| | | | |  | | By Ben Leonard and Chelsea Cirruzzo | | | | | 
Communities are having a hard time getting states to invest in their interventions to reduce fatal overdoses. | Andrew Burton/Getty Images | LESSONS FROM FAILURE — A failed $350 million federal effort to meaningfully reduce fatal drug overdoses could still hold answers on how to beat back the opioid crisis. Last week, the National Institutes of Health released topline results of a study in Kentucky, Massachusetts, New York and Ohio that aimed to reduce opioid overdose deaths by 40 percent. Overall, the 67 counties that participated couldn’t significantly reduce deaths between July 2021 and June 2022. Analysts cited the pandemic and a rise in illicit fentanyl use as headwinds. And yet, in some counties, like Ohio’s Toledo-Lucas County, a data-focused approach showed promise, POLITICO’s Ruth Reader reports. The details: The study brought together local coalitions of health department workers, treatment providers, clergy and law enforcement and equipped them with data on where overdoses and deaths were occurring so they could target resources to where they were most needed. Strategies included offering videos on using naloxone, the opioid overdose reversal drug, and a mobile van for educational outreach and naloxone distribution. And the communities had access to a staff who coordinated and analyzed data, designed interventions and helped with marketing. The data provided a clearer view of Lucas County’s drug problem, showing which ZIP codes and demographics were seeing the most overdose deaths. And it allowed the coalition to bring deaths down 20 percent. The path forward: When the study ended, the federal money that came with it ran dry. Now, communities are having a hard time getting states to invest in their chosen interventions and keep the momentum going. “That is the reality,” said Nora Volkow, director of the National Institute on Drug Abuse, the NIH unit that oversaw the study, in an interview. “You have these political decision processes that determine the access to treatment.” Researchers involved in the study believe the approach could be a template for the country — if they can convince state and federal lawmakers to continue funding their efforts and pass laws eliminating the red tape they encountered. WELCOME TO WEDNESDAY PULSE. Here’s our guide to this summer's House GOP spending fights. Reach us and send us your tips, news and scoops at bleonard@politico.com or ccirruzzo@politico.com. Follow along @_BenLeonard_ and @ChelseaCirruzzo.
| | | | THE GOLD STANDARD OF HEALTHCARE POLICY REPORTING & INTELLIGENCE: POLITICO has more than 500 journalists delivering unrivaled reporting and illuminating the policy and regulatory landscape for those who need to know what’s next. Throughout the election and the legislative and regulatory pushes that will follow, POLITICO Pro is indispensable to those who need to make informed decisions fast. The Pro platform dives deeper into critical and quickly evolving sectors and industries, like healthcare, equipping policymakers and those who shape legislation and regulation with essential news and intelligence from the world’s best politics and policy journalists.
Our newsroom is deeper, more experienced and better sourced than any other. Our healthcare reporting team—including Alice Miranda Ollstein, Megan Messerly and Robert King—is embedded with the market-moving legislative committees and agencies in Washington and across states, delivering unparalleled coverage of health policy and the healthcare industry. We bring subscribers inside the conversations that determine policy outcomes and the future of industries, providing insight that cannot be found anywhere else. Get the premier news and policy intelligence service, SUBSCRIBE TO POLITICO PRO TODAY. | | | | | | | | | FIRST IN PULSE: DEMS’ WINDOW ON HEALTH CARE — Democrats hold a sizeable edge over Republicans when it comes to voters supporting their health care cost policies, according to new polling from Hart Research on behalf of Democratic-aligned health care group Protect Our Care. The poll of 1,204 registered voters, roughly evenly split among parties and intended to be representative of the national electorate, found that Democrats’ messaging touting insulin cost caps and other pricing policies is significantly more compelling than that of Republicans’ on rising premiums for prescription coverage, with 72 percent of voters saying the Democrats’ messaging is more convincing. The margin of error is plus or minus 3 percentage points. The polling also showed strong support for extending enhanced premium tax credits for Obamacare marketplace plans, with 82 percent saying the federal government should continue providing them. The polling also found that President Joe Biden has a substantial advantage over former President Donald Trump on the future of the Affordable Care Act. There was some crossover appeal: 21 percent of those who said they'd vote for a generic GOP congressional candidate backed Biden on the ACA. The potential snag for Democrats: Making those issues more salient to voters will be key for Democrats if they want to hold the White House and the Senate and flip the House. Democrats hold significant advantages on health care when voters are asked directly about the issues, but most voters still aren’t aware of many of Biden’s accomplishments on drug pricing despite some growth in knowledge. Leslie Dach, the group’s chair, told Pulse that the answer is to simply talk about the issues more. “There are receptive audiences for this everywhere,” Dach said. “It’s also so powerful in a way that sometimes people inside the Beltway who are insured don't fully understand — how emotional it is to be sick and not be able to see the doctor or afford the drugs you need.”
| | BROAD SUPPORT FOR HEALTH AI RULES — A large majority of Americans across the political spectrum want federal and state lawmakers to take action to regulate artificial intelligence in health care, according to a new Morning Consult poll. About three-quarters of Democrats, Republicans and independents supported AI transparency mandates, according to the national poll of 2,517 U.S. adults on behalf of the left-leaning health care group United States of Care. Support for mitigating risks of exacerbating inequities in health care was similarly high among Democrats at 77 percent but lower among Republicans and independents at 62 and 65 percent, respectively.
|  | The state of play: HHS has enacted transparency requirements for some AI in the sector, but Congress appears far from any sort of new regulations. Proposals have focused on boosting innovation and mitigating risk — both popular themes, according to the polling. But in recent weeks, the path forward on AI regulation has become murkier. In a meeting with Republican members of the bipartisan House AI task force, there was substantial concern among committee chairs and GOP members on the panel about taking action “right now,” according to a person familiar with the meeting. House Republicans also won’t back legislation establishing new agencies or adding burden for technology developers, the person said. With little action in Capitol Hill, lawmakers in some states, including California and Colorado, have begun to take action. CONGRESS TO CMS: MORE GUIDANCE ON AI IN MA — A heavily Democratic group of more than 50 members of Congress on Tuesday called on the Centers for Medicare and Medicaid Services to do significantly more to rein in Medicare Advantage insurers’ use of artificial intelligence in care decisions. The group, led by Rep. Judy Chu (D-Calif.), asked CMS Administrator Chiquita Brooks-LaSure for her agency to instate an approval process for AI tools and to limit their use until they can receive a “systematic evaluation.” They also said an agency notice earlier this year on AI didn’t go far enough. The bigger picture: As Medicare’s private sector alternative now has more than half of Medicare enrollees, Congress’ concerns about care denials through prior authorization have grown, and Tuesday’s push is just the latest in bipartisan scrutiny. CMS said it has received the letter and will respond to the members of Congress. The agency has a track record of responding to liberal concerns, including on MA prior authorization and advertising. The group was almost entirely Democrats, including Sen. Elizabeth Warren (D-Mass.) and Rep. Rosa DeLauro (D-Conn.), but Sen. Mike Braun (R-Ind.) also signed on. James Swann, a spokesperson for insurer lobbying group AHIP, said that prior authorization can help ensure affordable coverage and that insurers welcome the chance to work with providers and policymakers to “simplify and accelerate” the process. Medicare Advantage plans approved 95 percent of prior authorization requests in 2021, according to the nonpartisan Medicare Payment Advisory Commission.
| | TAKING STOCK OF ‘PAY-FORS’ — Lawmakers have a growing number of options to pay for health care legislation in a postelection package, including a likely telehealth extension. The House Energy and Commerce Committee is set to mark up telehealth legislation Thursday, the panel announced late Tuesday. E&C Chair Cathy McMorris Rodgers (R-Wash.) has previously said the legislation would be “fully paid for.” Exactly how much an extension of eased Medicare telehealth rules will cost is unclear, but the CBO scored a two-year extension at the end of 2022 to cost about $2.4 billion. A number of other health care priorities would likely need offsets in a “lame-duck” package. Here are some ways lawmakers could choose to offset health care spending: Several bills aimed at improving competition in the pharmaceutical marketplace could save $5 billion, the CBO recently said. Those involve patent reforms and more generic competition. Site-neutral payments, which have drawn significant opposition from hospitals and are included in the House-passed Lower Costs, More Transparency Act, have often been floated as a pay-for that the CBO estimates would save billions. Those provisions would change Medicare policy so that drugs administered in a hospital outpatient department are reimbursed at the same rate as a doctor’s office. A ban on so-called “spread-pricing” in Medicaid — a practice in which PBMs reimburse a pharmacy less for a drug than what they charged the insurance provider — could also be an offset. The CBO said the ban included in the Lower Costs, More Transparency Act would save more than $1 billion over a decade. The E&C Committee earlier this month advanced an amendment to a different bill that added a spread-pricing ban.
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