JustCare

Tag: Joe Biden

  • Will Biden support improving and expanding Medicare?

    Will Biden support improving and expanding Medicare?

    Jonathan Cohn writes for the Huffington Post on how Democrats in Congress were reacting to President Joe Biden’s apparent unwillingness to engage in healthcare reform. As it turns out, their fear that President Biden’s American Family Plan would not include a major health care piece appears to have been misplaced. The Biden American Family Plan fact sheet calls for Medicare drug price negotiation, lowering the Medicare eligibility age to 60 and more.

    That said, for whatever reason, the American Family Plan does not go into any real healthcare reform details, apparently leaving it to Congress to decide what to do. Democrats in Congress recognize that the simplest and most likely way to pass any healthcare reform legislation is through reconciliation, because the Democrats only need a majority to pass the law. Reconciliation bills are bills involving the budget.

    The administration does propose making permanent subsidies to help people buy private insurance in the state health insurance exchanges. This proposal is not what progressives in Congress are looking for. It is a costly bandaid solution, doesn’t address the fact that high deductibles and copays will still keep insured Americans from getting needed care. It also props up an unsustainable private health insurance system.

    Progressives like Sanders and Jayapal want to ensure that Congress improves Medicare with an out-of-pocket cap and vision, hearing and dental benefits and expands Medicare to people under 65. It’s not yet clear where Biden stands on these policies.

    We can pay for these Medicare improvements and expansions with the savings from passing H.R.3, the legislation that authorizes the federal government to lower drug prices on 250 of the most commonly used drugs. And, there is major public support for reducing drug costs.

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  • Public supports benchmarking US drug prices to prices in other countries

    Public supports benchmarking US drug prices to prices in other countries

    It’s still not clear whether President Joe Biden is going to push for prescription drug price negotiation in the American Families Plan, but public opinion strongly suggests he should. A recent Data for Progress poll shows that while the public believes that the pharmaceutical companies did a good job coming up with a COVID-19 vaccine, Americans still want Congress to regulate prescription drug prices. A substantial majority of people want to ensure that everyone in the US can get the life-saving medicines they need; they want some balance between drug prices in the US and other wealthy countries.

    Data for Progress found that 77 percent of the public supports drug price negotiation at the same time that they are pleased with the job that pharmaceutical companies have done developing COVID-19 vaccines. Just 17 percent of people oppose drug price negotiation. Of that 17 percent, eight percent strongly oppose drug price negotiation. Interestingly, 76 percent support matching drug prices in the US to prices in other wealthy countries–as does the drug price negotiation bill that passed in the House in 2019, H.R.3–with only 13 percent opposing this.

    And, while the public supports using prescription drug savings to pay for President Joe Biden’s infrastructure plan, 5o percent more Americans strongly favor paying for the infrastructure plan through increased taxes on the wealthy and corporations. Almost one in four (24%) Americans favor using drug savings towards infrastructure building; nearly four in ten (38%) Americans favor paying for infrastructure through increased taxes on the wealthy and corporations. Of note, only six percent (6%) of Americans believe that the government should not be investing in infrastructure.

    The public also supports increasing government investment for research on affordable prescription drugs. Nearly seven in ten (68%) Americans support this initiative. Just 19 percent oppose it, and of that 19 percent, eight percent strongly oppose it.

    Eight in ten Americans support allowing multiple companies produce the same medicines in order to bring down their cost. Only 12 percent oppose this proposal.

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  • President Biden proposes funding for long-term care infrastructure

    President Biden proposes funding for long-term care infrastructure

    John Nichols reports for The Nation on President Joe Biden’s American Jobs Plan, which is designed to address America’s failing infrastructure. Billions would go to bridges, roads and other public transportation engines. Wisely, billions would also go to fund America’s failing long-term care infrastructure, supporting at home and community care.

    Joe Biden’s plan calls for Congress to allocate $400 billion to ensure the availability of more affordable home and community-based care. The goal is to foster a more humane life for hundreds of thousands of Americans. In the process, it will create hundreds of thousands more jobs for caregivers, along with better wages and benefits. Today, one in six care workers live in poverty.

    Right now, about four million people turn 65 every year. As they age, they often need help caring for themselves. But, the US offers precious little in the way of long-term supports and services, except for some people on Medicaid–and often people cannot access that care because they don’t meet the strict eligibility criteria or their state has a long waiting list. Medicare pays for only a small amount of nursing home care and home care, and only in limited situations.

    President Biden’s team recognizes that “increasing the pay of direct care workers greatly enhances workers’ financial security, improves productivity, and increases the quality of care offered.”

    Specifically, Biden’s plan will expand access to home and community-based services under Medicaid. It will also pay for caregiving jobs with benefits, and will enable collective bargaining and union membership for workers. The question is will Congress support it?

    If all goes well, the Biden administration will build on these benefits. Older adults and people with disabilities who do not qualify for Medicaid also need help paying for at home and community-based care. And, families need paid family and medical leave. We have a long way to go to build a more humane society.

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  • Biden administration acts to ensure people with disabilities keep their Social Security benefits

    Biden administration acts to ensure people with disabilities keep their Social Security benefits

    The Trump administration worked hard to destroy Social Security every which way it could. Among other things, it made it extraordinarily difficult for people to get the Social Security benefits to which they are entitled. Now, Jake Johnson reports for Common Dreams, that the Biden administration has withdrawn a Trump administration not-yet-final regulation that would likely have taken disability benefits from hundreds of thousands of Americans.

    The Trump administration tried to subject people receiving Social Security long-term disability benefits to constant reviews if they wanted to retain these benefits. The additional reviews would have posed challenging administrative hurdles for people receiving benefits. As it is, qualifying for Social Security disability benefits is not easy.

    Social Security Works led the advocacy effort. According to its executive director, Alex Lawson, the proposed regulation was “the Trump administration’s most brazen attack on Social Security yet.” “When Ronald Reagan implemented a similar benefit cut, it ripped away the earned benefits of 200,000 people. Ultimately, Reagan was forced to reverse his attack on Social Security after massive public outcry—but not before people suffered and died.”

    President Joe Biden has a history of proposing Social Security cuts. And, he was criticized for his record on Social Security during the 2020 presidential campaign. He is now holding true to his word during the campaign that he would protect Social Security.

    President Biden also promised during the campaign to increase Social Security benefits, which are not as high as they should be. For a wealthy country, Social Security benefits in the US are stingy relative to other countries. To increase Social Security benefits, it would be particularly helpful for President Biden to fire the Social Security Administration Commissioner Andrew Saul and Deputy Commissioner David Black. Donald Trump is responsible for putting these high-level anti-Social Security officials in charge of Social Security.

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  • Several states plan to import drugs from Canada

    Several states plan to import drugs from Canada

    With drug prices in the US now substantially more than twice as much as in other countries, Donald Trump issued an executive order in his final days as president allowing states to import many drugs from Canada under certain conditions. Now, Phil Galewitz reports for Kaiser Health News that several states are planning to seek approval from the US Department of Health and Human Services (HHS) to get drugs at lower cost from our northern neighbor. Will the Biden administration provide approval?

    A new RAND report finds that in the 17 years between 2000 and 2017, drug prices in the US rose 76 percent. They are likely to continue to increase. Today, we pay on average more than two and a half times what other wealthy countries pay for brand-name and generic prescription drugs.

    Interestingly, we pay about 3.44 times more than other countries for brand-name drugs, but 84 percent of what other countries pay for generic drugs. We pay on average about 1.7 times what Mexicans pay for their brand-name drugs and 7.7 times what Turks pay for their brand-name drugs.

    During his presidential campaign, President Joe Biden supported the policy of drug importation from Canada as one way to help Americans afford their medications. Of course, Pharma opposes importation, claiming patient safety issues. But, its arguments around safety hold little weight. People have been importing drugs safely from Canada for years. Moreover, forcing people to go without needed medicines because they are unaffordable creates grave patient safety issues.

    Pharma has sued to stop the Trump policy from taking effect. The federal government must respond shortly. We will have a good sense of whether President Biden still supports importation from Canada, based on the federal government’s response to the lawsuit.

    Florida, Colorado, Vermont, New Hampshire and Maine have decided to take importation into their own hands. Some are contracting with private businesses to deliver them drugs from abroad. Florida’s plan is to get lower-cost drugs for state programs, such as Medicaid. It thinks it could save as much as $150 million in year one.

    Colorado is looking to contract with a private company to obtain drugs from Canada for its residents that would be available at their local pharmacies. And, health insurers in Colorado would be able to make the drugs available on their formularies. Colorado policy experts believe that importing drugs from Canada would more than cut the price of many drugs in half for Colorado residents.

    For its part, the Canadian government seems willing to cooperate with the states. However, it will only cooperate when it has a healthy supply of a drug. While that could be an issue with generic drugs, it does not appear to be an issue with brand-name drugs. Trump’s executive order does not allow importation of insulin or injectables.

    The Secretary of HHS must approve a state’s importation policy and find it safe. President Biden’s HHS nominee, Xavier Becerra supported a law allowing importation from Canada as a member of the House of Representatives back in 2003. That was a while ago; it’s not clear how HHS will respond in 2021.

    Again, safety should not be an issue. Many drugs sold in the US are safely imported from abroad already.

    Importation is not a solution to out-of-control drug prices in the US. It will only help a small portion of the population. But, making it legal to import drugs should help reset the market price for drugs in this country. It should make it harder for Pharma to challenge regulation of drug prices to levels at which people can legally import them.

    Here’s more from Just Care:

  • Health care: Where’s the data?

    Health care: Where’s the data?

    If we’ve learned anything during this novel coronavirus pandemic, it’s that the data matters. We need data to know what’s working and not working in our health care system, and how to fix problems. Not making data a priority is tantamount to ignoring issues of equity and access to care. And, yet, a national electronic health care data system does not yet seem to be either a Congressional or Biden administration priority.

    Rachana Pradhan and Fred Schulte report for Kaiser Health News that the government is not even collecting important data about the people receiving COVID vaccinations. As a result, we don’t know who has received and who is receiving the vaccine. We don’t know whether people less in need are getting the vaccine ahead of health care workers or the extent to which minority populations are being discriminated against.

    President Biden recognizes that data matters. Yet, the federal government is literally spending trillions of dollars on health care, including on the vaccine, and it has little data to show for it, except in traditional Medicare. If the goal is to promote racial and social equity, to address issues of discrimination in health care, to ensure that critical treatments are available throughout the country, where they are needed, data must be a top priority.

    Right now, the available data reveal that Black Americans are not getting vaccinated at the same rate as whites. But, the data is limited. And, it’s hard to know where vaccinations are needed to reach herd immunity.

    Each state has a vaccine registry, but the sophistication of the registry varies by state. It’s inexcusable that vaccination data collection is not standardized and, in this technological era, states are not collecting and reporting to HHS all the needed data. It’s beyond inexcusable that registries do not even exist for drugs or medical equipment; when equipment is defective or drugs are causing harmful side effects, the data is generally not available.

    Real-time data does not exist for health care services, including vaccinations. There is no national public health system in charge of data. Moreover, each of the 64  immunization registries that collects vaccination data is siloed, unable to connect with one another.

    The CDC wants the name, address, sex, birthday, race, ethnicity and vaccine site for every person vaccinated. It does not ask for occupation, so few states collect that information. And race and ethnicity information is often missing. In many states, half the time, race and ethnicity information is not collected.

    Electronic health records companies that provide software to hospitals and other facilities said they are scrambling to modify software to accommodate data reporting requirements that vary by state.

    There are plans in place to invest in better data collection at the national level, when it comes to vaccines. But, really, data collection only for vaccines? For our individual and collective health, we need a single national system collecting real-time time that flows directly to the appropriate federal government agency.

    We can learn a lot about strengths and deficiencies in our health care system through a national electronic database. We could develop plans to address deficiencies. You have to wonder why Congress and the Biden administration are not making it data collection and reporting a priority.

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  • Will Biden quickly replace Social Security leadership?

    Will Biden quickly replace Social Security leadership?

    Union heads are leading the fight to install new leadership at the Social Security administration. They want Commissioner Andrew Saul and Deputy Commissioner David Black out on day one. How quickly will President Biden replace them?

    The American Federation of Government Employees (AFGE) speaks for Social Security field office workers. The Association of Administrative Law Judges represents judges employed to make Social Security disability determinations. They say that neither the SSA Commissioner nor the Deputy Commissioner have any intention of either strengthening Social Security or supporting the reopening of its field offices post-pandemic.

    Under the Trump administration, Social Security has granted disability benefits to one hundred thousand fewer people in the period between July and November 2020 than it did in that same period in 2019.  It is estimated that, as a result, 230,000 individuals do not have access to SSI benefits, an average of $560 a month, or Medicaid.

    The Social Security Administration has also put into effect a group of policies that undermine Social Security. It has weakened the power of union workers. It closed its 1,200 field offices during the pandemic but did not let most employees work from home. And, the unions allege it is violating labor laws.

    McIntosh, president of the Association of Administrative Law Judges, said agency leadership has repeatedly violated federal labor laws in dealings with her union.

    Leadership has directed salaried staff beholden to them, and not independent judges, to make disability determinations. There is no apparent Covid-19 plan in place and no plan in place for reopening the Social Security Field Offices and making them safe for workers and visitors.

    Even though Saul and Black are political appointees, their term is not scheduled to end until 2025. That said, President Biden has the power to fire them for cause.

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  • Will Congress allow Medicare drug price negotiation in 2021?

    Will Congress allow Medicare drug price negotiation in 2021?

    President Joe Biden’s election, combined with Democratic control of the House and Senate, give Democrats the opportunity to help Americans and bring down the price of prescription drugs. As a starter, Congress could end the ban on Medicare drug price negotiation. Better still, it could benchmark drug prices in the US to prices in other wealthy countries. But, it’s not at all clear that the Democrats will try to pass drug price legislation or, if they do try, that they will succeed.

    At the end of 2019, the House passed legislation that would allow Medicare to negotiate the price of 350 drugs over 10 years. HR3 also extended Medicare’s negotiated prices to all private insurers. Strangely, however, HR3 does not allow uninsured Americans to benefit from the negotiated prices.

    Nicholas Storko reports for StatNews that it will be a heavy lift for the Senate to repeal the ban on Medicare drug price negotiation. Even if every Democrat agreed–and that should not be taken as a given–passing the legislation might require 60 votes. Moreover, Republicans and Pharma will put up a big fight.

    Usually, Senator Joe Manchin of West Virginia, arguably the most conservative of the Democratic House members, resists joining with his party over progressive policies. With drugs, he might join with them; he co-sponsored legislation in 2019 to allow Medicare to negotiate drug prices. This time around, Senators Bob Menendez of New Jersey and Kirsten Sinema of Arizona might keep the Senate from repealing the ban, even if only a majority of Senators are needed to pass the legislation. Sinema appears to be closely tied to Pharma.

    Menendez openly voted against allowing Medicare to negotiate drug prices in 2019. He has said privately that he opposed the 2019 legislation because he didn’t think it would benefit individuals adequately. His spokesperson reports that Menendez does not think repealing the ban would save people money, a misleading claim that the Congressional Budget Office made when the conservative Douglas Holz-Eakin headed it. If the legislation benchmarks drug prices to the average of what other wealthy nations pay, it probably would cut drug prices in half.

    Some Republicans might support repeal of the Medicare ban on negotiating drug prices. But, that’s a long shot. No Senate Republicans are co-sponsoring bills to lower Medicare drug prices.

    In addition, this year, the Democrats hold a much slimmer majority in the House than in 2019. So, HR3 would not likely pass in the House as currently drafted. If a new version were to pass, it is likely to be even less comprehensive than HR3.

    Here’s more from Just Care:

  • Biden has power to authorize free Medicare for everyone

    Biden has power to authorize free Medicare for everyone

    President-elect Biden could guarantee everyone in the US affordable healthcare if he wanted to. David Dayen writes for The American Prospect that, because of the pandemic, a Biden administration–without Congress–has the power to ensure everyone in the country free health care coverage through Medicare. Will Biden have the courage to act and save millions of lives in the process?

    Dayen reports that the Social Security Administration and the Department of Health and Human Services have the authority to give people Medicare for free during the pandemic. A provision in the Affordable Care Act allows this coverage for all people who are subject to an “environmental exposure.” Consequently, the COVID-19 pandemic could make everyone in the country eligible for Medicare, if the incoming administration chose to exercise its authority to do so. 

    Congress might not be planning to enact Medicare for All any time soon. But, in a real way, Section 1881A of the Social Security Act specifically confers the authority on the administration to put in place Medicare for all who want it. Today, more than 2,500 people of Libby, Montana have free Medicare. These people have Medicare because they were exposed to an environmental hazard that could lead to medical issues. So, the federal government is covering their medical costs.

    It’s hard to imagine that President-elect Joe Biden will use this power even in a limited way to provide Medicare to millions of Americans with COVID-19 or who have tested positive for COVID and who otherwise might not be able to afford needed care during this pandemic. But, the ACA provides his administration the authority to establish “optional pilot programs” throughout the country, because of President Trump’s public health emergency declaration. Individuals can then choose to apply for Medicare benefits. They will meet the criteria so long as they are in the middle of a “public health hazard to which an emergency declaration applies . . .” There is nothing to stop HHS from establishing such a pilot program.

    Indeed, HHS could establish the program for everyone in the country, as everyone is at risk of COVID. Cost of testing and treatment should not impede people’s access to care and would promote the public health. And, Biden has said that he supports free coronavirus treatment and a free vaccine.

    What’s more radical: Giving everyone free Medicare or letting tens of thousands of Americans die because the federal government did not do so?

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  • President-elect Biden proposes German model for drug pricing

    President-elect Biden proposes German model for drug pricing

    President-elect Joe Biden is proposing that the US look to Germany as a model for drug pricing. On one hand, a German model could be a step forward, putting in place a national system for evaluating and pricing drugs. But, the devil is in the details; how will they compare with President Trump’s latest interim-final drug pricing rule for Medicare.

    Germany, like many other countries, has a government-run system for determining the value of a drug and pricing the drug. The US has no such system at the moment. Our federal government does nothing to assess the value of drugs it approves or to rein in drug prices.

    Biden’s proposal would establish a government team charged with determining a drug’s fair value. It could work much like the non-profit Institute for Clinical and Economic Review. That group has taken on a significant amount of work evaluating the cost-effectiveness of drugs.

    Biden also proposes that, as in Germany, pharmaceutical companies would be required to negotiate drug prices, in collaboration, at the national level, that would apply to both public and private insurance.

    It’s not clear what pricing elements a Biden administration would factor into the determination of a drug’s price. Everything turns on how much weight the group gave to various pricing elements. Under Biden’s proposal, if a “quality-adjusted life year” or QALY was worth as much as $150,000, much higher than in Europe, drug prices likely would not come down much. And, tens of millions of Americans would continue to be forced to forego needed medicines.

    The international reference pricing bill, which passed in the House of Representatives, HR3, gives significant weight to the price paid by other wealthy nations, which makes tremendous sense. Why should we be paying more than the Germans and the Japanese for our drugs?

    HR3 would bring down the price of 350 drugs significantly. But, it is going nowhere in the Senate. That said, the Trump administration has issued an interim final rule that would set Medicare drug prices at a level comparable to what other wealthy countries pay. President-elect Biden might intend to undo Trump’s rule, even though it would drive down prices considerably and eat deeply into pharmaceutical company profits.

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