Jul 29, 2021 - Health

Infrastructure deal's health care winners and losers

Senator Rob Portman, a Republican from Ohio, center, speaks during a news conference in the Dirksen Senate Office Building in Washington, D.C., U.S., on Wednesday, July 28, 2021.
Sen. Rob Portman, a Republican from Ohio, center, speaks during a news conference in the Dirksen Senate Office Building on July 28, 2021. Photo: Stefani Reynolds/Bloomberg via Getty Images

Providers can breathe a sigh of relief: Congress isn't planning on repurposing unspent money from the pandemic provider relief fund, at least not yet.

Driving the news: The White House finally reached an infrastructure deal with a bipartisan group of senators yesterday, paid for in part with health care policies.

  • Providers have been warning that they wouldn't be happy if the remaining provider bailout money was used to pay for bridges and roads.
  • Hospitals in particular would have been an unwelcome opponent for advocates of the infrastructure package, which will already have a tough time getting across the finish line.

Between the lines: Hospitals may have been the most powerful industry group awaiting the list of infrastructure pay-fors, but pharmacy benefit managers may be the bigger winners.

  • The proposal delays the Trump administration's rebate rule, which would force prescription drug discounts to occur at the pharmacy counter — a massive disruption to PBMs' business model.
  • Democrats will likely try to fully repeal the regulation in a partisan package down the road.

What we're watching: The infrastructure proposal also includes savings from reducing what Medicare spends on unused drugs that are left over from single-use vials.

  • This may sound like a niche policy, but drugmakers stand to lose money from it, and thus probably won't like it.
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