Biden’s billion-dollar Medicare bet

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Aug 12, 2024 View in browser   By Chelsea Cirruzzo and Ben Leonard Driving the Day The jump in premiums is due to changes in the 2022 Inflation Reduction Act taking effect next year that reduce drug costs for older Americans. CURBING A MEDICARE PREMIUM HIKE — President Joe Biden’s signature domestic achievement is likely to cause a major spike in Medicare premiums next year for millions of Americans, POLITICO’s Robert King and David Lim report. Now the administration seeks to dole out billions of dollars to private insurers in a bid to blunt the hikes expected right before the election. The jump in premiums is due to changes in the 2022 Inflation Reduction Act taking effect next year that reduce drug costs for older Americans. Insurers must now cover what patients used to pay and are raising drug premiums to compensate. The administration released a program that would give insurers an extra $15 per member a month amid other changes. Republicans balked at the program, saying it is a cynical ploy to avoid bad headlines right before the November election. “It's using the federal treasury for political advantage,” said Sen. Bill Cassidy (R-La.). “This is a way for the executive branch to implement a policy which has very positive political ramifications for them, but with very sketchy legal standing.” Top Republicans in Congress have asked the Government Accountability Office to investigate the program as well. Senate Democrats, however, counter that the program is needed to stabilize the market for Medicare Part D, the prescription drug benefit. “The Biden-Harris administration is taking additional steps that I fully support to keep premiums stable as insurance companies learn how to be competitive in this market,” said Sen. Ron Wyden (D-Ore.), chairman of the Senate Finance Committee. CMS said the agency has installed such programs before when major changes are introduced into Part D. For example, the George W. Bush administration implemented several of them in 2006 and 2007 after the Part D market was created. The agency projected the program will cost $5 billion in its first year if all standalone Medicare Part D plans participate. CMS declined to say how many have signed up since the deadline for participation passed last week. “The Treasury is going to borrow more money to do this,” Cassidy said. “I don't see them as being particularly hyper aware of the potential cost of all this. I don't think it matters to them, but it should matter to us as taxpayers.” WELCOME TO MONDAY PULSE. With the end of the Olympics,a hearty congratulations to the Team USA women’s soccer team that clinched gold in a heartstopping match against Brazil on Saturday — though I’m wary of the Olympic Covid-19 protocols. Send your tips, scoops and feedback to ccirruzzo@politico.com and bleonard@politico.com and follow along @ChelseaCirruzzo and @_BenLeonard_.   During unprecedented times, POLITICO Pro Analysis gives you the insights you need to focus your policy strategy. Live briefings, policy trackers, and and people intelligence secures your seat at the table. Learn more.     AROUND THE AGENCIES Rep. Jack Bergman (R-Mich.) is part of a push by lawmakers with military ties to persuade the FDA to approve psychedelic therapy. | Healing Breakthrough VETS  UPSET OVER MDMA DECISION — Veterans groups are disappointed that the FDA rejected drugmaker Lykos Therapeutics' application for MDMA and talk therapy as a post-traumatic stress disorder treatment. “I am living proof that MDMA-Assisted Therapy is safe, effective, life-changing, and even life-saving. By not approving MDMA-AT, the FDA is risking the lives of the 13 million Americans suffering from PTSD,” Cristina Pearse, a participant in Lykos’ clinical trials, said Friday. What happened: The FDA told Lykos on Friday that the agency had reviewed the drugmaker's application, but could not approve Lykos' application based on the data the company had submitted to date, POLITICO’s Erin Schumaker reports. The FDA requested that Lykos conduct an additional Phase 3 clinical trial to further study MDMA's safety and efficacy, according to a Lykos press release. Lykos plans to ask for a meeting with the FDA in hopes the agency will reconsider its decision and to discuss the possibility of Lykos resubmitting. Why it matters: While psychedelics research will continue, including at the Department of Veterans Affairs and the National Institutes of Health, FDA approval would have cut red tape for psychedelics researchers and likely sped up their work. Veterans react: “This is the epitome of bureaucratic red tape — and the result is people will keep dying,” advocacy group Heroic Hearts Project and Healing Breakthrough said in a statement. The FDA’s decision comes days after a bipartisan group of lawmakers appealed to President Joe Biden and FDA Commissioner Robert Califf in letters signed by 80 members of Congress, arguing that the agency should fast-track approving the treatment. THE PACT ACT AT TWO — President Joe Biden signed sweeping legislation expanding benefits for veterans exposed to toxins like burn pits known as the PACT Act two years ago on Saturday, Ben reports. The legislation has meant the agency is serving more veterans than ever. According to the agency’s latest data, more than 1 million claims have been approved under the act totaling $6.8 billion in benefits. Still, the implementation hasn’t always been smooth.  Of the 385,000 claims related to contaminated drinking water at Camp Lejeune in North Carolina, the government has made 114 settlement offers, CNN has reported. And The Washington Post has reported that dozens of for-profit companies are making hundreds of millions of dollars from the law — by charging veterans to help them file disability claims. The agency on Friday said it would offer benefits for veterans serving at a base in Uzbekistan just after the Sept. 11 terror attacks. Veterans had been frustrated that they were told to wait to see whether the VA would connect their illnesses to the toxic base. Earlier this year, the VA inspector general also found the agency doled out millions in bonuses to VA staff and officials under the PACT Act. The VA acknowledged a “policy error,” and Secretary Denis McDonough said the agency canceled payments to senior executives “as soon as we identified this error.” Now, lawmakers are trying to address a nearly $2.9 billion budget shortfall due to the major expansion of benefits. Congress Rep. Susan Wild (D-Pa.) wrote a bill to guarantee access to IVF that has nearly 200 cosponsors, including four Republicans. | Andrew Harnik/AP IVF FIGHT REIGNITED — House Democrats are expected to reignite a fight over in vitro fertilization, POLITICO’s Olivia Beavers and Sarah Ferris report. When they return next month, House Democrats and reproductive health activists plan another legislative push to legalize IVF protections. The push comes after Democratic vice presidential candidate Gov. Tim Walz of Minnesota spoke on the campaign trail about his family’s experience with IVF. The effort faces an uphill climb to a floor vote in the GOP-controlled House. Still, Democrats are eager to ramp up the pressure on at-risk Republicans over IVF access — like their Senate counterparts did in June — following an Alabama court ruling that raised questions about IVF’s future. Rep. Susan Wild (D-Pa.) wrote a bill to guarantee access to IVF that has nearly 200 cosponsors — including four Republicans — and has spent the last several weeks lining up backers for the legislation. Former Speaker Nancy Pelosi has helped, whipping Democratic support in recent days. And multiple advocacy groups, including the American Society for Reproductive Medicine and the Resolve: The National Infertility Association, plan to step up its pressure on Republicans. Rep. Marc Molinaro (R-N.Y.), one of the four Republicans who signed onto Wild’s bill, said he hopes the measure will get a vote in the House soon. But neither Molinaro, nor the other Republican cosponsors, have signed onto Wild’s discharge petition to force a floor vote on the bill — which requires a House majority, and therefore some GOP support, to work.   DON’T MISS OUR AI & TECH SUMMIT: Join POLITICO’s AI & Tech Summit for exclusive interviews and conversations with senior tech leaders, lawmakers, officials and stakeholders about where the rising energy around global competition — and the sense of potential around AI and restoring American tech knowhow — is driving tech policy and investment. REGISTER HERE.     Names in the News Novo Nordisk, the pharmaceutical giant that makes weight-loss drugs Ozempic and Wegovy, has added a new lobbying firm. The drugmaker retained E3 Strategic Consulting Group’s Patrick Foley to lobby on research and funding for Novo’s products, according to a disclosure filing. WHAT WE'RE READING The Wall Street Journal reports on the overdose deaths of Medicare patients in the care of a Florida doctor. NPR reports on the lingering consequences of the disappearance of Black hospitals decades ago. STAT reports that the journal Psychopharmacology has retracted three papers about MDMA-assisted psychotherapy over data intergrity concerns.   Follow us on Twitter Dan Goldberg @dancgoldberg Chelsea Cirruzzo @chelseacirruzzo Lauren Gardner @Gardner_LM Sophie Gardner @sophie_gardnerj Kelly Hooper @kelhoops Robert King @rking_19 Ben Leonard @_BenLeonard_ David Lim @davidalim Megan Messerly @meganmesserly Alice Miranda Ollstein @aliceollstein Carmen Paun @carmenpaun Daniel Payne @_daniel_payne Ruth Reader @RuthReader Erin Schumaker @erinlschumaker   Follow us

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