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Illustration: Aïda Amer/Axios

Democrats' ambitious health plans are slowly transitioning from bullet point proposals to more fleshed-out policies, inching the legislative process forward and shedding more light on who stands to win or lose.

Yes, but: Some of these proposals put the House and Senate in conflict with one another, emphasizing just how far Democrats still have to go.

Driving the news: One House committee with health care jurisdiction began considering legislation yesterday, while a second released its portion of the reconciliation package.

  • The House Ways and Means Committee began marking up a bill that would expand Medicare to include dental, hearing and vision benefits. Notably, the dental benefits wouldn't kick in until 2028 — a timeline that Sen. Bernie Sanders has already taken issue with.
  • The Energy & Commerce Committee legislation addresses the Medicaid coverage gap in non-expansion states, first by extending the ACA's premium tax credits to people who currently make too little to qualify for them and then, beginning in 2025, by establishing a federal Medicaid program in non-expansion states.
  • The committee also pitched a $190 billion investment into home- and community-based services for elderly and disabled people — which is well short of the $400 billion that the White House has called for.

There were also multiple news nuggets on the drug pricing front yesterday:

  • The Biden administration released its drug pricing plan, throwing its support not only behind allowing Medicare to negotiate drug prices, but also behind making those negotiated prices available to employers and the commercial market.
  • That's a major — albeit exceptionally controversial — piece of the House drug pricing bill, which the Energy & Commerce committee reiterated its support for yesterday.
  • But the Senate is still working on its own version of a Medicare negotiation plan. It's been reported that, unlike the House approach of tying U.S. drug prices to what other countries pay, the Senate is interested in some kind of domestic benchmark price.
  • Senators are considering tying what Medicare pays for drugs to what other government programs like the VA pay, STAT reported yesterday.

What we're watching: There's every reason to think that the policymaking process is about to start moving extremely fast — and that the policies themselves are extremely fluid.

Go deeper

Oct 21, 2021 - Health

Aduhelm is bombing

The average list price of Aduhelm is roughly $4,300 per monthly infusion. Photo: Biogen

Biogen sold $300,000 worth of Aduhelm in the third quarter, well below Wall Street's expectations, which prompted analysts at Raymond James to call the Alzheimer's drug "potentially the worst drug launch of all time" amid Biogen's "persistent hyperbole about the drug's purported benefits."

The big picture: Aduhelm's controversial approval and high price tag have shaped the market reaction. Health insurers are hesitant to cover Aduhelm until Medicare makes a decision next year, and doctors aren't embracing the drug either.

Bryan Walsh, author of Future
Oct 20, 2021 - Technology

The AI pharmacist

Illustration: Annelise Capossela/Axios

Artificial intelligence — the ultimate optimization engine — is meeting one of its biggest challenges: untangling the messy, slow and expensive work of drug development.

Why it matters: Even as computing power has gotten faster and cheaper, drugs remain slow and costly to develop, in part because of the sheer work in selecting a candidate and getting it across the finish line.

Biden rejects Trump's latest executive privilege claims

Photo: Jim Watson and Saul Loeb/AFP via Getty Images

The White House on Monday rejected two more of former President Trump's claims of executive privilege over documents that the House select committee investigating the Jan. 6 Capitol riot requested, CNN first reported.

Why it matters: Trump's legal team is seeking to block some of the panel's requests for records by invoking executive privilege, which can allow presidents and their aides to sidestep congressional scrutiny. The Biden administration has maintained that it will evaluate on a case-by-case basis.