Ron DeSantis and the rise of medical freedom

Presented by PhRMA: Delivered daily by 10 a.m., Pulse examines the latest news in health care politics and policy.

Mar 01, 2023 View in browser   By Krista Mahr and Daniel Payne Presented by Driving the Day Gov. Ron DeSantis has a new vision for public health in America. | Scott Olson/Getty Images ALL EYES ON THE FREE STATE OF FLORIDA — Florida Gov. Ron DeSantis has helped bring the once-fringe medical freedom movement onto the national stage, and lawmakers across the country are paying attention, POLITICO’s Megan Messerly, Arek Sarkissian and Krista report. Building on his popular handling of Covid-19 in the state, DeSantis launched a “Prescribe Freedom” campaign last month that aims to permanently limit Covid-19 vaccination and mask requirements and give cover to doctors whose medical views depart from scientific consensus. It’s designed to protect “Floridians from the biomedical security state” — and if DeSantis declares his candidacy as expected, all Americans will start hearing more about it. Many state lawmakers already like what they see. “Governor DeSantis has been leading the way,” Texas state Rep. Matt Schaefer told POLITICO. “A lot of people are looking to DeSantis to see what he's doing at this point, and it gives cover to other governors, I think, to step out there." This year, state lawmakers have introduced more than 400 bills promoting a small-government vision for public health, according to the National Academy for State Health Policy. Some are Covid-specific, such as a bill in Indiana that would prohibit employers from requiring routine testing for the virus. Other proposals would make significant changes to the mandate-driven approach to public health. Most aren’t expected to go anywhere. But their volume speaks to the backlash federal pandemic policies have engendered and how DeSantis’ proposals could be the inevitable result of so many Americans losing trust in local, state and federal health officials. “Taking a different approach in public health requires a lot of guts,” Brian Miller, a non-resident fellow at the American Enterprise Institute, told POLITICO. “The public health community has historically not done a good job in integrating centrist, conservative and libertarian viewpoints.” WELCOME TO WEDNESDAY PULSE. Nearly half of U.S. adults believe SARS-CoV-2 was leaked from a laboratory in Wuhan, China, dwarfing the quarter of Americans who believe it spilled over from animals to humans. Send your news and tips to kmahr@politico.com and dpayne@politico.com. TODAY ON OUR PULSE CHECK PODCAST, hear more from host Megan Messerly and Krista Mahr about the medical freedom movement and how Ron DeSantis is bringing it into the mainstream. Listen to today’s Pulse Check podcast   A message from PhRMA: Costly out-of-pocket expenses tied to deductible and coinsurance requirements are a leading concern for patients with commercial insurance. These harmful practices put in place by insurers and pharmacy benefit managers (PBMs) are even causing patients to abandon their medicines. New IQVIA data break down how insurers and their PBMs are impacting how patients access and afford their medicines.   In Congress Sen. Maggie Hassan (D-N.H.) wants to stop pharmaceutical companies from blocking competitors trying to sell cheaper — and better — drugs. | Shawn Thew-Pool/Getty Images FIRST IN PULSE — Sens. Maggie Hassan (D-N.H.) and Mike Bruan (R-Ind.) will reintroduce a bill today that aims to close a loophole pharmaceutical companies have used to block other firms from selling competing drugs, including lower-cost generics, PULSE has learned. What the bill would do: The FDA often requires manufacturers to have a Risk Evaluation and Mitigation Strategy program for potentially dangerous drugs, which some companies patent to delay other, potentially cheaper versions coming on the market. The Increasing Prescription Drug Competition Act would allow the FDA to immediately approve drugs if a REMS patent is the only barrier to approval. Its reintroduction follows a Monday New York Times report on Jazz Pharmaceuticals’ use of this tactic to block the release of a drug from a competitor. “Our bipartisan bill would finally close this absurd loophole that big pharmaceutical companies, such as Jazz, can use to slow down the release of better, cheaper drugs in order to line their own pockets,” Sen. Hassan said in a statement to Pulse. “For too long, Big Pharma has artificially inflated drug prices at the expense of patients, but it doesn’t need to be this way. I will continue working across the aisle to take on Big Pharma and lower health care costs for all Americans.” AND SPEAKING OF WUHAN … Congressional Republicans want to use new Covid-19 lab leak reports to lash out at Beijing and paint President Joe Biden’s administration as soft on China, but they can’t agree on how to do that, POLITICO’s Alice Miranda Ollstein and Gavin Bade report. A spectrum of responses played out Tuesday across nearly a dozen hearings and legislation markups aimed at deterring what GOP lawmakers say is increasingly aggressive behavior from China that the Biden administration hasn’t effectively addressed. Some hope a reported new assessment from the Energy Department, concluding that the so-called lab leak theory is the likely explanation for Covid’s origin, will give new life to legislation that stalled last year — including introducing bills to declassify intelligence about the pandemic, setting up a 9/11-style nonpartisan commission to study the virus’ beginnings and restricting data-sharing with Chinese scientists. Others want the White House to hold classified briefings on what they knew about Covid-19’s origins, when they knew it and what led to the latest agency assessment. Still others hope to use the lab leak assessment as momentum for sanctions and investment restrictions on the world’s second-largest economy.   DOWNLOAD THE POLITICO MOBILE APP: Stay up to speed with the newly updated POLITICO mobile app, featuring timely political news, insights and analysis from the best journalists in the business. The sleek and navigable design offers a convenient way to access POLITICO's scoops and groundbreaking reporting. Don’t miss out on the app you can rely on for the news you need, reimagined. DOWNLOAD FOR iOS– DOWNLOAD FOR ANDROID.     Mental Health THE LAST LINE OF CARE — A CDC report released today shows that from 2018 to 2020, Black adults sought help in emergency departments for problems related to mental health at far higher rates than white or Hispanic adults. Their rates of emergency visits for specific disorders, such as anxiety disorder and substance use disorder, were also highest among Black adults. At the same time, ED visits by Black patients “were less likely to result in admission or transfer to a hospital” than visits by white patients, the report said. Hispanic adults had the lowest rates of ED visits for any mental health disorders. The backdrop: One in 5 American adults were estimated to be living with a mental health disorder in 2020, and less than half of those individuals received any services for the condition. Black and Hispanic individuals are less likely to receive mental health treatment than white Americans.   A message from PhRMA:   At the Agencies OUCH — During the Trump Administration, Don Rucker oversaw the beginning of the Trusted Exchange Framework and Common Agreement, a health data-sharing project known as TEFCA. Rucker had some choice words for the way the CDC handles health data — and how the agency wants to use TEFCA — in a recent interview with Ben Leonard over at Future Pulse. “The CDC doesn’t get modern computing,” Rucker told Ben. “If you want to fight the next pandemic, where you actually have to monitor a population in real time, you can’t generate enough queries to do that. TEFCA doesn’t lend itself to population-based surveillance. “CDC should totally shift its focus from trying to ingest little pieces of information to funding every gap in health information exchanges in the states,” he said.   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.     Names in the News Theo Merkel will join the Paragon Health Institute as director of its Private Health Reform Initiative and a senior research fellow. Merkel is a former special assistant to the president for economic policy at the National Economic Council in the White House and former legislative director for Sen. Pat Toomey (R-Pa.). What We're Reading In STAT, a former deputy chief of staff for the Department of Health and Human Services calls on the FDA to rethink how new drugs for rare diseases are developed and remove needless obstacles that hinder clinical trials. The Chinese doctor who claimed to have genetically engineered babies has staged a rocky return to science, The Associated Press reports. As tensions rise with Washington, D.C., Beijing is trying to rewrite its response to the pandemic, The New York Times reports.   A message from PhRMA: Every day, patients at the pharmacy counter discover their commercial insurance coverage does not provide the level of access and affordability they need. New data from a study by IQVIA reveal the harmful practices of insurers and their pharmacy benefit managers (PBMs) can lead to significantly higher out-of-pocket costs for medicines — causing some patients to abandon their medicines completely. Learn more.     Follow us on Twitter Dan Goldberg @dancgoldberg Katherine Ellen Foley @katherineefoley Lauren Gardner @Gardner_LM Ben Leonard @_BenLeonard_ David Lim @davidalim Krista Mahr @kristamahr Megan Messerly @meganmesserly Alice Miranda Ollstein @aliceollstein Carmen Paun @carmenpaun Daniel Payne @_daniel_payne Ruth Reader @RuthReader Erin Schumaker @erinlschumaker Megan R. Wilson @misswilson   Follow us

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