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3 debate health care takeaways

Delivered daily by 10 a.m., Pulse examines the latest news in health care politics and policy.
Jun 28, 2024 View in browser
 
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By Chelsea Cirruzzo and Ben Leonard

With Toni Odejimi 

Driving the Day

Joe Biden and Donald Trump participate in the CNN Presidential Debate.

Health policy topics like abortion, insulin prices and Medicare were featured throughout Thursday's presidential debate. | Justin Sullivan/Getty Images

MYRIAD HEALTH TOPICS — A number of health care issues surfaced during Thursday’s presidential debate between Joe Biden and Donald Trump — including the cost of prescription drugs, veterans’ health care, the opioid crisis and the future of Medicare.

Though Biden’s lackluster performance — and the ensuing Democratic concerns — dominated the post-debate coverage, we did circle some notable health care points that might have been lost in the shuffle.

1. Health care got a surprisingly high level of attention: Both Biden and Trump talked about health care issues unprompted, and CNN moderators Jake Tapper and Dana Bash asked several health care-related questions.

Biden pivoted from issues he’s not strongly polling on, like the economy, to efforts to bring down prescription drug costs. Trump saw veterans’ health care as a winning issue, bringing up efforts to expand private health care options outside the VA.

And, although both saw opportunity in the pandemic response, Trump opted to hit Biden over Covid-19 “mandates.” Both candidates largely sidestepped what they would do to tackle the opioid epidemic.

2. Both candidates sought wins on Medicare and insulin: Biden and Trump attempted to win over older Americans, a higher-propensity voting group than younger Americans.

Trump took aim at the Biden administration for “beating [Medicare] to death,” suggesting Biden threatens the program’s solvency. Trump also misleadingly claimed he was the one who “got the insulin down for the seniors.” His administration had a voluntary program to cap monthly insulin co-pays to $35, but Biden’s efforts have been much broader, signing the Inflation Reduction Act into law, which would cap insulin co-pays for Medicare patients at $35 a month.

Biden, meanwhile, fumbled when touting the IRA, a cornerstone of his reelection campaign. He mixed up his numbers on the legislative cap on out-of-pocket prescription drug costs as well as the cost of insulin in Medicare.

3. Trump says states should “work it out” on abortion: Trump followed his own advice to House Republicans on abortion, saying the issue should be left to the states.

Trump argued that states are “working it out” post-Roe, with some states enacting near-total bans and others opting to protect access to the procedure. As many as a dozen states could have abortion on the ballot this November.

Biden said he supports the framework of Roe v. Wade, which allowed states to ban the procedure after the point of fetal viability — around 22 or 24 weeks of pregnancy. Many abortion rights groups want him to go further and push for abortion access without government interference throughout pregnancy.

WELCOME TO FRIDAY PULSE. Did you know Beethoven was also a big heavy metal guy? Well, kind of. Scientists say he likely suffered from the effects of lead exposure — the 18th- and 19th-century equivalent of microplastics, perhaps? Send your tips, scoops and feedback to ccirruzzo@politico.com and bleonard@politico.com and follow along @ChelseaCirruzzo and @_BenLeonard_.

 

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AROUND THE AGENCIES

Merrick Garland speaks during a news conference.

Attorney General Merrick Garland announced the results of a nationwide health care fraud enforcement action involving false billings. | Jose Luis Magana/AP

HEALTH FRAUD UNCOVERED — Seventy-six health care providers are among the nearly 200 people charged in alleged health care fraud schemes uncovered during a two-week enforcement operation, the Department of Justice announced Thursday, Chelsea and Toni report.

U.S. Attorney General Merrick Garland said the charges are part of the administration’s efforts to catch people who exploit Medicare, Medicaid and other federally funded programs. The operation identified 145 cases involving allegations of fraudulent addiction treatment centers, misbranded HIV drugs and a scheme to defraud Medicare through unnecessary skin grafts.

Additional defendants were also added to a federal indictment of telehealth company Done Global, which is accused of prescribing the ADHD drug Adderall to patients who didn’t need it.

“One of the three major pillars of the Justice Department is keeping our community safe with respect to health care fraud,” Garland said.

Federal officials warned Thursday that health care fraud is an “evolving threat” and said proactive data analytics are key to catching bad actors. For example, Garland said data analytics were used to identify “the misuse of telemedicine as a possible source of an increase in prescriptions for stimulants.”

HELIUM SALE CLOSED — The Bureau of Land Management closed its sale of the federal helium reserve on Thursday despite the concerns of health care and industry groups who worried that, as a result, legal and operation issues could cause supply-chain disruptions, Ben reports. Congress directed the reserve to be privatized in 1996, initially to boost military readiness via blimps.

The move came after a 45-day hand-off period to the new owner, Messer, to allow for a “smooth transition.” Messer placed the highest bid for the reserve.

Helium cools magnets in MRIs so the machines can operate and is also used in laser eye surgery, ventilators and semiconductors used in many medical devices.

“Messer is committed to being a safe and responsible operator of the Helium System and continuing to serve the many industries that rely on this vital resource,” the company’s CEO Elena Skvortsova said in a release.

The concerns: Health care and helium industry groups had argued that the Biden administration should delay the privatization to resolve any issues and avoid holding up supply distribution.

GENDER-AFFIRMING CARE

WHO’S GETTING GENDER-AFFIRMING CARE? No insured minors were reported to have had gender-affirming surgeries in the U.S. in 2019, according to researchers, and many breast-reduction surgeries done that year on minors were on cisgender men.

Why it matters: Half of U.S. states have laws restricting access to gender-affirming care for minors — with the first state law passed in 2021 — and Republicans on Capitol Hill have opposed policies to expand access for young people.

But in a JAMA Network Open research letter published Thursday, researchers from the Harvard T.H. Chan School of Public Health, Boston Children’s Hospital and the Brown School of Public Health suggested that fears about minors receiving gender-affirming surgery were overblown.

Researchers looked at claims data for 47 million insured adults and 22 million insured minors — of which more than 71 percent were 12 and younger. Of the gender-affirming procedures within this group, nearly 60 percent in adults and just over 96 percent in minors were chest-related procedures. Of the breast reductions performed on minors, most were on cisgender males.

No gender-affirming procedures were performed on insured minors 12 and younger in that timeline, according to the claims data.

“Low use by [transgender] people likely reflects adherence to stringent standards of gender-affirming care,” researchers wrote.

The limitations: The study relies on diagnostic codes in claims data, which could potentially include misclassifications and doesn’t reflect uninsured patients.

ELECTION 2024

IRA PERCEPTIONS — In a recent poll of 1,000 voters, most believe the Inflation Reduction Act has increased health insurance costs, according to a poll by former Trump administration adviser Kellyanne Conway’s consulting firm.

The nationwide poll of 1,000 registered voters, of which nearly half were adults 65 and older, was commissioned by the advocacy group Commitment to Seniors, which is critical of AARP’s relationship with big insurers and pharmacy benefit managers, which manage prescription drugs for health insurers.

Why it matters: President Joe Biden has touted the IRA for lowering health care costs, pointing to the subsidies it creates to lower premiums — which he has asked Congress to make permanent.

However, many voters are unaware of what the law actually does, according to health policy research group KFF.

According to the poll by Conway’s group, 60 percent of voters said they believed their health insurance increased in cost after the IRA became lower, and 48 percent said the cost of their prescription drugs increased.

Conservative lawmakers and groups have criticized the IRA, particularly its Medicare drug negotiation provisions, which they argue stifles innovation for new drugs.

 

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Names in the News

Steph Guerra is now senior adviser at the U.S. AI Safety Institute at the National Institute of Standards and Technology. She most recently was assistant director for health security and biodefense at the White House Office of Science and Technology Policy.

Gui Woolston has joined Aledade as its chief analytics officer. He previously was director of Connecticut Medicaid.

WHAT WE'RE READING

STAT reports on the rise of alcohol-related health problems in the U.S.

KFF Health News talks to Wisconsin voters about health costs.

 

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