The Senate passed its budget reconciliation bill (H.R. 5376) this afternoon by a 51-50 vote, with Vice President Harris casting the deciding vote. The Senate Democrats have created a one-page summary of the bill.

The Wall Street Journal reports

The deal would dedicate $64 billion to extending for three years the Affordable Care Act subsidies that first kicked in under the 2021 American Rescue Plan. Nearly all of the 13 million people who get federal subsidies under the ACA would be spared from higher health-insurance premiums they would see next year without an extension.  * * * The change would push the next expiration beyond the 2024 election.

The measure would also allow Medicare to negotiate the cost of some prescription drugs with pharmaceutical companies, a longtime goal of many Democrats that has been opposed by the drug industry, which says it would stifle innovation. That move would save the government $288 billion, according to the summary.

Here is a link to the Senate Democrat’s summary of the Medicare changes.

Bloomberg adds

[While Medicare was cleared [yesterday] to negotiate drug prices for the first time by the Senate’s top rules official, the Democrats’ proposal intended to cap price increases for prescription drugs in the commercial market was blocked. * * *

The rulings are a partial victory for drug makers, who could try to make up their lost profits in Medicare on private insurers.

Axios notes that during the amendment “vote-a-rama” preceding the vote on H.R. 5376, a provision to cap insulin copayments at $35 was stripped from H.R. 5376.

The House of Representatives will convene on Friday, August 12, to consider and, in all likelihood, pass H.R. 5376. Otherwise, both Houses of Congress are now on their August State/District work break.

In U.S. healthcare business news, the Wall Street Journal reports

CVS Health Corp. is seeking to buy Signify Health Inc., according to people familiar with the matter, as the drugstore and insurance giant looks to expand in home-health services.

Signify Health is exploring strategic alternatives including a sale, The Wall Street Journal reported this past week. Initial bids are due this coming week and CVS is planning to enter one, some of the people said. Others also are in the mix, they said, and CVS could face competition from other managed-care providers and private-equity firms.

There is no guarantee any of them will reach a deal for Signify, which has a market value of around $4.7 billion after its shares rose on the news of a potential sale.

From the Rx coverage front, BioPharma Dive informs us

A new targeted treatment for breast cancer could reshape how doctors classify and treat the disease, offering another option for people whose tumors have spread or are unable to be removed through surgery.

On Friday, the Food and Drug Administration approved Enhertu, a medicine developed by AstraZeneca and Japanese drugmaker Daiichi Sankyo, for patients with advanced breast cancer that has low levels of a protein called HER2. It’s the first targeted drug to be approved for this group of patients.

For more than two decades, HER2 status has shaped treatment of breast cancer. Named after the gene that encodes it, the protein’s presence in high levels is linked to more aggressive tumors that grow and spread faster. But the approval in 1998 of a HER2-targeting drug called Herceptin gave doctors a powerful treatment to combat breast cancers positive for the protein. Since then, several other drugs aimed at HER2 have joined Herceptin on the market.

Until now, HER2 status has been black or white — either positive or negative. However, testing showed Enhertu to be dramatically effective in treating tumors with very low levels of HER2, levels that would typically be considered negative.

The drug’s approval therefore creates a new classification on which doctors can act. About 60% of breast cancer patients who would previously be categorized as having HER2-negative tumors can be now be counted as HER2-low and potentially receive Enhertu, the FDA estimated. HER2-negative cancers are estimated to be by far the most common, accounting for between 80% to 85% of the more than 250,000 people who are diagnosed with breast cancer in the U.S. each year.

From the health information technology front, the FEHBlog picked up this tidbit from a Health Data Management email from “Fred Bazzoli, Editor-in-Chief” this morning:

Much has been changing in healthcare – for providers, payers and consumers.

With a lot of change to assimilate, it’s no wonder that the results are delayed and hard to see. A case in point is healthcare APIs that enable patients to access their medical data. Industry players spent heavily to ready systems for patients to use APIs to access their records. But at this week’s WEDI Summer Forum in Chicago, attendees reported that there was little or no activity in patients using such capabilities. Shoot, only 5 percent to 20 percent of patients are using portals for that purpose now, one payer executive at the forum estimated – so it will take time for them to learn about these apps and get used to using them. Consumers don’t want multiple sources of medical information, or services…they want simplicity, which change doesn’t always seem to provide immediately. 

Change is also hard – WEDI is compiling challenges with rules requiring providers to provide patients with good faith estimates. Seemingly simple, providing accurate estimates is wrought with difficulty and peril, as forum attendees heard (see my story next week). More time is needed, WEDI contends. 

Slowing down change to allow for consumer adjustment seems to be the right course of action now.

From the public health front, the American Medical Association shares what doctors wish their patients knew about family immunizations.