Interested in health care? This is what I'm reading this week.

I read all this stuff so you don't have to.

Is Build Back Better back from the brink? Sens. Joe Manchin and Krysten Sinema torpedoed the House-passed Build Back Better bill months ago. Obits were written, both for the bill and the ability of Democrats to keep control of Congress. But now it seems that Manchin is talking seriously to his fellow Dems about a skinnier but still meaningful version of the bill. And according to some reports, reducing and capping Medicare Part D out-of-pockets at $2,000 (or $3,000) a year is on the list of things Manchin may be on board with–which would be a huge win for many seniors–along with allowing Medicare to negotiate some drug prices directly with pharmaceutical companies. Many of those Dems had hoped the Senate could pass a version of BBB by Memorial Day. Can it be done by July 4? We’ll see. Labor Day might be more likely. Getting it done as part of the reconciliation process no later than mid-September is key for Democrats in tight races to have something positive to talk about on the campaign trail. Manchin reportedly is talking with Sen. Ron Wyden, chair of the Senate Finance Committee and a leading proponent of the legislation, as well as with Majority Leader Chuck Schumer. 

You’d think this would be a no-brainer. The aforementioned Ron Wyden is also pushing for a telehealth “Bill of Rights” for mental health care services. It would be a big help for millions of us. You’d think that and other bills to improve access to mental health services would have the support of Republicans as well as Democrats, considering how often they say it’s mental health, not guns, that needs to be addressed whenever we have a mass shooting. The Republicans have a point, but will they get behind any bill that would make mental health services more accessible and affordable but that Big Insurance will surely try to kill? Congress passed the Mental Health Parity Act years ago, but insurers have erected barriers that make it difficult for people with mental health and substance use issues to actually use their insurance. Many of their provider networks are grossly inadequate, their prior authorization demands are often beyond onerous, and they still pay mental health professionals so little that many doctors and therapists (and facilities) refuse to join their provider networks. I’ll be talking about this–and what patients and mental health professionals can do when insurance companies refuse to pay for often life-saving care–at the annual meeting of Mental Health America next week in Washington. 

A new word for you: pay-vider. If you haven’t already been seeing “pay-vider” in articles about U.S. health care, you will. It’s a term some journalists and “experts” are using to describe insurance companies that are also providing care (and hospital systems that are getting into the insurance business). Modern Healthcare had a cover story about this “trend” a few weeks back. It has been a trend for years now, and it has been contributing big time to insurance industry profits. Did you know that UnitedHealth Group is the biggest employer of doctors (well over 50,000) in the United States? That company continues to gobble up physician practices, clinics, and other facilities, like DaVita, one of the largest kidney dialysis companies. Here are some of the recent mergers and acquisitions that are changing health care. They’ve also made it possible for CVS Health (which now owns Aetna) and UnitedHealth to leap to #4 and #5 on the Fortune 500 list of America’s biggest companies. Cigna now owns the big PBM Express Scripts, and Humana, which recently announced it is buying a home health business, is sorta going back to its roots: It started out in life as a nursing home company before it became a hospital company before it became a managed care company.