Health care gets a checkup

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

Jun 08, 2023 View in browser   By Daniel Payne Presented by With help from Robert King, Alice Miranda Ollstein and Carmen Paun Driving the Day Rahul Gupta, director of the White House Office of National Drug Control Policy, told attendees at POLITICO's Health Summit that the opioid epidemic could get worse before it gets better. | Rod Laskey for POLITICO SUMMIT TAKEAWAYS — The POLITICO Health Care Summit on Wednesday came with news across sectors, Carmen reports. Government officials, industry leaders and experts came together to discuss — and make sense of — the hottest topics in health policy, from artificial intelligence to drug pricing and pandemic preparedness to health equity legislation. Here are the event’s top takeaways: — Operation Warp Speed won’t likely be repeated to develop next-gen Covid vaccines. HHS Secretary Xavier Becerra downplayed expectations that the Biden administration would be able to reprise Operation Warp Speed in developing the next generation of Covid vaccines — unless the effort gets a lot more money from Congress. — The worst of the opioid crisis could still be ahead. Rahul Gupta, director of the White House Office of National Drug Control Policy, said the number of fatal drug overdoses could climb to 165,000 a year by 2025, about 55,000 more than last year. — Democrats aren’t backing down from their battles with drugmakers. Rep. Debbie Dingell of Michigan was among the Democratic panelists who lashed out at drugmaker Merck for suing to block Medicare drug price negotiations ordered by Congress in last year’s Inflation Reduction Act. And Becerra joined in, saying negotiating over prices is “as American as apple pie.” — Major health equity legislation isn’t likely until after the election. Next year’s elections will be crucial to diminish racial disparities in health, Rep.Jamaal Bowman (D-N.Y.) said, adding that major investments and “transformational” legislation would be needed to reduce inequities. — AI could be transformational — with the right rules in place. Health tech leaders agreed that AI has huge potential for care. But they added that government regulators will play a key role in creating rules for the technology, emphasizing the importance of balancing innovation and patient safety. That could be a challenge, though, leading one former FDA official to suggest using AI to help create regulations for AI use. WELCOME TO THURSDAY PULSE. Did I miss you at our health summit? Let’s catch up later. Drop me a line — and include some news that hasn’t been reported yet — at dpayne@politico.com. TODAY ON OUR PULSE CHECK PODCAST, host Katherine Ellen Foley takes us behind the scenes of POLITICO's annual Health Summit on Wednesday. Katherine spoke with attendees at the summit, including Ashish Jha, White House Covid-19 response coordinator, about the transformative impact of technology and innovation on health care and the challenges ahead. Plus, Carmen Paun shares her biggest takeaways from the day. Listen to today’s Pulse Check podcast     Global Health Rep. Chris Smith (R-N.J.) is accusing PEPFAR of promoting abortion. | AP Phoyo PEPFAR’S ABORTION CLARIFICATION — PEPFAR doesn’t offer a platform for abortion in Africa, its coordinator John Nkengasong said Wednesday in reaction to accusations from Rep. Chris Smith (R-N.J.) that the U.S. HIV program is promoting abortion abroad, Carmen reports. “PEPFAR has never, will not ever use that platform in supporting abortion,” Nkengasong said at the Global Impact Forum organized by the U.S. Global Leadership Coalition. He stressed that PEPFAR is implemented in strict compliance with U.S. law. In Congress WYDEN AIMS TO EXAMINE AI ROLE IN HEALTH INSURANCE — In today’s Senate Finance Committee hearing, Sen. Ron Wyden (D-Ore.) plans to probe how health insurers might be using artificial intelligence in patient care denials, Robert reports. He referenced data from a KFF report in February that showed insurers denied 2 million prior authorization requests in 2021 out of 35 million. “I would be very concerned about these deep-pocketed kinds of conglomerates in healthcare being in a position to use all these new technologies to facilitate a lot of rejections very quickly,” Wyden said. The hearing comes as scrutiny over AI’s role in health care has increased in Congress. Leaders of the Senate Homeland and Governmental Affairs Committee’s investigations panel wrote to three major Medicare Advantage insurers — Humana, CVS-Aetna and Humana — asking for information on AI’s role in care denials. Sen. Richard Blumenthal (D-Conn.), the subcommittee’s chair, said that CMS should also improve on a rule it finalized earlier this year to rein in AI practices in Medicare Advantage. “The rule that was issued, in my view, leaves a lot of ambiguity, somewhat mushy,” Blumenthal said earlier this week. “It has to be more unequivocal and clear.” MAKING IT PERMANENT — High-deductible health plans are one step closer to being permanently allowed to cover telehealth before customers hit their deductibles, POLITICO’s Ben Leonard reports. The Ways and Means Committee advanced legislation Wednesday that would do just that, with five Democrats joining Republicans in a 30-12 vote. A provision in the 2020 CARES Act Covid relief package allowed the insurance plans to cover telehealth through the end of 2021. Congress let the provision lapse for several months before reviving it and later extended it through the end of 2024 in the most recent omnibus appropriations bill. Committee Chair Jason Smith (R-Mo.) argued that making the policy permanent would not only save money by improving care but also expand access to care, including for Americans in rural areas.   GET READY FOR GLOBAL TECH DAY: Join POLITICO Live as we launch our first Global Tech Day alongside London Tech Week on Thursday, June 15. Register now for continuing updates and to be a part of this momentous and program-packed day! From the blockchain, to AI, and autonomous vehicles, technology is changing how power is exercised around the world, so who will write the rules? REGISTER HERE.     Abortion VIRGINIA COURT HEARS ABORTION PILL ARGUMENTS — A federal district court will hear arguments today on a lawsuit filed by medical clinics seeking to preserve access to abortion pills, Alice reports. The court, in Roanoke, Virginia, will determine access to the drugs in Virginia, Kansas and Montana should other courts impose nationwide restrictions on the drugs. The case comes as the 5th U.S. Circuit Court of Appeals deliberates on a broader challenge that could cut off access to the pills nationwide. A federal district court in Washington ruled in April that 17 Democratic-led states and the District of Columbia must be shielded from such a decision — ordering the FDA not to make any changes to regulation around abortion pills in those states. Now, abortion providers in the three additional states that opted not to join that lawsuit are attempting to secure similar protections. The plaintiffs say judicial relief is especially needed because their clinics have become a destination for thousands of patients traveling from states where abortion is banned. “Our ability to meet the overwhelming demand for services will be challenged, and patients will experience devastating wait times for appointments,” said Rebecca Tong, co-executive director of the Trust Women clinic in Wichita, Kansas.   A message from PhRMA:   Covid NO SAFETY CONCERNS — The mRNA Covid vaccines posed no serious safety issues for young children who got the shots, according to a new study from Kaiser Permanente. Among the 245,000 doses of the vaccine given to young children, there was no indication of myocarditis — an inflammation of the heart muscle — in the group, mostly consisting of those under 5 years old, according to the research published in Pediatrics. It’s yet another piece of research pointing to the safety and efficacy of the shots. At the Agencies ANOTHER CONFERENCE TO WATCH — The Centers for Medicare and Medicaid Services kicked off its first Health Equity Conference on Wednesday. Administration officials and health experts are coming together to discuss health equity challenges and opportunities. Discussions include oral health disparities, the use of data to advance LGBTQ health, the need for growing the health workforce at health clinics in underserved areas and the pandemic’s impact on inequity in the health system.   LISTEN TO POLITICO'S ENERGY PODCAST: Check out our daily five-minute brief on the latest energy and environmental politics and policy news. Don't miss out on the must-know stories, candid insights, and analysis from POLITICO's energy team. Listen today.     Names in the News Rachel Gartner Clark joined public affairs firm Narrative Strategies as a managing director, where she will lead a new, formal health care practice for the firm. Gartner Clark was most recently a senior group director at Real Chemistry and is a Weber Shandwick and an Edelman alum. Nomi Health has added Taylor Teepell as director of state government affairs and Stephanie Sonoda as director of corporate communications. What We're Reading The Wall Street Journal reports on a mental health chatbot that went rogue. KFF Health News reports on the people filling the gap in rural primary care.   A message from PhRMA: PBMs control your health care. Pharmacy benefit managers (PBMs) decide if medicines get covered and what you pay, regardless of what your doctor prescribes. They say they want lower prices, yet they often deny or limit coverage of lower-cost generics and biosimilars, instead covering medicines with higher prices so they make more money. This business model allows PBM profits to soar and can lead to higher costs for everyone. What else are they hiding?     Follow us on Twitter Dan Goldberg @dancgoldberg Katherine Ellen Foley @katherineefoley Lauren Gardner @Gardner_LM Kelly Hooper @kelhoops 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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