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The Health 202

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

Republicans are hardly unified on wanting to cut Medicare

The Health 202

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

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Today’s edition: A manufacturer of an abortion pill filed a lawsuit this morning challenging the constitutionality of West Virginia’s ban on the medication. A dive into the House Republicans named to the chamber’s covid panel. But first … 

Republicans are pledging Medicare cuts (once again) but there’s reason to be skeptical

Looming spending battles have reignited a politically treacherous debate. 

Some House Republicans have started weighing a series of legislative proposals targeting Social Security and Medicare, which are often considered the third rail in American politics. The effort is part of a broader pledge to slash federal spending, our colleague Tony Romm reports. 

But any notion of cuts to the programs will hit resistance from the White House and congressional Democrats. And it’s not clear that all House Republicans would be on board or what exactly such a plan would look like. It could face pushback from some in the party ahead of the 2024 elections, such as populist Republicans, with former president Donald Trump already issuing a warning to his party to avoid cuts to Medicare and Social Security. 

More from Tony:

The details

Republicans have pledged to balance the budget over the next 10 years, and have also indicated that they plan to extract major concessions from the fight over the debt ceiling, where Congress must pass legislation that raises or suspends the amount the government can borrow. 

  • “So far, the party has focused its attention on slimming down federal health care, education, science and labor programs, perhaps by billions of dollars. But some Republicans also have pitched a deeper examination of entitlements, which account for much of the government’s annual spending — and reflect some of the greatest looming fiscal challenges facing the United States,” Tony writes. This includes calls for the creation of special panels to recommend changes, while others have looked to past proposals.
  • “We have no choice but to make hard decisions,” Rep. Kevin Hern (R-Okla.), the leader of the Republican Study Committee (RSC), a large bloc of conservative House Republicans, told Tony. “Everybody has to look at everything.”

It’s unclear what path, if any, Republicans will ultimately pursue. But here’s one potential road map: Last summer, the RSC put out a detailed blueprint of how it would change Medicare, with Hern chairing the task force charged with crafting the alternative conservative budget. 

The document included divisive policies, like increasing the Medicare eligibility age to 67 and then indexing it to life expectancy. It also pitched a plan to combine traditional Medicare into a “fed plan” and give seniors premiums to buy that plan or a private one, as well as ensuring the federal health program pays providers the same rate no matter if they’re located in a hospital outpatient department or physician’s office.

The White House is planning to invite House Speaker Kevin McCarthy (R-Calif.) to meet with Biden before the Feb. 7 State of the Union, Punchbowl News reported this morning, writing that McCarthy won’t demand entitlement reforms despite some calls to do so as part of the debt ceiling negotiations.

Yet, even the specter of revisions to Medicare has some Republicans on edge. 

“We’ve said there’s not going to be any cuts to any beneficiaries in Medicare,” said Rep. Brett Guthrie (R-Ky.), a longtime member of the House Energy and Commerce Committee, when asked where he stood on changes to Medicare as part of the debt limit debate. 

Robert Costa, CBS News:

The politics

Democrats have portrayed Republicans as a threat to Medicare and Social Security, rhetoric that ramped up in the weeks before the midterm elections, and has continued since then.

Both programs are facing future insolvency, and some experts say changes to the programs are necessary to keep them afloat, bemoaning the partisan politics surrounding such an overhaul. 

“I don't know that putting together a package of fixes is realistic in the time we have to lift the debt ceiling … given the demagoguing on the issue, how political it is and the timeline,” said Maya MacGuineas, president of the Committee for a Responsible Federal Budget, a nonprofit think tank that advocates for reducing the deficit. She suggested setting up a commission to address the programs — a notion several other lawmakers have floated. 

“Any entitlement reforms have to be bipartisan,” Rep. Tom Cole (R-Okla.), the chair of the powerful House Rules Committee, told The Health 202. “We all know these systems are going broke. I don't think anybody wants them to go broke … We’ll continue to work on that, and I think that should be on the table.”

But in the meantime, advocacy groups for seniors are ramping up the pressure, specifically calling for Congress to pass “clean” debt limit legislation.

Max Richtman, the head of the National Committee to Preserve Social Security and Medicare, said he was getting “inundated with calls” from the group’s “very extensive grass-roots network.” Their message? “Keep your hands off of these programs.”

Reproductive wars

New this a.m.: Lawsuit challenges state ban on abortion pills

A manufacturer of an abortion pill filed a lawsuit today challenging West Virginia’s ban on the medication, part of the legal battle over the pills that’s expected to heat up this year.

GenBioPro filed the case in federal court in West Virginia, and the state adopted a ban on abortion in September. The lawsuit is the first-of-its-kind filed in federal court since the Supreme Court overturned Roe v. Wade and argues that the ban violates the Constitution’s Supremacy and Commerce clauses. 

Medication abortion is the next frontier in the abortion wars. The issue of whether states can ban an FDA-approved medication isn’t settled law, and experts had predicted the answer would be litigated in courts. 

On the Hill

Meet the House Republicans investigating covid-19

Rep. Brad Wenstrup (R-Ohio), a physician who has served as co-chair of the GOP Doctors Caucus, has been tapped to lead the chamber’s special investigative panel charged with probing the origins of the coronavirus pandemic and the federal government’s response.

House Speaker Kevin McCarthy (R-Calif.) appointed nine Republicans to serve on the select subcommittee on the coronavirus pandemic, some of which have questioned whether the pandemic is real and protested the government’s virus control measures. That includes Reps. Ronny Jackson (Tex.), physician to the president under Barack Obama and Donald Trump who claimed that the omicron variant was a hoax created by Democrats, and Marjorie Taylor Greene (Ga.), who had been suspended from social media platforms for promoting covid-19 misinformation online.

Reps. Nicole Malliotakis (N.Y.) and Mariannette Miller-Meeks (Iowa) also got the nod for the committee, both of whom were members of the Democrat-led panel in the last Congress that had focused much of its work on probing the Trump administration’s pandemic response, nursing homes and fraud in pandemic aid programs. Check out the full list of GOP committee members here.

Rep. Marjorie Taylor Greene (R-Ga.):

From our notebook

CDC chief to add new offices, leadership in latest agency revamp

The Post’s Lena H. Sun sends us this dispatch:

The Centers for Disease Control and Prevention Director Rochelle Walensky announced the latest changes in her ongoing agency restructuring effort yesterday during an all-hands call with employees.

The moves are mostly changes in the agency’s organizational chart that Walensky told staff would eliminate bureaucracy, reduce silos within the agency, and make it more nimble and responsive.

The details: Most of CDC's centers will be reporting to a new leadership office called the Immediate Office of the Director. In addition to Walensky, that office will include Chief of Staff Sherri Berger, Chief Operating Officer Robin Bailey and the agency’s newly appointed Principal Deputy Director Nirav Shah, who starts in March.

The office will also feature three new positions: deputy director for policy, communications and legislative affairs/chief strategy officer; deputy director for global health; and deputy director for science and program/chief medical officer, which will be filled by Deb Houry, the agency’s current acting principal deputy director.

Also … As part of Walensky’s efforts to elevate data, surveillance and science, the agency is creating an Office of Public Health Data, Surveillance and Technology and boosting the profile of its Office of Science and Office of Laboratory Science and Safety, which some public health groups have long sought. A new Office of Health Equity will also report directly to the new senior leadership office. Two other centers are being consolidated to work with state and other public health partners.

State scan

Pharmacists could be charged for dispensing abortion pills, Noem says

South Dakota will prosecute pharmacists who dispense abortion pills, Republican Gov. Kristi Noem said yesterday in response to a recent change from the Food and Drug Administration aimed at expanding access to the drugs, the Associated Press reports.

Noem and the state’s Republican Attorney General Marty Jackley released a letter yesterday warning pharmacists that they are “subject to felony prosecution” if they procure or dispense abortion-inducing medication. “South Dakota will continue to enforce all laws including those that respect and protect the lives of the unborn,” Noem and Jackley wrote.

Catch up quick: Earlier this month, the FDA announced that it would permit some retail pharmacies to dispense abortion pills for the first time, which previously were available only at clinics, directly from doctors or by mail.

Abortions are almost completely outlawed in South Dakota under a ban that took effect shortly after the Supreme Court overturned Roe v. Wade. The law includes exceptions to save the life of the patient, but not in cases of rape and incest. 

South Dakota Gov. Kristi Noem (R):

In other health news

  • The FDA issued marketing denial orders for two popular menthol-flavored e-cigarette products from R.J. Reynolds Vapor Company yesterday, the latest move in the agency’s larger campaign to review the nation's vaping devices.
  • The FDA proposed new maximum limits for the amount of lead allowed in processed food for babies and young children yesterday, in an effort to reduce exposure to the toxin that can impair brain development and the nervous system.
  • Medicare’s new $35 monthly cap on insulin costs could have saved beneficiaries an average of $500 per year if the Inflation Reduction Act had been implemented in 2020, according to a new report released yesterday by the Department of Health and Human Services.
  • Multiple first-term House Republicans skipped a White House reception for freshman members last night in protest of the event's coronavirus prevention protocols, which include mandatory testing, Axios reports.

Health reads

Major medical schools join widening revolt against U.S. News rankings (By Susan Svrluga and Nick Anderson | The Washington Post)

The Tests Are Vital. But Congress Decided That Regulation Is Not. (By Anna Clark | ProPublica)

Schools Speed Up Covid-Aid Spending After a Slow Start (By Ben Chapman | The Wall Street Journal)

Sugar rush

Thanks for reading! See y'all tomorrow.