Week in Washington 101421

Week in Washington is brought to you by Michael Cohen, PhD. Tune in each week to read the latest on healthcare policy and get a glimpse of what’s on the horizon.

Week in Washington



Different factions within the Democratic Party continue to jockey over which health provisions should change. As a quick recap there are four major health care provisions in the bill: 1) Medicare negotiations for certain prescription drugs; 2) Extension of ACA Subsidy Enhancement from the American Rescue Plan; 3) Medicaid coverage for residents in non-Expansion states; and 4) Expansion of benefits like dental or vision for Medicare beneficiaries. The expectation is that the impact of the prescription drug provisions will be reduced. This would reduce the size or scope other provisions (namely Medicaid or Medicare expansions) will be paired down. It is unclear if the final bill will have both provisions included that is giving rise to continued rhetoric as to which one is more important. There appears general agreement that if a bill passes the ACA subsidy extension would be included.


  • Numbers- Overall national cases have decreased about 19% in the last 2 weeks. Generally, these declines have been driven by large declines in large population states like Texas and Florida. Small population states like Alaska, Minnesota, Wyoming, and Wisconsin are currently experiencing larger outbreaks.

  • Boosters – The FDA met today to discuss boosters for individuals who received Moderna or Johnson&Johnson vaccine. Preliminary data seems to show that individuals receive a larger immune boost from getting a Moderna or Pfizer booster. Recent survey data suggests about 10% of those that are fully vaccinated received a booster shot.

  • Future State – Increasing attention is being paid to the end state of the pandemic. While there continues to be large disagreements as to what that could entail, I’d recommend Trevor Bedford’s thread on the long-term outcome of COVID (i.e., being endemic). In this world, COVID would represent an additional disease burden, the equivalent of a bad flu season. 

Odds and Ends

  • Medicare Shopping – KFF reported that 71% of Medicare Beneficiaries did not compare Medicare Plans during Open Enrollment. Beneficiaries that were lower income, poorer health, lived in rural areas, or were older were less likely to shop plans.

  • STAR Rating – HMA released a report summarizing how regulatory changes during the COVID pandemic resulted in a record number of Medicare plans receiving high STAR (Quality) ratings. You can read the report here.

  • Social Security – The Social Security Administration announced that the Social Security cost of living adjustment would be 5.9% in 2022, the largest increase in nearly 40 years. Social Security payments are adjusted for COLA (cost-of-living-adjustment) and higher inflation this year is resulting in a larger increase in payments.

  • Flu – There is growing concern that this year’s flu season could be worse than normal. Partially this may be the case because there seems to be confusion among the public if COVID vaccines also protect against the flu (it does not). Lower vaccination rates for the flu could result in a worse than normal year.

Previous editions: 

10/07/2021: Week in Washington

09/30/2021: Week in Washington

09/23/2021: Week in Washington

09/09/2021: Week in Washington



9/02/2021: Week in Washington

8/26/2021: Week in Washington

8/19/2021: Week in Washington

8/12/2021: Week in Washington


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