The secret behind one state’s public health windfall

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

Jul 13, 2023 View in browser   By Daniel Payne Presented by With Ben Leonard, Evan Peng and Megan R. Wilson Driving the day Indiana Republican Gov. Eric Holcomb, seen here with Kristina Box, the state's former health commissioner, secured $225 million to spend on public health. | Tom Davies/AP Photo ‘NOW WAS THE TIME’ — Indiana has long ranked poorly when it comes to public health: 45th in the nation for smoking, 46th for obesity, 43rd for mental health access, 41st for childhood immunizations — and 45th for public health funding, POLITICO’s Megan Messerly reports. Then came the pandemic — which, for Republican Gov. Eric Holcomb, created an opportunity to address the state’s lack of investment in public health. This year, he pushed a 1,500-percent increase in state funding to local health departments through the state’s GOP-controlled legislature. That investment is expected to transform public health in the Hoosier State and could serve as a model for other Republican states grappling with a conservative path forward on the issue post-pandemic. “If we wanted to address this, now was the time,” Holcomb told Megan. “If we were going to make a mistake, it was not going to be because we were sitting around admiring the problem.” Public health advocates eschewed terms like public health, systemic racism, equity — or anything else that might make GOP lawmakers squeamish — in conversations with skeptical lawmakers about the bill. They instead emphasized what public health could achieve, like healthy babies, clean water and economically vibrant communities. Those lobbying in favor of the bill found that while public health itself was an uncomfortable term for some — and many carried deep wounds from pandemic-era business closures, mask mandates and vaccination campaigns — there was broad consensus around many of public health’s core functions. Ultimately, the legislature approved $225 million in state public-health funding for local health departments that decide to accept it — $75 million this fiscal year and $150 million in the next, up from $7 million the state previously spent annually. The measure received overwhelming bipartisan support, despite a quarter of Republican lawmakers voting against the proposal. “One of our major goals was that no matter where you lived in the state of Indiana, you would have the same access to the same public health services that any other county does,” said Kristina Box, who retired as Indiana’s health commissioner in May. “We were careful to avoid terms we know that just turn our legislators’ hearts and minds off.” WELCOME TO THURSDAY PULSE, where we learned there’s a new way to beat the heat: paint. Scientists have developed a white paint that can cool surfaces anywhere from 8 to 19 degrees, which could cut air conditioning demands by as much as 40 percent. Send your best tips — about health news or how to handle the heat — to me at dpayne@politico.com. TODAY ON OUR PULSE CHECK PODCAST, host Katherine Ellen Foley talks with Adam Cancryn, who explains why the nomination of Monica Bertagnolli to lead the NIH is caught between President Joe Biden and Sen. Bernie Sanders (I-Vt.) over the administration's drug pricing agenda. Listen to today’s Pulse Check podcast   A message from PhRMA: Research and development of cancer medicines after their initial FDA approval can help expand treatment populations, find new ways of treating a cancer or help patients earlier in their cancer battle. Unfortunately, provisions in the Inflation Reduction Act put this progress in jeopardy by selecting medicines for price setting before many of these critical advancements can be fully realized. Read the new report.   In Congress It's unclear whether House Speaker Kevin McCarthy will bring a price transparency bill to the House floor before the August recess. | Francis Chung/POLITICO NOT SO FAST — Lawmakers and lobbyists are pushing to see a bipartisan price transparency bill go to the House floor — before August recess, Megan R. Wilson, Ben and your host report. But a leadership aide granted anonymity to discuss the plans told Pulse that ongoing committee work on the issues means it’s more likely to get handled later this year. The plan to get a vote for the PATIENT Act in the House in the coming weeks is circulating among lawmakers and lobbyists, said four lobbyists and a GOP congressional aide. Speaker Kevin McCarthy’s office did not respond to requests for comment about whether he would move a health package in the few legislative days left before August. Meanwhile, Patient Rights Advocate, a group that has pushed for price transparency policy across Congress, is launching a new digital ad campaign today — shared first with Pulse — in House leaderships’ districts. The bill, unanimously advanced by the House Energy and Commerce Committee in May, would codify and expand price transparency rules for hospitals and insurers and add disclosure requirements for pharmacy benefit managers, which manage prescription drugs for health insurers. The measure is part of a larger movement in Congress to increase transparency as a way to lower health care costs. It’s more sweeping than other transparency measures, reauthorizing several health care programs that expire on Sept. 30, including funding for community health centers and diabetes programs and delaying payment cuts for hospitals that serve low-income individuals for two years. BUT THE BILL COULD HAVE COMPETITION — The House Education and the Workforce Committee advanced four bipartisan transparency-heavy bills on Wednesday, Ben and Megan R. Wilson report. There’s some overlap with the broad Energy and Commerce bill — including one that would codify price transparency rules — but others that go further, such as legislation aiming to ensure that employers aren’t barred by PBMs or others from including cost and quality information on their plans. It’s unclear, though, how or which of these measures could fit into an overall health care package. “We’re on the cusp of a necessary overhaul of a health care system that has left patients in the dark,” Chair Virginia Foxx (R-N.C.) told POLITICO in a statement. “Whether these bills are brought to the floor individually or in a package, the only thing that matters is getting them across the finish line and to the president’s desk.” VA HEALTH CARE HEARING — The Senate Veterans’ Affairs Committee is working on a bipartisan health care legislative package, ranking member Jerry Moran (R-Kan.) said at a hearing Wednesday, Ben reports. It’s not clear what that might look like, but the committee considered 19 bills Wednesday, which included efforts to put more scrutiny on the VA’s troubled electronic health record program, bolster long-term care and reduce veterans’ homelessness. There was also a focus on community care — allowing veterans to get care outside the VA. Committee Chair Jon Tester (D-Mont.) has touted the Making Community Care Work for Veterans Act, which would help strengthen the community care program established in the VA MISSION Act, which became law in 2018. The VA came out against key parts of the legislation in written testimony, saying it could create "significant operational challenges,” and also opposed significant portions of Moran’s community care bill. The Disabled American Veterans group also was critical of Tester and Moran’s bills, saying their provisions codifying access standards won’t “by itself” increase access to care, but boosting infrastructure and staffing would. Moran suggested there could be a compromise bill with Tester’s legislation and his own.   A message from PhRMA:   At the Agencies FIRST IN PULSE: CALIFF TO THE HILL — FDA Commissioner Robert Califf will join members of the GOP Doctors Caucus for a closed-door meeting this morning, an aide told your host. The group will discuss FDA regulatory policies. Though the details of the agenda are unclear, Califf’s visit comes amid a flurry of high-profile activity for the agency — from approving the first new Alzheimer’s drug in decades to working through regulating drugs for obesity. And Congress has been mulling policies related to the FDA. House Democrats have been advocating for FDA-related authority that would cut down on drug shortages to be added to a pandemic preparedness bill up for reauthorization.   UNLEASH THE FUTURE OF HEALTHCARE WITH POLITICO, A 7/20 INTERACTIVE EVENT: Imagine a future where rare genetic diseases are not only treatable, but potentially curable. Where our approach to chronic illness takes a monumental leap forward. That future is already taking shape in the form of next-generation health care treatments such as gene therapy. Join POLITICO on Thursday, July 20 and delve into the burgeoning field of gene therapies, which hold the power to redefine our health care landscape. Are you ready to explore this new frontier in health care? Don't miss this chance to be part of the conversation. REGISTER NOW.     Public Health STOPPING TRAFFIC — The leaders of the House Homeland Security’s subcommittee on Border Security and Enforcement introduced bipartisan legislation Wednesday aimed at combating fentanyl trafficking and human smuggling along the southern border, Evan reports. Chair Clay Higgins (R-La.) and ranking member Lou Correa (D-Calif.) announced legislation in advance of their hearing on the problem. They hope to bolster partnerships between U.S. and Central and South American law enforcement agencies by directing the secretary of Homeland Security to seek to establish transnational criminal investigative units. The Homeland Security Department’s Customs and Border Protection division has seized more than 22,000 pounds of fentanyl so far this fiscal year, a record level, according to hearing witness James Mandryck, the agency’s deputy assistant commissioner for intelligence. But Mandryck also said most of that fentanyl seized was found on Americans at legal ports of entry, not on foreigners trying to enter the country illegally.   A message from PhRMA: A new report showcases the vital role of post-approval R&D in nine critical oncology treatments. This research can help expand treatment populations, find new ways of treating a cancer or help patients earlier in their cancer battle. Unfortunately, provisions in the Inflation Reduction Act put this progress in jeopardy by selecting medicines for price setting before many of these critical advancements can be fully realized. See how post-approval R&D in cancer is at risk.   Names in the News The International Federation of Pharmaceutical Manufacturers and Associations has announced a new CEO leadership team for the coming two years: Albert Bourla, chair and CEO of Pfizer; Thomas Schinecker, CEO of Roche; and Sunao Manabe, executive chair and CEO of Daiichi Sankyo. What We're Reading The New York Times reports on new EPA standards for lead dust in homes and child care facilities. STAT reports on the push to make fixes to the 988 system one year after it launched.   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.       Follow us on Twitter Dan Goldberg @dancgoldberg Katherine Ellen Foley @katherineefoley Lauren Gardner @Gardner_LM Kelly Hooper @kelhoops Robert King @rking_19 Ben Leonard @_BenLeonard_ David Lim @davidalim 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

To change your alert settings, please log in at https://www.politico.com/_login?base=https%3A%2F%2Fwww.politico.com/settings This email was sent to rouf@idiot.cloudns.cc by: POLITICO, LLC 1000 Wilson Blvd. Arlington, VA, 22209, USA Please click here and follow the steps to unsubscribe.