KHN’s ‘What the Health?’: Much ado about (vaccine) mandates

Reviewed by Emily Henderson, B.Sc.Dec 9 2021

Even with the new omicron variant of the covid virus spreading in the U.S., Republicans on Capitol Hill are pushing to stop President Joe Biden from requiring workers to either be tested regularly or vaccinated. The effort is likely to end in failure — even if it reaches Biden's desk, he has vowed to veto it. But apparently Republicans think the effort will boost their popularity with their base.

Meanwhile, Congress is also moving to block scheduled Medicare cuts, and the Supreme Court heard two health cases that are not about abortion.

This week's panelists are Julie Rovner of Kaiser Health News, Joanne Kenen of Politico and the Johns Hopkins Bloomberg School of Public Health, Sarah Karlin-Smith of the Pink Sheet and Rachel Cohrs of Stat News.

Among the takeaways from this week's episode:

• Congress is expected to pass a bill shortly that will protect Medicare reimbursements for hospitals and doctors, who faced some automatic pay cuts based on previous laws that sought to rein in federal spending. Some physicians were looking at a 10% cut in payments.
• Republican and Democratic leaders agreed this week to add to that Medicare bill a complicated scheme that will allow Congress to approve an extension of the federal debt limit. The measure will give the Senate a one-time option to pass the debt ceiling bill by a simple majority and not face the threat of a filibuster.
• Public health officials say preliminary data suggests that the newest covid-19 variant, omicron, may be more contagious than delta but perhaps may cause less severe symptoms. Still, more infections could create problems for the already-straining health care system.
• Senate Republicans — with the support of two Democrats — launched an attack on Biden's vaccination mandates at work and passed a bill that would repeal that regulation. That effort is a sign of how the political opposition to the effort to force vaccines is growing. It's an outgrowth of other efforts by conservatives to oppose public health measures designed to fight the pandemic, including mask mandates and business shutdowns.
• A successful effort to stop covid requires robust testing, but in this country getting rapid tests to the public has been lacking. Overseas, those tests often are ubiquitous and cheap. But here, they are relatively expensive and often hard to find. Biden's efforts to help consumers by requiring insurers to cover the costs is still a month from starting and will be cumbersome to set up. It will help only those who have private insurance because the requirement does not apply to people who don't have insurance or are covered by Medicare or Medicaid.
• Often overlooked last week in the hype about the Supreme Court arguments on the Mississippi abortion law were two recent cases about federal hospital payments. Both are complex cases, one dealing with administrative rules about hospital funding for poor patients and the other concerning a drug discount pricing program.
• The highly publicized trial of Elizabeth Holmes, former head of the now-defunct company Theranos, points to a federal regulatory issue. Both the Food and Drug Administration and the Centers for Medicare & Medicaid Services have authority over diagnostic lab testing, but neither apparently made much of an impact in stopping what prosecutors allege was a fraudulent scheme by Theranos to test people for maladies by analyzing a few drops of blood.
• Sen. Bob Dole (R-Kan.), who is being lauded this week after his death Sunday, was a strong Republican. But that never meant he wouldn't work with people from the Democratic Party. For him, issues were about policy and were not personal. It was an era far different from today.

Plus, for extra credit, the panelists recommend their favorite health policy stories of the week they think you should read, too:

Julie Rovner: NPR's "Inside the Growing Alliance Between Anti-Vaccine Activists and Pro-Trump Republicans," by Geoff Brumfiel

Joanne Kenen: Slate's "We're Not Going Back to 'Before Roe,'" by Dahlia Lithwick.

Sarah Karlin-Smith: Axios' "Documents Reveal the Secrecy of America's Drug Pricing Matrix," by Bob Herman.

Rachel Cohrs: Stat News' "Biogen's Reckoning: How the Aduhelm Debacle Pushed a Troubled Company and Its Fractured Leadership to the Brink," by Adam Feuerstein and Damian Garde.

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