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Chiquita Brooks-Lasure, head of the Centers for Medicare and Medicaid Services, wants to streamline the process for Americans who transition between Medicaid plans and private health insurance.
Expanding Medicaid coverage for new mothers is a key health equity priority.
Brooks-Lasure says the agency has little recourse to provide access to abortion if Roe v. Wade is overturned, but it could provide more birth control.
Medicare recipients could see lower drug plan premiums in 2023.

Chiquita Brooks-LaSure testifies before the Senate Finance Committee during her nomination hearing to be administrator of the Centers for Medicare & Medicaid Services in Washington on Thursday, April 15, 2021.
Caroline Brehman | CQ-Roll Call, Inc. | Getty Images

In her first year as administrator of the Centers for Medicare and Medicaid Services, Chiquita Brooks-Lasure has overseen the expansion of government health coverage to a record number of Americans under Medicare, Medicaid and private Affordable Care Act exchange plans.
Now, she wants to keep them insured, and expand access to services for women.

“We cover over 150 million people as a result of all of the hard work of the agency really enrolling people in coverage. So, we are a huge payer, and we help dictate coverage in this country … and have a powerful opportunity to advance health equity,” Brooks-Lasure said.
In the year ahead, one of the agency’s biggest challenges will be to create a smooth transition for millions of Medicaid members who could lose coverage when the Covid public health emergency ends. Under the federal health emergency, states have put eligibility redeterminations on hold for the last two years.

Loss of coverage

While the administration is expected to renew the current emergency designation next month, a Kaiser Family Foundation study estimated that between 5 million and 14 million people could be disenrolled when redeterminations resume.  
Brooks-Lasure says health insurers that administer state Medicaid programs will play an important role to help those who lose eligibility to transition to private exchange health plans, or Medicare if they’ve turned 65.  
“We have more plan participation, particularly in Medicaid coverage, than we did, say, 10 years ago. So they are a key component to helping make sure that we — and by we, I also mean the states — move people to whatever type of coverage they are eligible for,” she said.

Even beyond the public health emergency, she wants health coverage to be more consistent across public and private programs.
“Because whether it’s talking about maternal health or you’re in the middle of cancer treatment … you want to stay focused on the condition itself rather than having to worry about what changed in your coverage,” she said.

Birth control

In a new report outlining priorities for the agency, Brooks-Lasure says addressing health disparities is a central pillar of the agency’s mission. It’s been especially focused on improving maternal health coverage; Medicaid programs now cover 40% of births in the U.S. With funding from the American Rescue Plan Act, passed in 2021, the agency is working with states to expand Medicaid coverage for new mothers who are uninsured from 60 days to 12 months.
When it comes to reproductive care, Brooks-Lasure said CMS will also prioritize improving access to contraception in Medicaid and ACA health plans in the year ahead. If the Supreme Court overturns Roe v. Wade, as expected this month, the agency will be limited in its ability to provide access to abortion for women on Medicaid under federal funding rules.
Brooks-Lasure said the agency was focused on areas it has authority over, such as preventative care and contraception. She said CMS is encouraging states to use Medicaid to ensure men and women have access to birth control, “in light of whatever the Supreme Court decision is regarding broader services.”

Medicare premium rollback

One of the biggest decisions CMS issued this year was to limit Medicare coverage for the Alzheimer’s treatment Aduhelm, after mixed data on the drug’s efficacy. However, the move came after actuaries had factored in the expected high cost of the drug into 2022 Medicare premiums. Medicare recipients can expect a rollback in 2023.
“Because coverage is lower, we are going to incorporate that in the premium for next year,” Brooks-Lasure said.
Medicare recipients could also get a break on drug plan premiums with the introduction of several biosimilar versions of AbbVie’s high-priced arthritis treatment Humira over the next year. Humira sales topped $20 billion in 2021. Amgen’s biosimilar version will be the first to go on sale in the U.S., in January.
Brooks-Lasure said CMS actuaries are calculating the potential impact of the transition to Humira biosimilars and are expected to release their analysis in early September, in time for setting 2023 premiums.

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Spirit Airlines is postponing its shareholder meeting, previously scheduled for Friday, until June 30.
The carrier will continue talks over competing offers from Frontier Airlines and JetBlue Airways.
Both Frontier and JetBlue sweetened their offers in the last week.

A JetBlue Airlines plane takes off near Spirit Airlines planes at the Fort Lauderdale-Hollywood International Airport on May 16, 2022 in Fort Lauderdale, Florida.
Joe Raedle | Getty Images

Spirit Airlines is postponing its shareholder meeting, previously scheduled for Friday, until June 30 so it can continue deal talks with Frontier Airlines and JetBlue Airways, and with its stockholders, the carrier said Wednesday.
Spirit’s announcement came two days after JetBlue sweetened its offer for the discount airline, which has had a merger agreement in place with fellow budget carrier Frontier since February.

Frontier and JetBlue both say they see Spirit Airlines as key to their future growth. Either combination would create the fifth-largest airline in the U.S.
Spirit has repeatedly rebuffed JetBlue’s offers and said that an acquisition would be unlikely to pass muster with regulators, while JetBlue has contended both deals would face scrutiny from the Justice Department
JetBlue had previously offered to divest Spirit’s assets in New York and some in Florida to make the deal more palatable to regulators.
“We welcome this development as a necessary first step toward genuine negotiation between the Spirit Board and JetBlue,” JetBlue CEO Robin Hayes said in a statement Wednesday. “Spirit shareholders are clearly urging the Spirit Board to engage with us constructively and provide us with the same information previously made available to Frontier so that we can reach a consensual transaction.”
Spirit didn’t immediately comment further.

JetBlue on Monday raised its offer for a reverse breakup to $350 million if the Justice Department were to block its purchase of Spirit. Frontier last week offered a $250 million reverse breakup fee, payable to Spirit shareholders, if that deal is knocked down by regulators.
Spirit shareholders were due to vote on the cash-and-stock Frontier deal on Friday. JetBlue urged Spirit stockholders to reject that merger.
Proxy advisory firm Glass Lewis last week recommended shareholders vote in favor of the Frontier deal while another firm, ISS, said they should reject it.
Shares of Spirit and Frontier were up less than 1%, while JetBlue was down modestly in premarket trading Wednesday.
Frontier didn’t immediately comment.

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The average contract interest rate for 30-year fixed-rate mortgages with conforming loan balances ($647,200 or less) increased to 5.40% from 5.33%.
Applications for a mortgage to purchase a home fell 7% for the week and were 21% lower than the same week one year ago.
Refinance demand dropped 6% for the week and was down 75% year over year.

Real estate agents Rosa Arrigo, center, and Elisa Rosen, right, work an open house in West Hempstead, New York.
Newsday LLC | Newsday | Getty Images

Mortgage rates are back on the upswing, after a brief decline in May, and the housing market is still suffering from a lack of listings. As a result, mortgage demand continues to drop.
Total mortgage application volume fell 6.5% last week compared with the previous week, according to the Mortgage Bankers Association’s seasonally adjusted index. Demand hit the lowest level in 22 years.

The average contract interest rate for 30-year fixed-rate mortgages with conforming loan balances ($647,200 or less) increased to 5.40% from 5.33%, with points rising to 0.60 from 0.51 (including the origination fee) for loans with a 20% down payment.
Refinance demand, which is most sensitive to weekly rate moves, fell another 6% for the week and was 75% lower than the same week one year ago. The vast majority of mortgage holders now have rates considerably lower than the current one, and even those who would like to pull cash out of their homes are choosing second mortgages, rather than refinancing their first liens.
“While rates were still lower than they were four weeks ago, they remained high enough to still suppress refinance activity. Only government refinances saw a slight increase last week,” said Joel Kan, an MBA economist.
Applications for a mortgage to purchase a home fell 7% for the week and were 21% lower than the same week one year ago.
“The purchase market has suffered from persistently low housing inventory and the jump in mortgage rates over the past two months. These worsening affordability challenges have been particularly hard on prospective first-time buyers,” Kan said.

Mortgage rates moved even higher to start this week, according to a separate survey by Mortgage News Daily. Rates have been in a narrow range for several weeks after moving decidedly higher in the previous months.
“There’s some chance that the upper boundaries of that range end up being a ceiling for rates, but that will depend on inflation and other incoming economic data,” wrote Matthew Graham, chief operating officer at Mortgage News Daily. “With a key inflation report set to release on Friday morning, the potential for volatility remains high.”

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A senior executive at China’s BYD said during a Chinese state media interview that the firm is poised to supply Tesla with batteries “very soon.”
Hong Kong-listed shares of BYD jumped 2.79% on Wednesday, mirroring broader positive sentiment in tech as the Hang Seng Tech index advanced 4.76% to 4,818.36. Shares of other Chinese EV makers in Hong Kong also rose, with Nio up 5.07% while Xpeng surged 6.13%.
Mainland-listed shares of Chinese battery maker and Tesla supplier Contemporary Amperex Technology plunged more than 7% during Wednesday trading before recovering from those losses to rise 0.218% by the close.

This photo from Dec. 2019 shows robotic arms spray painting a car body shell at the BYD Automobile Company Limited Xi’an plant. BYD is set to supply Tesla with batteries “very soon,” a senior company executive told a Chinese state media anchor.
Yuan Jingzhi | Visual China Group | Getty Images

Shares of electric vehicle maker BYD jumped on Wednesday after a senior executive said during an interview with Chinese state media that the company is set to supply batteries to Tesla “very soon.”
“We’re now good friends also with Elon Musk, because we’re preparing to supply batteries to [Tesla] very soon,” BYD Vice President Lian Yubo said during an interview with Chinese state media anchor Kate Kui.

BYD and Tesla did not immediately respond to CNBC’s requests for comment.
Rechargeable batteries and photovoltaic (the conversion of light from the sun to electricity) made up 7.29% of BYD’s revenue pool in 2021, dwarfed by the more than 50% share taken up by automobiles and related products, according to the company’s latest annual report.
Hong Kong-listed shares of BYD jumped 2.79% on Wednesday, mirroring broader positive sentiment in tech as the Hang Seng Tech index advanced 4.76% to 4,818.36. Shares of other Chinese EV makers in Hong Kong also rose, with Nio up 5.07% while Xpeng surged 6.13%.
Mainland-listed shares of Chinese battery maker and Tesla supplier Contemporary Amperex Technology (CATL) plunged more than 7% during Wednesday trading before bouncing back to close 0.218% higher. CATL had roughly 25% of global EV battery market share in 2020, far ahead of BYD’s 7%, according to Nomura research.
Elsewhere in Asia, shares of Panasonic in Japan dipped 0.78% while South Korea’s LG Energy Solution dropped 1.5%. Both companies also supply batteries to Tesla.
— CNBC’s Evelyn Cheng contributed to this report.

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After more than two years of closed border policies, Japan is set to welcome back international travelers this week.
Come June 10, foreign tourists traveling via packaged tours can enter Japan.

However, the government’s priority still lies in boosting domestic tourism numbers, said Tadashi Shimura, president of Japan Association of Travel Agents.
Even before the pandemic, domestic tourism contributed far more to Japan’s overall gross domestic product than foreign tourism, according to JATA.

Tourism numbers

Overall tourism contributed 28 trillion yen ($211 billion) to Japan’s economy in 2019, with nearly 80% — or 22 trillion yen — coming from domestic tourists, according to a report by the Japan Tourism Agency.

Despite a rise in Covid cases in 2021, tourism spending from those living in Japan still managed to bring in 9.2 trillion yen that year, JTA said.
Nevertheless, boosting international arrivals to Japan is still vital, especially for the heavily hit hospitality, transportation and travel sectors, said Shimura.

Japan welcomed about 32 million foreign visitors in 2019 and had been on track to achieve its goal of 40 million in 2022, said Ejaz Ahmed, a research analyst at the Economist Intelligence Unit, during a webinar on June 1.
However, the pandemic caused arrival numbers to plummet rapidly, and there were only 250,000 foreign visitors in 2021, government data previously showed.

The loss of international travelers cost Japan “about 10 trillion yen over the past two years,” said Shimura, as spending from international students and long-term foreign residents brought in an average of 4.3 million yen per person per year, he said, citing a report by Nomura Research Institute.
Travel agencies in Japan are gearing up for the return of tourists with packaged tours to famous destinations across the country.
All Japan Tours has six tour packages, including the “Golden Route Japan Tour” which takes participants on an eight-day tour around Tokyo, Osaka and Kyoto for $2,698.

What are the rules? 

The daily cap on the number of visitor arrivals — which includes Japanese nationals and returning foreign residents — doubled from 10,000 to 20,000 on June 1, according to the Japan National Tourism Organization.
Local reports indicate the government may increase the limit to 30,000 people in July.
Still, Shimura said, those limits are too low, as the country used to welcome “140,000 [visitors] per day.”
Countries are classified into three categories — blue, red and yellow — and travelers may be subjected to additional restrictions depending on where they are coming from, according to the Ministry of Foreign Affairs of Japan. 
Travelers from 98 countries and regions — including the United States, United Kingdom, Singapore and China — fall under the “blue” category and are not required to test or quarantine on arrival or be vaccinated to enter.
Travelers from any of the 99 countries in the “yellow” category are also exempted from testing and quarantining upon arrival if they have had three doses of an accepted Covid-19 vaccination. The category includes countries such as India, Vietnam and Sri Lanka.
Those coming from “red” countries, such as Fiji, Pakistan and Sierra Leone, must test on arrival and quarantine for a period of three to seven days. More

The Food and Drug Administration’s advisory committee voted unanimously to recommend Novavax’s Covid-19 vaccine for use in the U.S.
The FDA usually follows the committee’s recommendations, though it is not obligated to do so.
The agency could clear Novavax’s vaccine for distribution in the U.S. as soon as this week.
FDA officials and committee members raised concerns about a risk of heart inflammation with Novavax’s shot that are similar to the Pfizer and Moderna vaccines.

Novavax’s two-dose Covid-19 vaccine for adults ages 18 and older cleared a key step on the path toward Food and Drug Administration authorization on Tuesday.
The FDA’s committee of independent vaccine experts voted 21 to 0 with one abstention at the end of an all-day meeting to recommend authorizing the shot for use in the U.S. after an all-day public meeting in which it weighed safety and effectiveness data. The FDA usually follows the committee’s recommendations, though it is not obligated to do so. The agency could clear Novavax’s vaccine for distribution in the U.S. as soon as this week.

The Centers for Disease Control Prevention would still need to sign off on the shots before pharmacies and other health-care providers can start administering them to people.
Novavax’s shot would be the fourth Covid vaccine authorized for use in the U.S. and the first new one since the Johnson & Johnson vaccine was cleared in February 2021.
Novavax was one of the early participants in the U.S. government’s race to develop a Covid vaccine in 2020, receiving $1.8 billion in taxpayer funding from Operation Warp Speed. However, the company struggled for more than a year to get manufacturing in place and its clinical trial data appeared much later than Pfizer and Moderna.

Known technology

The Maryland biotech company’s shots are based on protein technology that’s been in use for decades in vaccines against hepatitis B and HPV. The technology differs from Pfizer and Moderna’s shots, which were the first ones using messenger RNA technology to receive FDA approval.
Dr. Peter Marks, who leads the FDA office responsible for reviewing vaccine safety and effectiveness, said Novavax’s vaccine would potentially appeal to unimmunized people who would prefer a shot that is not based on the mRNA technology used by Pfizer and Moderna. Though Johnson & Johnson’s shot is also available, the CDC has restricted its use due to a risk of blood clots, primarily in women.

In this photo illustration the Food and Drug Administration (FDA) and Novavax logos are seen behind a medical syringe and vials.
Pavlo Gonchar | LightRocket | Getty Images

About 76% of adults ages 18 and older have already received two doses in the U.S., primarily with Pfizer and Moderna’s vaccines, according to data from the CDC. However, about 27 million adults in the U.S. have not received their first dose yet, according to Heather Scobie, an official on the CDC’s Covid emergency response team. Novavax executives believe their vaccine will appeal to some people in this group who are not against vaccination, but want an option that uses technology with a longer track record than mRNA.
Novavax’s vaccine was 90% effective at preventing illness from Covid across the board and 100% effective at preventing severe illness, according to the company’s clinical trial results from the U.S. and Mexico. However, the trial was conducted from December 2020 through September of 2021, months before the highly contagious omicron variant and its various sublineages became dominant in the U.S.

Omicron

In briefing documents published ahead of Tuesday’s meeting, FDA officials said there is no data available on the effectiveness of the Novavax vaccine against omicron, though the shots would likely still protect against severe illness from the variant. Novavax, like every Covid vaccine, was designed to target the original strain of the virus that first emerged in Wuhan, China, in 2019. However, the virus has mutated dramatically over the past two years. The effectiveness of all the vaccines against mild illness from Covid has declined substantially as the virus has evolved.
“The study was conducted quite a while ago and said the cases that accrued were not during the time that omicron was circulating,” Dr. Lucia Lee, an official with the FDA’s division of vaccine research, said during her presentation to the committee.
Committee member Dr. Eric Rubin, an infectious disease expert at Harvard, said he was disappointed the company didn’t present data on Novavax’s effectiveness against omicron. However, Rubin said the data the company did submit meets the same standard used to authorize Pfizer and Moderna’s vaccines in December 2020.
Novavax’s Chief Medical Officer Dr. Filip Dubovsky told the panel that data from the company’s trials showed that two doses induced an immune response against omicron, though it was lower than against the Wuhan strain. A third dose boosted the immune response against omicron to levels comparable to the first two doses which had 90% effectiveness against illness, Dubovsky said. Novavax plans to ask the FDA to authorize a third dose if the agency clears the primary series for use in the U.S., he said.
“It’s factual that we don’t have efficacy data against omicron, what we do have is a technology that we think generates a broad immune response, demonstrated against a broad array of variants,” Dubosvky said. 

Side effects

The most common side effects of Novavax’s shots were injection site pain, fatigue, headache and muscle pain, according to FDA briefing documents. However, FDA officials also raised a red flag that Novavax’s vaccine might be associated with a risk of heart inflammation as is the case with Pfizer and Moderna’s shots.
In a safety database of 40,000 Novavax vaccine recipients, four young men who ranged in age from 16 to 28 reported myocarditis or pericarditis within 20 days of receiving a shot, though one of them had a viral illness that could have caused the symptoms. Myocarditis is an inflammation of the heart muscle and pericarditis is inflammation of the outer lining of the heart.
Lee said these cases were concerning because the patients reported their symptoms within days of receiving a Novavax shot, and there is already an established link between mRNA vaccination and heart inflammation among younger men. In the case of the mRNA shots, the CDC has found that the risk of myocarditis is higher from Covid infection than vaccination.

Myocarditis

Novavax’s chief safety officer Dr. Denny Kim said the rates of myocarditis were essentially the same between people who did and did not receive the vaccine in the clinical study, though it was slightly higher among people who received the shots.
“We believe that the totality of the clinical evidence here is not enough to establish an overall causal relationship with the vaccine,” Kim told the committee. He said Novavax is monitoring for cases of heart inflammation in the accumulating data from its clinical trials and real world use of the shots where they are already authorized.
Panel member Dr. Arthur Reingold, an epidemiologist at UC Berkeley, said he was skeptical that large numbers of vaccine-hesitant people would get Novavax’s shot, given there’s evidence the company’s vaccine might be associated with a risk of heart inflammation at comparable levels to the Pfizer and Moderna shots. 
Dr. Cody Meissner, a pediatrician at Tufts University who also sits on the committee, said there’s clearly a link between Covid vaccines and myocarditis, though there’s not enough data to say whether one company’s shot carries a higher risk.
Novavax’s vaccine technology differs in a number of ways from Pfizer and Moderna’s shots. The latter rely on messenger RNA to turn human cells into factories that produce copies of Covid’s spike protein to induce an immune response that fights the virus. The spike protein is the part of the virus that latches on to and invades human cells.
Novavax produces copies of the virus’ spike protein outside the human body. The genetic code for the spike is put into a baculovirus that infects moth cells, which then produce copies of the spike that are then purified and extracted. The spike copy, which can’t replicate or cause Covid, is injected into people inducing an immune response against the virus.
The vaccine also uses another ingredient called an adjuvant, which is an extract purified from the bark of a tree in South America, to induce a broader immune response against the virus. The shots consist of 5 micrograms of the spike copy and 50 micrograms of the adjuvant.
Novavax’s vaccine can also be stored at refrigerator temperatures, while Pfizer and Moderna’s shots require deep subzero cold temperatures.

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Lyft’s vehicle fleet will remain largely commandeered by drivers even as the company continues to develop its autonomous driving capabilities, co-founder and president John Zimmer told CNBC’s Jim Cramer on Tuesday.
“It’ll do five percent of the trips. 95% of the time you’re going to rely on a rideshare driver. So that’s all going to happen within the Lyft network, and we’ll scale up with our autonomous partners,” he said.

Lyft’s vehicle fleet will remain largely commandeered by drivers even as the company continues to develop its autonomous driving capabilities, co-founder and president John Zimmer told CNBC’s Jim Cramer on Tuesday.
“What we see happening is that there will be a hybrid network, meaning on day 1, just like what happened with phones, you didn’t have 3G go to 4G go to 5G on separate networks. You still needed to be able to make a 3G call when 4G wasn’t available,” Zimmer said in an interview on “Mad Money.”

“The same thing’s going to be true with autonomous vehicles. … It’ll do five percent of the trips. 95% of the time you’re going to rely on a rideshare driver. So that’s all going to happen within the Lyft network, and we’ll scale up with our autonomous partners,” he added.
Lyft Autonomous’ AV partners include Ford Motor and Argo AI, Motional and Waymo. Lyft announced in 2021 that it will launch a driverless robotaxi service in Las Vegas next year through its partnership with Motional.
Zimmer also told Cramer that the rideshare platform has seen “a 40% active drivers year-over-year improvement,” and that productivity has been higher, with Lyft facilitating 20% more rides per driver compared to during the first quarter in 2019.
Soaring gas prices led to a shortage of rideshare drivers earlier in the year, and the Covid pandemic kept Lyft drivers off the road before that.
Disclosure: Cramer’s Charitable Trust owns shares of Ford.

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It’s that time again! “Mad Money” host Jim Cramer rings the lightning round bell, which means he’s giving his answers to callers’ stock questions at rapid speed.

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Blackline Inc: “They’re losing money. … We can just not go with it.”

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MetLife Inc: “I’m going to have to say yes to that, even as I’m not a great fan of the insurers. … That is too cheap a stock.”

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Farfetch Ltd: “I say, buy Target down here.”
Disclosure: Cramer’s Charitable Trust owns shares of Johnson & Johnson.

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