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The Health 202

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

Bernie, on his agenda for the Senate health panel

The Health 202

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

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Today’s edition: The House will vote on two abortion-related measures today. Advisers to the Food and Drug Administration will meet next month to discuss an over-the-counter opioid overdose reversal drug. But first …  

Sen. Sanders wants to move “very aggressively” on the high cost of prescription drugs

You might not have guessed this: As Sen. Bernie Sanders takes the gavel of the chamber’s prestigious health panel, a hearing on Medicare-for-all isn’t at the top of his list.

The independent firebrand has long championed a far-reaching proposal to transform the nation’s health care into a single-payer system, succeeding in making the issue one of the top fights among 2020 Democratic presidential candidates. But as the Vermont senator is poised to chair the Senate HELP Committee this Congress, he’s acutely aware that the policy is nowhere near close to having enough support to pass this year, though he will still introduce and publicly discuss the measure.

From the top of his new health perch, Sanders plans to instead push to move “very aggressively” on the high cost of prescription drugs, saying there’s an “incredible level of greed” within the pharmaceutical industry. And in an interview, he ticked off a list of broad areas he sees ripe for bipartisanship: lowering prescription drug prices, expanding primary care, bolstering the health workforce and beefing up rural health care.

Sanders’s comments underscore the tightrope the self-described democratic socialist must walk to pass legislation with a slim Democratic majority and find overlap with the panel’s ranking Republican, Sen. Bill Cassidy (La.), a gastroenterologist and health policy wonk who Sanders hasn’t worked with much before. Some people on and off Capitol Hill have privately wondered whether Sanders will be able to build consensus among Republicans and within the Democratic caucus.

The 81-year-old plans to prove skeptics wrong by sitting down and talking with every lawmaker on his committee about their priorities, and said he’s already begun discussions with Cassidy. 

  • “Look, there are areas where there's not going to be bipartisan support,” Sanders said. “There will be areas there are, and I will do my best to pursue those areas.”
The details

The Senate health committee has sweeping jurisdiction over the nation’s public health agencies, the Food and Drug Administration and other aspects of federal health policy. (Medicare-for-all and empowering the federal insurance program to negotiate the price of drugs are both technically under the purview of the Senate Finance Committee, but that doesn’t mean Sanders couldn’t use his high-profile platform to promote both policies.)

Aside from saying a hearing on Medicare-for-all wasn’t at the top of his list right now, Sanders didn’t offer a glimpse of the upcoming hearing schedule, other than to say he planned to “take the show on the road” by holding events outside of Washington, D.C. Nor did he hint at which health executives he planned to haul to Capitol Hill. 

It’s a “little bit premature,” Sanders said, though he cited a letter he sent yesterday to Moderna demanding the company refrain from more than quadrupling the price of its coronavirus vaccine as an example of the issues he plans to pursue. Moderna, for its part, said the company is “committed to pricing that reflects the value that covid-19 vaccines bring to patients, health-care systems and society.”

In a warning shot, Sanders noted that the committee has subpoena power. “We will use it judiciously, but we are prepared to use it when necessary,” he said. 

Eye on pharma

Sanders is known for his diatribes against the pharmaceutical industry. It’s no surprise that lowering the costs of medicine is high on his agenda, though it’s unclear what could get done in a divided Congress, particularly after Democrats passed their own drug pricing bill last year without GOP support. 

The incoming chair didn’t detail specific policies, but he said that drug importation is one of the options. Last year, Sanders attempted to push a sweeping amendment allowing the importation of drugs from other countries through the HELP Committee to no avail, though he would have the power to make it more of a priority as the panel’s chair.

The powerful drug industry lobby pushed back on that idea. In a statement, Brian Newell, a spokesman for the Pharmaceutical Research and Manufacturers of America, said “the last thing we should do is pursue a risky importation scheme that will jeopardize the health and safety of the American people.”

“If you’re already an industry that’s in [Sanders’s] crosshairs, you need to be worried,” said one Democratic pharmaceutical lobbyist, who spoke on the condition of anonymity to be candid. “He’ll get out and get all his press, and he’ll find a way to actually pass something.”

But one thing Sanders won’t be doing? Paying attention to lobbyists. 

  • “My job is to listen to the needs of the American people, not the industry,” he said. “I'm interested in learning as much as I can, but we’re not going to be sitting down and getting lobbied by powerful corporate interests.”

On the Hill

On tap today: House lawmakers to consider two abortion-related bills

House lawmakers are expected to bring a resolution to the floor today condemning attacks on antiabortion facilities, churches and groups, as well as a measure that would compel doctors to provide care to infants that survive an attempted abortion — something that is exceedingly rare.

Ahead of the House vote, Rep. Nancy Mace (R-S.C.) cautioned that the GOP should be more centrist on the issue of abortion, noting that the fall of Roe v. Wade last year played an outsize role in the midterm elections.

“We learned nothing from the midterms if this is how we’re going to operate in the first week,” Mace told Politico’s Olivia Beavers, adding that the bills stand no chance in the Democratic-controlled Senate. “What we’re doing this week is paying lip service to life,” she said.

Rep. Katherine Clark (D-Mass.):

Meanwhile …

The incoming leaders of the Senate Appropriations Committee — Sens. Patty Murray (D-Wash.) and Susan Collins (R-Maine) — issued a joint statement yesterday pledging to work on “funding the government in a responsible and bipartisan manner.”

Murray previously served as the top Democrat on the Senate HELP Committee, where she emerged as a bipartisan dealmaker in an increasingly polarizing era of Congress.

Why it matters: As chair and ranking member of the panel, it will be up to Murray and Collins to oversee the legislation that allocates federal funding across the entire government annually, including for critical health agencies like the Department of Health and Human Services and the FDA.

Also, on our radar …

House Majority Leader Steve Scalise (R-La.) and Rep. Christopher H. Smith (R-N.J.), the co-chair of the Congressional Pro-Life Caucus, will speak at next week’s 50th annual March for Life, an annual event in January protesting abortion around the anniversary of Roe v. Wade, the March for Life Education and Defense Fund announced yesterday.

Agency alert

FDA advisers to meet on Narcan next month

The Food and Drug Administration’s advisory panel is meeting Feb. 15 to consider whether Emergent BioSolutions’s opioid overdose reversal drug should be approved for over-the-counter use.

Last month, the agency granted Emergent’s application for the nonprescription sale of its naloxone nasal spray, called Narcan, a priority review status. The health regulator is expected to issue a decision by March 29, Reuters reported.

Key context: Every state and D.C. have already enacted some form of legislation to increase access to naloxone, such as authorizing pharmacists and licensed practitioners to dispense the drug to anyone who is at risk for an opioid overdose or have a statewide standing order allowing for naloxone. 

However, public health experts say removing the prescription requirement could expand access to the drug as the Biden administration seeks to stem the tide of overdose deaths nationwide.

In other news from around the agencies …

New this a.m.: Nearly 16 million people have signed up for health coverage through the Affordable Care Act marketplaces since the start of the 2023 open enrollment period on Nov. 1, the federal health department announced this morning. 

The health insurance exchanges have gained about 3.1 million new enrollees so far, and the annual sign-up season lasts through Jan. 15.

In the courts

HHS tasked with repaying 340B hospitals

It will be up to the Department of Health and Human Services to devise a plan for how to compensate hospitals enrolled in a federal drug discount program for years of underpayments, Stat reports.

What happened: A federal court yesterday remanded the payment issue to HHS in the latest chapter of a years-long legal dispute between hospitals that serve low-income patients in exchange for discounted drugs through the 340B program and the federal government over Medicare payment rates.

The fight reached the Supreme Court, which ruled unanimously in June that the Trump administration acted illegally when it cut Medicare payment rates for drugs that hospitals acquired through the 340B discount program.

More than six months after the ruling, hospitals are still waiting to be paid back more than $1 billion. The district court’s decision delivered a disappointing blow to industry groups, who had hoped that the judges would order HHS to repay the hospitals immediately.

The agency’s exact compensation plan remains unclear. The situation is particularly complex because hospitals that aren’t a part of the discount program received additional payments for medications while the Medicare cuts were in place, so the funds aren’t readily available, Stat’s Rachel Cohrs notes.

Health reads

Hospitals’ Use of Volunteer Staff Runs Risk of Skirting Labor Laws, Experts Say (By Lauren Sausser | Kaiser Health News)

Mpox has faded in the US. Who deserves the credit? (By Mike Stobbe | The Associated Press)

Satellite images show crowds at China’s crematoriums as covid surges (By Samuel Oakford, Lily Kuo, Vic Chiang, Imogen Piper and Lyric Li | The Washington Post)

Sugar rush

Thanks for reading! See y'all tomorrow.