Pelosi Dares Moderate Dems to Blow Up Biden Agenda

By Yuval Rosenberg

Good Monday evening! House
Democrats returned to the Capitol today looking to mend intraparty
rifts and resolve a standoff that threatens to derail their
economic agenda and scuttle President Biden’s proposed expansion of
the social safety net. At the moment, it’s not clear they’ll
succeed. Here’s what you need to know.
Pelosi Dares Moderate Dems to Blow Up
Biden Agenda

With President Biden’s economic agenda hanging in the balance,
House Speaker Nancy Pelosi and a band of moderate Democrats are
still engaged in a standoff over the party’s $3.5 trillion budget
blueprint.

Here's where things stand:

As moderates and progressives continue to jockey for leverage,
Pelosi (D-CA) on Monday called for a 5:30 p.m. meeting of her
caucus ahead of a planned procedural vote to begin debate on the
budget resolution later in the evening. She reportedly also held
talks with Rep. Josh Gottheimer (D-NJ), the leader of a group of
nine moderates who have insisted that they won’t vote for the
budget framework unless the House first holds a stand-alone vote on
the $1 trillion bipartisan infrastructure deal passed by the Senate
earlier this month.

Pelosi reportedly offered the moderates a deal that would fold
the rules for debate and passage of the budget resolution into one
vote. That wouldn’t address moderates’ demands that the
infrastructure bill be passed first, but it would allow Democrats
who are uneasy about the $3.5 trillion spending package a way to
avoid a direct vote on it. Pelosi reportedly also suggested setting
a firm deadline for passing the infrastructure bill of October 1,
when current surface transportation programs expire.

Members of the moderate holdout group reportedly were less than
enthusiastic about the offer.

The whip count on the budget bill was further complicated when
Rep. Stephanie Murphy (D-FL)
announced late Monday that she would not vote to start
the reconciliation process unless the infrastructure bill is
finished first. Democrats can’t afford to lose more than three of
their members given that Republicans are expected to uniformly
oppose the budget framework.

Both sides warn against delay: Pelosi’s latest proposal
came after both sides ramped up the pressure by signaling that they
would stick by their strategies. Pelosi has insisted that she will
only bring the infrastructure bill up for consideration in the
House after the Senate has passed a budget reconciliation bill.
Dozens of progressives have said they won’t vote for the
infrastructure bill until they see that the reconciliation package
addresses their priorities and isn’t stripped down or killed by
moderates.

In a “Dear Colleague” letter on Monday, Pelosi urged her members
to pass both the budget plan and the infrastructure bill. “We must
not squander our Congressional Democratic Majorities and jeopardize
the once-in-a-generation opportunity to create historic change to
meet the needs of working families,” she wrote, adding, “The
success of each bill contributes to the success of the other.”

But in an op-ed published at
The Washington Post on Sunday night, the moderates
insisted that the infrastructure bill should not take a back seat,
and that delay could threaten its passage. “Time kills deals,” they
wrote. “This is an old business saying and the essence of why we
are pushing to get the bipartisan infrastructure bill through
Congress and immediately to President Biden’s desk — as the
president himself requested the day after it passed the
Senate.”

The bottom line: Given the chaotic withdrawal from
Afghanistan, Biden could use a win — and a messy intraparty battle
is probably the last thing the White House wants at this point. As
of now, though, any deal on the budget and infrastructure remains
very much in question. Gottheimer and several other moderates in
his group have indicated a willingness to negotiate, meaning that
Democratic leaders may still be able to find a path forward.

At this point, though, it looks like House leaders will hold a
vote tonight on a rule that will also pass the budget resolution,
daring the moderates holdouts to oppose it.

FDA Approves Pfizer’s COVID-19 Vaccine

The Food and Drug Administration on Monday gave full approval to
the Covid-19 vaccine manufactured by Pfizer and BioNTech, which
until now had been used under emergency authorization. The vaccine
has also been given a new name: Comirnaty.

The first Covid-19 vaccine to receive full approval, Comirnaty
can be given to everyone aged 16 and older. The green light from
the FDA opens the door to wider use of vaccine mandates at a
variety of private and public institutions, and could help reduce
resistance to the shots among those who have expressed concerns
about the hurried conditions under which they were first approved
for use.

“The FDA’s approval of this vaccine is a milestone as we
continue to battle the COVID-19 pandemic,” said Acting FDA
Commissioner Janet Woodcock in a statement. “While this and other
vaccines have met the FDA’s rigorous, scientific standards for
emergency use authorization, as the first FDA-approved COVID-19
vaccine, the public can be very confident that this vaccine meets
the high standards for safety, effectiveness, and manufacturing
quality the FDA requires of an approved product.”

White House pushes mandates: Following the announcement
of the approval, President Joe Biden called on leaders in business
and government to implement vaccine mandates.

“I'm calling on more companies in the private sector to step up
with vaccine requirements that will reach millions more people,”
Biden said. “If you're a business leader, a nonprofit leader, a
state or local leader, who has been waiting for full FDA approval
to require vaccinations, I call on you now to do that — require
it.”

The Department of Defense announced Monday that it would require
the vaccine for all active members of the military. White House
Press Secretary Jen Psaki said that the administration expects to
see more departments within the federal government start rolling
out mandates. “I think you’re looking more at agency-to-agency or
different factions of the government at this point. But I expect
there will be more on that front,” she told reporters.

Some university systems will also start enforcing mandates. All
students at the State University of New York and City University of
New York schools will now have 45 days to get vaccinated, and the
University of Minnesota System and Louisiana State University have
announced they will also start enforcing a mandate as well.

Some Surprising Findings From Once-Secret
Hospital Prices

The federal government this year began requiring hospitals to
publicly post a full list of the prices they negotiate with private
insurers. Many hospitals
are not complying with the rule, which was enacted
by the Trump administration and is also supported by the Biden
administration. But Sarah Kliff, Josh Katz and Rumsey Taylor of The
New York Times report that the information already available shows
why hospitals and insurers fought hard against the new rule:

“It shows hospitals are charging patients wildly
different amounts for the same basic services: procedures as simple
as an X-ray or a pregnancy test.

“And it provides numerous examples of major health
insurers — some of the world’s largest companies, with billions in
annual profits — negotiating surprisingly unfavorable rates for
their customers. In many cases, insured patients are getting prices
that are higher than they would if they pretended to have no
coverage at all.”

The Times worked with researchers from the University of
Maryland-Baltimore County to study data from 60 major hospitals.
They found many cases in which insurers are paying more than the
cash price for people without insurance. “The worrying thing is
that the third party you’re paying to negotiate on your behalf
isn’t doing as well as you would on your own,” Zack Cooper, a Yale
economist who studies health care pricing, told the
Times.

At the University of Mississippi Medical Center, for
example, a colonoscopy costs $1,463 for patients covered by Cigna,
$2,144 for those on Aetna plans and $782 for those with no
insurance. At Memorial Regional Hospital in Florida, an MRI costs
$1,827 for Cigna patients, $2,455 for those with Blue Cross plans
and $262 for Medicare patients.

Those previously hidden differences could spoil even the
most careful calculations of someone shopping for an insurance
plan. “People carefully weighing two plans — choosing a higher
monthly cost or a larger deductible — have no idea that they may
also be picking a much worse price when they later need care,” the
Times notes. “Even for simple procedures, the difference can be
thousands of dollars, enough to erase any potential
savings.”

What hospitals and insurers say: Industry
representatives told the Times that looking at just some services
fails to provide a complete picture of their negotiated prices and
doesn’t account for key elements of their contracts, such as
bonuses for high-quality care. “Insurers want to make sure they are
negotiating the best deals they can for their members, to make sure
their products have competitive premiums,” said Matt Eyles, CEO of
America’s Health Insurance Plans, a trade group for
insurers.

Why it matters: The rationale behind the new rule
was that price transparency would lead to greater competition and
ultimately lower costs. The Times report hints at how lifting the
veil of secrecy around prices could still help that happen — but it
also illustrates the many obstacles and financial incentives that
stand in the way of such efforts to empower patients or employers
trying to navigate the complicated maze of health care
pricing.


Read the full piece at The New York
Times.

Consultants Raking In Millions From Government Covid Contracts:
Report

Private consultants have been running key parts of the
governmental response to the Covid-19 pandemic, and that isn’t
always producing the best results, according to an
analysis by The Washington Post’s Isaac
Stanley-Becker.

The service contracts for consulting services signed by federal,
state and local governments can be quite costly, Stanley-Becker
says, and tend to leave states without the internal resources and
capacities they need to respond to this and other crises over the
long term.

“At least 25 states, along with federal agencies and many cities
and counties, hired consulting firms,” Stanley-Becker writes. “The
American vaccination drive came to rely on global behemoths such as
McKinsey and Boston Consulting Group (BCG), with downsized state
and local health departments and even federal health agencies
relying on the private sector to make vaccines available to their
citizens.”

While the consultants say they are providing essential services
and specialized expertise, critics charge that the contracts, which
are often awarded on a no-bid basis, are difficult to monitor, with
little oversight of the goals and work product. In one example
cited by Stanley-Becker, an official said that California paid Blue
Shield and other consultants millions of dollars to do work that
was already being done by state employees.

In a more critical example at the national level, Stanley-Becker
reports that Boston Consulting Group has been paid more than $9
million to develop a plan to distribute Covid vaccines across the
country, with the contract calling for the delivery of “robust
central infrastructure” to coordinate the effort at all levels of
government. But coordination of the vaccine effort has been notably
lacking, especially in the beginning of the year, and neither the
consultants nor officials at the Center for Disease Control and
Prevention can identify any “robust central infrastructure” that
has been created by the consultants.

“It’s another example of the government farming things out, and
often to the wrong folks,” Jeffrey P. Koplan, a former CDC
director, told Stanley-Becker.

Even when the consulting firms do provide obviously
necessary services, their know-how disappears as soon as their
contracts end. “The contractors leave and we’re not retaining that
expertise,” Robin Taylor Wilson, former chair of the American
Public Health Association’s epidemiology section, said. “So the
next time an emergency hits, we’re going to have another delayed
reaction.”

Early Cutoff of Unemployment Benefits Pushed Few Back Into
Jobs: Analysis

Twenty-six states ended federal unemployment programs early in
an effort to force reluctant workers to take jobs, but the cutoff
appears to have produced few job takers while leaving those who
remain unemployed worse off.

The latest evidence comes from a report released by the Labor
Department late last week showing that states that cut the benefits
early had roughly the same rates of job growth as those that did
not.

Arindrajit Dube, an economist at the University of
Massachusetts,
told The New York Times that the basic idea
underlying the early cutoff was just plain wrong. “The idea was
that there were lots of jobs — it was just that people weren’t
looking. That was the narrative,” he said. “I don’t think that
story holds up.”

In a separate study, Dube found that few workers in cutoff
states found jobs, while aggregate spending showed a significant
drop, hurting overall demand – possibly weighing on job growth.
Here’s his quick summary of the findings from the study, which Dube
co-wrote:

* For every eight workers who lost benefits early, one found a
job by August.

* Cutoff states lost $4 billion in income due to loss of benefit
payments.

* Aggregate spending in cutoff states fell by $2 billion.

* Aggregate earnings in cutoff states rose by $270 million.

* At the individual level, the unemployed saw a loss of $218 on
average per week in benefits in cutoff states.

* Earnings rose by $14 on average per week in cutoff states.

The take-away from the analysis, says Dube, is “of the ~1.1 mil
additional people losing benefits, ~145k found jobs by early Aug.
But ~900k did not. Added jobs were moved up by few months, but at
substantial cost to recipients.”

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