentarian Agrees Democrats Have At Least One More Shot At Reconciliation
  • MA Benchmark Policy Replacements Will Lead to More Savings, According to MedPAC Advisors
  • White House Unveils Drug Control Policy Priorities for Year Ahead
  • Democrats Consider Medicare Enhancements, Additional Health Care Policies in Next Legislative Package

    Lawmakers and lobbyists are keen to find out what health care elements the White House plans to include in its upcoming legislative package, expected to be unveiled in the next few weeks. According to House Speaker Nancy Pelosi (D-Calif.), the package could be a “kitchen sink” of policies that may help Democrats obtain enough support from their own party, though many Democrats’ platforms on health care range from a modified version of Obamacare to a full single-payer system that covers every American.

    When asked if the package would include a Medicare-like insurance plan, despite the administration’s refusal to commit to a public health care option since taking office, White House chief of staff Ron Klain said that health care “will certainly be a part of [the plan], with a focus on trying to lower costs for most Americans, particularly around prescription drugs, and efforts also to expand affordable health care.”

    According to sources, Senate Budget Committee Chair Bernie Sanders (I-VT) is also looking to gather support around provisions that would lower the Medicare eligibility age and expand program benefits. Sanders recently told Politico that he will push for these policies as other rumors are circulating around the inclusion of Medicare dental, vision, and hearing coverage as a potential part of the package. (InsideHealthPolicy)

    Pelosi confirmed that everything is on the table for the package, which will likely be paid for by tackling prescription drug prices.

    Non-Partisan Parliamentarian Agrees Democrats Have At Least One More Shot At Reconciliation

    The U.S. Senate’s non-partisan parliamentarian gave its decision on Monday (Apr. 5) that would allow Democrats to have another shot at passing legislation without the support of Republicans. The ruling could allow Democrats to break big packages into two or three smaller pieces, potentially making it easier to pass elements of the administration’s agenda, like President Biden’s $2 trillion infrastructure plan unveiled last week, and enticing Republicans to support some of its policies.

    According to the terms of the decision, Democrats could also include reconciliation instructions in the 2022 budget bill. While Democrats had already used the budget fast-track process to enact the American Rescue Plan, the parliamentarian confirmed Senate Majority Leader Chuck Schumer’s (D-NY) statement on the process that it could be used again if the 2021 budget resolution was revised. (InsideHealthPolicy)

    “While no decisions have been made on a legislative path forward using Section 304 and some parameters still need to be worked out, the Parliamentarian’s opinion is an important step forward that this key pathway is available to Democrats if needed,” said Justin Goodman, a spokesperson for the Majority Leader.

    Last week, Biden announced that his substantial infrastructure plan includes $400 billion to boost home- and community-based services, and officials have said he’ll roll out the health provisions later this month. (InsideHealthPolicy)

    MA Benchmark Policy Replacements Will Lead to More Savings, According to MedPAC Advisors

    Last Thursday, MedPAC voted in favor of recommending that Congress replace the current benchmark policy set for Medicare Advantage with a new system that would share plans’ cost efficiencies with the federal government. According to the group, replacing the existing policy would help establish stable payment rates and share savings from MA plan efficiency with the government.

    The group recommended that the new benchmarks blend local fee-for-service spending with national fee-for-service spending and include a 75% rebate for plans and a 2% discount rate. According to MedPAC staff, the new benchmarks are estimated to reduce spending by more than $10 billion over five years. (InsideHealthPolicy)

    “Be mindful that the existence of supplemental benefits drives the efficiency that we are all admiring in the MA program, MA plans. It’s a market product. And in order to do well, they have to offer the right level of supplements…I would just be careful about sort of making external judgment calls about what’s the right level of supplemental benefits, [or] let’s homogenize the supplemental benefits,” said Commissioner Pat Wang, president and CEO of a New York-based health plan, who voted in favor of the recommendations.

    Several other commissioners commented that they support MA’s supplemental benefits, though there is skepticism on whether they are being paid for in an economically efficient way. In the future, Commissioner Amol Navathe suggested the commission assess how to make supplemental benefits more economically efficient without disrupting them. (InsideHealthPolicy)

    White House Unveils Drug Control Policy Priorities for Year Ahead

    Last week, the Biden administration released an outline of its drug policy priorities for the coming year. According to the White House Office of National Drug Control Policy, drug deaths spiked dramatically during a period that includes the first six months of the pandemic, up roughly 27% compared with the previous year. The plan will focus on harm reduction, racial equity, and helping people with substance use disorder find employment.

    The administration’s plan also endorses the use of fentanyl strips, as data reported from the Centers for Disease Control and Prevention indicates a dangerous upward trend of drug overdose fatalities from “illicitly manufactured fentanyl”. The strips help identify the presence of fentanyl in illicit drugs, though some substance abuse experts who argue that substance users might use them to seek out fentanyl rather than avoid it.

    “Fentanyl test strips are an important tool for engaging people and building trust so that when they’re ready to seek treatment, they know where to turn,” says Regina LaBelle, acting director of the Office of National Drug Control Policy.

    The administration also said it would expand interventions that provide substance users with incentives to change their behavior, as a way to deal with the surging number of overdoses related to stimulants. Where the Biden administration has yet to name a “drug czar”, LaBelle said the agency is still studying exactly what it can do about the limitations.