President Biden said Monday that people who have diabetes would no longer have to ration insulin and Americans would see lower prices at the pharmacy counter under his social welfare legislation.

In a bid to build momentum for the multitrillion-dollar bill that passed the House but faces a rewrite in the Senate, Mr. Biden said the millions of Americans who need insulin to live will pay no more than $35 per month out-of-pocket under any kind of health plan.

He also said people without insurance can get covered through expanded federal subsidies for Obamacare under his bill.

He touted the provisions after recounting tales of people rationing insulin or sharing their medicine with other diabetics.

“Shame on us as a nation, we can’t do better than this,” Mr. Biden said. “It’s enough. Enough. Nobody has held the manufacturers accountable until now.”

The social welfare bill also says Medicare, for the first time, would be empowered to negotiate the price of 10 life-saving drugs starting in 2023. The list of drugs eligible for negotiation would increase over time.

“All of us, whatever our background, our age, where we live we can agree that prescription drugs are outrageously expensive in this country,” Mr. Biden said. “It doesn’t need to be that way.”

Mr. Biden said drugmakers will face a “steep” excise tax if they raise prices on drugs higher than the rate of inflation, and the deal further caps out-of-pocket costs for Medicare beneficiaries to $2,000 per year.

The House approved the social welfare bill, 220 votes to 213, in mid-November but it faces a tougher test in the Senate, where Democrats cannot afford to lose a single vote in the evenly divided chamber.

“We need the Senate to follow the House of Representatives’ lead and pass my ‘Build Back Better’ bill,” Mr. Biden said.

Americans often cite drug prices as a source of worry, particularly as specialized drugs for conditions like hepatitis C and Alzheimer’s disease come onto the market with great promise, but with eye-popping prices to match.

Solutions are hard to find.

Drug and insurance lobbies point the finger at each other, while politicians bicker over how much government intervention will cut into drugmakers’ profits, resulting in job losses and/or hindering the discovery of new cures.

Former President Donald Trump made drug prices a key focus of his time in office and berated some companies into holding off on some prices increases. But many of his core ideas were withdrawn, blocked by courts or foundered in Congress before the pandemic took over as the main health concern.

Mr. Biden claimed momentum around his own plan.

“We need Congress to finish the job. Come together and make a difference in people’s lives,” he said, though later told reporters he wouldn’t set a deadline for senators. “As early as we can get it. We want to get it done no matter how long it takes.”

The Congressional Budget Office estimates that Mr. Biden’s drug provisions would reduce the federal deficit by nearly $297 billion over 10 years, although the analysts estimated the overall legislation will add upwards of $367 billion to the federal deficit.

The pharmaceutical industry is lobbying against the bill while it is revised in the Senate.

“A damaging bill jammed through a partisan process will not provide patients struggling to afford their medicines meaningful relief. The bill inserts the heavy hand of government into America’s medicine cabinet, and we know when government bureaucrats set the price of medicine, patients ultimately have less access to treatments and cures,” said Stephen J. Ubl, president and CEO of The Pharmaceutical Research and Manufacturers of America, after Mr. Biden‘s event.

“It will stifle continued innovation after a medicine is first approved, discourage the introduction of generics and biosimilar treatments, and undermine the robust competition that has made the Medicare Part D program a success for millions of seniors,” he said.

The president said drugmakers deserve to make a profit on life-saving drugs but there are limits.

“We can make a distinction between developing those breakthroughs,” Mr. Biden said, “and jacking up prices on a range of medicines, which have been on the market for years within making a substantive change in the medication.”

• Haris Alic contributed to this report.

Health, The New York Today

BATON ROUGE, La. — A bipartisan group of Louisiana lawmakers Monday voted against Gov. John Bel Edwards’ coronavirus vaccine requirement for some students, but the Democratic governor intends to overrule the rejection and add the shot to the immunization schedule starting next school year.

The fate of the plan seems likely to be decided by the courts, with Republican Attorney General Jeff Landry and the Edwards administration at odds over whether the vaccine requirement can be legally enacted by the governor without support from the full Legislature.

The House Health and Welfare Committee objected to the requirement in a 13-2 decision. All GOP lawmakers voted in opposition along with an independent and three Democrats. Only Democratic Reps. Dustin Miller of Opleousas and Robby Carter of St. Helena Parish supported adding the COVID-19 vaccine to the state’s immunization schedule for schools.

The Edwards administration said the vote can’t legally stop the governor from enacting the regulation.

Edwards “supports adding the safe and effective COVID-19 vaccine to the immunization schedule and, barring a recommendation from public health experts, his opinion would not change,” the governor’s spokesperson Christina Stephens said in a statement.

Even if the shots are mandated for Louisiana schools, the state allows broad exemptions for parents and students to opt out by submitting a written objection from a doctor or a general written dissent.

Across a daylong hearing, opponents of the regulation described the vaccine requirement as government overreach.

Some downplayed the threat of COVID-19 to children and repeated misinformation suggesting widespread risks from the vaccine. Others said while they believe in vaccines, they thought it was too soon to require the coronavirus immunization until there was more long-term study. Some said natural immunity from contracting COVID-19 was enough to keep from needing a vaccine, even though infectious disease experts disagree.

“I’m not anti-vaccine. I’m anti-vaccine mandate,” said Rep. Richard Nelson, a Mandeville Republican. “Is this really about controlling the virus anymore, or is this about controlling the citizens?”

Lawmakers worried children could be excluded from in-person classes if they file the exemption paperwork, even though the Louisiana Department of Health said it doesn’t intend to push the exclusion of unvaccinated children from school. The lawmakers – several of whom said they are vaccinated – said parents should get to make decisions about the shots their children receive.

“Parents should not be forced to jump through hoops,” said House Speaker Clay Schexnayder, a Gonzales Republican. He said he doesn’t believe the Edwards administration has the authority to add the coronavirus vaccine to the schedule of immunizations required to attend school.

Miller said parents will get the choice they want.

“I think we’re simply allowing parents to sign paperwork” if they don’t want to comply, he said.

Edwards’ chief public health adviser, Dr. Joe Kanter, pushed back against suggestions that COVID-19 isn’t a significant threat to children, that the vaccines are experimental and that they shouldn’t be added to the immunization schedule because they don’t keep someone from getting infected.

“Vaccines are the single best tool we have to fight back,” he said. “We need to encourage and promote their use while continuing to respect the tradition of parental autonomy which has served us well in Louisiana to date.”

Students in Louisiana are required to be immunized against certain diseases before attending K-12 schools, daycare centers and colleges, and lawmakers have delegated some of the responsibility about what’s on the list to the health department.

If it takes effect, the initial rollout of the COVID-19 vaccination requirement would only apply to age groups for whom the U.S. Food and Drug Administration has given full approval of the immunization. Currently, that’s high school students 16 and older. But that would broaden to cover younger children if the FDA grants full backing to the shots for more age groups.

Already, many of Louisiana’s colleges have begun requiring the vaccine – or an exemption request.

Monday’s hearing was packed with hundreds of parents opposed to the vaccination rule and with Republican lawmakers who don’t sit on the committee but wanted to speak in opposition. Landry appeared with Robert F. Kennedy, Jr., who has promoted debunked claims about the vaccine.

Health, The New York Today

Kentucky Derby winner Medina Spirit collapsed and died after a workout Monday at Santa Anita.

The 3-year-old colt trained by Bob Baffert had just completed five furlongs in his second workout since finishing second in the Breeders’ Cup Classic a month ago at Del Mar, according to Craig Robertson, Baffert’s attorney. Baffert said in a statement that the horse suffered a heart attack.

“My entire barn is devastated by this news,” Baffert said. “Medina Spirit was a great champion, a member of our family who was loved by all, and we are deeply mourning his loss. I will always cherish the proud and personal memories of Medina Spirit and his tremendous spirit.”

The colt will undergo a full necropsy, which is required by the California Horse Racing Board.

Medina Spirit tested positive after the May 1 Derby for betamethasone, a legal medication that is not allowed on race day. It was Baffert‘s record seventh win in the Derby.

Last Friday, Robertson released a statement saying that tests done by a New York lab have “definitely confirmed” Medina Spirit tested positive for the steroid – not through an injection but due to an ointment used to treat a skin rash.

The Kentucky Horse Racing Commission has been investigating the case, and has yet to hold a hearing that could possibly disqualify Medina Spirit.

In the $6 million BC Classic, Medina Spirit couldn’t muster the necessary late kick to threaten winner Knicks Go.

“I’m very proud of him. He ran a great race,” Baffert said last month. “To me, he’s the best 3-year-old. He showed it today. That’s what racing is all about, proving it on the racetrack. And he proved it today that he’s the real deal.”

Baffert was allowed to enter horses in the season-ending world championships, but the event’s money-leading trainer had to meet certain conditions, including stricter out-of-competition testing of his horses and greater security at his barn. He agreed to the extra scrutiny and was required to pay for it out of his own pocket.

Medina Spirit had five wins in 10 career starts and earnings of $3,545,200, according to Equibase. The colt was owned by Amr Zedan, who competes as Zedan Racing Stables.

“Our most sincere condolences go out to Mr. Amr Zedan and the entire Zedan Racing Stables family,” Baffert said in his statement. “They are in our thoughts and prayers as we go through this difficult time.”

Health, The New York Today