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The Health 202

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

Sen. Cassidy shares his HELP Committee hopes this year

The Health 202

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

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Today’s edition: Abortion rights groups worry conservative judges could decide the fate of a Texas lawsuit over an abortion pill. The new ways communities are trying to curb drug overdose deaths: Reddit, texts and wastewater. But first … 

Nurse shortages will be a top focus on the Senate health committee this year

Senate committees are just now getting off the ground, and there’s one potential area ripe for bipartisanship in the chamber’s sweeping health panel: addressing the nation’s nursing staffing shortage. 

Sen. Bill Cassidy (R-La.) says the issue has come up in early meetings with Sen. Bernie Sanders (I-Vt.), as the pair prepare to helm the Senate HELP Committee for the first time. 

For Cassidy — a gastroenterologist who has a penchant for using a whiteboard to explain complicated health policy — his new perch as the panel’s ranking Republican is like being a “kid in a candy store.” But in an interview in his new office this week, he acknowledged the political reality of being in the minority party.

  • “I'm a pretty practical guy,” he said, adding, “I am not the chair, and so Bernie Sanders will set the agenda for the committee.”

There will indeed have to be deals with Sanders, a self-described democratic socialist, in order for Cassidy to see any of his priorities get off the ground. The new leaders don’t have a long history of working together, and there’s the potential for fiery debates between the two over how to curb the cost of prescription drugs, an issue Sanders said he wants to move “very aggressively” to tackle. But the Senate HELP Committee has a long history of bipartisanship, and both senators have detailed policies they believe they can work on together. (Read our interview with Sanders on his agenda here.)


Let’s start with what’s possible this year. Cassidy said both he and Sanders are “very interested” in addressing the nursing shortage, and it was “the very first thing” the independent firebrand brought up to him when they began discussing the committee’s future. 

Cassidy said he has a few questions before he can formulate a policy response. What’s the root cause of the issue? What restrictions are there on who can be a nursing instructor?

The answer to those questions is different depending on who you ask. Kenneth White, the president of the American Academy of Nursing, mentioned a few reasons for the shortage, including the retirement of baby boomers and the stress of the pandemic. Meanwhile, Jean Ross, a co-president of National Nurses United — a large union and professional organization — rejected the idea of a shortage, arguing it’s a manufactured crisis and that more nurses would come back into the workforce, particularly in acute-care settings, if employers created a reasonable workload and a safe environment.

Even if Cassidy and Sanders write a bipartisan bill, there would still be an uphill battle ahead. Getting legislation to pass both the Senate and the House ahead of the 2024 presidential election is a difficult task, even if the legislation has the support of both parties. 

Eye on Pharma

It’s no surprise that lowering the cost of drug prices is a top priority for Sanders, who argues there’s an “incredible level of greed” within the pharmaceutical industry. But Cassidy’s rhetoric toward the private sector is different from Sanders’s and aligns with how Republicans typically talk about drug prices. 

  • “We’ve got to see the affordability,” Cassidy said, “but we have to understand that there is a component of innovation driven by profit. And that’s why I’m seeing people alive that would not be alive were it not for that innovation.”

Sanders appears ready to go after Moderna and Pfizer for indicating the companies will hike the cost of the coronavirus vaccine when the government is no longer buying the shots. He’s already demanded Moderna refrain from more than quadrupling the price of the product, calling the move “offensive” and an “outrageous price boost.” Meanwhile, Cassidy didn’t criticize the companies, saying instead that more information was needed.

  • “I’d like to have a few more facts before I comment on it,” Cassidy said. “You obviously have a marginal cost. It’s easier to spread a marginal cost over billions of doses than it is over millions of doses. And so what is their justification for all this? I just don't know that. … Give me more data before I render an opinion.”

In the interview, Cassidy mentioned one area that he believes could lead to some common ground: examining the pricing of innovative gene therapies. It’s something that he’s mentioned previously, writing in a 2019 op-ed in Stat that “Congress will likely need to play a part in developing a new paradigm for financing such treatments.”

In the past, Cassidy has supported some nontraditional ways of paying for drugs. For instance, he was supportive of Louisiana’s efforts under a Democratic governor to chart a new way of paying for expensive hepatitis C treatments, where the state would essentially pay a flat fee to get an unlimited supply of the drug.

Reproductive wars

Abortion rights groups fret ‘catastrophic’ abortion pills case as decision nears

Abortion rights groups are warning the Biden administration and congressional Democrats to take seriously “fringe” threats that could wind up blocking access to medication abortion, The Post’s Caroline Kitchener and Perry Stein report.

Stoking their fears is a Texas lawsuit brought by conservative groups, which seeks to revoke the decades-old government approval of a key abortion drug, mifepristone. Abortion rights groups and some in the Biden administration have become concerned in recent weeks that the case is likely to be entirely decided by conservative judges, who may be eager for a chance to render it illegal in Democrat-led states. 

Coming soon: The case was filed in Amarillo, Tex., where U.S. District Court Judge Matthew Kacsmaryk — who was nominated by former president Donald Trump — could rule as early as this week. An appeal would then go to the right-leaning U.S. Court of Appeals for the 5th Circuit, and could then ultimately present the Supreme Court with another major abortion case.

The Justice Department argues that Congress empowered the Food and Drug Administration to approve the use of new drugs, not states. Alliance Defending Freedom, a conservative legal group that has been involved in antiabortion litigation, expressed confidence that the court will find that the “FDA has failed in its job to protect America’s women and girls.” 

State scan

Communities turn to Reddit, texts and wastewater to curb drug deaths

Health authorities are attempting to make a dent in the nation’s drug crisis by sharing information in real time, or as soon as they get it, to predict overdose hot spots and prevent some deaths, our colleagues Lenny Bernstein and Meryl Kornfield.

Some cities are examining their wastewater for opioids and other drugs. Academic researchers are looking for drug-related chatter on Reddit. The staff of New York’s overdose prevention center is walking the city’s streets to warn of particularly potent batches of drugs. And the federal government has launched a program to track and share information on nonfatal overdoses, which have proved to be a predictor of individual fatal overdoses.

But many of these projects are in their infancy and are plagued with time lags, lack of coordination or information gaps. Yet researchers believe that some combination of these efforts could help curb the crisis as nearly 300 people in the country are dying of drug overdoses every day. 

In other health news

  • Alondra Nelson will step down from her post as deputy director of the White House’s Office of Science and Technology Policy on Feb. 10 to return to her faculty position at the Institute for Advanced Study in Princeton, N.J., Axios reports. 
  • California’s coronavirus vaccine requirement for schoolchildren, which has been on hold since April, will not be enacted, state public health officials confirmed Friday, terminating one of the nation’s only remaining coronavirus vaccine mandates for students, the Los Angeles Times reports. 
  • The Department of Agriculture proposed major changes to the nutrition standards for school meals on Friday, which aim to reduce sugars, fat and salt while increasing whole grains in lunches. The announcement revives efforts to improve the health of millions of public school students amid rising rates of childhood obesity and other diet-related diseases, our colleague Laura Reiley reports. 


Buckle up, it’s State of the Union week. Here’s what we’re watching over the next few days: 

On Monday: The House Rules Committee will meet to consider several pieces of legislation, including a Republican-backed bill that would end the Centers for Disease Control and Prevention’s requirement that most foreign air travelers coming to the United States must be vaccinated against covid-19. 

On Tuesday: President Biden will deliver his second State of the Union address at 9 p.m. 

On Wednesday: The House Energy and Commerce health and oversight subcommittees will hold a joint hearing probing the federal government’s response to the coronavirus pandemic, where senior health officials such as FDA Commissioner Robert Califf and CDC Director Rochelle Walensky will testify. 

Thursday: The Senate Judiciary Committee will meet to discuss several bipartisan bills aimed at boosting transparency over pharmacy middlemen, lowering prescription drug prices and expanding access to generic medications. Biden will travel to Tampa to discuss a plan to protect and strengthen Social Security, Medicare and lower health-care costs.

Health reads

They handled nuclear missiles. Now they’re getting cancer. (By Meryl Kornfield | The Washington Post)

House Republicans float one spending cut in a debt ceiling bill: Unspent Covid money (By Sahil Kapur | NBC News )

Why a new Alzheimer's drug is having a slow US debut (By Tom Murphy | The Associated Press)

Sugar rush

Thanks for reading! See y'all tomorrow.