Summary
Over the weekend, Senate Democrats successfully passed a modified version of the Inflation Reduction Act, including priority provisions such as Medicare drug negotiations and an extension to the Affordable Care Act (ACA) premium subsidies. This comes after Democrats faced major hurdles before the final vote, including rulings from the Senate Parliamentarian on which provisions could be included in a budget reconciliation package, as well as a whirlwind vote-a-rama in which Republicans raised several failed amendments to the bill.
The legislation differs in only a few though substantial ways from what Senate Democrats introduced just over a week ago:
- Inflation Rebates: The Senate Parliamentarian ruled against extending the inflation rebate provisions to the private market, limiting them instead to Medicare sales.
- Insulin: Senate Democrats added a provision that would cap copays for monthly supplies of insulin at $35 for Medicare beneficiaries. Democrats had originally intended to implement a similar cap in private markets, though Republicans successfully voted against such a change.
- Taxes: To garner Sen. Krysten Sinema (D-AZ)’s vote, Senate Democrats agreed to the removal of a provision that would narrow the carried interest loophole for some investment income – a provision would have saved approximately $14 billion.
- Rebate Rule: Democrats moved to delay implementation of the Trump Administration rebate rule until 2032 rather than fully repealing it as under previous versions.
Aside from these changes, the signature provisions of the legislation remained in tact, including the mentioned drug negotiations program and ACA subsidy extensions, as well as provisions to redesign the Medicare Part D benefit, changes to address climate change and clean energy, and tax reform.
Our full summary of the updated Inflation Reduction Act is available here.
Next Steps: The House is expected to return from recess and vote on the legislation as soon as this Friday and is expected to pass.
Monkeypox
Following the Biden Administration declaring monkey a public health emergency, we could see additional announcements on how the Department of Health and Human Services (HHS) is supporting states and jurisdictions. As of August 4, HHS delivered more than 602,000 doses of Bavarian Nordic’s JYNNESO vaccine for the prevention of monkeypox and smallpox, to support local response efforts. Details on the amount of JYNNEOS vaccine that has been allocated, requested, and shipped to jurisdictions nationwide is available here. The Centers for Disease Control and Prevention (CDC) has also ramped up the release of guidance and resources on monkeypox.
COVID-19 PHE
It is expected that the Biden Administration will again extend the COVID-19 PHE declaration for another 90-day period, though those close to the situation have cautioned that this could change leading up until the date by which the Administration must provide notice that it will allow the PHE declaration to expire. The deadline to provide notice is this Sunday, August 14. If the PHE declaration is extended once more, that would push the expiration date into January 11, 2023.