Nov 25, 2019

Axios Vitals

By Caitlin Owens
Caitlin Owens

Good morning. Here is a great example of a joke that may or may not have been funny to everyone involved.

Today's word count is 653 words, or <3 minutes.

1 big thing: Trump's still interested in drug prices

Illustration: Aïda Amer/Axios

The Trump administration is pushing ahead with its drug pricing agenda even as impeachment sucks up all the political oxygen.

Why it matters: Drug pricing remains a huge issue that both parties want to run on in 2020. Trump has not actually moved forward on some of his most ambitious proposals; others have been tied up in the courts.

Driving the news: The administration is planning to have the next regulatory phase of the international pricing index — a notice of proposed rulemaking — ready to issue within a month, a senior administration official said.

  • That leaves plenty of time for the industry to kill the proposal, but it's a signal that the administration isn't yet backing down from the proposal in the face of intense opposition from the drug industry.

The administration is also working with Congress on drug pricing legislation, and thinks that it's still possible that the Senate will pass a bill by the end of the year.

  • The official said the Trump administration is working with Sens. Chuck Grassley and Ron Wyden to add a monthly cap on what seniors pay out-of-pocket for drugs.
  • The administration also wants change the way that bill would take money from drugmakers, to address industry concerns that it would hit some drugs and therapeutic areas harder than others.

The bottom line: Trump certainly has a political incentive to get something done on drug prices, but some of these policies could go a long way toward helping Americans — especially seniors — afford their drugs.

Yes, but: These administrative actions haven't yet been formally proposed, and could take years to finalize — meaning there's no guarantee they'll actually happen before the 2020 election.

2. Buttigieg's new plan for long-term care

South Bend, Indiana, Mayor Pete Buttigieg is out this morning with a new plan to address long-term care, along with other retirement-related priorities, Axios' Sam Baker reports.

Why it matters: Older people caucus, and long-term care is an enormous strain on millions of families.

The big picture: Medicare doesn’t cover the services performed in nursing homes or by home health aides.

  • Medicaid does, but families often have to sell their homes and spend all their money to become poor enough to get Medicaid.
  • Some pay out of pocket, but the costs can be astronomical.

How it works: The cornerstone of Buttigieg's plan is a stipend to help people cover their long-term care costs — $90 per day, which the campaign says "would kick in after an income-related waiting period."

  • Medicaid today only covers long-term care for people who have less than $2,000 in assets. Buttigieg proposes raising that to $10,000.
  • He has endorsed a $15/hour minimum wage and argues that this would help expand the long-term care workforce.
  • The plan also calls for mandating Medicaid coverage either at home or in a nursing home — home care can be harder to come by today.

Go deeper: The looming crisis in long-term care

3. More problems with Indian Health Service

Illustration: Sarah Grillo/Axios

At least 66 Indian Health Service patients died as a result of alleged malpractice since 2006, according to a sweeping report from the Wall Street Journal.

By the numbers: The U.S. government has paid out about $55 million in settlements in 163 malpractice cases at IHS hospitals, Axios' Marisa Fernandez writes.

  • WSJ looked into 171 doctors, at least 44 of whom doctors had histories that were of concern according to IHS guidelines that urge managers to screen doctors for multiple past malpractices cases, medical-board sanctions and criminal convictions.
4. BYU-Idaho won't let students have Medicaid

Here's a story unlike any I've heard before: Brigham Young University-Idaho requires students to have health insurance, but announced this month that it will no longer accept Medicaid, the New York Times reports.

Why it matters: This makes coverage unaffordable for some students, or forces them to enroll in a plan that doesn't cover a comprehensive set of benefits.

Between the lines: The school recently "appeared to tie its decision to the Medicaid expansion," per NYT. Idaho's expansion, which was agreed to by voters in a 2018 ballot initiative, goes into effect in January.

  • The university said that it was worried the expansion would overwhelm local health care providers, but the local hospital says that it doesn't share these concerns.
5. While you were weekending...
  • Novartis announced a $9.7 billion acquisition of The Medicines Company, which STAT writes could represent a comeback for heart drugs.
  • Almost 2,000 CT scans went unread for years at Walter Reed, the Wall Street Journal reports, which could have led to delays in treatment.
  • NYT explores how difficult it can be to decide when parents should get their kids back after being separated because of drug use.
Caitlin Owens