Analysis | Medicare vision, hearing and dental benefits are No. 1 on progressives' list – The Washington Post

A newsletter briefing on the health-care policy debate in Washington.
A newsletter briefing on the health-care policy debate in Washington.
Hey, happy Monday — if you’re in the D.C. area, and commuting via train, might want to get a head start (spoiler: Metro suspended over half of its rail cars).
Today, we dive into what the FDA’s outside advisers thought about Johnson & Johnson’s booster shot and whether hospital vaccine mandates are working. But first:
It’s not Medicare-for-all.
But for months, progressives have fiercely rallied around a push for expanding Medicare, believing they have the numbers to muscle through Congress the biggest upgrade in seniors’ benefits in nearly 20 years. 
The policy is a far cry from liberals’ call to fundamentally overhaul the country’s health-care system. Yet, progressive members have used their growing numbers — and Democrats’ small congressional majority — to double down on the more incremental notion of adding dental, vision and hearing coverage to the federal insurance program for older Americans and the disabled. 
Democrats are still fighting over the size of President Biden’s social spending package — and what will go in it — as party leaders desperately try to forge an agreement. House Speaker Nancy Pelosi (D-Calif.) is a big proponent of shoring up Obamacare, and Majority Whip Jim Clyburn (D-S.C.) has spoken forcefully about extending Medicaid to 2.2 million poor adults.
Yet adding new Medicare benefits appears necessary to get progressive lawmakers on board.
Rep. Pramila Jayapal (D-Wash.), chair of the Congressional Progressive Caucus:
The idea began to crystallize during the Biden-Sanders unity task force, according to three people with knowledge of the situation, where the primary rivals teamed up to create a list of policy recommendations both camps could support.
They see it as a way to close some of the gaps in Medicare, while continuing to advocate for Medicare-for-all. 
But what about lowering the Medicare eligibility age? That idea has largely been on the cutting room floor of the economic package for roughly two months. 
For Democrats, the last few weeks have been a lesson in the difficulty of governing with slim majorities. To pass Biden’s social spending bill, the party can’t lose a single senator’s vote. It can afford only three defections in the House. 
That gives each Democratic faction a lot of power — and has helped fuel progressives’ leverage over the legislation. But their numbers have also grown in the past decade. 
Despite the growth of the progressives, they’re competing with other sizable groups. 
The House’s New Democrat Coalition, a moderate-leaning group, consists of 95 members. They want to go big on a few programs, rather than implement a host of new ones where funding ends in just a few years. On health care, they’re pushing for two main policies: boosting financial assistance to Obamacare shoppers and closing the Medicaid coverage gap.
And in the Senate, all eyes are on Sens. Joe Manchin (D-W.Va.) and Kyrsten Sinema (D-Ariz.). But the slim margin means Democrats also need a vote from Sanders — who is openly feuding with Manchin.  
“Ultimately, how much power progressives have in this process hinges on whether they’re willing to walk away if their priorities aren’t met,” said Larry Levitt, an executive vice president at the Kaiser Family Foundation.
A panel of outside experts unanimously endorsed an additional shot of the Johnson & Johnson coronavirus vaccine for those 18 and older, recommending that it be given at least two months after the first shot. The FDA is expected to make its decision within days.
But still, that recommendation could be muddied. The committee was presented with data from a small National Institutes of Health study suggesting that patients who initially got the Johnson & Johnson vaccine might get a bigger antibody boost from an mRNA booster. Limitations in the study’s design made it hard to draw conclusions, and the committee did not take a vote on mixing and matching vaccines.
There’s more: Many experts weren’t surprised by the panel’s decision, pointing out that they had always expected that the single-shot vaccine would end up requiring another dose. Speaking Sunday on ABC, Anthony Fauci, Biden’s chief medical adviser, said it was “very likely this should have been a two-dose vaccine to begin with.”
Administrators of large health-care systems with vaccine mandates say they are seeing widespread compliance and declining coronavirus infections, The Post’s Meryl Kornfield and Annabelle Timsit report.
At Houston Methodist — one of the first health systems to require employees to get vaccinated — some 98 percent of staff members are now vaccinated, and the hospital credits widespread vaccinations with protecting 300 workers from getting sick over the summer. 
Two percent of employees were exempt or allowed to defer vaccination, mostly for medical reasons, and less than 0.6 percent of employees quit or were fired.
About 41 percent of hospitals nationwide have some sort of vaccine mandate, according to data collected by the American Hospital Association. Others are expected to follow suit after Biden announced he would require most institutions that receive Medicaid or Medicare funding to mandate coronavirus vaccines.
Here’s what else you need to know:
We’ve got a busy week ahead. Here’s what we’ll be watching.
We’re not done with boosters: The FDA’s advisers weighed in with their recommendations on booster shots for Moderna and Johnson & Johnson. Now, it’s time for advisers to the CDC to have its say. That panel will meet Thursday to discuss how booster shots should be used if authorized by the FDA.
On the Hill: On Wednesday, the Senate Finance Committee will hold a hearing on health insurance coverage and federal programs. That same day, the House Energy and Commerce panel will convene a hearing on legislation to protect public health, including measures to prevent lead poisoning and increase early detection of hearing problems in children.
Tune in: On Thursday, we’ve got a Washington Post Live event with oncologist and author Siddhartha Mukherjee and Tempus CEO Eric Lefkofsky. They’ll be talking about the future of precision medicine at 9 a.m.
Thanks for reading! See y’all tomorrow.
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