| | | | | | | Presented By PhRMA | | | | Axios Vitals | | By Tina Reed · Jul 14, 2022 | | 👋 Good morning, Vitals readers. Today's newsletter is 938 words or a 3.5-minute read. Join me and Axios' Alayna Treene today at 12:30pm ET for a virtual event examining the Supreme Court's decision to overturn Roe v. Wade. - Guests include Sen. Tina Smith (D-Minn.), Rep. Nancy Mace (R-S.C.) and American Medical Association president Jack Resneck Jr. Register here.
| | | | | | 1 big thing: Rural hospitals again face financial jeopardy |  Data: UNC; Map: Baidi Wang/Axios After weathering the pandemic with federal COVID aid, rural hospitals are facing a convergence of challenges that could leave many facilities deep in the red and at risk of closing as soon as the end of this year, Axios' Arielle Dreher writes. Why it matters: Hospitals are among the biggest employers in rural communities and the only health providers in large swaths of the country. But they've been operating on the edge for years, tending to older, sicker patients who often can't afford care. Driving the news: Hospitals couldn't persuade Congress to delay a scheduled 2% cut in Medicare payments, then were frustrated by a Medicare payment proposal for 2023 they say ignores the effects of inflation, labor and supply cost pressures. - Many facilities have burned through federal COVID provider relief funds and Paycheck Protection Program loans that helped them cope with staffing and supply shortages and lower demand as patients deferred care.
- "The data would suggest we will see a lot more rural hospital closures at the end of this year and into 2023," Alan Morgan, chief executive of the National Rural Health Association, told Axios.
The bottom line: Closures could dramatically reduce access to care, forcing patients to travel longer distances for inpatient services, substance use treatment and other needs, per the Bipartisan Policy Center, which recommends new payment models and incentives to retain health workers to ease the crunch. - Yes, but: Sympathy may be limited for an industry that recently received large sums of federal dollars to get through the pandemic.
Go deeper. |     | | | | | | 2. Manchin broaches stand-alone drug pricing bill |  | | | Photo: Kevin Dietsch/Getty Images | | | | Congressional Democrats see government drug price negotiations as a core piece of a reconciliation bill — but one key swing lawmaker suggested Wednesday it could wind up being an end in itself, Axios' Adriel Bettelheim writes. What happened: Sen. Joe Manchin (D-W.Va.) reiterated concern about big spending initiatives worsening inflation on a day the Consumer Price Index hit another four-decade high. - But, he added, if lawmakers can't agree on anything else, they could still use the reconciliation process to pass a drug price plan he's been negotiating with Senate Majority Leader Chuck Schumer.
- Manchin's gone down this road before, portraying Medicare-negotiated payments to drugmakers as the one thing that could get through the 50-50 Senate using the partisan reconciliation process.
Yes, but: That would effectively shelve other ambitious health initiatives Democrats want to enact before the midterms, including permanently extending enhanced Affordable Care Act subsidies. Quotable: Manchin's flipping the usual politics of health care, said Larry Levitt, executive vice president for health policy at the Kaiser Family Foundation. - "It's generally relatively easy to get the votes to spend money, but very difficult politically to take on health care providers and the drug industry to control costs. Right now, the opposite seems to be true," Levitt tweeted.
| | | | | | | | 3. Abortion medication guidance may not be enough |  | | | Photo: Mark Wilson/Getty Images | | | | The Biden administration says powers under the Affordable Care Act can clear up uncertainty about whether states with abortion bans can influence what medicines pharmacists dispense. But it may not be so straightforward. Driving the news: HHS released guidance on Wednesday to clarify that pharmacies that receive federal funding cannot deny people from accessing prescribed medication that could be used to terminate a pregnancy because doing so runs afoul of anti-discrimination provisions in the ACA. - Some patients, particularly in states that have banned or restricted abortions, have been denied access to cancer treatments and other drugs because they can also be used to terminate a pregnancy.
A senior HHS official told reporters on Wednesday that federal law supersedes state law, and the department will evaluate on a case-by-case basis whether laws are in conflict. - Yes, but: The American Pharmacists Association (APhA) said the HHS' guidance offers potential examples when pharmacists' refusal to dispense a medication to a person "may be" a violation of a federal law. This type of language makes it "unclear" if the guidance preempts state law.
What they're saying: The APhA said HHS "hastily issued this guidance which attacks and undermines the fundamental responsibilities and professional judgment of the pharmacist." | | | | | | | | A message from PhRMA | | What's fueling inflation? | | |  | | | | Not prescription drugs — and the presidential administration's economic data proves it. The proof: Overall inflation surged by 8.6% since May 2021 while prices for medicines grew less than 2%, even before factoring in the discounts insurers receive. Find out more. | | | | | | 4. COVID hospitalizations up in South, Great Plains |  Data: CDC; Map: Jared Whalen/Axios New hospital admissions of patients with COVID-19 are up in the U.S. and are forecast to continue to rise, CDC data shows. Why it matters: We don't know how many cases are individuals admitted for COVID versus those hospitalized for other conditions who happen to have COVID. But with many COVID cases being detected through home testing, experts have increasingly pointed to hospitalizations as an important metric for understanding what's happening at a community level, Insider reports. By the numbers: Hospitalizations from the BA.5 subvariant of Omicron circulating the U.S. are about 78% lower than their peaks in January, and deaths remain relatively low. But hospitalizations are on the rise, up 11% over a seven-day period. - Hospitalizations were up the most in HHS region 6, which includes Texas, Louisiana, New Mexico and Oklahoma (21.5%), followed by region 7 (15.3%), which includes Iowa, Kansas, Missouri and Nebraska.
| | | | | | | | 5. Catch up quick | | 🤰The Dobbs decision banning a federal right to abortion is fueling new Republican interest in paid family leave policy — which would provide parents with paid time off from work after a baby is born. (Axios) 👀 The Biden administration said it wants Congress to pass stand-alone funding for the semiconductor industry. (Remember, shortages impact the medtech industry in a big way.) "Cleave off the CHIPS and pass it," Commerce Secretary Gina Raimondo said. (Axios) 💉 The FDA issued an EUA for Novavax's coronavirus vaccine, making it the fourth COVID vaccine available in the U.S. In June, the FDA said the vaccine was shown to be 90% effective at preventing new coronavirus cases, but carried the possible risk of causing heart inflammation, particularly in young men. (Axios) | | | | | | | | A message from PhRMA | | The real root of inflation | | |  | | | | Some policymakers are blaming the cost of prescription medicines for the rise of inflation to build support for harmful policies. What you need to know: Medication affordability is key, but the fact is that prescription drugs are not fueling inflation. Learn what drives up costs for patients. | | |  | | Why stop here? Let's go Pro. | | | | | | Axios thanks our partners for supporting our newsletters. If you're interested in advertising, learn more here.
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