KHN’s ‘What’s Health?’: Manchin makes a deal


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Democrats’ on-again, off-again budget bill is apparently back on, and it’s bigger than expected. In a surprise move, Senate Majority Leader Chuck Schumer announced an agreement with Sen. Joe Manchin (DW.Va.) to expand the scope of the limited health bill that was headed to the Senate floor to include climate change and some tax increases. Corporations and some wealthy Americans.

But the measure is still a fraction of what President Joe Biden and Democratic leaders had hoped for and does not include high-profile health priorities like new Medicare benefits or expanded eligibility for insurance that did not opt ​​to expand the Medicaid program. .

Meanwhile, the Biden administration restored anti-discrimination protections in health care for LGBTQ+ people that the Trump administration rolled back, while the Affordable Care Act returned to Texas courts, this time to hear a case challenging the health law’s requirement for preventive benefits.

This week’s panelists are KHN’s Julie Rovner, Joan Kenen of the Johns Hopkins Bloomberg School of Public Health and Politico, Pink Sheets’ Sarah Carlin-Smith and Politico’s Alice Miranda Wolstein.

Among the takeaways from this week’s episode:

  • The blockbuster announcement late Wednesday that Manchin had changed his mind and was willing to back a broader party-line bill for some of the president’s key priorities did not unveil any major changes to previously agreed-upon health provisions. Manchin previously said he would sign on to Senate Democrats’ plan to allow Medicare to negotiate drug prices and maintain increases in premium subsidies for health policies purchased in the Affordable Care Marketplace.
  • The new Senate legislation outline, however, would extend those premium increases for three years, one year longer than Manchin and Senate Majority Leader Chuck Schumer had previously agreed upon. That means renewing these subsidies won’t become a 2024 campaign issue.
  • The legislation leaves out several big-ticket health items that progressives wanted, including new funding for home health care and a popular provision to reduce consumers’ out-of-pocket costs for insulin. A separate bill would do that, but it’s stalled in the Senate.
  • Bill passage is not guaranteed. First, the Senate must ensure that its provisions are approved under complex rules that allow the Senate to pass spending and tax measures without the threat of a filibuster. Under that process, all 50 senators in the Democratic caucus must support the bill and the vice president must cast the tie-breaking vote. It’s not yet clear if all the senators are on board or if they could all show up for the vote next week. Many, including Manchin and Sen. Dick Durbin (D-Ill.), have announced they have Covid and are in isolation.
  • Biden has recovered from his Covid infection, according to the White House physician. While recovering, he was careful to keep working and doing quite well. And he noted that federal efforts he helped make more vaccines and treatment options more readily available will help others beat the infection.
  • Some critics, however, suggested that Biden’s message about working while convalescing sent a bad signal because patients should be encouraged to rest and recover.
  • A new survey by KFF found that 4 out of 10 parents of children under 5 said they would not vaccinate their children against Covid. This appears to be a byproduct of parents believing the disease is not a threat to little ones, their confusion about vaccine studies, and their long wait for a vaccine.
  • In a surprising twist, it appears that Congress can pass a bill enshrining same-sex marriage rights but cannot pass a bill guaranteeing a woman’s right to contraception. The contraception bill passed the House but stalled in the Senate. Conservatives are concerned about accusations from anti-abortion groups who think some types of contraceptives cause abortions.
  • A federal judge in Texas who has previously ruled against parts of the ACA is presiding over a challenge to the law’s provision that ensures insured people have no out-of-pocket costs for preventive care. The case could go to the Supreme Court, which has sidelined other attempts to weaken the ACA. But the center of power has shifted to the courts, so it’s unclear how judges will view the case.

Also this week, Rovner interviews Dr. Celine Gounder, an infectious disease doctor, a KFF Senior Fellow and KHN’s editor-at-large for public health, about the ongoing monkeypox outbreak in the United States and around the world.

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

Julie Rovner: NPR’s “Due to Texas Abortion Laws, Her Desired Pregnancy Turned into a Medical Nightmare,” by Carrie Fiebel

Alice Miranda Wolstein: The Hill’s “Top FDA Tobacco Officials Living for Philip Morris Job,” by Nathaniel Wicksell

From Joan: Science “Blots on a field? A neuroscience image sleuth finds spurious signs in scores of Alzheimer’s articles, threatening one-kingdom theory of disease,” by Charles Peeler

Sarah Carlin-Smith: NPR’s “Drugmakers are slow to prove drugs that work quickly to market” by Sidney Lupkin


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