First Edition: Nov. 5, 2021

KHN: Democrats Plan To Expand Medicare Hearing Benefits. What Can Consumers Expect? 
President Joe Biden’s mammoth domestic spending bill would add hearing benefits to the traditional Medicare program — one of three major new benefits Democrats had sought. The Biden administration appears to have fallen short of its ambition to expand dental and vision along with hearing benefits. Sen. Bernie Sanders (I-Vt.) and other progressives have long pushed for more generous benefits for seniors. Citing the cost, Sen. Joe Manchin (D-W.Va.) opposed such expansion. (Pradhan, 11/5)

KHN: Despite Restraints, Democrats’ Drug Pricing Plan Could Still Aid Consumers
The Medicare prescription drug pricing plan Democrats unveiled this week is not nearly as ambitious as many lawmakers sought, but they and drug policy experts say the provisions crack open the door to reforms that could have dramatic effects. Tamping down drug expenses has been a longtime rallying cry for consumers beset by rapidly rising prices. Although people in private plans had some protections, those on Medicare often did not. They had no out-of-pocket caps and frequently complained that federal law kept them from using drugmakers’ coupons or other cost-cutting strategies. (McAuliff, 11/5)

KHN: ‘Covid Hit Us Over The Head With A Two-By-Four’: Addressing Ageism With Urgency
Earlier this year, the World Health Organization announced a global campaign to combat ageism — discrimination against older adults that is pervasive and harmful but often unrecognized. “We must change the narrative around age and ageing” and “adopt strategies to counter” ageist attitudes and behaviors, WHO concluded in a major report accompanying the campaign. Several strategies WHO endorsed — educating people about ageism, fostering intergenerational contacts, and changing policies and laws to promote age equity — are being tried in the United States. But a greater sense of urgency is needed in light of the coronavirus pandemic’s shocking death toll, including more than 500,000 older Americans, experts suggest. (Graham, 11/5)

KHN: KHN’s ‘What The Health?’: Compromise Is Coming — Maybe 
Democrats on Capitol Hill hope they are nearing the finish line in their months-long quest to enact President Joe Biden’s social spending agenda. After briefly dropping from the massive bill provisions aimed at lowering prescription drug costs, lawmakers in the House and Senate reached a compromise on that issue over the weekend. Also back in the bill — at least in the House — are provisions for paid family leave. But the bill cannot get to Biden without the signoff of every Democrat in the Senate, which has not happened yet. (11/4)

KHN: Few Acute Care Hospitals Escaped Readmissions Penalties
Preventable rehospitalization of the nation’s older adults has proved a persistent health and financial challenge for the U.S., costing Medicare hundreds of millions of dollars each year. Various analyses have found many readmissions within a month of discharge might have been avoided through better care and more attention paid to the patients after they left the hospital. The federal government’s campaign to reduce the frequency of so-called boomerang patients by applying financial disincentives has entered its 10th year with Medicare’s decision to lower payments to 2,499 hospitals throughout the current fiscal year, which began last month and runs through September 2022. (Rau, 11/4)

ABC News: Majority Of US Workers To Fall Under Vaccine Mandate On Jan. 4
Nearly 100 million U.S. workers will be required to get the COVID vaccine by Jan. 4, with some workers allowed to test weekly instead, under sweeping federal rules released Thursday by the Biden administration that identifies COVID-19 as an occupational hazard. The regulations are aimed at health care workers and businesses with 100 or more employees, covering two-thirds of the nation’s workforce. Businesses that don’t comply could be fined $14,000 per infraction, and hospitals could lose access to Medicare and Medicaid dollars. (Flaherty, 11/4)

AP: What Vaccine Mandate Means For Firms And Workers
The Biden administration’s sweeping new COVID-19 mandate will apply to 84 million workers at mid-size and large companies. President Joe Biden described the rules issued Thursday as urgently needed to get more Americans inoculated. Though confirmed viral cases and deaths have fallen sharply since the start of the year, they remain dangerously high, especially in some areas and industries. Average case numbers have leveled off at about 70,000 new infections a day and confirmed viral deaths at more than 1,200 a day. (Krisher and Wiseman, 11/5)

USA Today: OSHA Rules On COVID Tests: Who Pays For Vaccine Alternative?
Who pays and how much? Those are among the lingering questions about President Joe Biden's new rules requiring that many employers test their workers for COVID-19 weekly if they decline his vaccination mandate. This much we know: The Occupational Safety and Health Administration rules announced on Thursday – which cover an estimated 84 million people – don't require employers to pay for the tests. The upshot is that Americans who refuse to be vaccinated could be forced to pay the tab for their weekly screenings. (Bomey, 11/4)

AP: Thousands Of Intel Officers Refusing Vaccine Risk Dismissal
Thousands of intelligence officers could soon face dismissal for failing to comply with the U.S. government’s vaccine mandate, leading some Republican lawmakers to raise concerns about removing employees from agencies critical to national security. Several intelligence agencies had at least 20% of their workforce unvaccinated as of late October, said U.S. Rep. Chris Stewart, a Utah Republican who is a member of the House Intelligence Committee. Some agencies in the 18-member intelligence community had as much as 40% of their workforce unvaccinated, Stewart said, citing information the administration has provided to the committee but not released publicly. He declined to identify the agencies because full information on vaccination rates was classified. (Merchant, 11/5)

AP: GOP State Officials Push Back On Employer Vaccine Mandate
Republican state officials reacted with swift rebukes Thursday to President Joe Biden’s newly detailed mandate for private employers to require workers to be vaccinated against COVID-19, threatening a wave of lawsuits and other actions to thwart a requirement they see as a stark example of government overreach. At least two conservative groups moved quickly to file lawsuits against the workplace safety mandate, and a growing roster of GOP governors and attorneys general said more lawsuits were on the way as soon as Friday. Some Republican-led states had already passed laws or executive orders intended to protect employers that may not want to comply. (DeMillo and Mulvihill, 11/5)

AP: States Sue To Block Vaccine Mandate For Federal Contractors
Kentucky’s attorney general pushed back Thursday against President Joe Biden’s coronavirus vaccination mandate for private employers, filing a lawsuit claiming the requirement amounts to government overreach. The suit, filed in federal court in Kentucky, takes aim at the Biden administration’s vaccine mandate for federal contractors, Republican Attorney General Daniel Cameron said. Ohio and Tennessee joined in filing the suit, which claims the vaccination requirement is unlawful and unconstitutional. (11/4)

AP: Alabama Lawmakers Approve Job Protections For Unvaccinated
In an effort to fight COVID-19 vaccination requirements on workers, Alabama lawmakers on Thursday approved legislation to prevent companies from firing workers who claim a religious or medical exemption. Republicans said they were responding to an outcry from unvaccinated constituents afraid of losing their jobs because of the Biden administration’s vaccination mandate on federal contractors. Democrats argued the bill would put both federal contractors and public health in jeopardy for the sake of scoring political points. (Chandler, 11/5)

Modern Healthcare: Industry Has Questions, Concerns About CMS Vaccine Mandate
Industry stakeholders lauded the intent of COVID-19 vaccine rules released Thursday morning by the Centers for Medicare and Medicaid Services and the Occupational Safety and Health Administration, but many still have lingering concerns, particularly about whether the requirements will lead to more healthcare workers leaving an already tight labor market. Meanwhile, Republican state officials immediately indicated they're planning to sue the federal government over the OSHA rule, a move that's been expected since the Biden administration announced it would require the two agencies to put out COVID-19 vaccine policies in September. The legal battle could begin as soon as Friday. (Goldman, 11/4)

Bloomberg: Biden’s COVID-19 Mandate For Business Could Make Hiring Even Harder
President Joe Biden’s call for companies to enact Covid-19 vaccine or testing requirements is likely to exacerbate the labor shortage at some U.S. firms. The Labor Department said Thursday that companies with 100 or more employees will need to have all staff vaccinated or regularly tested for Covid-19. It set a Jan. 4 deadline. Failure to comply could trigger fines of as much as $136,000. The government is seeking to make workplaces safer as it tries to stop the spread of the virus, which slowed the economy last quarter. It said the measure will increase protections for 84 million workers.

Dallas Morning News: American Airlines Pushes Back Vaccine Mandate Until After Holidays On New White House Deadline
American Airlines pushed back its deadline for employees to get COVID-19 vaccinations by more than a month after the White House released updated rules Thursday that aligns the mandated start for both federal contractors and businesses with more than 100 employees. American Airlines’ 100,000 workers will now have until Jan. 4 to turn in proof of vaccination or get an exemption. The carrier also will extend the window for employees who do get vaccinated to receive an extra day of vacation next year and a $50 voucher, according to a memo from CEO Doug Parker and President Robert Isom. (Arnold, 11/4)

The Washington Post: New York City Cuts Vaccine Mandate Deal With Unions 
New York City said Thursday that it had reached an agreement with at least four unions representing some 75,000 city employees to establish rules about how workers can apply for medical or religious exemptions to the city’s coronavirus vaccine mandate. The development eases tensions between some city workers and Mayor Bill de Blasio’s (D) administration over requirements to get vaccinated against the coronavirus or go on unpaid leave. Though about 92 percent of city employees were compliant with vaccine mandates as of Wednesday, there are small pockets of resistance to the mandate, particularly among some police officers and firefighters. (Jeong and Suliman, 11/5)

The Baltimore Sun: Emergent BioSolutions, Operator Of Troubled Baltimore Facility, Ends Contract With Federal Government To Produce COVID Vaccines, Respond To Pandemic 
The specialty pharmaceutical manufacturer that operates the troubled Baltimore facility where millions of Johnson & Johnson vaccines went to waste this year announced the end of its involvement Thursday in a federal program that prepares for and responds to infectious diseases and other threats to public health. Gaithersburg-based Emergent BioSolutions discussed its withdrawal from the federal government’s Centers for Innovation in Advanced Development and Manufacturing program Thursday afternoon during a virtual earnings call with investors. (Miller, 11/4)

Axios: Moderna Falls Behind On COVID-19 Vaccine Deliveries 
Moderna lowered the expected number of its COVID-19 vaccine doses that will be delivered this year, from a previous high of 1 billion doses down to 800 million. Exporting vaccines outside of the U.S. to more countries took longer than expected, and is the primary reason behind the reduced shipments, CEO Stéphane Bancel said on an earnings call Thursday. (Herman, 11/4)

The Hill: House Sets Up Friday Votes For Biden Agenda
The House will convene at 8 a.m. Friday to begin work on passing President Biden's $1.75 trillion social spending and climate package, which has been stuck in a battle within the party between liberals and centrists fighting over its size and shape. The internal battles, which have also gridlocked a bipartisan infrastructure bill already approved by the Senate, have been blamed for pulling down Biden's approval ratings, and for a dismal showing by the party in Tuesday's off-year elections, when Democrats lost the governor's race in Virginia — where Biden won by 10 points just a year ago. (11/5)

AP: Biden's Big Bill On Brink Of House Votes, But Fights Remain
Democrats in the House appear on the verge of advancing President Joe Biden’s $1.85 trillion-and-growing domestic policy package alongside a companion $1 trillion infrastructure bill in what would be a dramatic political accomplishment — if they can push it to passage. The House scrapped votes late Thursday but will be back at it early Friday, and White House officials worked the phones to lock in support for the president’s signature proposal. After months of negotiations, House passage of the big bill would be a crucial step, sending to the Senate Biden’s ambitious effort to expand health care, child care and other social services for countless Americans and deliver the nation’s biggest investment yet to fight climate change. (Mascaro and Fram, 11/5)

The Wall Street Journal: Nancy Pelosi’s Push For Quick Votes On Bills Hits Snags 
The timetable for House Speaker Nancy Pelosi to bring up Democrats’ healthcare, education and climate package slipped to Friday after lawmakers hit snags on immigration and the state and local tax deduction. The California Democrat initially told House Democrats in a closed-door meeting on Thursday that she hoped the House would vote on the bill later that day, and then vote on the Senate-passed infrastructure bill on Friday, according to people familiar with her remarks. Progressives have been blocking the roughly $1 trillion infrastructure bill until they were satisfied with the language in the social-spending and climate-change bill. (Duehren, Wise and Hughes, 11/4)

The New York Times: House Democrats Hunt For Votes To Pass Biden’s Domestic Agenda
House Democrats are scrambling to line up the votes needed to push through a $1.85 trillion social safety net, climate and tax bill, as moderate Democrats, spooked by Tuesday’s electoral drubbing, have raised concerns about the cost and details of the rapidly evolving plan. Late Thursday night, Democratic leaders postponed a vote on the measure to Friday, when they also hoped to clear a Senate-passed $1 trillion bipartisan infrastructure bill for President Biden’s signature. A senior aide who disclosed the update on the condition of anonymity said they were confident they could complete the measures by Friday. (Cochrane and Weisman, 11/4)

The Hill: Fauci Blasts Paul For Saying He Is Responsible For COVID Pandemic 
America's top infectious disease doctor Anthony Fauci on Thursday blasted Sen. Rand Paul (R-Ky.) for suggesting he is somehow responsible for the COVID-19 pandemic."You have said I am unwilling to take any responsibility for the current pandemic. I have no responsibility for the current pandemic," Fauci said. Paul accused Fauci of misleading the public about the role the National Institutes of Health played in funding potentially dangerous "gain of function research" in Wuhan, China, and suggested that the SARS-CoV-2 virus was the result of such research, and then was released into the world because of a lab leak. (Weixel, 11/4)

Bloomberg: Biden Aide Tests Positive For Virus After Summit In Scotland
A White House aide who accompanied Joe Biden to international summits in Europe last week tested positive for coronavirus infection before the president returned to the U.S., according to people familiar with the matter. The aide and some of Biden’s other traveling staff remained in Scotland after the president attended the United Nations climate summit in Glasgow because of concern about transmission, the people said. The exact number of staff involved is unclear. (Jacobs, 11/4)

USA Today: Infections Edge Higher In 24 States As Weather Turns Colder
Cases rose week-over-week in 24 states in the seven-day period that ended Wednesday, a USA TODAY analysis of Johns Hopkins University data indicates. The rolling average of seven-day cases nationwide has more or less leveled off around 500,000 over the last 10 days after weeks of broad, steady decline. Infection numbers are rising primarily in colder states that hadn't been as hard-hit in the worst of the delta variant wave. The list includes Arizona, Arkansas, California, Colorado, Connecticut, Illinois, Indiana, Iowa, Maine, Michigan, Minnesota, Missouri, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Dakota, Ohio, Rhode Island, South Dakota, Vermont and Wisconsin. (Stucka, 11/4)

The Boston Globe: Mass. Reports 1,879 New Coronavirus Cases Among Public School Students And 339 Among Staff Over Two-Week Period
State education leaders on Thursday reported 1,879 new cases among public school students and 339 among staff members for the two-week period that ended Wednesday. Due to the power outages across the state last week, the COVID-19 cases reports from Oct. 21 and Oct. 27 were delayed. The 2,218 total cases were 64 fewer than those reported from Oct. 14-20, continuing a steady decline seen in recent weeks. (Gans and Vega, 11/4)

AP: Connecticut Changes COVID Policy On Quarantining Students
Gov. Ned Lamont announced a new policy Thursday allowing many unvaccinated students to stay in school — even if they had close contact with someone who has COVID-19. Under the Screen and Stay policy, students and staff who may have been exposed to the virus under certain circumstances, but show no symptoms of having caught it and were wearing a mask at the time of the potential exposure, will be allowed to remain in the classroom without a test for the virus. The state already allows vaccinated students who were in close contact with someone with COVID-19 to stay in school. (Eaton-Robb and Haigh, 11/4)

PBS NewsHour: What Young Americans Think About Vaccines And Mandates
Young people in the United States broadly support COVID-19 vaccine mandates to support in-person learning and work, and a majority believe that getting vaccinated is — at least in part — an obligation we owe to each other, according to a new poll among 13- to 29-year-olds from the PBS NewsHour and Generation Lab. And even though their lives have been upended, most Gen Zers and millennials say they do not feel more stressed now than they were before the pandemic, suggesting that hardships have perhaps reinforced resiliency for Americans under 30. (Santhanam, 11/4)

CNN: These States And Cities Are Offering To Pay Kids If They Get Vaccinated 
Millions of children in America became eligible to receive the Covid-19 vaccine this week. And some officials are sweetening the deal by including them in various incentive programs. In New York City, children can claim $100 if they get their first dose of Pfizer's vaccine at city-operated vaccine site. Alternatively, they can get tickets to city attractions such as the Statue of Liberty or the Brooklyn Cyclones baseball team. The incentive program was already available to other New Yorkers who got vaccinated. (Elamroussi, 11/5)

Bloomberg: Scientists Find Gene That Doubles Risk Of Dying From Covid-19 
Scientists identified a specific gene that doubles the risk of respiratory failure from Covid-19 and may go some way to explaining why some ethnic groups are more susceptible to severe disease than others. Researchers from the University of Oxford found that a higher-risk version of the gene most likely prevents the cells lining airways and the lungs from responding to the virus properly. About 60% of people with South Asian ancestry carry this version of the gene, compared with 15% of people with European heritage, according to the study published Thursday. (Ring, 11/4)

Modern Healthcare: Top 8 Healthcare Fraud Cases Related To COVID
Dozens of healthcare workers, executives and medical business owners have faced charges or other consequences for their involvement in fraud schemes related to COVID-19 and abuse of programs designed to facilitate access to medical care during the pandemic. The most recent charges allege a laboratory operator submitted $88 million in fraudulent claims. He and other individuals gained funds they then used to purchase items like exotic automobiles and luxury real estate, according to the U.S. Department of Justice on Thursday. (Devereaux, 11/5)

Modern Healthcare: Nearly 32,000 Kaiser Permanente Workers Plan Strike On Nov. 15
Nearly 32,000 Kaiser Permanente workers in California, Oregon and Washington plan to strike Nov. 15, the United Nurses Associations of California/Union of Health Care Professionals announced Thursday. The union represents 21,000 employees of the Oakland, California-based not-for-profit integrated health system. Thousands more workers who belong to the Oregon Federation of Nurses and Health Professionals and a United Steelworkers local also notified the company they intend to strike Nov. 15. The unions' contracts with Kaiser Permanente expired Oct. 1 and union members voted to authorize a labor action weeks later. Nearly 2,000 Kaiser Permanente employees with the National Union of Healthcare Workers also OK'd a strike last month but have not called one. (Christ, 11/4)

AP: Maintenance, Service Workers Strike At West Virginia Hospital
Maintenance and service union workers at a West Virginia hospital went on strike Wednesday after their contract expired. About 1,000 members of the Service Employees International Union District 1999 walked off the job at noon at Cabell Huntington Hospital, one of the largest employers in Huntington, West Virginia. In a statement, union district secretary-treasurer Joyce Gibson said hospital officials "have repeatedly made it clear that they value profits over workers and patients." (11/4)

Modern Healthcare: Home Health Sector Glad CMS Didn't Finalize Pay Adjustment Method
Home health providers are counting CMS' decision not to finalize methods for keeping the payment system for home health agencies budget neutral as a win, though they're still disappointed that CMS decided to move forward with a 4.36% cut for the third year in its final 2022 payment rule. CMS began the Patient-Driven Groupings Model for home health agencies last year, aiming to cut down on unnecessary therapies and instead emphasize patient characteristics. PDGM also changed the case-mix system and switched to reimbursing agencies based on 30-day periods. (Goldman, 11/4)

Bloomberg: J&J Takes Second Shot at Halting Baby Powder Suits in Bankruptcy
Johnson & Johnson is seeking to revive its strategy for resolving tens of thousands of lawsuits alleging its baby powder caused ovarian cancer and other health problems in women. A federal judge opened a two-day trial in Charlotte, North Carolina, on Thursday to decide whether to temporarily halt 38,000 lawsuits aimed at J&J and about 250 retailers and insurance companies.  Stopping the suits is a key part of J&J’s strategy to pay at least $2 billion to end all current and future claims related to baby powder and other talc-based products. To do so, J&J executed a legal strategy known as the Texas Two Step, creating a unit in Texas to hold all of the lawsuits, then transferring that unit to North Carolina and placing it in bankruptcy. (Church, 11/4)

USA Today: HPV Vaccine Reduced Women Cervical Cancer Rate By 87%, Study Finds
Vaccinating girls against the human papillomavirus, or HPV, has dramatically reduced the rates of cervical cancer in women, a study from the United Kingdom found. Cervical cancer rates were 87% lower in women who were vaccinated against HPV when they were between ages 12 and 13 compared to previous generations, the study published Wednesday reported. The rate of cervical cancer in women who were vaccinated between ages 14 and 16 was 62% lower. And in those vaccinated between 16 and 18, it was 34% lower. (Miller, 11/4)

Bloomberg: Does Deodorant Cause Cancer? Leukemia-Causing Benzene Found In Some Sprays
Antiperspirant and deodorant body sprays have been found to contain elevated levels of the carcinogen benzene and should be recalled, an independent testing lab said in a petition filed with the U.S. Food and Drug Administration late Wednesday. The sprays are the latest in a string of aerosol products found to contain the cancer-causing chemical, including sunscreens and antifungals. Earlier this year, Johnson & Johnson recalled certain aerosol sunscreen sprays under the brands Neutrogena and Aveeno. Beiersdorf AG recalled some Coppertone sunscreen sprays in September. The next month, Bayer AG pulled certain Lotrimin and Tinactin sprays used for athlete’s foot and jock itch after tests showed some samples contained benzene. (Edney, 11/4)

Bloomberg: Bat Bite Causes First Human Rabies Death Since 1978 In Idaho
A bat bite caused the first human rabies death since 1978 in Idaho, the state Department of Health and Welfare announced Thursday. The bat became caught in the male victim’s clothing in August. “He did not believe he had been bitten or scratched,” a press release said. He was hospitalized in October. It was not until after he took ill that officials determined he encountered the bat in Boise County. In 2020, 11% of 159 bats tested were positive for rabies in Idaho. So far in 2021, a total of 14 bats tested positive. (Del Giudice, 11/4)

AP: Lawsuit Briefly Blocking California Assisted Death Law Ends
An appeals court has formally ended a lawsuit that in 2018 temporarily suspended a California law that allows adults to obtain prescriptions for life-ending drugs, a gap that advocates blamed Thursday for a significant drop in its use that year. California lawmakers made the lawsuit moot last month when they reauthorized and extended the law until 2031 while reducing the time until terminal patients projected to have six months or less to live can choose to be given fatal drugs. (Thompson, 11/5)

Houston Chronicle: Texas Extends SNAP Food Stamp Program In November As Food Prices Rise
Texas has boosted funding for a key food assistance program, the latest effort to combat soaring food prices caused by the COVID-19 pandemic and related, global supply chain issues. On Thursday, the state announced an additional $310 million in funding for the emergency Supplemental Nutrition Assistance Program for November. The move maxes out the allowable amount of benefits for recipients based on family size and, according to officials, will give recipient families a minimum $95 extra by the end of the month. The Texas Health and Human Services Commission said it expects the funding will help more than 1.5 million households in the state. (Downen, 11/4)

AP: Body Donated For Science Dissected At 'Oddities' Expo
The body of a Louisiana man who wanted it donated for science was dissected before paying viewers at an “Oddities and Curiosities Expo” in Oregon, news agencies report. His wife is aghast. “As far as I’m concerned, it’s horrible, unethical, and I just don’t have the words to describe it,” Elsie Saunders of Baker, a Baton Rouge suburb, told The Advocate. ... Saunders’ husband, World War II and Korean War veteran David Saunders, died of COVID-19 at age 98. She said she learned his dissection had been watched by people paying up to $500 a seat when she was called Tuesday by Seattle station KING-TV. (11/4)

AP: State Says Disabled Not Entitled To Reasonable Accommodation
A Delaware judge is weighing whether a medical facility violated the state’s equal accommodation law by refusing to complete a sports physical for a boy with Down syndrome who wanted to compete in Special Olympics. The judge heard arguments Thursday in an appeal filed by the boy’s parents after the State Human Relations Commission determined that businesses do not have to provide reasonable accommodations to people with disabilities under Delaware’s Equal Accommodations Law. (Chase, 11/4)

AP: Denver Police Hope Therapy Dog Will Break Down Barriers
The Denver Police Department’s first therapy dog was originally trained to be a guide dog, but she turned out to be too friendly to focus on helping one person. Now the department is counting on the Black English Labrador Retriever’s outgoing nature to help it break down barriers and start conversations with people in high-crime areas and those wary of the police. (Slevin, 11/4)