Health Care — Biden orders inquiry into ways to lower drug costs

Harrison Ford is reportedly joining the Marvel Cinematic Universe, because he apparently doesn’t have enough iconic characters on his resume already. 

Today in health, President Biden signed an executive order to explore new ways of potentially lowering prescription drug costs. 

Welcome to Overnight Health Care, where we’re following the latest moves on policy and news affecting your health. For The Hill, we’re Nathaniel Weixel and Joseph Choi. Someone forward you this newsletter? Subscribe here.

Biden to sign order on drug pricing  

President Biden will sign an executive order on Friday to explore additional ways his administration can lower prescription drug costs. 

• The order directs the Department of Health and Human Services (HHS) to examine how it can use its Innovation Center to lower drug costs, the White House said in a press release.  
  
• The Innovation Center, which was created under the Affordable Care Act, develops and tests new payment and delivery models for Medicare and Medicaid. 
  
• The agency will have 90 days to report its plans to use the center for lowering drug prices. 

The announcement by the White House comes just one day after the largest Social Security cost of living increase in 40 years. Payments will increase by $140 per check, an 8.7 percent increase that attempts to close the gap brought on by high prices. 

Friday’s executive order aims to build on the Inflation Reduction Act’s drug pricing reforms. 

The law, which was passed and signed into law in August, allowed Medicare to negotiate drug prices for the first time and placed caps on the cost of insulin under Medicare and drug costs for seniors on Medicare. 

Read more here.

Drug costs to be highlighted in Biden’s Western tour

President Biden will highlight the administration’s efforts to lower prescription drug costs during stops in California and Oregon this weekend.

He will visit a community college in Irvine, Calif., and then a community center in Portland, Ore., to talk about plans to strengthen Medicare and Social Security, as well as to tout the Inflation Reduction Act and efforts to lower costs for older Americans. 

The visit to Oregon comes amid signs that Democrats’ hold on the governor’s mansion may be at risk, and as Democrats face tight races up and down the ballot. 

Republicans are capitalizing on rising inflation and higher prices, and seeing openings to gain power in once-reliably blue areas. 

Both the events and the executive order come as Democrats try to sell the public on drug pricing provisions of the Inflation Reduction Act just a month before the midterms, like Medicare drug price negotiations and price cap on insulin for Medicare. 

VA EXPANDS SURVIVOR BENEFITS TO SAME-SEX COUPLES 

The Department of Veterans Affairs (VA) on Friday announced an initiative to expand survivor benefits to survivors of LGBT veterans, many of whom were unable to legally wed before the Supreme Court legalized same-sex marriage nationwide in 2015. 

Before the Supreme Court’s landmark decision, same-sex couples in at least a dozen states were unable to legally marry. 

That fact continues to impact survivors of LGBT veterans, who are excluded from VA survivor benefits because their veteran spouse died before their legal union met the department’s length-of-marriage requirements. 

Under VA guidelines, a couple must be married for at least one year to qualify for survivor benefits and at least eight years to become eligible to receive a higher rate of benefits. 

But on Friday, the department said survivors of LGBT veterans are now able to apply for these benefits. Eligible surviving spouses who apply in the next year will receive benefits backdated to Oct. 11, 2022, the department said. 

Read more here. 

PERSONAL HARMS FROM COVID INCREASED’ SUPPORT FOR EQUALITY

Americans who experienced personal harm throughout the COVID-19 pandemic — whether in the form of infection, financial hardship or psychological distress — were more likely to support and push for equality one year later, according to a new study published by Washington University in St. Louis. 

• The study was conducted as a three-part longitudinal survey beginning in May 2020, with follow-ups in October 2020 and May 2021.   
  
• A total of 688 U.S. adults completed all three surveys.  

Equality was measured based on individuals’ support for programs like universal health care and their efforts to engage with a public official to express support for reducing inequality. 

Results showed those personally harmed at the start of the pandemic were able to better appreciate how structural factors contribute to inequality. A year later, these respondents were more likely to advocate for equality.  

The research suggests harms resulting from COVID-19 could have long-lasting impacts on Americans’ attitudes and beliefs towards inequality.  

Read more here. 

CMS to release Medicare Advantage audits 

The Centers for Medicare and Medicaid Services (CMS) has agreed to publicly release dozens of private Medicare Advantage health plan audits to settle a 2019 lawsuit filed by Kaiser Health News (KHN). 

KHN in September 2019 filed a lawsuit asking that CMS provide 90 government audits, including documents from the years 2011, 2012 and 2013. 

These documents were reviews of the Medicare Advantage Risk Adjustment Data Validation. Risk adjustment is used by health insurance providers to determine expected medical costs of enrolled individuals. 

• KHN argued in its lawsuit that CMS was improperly withholding audits of Medicare Advantage plans, with these reviews allegedly having identified more than $650 million in improper charges. 
  
• By settling the lawsuit, CMS did not admit to wrongfully withholding the requested documents and also agreed to pay $63,000 in legal fees, according to KHN. The agency will make “best efforts” to provide the documents over the next six weeks. 

Medicare Advantage, also known as Medicare Part C, is largely run through contracted private insurance companies. Around the time that the lawsuit was filed in 2019, it had been reported that Medicare Advantage plans had overcharged the federal government by about $30 billion over the preceding three years, prompting scrutiny from both the media and lawmakers. 

As of 2022, more than 28 million Medicare beneficiaries are enrolled in Medicare Advantage, accounting for nearly half of all beneficiaries. 

Read more here. 

WHAT WE’RE READING

• The next U.S. COVID wave is coming. Why it will be ‘much weirder than before.’ (Yahoo News) 
• Documents detail how pharmacy giants Walgreens, CVS, and Walmart failed patients in the opioid crisis (Stat) 
• ‘Kind of awkward’: doctors find themselves on a first-name basis (New York Times) 

STATE BY STATE

• South Dakota signals the end of an era on Medicaid expansion (Politico) 
• 5 things to know about Colorado’s psychedelics ballot initiative (Kaiser Health News) 
• Study: Kansas ranks last in nation in accessing mental health resources (KWCH) 

That’s it for today, thanks for reading. Check out The Hill’s Health Care page for the latest news and coverage. See you next week.