| | | | |  | | By Ben Leonard and Chelsea Cirruzzo | | Presented by |  | | | | | | | 
The Biden administration has so far resisted calls to repeal a Trump-era health policy that its proponents say bolsters Obamacare. | Joe Raedal/Getty Images | Getty | BIDEN POISED TO KEEP ICHRA — Progressive groups for three years pleaded with the Biden administration to kill a Trump-era health insurance policy they say allows companies to discriminate against older, sicker employees, POLITICO’s Kelly Hooper reports. In the end, Biden officials kept the rule in place — a win for the policy’s proponents, including several business groups and an advocacy group aided by a former Trump White House adviser. Background: The 2019 rule expands individual coverage health reimbursement arrangements, or ICHRAs, which allow employers to provide tax-exempt subsidies to their workers to purchase H.R. 3590 (111) plans. The arrangements offer an alternative for companies that find group health insurance plans too expensive, the policy’s supporters say. But some liberal groups argue that ICHRAs provide an incentive for companies to discriminate against older, sicker workers and push them into the Affordable Care Act’s marketplace, which could raise premiums for everyone. HHS hasn’t indicated whether it plans to rescind the rule before the end of President Joe Biden’s term, said Sonja Nesbit, a senior HHS official during the Obama administration who is now senior policy adviser for Keep US Covered, an advocacy group that’s been pushing the Biden White House to scrap the rule. “In a situation where [former President] Donald Trump becomes president again, a big concern here is seeing the immediate codification of this policy,” Nesbit said. “This could be a very fatal blow for folks hoping to ensure equity in private health care coverage.” Even so: The White House might see the policy as a way to boost its efforts to enroll more people in Obamacare, for which record enrollment has become a campaign talking point. An HHS spokesperson declined to say whether the administration is looking to reverse the rule but said in a statement that expanding and lowering the cost of health coverage “will continue to be this Administration’s north star.” Proponents of the ICHRA rule say it has bolstered Obamacare, and fears among Democrats that the policy would allow companies to discriminate against their employees haven’t materialized. “You’re bringing in younger folks, bringing in folks who’ve never been covered in their adult lives with health insurance. This is a big win,” said Robin Paoli, executive director of the HRA Council, a group that’s provided the Biden administration with data to demonstrate the arrangement’s benefits. “It’s expanding coverage, more Americans are being covered, and so it’s satisfying all of its goals as public policy.” WELCOME TO WEDNESDAY PULSE. We’re excited about a new pizza spot opening near the Hill soon. Reach us and send us your tips, news and scoops at bleonard@politico.com or ccirruzzo@politico.com. Follow along @_BenLeonard_ and @ChelseaCirruzzo.
| | | | A message from PhRMA: The 340B drug pricing program is supposed to help vulnerable patients access medicines at qualifying hospitals and clinics. It’s meant to be a safety net for those who really need it. So why is the 340B program padding profits for large hospitals, PBMs and chain pharmacies? Let’s fix 340B so it can help the patients that need it most. Let’s fix 340B. | | | | | | | 
Former Trump advisers suggest curbing restrictions on Medicare medical savings accounts to bolster efficiency. | Justin Sullivan/Getty Images | PITCHING HEALTH TAX CHANGES — With the impending expiration of the Trump administration’s tax cuts, former Trump advisers are calling for Congress to change the tax code to bolster efficiency. “The sheer size of the revenue impact of health care tax provisions is … unrivaled anywhere else in the American economy,” Theo Merkel and Brian Blase of the conservative Paragon Health Institute wrote. “Any policymaker seeking to improve the value of health care provided to Americans today would find a target rich environment in the tax code.” The details: The proposal released today would allow more plans to take advantage of health savings accounts, end tax credits for Affordable Care Act marketplace plan premiums and remove obstacles for individual coverage health reimbursement arrangements, or ICHRAs. The Trump administration expanded those arrangements, allowing employers to provide tax-exempt subsidies to help workers purchase Obamacare plans. Merkel and Blase, who were leading officials on Trump’s White House’s National Economic Council, also called for: — Curbing restrictions on Medicare medical savings accounts — Allowing flexible spending account holders to roll over unused balances into health savings accounts — Ending the Small Business Health Care Tax Credit, saying there are “more efficient” ways to aid small businesses in offering insurance, including expanding association health plans and ICHRAs The bigger picture: The proposal comes as conservatives prepare policy ideas for former President Donald Trump to weigh ahead of his November run. Lawmakers are looking to rein in health care costs, though some of the proposals Paragon put forward would be unpopular with many Democrats.
| | | | THE GOLD STANDARD OF HEALTHCARE POLICY REPORTING & INTELLIGENCE: POLITICO has more than 500 journalists delivering unrivaled reporting and illuminating the policy and regulatory landscape for those who need to know what’s next. Throughout the election and the legislative and regulatory pushes that will follow, POLITICO Pro is indispensable to those who need to make informed decisions fast. The Pro platform dives deeper into critical and quickly evolving sectors and industries, like healthcare, equipping policymakers and those who shape legislation and regulation with essential news and intelligence from the world’s best politics and policy journalists.
Our newsroom is deeper, more experienced and better sourced than any other. Our healthcare reporting team—including Alice Miranda Ollstein, Megan Messerly and Robert King—is embedded with the market-moving legislative committees and agencies in Washington and across states, delivering unparalleled coverage of health policy and the healthcare industry. We bring subscribers inside the conversations that determine policy outcomes and the future of industries, providing insight that cannot be found anywhere else. Get the premier news and policy intelligence service, SUBSCRIBE TO POLITICO PRO TODAY. | | | | | | | | | RSV SHOT PLANS IN MOTION — Demand is expected to be high this fall for a shot that protects babies against respiratory syncytial virus, or RSV — and federal officials and manufacturers say parents should have an easier time getting it this time around than they did last fall, Chelsea and POLITICO’s David Lim report. “We all know that last year there was a supply-demand mismatch,” said Demetre Daskalakis, director of the CDC’s National Center for Immunization and Respiratory Diseases. Last year — the first year the shot was on the market — there was enough supply for 40 percent of U.S. infants. Supply shortages, which manufacturers attributed to underestimating demand, led the CDC to urge providers to ration the shots. RSV sends 58,000 to 80,000 children under age 5 to the hospital each year, and severe cases can be fatal. Sanofi, which leads the therapy’s marketing, said that efforts to expand manufacturing are progressing. Manufacturers plan to more than double the number of available U.S. doses this upcoming season, according to Ayanna Santos, head of the RSV franchise in Sanofi’s U.S. vaccines unit. The CDC is working with CMS to ensure that providers receive reimbursement when they administer shots, and the agencies are making efforts to get private insurance plans to cover them, according to Daskalakis. Still, there could be surprises. A manufacturing insider familiar with AstraZeneca’s production efforts granted anonymity to speak candidly about the upcoming season said that while manufacturing capacity is stronger, the shot is complicated to make. “If there were any hiccups along the way, that would potentially cause a disruption,” the person said.
| | | | A message from PhRMA:   | | | | | FIRST IN PULSE: HEALTH CARE MESSAGING — Protect Our Care, a Democratic-aligned health care group, is releasing a report today previewing its latest line of attack on Republicans. The report accuses former President Donald Trump and the Republican Party of wanting to “deny tens of millions of Americans affordable life saving health care” and “destroy” the Affordable Care Act, Medicare and Medicaid. It zeroes in on the Republican Study Committee’s proposals, including reducing Medicaid spending by more than half, according to some estimates. It will be released this afternoon at an event featuring former House Speaker Nancy Pelosi (D-Calif.) in the latest effort to take Republicans to task on health care, a top issue for Democratic campaigns. “The GOP agenda is reckless and unpopular among voters of all parties,” Protect Our Care’s chair, Leslie Dach, told Pulse. Trump said late last year that he was “seriously looking at alternatives” to the ACA, which Democrats have seized on as a campaign issue. The Republican Study Committee’s budget proposal released in March calls for repealing the Inflation Reduction Act’s drug price negotiation provisions, ending ACA premium subsidies “for the wealthy” and turning Medicaid into block grants. RSC members have touted the plan to rein in spending and take steps to protect the future of Medicare.
| | | | DON’T MISS POLITICO’S ENERGY SUMMIT: The future of energy faces a crossroads in 2024 as policymakers and industry leaders shape new rules, investments and technologies. Join POLITICO’s Energy Summit on June 5 as we convene top voices to examine the shifting global policy environment in a year of major elections in the U.S. and around the world. POLITICO will examine how governments are writing and rewriting new rules for the energy future and America’s own role as a major exporter. REGISTER HERE. | | | | | | | | | VETS’ TRUST IN VA RISES — Veterans’ trust in the Department of Veterans Affairs has hit an all-time high, according to new agency data. More than 80 percent of veterans using VA services said they trust the agency, up from 55 percent in 2016 when the survey began in the wake of significant criticism of the VA over wait times. Close to 92 percent of those surveyed also said they trust the agency’s health care. The findings come as more veterans move to receive care outside the VA and as the PACT Act, which expands benefits for those exposed to toxins, has gone into effect. Some Democrats, including Sen. Jon Tester (D-Mont.), are using the latter as an issue for his reelection campaign.
| | | | Dani Walker is joining the House Select Subcommittee on the Coronavirus Pandemic as Democratic press secretary and speech writer. She was previously a public relations specialist at the American Public Health Association. Ladan Ahmadi is joining Elevance Health as government relations director. She most recently was VP of government relations and public affairs at Tiger Hill Partners.
| | | | A message from PhRMA: Hospitals that participate in the 340B program contract with more than 33,000 pharmacies to dispense the program’s drug prescriptions. More than 40% of these pharmacies have financial ties to one of the three largest PBMs – CVS Health, Express Scripts and OptumRx. 340B hospitals and the PBM-owned pharmacies they contract with are profiting off discounted medicines while uninsured patients are left paying full price for their medicines. Let’s fix 340B so it better helps patients. | | | | | The Tennesse Lookout reports on the state giving a state-sanctioned hospital monopoly an “A” grade no matter how it performs. Healthcare IT News reports on Oklahoma giving police iPads to connect people in mental health crises with providers via telehealth and save tens of millions of dollars. | | | | Follow us on Twitter | | | | Follow us | | | | |
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