Overnight Health Care — Insurance will soon cover COVID-19 tests
Welcome to Monday’s Overnight Health Care, where we’re following the latest moves on policy and news affecting your health. Subscribe here: digital-release.thehill.com/newsletter-signup.
People are understandably fed up with pretty much everything right now. So maybe it’s not surprising that an old clip of Elmo losing his mind over a pet rock has resurfaced and resonated.
There was another flurry of testing news today, with new rules to make insurers cover rapid tests going into effect Saturday, but congressional Democrats are pushing for more action. Also look out tomorrow at 10 a.m. for top administration health officials testifying before the Senate Health Committee.
For The Hill, we’re Peter Sullivan (psullivan@digital-release.thehill.com), Nathaniel Weixel (nweixel@digital-release.thehill.com) and Justine Coleman (jcoleman@digital-release.thehill.com). Write to us with tips and feedback, and follow us on Twitter: @PeterSullivan4, @NateWeixel and @JustineColeman8.
Let’s get started.
Officials to make insurers cover at-home tests
The Biden administration on Monday issued rules requiring private health insurers to cover the cost of at-home COVID-19 tests starting Jan. 15, amid pressure to make testing more available.
Under the policy, insurers will be required to cover the cost of eight at-home COVID-19 tests per person each month.
The broad outlines of the policy were first announced by President Biden in early December, but the new rules provide details — like the number of tests that will be covered — for the first time.
The steps come as the Biden administration has faced intense pressure to do more to increase availability, amid long lines for PCR tests and pharmacies sold out of rapid at-home tests.
Experts criticized the announcement when Biden made it last month for relying on consumers to pay for the tests up front at a pharmacy or other retailer, and then get a reimbursement from their insurer after the fact, a cumbersome process that could discourage people from seeking tests.
Responding to criticism: The administration took some steps to try to address that issue in Monday’s rules by incentivizing insurers to cover the cost of tests upfront. If insurers establish a network of preferred pharmacies or retailers where they pay upfront for the tests, then they could cap their costs at $12 per test at pharmacies outside of that network.
Dems call on Biden to expand rapid testing
Nearly 50 House and Senate Democrats are calling on the Biden administration to substantially increase the nation’s supply of rapid COVID-19 tests.
In a letter led by Rep. Adam Schiff (D-Calif.), along with Rep. Ro Khanna (D-Calif.) and Sen. Bernie Sanders (I-Vt.), the lawmakers acknowledged efforts already underway, like acquiring 500 million additional tests and setting up federal testing sites, but said the administration needs to do more to boost supplies.
“But as the Omicron variant spreads and we enter an ominous and unprecedented next phase of this pandemic, it is critical that we ensure these efforts meet the severity of the moment,” the lawmakers wrote.
The asks: The requests included manufacturing enough tests that every American could take at least one rapid test per week, and ensuring that Americans without internet access can order free COVID-19 rapid tests delivered to their homes.
A White House official said the administration is in “full agreement” with the lawmakers that “rapid tests are a critical tool in mitigating the impact and spread of COVID-19, which is why we’ve taken action on all of the mentioned areas.”
PSAKI: WHITE HOUSE WANTS TO SEE CHICAGO SCHOOLS OPEN
White House press secretary Jen Psaki on Monday said President Biden wants to see schools open, citing the mental health implications on children, as Chicago Public Schools closed for a fourth day.
“We have been very clear publicly and privately that we want to see schools open,” Psaki said when asked what the White House’s message is to the teachers union that forced the closure and Chicago Mayor Lori Lightfoot (D) on what it wants to see in the coming days.
Chicago Public Schools closed again on Monday, Lightfoot announced on Sunday evening, as negotiations continue between schools and the Chicago Teachers Union about COVID-19 safety protocols.
The White House has been in touch regularly with Lightfoot, Illinois Gov. J.B. Pritzker (D) and the teachers union, Psaki said. She pointed to funding in the American Rescue Plan, which the president signed into law in March, to assist with schools staying open.
What’s happening: In a vote held last Tuesday night, the evening before they were supposed to return from winter break, the union said 73 percent of rank-and-file members opted to pause in-person learning until Jan. 18 or until COVID rates subside.
The union said the spiking COVID cases, staff shortages and a botched take-home testing requirement have made it unsafe to teach in person. School administrators in turn have refused to allow teachers access to their virtual classrooms.
Becerra seeks to ‘reassess’ premium increase
Secretary of Health and Human Services (HHS) Xavier Becerra on Monday ordered Medicare to “reassess” a proposed premium increase after an expensive new Alzheimer’s drug fell in price.
“Today I’m instructing the Centers for Medicare and Medicaid Services (CMS) to reassess the recommendation for the 2022 Medicare Part B premium, given the dramatic price change of the Alzheimer’s drug, Aduhelm,” Becerra said in a statement. “With the 50% price drop of Aduhelm on January 1, there is a compelling basis for CMS to reexamine the previous recommendation.”
Medicare had announced in November a steep 14.5 percent increase for 2022 in the monthly premium that millions of seniors have to pay, from $148.50 to $170.10. Part of the reason for that increase was to cover the cost of Aduhelm, a pricey and controversial new Alzheimer’s drug, made by Biogen.
But in late December, Biogen, facing uproar over the $56,000-per-year initial Aduhelm price, cut its price to $28,200.
Medicare may now not need to raise as much money through premium hikes to cover the cost of the drug.
Big decision coming up: CMS is facing a major decision, set to be announced this week, over whether Medicare will cover Aduhelm, and in what situations, a move that will help decide the drug’s fate.
STATE OF EMERGENCY DECLARED IN VIRGINIA
Ralph Northam (D) declared a limited state of emergency for Virginia on Monday to alleviate pressure on hospitals after the state has counted record COVID-19 cases and hospitalizations in recent days.
The governor announced the emergency order that aims to boost hospital capacity and support “exhausted” health care workers after Virginia counted its highest daily COVID-19 hospital admissions on Friday.
The order is set to last 30 days because of modeling predicting a peak of cases “in the next few weeks” following the omicron variant surge, the announcement said.
It waives license requirements for hospitals to increase their bed capacity, permits out-of-state licensed providers to provide care in Virginia and grants physician assistants with at least two years’ experience to provide care without written agreements.
Northam is only in office for a few more days, as Gov.-elect Glenn Youngkin (R), who has the option of rescinding the order, prepares to be inaugurated on Saturday, although Northam hopes for Youngkin’s support.
“The Governor has spoken to the Governor-elect, and is hopeful this order will remain in place for 30 days or until no longer necessary,” Northam spokesperson Alena Yarmosky said in an email.
WHAT WE’RE READING
- The Biden administration has a COVID credibility crisis (Axios)
- Health care workers are panicked as desperate hospitals ask infected staff to return (Politico)
- Covid test misinformation spikes along with spread of omicron (The New York Times)
- A looming decision on Medicare coverage for Biogen’s Alzheimer’s drug could shock state Medicaid programs (Stat)
STATE BY STATE
- New York sees signs of omicron peak while ICUs remain pressured (Bloomberg News)
- Changes to Mass. COVID-19 hospitalization reporting taking effect (NBC Boston)
- Michigan COVID-19 hospitalizations reach new high (The Associated Press)
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.
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