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The Health 202

A newsletter briefing on the health-care policy debate in Washington.

These are the nine Democrats most likely to buck their party's drug plan

The Health 202

A newsletter briefing on the health-care policy debate in Washington.

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Helloo, happy Tuesday! In case you didn't look up last night, NASA's got ya covered. 🌕🌟New this morning: J&J data shows a second shot boosts protection. Meanwhile, we dive into a new lawsuit over Texas' abortion ban and how Republicans are maneuvering to block vaccine mandates. But first: 

Nine Democrats who could thwart their party's drug price quest

Democrats’ health-care ambitions rely partly on making massive changes to one powerful industry used to getting its way: Big Pharma. 

But several Democratic lawmakers are already publicly airing concerns with prescription drug legislation House leaders are embracing. And even more may be harboring reservations. 

The proposal hated by the drug lobby is the linchpin to paying for the party’s pricey plans to expand Medicare and shore up Obamacare, since it’s slated to save hundreds of billions of dollars. Congressional leaders are acutely aware that because of their narrow majorities in the House and Senate, virtually any Democrat can throw a wrench in their plan to pass Biden’s massive social spending bill simply by opposing the drug pricing measures. 

Here are the Democrats to watch:

Sen. Bob Menendez: Hailing from New Jersey — the home of several major pharmaceutical companies — Menendez is viewed as one of the Senate Democrats most sympathetic to the pharmaceutical industry. He wields influence as a senior member of the Senate Finance Committee, the panel hammering out the chamber’s drug pricing bill.

  • Key vote: In 2019, Menendez was the only Democrat in the committee to oppose an amendment that would have allowed Medicare to negotiate drug prices, a central tenet of Democrats' drug reform policies. A spokesperson didn’t say whether the senator would reject a plan that included drug price negotiation, but that he wanted to see “significant savings for consumers at the pharmacy counter.”

Sen. Tom Carper: The Delaware Democrat also comes from a state where the pharmaceutical industry looms large. And he’s also a senior member of the Senate Finance Committee. One key group favoring Democrats' proposals recently targeted Carper, along with Menendez, in ad campaigns, believing they needed a nudge to support strong Medicare drug negotiation. 

  • Notable pushback: Last week, Carper expressed reservations about cutting $600 billion from the pharmaceutical industry, which is the amount party leaders are hoping the drug pricing bill could save, STAT reported. In a statement to The Health 202, Carper said he wants to find a “workable way” for Medicare to negotiate drug prices, though didn’t define what that meant. 

Sen. Kyrsten Sinema: Publicly, the Arizona Democrat has laid low on drug pricing reforms. But privately, she told the White House she opposes the House’s plan, Politico reported. A spokesperson for her office declined to comment on her position on the drug policies. 

Politico's Laura Barrón-López:

Sen. Joe Manchin: It’s always worth keeping an eye on Manchin. The influential West Virginia Democrat is central to the party’s ability to pass a bill under a legislative maneuver that bypasses GOP opposition. His concerns over the spending package’s $3.5 trillion price tag are no secret.

  • But if he sticks to them, it could seriously imperil Democrats' legislative agenda. Privately, Manchin is now saying Congress should take a “strategic pause” until next year, Axios reported. (His office did not return a request for comment on how he views the drug pricing plan.)

The House centrists: A trio of Democrats bucked their party last week and opposed its signature proposal to lower drug prices. The move threw the drug pricing provisions into the limelight — and potentially thrust the $3.5 trillion package into jeopardy. 

  • The key players: Reps. Scott Peters (Calif.), Kurt Schrader (Ore.) and Kathleen Rice (N.Y.) already proved they were willing to vote against the plan (at least in committee). House leaders have a slim majority and can’t afford a fourth defection. 
  • But there are at least two more lawmakers in the House to watch. Last week, the trio unveiled a rival proposal to instead limit Medicare’s power to negotiate the cost of the most expensive drugs on the market. That bill has two more backers: Reps. Lou Correa (Calif.) and Stephanie Murphy (Fla.). 
  • Peters implied more members are wary of the drug plan. “There’s a lot of people who share my concern, would prefer my approach, but choose not to speak up about that. I think the five people on my bill have been vocal about it,” he told The Health 202.

Reproductive wars

The Texas doctor who defied abortion law has been sued

Oscar Stilley, a former Arkansas lawyer convicted of tax fraud in 2010, has filed a lawsuit against Alan Braid, the San Antonio physician who admitted to performing an abortion now considered illegal under the nation’s most restrictive ban. Stilley filed the lawsuit Monday to test the constitutionality of the Texas measure, The Post’s Ann E. Marimow reports. 

“If the state of Texas decided it’s going to give a $10,000 bounty, why shouldn’t I get that $10,000 bounty?” Stilley said.

This is the first legal challenge by a private citizen. And it sets in the motion the legal process that could result in courts blocking the law. The Texas law is unusual in that it was deliberately designed to avoid judicial scrutiny by barring state officials, who would typically be the target of lawsuits, from enforcing the ban.

The Supreme Court will hear Mississippi's challenge to Roe v. Wade on Dec. 1

Around noon Monday, there was an abortion split screen. The high court set Dec. 1 as the day for oral arguments in Mississippi’s ban on most abortions after 15 weeks of pregnancy — a case which could revise Roe v. Wade’s decades-old protections.

At that moment, the House Rules Committee had just begun debating a bill attempting to guarantee abortion access, a key part of Democrats’ strategy to fight for abortion rights. The chamber could vote on the bill as soon as this week, though it faces an uphill battle in the Senate. 

Coronavirus

White House lifts travel ban for vaccinated visitors from across the globe

The Biden administration announced Monday it would ease travel restrictions for international travelers from 33 nations, including Britain and India, The Post’s Adam Taylor, Annie Linskey and Marisa Iati report.

Vaccinated travelers must show proof of vaccination, test negative for the virus within three days before departure and provide passenger information to improve contact tracing. However, it’s unclear if travelers who have received vaccines that haven’t been approved by the United States, such as Oxford-AstraZeneca or Russia’s Sputnik V, meet these requirements. The new rules will take effect in November. 

Republican governors defy policy widely seen as an effective tool against infectious diseases

From Florida’s Ron DeSantis to Mississippi’s ​​Tate Reeves, Republican governors across the board have adopted a hard-line stance against mask and vaccine mandates. The approach contradicts public health guidance on how to fight infectious diseases, making it harder for the country to overcome the pandemic, The Post’s Yasmeen Abutaleb and Annie report. 

The opposition toward vaccine mandates, which has become the prevailing view of the Republican Party, has left public health officials worried that the GOP’s critiques could extend to vaccinations for other diseases including measles. 

Another vaccinated lawmaker tests positive for the coronavirus

Rep. Tim Ryan (D-Ohio), who is vaccinated, said Monday that he has tested positive for the coronavirus. Ryan is isolating at his home in Howland and will vote remotely until he can safely return to Capitol Hill, The Post’s Eugene Scott reports. 

He is the 11th member of Congress to experience a breakthrough case of covid-19, The Hill’s Cristina Marcos reports. Other lawmakers include: Reps. Vern Buchanan (R-Fla.), Ralph Norman (R-S.C.), Sharice Davids (D-Kan.), Troy E. Nehls (R-Texas), Mike Doyle (D-Pa.) and Darren Soto (D-Fla.), as well as Sens. Lindsey Graham (R-S.C.), Roger Wicker (R-Miss.), Angus King (I-Maine) and John Hickenlooper (D-Colo.).

Rep. Tim Ryan (D-Ohio)

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Here’s what else you need to know: 

  • A second shot of the Johnson & Johnson vaccine increases protection against symptomatic and severe illness, the company announced this morning. The boosters also produced additional antibodies to help fight off infections, The Post's Ben Guarino reports.
  • The coronavirus pandemic’s death toll has surpassed that of the 1918 flu pandemic — as more than 675,000 deaths have now been associated with covid-19, The Post's Rachel Pannett and Annabelle Timsit report.
  • Today, Biden will address the United Nations General Assembly for the first time as president. This is also the first time in two years that world leaders will meet in person at the world’s largest diplomatic gathering. The event is expected to be a major test of Biden’s ability to rally a global response to the pandemic, The Hill’s Brett Samuels and Alex Gangitano report.
  • Biden will receive a booster shot of the Pfizer-BioNTech coronavirus vaccine on camera in the coming weeks, The Post’s John Wagner reports.
  • HHS Secretary Xavier Becerra has seldom been the one giving orders on Biden's covid response, despite running the department integral to ending the pandemic, Politico's Adam Cancryn reports.
  • Health-care workers’ patience toward vaccine skeptics is waning as they deal with the third surge of coronavirus cases in the Washington region. The surge, driven by the highly contagious delta variant, has left many feeling frustrated, The Post’s Antonio Olivo and Rachel Chason report.

Agency alert

The Biden administration to tackle workplace safety and extreme heat

Biden is mobilizing six federal agencies to protect workers from extreme heat. The move could create new Occupational Safety and Health Administration heat standards, increase funding for cooling centers and air-conditioning units, and reduce heat-related illness and death. 

The Department of Health and Human Services will focus on steering existing dollars toward helping low-income households to help buy air-conditioning units. Extreme heat, driven by climate change, has affected the health of thousands of Americans and is the leading weather-related cause of death in the country, The Post’s Maxine Joselow reports. 

Sugar rush

Thanks for reading! See y'all tomorrow.

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