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The Health 202

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

How liberal states are shoring up abortion rights

The Health 202

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

Happy Monday, y’all. We’ve heard states are the laboratories of democracy. So this year, we’re beefing up our coverage of state legislative sessions, starting today with the abortion rights bills being considered across the country. But we want to hear from you: What areas of state health policy are you interested in? Send tips and new developments to rachel.roubein@washpost.com and mckenzie.beard@washpost.com

Reading this online? Sign up for The Health 202 to get scoops and sharp analysis in your inbox each morning. 

Today’s edition: A Post health reporter on her difficult journey to get her toddler a high-priced drug. The House will consider several Republican bills this week aimed at moving the country past the pandemic. But first … 

Three ways states are protecting abortion rights

Minnesota Democrats capitalized on their new trifecta and sent legislation to protect abortion rights to the governor’s desk early Saturday morning.

Earlier this month, Illinois Gov. J.B. Pritzker (D) signed a sweeping bill to further solidify the state as a blue-state refuge for women seeking abortions from places across the South and Midwest. And in Democratic-led states across the country, lawmakers are aiming to pass a host of bills in their first legislative sessions since the Supreme Court overturned the constitutional right to an abortion in June.

Liberal states are enshrining the right to an abortion into state law or the state constitution, protecting providers who see patients from out-of-state and expanding the type of providers who can perform an abortion. It’s just the beginning of the state legislative season, and both abortion rights and antiabortion groups are starting to execute their plans for this year’s sessions.

  • “This has all been galvanized by the overturning of abortion rights in 2022,” said Elizabeth Nash, who tracks abortion and reproductive health legislation for the Guttmacher Institute, a research group that supports abortion rights. “It does look now to be an issue that's going to be playing out in a very different way in state legislatures for the next several years.”

Minnesota Gov. Tim Walz (D):

The trends

Democratic-led states rushed to shore up and expand access to abortion last year in anticipation of the nation’s highest court overturning Roe v. Wade. Now with Roe overturned, they’re attempting to build on legislation passed last year, advance new measures or approve legislation for the first time in states with new Democratic trifectas.

As Nash notes, more trends will become clearer over time, since many state legislative sessions are just getting off the ground (and we’ll be following them). But here are two trends we’re watching so far in states controlled by Democrats:

Solidifying abortion rights: In Minnesota, the state legislature just passed a bill that would codify the right to an abortion into state law. The procedure is already protected under a 1995 state Supreme Court decision, but supporters said they aimed to take the decision out of future judges’ hands, while Republicans blasted the measure as “extreme.”

  • Meanwhile, in Washington state, there was a hearing last week on a bill to enshrine abortion rights into the state constitution. The legislation faces an uphill battle, since it requires a supermajority two-thirds vote in both chambers and then would need to be put to voters.
  • And bear in mind, abortion rights advocates are exploring whether to gather signatures for ballot measures that would enshrine access to the procedure into state constitutions in 2024, following on recent wins during the midterm elections.

Shielding providers: Several states have proposals aimed at ensuring prosecutors in other states can’t charge providers for performing an abortion on an out-of-state patient in states where the procedure is legal. This includes liberal states like Washington, Hawaii and Illinois.

  • The new law in Illinois is broader than protecting providers from legal action in other states. It contains other provisions, such as expanding the types of providers who can perform abortions — which Hawaii’s bill also includes — and preventing higher charges for out-of-network care if a patient’s in-network provider objects to performing an abortion based on moral grounds.

Illinois state Sen. Sue Rezin (R): 

The new trifectas

Across the country, Republicans hold the majority of state legislatures. But at least two states with new Democratic trifectas are already pushing abortion bills they didn’t have the votes to pass last year.

In Michigan: Democrats have control of both the state House and Senate for the first time in nearly four decades. This dynamic is paving the way for Democratic Gov. Gretchen Whitmer — who centered her November campaign around abortion access perhaps more than any other gubernatorial candidate — to make good on those pledges.

Lawmakers in both chambers have already introduced legislation to repeal a 1931 near-total ban on abortion, which isn’t being enforced, on the heels of Michigan voters approving an amendment to enshrine the right to an abortion into the state constitution in November. That’s part of a package of several bills Michigan Democrats have proposed, including repealing a provision criminalizing providers.

In Minnesota: In a surprising upset, Democrats took full control of the state government for the first time since 2014, reclaiming the state Senate and reelecting Gov. Tim Walz (D).

Democrats wasted no time in passing their abortion rights bill, which the state Senate approved on a party-line vote early Saturday. And top lawmakers are pledging that they’ll advance more abortion-related legislation “in the coming weeks.”

More from Whitmer:

From our reporters' notebooks

Carolyn Y. Johnson is a health and science reporter at The Post who has written about high-priced drugs for years. But when her toddler needed one, she writes that she still got lost in the U.S. health-care system’s complex maze. 

In a piece out this morning, Carolyn details her efforts to get a pricey medication for her 3-year-old son who had been diagnosed with a rare type of childhood arthritis, which can cause young kids to suffer from daily spiking fevers, a fleeting rash and arthritis.

Doctors mentioned a drug called anakinra — a medication private health plans pay on average roughly $4,000 per month for and which would require approval from insurance before it’d be covered. Aetna denied the request in early September, seeking an additional test. Doctors ordered that test and appealed the decision. But then the next month, the company upheld the denial.

Carolyn was able to get her son the medication for a limited time through a free program offered by the drugmaker. His symptoms dissipated. Carolyn spent chunks of time each day calling the insurance company, the drug manufacturer, rheumatologists and others to figure out what to do next, terrified about using up her son’s last dose in the next few days. Ultimately, a different high-cost drug that worked in a similar way was approved because the request was subject to different rules.

  • “This isn’t a unique story about American health care, a single high-priced drug or just one insurance company. It is a tale of routine aggravation, inconvenience, futility and fear, but fortunately, not tragedy. Our battle was hair-raising, but typical,” Carolyn writes.

Have you struggled to get insurance to pay for high-priced drugs? The Post wants to hear from you. Fill out this questionnaire (and we won’t publish your response without following up).

Agency alert

NIH advisers approve recommendations to strengthen oversight of pathogen research

An expert panel on Friday endorsed a sweeping set of proposals to strengthen the federal government’s oversight of experiments on potentially dangerous pathogens, Stat reports.

The advisers unanimously approved the draft recommendations, which include asking health officials to broaden the definition of potential pandemic-inducing viruses and developing clearer guidelines for federally funded gain-of-function research, in which scientists manipulate pathogens to study them. However, some scientists who attended the public meeting expressed concern the new recommendations could accidentally hinder research into relatively low-risk viruses.

Next steps: The advisory board’s draft report will be finalized and then sent to the National Institutes of Health for consideration. The medical research agency is currently without a permanent leader or a replacement for Anthony Fauci, the longtime head of the National Institute of Allergy and Infectious Diseases, Stat’s Sarah Owermohle notes.

NIH acting director Lawrence Tabak:

On the Hill

Meet the Democratic leaders of the House Energy and Commerce Committee

Rep. Anna Eshoo (Calif.) is slated to serve as the ranking member of the health subcommittee, a position she’s previously held. Rep. Kathy Castor (Fla.) will be the top Democrat on the oversight and investigations subcommittee, a position previously held by Rep. Diana DeGette (Colo.). Rep. Kim Schrier (Wash.), a pediatrician, is expected to be the vice ranking member of the full committee.

Read the full roster here. The appointments will now need to be approved by the Democratic Steering and Policy Committee and the Democratic caucus.

More from Castor:

In other health news

  • Eric Lander, who resigned as President Biden’s science adviser last year after facing allegations of workplace bullying, is heading back to the Broad Institute. Lander will continue running his genetics lab at the biomedical research center and will resume his tenured faculty positions at MIT and Harvard, Broad Director Todd Golub announced Friday.
  • Utah Gov. Spencer Cox (R) signed legislation on Saturday prohibiting most surgeries or hormone treatments for transgender minors in the state, marking the first major win for Republicans on the issue this year as statehouses across the country tee up similar restrictions.
  • Cuts to Medicare and Social Security are “off the table” in debt ceiling negotiations, House Speaker Kevin McCarthy (R-Calif.) said on CBS’sFace the Nation” yesterday ahead of a meeting with Biden this week.

Daybook

Welcome back to another week of Congress, where House Republicans have teed up floor votes on a slew of pandemic-related bills over the next few days.

As soon as Tuesday, lawmakers could vote on legislation that would lift the Biden administration’s coronavirus vaccine mandate for health workers whose services are billed under Medicare and Medicaid, as well as another bill to end the public health emergency declaration for covid-19.

Later in the week, the House is slated to vote on a measure that would require federal agencies to reinstate their pre-pandemic telework policies and study the impact of working from home. Lawmakers will also vote on a resolution that would end the covid-19 national emergency first declared in March 2020.

On Wednesday: The House Committee on Oversight and Accountability will hold a hearing probing the federal government’s pandemic spending; the House Energy and Commerce health subcommittee will discuss the nation’s fentanyl crisis; the House Energy and Commerce oversight and investigations subcommittee will examine the challenges of investigating pandemic origins and other biological outbreaks.  

Health reads

Packed session offers advice and a lifesaving giveaway as local overdoses rise (By Laura Meckler and Tara Bahrampour | The Washington Post )

Video of Tyre Nichols Beating Raises Questions About Medical Response (By Nicholas Bogel-Burroughs, Gina Kolata and Mark Walker | The New York Times)

A bellwether for biosimilars: Why the new competition for Humira matters to pharma, payers, and patients (By Ed Silverman | Stat )

Sugar rush

Thanks for reading! See y'all tomorrow.

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