New! We have added, after the events section, links to all notes, presentations and Black Books in calendar format with appropriate tickers. This file will provide you with a searchable record of all health policy publications by date. The first tab includes all tickers mentioned, so a search by ticker will take you to the relevant note(s). You must be logged in to access, please see your sales contact or reply to me if you have trouble with access.
Chart of the Week
Congress
Ugh. Reconciliation. The timeline has shifted for resolution of the budget reconciliation mess to late October which, given how far apart Democrats are from each other, does not seem like enough time.
On one side you have House progressives, led by Rep. Pramila Jayapal in the House, and Sen. Bernie Sanders in the Senate. On the other side are moderate members of the House, like Rep. Josh Gottheimer and Sen. Joe Manchin in the Senate.
Republicans appear to have gone out for popcorn.
At issue are many of the social programs like paid family leave, expansion of the Medicare scope of benefits and free community college. Progressives want to pass these programs in some form. Moderates want to means-test or otherwise limit them to the most-needy and prevent the U.S. from becoming “an entitlement society” to quote Manchin.
Like Members of Congress, we are not sure where the compromise is as both sides seem dug in. We do know that time is not the Democrats’ friend. The longer the debate endures, the closer we get to the mid-term elections, the more Members can more accurately assess their risk, if any, of defeat. Based on that calculation, leadership is likely to force a decision that optimizes the 2022 election outcome – whatever that is.
That said, based on Manchin’s comments, health proposals that are likely to survive are those aimed at support of health care for the indigent, or close to it, such as home and community-based services in Medicaid, filling the Medicaid gap in non-expansion states, possible permanent expansion of ACA tax credits to those making over 400% of the federal poverty threshold but perhaps with limits.
We will stay tuned, so you don’t have to.
Mental Health Legislation. Senate Finance Committee members sent out a stakeholder letter to the mental health community soliciting comments on:
- Strengthening the workforce
- Increasing care coordination
- Ensuring parity between mental and physical health
- Furthering use of telehealth
- Improving access for children and young people
The Committee hopes to have a bi-partisan response by the end of the year.
The White House
Testing. The Biden Administration announced they were spending another $1B on at-home COVID tests. They believe there will be 200 million test available by the end of the year. This announcement comes on the heels of $2B planned for 280 million at-home test and an unknown number of point-of-care solutions. We do not expect these test to impact the traditional channels immediately. Schools, institutions and others prefer the PCR test for now but it lacks speed and scale is inflexible. We do expect as testing normalizes – PCR for high risk situations like hospitals and at-home antigen tests for travelers and party-goers – that capacity currently accommodated by DGX and LH will migrate.
Vaccines. The state of play is: PFE has asked the FDA for approval of the COVID-19 vaccine for children 5-11. JNJ has asked for authorization of a booster and AZN wants an EUA for a long-acting COVID-19 antiviral cocktail. The armature continues to accumulate.
Medicare Rule-A-Rama.
CY 2022 Changes to the ESRD Prospective Payment System. Final Rule.
Other Rules.
Over the Counter Hearing Aids. OMB completed review of this proposed rule
Other Stuff
Employment. Health care employment declined MoM by 11bps and only improved YoY by 84bps. Some of the MoM job loss is associated with vaccine mandates, some of it is burnout and some of it is retirement. Regardless of the cause, the situation is not good as job opening stand at nearly 2 million.
Child Care. NIH released a study suggesting 140,000 primary and secondary care givers died during the COVID-19 pandemic. It is a modeling study so apply all the skepticism you have earned the last year and a half. Regardless, mortality and childcare challenges are almost certainly contributing to health care labor woes as well.
Upcoming Events
October 13th @10am ET | Venture View: Distributed Clinical Trials, New Hope or False Dawn with Marcus Whitney. Add to Outlook Calendar.
Publication Calendar
Searchable Health Policy Publication Calendar 2Q -3Q. Link here.
SPAC and S-1 Corner
IPOs
Bluejay Diagnostics, Inc. “If cleared, authorized, or approved by the U.S. Food and Drug Administration (“FDA”), can provide a solution to this market need rapidly and with laboratory quality results in approximately 24 minutes, in the clinic, Intensive Care Unit (“ICU”), Emergency Room (“ER”) and in other hospital and clinical setting settings where rapid and reliable results are required.” Our Thought Bubble: The massive amount of money that has gone into testing and capacity will continue to stress the reference lab model. Ore-revenue but still….
Airsculpt Technologies, Inc. “We provide custom body contouring using our proprietary AirSculpt® method that removes unwanted fat in a minimally invasive procedure, producing dramatic results.” Our Thought Bubble: With less supply in many things consumers like to spending money on, aesthetics has captured more discretionary spending. The Airsculpt procedure, if it works, removes one barrier to liposuction which is its invasion nature and long downtimes.
SPACs.
Total SPAC resources stand at about $28B, all of it in search of a dance partner. One interesting trend emerging outside of health care are SPACs to address supply chain needs. In this case a SPAC is a useful tool. It provides a large pool of capital that can help reach the scale necessary to deal with all the problems around the world. Let's see if it translates to health care.
SPAC spreadsheet here.
Emily Evans
Managing Director – Health Policy
Twitter
LinkedIn
