| | | | |  | | By Chelsea Cirruzzo and Ben Leonard | With help from Alice Miranda Ollstein
| | |  Georgia House Speaker Jon Burns has said that he’s “encouraged” that Republican lawmakers are “looking at the facts that surround expansion.” | Jeff Amy/AP | THE SOUTH WARMS TO OBAMACARE — Conservative lawmakers in much of the South have for years had a knee-jerk reaction to expanding public health benefits to more low-income people. That’s starting to change, POLITICO’s Megan Messerly reports. House speakers in three Republican-controlled states — Alabama, Georgia and Mississippi — have said in recent weeks that they need to consider covering more people through their state health insurance programs. Their shifting attitudes could reshape health care in the South by allowing nearly half a million uninsured people to obtain coverage. “Our legislators and other officials are looking for ways to improve our health care system in Mississippi,” said Austin Barbour, a Republican strategist and nephew of former Mississippi Gov. Haley Barbour. Legislative leaders in Alabama have met with Gov. Kay Ivey’s staff multiple times since December to discuss such a proposal, according to an advocate briefed on the conversations. Among the factors Republican strategists, advocates and lawmakers in those states say are contributing to lawmakers’ shifts: — A historic realignment that’s seen more working-class voters gravitate to the GOP, largely driven by an affinity for former President Donald Trump’s populist rhetoric — Fading antipathy toward Obamacare as a new guard of Republicans assumes leadership — Rural hospitals in conservative areas closing their doors — Acknowledgement that expanding coverage would mostly benefit people already working The states could also put their own spin on boosting health coverage instead of taking the deal offered under the Affordable Care Act. Legislative leaders in Alabama and Georgia have expressed interest in some sort of public-private partnership, like in Arkansas, which uses Medicaid dollars to purchase private health plans. But: Outside those three states, prospects are less promising despite some support among rank-and-file Republican lawmakers in Kansas, South Carolina and Wyoming. Democratic Kansas Gov. Laura Kelly tried to persuade conservative legislative leadership to support her latest Medicaid expansion plan by including a work requirement, but opponents continue to balk. House Speaker Dan Hawkins, a Republican, said in an interview that “Medicaid should be reserved for only those truly that need it, the children, the elderly, the disabled.” Kelly’s office last week highlighted the expansion momentum in Alabama, Georgia and Mississippi — and warned that her state could soon be one of only seven that hasn’t adopted the policy. WELCOME TO WEDNESDAY PULSE. Are pig organs the future of organ donation? Maybe, but we still have a ways to go. Send your tips, scoops and feedback to ccirruzzo@politico.com and bleonard@politico.com and follow along @ChelseaCirruzzo and @_BenLeonard_.
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Today is Dr. Janet Woodcock’s last day as the FDA’s principal deputy commissioner. | Chip Somodevilla/Getty Images | WOODCOCK’S LAST DAY — The FDA’s No. 2 leader leaves the agency today after nearly four decades there, POLITICO’s Lauren Gardner and David Lim report. Dr. Janet Woodcock, the FDA’s principal deputy commissioner, will be remembered as an accomplished regulator who advanced the FDA’s mission despite controversy, per lawmakers, officials, congressional staff and advocates who spoke with POLITICO. Her accomplishments at the FDA include modernizing the agency’s drug-review and safety-monitoring process and shepherding the agency through the Covid-19 pandemic and infant formula crisis. She’s known for her hands-on approach, transforming how the agency worked with lawmakers. Her fingerprints are particularly visible on the 21st Century Cures Act, a landmark 2016 law that overhauled how the FDA regulates medical products. But she also acknowledges her critics, telling POLITICO that the agency “maybe … could have done more” to address the opioid crisis. She also faced criticism for her role in greenlighting controversial treatments, including one for Alzheimer’s disease, and overruling her scientific staff on approving Sarepta’s contentious drug to treat Duchenne muscular dystrophy, which the FDA’s dispute review board later said could “chill” scientific debate within its drug center. Public health advocates also question whether the FDA became too reliant on financial support from the industries it regulates during her tenure. Woodcock pushed back on the criticisms, noting that Congress could directly fund the agency. About 50 percent of the FDA’s annual budget comes from Congress; the rest comes from user fees. What’s next? Woodcock has plans for “another project” unrelated to drug regulation — one that an FDA spokesperson would describe only as related to “helping patients.” “I’m 75,” Woodcock said. “I’ve wanted to retire for quite a number of years.” SICKLE CELL MODEL ANNOUNCED — As the Biden administration touts its push to lower drug prices, it has its eyes on a new target: sickle cell disease, a rare inherited blood disorder that primarily affects Black people — and which can cost millions to treat. CMS said on Tuesday that it wants to enter into voluntary agreements with drugmakers to pay for sickle cell treatments based on the outcomes the drugs deliver, POLITICO’s Robert King reports. How it works: Starting in 2025, the Center for Medicare and Medicaid Innovation would negotiate with drug companies on behalf of participating states to offer new Medicaid rebates for a recently approved and pricey sickle cell gene-therapy treatment. A state could then choose whether to accept this agreement, but it must remove any barriers to patient access to the product. Sickle cell treatments can run in the millions for some patients. The FDA approved the first gene-editing therapy for sickle cell last year. About 100,000 Americans suffer from the disease, in which a defective gene alters blood cells and causes extreme pain. More models coming: This model was first teased by CMMI in February 2023 and could be later applied to other cell and gene therapies.
| | NEW PAC TAKES AIM AT TEXAS JUSTICES — Former Under Secretary of the Air Force and two-time House candidate Gina Ortiz Jones is launching a PAC aimed at ousting three of the nine justices on the Texas Supreme Court who ruled last year that Kate Cox couldn’t terminate a nonviable pregnancy that threatened her health and future fertility, Alice reports. Ortiz Jones’ PAC — named Find Out — intends to promote videos and digital ads targeting Justices Jimmy Blacklock, John Devine and Jane Bland, who are all up for reelection in November. The PAC plans to shine a light on their backgrounds and records on the bench by highlighting, for example, that Blacklock attended anti-abortion rallies before he was elected and Devine was arrested dozens of times for protesting outside abortion clinics. “Like many Texans, I found the ruling infuriating,” she told POLITICO. “Who are these partisan judges to think they know better than this woman’s doctors?” The Cox case has been a lightning rod amid a broader electoral backlash to the fall of Roe v. Wade, and Democrats, including President Joe Biden, have seized on it as an example of what could happen nationwide if Donald Trump were elected president. And while abortion-rights advocates in other states have channeled a wave of popular outrage into ballot initiatives to restore or protect access to the procedure, that isn’t an option under Texas law. “We may not be able to do a ballot measure, but we’re not hopeless or helpless,” said Ortiz Jones. “Abortion is still absolutely on the ballot in Texas.”
| | HELIUM RESERVE SALE PROCEEDING — Two gas companies have bid millions of dollars to purchase the Texas-based Federal Helium Reserve despite worries from some in the health care industry that the sale will slow down production of the chemical. A General Services Administration spokesperson told Pulse that Messer, a supplier of industrial gasses, has bid $21 million for one part of the reserve and $353.35 million for a second. Lazarus Energy Holdings has bid $30.1 million for one part, as well.
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| The federal government has more than four months to review the bids, and the awarded buyer has another few months to close the sale. But, as POLITICO reported last week, some in the health care industry worry that the sale could derail the supply chain, harming patients and raising costs. A spokesperson for the Department of the Interior had told Pulse that privatizing the helium supply — used in ventilators and to cool MRI magnets — won’t “meaningfully change” availability.
| | | | Kathy Paro has been named vice president of strategic execution and partnerships at the Blue Cross Blue Shield Association. She was senior vice president at Guidewell Connect.
| | POLITICO’s Alice Miranda Ollstein reports on a sharp rise in syphilis cases. NBC reports on the Democrats urging the Biden administration to deschedule cannabis.
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