KHN’s ‘What the Well being?’: A lot Ado About Drug Costs


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Congressional Democrats are finding it harder to actually write legislation to lower drug prices than it is to make promises about it. But the drug price provisions of the $3.5 trillion social-spending bill are critical — not only to keep that promise to voters but to produce savings that will pay for many of the other promised improvements, like new dental and other benefits for Medicare patients.

Meanwhile, the abortion debate has been jolted by the Supreme Court’s decision to allow a highly restrictive law to take effect in Texas. And the Biden administration unveils a “Covid Control 2.0” strategy that includes more sticks and fewer carrots.

This week’s panelists are Julie Rovner of KHN, Alice Miranda Ollstein of Politico, Rachel Cohrs of Stat and Shefali Luthra of The 19th.

Among the takeaways from this week’s episode:

  • The budget reconciliation process has claimed considerable congressional attention this week. Different committees have been writing and voting on their parts of this detailed and complex budget and savings measure. There have been marathon markup sessions and a degree of drama.
  • What could become a major sticking point is the reconciliation bill’s prescription drug provisions, which by reining in drug costs provide a lion’s share of the savings set to pay for Medicare, Medicaid and ACA expansions. The drug proposal would tie the prices Medicare pays for drugs to those of other nations — something the drug industry strongly opposes.
  • Democratic leaders continue to project confidence that drug price restraints will make it into the final bill. Bringing down drug costs was a big campaign issue for Democrats. Also, the funding it would provide pays the tab for a number of progressive priorities. However, the margins in the House are very slim and committee action has already spotlighted caucus members who voted against it.
  • It also appears that leaders are leaning toward scaling back some investments — doing a little for everyone rather than going big on certain initiatives. For instance, Medicare’s expansion of dental and vision coverage is not as robust as many progressives wanted. Home health investments have also been scaled back and a new cancer research institute will receive significantly less funding. However, the reconciliation measure currently does appear to make funding for Medicaid expansion and ACA subsidies permanent.
  • In the wake of the recent Supreme Court decision, abortion is effectively unavailable in Texas. Though the new Texas law the court allowed to take effect does not make getting abortion a crime, it allows private citizens to bring lawsuits against a person who may have aided or abetted a woman in getting an abortion. It’s already had an intense chilling effect. Health professionals who previously performed abortions are stopping, even though the law technically allows abortions during the first six weeks of pregnancy.
  • The Supreme Court’s take on this measure will likely open the door to other such state laws. The reach could also go beyond abortion to other issues, such as voting rights. Politically, the Supreme Court’s decision to allow the Texas law to go forward plays into the angst and debate surrounding the court itself. Chief Justice Roberts, for instance, who worries about the court’s credibility, voted with the minority to block the law.
  • Meanwhile, President Joe Biden, who has been criticized for not talking about the issue, has become more vocal and forward about his position. And Congress is planning a vote to write the protections of Roe v. Wade into federal law. However, such a bill likely would not gain Senate approval, since it would need 60 votes to overcome a filibuster by abortion opponents.
  • Medicare trustees finally released their delayed annual report, which found the program’s Hospital Insurance Trust Fund will likely remain solvent until 2026 — the same estimate floated last year. Meanwhile, the Census Bureau released its annual statistics on health insurance, which also stuck mostly to the status quo — although many people who lost private health coverage in 2020 apparently picked up public coverage instead.

Also this week, Rovner interviews KHN senior correspondent Phil Galewitz, who reported the latest KHN-NPR “Bill of the Month” feature about two similar jaw surgeries with two very different price tags. If you have an outrageous medical bill you’d like to send us, you can do that here.

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

Julie Rovner: The New York Times’ “A Medical Career, at a Cost: Infertility,” by Jacqueline Mroz

Alice Miranda Ollstein: The New York Times’ “Phony Diagnoses Hide High Rates of Drugging at Nursing Homes,” by Katie Thomas, Robert Gebeloff and Jessica Silver-Greenberg

Rachel Cohrs: KHN’s “Over Half of States Have Rolled Back Public Health Powers in Pandemic,” by Lauren Weber and Anna Maria Barry-Jester

Shefali Luthra: The 19th’s “’No One Wants to Get Sued’: Some Abortion Providers Have Stopped Working in Texas,” by Jennifer Gerson

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