Checking Mike Johnson’s vitals

Oct 26, 2023

Presented by

With Daniel Payne

Mike Johnson (center) accompanied by Elise Stefanik (left) and other members of the Republican Conference, walks down the stairs at the Capitol.

Democrats are raising concerns about new House Speaker Mike Johnson's (center) record on abortion and other health care issues. | Jose Luis Magana/AP

THE NEW SPEAKER ON HEALTH CARE — After weeks of turmoil, the House has a speaker — Rep. Mike Johnson (R-La.) — allowing the chamber to resume legislating and attempting to fund the government.

The consensus among health policy experts that Pulse consulted over the past several weeks has been that it mattered more for health policy that a speaker was in place than who that speaker was. Johnson will have to move quickly to fund the government by Nov. 17.

The path forward: Johnson has proposed a floor vote on the Labor/HHS appropriations and the Agriculture-FDA appropriations bills the week of Nov. 13. The Labor/HHS bill has been among the most difficult to move in the chamber, with the GOP looking to add abortion-related and other controversial amendments. He also calls for a working group to “address Member concerns” with the FDA bill.

Johnson acknowledged his schedule is “ambitious” and has proposed a stopgap spending bill that would run through Jan. 15 or April 15 to avoid a “Christmas omnibus.”

He hopes to have by the end of November a “legislative blueprint through the end of the 118th Congress.” In health care, that could include moving on a sweeping transparency package and addressing expired programs, including the SUPPORT Act on the opioid epidemic, the Pandemic and All-Hazards Preparedness Act and the President’s Emergency Plan for AIDS Relief.

Johnson’s history: Johnson has been more directly involved in health care than some other candidates who had attempted to become speaker.

The former Republican Study Committee chair led a push in 2019 for the group’s health care plan to replace Obamacare. The plan would have rolled back Medicaid expansion and many regulations on the individual market. Democrats are raising concerns about Johnson’s push for Medicare and Medicaid cuts and his record on abortion.

Johnson is a former senior counsel for Alliance Defending Freedom — the conservative legal powerhouse behind the case that overturned Roe v. Wade — now spearheading efforts to restrict abortion pills nationwide, POLITICO’s Alice Miranda Ollstein reports. In that role, he worked to shut down abortion clinics and defend anti-abortion laws in Louisiana.

He’s also been out in front on a number of red-meat issues, including slamming gender-affirming care for children and the CDC for its guidance on school reopening amid the pandemic.

On K Street: Not many Johnson alums are in the health care lobbying world, according to a POLITICO review of his former staffers. Ruth Ward, a former policy adviser to Johnson, is at the conservative Family Policy Alliance.

WELCOME TO THURSDAY PULSE. The dust is still settling, but we want to know what’s next in health care policy with the House returning to having a speaker. We can keep you anonymous. Reach us at bleonard@politico.com or ccirruzzo@politico.com. Follow along @_BenLeonard_ and @ChelseaCirruzzo.

TODAY ON OUR PULSE CHECK PODCAST, host Alice Miranda Ollstein talks with POLITICO health care reporter Erin Schumaker, who explains why Sen. Bernie Sanders couldn't rally Democrats to reject President Joe Biden's pick to lead the NIH in an attempt to hold more sway over the administration and force it to take further action on lowering drug prices.

Listen to today’s Pulse Check podcast

A message from PhRMA:

Middlemen game the system at your expense. Pharmacy benefit managers (PBMs) charge fees tied to the price of medicines, which experts warn can lead to higher costs for patients and the health care system. A new survey finds 72% of voters believe PBMs should receive a fixed fee for their services instead. See the data.

Around the Agencies

A man uses a computer to write code.

HHS is looking into connecting minimum standards for health care cybersecurity to payments under federal health programs. | Getty Images

HHS EYES NEW CYBERSECURITY REGS — HHS Deputy Secretary Andrea Palm said Wednesday that the agency is considering tying minimum cybersecurity requirements to payments under federal health programs. Palm told reporters HHS is looking at “all our options.”

The broader context: Palm’s comments come as lawmakers on Capitol Hill look to beef up the sector’s cybersecurity preparedness amid a surge in attacks.

A POLITICO analysis earlier this month found that nearly 89 million people in the U.S. have had their sensitive health information breached so far this year, up from 43.5 million during the same period last year — on pace to more than double last year’s total.

FACING THE SKEPTICS — CDC Director Mandy Cohen thinks she can win over Republican support by emphasizing the CDC’s critical role in national defense, Chelsea and Daniel report.

“I see a lot of consensus of wanting to have a strong CDC that can protect the country — and that means resources to detect the threats that are out there and rapidly respond to them,” she said during an interview Tuesday with POLITICO.

In a meeting last week with members of the GOP Doctors Caucus, comprised of physicians in the House, Cohen said she’s cognizant that some are also veterans and highlighted the CDC’s work preventing veteran suicides.

“I’m trying to turn a new chapter. I think that there’s a lot of folks who want to look backwards. I want to look forward,” Cohen said. “I think the first part of building trust is showing up and listening.”

The caucus has been open about its skepticism of public health leadership through the pandemic and has suggested more work is needed to restore trust.

“We had an informative introductory meeting with Dr. Cohen to learn about her priorities and discuss the importance of the scientific process,” the caucus’ co-chairs told POLITICO in a statement. “We are looking forward to working with Dr. Cohen on best practices in our efforts to make the United States ‘the healthiest nation on the planet.’”

GO INSIDE THE MILKEN INSTITUTE FUTURE OF HEALTH SUMMIT: POLITICO is proud to partner with the Milken Institute to feature a special edition of our Future Pulse newsletter at the 2023 Milken Institute Future of Health Summit from November 6-8. The newsletter takes readers inside one of the most influential gatherings of global health industry leaders and innovators solving the biggest public health issues to ensure a healthier, more resilient future for all. SUBSCRIBE TODAY TO RECEIVE EXCLUSIVE COVERAGE.

‘FULL STEAM AHEAD’ — The White House’s domestic policy chief pushed back on criticism from drugmakers that the Biden administration’s Medicare drug pricing negotiation law would impact the development of drugs for rare diseases and told Chelsea the administration is “full steam ahead with implementation.”

The Biden administration began the process of haggling this fall with drug companies over 10 drugs, a policy Neera Tanden told Pulse was “incredibly popular in the country.”

While drugmakers have agreed to negotiate, multiple lawsuits challenging the law are winding their way through the courts.

Tanden pointed to a recent decision by an Ohio judge, a Trump appointee, to deny business groups’ attempts to halt the law as a win and added the White House supports expanding the number of drugs. When asked whether the White House would support Democrat-backed legislation to expand drug negotiation to private insurance, Tanden said the administration was supportive of “ensuring drug negotiation cover both public and private sector.”

She also rejected an argument from some behind the suits, including AstraZeneca, that the law would stymy the development of drugs for rare diseases, calling the Inflation Reduction Act settled law.

“I will just remind folks that the Congressional Budget Office determined that there will be only one drug [not developed] out of 1,300 drugs over the next decade,” she told Pulse. The CBO score of the bill indicates that 15 fewer drugs would be introduced over 30 years due to the law.

“Rare diseases have significant unmet medical need with fewer than 5% of conditions having available treatments,” Andrew Powaleny, spokesperson for pharmaceutical trade group PhRMA, said in an email to POLITICO. “Despite the significant challenges of researching and developing medicines for rare diseases, the law will make it even harder by devaluing post-approval research and development where progress for rare diseases is significant.”

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In Congress

SAME FIGHT, NEW ARENA — The fight over the Biden administration’s long-term care staffing rule has come to Congress, Daniel reports.

At a House Energy and Commerce subcommittee hearing Wednesday on health, its members questioned the potential consequences of the first-of-its-kind proposal from CMS that would likely require most facilities to hire more health workers.

Though the subcommittee members haven’t announced a statutory strategy to combat the proposal, the hearing and their letters to the administration make it clear they’re taking note of naysayers.

The arguments for and against the proposal were similar to those being brought to the administration as the public comment window closes.

The long-term care industry, along with GOP committee leaders, argues the administration’s proposal would be impossible to follow, leading to facility closures — and less access for patients. Subcommittee chair Brett Guthrie (R-Ky.) argued that the proposal would limit most home care agencies’ ability to take new referrals.

Health worker unions and patient advocates, plus a number of Democrats, have said the new standard would bolster patient care — though some Democrats have crossed party lines to critically question the CMS proposal.

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WHAT WE'RE READING

POLITICO's Erin Schumaker reports on the Senate HELP Committee's vote to advance the nomination of Dr. Monica Bertagnolli for NIH director despite Chair Bernie Sanders' objections.

POLITICO's Sarah Ferris, Burgess Everett and Olivia Beavers report on how Mike Johnson’s main strength will become his biggest liability.

CNN reports on the CDC saying that health workers are dealing with a mental health crisis.

Fierce Healthcare reports on telehealth giant Teladoc’s growing revenue but falling stock price.

A message from PhRMA:

Middlemen can make you pay more. Newly released data show 74% of voters think health insurers and their PBMs should pass the rebates and discounts they receive to patients, so no patient pays more for their medicines than their insurer. Read the new poll.