Congress is moving toward completion of its annual spending bills for the fiscal year that started last October, but a last-minute snag jettisoned from the bill the Biden administration’s requested funding for covid prevention and treatment.
Meanwhile, a federal court has ruled that the administration overstepped in the dispute-resolution portion of its measure to bar “surprise” medical bills, after doctors and hospitals charged that the formula would favor health insurers in billing disagreements.
This week’s panelists are Julie Rovner of KHN, Joanne Kenen of the Johns Hopkins Bloomberg School of Public Health and Politico, Rachel Cohrs of Stat, and Jessie Hellmann of Modern Healthcare.
Among the takeaways from this week’s episode:
- When the last-minute dispute arose over covid funding in the federal spending bill for 2022, House Speaker Nancy Pelosi pulled that section of the bill. The House then passed the overall spending measure and sent it to the Senate. Pelosi said Congress will look at that spending separately later.
- The dispute grew out of Republican complaints that they don’t want to support new covid funding sought by the Biden administration until they have a full accounting of how much of past appropriations have been spent. So congressional leaders brokered a compromise to claw back about $7 billion from states in unspent covid funding to cover about half of the new initiative. But state governors — including Republicans — and some Democratic lawmakers balked at the deal.
- Administration officials say they have used all the covid funds already appropriated and need more money to be ready for any future problems from the coronavirus. Their plan contains provisions to buy more drugs and vaccines to be given to the public and efforts to prepare for new covid variants.
- Despite the dust-up over covid funding, the federal spending bill includes boosts in funding for the National Institutes of Health and the Centers for Disease Control and Prevention. And it gives the FDA authority to regulate “synthetic” nicotine, a key ingredient in some vaping products.
- Republicans scored a political win in the bill, however, by insisting that it continue to include the so-called Hyde Amendment, which prohibits federal funds from being used for abortion services. Democrats had promised to delete that ban but could not muster enough votes to make it happen.
- The administration’s plan to set up “test and treat” protocols, in which people who test positive for covid could immediately be prescribed antiviral medication at drugstores, ran head-on into strong opposition from the American Medical Association, which says only doctors should be able to prescribe drugs. The administration says seeking a doctor’s appointment or prescription often takes too long for patients since the medication, to work properly, must be started very early in the course of an infection.
- A federal judge in Texas last week struck down rules specifying how insurers, hospitals, and doctors resolve billing differences when a patient has received a surprise medical bill. A new law protects patients from these bills, which may result when they receive emergency care at a facility they did not choose or when they are at a hospital that is in their insurance network but are treated unexpectedly by a doctor who does not contract with their insurer.
- The judge, who ruled in favor of doctors in the suit, said the plan’s rules do not follow the law passed by Congress. Under the Biden administration plan, the health care provider and the insurer each present their best offer on the billing dispute to an arbitrator, who can consider many factors but should give greatest consideration to the amount closest to the median in-network rate for the service in question. Doctors and hospitals say that is unfair to them, but the administration has argued that standard can help keep costs from escalating.
- State legislators are busy anticipating a possible decision by the Supreme Court that would weaken or overturn Roe v. Wade, which guaranteed access to abortion nationwide. In Missouri, a lawmaker has proposed that the state find a way to penalize residents who travel out of state for an abortion. And some states are looking for ways to limit access to abortion medications ordered online and delivered through the mail.
Plus, for extra credit, the panelists recommend their favorite health policy stories of the week they think you should read, too:
Julie Rovner: The Atlantic’s “How Did This Many Deaths Become Normal?” by Ed Yong
Joanne Kenen: Politico’s “‘I Almost Lost My Baby’: Parents Demand Answers From FDA,” by Helena Bottemiller Evich
Rachel Cohrs: Vox.com’s “Maternity Wards Are Shuttering Across the US During the Pandemic,” by Dylan Scott
Jessie Hellmann: NPR’s “Delaware Is Shrinking Racial Gaps in Cancer Death. Its Secret? Patient Navigators,” by Yuki Noguchi
Also discussed on this week’s podcast:
The New York Times’ “The Loophole That’s Fueling a Return to Teenage Vaping,” by Christina Jewitt
CNN’s “Health Experts Warn Florida’s Plan to Recommend Against Covid-19 Vaccine for Healthy Kids Is Irresponsible,” by Travis Caldwell
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- Surprise Bills
- U.S. Congress
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