Harris offers glimpse into her plans for health care if she is elected
When Vice President Kamala Harris introduced her economic agenda on Friday during a campaign speech in Raleigh, North Carolina, she provided an overview of health care priorities she would focus on if she wins the election in November.
In general, the plans she laid out build on what the Biden administration has accomplished thus far, with an emphasis on “building up the middle class” as a defining goal of her presidency.
One of Harris’ signature policy issues as vice president has been addressing burdensome medical debt. According to an analysis published by KFF in February (which was based on data from a 2021 survey), an estimated 3 million adults in the U.S. have more than $10,000 in medical debt.
In June, Harris and the Consumer Financial Protection Bureau proposed a rule to remove medical bills from credit reports and prevent lenders from factoring in consumers’ medical debt when deciding whether to approve loans.
At the time, Harris said, “No one should be denied access to economic opportunity simply because they experienced a medical emergency.”
Before ending his reelection campaign last month, President Joe Biden promised to eliminate medical debt, though he did not specify how he intended to do it. The Hill reported then that Americans owe about $220 billion in medical debt.
Harris said Friday that she wants to work with states to eliminate medical debt. She referred to an initiative CMS approved last month to forgive medical debt for 2 million residents in North Carolina through incentives for hospitals. According to an article by The Washington Post, all 99 of North Carolina’s eligible hospitals have committed to participating in the medical debt relief program.
Harris also wants to expand two provisions of the Inflation Reduction Act (IRA) — capping monthly out-of-pocket costs for insulin at $35, and capping annual out-of-pocket costs for prescription drugs at $2,000 — to all Americans, not just Medicare beneficiaries. Congress would need to pass legislation before that could occur.
She also wants to expand current Medicare drug price negotiations under the IRA so that “everyone” would have lower prescription drug costs, not just those enrolled in Medicare. (See the first brief after the Our Take editorial below for an update on this.)
Referring to pharmacy benefit managers, Harris said she would “demand transparency from the middlemen who operate between Big Pharma and the insurance companies who use opaque practices to raise … drug prices and profit off [consumers’] need for medicine.”
And Harris said she wants to extend the enhanced premium tax credits under the Biden administration’s American Rescue Plan Act for individuals who buy health care coverage through the Health Insurance Marketplace. Unless Congress intervenes, those enhanced subsidies will expire at the end of 2025.
Our Take: Friday’s speech is the first time Harris has provided insight into specific policies she plans to pursue if she is elected.
Former president Donald Trump, the Republican nominee, didn’t comment much about Harris’ plans for health care, according to The Hill, other than saying she wants private health care “out.”
But Harris has moved away from earlier stances she took, such as supporting Sen. Bernie Sanders’ Medicare for All bill in 2019. The health care plan she released during her 2019 campaign for the presidency included a strategy for adopting government-backed health insurance over the course of a 10-year period, without eliminating private health insurance.
A spokesperson for her current campaign said Harris will not push for single-payer government health insurance, CBS News reported.
Given that her campaign was launched less than a month ago, Harris’ policy proposals still need to be fleshed out. We anticipate hearing more details during interviews and the presidential debate next month.
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What else you need to know
The White House unveiled prices Thursday for the first 10 drugs chosen for Medicare price negotiations under the Inflation Reduction Act. In a fact sheet, the White House said when the negotiated prices take effect in 2026, there would be “a $6 billion savings” on those drugs and Medicare beneficiaries could save about $1.5 billion in out-of-pocket costs. But those amounts are based on list prices and actual savings will be lower, since payers, including Medicare, and consumers typically do not pay list price for prescription drugs. PBMs, rebates, out-of-pocket caps, health plan copays, and other factors influence drug costs. CMS will select up to 15 drugs in February for the next round of negotiations, unless ongoing legal challenges to the law or the outcome of the upcoming election change how, or whether, the negotiations are done. (The fact sheet referred to above includes a list of the 10 drugs, the negotiated prices, and the savings relative to list prices.)
Steward Health Care signed a definitive agreement to sell Stewardship Health, which combines Steward Health Care Network and the primary care providers of Steward Medical Group, to Rural Healthcare Group (RHG), a Nashville, Tenn.-based affiliate of private equity firm Kinderhook Industries. Although Steward did not provide details of the agreement, a bankruptcy court filing indicates a proposed purchase price of $245 million. According to Steward, the Stewardship Health primary care provider network consists of approximately 5,000 employed and affiliated providers across nine states. RHG was founded in 2022 and operates 17 clinics in Tennessee and North Carolina. RHG said in a news release it would make “significant investments in Stewardship’s infrastructure,” allowing providers to continue seeing patients in existing clinics across the network. The transaction, which is subject to regulatory review, bankruptcy court approval, and other closing conditions, will separate Stewardship Health from Steward’s hospital system. RHG said transitioning clinics “from health system-owned to independent” is one of its areas of expertise.
Kaiser Permanente has deployed Abridge’s generative AI-powered clinical documentation tool across the health system’s 40 hospitals and more than 600 medical offices in eight states and Washington, D.C. The health system has worked with Pittsburgh-based Abridge for the past year on “the largest implementation to date of the safe and effective use of ambient listening technology” in the U.S., a senior executive in Kaiser Permanente’s care delivery technology services unit said in a press release. Dr. Shiv Rao, Abridge’s CEO, said, “We have worked together [with Kaiser Permanente] to test and meet the highest standards of a true enterprise-wide deployment — addressing scale, evaluation, quality control, as well as the complexity of clinical workflows and IT system integrations.” The tool requires patient consent, Kaiser Permanente noted, adding that physicians and clinicians will review the clinical notes the tool creates before entering them into EHRs.
Separately, Kaiser Permanente reported net income of $2.095 billion for its second quarter and an operating margin of 3.1% (vs. $2.079 billion and 2.9%, respectively, in last year’s Q2). The most recent quarter’s financial results include Geisinger, which became part of Risant Health on March 31, 2024.
Mayo Clinic is collaborating with SandboxAQ to explore the use of advanced, AI-powered magnetocardiography (MCG) technology, with the intent to “radically” improve cardiac diagnostics. Researchers at Mayo Clinic will test CardioAQ, a mobile, non-invasive, non-contact MCG imaging system developed by SandboxAQ that is powered by state-of-the-art magnetic sensors and advanced AI algorithms, the company said in a news release. SandboxAQ believes the device could “enable rapid and radiation-free visualization and assessment of the magnetic signals of the heart.” The collaboration will begin with a study examining the relationship between MCG and findings seen in angiography. Based in Palo Alto, Calif., SandboxAQ emerged from Alphabet in 2022 as an independent company that delivers AI solutions for life sciences, financial services, and other sectors.
Elevance Health introduced a new care delivery platform, Mosaic Health, in partnership with private equity firm Clayton, Dubilier & Rice. The debut follows Elevance Health’s announcement in April that it would collaborate with CD&R to create a payer-agnostic advanced primary care and physician-enablement business, which Elevance would market to payers through its Carelon Health subsidiary. The plan is to bring together Carelon Health’s care delivery capabilities with two of CD&R’s operating companies, apree health (a digital navigation platform) and Millennium Physician Group — though the required regulatory approvals to include Carelon’s advanced primary care solution are still pending. Mosaic Health will focus on expanding access to primary care with coverage across commercial, individual exchange, Medicare, and Medicaid health plans, and will serve nearly 1 million members across 19 states, according to the press release. Clay Richards, an operating partner at CD&R, will serve as Mosaic Health’s executive chairman.
Baxter International will divest its kidney care business after signing a definitive agreement last week. Private equity firm The Carlyle Group will acquire the business segment — which Baxter originally considered spinning off as a publicly traded company — for $3.8 billion. Moving forward, the business line will be called Vantive. Baxter said in a news release that Carlyle’s investment in Vantive is in partnership with Atmas Health, an entity established in 2022 to acquire and build “a market-leading health care business.” One of Atmas Health’s founders, Kieran Gallahue, will serve as Vantive’s chairman. Chris Toth, who joined Baxter a year ago as group president of the kidney care business, will serve as Vantive’s CEO. Vantive has more than 23,000 employees and generated revenue of $4.5 billion last year.
What we’re reading
10 Numbers Making Physicians Nervous. Becker’s ASC Review, 8.15.24
The Strongest U.S. Healthcare Organizations Invest in Social Capital. HBR, 8.9.24
The Journey to an Incentive-Based Health Equity Quality Index. NEJM Catalyst, 8/21/24 (pre-publication, abstract available)
