Jul 15, 2021 - Health

Democrats' health care power play

Illustration of a gift box wrapped in wrapping paper with a health plus pattern on it.
Illustration: Aïda Amer/Axios

Democrats took yet another step forward this week in their effort to slash what Americans — particularly seniors — pay for health care.

Driving the news: Senate Democrats unveiled their framework for a massive legislative package that includes several of the party's largest health care priorities.

Why it matters: The package could plug some of Medicare's biggest coverage holes while reducing what patients pay for prescription drugs — policies that are popular across party lines.

  • It calls for expanding Medicare to cover dental, hearing and vision benefits, expanding home and community-based services and extending the enhancement of Affordable Care Act subsidies passed earlier this year.
  • It also calls for closing the Medicaid coverage gap in states that haven't expanded and for reducing what patients spend on drugs.

Between the lines: The outline doesn't mention lowering the Medicare eligibility age or creating a public option, other Democratic health priorities that have been part of the party's public discourse over the last several months.

  • Both of these would have been met with fierce resistance from hospitals, providers and insurers.

In fact, Democrats appear to be picking a fight with only one major industry group: pharma.

  • The framework doesn't specifically call for allowing Medicare to negotiate prescription drug prices, a policy fiercely opposed by drug companies.
  • But the framework does list "prescription drugs" as a source of savings to the federal government that will help offset trillions of dollars of new spending. Given that Medicare negotiations are estimated to save the government hundreds of billions a dollars over a decade, there's a strong financial incentive for Democrats to ultimately include the measure.

What we're watching: The party will now have to flesh out complicated policy details while also fighting a messaging war against the drug industry and its allies.

  • But for now, public opinion seems to be on Democrats' side.
  • In polling conducted in May, KFF found that 92% of U.S. adults said allowing the federal government to negotiate with drug companies for lower prices should be a top or important priority for Congress.
  • 90% said the same of expanding Medicare coverage to include hearing aids, dental and vision coverage.
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