The Washington PostDemocracy Dies in Darkness
The Health 202

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

Health care is top of mind for Democratic voters

The Health 202

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

Good morning, and TGIF, everybody.

Today's edition: Sen. Mitt Romney (R-Utah) received an offer of ways to pay for new coronavirus aid. The Food and Drug Administration authorized several tobacco-flavored vaping products — and signaled major announcements are on the way. But first …

Democrats are under pressure from their voters to expand and improve health care

Health care is the No. 1 issue for Democratic voters in the upcoming midterm elections, according to a new survey from Pew Research Center. 

Yet congressional Democrats are floundering on advancing new health-care policies, despite their best chance in more than a decade to make sweeping alterations to the health system.

Democrats are still seeking a major win on health care. President Biden and congressional leaders are resetting expectations for what can get done ahead of the midterms, focusing instead on smaller bits of last year’s ill-fated economic package. 

  • “Health care will be a major issue for Democrats, no question about that,” said Robert Blendon, a professor of health policy and political analysis at the Harvard T.H. Chan School of Public Health. “And the question will be, what does the administration show that it did?”
The poll

Here were the new survey’s major findings:

  • Health care ranks third among the top issues for all voters.
  • But there’s a huge disparity between the two parties. Roughly 74 percent of Democratic voters say the issue is very important to their vote, compared with 44 percent of Republicans.
  • Overall, the economy topped the list for voters, as inflation has risen to the highest level in four decades.
  • Meanwhile, just one-third of voters say the coronavirus is a very important issue to their vote in November, though Democrats are more than twice as likely as Republicans to feel this way (46 percent vs. 19 percent).
On the left

There’s been increasing concern within the party about what falling short on Democrats’ health-care ambitions could mean for the midterms. Lawmakers and advocates haven’t given up on passing some sort of health-care legislation, which could include letting Medicare negotiate drug prices or expanding Obamacare’s financial aid for good. 

Republicans were more likely to say it “really matters” which party gains control of Congress. That stood out to Chris Jennings, a longtime Democratic health policy consultant. 

  • “Democratic voters aren’t very excited about this election,” he said. “They’re not very motivated and the reason that this seems to be the case is that they don't feel there’s a difference between who’s in power in the Congress.”
  • A way to reverse course? “Pass something meaningful on health care,” he said.
On the right

Republicans haven’t coalesced around a health-care message since the party failed to deliver on its years-long pledge to repeal Obamacare. But some experts say that really doesn’t matter right now.

For one, health care isn’t seen as a top issue for the GOP base. And two, the Republican party is out of power — and that’s a midterm advantage. The president’s party has improved its share of the House popular vote just once in the 19 midterm elections between 1946 and 2018, per FiveThirtyEight.

  • “When they needed to come up with a [health-care] plan, they didn't do it. So now when they don't need to do one, I don't think they're about to,” said Thomas Miller, a senior fellow at the American Enterprise Institute, a conservative-leaning think tank.

Pew Research Center surveyed 10,441 adults between March 7-13. The margin of error is plus or minus 1.5 percentage points for the full sample.

Readers help us

The Post is looking to speak with families with a child currently struggling with suicide. Your story can help us understand this difficult issue. We recognize this is a sensitive topic and respect your privacy. We won’t publish any part of your response without contacting you first and getting your permission. Here’s how to share your story with us.

On the Hill

The latest on coronavirus 💰: Sen. Mitt Romney (R-Utah) said he received a new offer from Democrats on how to pay for new pandemic aid and is working on a counterproposal, The Hill’s Peter Sullivan first reported.

This comes as the congressional impasse over new dollars to pay for additional vaccines, tests and treatments has stretched into the third week. It was not immediately clear what funds could be repurposed, as Republicans demand that Democrats find a way to pay for the package.

One top lawmaker, Sen. Roy Blunt (R-Mo.) — the ranking member on the Senate health appropriations subcommittee — said yesterday afternoon that he hadn’t seen a new list of offsets.

  • “Sen. Schumer has decided to work with Sen. Romney on that,” Blunt told The Health 202.


Small lab that got $187M for covid-19 testing put patients in ‘jeopardy’

The federal government gave an Illinois-based lab services company millions in pandemic relief dollars to provide coronavirus tests for the uninsured, but what patients got in return put their health in “jeopardy,” a new investigation by The Post’s Shawn Boburg and Kim Bellware found. 

The details:

  • O’Hare Clinical Lab Services received $187 million in federal dollars over 15 months as it created a nationwide network of coronavirus testing locations.
  • But last month, regulators from the Centers for Medicare and Medicaid Services suspended its license to operate a lab and cut off payments.

The big picture: The company's quick rise — from a small testing center to one of the nation’s largest covid testing operations for the uninsured — illustrates the shortcomings of the U.S. government’s approach to build a robust public health testing infrastructure. The federal government instead infused billions of dollars into private health companies, including established firms and smaller businesses with spotty safety records, Shawn and Kim write. 

  • Zooming out: More than 30,000 companies have been reimbursed for providing testing to the uninsured, totaling more than $11 billion.
  • Earlier this month, the White House said that the Justice Department would create a task force to investigate similar instances of fraud in the government’s pandemic spending.

Colin Boyle, reporter and photographer at Block Club Chicago

Deaths outpaced births in most counties amid the pandemic

Nearly three-fourths of all U.S. counties reported more deaths than births last year, a dynamic caused largely by the pandemic, according to data released by the Census Bureau. 

Low fertility rates and a demographic shift toward an older population also played a role in what one professor called the smallest population increase in 100 years.

What that means: There was a dramatic slowing in the overall population growth of the nation, The Post’s Fredrick Kunkle reports. 

Agency alert

FDA allows another e-cigarette — and pledges more decisions soon

The Food and Drug Administration authorized several e-cigarette products made by the company Logic, a move that signals the agency could soon announce whether other major manufacturers will be allowed to continue selling their products in the United States, our colleague Laurie McGinley reports.

  • Federal regulators said the benefits from Logic’s production of tobacco-flavored vaping products — aimed at helping adult smokers transition away from traditional cigarettes — outweigh the risk of young people picking up the devices.
  • The agency also said data showed that people who don’t already smoke already are unlikely to start using the tobacco-flavored items.

The announcement comes as the agency has ramped up its efforts to expand regulation of e-cigarette products in recent years, after cracking down on sweet and fruit- flavored devices that attracted new young users to the market in 2015. 

Meanwhile, Mitch Zeller, director of the FDA’s Center for Tobacco Products, is retiring in early April, and there’s widespread speculation that he wants to issue decisions on the big companies before he leaves.

Global health

Russians panic buy prescription drugs amid worsening sanctions

Russians are scrambling to stockpile pharmaceuticals amid fears of price increases and future shortages as the West ramps up sanctions against Moscow, Reuters reports. 

In the two weeks following Russia’s invasion of Ukraine, Russians purchased 270.5 million medicinal items in pharmacies — a figure almost comparable to sales in the entire month of January — according to sales data gathered by analytical company DSM Group

  • In particular, antidepressants, sleeping pills, insulin, cancer and heart drugs, hormones and contraceptives were in high demand.
  • While some foreign pharmaceutical companies have remained in the country to supply lifesaving medications, their products are now being sold at a higher price.

In other health news

  • At least 1 in 5 people with large employer coverage who take insulin would save money under Congress proposal to cap the drug’s out-of-pocket costs at $35 per month, according to a new Kaiser Family Foundation analysis.
  • The Arizona legislature passed a bill along party lines banning abortion after 15 weeks of pregnancy that contains no exception for rape, incest or a medical emergency, the Associated Press reports. Republican Gov. Doug Ducey is expected to sign the measure.
  • The CDC updated its guidance to allow those visiting health care facilities to wear highly protective N95 masks, Politico reports.

Quote of the week

Sugar rush

Enjoy peak bloom!

Thanks for reading! See y'all Monday.