Tuesday, March 12, 2024

Your guide to Biden’s health budget

Delivered daily by 10 a.m., Pulse examines the latest news in health care politics and policy.
Mar 12, 2024 View in browser
 
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By Ben Leonard and Chelsea Cirruzzo

With Megan Messerly and Alice Miranda Ollstein 

Driving the Day

President Joe Biden is pictured surrounded by lawmakers the House chamber.

President Joe Biden made his annual budget request to Congress on Monday, which includes proposals that he outlined in last week's State of the Union address. | Francis Chung/POLITICO

WE READ BUDGETS SO YOU DON’T HAVE TO — The Biden administration is focused on protecting Medicare and expanding drug price negotiations in the fiscal 2025 budget.

Those measures might sound familiar: Biden made similar calls in his State of the Union address last week. On Monday, he proposed hiking taxes on the rich to protect the Medicare trust fund, limiting Medicare Part D cost-sharing for more expensive generic drugs to $2 for program beneficiaries and permanently expanding premium tax credits for Obamacare plans.

They likely won’t go anywhere in Congress this year, but they reflect the administration’s vision for a potential second term.

There’s plenty more in the reams of budget documents for health policy watchers. Here are more details of proposals that you might have missed in the shuffle: 

Medicaid: The plan proposes providing “Medicaid-like coverage” to individuals in the 10 states that haven’t taken advantage of an Obamacare provision and offering financial incentives to ensure states keep expansions already in place.

Mental health: The administration proposed $125 million in funding to aid states in enforcing mental health parity requirements. The proposal would also mandate that all plans cover three behavioral health visits and three primary care visits annually sans cost-sharing.

Infectious diseases: HHS’ budget proposes making the HIV prevention drug PrEP available to everyone on Medicaid and the uninsured to the tune of about $9.8 billion over a decade, with coverage for HIV testing and other services.

Telehealth: HHS’ budget would support permanently expanding virtual care and prohibiting "facility fees" for telehealth.

At the VA: The request for the VA’s electronic health record modernization project is less than half of last year’s. The program is on pause after costs have spiraled and several veterans’ deaths have been tied to the Oracle Cerner software.

The agency is seeing “incremental progress” in its program reset, it said in a budget document.

WELCOME TO TUESDAY PULSE. What caught your eye most in the budget? Reach us and send us your tips, news and scoops at bleonard@politico.com or ccirruzzo@politico.com. Follow along @_BenLeonard_ and @ChelseaCirruzzo.

DON’T MISS POLITICO’S HEALTH CARE SUMMIT: The stakes are high as America's health care community strives to meet the evolving needs of patients and practitioners, adopt new technologies and navigate skeptical public attitudes toward science. Join POLITICO’s annual Health Care Summit on March 13 where we will discuss the future of medicine, including the latest in health tech, new drugs and brain treatments, diagnostics, health equity, workforce strains and more. REGISTER HERE.

Around the Agencies

Secretary of U.S. Health and Human Services, Xavier Becerra

HHS Secretary Xavier Becerra told reporters that hospitals that fail to adopt cybersecurity practices proposed by the Biden administration could face financial penalties. | Butch Dill/AP

BECERRA TALKS CYBER MANDATES — The Biden administration proposes significant penalties for hospitals that don't adopt minimum cybersecurity standards and also offers incentives for cybersecurity upgrades, Chelsea reports.

The move comes in the wake of a massive hack at Change Healthcare that’s upended provider payments, though the HHS has signaled that mandates are coming before that attack. The penalties would begin in fiscal 2029.

Hospitals that fail to adopt essential cybersecurity practices would face penalties up to 100 percent of the annual market basket increase, with penalties escalating in fiscal 2031. HHS Secretary Xavier Becerra told reporters Monday it would take “a little bit of both” federal rulemaking and Congress to implement mandates.

Becerra added that “it’s not an option” for hospitals to not adopt cybersecurity standards. He pointed to a cybersecurity plan the agency released in December, which he said offers support to health care entities as they set up the systems needed to protect sensitive information.

“It can be difficult to adopt some of these new technologies and have a system that will be operable in years to come … so we understand that can be a dicey proposition,” Becerra said.

Hospitals’ take: The American Hospital Association called the budget proposal “misguided” and said “it will not improve the overall cyber security posture of the healthcare sector.”

“The AHA cannot support proposals for mandatory cybersecurity requirements being levied on hospitals as if they were at fault for the success of hackers in perpetrating a crime,” the group said in a statement.

GOP GRAPPLES WITH THE MEANING OF PRO-LIFE ON IVF — The anti-abortion movement and Republican lawmakers marched in lock step for decades against the common enemy of Roe v. Wade. 

But they’re clashing in the post-Roe era over what it means to be “pro-life,” Megan and Alice report.

Amid an outcry over an Alabama Supreme Court decision last month ruling that frozen embryos are children, Republican lawmakers in Congress and statehouses have drawn the ire of anti-abortion groups by pushing legislation to protect IVF access.

The rift over the legislation underscores the deepening divide between the GOP and the anti-abortion movement as Republicans grapple with the political and policy consequences of passing laws that say life begins at conception.

“Frankly, a lot of Republican lawmakers are not in touch with conservative principles because they have not taken sufficient time to think through what those principles are,” said Jameson Taylor, director of policy and legislative affairs for the Mississippi-based American Family Association Action.

Some Republicans have dismissed the criticism of the bills, arguing that protecting IVF is a “pro-life” position.

“I’ve had some negative comments from extreme pro-life type folks,” said Missouri state Rep. Bill Allen, a Republican who has introduced pro-IVF legislation. “But I’m pro-life. This is bringing life into the world.”

In Alabama, the anti-abortion movement has condemned legislation passed by the state’s Republican supermajority legislature and signed by GOP Gov. Kay Ivey last week aimed at preserving access to IVF.

In Mississippi, the movement and its GOP allies have called a Republican-backed proposal to protect IVF the “greatest assault on the cause of life that we’ve seen in Mississippi in a long time.”

And in Congress, the anti-abortion movement has promised to ding GOP lawmakers if they support pro-IVF bills they believe go too far, including a nonbinding resolution introduced by Rep. Nancy Mace (R-S.C.) earlier this month.

 

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In Congress

WAYS AND MEANS TAKES ON TELEHEALTH — The House Ways and Means Committee will consider the future of telehealth, remote patient monitoring and hospital at-home care today, several hearing witnesses told Pulse.

The hearing will focus on boosting care at home in “rural and underserved communities,” according to the committee.

The bigger picture: The hearing comes as the future of several home-based care models is in flux after the end of the year when loosened pandemic rules run out. Eased Medicare and commercial market telehealth rules expire at the end of 2024, as do acute hospital care at-home waivers under Medicare.

Lawmakers have several major decisions ahead of them on home-based and virtual care that will likely be determined at the end of the year.

The details: Witnesses include patients, leading telemedicine researcher Dr. Ateev Mehrotra of Harvard Medical School; Chris Altchek, CEO of remote patient-monitoring firm Cadence; and Dr. Nathan Starr, lead hospitalist at a tele-hospitalist program at Utah-based Intermountain Healthcare and Castell Home Services.

Ahead of the hearing, dozens of groups led by the American Medical Association, Moving Health Home and the American Academy of Home Care Medicine called for a minimum five-year hospital-at-home extension. Starr also told Pulse he’ll push for a five-year extension.

ELSEWHERE ON THE HILL — As lawmakers seek to reach an agreement to fund the rest of the government — including HHS — by March 22, there’s plenty of other action to watch.

Sen. Patty Murray (D-Wash.) said she’ll seek unanimous consent this week on her bill that would expand access to in vitro fertilization for all veterans.

It’s just the latest push by Democrats to bring IVF to the forefront after the Alabama Supreme Court ruled frozen embryos are people last month.

It comes after an expected move Monday by the VA and Defense Department following a lawsuit to expand access to IVF for unmarried and same-sex couples. Veterans still need to show that their fertility issues were caused by their service under existing law, which Murray hopes to change.

The House Energy and Commerce Committee’s Health Subcommittee meets today for a markup of 19 bills following a hearing on them last month.

Lawmakers will consider a wide range of bipartisan bills, many of which reauthorize programs, including legislation to tackle provider burnout, continue programs for traumatic brain injuries, boost rural emergency medical services and extend the National Alzheimer’s Project.

The Senate Finance Committee will convene Thursday to review HHS’ budget request, with Secretary Xavier Becerra testifying.

Names in the News

Kota Mizutani is joining the White House Office of Public Engagement as a senior adviser. He was deputy communications director at the House Committee on Education and the Workforce for ranking member Bobby Scott (D-Va.).

WHAT WE'RE READING

Healthcare Dive reports on small providers being at risk from the fallout of the recent Change cyberattack.

The New York Times reports on the debate over the nomenclature for drug-related deaths.

 

DON’T MISS POLITICO’S HEALTH CARE SUMMIT: The stakes are high as America's health care community strives to meet the evolving needs of patients and practitioners, adopt new technologies and navigate skeptical public attitudes toward science. Join POLITICO’s annual Health Care Summit on March 13 where we will discuss the future of medicine, including the latest in health tech, new drugs and brain treatments, diagnostics, health equity, workforce strains and more. REGISTER HERE.

 
 
 

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