Welcome to Thursday’s Health 202, where today I want to give a big shoutout to our wonderful researcher, McKenzie Beard, who this week is celebrating her one-year workiversary helping bring you this newsletter. Send her all your tips: email@example.com. Was this forwarded to you? Sign up here.
Today’s edition: A group of Senate Democrats urge an abortion pill manufacturer to add miscarriage management to its label. The details on the House Democrats serving on the chamber’s panel to investigate the pandemic. But first …
Passing ballot questions in Ohio, Florida and Missouri could soon require a lot more voters
Some Republicans are pushing back against ballot measures.
Lawmakers in a handful of states are seeking to make it more difficult to pass citizen-led initiatives after a string of liberal policies — from protecting abortion rights to expanding Medicaid to raising the minimum wage — have won at the ballot box across the country. The effort to raise the bar to amend state constitutions has cropped up during legislative sessions in recent years, and this year is no exception.
If such efforts prevail, it could throw a wrench into one of abortion rights groups’ key strategies for restoring access to the procedure in states where it’s banned. Since Roe v. Wade was overturned, advocates have been exploring ballot measures to enshrine the procedure’s legality into state constitutions in at least a dozen states.
It’s unclear if the measures will pass during state legislative sessions this year, which some supporters argue is necessary to ensure there’s widespread support for making changes. And even if they do, voters generally have to then approve changes to constitutional amendments, which will likely face fierce resistance from groups helping support liberal ballot measures.
- “People's enthusiasm for ballot measures has to also include space for protecting the process itself,” said Kelly Hall, executive director of the Fairness Project, which funds and organizes progressive state ballot measure efforts across the country.
Lawmakers in some conservative-leaning states — like Florida, Missouri and Ohio — have already filed bills during the nascent state legislative season that would increase the threshold for amending state constitutions, according to the Ballot Initiative Strategy Center, which helps with liberal ballot measures.
The group has been tracking such measures introduced in states over the years, which has substantially increased since 2017, according to Chris Melody Fields Figueredo, BISC’s executive director. Only 18 states allow voters to directly amend their state constitutions through citizen-led petitions.
In Ohio, state Rep. Brian Stewart (R) has again introduced a bill to require a vote of 60 percent to pass constitutional amendments. In mid-December, a state House committee cleared the measure, but it ultimately didn’t advance to the governor’s desk at the end of the lame-duck session.
- “Our Founding Fathers ensured that the United States Constitution would be protected against outside influence and special interests by requiring a supermajority vote for amendments,” Stewart said in a statement when he reintroduced the bill. “We can and should protect the Ohio Constitution in a similar way.” His office didn’t respond to a request for comment.
Two abortion rights coalitions have already formed to launch ballot measure committees aimed at enshrining abortion rights into Ohio’s constitution. This comes after abortion supporters scored victories on ballot measures last year, including in Michigan, Kansas and Kentucky.
Mike Gonidakis, the president of Ohio Right to Life, said he expects his group to come out soon in support of raising the threshold for passage to 60 percent. He called it a “double-edged sword” since, if successful, that’d mean a higher bar if the antiabortion group ever wanted to launch its own ballot initiative. But he said it better safeguards against out-of-state groups pouring money into the state to sway the Ohio electorate.
Across the country
Similar legislation has been filed in other states.
Missouri: Some bills introduced this year would raise the threshold for collecting the necessary signatures to put an amendment on the ballot, while others would require roughly two-thirds approval of voters to change the constitution instead of a simple majority.
Florida: An amendment to the constitution already must garner 60 percent support at the ballot box to pass as of 2006, and a bill introduced this month would raise that threshold to two-thirds.
In both states, abortion rights activists have been exploring whether to launch campaigns to try to put an amendment protecting the procedure to voters. Missouri state Rep. Bill Falkner (R) wrote in an email that he’s filed the same bill to raise the bar for signature collections for the last three years, and that a potential abortion rights ballot measure didn’t play a role in the decision to introduce a measure again this year.
White House Prescriptions
New this a.m.: One year ago, President Biden relaunched his cancer moonshot, an initiative deeply personal to him. The White House announced several actions today, such as a new clinical and navigation support for children with cancer, a public-private partnership to develop new tools to better coordinate cancer care and an intent to nominate six members to the National Cancer Advisory Board.
First in The Health 202: Democrats urge abortion pill manufacturer to update drug’s label
A group of Senate Democrats are calling on Danco Laboratories, a manufacturer of the abortion pill mifepristone, to update the medication’s label to make it easier for patients to obtain it for purposes other than elective abortion.
In a letter sent yesterday by a group led by Sens. Mazie Hirono (Hawaii), Maggie Hassan (N.H.) and Elizabeth Warren (Mass.), the lawmakers urged the company to seek the Food and Drug Administration’s greenlight to add a new indication to mifepristone’s label making it clear that the medication can be safely used for miscarriage management.
The lawmakers argue that it’s a necessary step to ensure that patients experiencing early-pregnancy loss can access the drug in states that have banned or restricted abortion. A call to the company went unanswered.
Key context: Last month, the FDA denied a petition to update the medication’s label from the American College of Obstetricians and Gynecologists. The agency said that only drugmakers can ask to change labeling, and to do so, they must present data showing that the drug is safe and effective for the new use.
On the Hill
Meet the House Democrats investigating covid-19
Rep. Raul Ruiz (D-Calif.), an emergency room doctor, will serve as Democrats’ top official on the select subcommittee on the coronavirus pandemic.
Minority Leader Hakeem Jeffries (D-N.Y.) tapped five Democrats to serve on the chamber’s special investigative panel charged with probing the origins of the coronavirus pandemic, the development of vaccines and the federal government’s response to the crisis. As ranking Democrat of the subcommittee, Ruiz pledged to “take an equity-based and patient-centered approach to put people above politics and identify common-sense solutions that will protect our nation’s health.”
Also in the House …
Eleven Democrats voted with Republicans to pass a resolution that would immediately end the coronavirus national emergency, despite the Biden administration’s announcement earlier this week that it will end the declaration in May.
The chamber also approved a measure that would require federal agencies to reinstate their pre-pandemic telework policies and study the impact of working from home.
Federal watchdogs ask Congress for long-delayed help to fight covid fraud
The full extent of criminal activity targeting the U.S. government’s roughly $5 trillion in coronavirus aid may not be known for “years to come,” an investigative official warned Congress yesterday as he and others pleaded for new laws and money to help combat an emerging torrent of waste, fraud and abuse, The Post’s Tony Romm writes.
Appearing before the House Oversight and Accountability Committee, three federal officials pointed to the staggering amount of money stolen from federal aid programs since 2020. They called on lawmakers to enhance their powers to collect and monitor data on pandemic aid spending, bring civil and criminal charges, and recover stolen taxpayer money.
The requests offered an early test for House Republicans, who have promised to investigate Biden — even though much of the trouble that plagues pandemic spending dates back to the Trump administration.
Rep. James Comer (R-Ky.), chair of the House Oversight Committee:
After spending trillions under the name of COVID with no guardrails, billions of taxpayer dollars were lost to waste, fraud, abuse, and mismanagement.— Rep. James Comer (@RepJamesComer) February 1, 2023
Republicans will identify where this money went and how much ended up in the hands of fraudsters.
Watch my opening statement.👇 https://t.co/IwsB4mDjow
GoodRx leaked user health data to Facebook and Google, FTC says
Vanessa Montalbano, of The Cyber 202, writes to us:
The Federal Trade Commission imposed a $1.5 million fine on the drug discount app GoodRx yesterday for leaking millions of users’ sensitive health information to companies like Facebook and Google without their consent, Natasha Singer reports for the New York Times.
In its complaint, the FTC said that GoodRx’s use of tracking tools and other information-sharing practices to identify users’ social media accounts for targeted medical ad purposes went against a federal regulation that requires health apps to notify consumers of cybersecurity breaches and the unauthorized disclosure of their data to a third party.
The app said that it disagreed with the regulator's accusations dating back to 2017 but agreed to settle the case to avoid litigation. If the settlement is approved by a judge, GoodRx would be permanently prohibited from disclosing users' health details for advertising purposes.
The bigger picture: This comes as the FTC is cracking down on health privacy and security amid a moment of heightened sensitivity around such practices, particularly in states that have moved to ban or restrict access to abortions.
FTC Commissioner Christine Wilson:
Congratulations to @FTC staff on bringing the agency’s first HBNR case. GoodRx used consumers’ personal health information to sell ads, breaking promises it made to consumers. And it never notified users about this unauthorized access to consumer data. https://t.co/xSYv9Nk5tk— Christine S. Wilson (@CSWilsonFTC) February 1, 2023
In other health news
- New this a.m.: Senate Finance Chair Ron Wyden (D-Ore.) is asking the Centers for Medicare and Medicaid Services for details about its plans to implement the Inflation Reduction Act’s Medicare Part D and Part B inflation rebates, which went into effect in October and January respectively, per a letter shared with The Health 202.
- After a highly anticipated meeting with Biden yesterday, House Speaker Kevin McCarthy (R-Calif.) reiterated that cuts to Social Security and Medicare are off the table in debt ceiling talks, The Post reports.
- The United States should develop a national strategy for investigating pandemic origins, a federal watchdog recommended in a report released yesterday in concert with the House Energy and Commerce oversight subcommittee’s first hearing of the new Congress probing the covid-19 outbreak.
Medicare Advantage insurers will score $2 billion gift thanks to limited audits (By Bob Herman and Tara Bannow | Stat)
Nursing Home Owners Drained Cash During Pandemic While Residents Deteriorated (By Jordan Rau | Kaiser Health News)
Vaccine Makers Kept $1.4 Billion in Prepayments for Canceled Covid Shots for the World’s Poor (By Stephanie Nolen and Rebecca Robbins | The New York Times)
Thanks for reading! See y'all tomorrow.