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Presented by Better Medicare Alliance: Delivered daily by 10 a.m., Pulse examines the latest news in health care politics and policy.
Mar 15, 2023 View in browser
 
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By Krista Mahr and Daniel Payne

Presented by

Better Medicare Alliance

With David Lim, Alice Miranda Ollstein and Megan R. Wilson

Driving the Day

The J. Marvin Jones Federal Building and Mary Lou Robinson United States Courthouse in is pictured in Amarillo, Texas.

A high-profile case in Texas could wipe out access to the abortion pill mifepristone nationwide. | Justin Rex/AP Photo

ABORTION PILL ACCESS IN JEOPARDY — District Court Judge Matthew Kacsmaryk will hear four hours of oral arguments today in Amarillo, Texas, today in a high-profile case that could wipe out access to the abortion pill mifepristone nationwide, Alice reports.

At the hearing, Justice Department attorneys will face off with the anti-abortion medical groups challenging the FDA’s two-decade-old approval of the drug and recent agency decisions making the pills available via telemedicine, mail delivery and pharmacy pickup. The pill’s manufacturer, Danco, will argue in defense of its product’s safety.

Kacsmaryk, an appointee of former president Donald Trump, has a record of anti-abortion advocacy and is widely expected to restrict the drug’s availability.

The stakes: A ruling in the case could either cut off access to the pills in the mostly Democratic-led states where they remain legal or reinstate rules mandating that patients receive them only in person from a doctor. The drugs are the most common method of abortion in the U.S. and the only means of terminating a pregnancy in many parts of the country where clinics have closed.

The Biden administration has vowed to swiftly appeal any ruling that blocks patients from using the pills. Such an appeal would first go to the right-leaning 5th Circuit Court of Appeals and then to the U.S. Supreme Court.

Shrouded in secrecy: Kacsmaryk scheduled today’s oral arguments Friday but, according to a transcript of his call with the attorneys, wanted to delay alerting the public until the night before the hearing to minimize protests at the courthouse. There will be no public livestream of the hearing, and it’s unclear when a transcript will be released.

WELCOME TO WEDNESDAY PULSE — It’s official: Pickleball is taking over the world. We don’t get it. Do you? Send us your feelings on America’s new favorite pastime, news and tips to kmahr@politico.com and dpayne@politico.com.

TODAY ON OUR PULSE CHECK PODCAST, host Megan Messerly talks with Katherine Ellen Foley about the Veterans Health Administration's announcement that it will cover Leqembi, a new Alzheimer’s drug that appears to slow the disease’s progression, and why the VHA’s decision differs from other federal agencies.

A message from Better Medicare Alliance:

Leading organizations representing physicians, nurses and patients have raised concerns about CMS rushing through major changes to risk adjustment in Medicare Advantage before the proposal has been properly analyzed and the impact on seniors and those who care for them is fully understood. Tell the White House to slow down and protect the 30 million seniors who count on Medicare Advantage.

 
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At the Agencies

Christina McGowan fills orders at the Table Rock Pharmacy.

President Joe Biden is set to stump in Las Vegas for the Inflation Reduction Act’s prescription drug provisions. | Chris Carlson/AP Photo

WHAT HAPPENS IN VEGAS WON’T STAY IN VEGAS — President Joe Biden is set to stump in Las Vegas today for the Inflation Reduction Act’s prescription drug provisions fresh off of Novo Nordisk's announcement it will cut the list price of several insulin products, David reports.

The speech coincides with the release of a new HHS report that found if the IRA’s provision eliminating cost-sharing for adult vaccines covered under Medicare Part D had been in effect in 2021, 3.4 million people would have saved an average of $70 in out-of-pocket costs — a total of $234 million.

HHS will also release the list of the first set of Medicare Part B prescription drugs that will have lower co-pays starting April 1 as a result of the IRA’s inflation rebate provisions. The 27 drugs include antibiotic Fetroja, anti-nausea medication Akynzeo and anemia treatment Mircera.

“Medicare will be reducing its Part B cost-sharing for these drugs this coming quarter and Medicare Advantage plans are also required to not exceed the level of cost-sharing that's provided here,” Christen Linke Young, deputy assistant to the president for health and veterans affairs, told reporters.

FDA AUTHORIZES BOOSTER FOR KIDS — The FDA authorized on Tuesday emergency use of Pfizer-BioNTech’s bivalent Covid-19 vaccine as a booster for kids 6 months to 4 years old, David reports.

The booster is authorized for children who have taken three doses of the monovalent vaccine before the bivalent shot was authorized as a third dose in December, according to the agency.

EPA ACTS ON ‘FOREVER CHEMICALS’ — The Biden administration is proposing the first-ever federal limits for toxic chemicals in drinking water, POLITICO’s Annie Snider reports.

The chemicals in question — used to make nonstick materials like Teflon, stain-resistant carpeting and military firefighting foam — are estimated to be contaminating 200 million Americans’ drinking water.

Health experts and community activists say the effort to begin reining in the widespread contamination from PFAS “forever” chemicals, which are linked with cancer, reproductive problems and a wide array of other health ailments, is long overdue. If finalized, the regulation would spark the first major upgrade to the safety of the nation’s drinking water in three decades.

 

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On K Street

THE ODD COUPLE — As the debate over drug pricing continues on Capitol Hill, a microcosm of the battle played out during a conference held by America’s Health Insurance Plans on Tuesday, when AHIP CEO Matt Eyles had a Q&A with PhRMA CEO Steve Ubl, Megan writes.

Both groups have spent millions of dollars on lobbying and advertising to push policies taking aim at each other, yet the deep divisions between the two industries appeared understated as the executives talked about finding ways to work together.

Still, Ubl suggested that insurers contribute to rising drug costs and “policymakers have prayed at the altar of premiums” — a nod to lawmakers' resistance to supporting policies if they lower patients’ drug costs but raise insurance premiums, which insurers use as powerful advocacy ammo on the Hill.

The next panel featured figures critical of large drugmakers, putting the discord about drug-pricing measures on display.

Eyles led a discussion with JC Scott, CEO of the Pharmaceutical Care Management Association, the industry group for pharmaceutical benefit managers that’s pushing a slate of patent reform bills loathed by major drugmakers, and Merith Basey, the executive director of Patients for Affordable Drugs, a group that hammered drug companies in the IRA battle that PhRMA ultimately lost.

 

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In Congress

RUBIO INVESTIGATES — Sen. Marco Rubio (R-Fla.) has posted a video teasing a report he’s preparing to release on Covid-19’s origins.

The report, based on nearly 18 months of investigation, presents “a mountain of circumstantial evidence that the Covid-19 pandemic likely came from a lab accident in Wuhan, China,” Rubio said in a statement Tuesday.

Stay tuned: Rubio says his office is finalizing the report and will release it “soon.”

HEALTH TECH

CHATGPT IS READY TO SEE YOU NOW — There’s much to be said about the promise and pitfalls of artificial intelligence and healthcare. In a new analysis for Pro readers, POLITICO’s Ruth Reader and Rosmery Izaguirre break down how we got here, what the regulators say and what’s next.

Providers

$28 BILLION — That’s the estimated value of tax exemptions for nonprofit hospitals in 2020, according to a new analysis from KFF, up from 2011 when it was about $20 billion.

Why it matters: The growing amount of taxes that nonprofit hospitals — which comprise about three-fifths of community hospitals in the country — are exempt from paying means that money isn’t going to federal, state and local governments, the report notes, and raises questions “about whether nonprofit facilities provide sufficient benefit to their communities to justify” the break.

Meanwhile ... A new documentary, American Hospitals: Healing A Broken System, released its trailer today, shared first with Pulse. The film looks into the nonprofit hospital system.

Names in the News

Javad Parvizi is now president of the American Association of Hip and Knee Surgeons. Parvizi is the James Edward professor of orthopedic surgery at Sidney Kimmel School of Medicine and Rothman Institute in Philadelphia.

Chuck Triano will take over as Biogen’s new senior vice president as of April 10. He was most recently chief financial officer for Xalud Therapeutics.

Jay Eberle is joining AstraZeneca as director of policy. He was most recently a longtime health policy adviser to Sen. John Barrasso (R-Wyo.).

A message from Better Medicare Alliance:

If proposed changes to risk adjustment in Medicare Advantage are rushed through, 30 million seniors could see unintended consequences. Low-income and chronically ill seniors could be disproportionally impacted, especially those with conditions such as diabetes and depression. Tell the White House to slow down and protect the 30 million seniors who count on Medicare Advantage.

 
What We're Reading

STAT plunges into the chocolate milk wars.

The New York Times ponders whether working from home is really so healthy after all.

Former CDC staffer Caitlin Rivers writes in Foreign Affairs why America’s “wait-and-see” approach to bird flu is dangerous.

 

STEP INSIDE THE WEST WING: What's really happening in West Wing offices? Find out who's up, who's down, and who really has the president’s ear in our West Wing Playbook newsletter, the insider's guide to the Biden White House and Cabinet. For buzzy nuggets and details that you won't find anywhere else, subscribe today.

 
 
 

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