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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.

Go deeper

Sep 27, 2021 - Health

Health policies at stake in Democrats' infrastructure bet

Illustration: Annelise Capossela/Axios

Democrats are at a pivotal moment in their quest to expand health care coverage, slash the cost of prescription drugs and create a social structure that prioritizes people's health.

Driving the news: Democrats have a clear list of health care priorities they'll be fighting for this week. Among them is a measure to expand Medicare to cover dental, vision and hearing benefits.

Biden's reengineer-America moment

Illustration: Sarah Grillo/Axios

The Senate's bipartisan $1.2 trillion infrastructure bill and President Biden's $3.5 trillion spending package could live or die this week — and take Democrats' fortunes with them. But all the minute-by-minute political drama obscures how much America could change if even a fraction of it passes.

The big picture: Anything short of total failure could have a transformative impact on day-to-day life — from how we move around to our access to the internet, paid family leave and child care, health care and college.

Sep 26, 2021 - Politics & Policy

Scoop: Centrists back $3.5T package

Reps. Vicente Gonzalez (left) and Filemon Vela. Photos: Bill Clark/CQ Roll Call and Tom Williams/CQ Roll Call

Two of the nine House centrists who demanded Speaker Nancy Pelosi (D-Calif.) bring the $1.2 trillion bipartisan infrastructure bill to the floor by Monday are now publicly promising to vote for the separate $3.5 trillion budget reconciliation package, Axios has learned.

Why it matters: By explicitly announcing their support for a big package targeting climate change and expanding the social safety net, Reps. Vicente Gonzalez (D-Texas) and Filemon Vela (D-Texas) are trying to convince progressives to vote for the infrastructure bill this week.