| | | | |  | | By Daniel Payne and Krista Mahr | | | With Megan Messerly and Katherine Ellen Foley
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Some Republican governors like Wyoming Gov. Mark Gordon are going against the GOP grain when it comes to certain health policies like Medicaid postpartum benefits. | Francis Chung/E&E News | A GOP ‘PRO-LIFE AGENDA’ — More people on Medicaid. Easier access to birth control. Comprehensive sex ed. Those are just some of the policies many Republicans nationwide are pushing in the final weeks of their legislative sessions. It may sound a little unorthodox, but the fall of Roe v. Wade has upended the traditional political battle lines in favor of a new “pro-life” agenda, prompting Republicans to embrace policies that Mississippi Gov. Tate Reeves admitted make them “philosophically uncomfortable.” Reeves and Wyoming Gov. Mark Gordon recently signed 12-month extensions of Medicaid postpartum benefits into law. Iowa Republican Gov. Kim Reynolds is pushing legislation to allow pharmacists to dispense hormonal contraceptives. The state Senate has passed the bill, and it’s moving through the House. The path is trickier for two comprehensive sex-ed bills introduced this year in Indiana and South Carolina — which both have an abstinence-focused sex-ed curriculum. The bills haven’t received hearings, but South Carolina Republican state Sen. Tom Davis plans to bring his sex-ed legislation forward as an amendment to another education-related bill. “If we want to reduce unwanted pregnancies and, by that, reduce the number of abortions, we need to do a better job of providing factually correct scientific information that’s age-appropriate,” he told POLITICO. WELCOME TO THURSDAY PULSE, where we’re concerned by the news that cockroaches are mutating to avoid poisons used to kill them. One thing we won’t avoid: tips from our readers. Drop us a line at dpayne@politico.com and kmahr@politico.com. TODAY ON OUR PULSE CHECK PODCAST, host Ruth Reader talks with Katherine Ellen Foley about the FDA's approval of Narcan, the first over-the-counter opioid overdose reversal nasal spray, and how it might positively impact the opioid overdose epidemic in the U.S.
| | | | A message from PhRMA: What’s a pharmacy benefit manager (PBM)? They decide if medicines get covered and what people pay for them, regardless of what your doctor prescribes. These middlemen are putting their profits before your medicines. And getting between you and your doctor. You need to see what’s going on. | | | | | | | | | | 
A group of key health sector groups has formed to strengthen and better coordinate response for future pandemics. | Seth Wenig/AP Photo | PLANS OF THE GIANTS — It’s rare that hospital, insurance, physician and government leaders get together — and agree on something. But late Wednesday afternoon, some of them did. A number of the biggest players in health care announced plans to take lessons learned from the pandemic into the future. The effort, led by Kaiser Permanente, looks to stop the boom-bust cycle of public health, especially in moments of crisis like the pandemic, and is divided into three goals: — Improve coordination of efforts and clearly define responsibilities among America’s Health Insurance Plans, the American Medical Association, the American Hospital Association, the Alliance of Community Health Plans and public health leaders — Maintain and grow connections made between health systems and communities during the pandemic, a task that will be led by community-based organizations and the CDC Foundation — Develop a research agenda in collaboration with AcademyHealth to inform better evidence-based public health practices The efforts come as hopes of new federal funding to prepare for the next pandemic are low and as the Biden administration is expected to lift the Covid public health emergency. “One of the things that makes this approach special is it is not simply heading over to Capitol Hill and asking for cash,” Ceci Connolly, president and CEO of the ACHP, told Pulse, saying the coalition’s work largely relies on the resources and efforts of the groups themselves. The Biden administration welcomes the effort, too, with Ashish Jha, the White House Covid-19 response coordinator, saying at yesterday’s launch that he was “somewhere between excited and gleeful” when he first heard about the effort. “This is what the country needs right now,” he said of attempts to better integrate public health and health care — a sentiment echoed by CDC Director Rochelle Walensky, also in attendance.
| | | | A message from PhRMA:   | | | | | | THE $$ QUESTION: HOW MUCH WILL OTC NARCAN COST? On Wednesday, the FDA said that Narcan, an inhaled version of the opioid overdose antidote naloxone, was clear for sale without a prescription, Katherine reports. Emergent BioSolutions, the company that makes Narcan, said it anticipates its over-the-counter version of Narcan would be available at gas stations and on grocery, convenience and other store shelves sometime this summer. But it’s not clear how much a two-pack of the drug will cost: Matt Hartwig, an Emergent spokesperson, told Katherine that the company wasn’t discussing pricing at this time but it was in talks with retail partners. Currently, a two-pack of Narcan costs about $70, though that may vary with individual store markup and insurance reimbursement. As the drug shifts to OTC status, it’s unclear whether insurers will cover the drug for patients. Bruce Alexander, the director of the office of communications for the Centers for Medicare and Medicaid Services, said the agency encourages payers to promote affordable access to naloxone. But Medicare, for example, doesn’t cover OTC drugs through its Part D program unless they’re part of a therapy protocol or drug-use management. State Medicaid coverage varies. “How many products do you see that cost $50 on the shelf of a corner bodega or gas station?” said Nabarun Dasgupta, the innovation fellow for the school of public health at UNC chapel hill and the board chair of the Remedy Alliance, a nonprofit that distributes free versions of naloxone. “When you do see those products, they’re usually locked behind glass. This is kind of the equivalent of top-shelf liquor.” The government could take actions to ensure that some people at the most risk of overdosing — those who use inhaled or intravenous drugs — like buying in bulk and distributing the drug to certain groups for free, said Lorraine Marchand, a pharmaceutical consultant and professor at the Katz School of Science and Health at Yeshiva University in New York.
| | | | JOIN POLITICO ON 4/5 FOR THE 2023 RECAST POWER LIST: America’s demographics and power dynamics are changing — and POLITICO is recasting how it covers the intersection of race, identity, politics and policy. Join us for a conversation on the themes of the 2023 Recast Power List that will examine America’s decision-making tables, who gets to sit at them, and the challenges that still need to be addressed. REGISTER HERE. | | | | | | | | VOTE MORE, LIVE LONGER — Counties with better access to civic infrastructure like parks, schools and libraries and higher civic participation are, on average, healthier than those with less access, according to a new report from the University of Wisconsin Population Health Institute. Their 2023 County Health Rankings & Roadmaps report found that counties ranking in the top 10 percent for health outcomes, measured by the length and quality of life, have better-than-average schools, broadband internet, libraries, local newspapers, parks and recreational facilities. The healthiest 10 percent of counties also have significantly higher rates of voter turnout and census participation than the least healthy counties. Behind the numbers: The report examined how counties with structural barriers to good civic life — including gerrymandering, laws that make it harder to vote and low investment in civic infrastructure — impacts countries’ health. It found that life expectancy in states with the most structural barriers was 75.4 — more than three years shorter than in counties with fewer barriers. Counties in the West, Midwest and Northeast in the U.S. are generally faring better, while counties along the U.S.-Mexico border, the Black Belt Region, American Indian and Alaska Native Tribal areas and Appalachia — which have long histories of discrimination and underinvestment resulting in underresourced civic infrastructure — have worse health outcomes.
| | | | A message from PhRMA: Insurers and their PBMs don’t want you to see that you could be paying more than they are for your medicines. Rebates and discounts can significantly lower what insurers and PBMs pay for medicines. These savings can reduce the cost of some brand medicines by 50% or more. But insurers and PBMs aren’t required to share those savings with you at the pharmacy counter.
They don’t want you to see that they use deductibles, coinsurance and other tactics to shift more costs on to you. Or that the three largest PBMs control 80% of the prescription drug market. Or that last year they blocked access to more than 1,150 medicines, including medicines that could have lowered costs for you at the pharmacy.
PBMs and insurance practices are shrouded in secrecy, they need to be held accountable. | | | | | | DOCTORS: MISINFORMATION … THERE’S A LOT OF IT — More than 70 percent of doctors in the U.S. say misinformation makes it harder to treat patients with Covid-19 and has negatively impacted patients’ health, according to a new poll from Morning Consult and the de Beaumont Foundation. In the national online poll conducted in December, doctors also reported that 44 percent of the Covid-19-related information their patients repeat to them is inaccurate. And they’re seeing the same problem when it comes to treatment for weight loss, mental health and other vaccinations. More than 90 percent of doctors said the Covid vaccine was safe and effective compared with 65 percent of the public surveyed in the same poll. Doctors also had greater confidence in the pandemic’s toll: While 92 percent agreed that Covid had killed more than 1 million Americans, only 67 percent of the public agreed.
| | | The New York Times reports on the anti-trans law in Kentucky that overrode the governor’s veto. Kaiser Health News checks in on the hospital price-transparency rule.
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