🦠 Axios Vitals: Funding fight

Plus, private Medicare plan care costs extra $12B | Wednesday, March 16, 2022

Open in app View in browser   Presented By PhRMA   Axios Vitals By Tina Reed ·Mar 16, 2022 Good morning, Vitals readers! I'm back from vacation with today's newsletter, which is 820 words or a 3-minute read.     1 big thing: White House fights for COVID funding amid waning interest Illustration: Sarah Grillo/Axios   The White House is intensifying pleas for new emergency COVID funding, warning Tuesday that a continued standoff in Congress on the matter will result in cutbacks in the U.S. pandemic response as early as next week. Why it matters: With many Americans and lawmakers eager to move on from the health crisis, the Biden administration is fighting an uphill battle trying to convince Congress that $22.5 billion in additional spending is worth it. Administration officials fear the consequences of being caught short if a new, more dangerous COVID variant were to emerge and needed treatments, testing and vaccines don't materialize. Catch up quick: Last week, Congress passed a $1.5 trillion government spending bill after stripping out a pared-down $15.6 billion request for COVID funds. Some House Democrats rebelled against a leadership plan to pay for about half of the sum by clawing back unallocated state and local pandemic relief. Republicans also called for better accounting of how previous funds were spent before approving more funding. Democratic leaders plan to hold a vote on a stand-alone bill without the offsets, the Wall Street Journal reported. Driving the news: Officials said Tuesday that without the requested funds, the federal government will delay buying "hundreds of thousands" of monoclonal antibody treatments and instead cut state allocations of the drug by 30% starting next week to stretch supplies. The White House also said it would start cutting back on a COVID-19 program to test, treat and vaccinate the uninsured, pull back on disease surveillance and stop buying oral antiviral treatments like Pfizer's Paxlovid. Yes, but: Republicans doubled down on their reluctance to support more funding on Tuesday, the Washington Post writes. The big picture: This comes amid signs from Europe that another COVID wave may be heading our way.     2. Private Medicare make windfall for senior care Illustration: Eniola Odetunde/Axios   Health insurers that sell private Medicare plans collected $12 billion more caring for seniors in 2020 than it would have cost in traditional Medicare, Axios' Adriel Bettelheim writes based on a report from the Medicare Payment Advisory Commission. It shows the need for major payment reforms, according to the report. Why it matters: Overpaying the Medicare Advantage plans as their enrollment continues to grow threatens Medicare's long-term finances. Go deeper: MedPAC laid blame on aggressive medical record coding, specifically "risk scores" that insurers assign to members based on the medical conditions they have. The higher the risk score, the more conditions, and the more money the insurer gets for covering them. The big picture: Backers of reforms worry Medicare is turning into a marketplace of private plans with a public plan as a backup option. From 2018 to 2021, the share of eligible Medicare beneficiaries enrolled in Medicare Advantage rose by 3 percentage points per year, from 37% to 46%, MedPAC said. Yes, but: The insurers argue they're providing more benefits than in traditional Medicare — nearly $2,000 in extra coverage annually that traditional Medicare enrollees can't get unless they buy additional coverage. Medicare Advantage plans also limit out-of-pocket costs.     🥱 3. Still recovering from the time change Illustration: Eniola Odetunde/Axios   The Senate passed a measure Tuesday that would end the twice-annual ritual of switching our clocks by making daylight saving time permanent across the U.S. Plenty of health groups have been calling to end the practice of changing the observed time by an hour, citing everything from disrupted sleep to increases in medical errors, upticks in accidents and consequences for heart health. Yes, but: There's not a consensus around what would be the healthiest move. But plenty of health experts advocate for a permanent shift — to American standard time. What's next: Rep. Vern Buchanan (R-Fla.) will lead a letter to House Speaker Nancy Pelosi calling for immediate House passage of his companion bill, the Sunshine Protection Act, Axios' Sophia Cai and Andrew Solender report.     A message from PhRMA Voters want Congress to address health insurance     Many Americans reject so-called government "negotiation" once they learn it could sacrifice access, choice and innovation. The story: Respondents find health care coverage costs unreasonable and a top priority health care issue for policymakers to address today. Read more in the new survey.     4. Pfizer seeks OK for second booster for seniors Photo: Pongmanat Tasiri/SOPA Images/LightRocket via Getty Images   Pfizer and partner BioNTech applied to the FDA Tuesday for emergency authorization for a second COVID-19 booster shot for people 65 and older. Driving the news: The move is an attempt to combat waning immunity that occurs several months after a first booster shot, according to the Washington Post, which first reported the news. Pfizer CEO Albert Bourla said on Sunday that a fourth dose of the COVID-19 vaccine "is necessary" to maintain manageable levels of hospitalizations and mild infections, Axios' Erin Doherty writes.     5. Catch up quick Americans who got the Johnson & Johnson COVID-19 vaccine were once told it was less effective, but data shows the shot appears to be preventing infections, hospitalizations and deaths as well as its mRNA competitors. (New York Times) A majority of healthcare workers could leave their profession by 2025 without some big changes, according to an Elsevier study. (Forbes) The conflict in Ukraine has created a massive children's mental health crisis that is difficult to address as refugees move to seek safety. (The Guardian) The New York State Health Department "misled the public" and failed to publicly account for the COVID-19 related deaths of over 4,000 New York nursing home residents, according to an audit. (Axios)     A message from PhRMA Voters want Congress to address health insurance     A decisive majority of Americans (86%) agree Congress should crack down on abusive health insurance practices impacting patients' access to care. Why it's important: Greater transparency and accountability within the current health insurance system. Read more in new poll.   Like this email style and format? It's called Smart Brevity®. Over 200 orgs use it — in a tool called Axios HQ — to drive productivity with clearer workplace communications.   Axios thanks our partners for supporting our newsletters. If you're interested in advertising, learn more here. Sponsorship has no influence on editorial content. 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