KHN’s ‘What the Health?’: On government spending, Congress decides not to decide

Reviewed by Emily Henderson, B.Sc.Sep 29 2022

Congress is supposed to complete its annual appropriations bills before the start of the fiscal year on Oct. 1. But it rarely does, and this year is no different, as lawmakers scramble to pass a short-term funding bill so they can put off final decisions until at least December.

Meanwhile, with an eye to the midterms, House Republicans put out a "Commitment to America," which includes only the vaguest promises related to health care. It's yet another demonstration that the only thing in health care that unifies Republicans is their opposition to Democrats' health policies. It's notable that this latest Republican plan does not suggest repealing the Affordable Care Act.

This week's panelists are Julie Rovner of KHN, Alice Miranda Ollstein of Politico, Rachel Cohrs of Stat, and Victoria Knight of Axios.

Among the takeaways from this week's episode:

• The short-term funding bill to keep the government open includes the five-year reauthorization of the FDA's user fees, which are charged to drugmakers and help pay the salaries of many FDA employees. Democrats had hoped to add provisions to that measure that would create regulations on dietary supplements, cosmetics, and lab tests. The current authorization runs out Oct. 1, and Republicans insisted they would support only a clean bill that did not have new government directives.
• That government funding bill also will not include President Joe Biden's request for $20 billion to help pay for additional covid-19 and monkeypox vaccines and testing. Democrats said they wanted to extend those programs, but Republicans balked and said the administration still has not accounted for all the previous appropriations.
• Biden's comment on "60 Minutes" suggesting that the covid pandemic "is over" hurt administration efforts to persuade Congress to pass the extra covid funding.
• Biden took a victory lap this week and touted successes on administration priorities for Medicare. Among them, he said, was a reduction in next year's Part B premium, which generally covers beneficiaries' outpatient expenses. But that premium went down, primarily because Medicare charged too much in 2022.
• Medicare premiums this year saw a dramatic increase because officials anticipated that the federal health program would see higher costs associated with the use of Aduhelm, an expensive medication for some Alzheimer's patients that received tentative approval in 2021 by the FDA. Medicare officials later said they would cover the drug only for patients who also enrolled in a clinical trial, and the expectations for use of the drug plummeted.
• Republican House members' proposed agenda pledged to reverse the Democrats' decision this year to allow Medicare to negotiate some drug prices. Although Democrats said the provision would help drive down costs, Republicans said they don't like the government interfering in the private market and fear that the measure would hamper innovation.

Also this week, Rovner interviews filmmaker Cynthia Lowen, whose new documentary, "Battleground," explores how anti-abortion forces played the long game to overturn Roe.

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

Julie Rovner: KHN's "Britain's Hard Lessons From Handing Elder Care Over to Private Equity," by Christine Spolar

Alice Miranda Ollstein: KHN's "Embedded Bias: How Medical Records Sow Discrimination," by Darius Tahir

Rachel Cohrs: The New York Times' "Arbitration Has Come to Senior Living. You Don't Have to Sign Up," by Paula Span

Victoria Knight: Forbes' "Mark Cuban Considering Leaving Shark Tank as He Bets His Legacy on Low-Cost Drugs," by Jemima McEvoy

Also mentioned in this week's episode:

• House Republicans' "The Republican Commitment to America"
• The New York Times' "They Were Entitled to Free Care. Hospitals Hounded Them to Pay," by Jessica Silver-Greenberg and Katie Thomas
• The New York Times' "How a Hospital Chain Used a Poor Neighborhood to Turn Huge Profits," by Katie Thomas and Jessica Silver-Greenberg
• Politico's "Patients Face Barriers to Routine Care as Doctors Warn of Ripple Effects from Broad Abortion Bans," by Alice Miranda Ollstein and Daniel Payne
• Stat's "Subject, Not Suspect: The New Hazards of Conducting Clinical Research in the Dobbs Era," by Aoife Brennan