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House Votes to Limit Health Costs as Drug Maker Adds Price Tag to Virus Treatment

WASHINGTON — House Democrats, moving to sharpen the distinction between themselves and Republicans as the coronavirus pandemic rages, passed legislation on Monday that would ensure that Americans paid no more than 8.5 percent of their income for health insurance and would allow the government to negotiate prices with drug makers.

The House passed the bill, voting almost entirely along party lines, 234 to 179, just hours after the Trump administration announced it had secured 500,000 treatment courses of a newly approved drug to treat Covid-19, remdesivir, but at a price. The drug’s maker, Gilead Sciences, will charge at least $2,340 per course, after weeks of donating the drug to hospitals with severely ill patients.

At the White House, President Trump’s press secretary, Kayleigh McEnany, defended the arrangement, saying that because remdesivir is an inpatient drug given by infusion, patients are highly unlikely to have to pay for it and “hospitals have to eat the cost of treatment use.”

But the House legislation and the remdesivir announcement once again put a spotlight on the cost of health care as a political and economic issue. While the House bill has no chance of passing the Republican-led Senate, Democrats — who reclaimed the House majority in 2018 on a promise to lower health costs and expand access — intend to use it to reprise that playbook in November.

The bill, unveiled last week, would expand the Affordable Care Act, President Barack Obama’s signature health care law, just as the Trump administration and Republican state attorneys general are asking the Supreme Court to overturn the 10-year-old law.

“Sadly, as we unveiled our lifesaving legislation last week, President Trump went to court to double down on his lawsuit to tear down the A.C.A.,” Speaker Nancy Pelosi said on the House floor before the vote. “At a time when families need health care more than ever, the president is trying to strip protections from about 130 million Americans with pre-existing conditions and take coverage away from 23 million Americans.”

The legislation would enable four million people to gain health coverage and make it more affordable for another 14 million, according to an analysis by the Center on Budget and Policy Priorities. Republicans argued that the bill wound hinder the development of new drugs and therapeutics by depriving drug makers of the profits they need for research and innovation.

“Our country currently leads the way in bringing new medications to market that would save lives and improve patients’ quality of life,” said Representative Phil Roe, Republican of Tennessee and a doctor, adding, “At this very moment American innovators are working at lightning speed to develop a Covid vaccine.”

Image“Sadly, as we unveiled our lifesaving legislation last week, President Trump went to court to double down on his lawsuit to tear down the A.C.A.,” Speaker Nancy Pelosi said.
Credit…Al Drago for The New York Times

While a broad expansion of the health law, commonly called Obamacare, is not in the offing this year, Mr. Trump and lawmakers in both parties have expressed strong interest in a narrower effort to control prescription drug costs. The remdesivir announcement might renew that push.

In the Senate on Monday, a new fight over drug price legislation broke out between Democrats and Republicans over a bill they drafted last year, which aims to limit how manufacturers like Gilead raise prices.

The bill would also cap the amount Medicare recipients pay every year for drugs. Senator Charles E. Grassley of Iowa, the chairman of the Senate Finance Committee, accused Democrats on the panel of abandoning negotiations over their legislation, which he said he hoped to include in the next coronavirus relief package Congress is expected to consider in July.

But the bill’s Democratic co-sponsor, Senator Ron Wyden of Oregon, shot back that Senator Mitch McConnell of Kentucky, the majority leader, had yet to schedule a vote on the bill.

“Democrats have not walked away from the table on drug pricing — Republicans never showed up in the first place,” Mr. Wyden said in a statement, adding: “Chairman Grassley and I have worked for over a year on a drug pricing bill that would end price gouging, lower consumers’ costs at the pharmacy counter, and save taxpayer dollars. I stand by that effort and maintain these policies are right on the merits.”

The bill that Mr. Grassley and Mr. Wyden wrote, which has been endorsed by Vice President Mike Pence and Alex M. Azar II, the health and human services secretary, does not give the federal government the power to limit the launch prices of drugs. But it caps the growth of drug prices in Medicare at inflation level, forcing manufacturers to pay back the difference — a move that could influence how much Gilead may choose to increase the price of remdesivir later this year. A Gilead spokesman said on Monday that the company did “not plan to adjust the price at this time.”

  • Frequently Asked Questions and Advice

    Updated June 24, 2020

    • Is it harder to exercise while wearing a mask?

      A commentary published this month on the website of the British Journal of Sports Medicine points out that covering your face during exercise “comes with issues of potential breathing restriction and discomfort” and requires “balancing benefits versus possible adverse events.” Masks do alter exercise, says Cedric X. Bryant, the president and chief science officer of the American Council on Exercise, a nonprofit organization that funds exercise research and certifies fitness professionals. “In my personal experience,” he says, “heart rates are higher at the same relative intensity when you wear a mask.” Some people also could experience lightheadedness during familiar workouts while masked, says Len Kravitz, a professor of exercise science at the University of New Mexico.

    • I’ve heard about a treatment called dexamethasone. Does it work?

      The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth.

    • What is pandemic paid leave?

      The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave.

    • Does asymptomatic transmission of Covid-19 happen?

      So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.

    • What’s the risk of catching coronavirus from a surface?

      Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.

    • How does blood type influence coronavirus?

      A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.

    • How many people have lost their jobs due to coronavirus in the U.S.?

      The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.

    • What are the symptoms of coronavirus?

      Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.

    • How can I protect myself while flying?

      If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)

    • What should I do if I feel sick?

      If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.


One hurdle for Mr. Grassley and Mr. Wyden has been Mr. Trump’s attention span, which has only intermittently turned to drug pricing legislation, an issue that he campaigned on in 2016 and that the White House has pursued for more than two years.

In his State of the Union address in February, he called on Congress to “get something on drug pricing done,” singling out Mr. Grassley and telling him to “get a bill on my desk.”

Without any progress by mid-May, Mr. Grassley confronted Mr. Trump in a meeting with Senate Republicans, asking him whether he was still interested in signing a bill. The president was enthusiastic and said that the Senate had “no choice” but to pass one, according to a person in the room.

But the White House’s interest has lagged. Senate aides familiar with the negotiations say that Mr. Trump has yet to apply enough pressure on Mr. McConnell, and the senior White House official who had been working with Congress on drug legislation, Joe Grogan, left in late May. Mr. Grogan said on Monday that before his departure, he had been pushing for Mr. Grassley’s bill and had been working with lawmakers to insert it in one of the coronavirus relief packages Congress has already passed.

Mr. Grogan’s successor, Brooke Rollins, did not directly respond to a question about whether the White House was still working with Congress to find a solution, saying in a statement, “We are continuing to talk to individual Americans, small business, employers and health care leaders to identify any gaps that may need to be addressed in future legislation.”

The new White House chief of staff, Mark Meadows, a former North Carolina congressman, has replaced Mr. Grogan as the White House’s point person on the issue, congressional aides said.

A spokesman for Mr. Grassley said he intended to reintroduce his legislation “with or without Democrats.” One senior Democratic aide familiar with the conversations said Mr. Grassley was merely trying to reintroduce the legislation with new Republican co-sponsors, including some in close re-election races, and not negotiate the policy components of the bill, which were not expected to change.

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