Fall could bring SUPPORT for opioid care

The ideas and innovators shaping health care

Oct 27, 2023 View in browser   By Carmen Paun, Daniel Payne, Evan Peng and Erin Schumaker WASHINGTON WATCH Guthrie's House bill to reup the opioid-fighting SUPPORT Act could come to the floor anytime. | Getty Images Congress allowed its landmark opioid-fighting law, the SUPPORT Act, to expire on Sept. 30, but advocates for substance use treatment hope to see some progress on new legislation this fall. Where it stands: Dysfunction in the House, which narrowly avoided a government shutdown last month before Republicans ousted their speaker, brought legislating to a standstill. But with Rep. Mike Johnson (R-La.) elected to the role on Wednesday, the pace should pick up. The House could bring up its new SUPPORT Act anytime. The Senate hasn’t begun to consider it. The House bill: The Energy and Commerce Committee unanimously approved a measure in July that would reup the prior version’s funding authorization for prevention, treatment and recovery programs. It would also repeal a 1965 rule prohibiting Medicaid-funded addiction treatment in large mental health institutions, which Congress adopted at the time for fear the states would foist more costs on the federal government. The bill from the panel’s Health Subcommittee chair, Brett Guthrie (R-Ky.), would also prohibit states from disenrolling people from Medicaid when they’re incarcerated. The bill would allow their coverage to automatically resume upon release so they’d have health care access at a time when they’re most vulnerable to dying from an overdose. The bill would also permit pregnant people in pretrial detention to retain their Medicaid coverage. “We were hoping to get this moving forward faster,” Guthrie said. “But we're now currently where we are,” adding that he wanted to see his bill passed “as soon as possible.” The Judiciary Committee, which has partial jurisdiction over the bill, advanced the legislation at the end of September on a 29-3 vote. The panel included a measure that would make the horse sedative xylazine — which drug traffickers are adding to illicit fentanyl to deadly effect — a Schedule III controlled substance, for three years, subject to additional regulation. And in the Senate? The ranking Republican on the Health, Education, Labor and Pensions Committee, Bill Cassidy of Louisiana, has proposed a bill, but no Democrat has. Missing the deadline to re-up the SUPPORT Act “puts vital resources in jeopardy,” Cassidy said in a statement.   GO INSIDE THE CAPITOL DOME: From the outset, POLITICO has been your eyes and ears on Capitol Hill, providing the most thorough Congress coverage — from political characters and emerging leaders to leadership squabbles and policy nuggets during committee markups and hearings. We're stepping up our game to ensure you’re fully informed on every key detail inside the Capitol Dome, all day, every day. Start your day with Playbook AM, refuel at midday with our Playbook PM halftime report and enrich your evening discussions with Huddle. Plus, stay updated with real-time buzz all day through our brand new Inside Congress Live feature. Learn more and subscribe here.     WELCOME TO FUTURE PULSE Washington, D.C. | Shawn Zeller This is where we explore the ideas and innovators shaping health care. If you ever thought a cat is smiling, you may be onto something. Cats have nearly 300 facial expressions that may have evolved from hanging around humans, a new study found. Share any thoughts, news, tips and feedback with Carmen Paun at cpaun@politico.com, Daniel Payne at dpayne@politico.com, Evan Peng at epeng@politico.com or Erin Schumaker at eschumaker@politico.com. Send tips securely through SecureDrop, Signal, Telegram or WhatsApp. Today on our Pulse Check podcast, your host Evan talks with Daniel, who sorts through the debate in Congress over health workforce issues, including the Biden administration's proposed rules to set new minimum staffing requirements for nursing homes. Listen to today’s Pulse Check podcast   DOWNLOAD THE POLITICO APP: Stay in the know with the 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. DOWNLOAD FOR iOS – DOWNLOAD FOR ANDROID.     INNOVATORS A novel approach to Zika research is underway in Baltimore. | AP A researcher at the Johns Hopkins Bloomberg School of Public Health in Baltimore got a close look at how Zika, a mosquito-transmitted virus that caused an international health emergency in 2016, behaves. Dr. Anna Durbin, an expert in vaccines for mosquito-borne diseases, led what’s considered the first study in which women, ages 18 to 40, volunteered to be infected with the virus and then spend time in a medical facility for observation on how the virus behaves. Durbin hopes the study, which will recruit men next, will one day help develop Zika vaccines or treatments. Why it matters: While the virus typically sparks either mild or no symptoms, it led to microcephaly — a condition where a baby’s head is smaller than expected — and other severe congenital disorders in children born to infected mothers while pregnant during the 2016 outbreak. Some 3,300 babies in Brazil were born with so-called congenital Zika syndrome between 2015 and 2018, according to a 2022 study that found they were 11 times more likely to die in their first three years of life compared to children born without the syndrome. How the study worked: Given there’s no treatment for Zika and studies in which people are deliberately infected with the disease pose ethical and safety concerns, the study was reviewed by the National Institutes of Health, the Food and Drug Administration and the World Health Organization. Nearly 30 women participated in the study, which used two Zika strains collected from an infected woman in Brazil with no symptoms and an infected child in Nicaragua. The women used birth control at the time of the study until at least two months after and weren’t pregnant or breastfeeding. All they developed was a rash, Durbin told Carmen. Participants received $200 for each of the nine days they spent in a health facility and $100 for outpatient followup visits. Durbin and her team wanted to see when the women’s infection peaked and could be transmitted to a mosquito that would then transmit the virus to other people. Durbin presented the study's results at the American Society of Tropical Medicine and Hygiene annual meeting in Chicago. The findings haven’t been peer reviewed. What’s next? Durbin plans to use the information she collected in the second part of the study, which will recruit men willing to be bitten by mosquitoes so researchers can better understand how transmission works and how long the virus lingers in semen.   Follow us on Twitter Carmen Paun @carmenpaun Daniel Payne @_daniel_payne Ruth Reader @RuthReader Erin Schumaker @erinlschumaker Evan Peng @thepngfile   Follow us

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