News: Where Harris could diverge from Biden

Monday, September 9, 2024

Where Harris could diverge from Biden

Sep 09, 2024

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With David Lim

Driving The Day

President Biden and Vice President Harris finish speaking about their administration's efforts to lower prescription drug costs during an event in Maryland on Thursday.

Potential differences between Vice President Kamala Harris' and President Joe Biden's health policies could surface in Tuesday's debate. | Stephanie Scarbrough/AP

WHAT HE REALLY MEANT — President Joe Biden stumbled over several health care-related attack lines in his disastrous June debate that ultimately led to his exiting the race.

His replacement, Vice President Kamala Harris, might use some of those rebukes in Tuesday’s debate with former President Donald Trump. Here’s what Biden said during the June debate, how Harris might approach those issues and where she might diverge from him:

Drug pricing: Biden touted his signing of the Inflation Reduction Act, which allowed Medicare to negotiate drug prices for the first time, though he muffed the delivery, saying he “finally beat Medicare” in an infamous line. He likely meant he finally beat the pharmaceutical industry.

Harris has also pushed the administration’s work on drug pricing but didn’t mention Medicare drug price negotiations when she accepted the nomination at the Democratic National Convention last month. She might reference the legislation and her push to accelerate negotiations in the Tuesday's debate, but she’s had a more forward-looking message than Biden.

Expect her to accuse Trump of trying to gut Medicare, as she did at the DNC multiple times.

Insulin: The IRA set an annual cap on out-of-pocket prescription drug costs and monthly insulin costs in Medicare, but Biden didn’t correctly describe the details in the debate.

Don’t expect Harris to make either a major debate priority, but it could be an attack line. As he did during the June debate, Trump may try to take credit for reducing insulin costs to $35 a month, but his administration’s program was voluntary and significantly less broad than the IRA’s program.

Abortion: Biden said the word “abortion” only twice and bungled a canned line about trimesters of pregnancy and Roe v. Wade. A devout Catholic, Biden has been hesitant to lean into abortion rights.

Don’t expect Harris to mince words. Harris made abortion and reproductive rights a major part of her message at the DNC and went on offense, claiming Trump would restrict access to birth control, ban medication abortion and enact a nationwide abortion ban — even without Congress. Trump has denied he would do those.

She tied him to the Heritage Foundation’s controversial Project 2025 blueprint from which Trump has distanced himself.

“They are out of their minds,” Harris said of Republicans.

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Mental Health

Psychiatrist with middle age woman

The White House is putting the final touches on expanded mental health parity rules. | Shutterstock

REFORMS FOR MENTAL HEALTH — The Biden administration is finalizing a sweeping expansion of regulations that require insurers to cover mental health and addiction care on the same terms as other care.

Administration officials, who said insurers have flouted a 2008 law requiring so-called mental health parity, are expanding the rules, with potential fines for violators.

The move will likely impact millions of Americans and comes as the nation faces a worsening mental health crisis. It also gives Harris a new administration measure to tout on the campaign trail a day before the debate.

The details: While the full regulations haven’t been released, senior administration officials said they are largely in line with what the White House proposed last year.

Officials said the rules reinforce that insurers can’t use tools like prior authorization and standards to determine out-of-network payment rates for mental health that are more restrictive than other types of care. They said the regulations would also mandate that insurers address material differences in access to care for mental health and substance use disorder care.

Neera Tanden, head of President Joe Biden’s domestic policy council, previously told POLITICO that while the administration hopes for a collaborative approach to enforcement “without the sticks,” it will “fully enforce the parity law.”

The response: The rules will likely get significant backlash from insurers, who’ve argued that they’re being unfairly targeted and workforce shortages are the main reason for barriers to care.

They could also be vulnerable to legal challenges because the Supreme Court overturned the so-called Chevron doctrine this year, giving more deference to agency interpretation of laws. Senior administration officials said they’re confident they have written regulations consistent with applicable law.

In Congress

WHAT’S ON TAP — Congress returns this week from its August recess to grapple with several health care issues — with just three scheduled weeks in Washington left before the elections.

Getting significant health care legislation across the finish line isn’t expected until after the elections, but we’re tracking progress on several issues.

Here are some key areas we’re watching:

Government funding: Lawmakers have until the end of the month to avoid a shutdown. A stopgap measure to keep funding at current levels is likely. House Republicans proposed a measure on Friday to fund the government through March 28, setting up a showdown with Senate Democrats.

ACA subsidies: Senate Democrats, looking to box in Republicans, plan to hold a vote on legislation that would permanently extend enhanced subsidies expiring after 2025 for Affordable Care Act coverage, POLITICO’s Robert King reports. The legislation is unlikely to survive a filibuster, but Democrats hope it paints the GOP as an opponent of middle-class subsidies.

VA: House Republicans unveiled a $3 billion veterans’ funding patch that’s expected to pass as a standalone bill. The VA has warned lawmakers it will need several billion dollars soon to pay out benefits by Oct. 1. More VA cash could be attached to a stopgap bill.

Telehealth: Legislation to extend eased pandemic-era telehealth rules in Medicare could be marked up by the full House Energy and Commerce Committee and maybe even get a floor vote in the coming weeks.

Older Americans Act: The Senate Health, Education, Labor and Pensions Committee advanced its version of legislation to reauthorize the Older Americans Act before its expiration at the end of the month. The legislation pays for meals and medical services such as health screenings and transportation to doctors’ offices. It’s unclear whether the House Committee on Education and the Workforce will mark up reauthorization legislation, which it hasn’t released.

Insulin: Senate Majority Leader Chuck Schumer said in a letter to Senate colleagues Sunday that there are "opportunities" for bipartisan work on insulin costs but didn't get into specifics. There are multiple proposals to do so. Schumer has pledged to hold a vote but hasn’t yet.

CHINA WEEK — The House is expected to vote today on the BIOSECURE Act, which would effectively bar Chinese biotech companies from doing business in the U.S. over fears that China could use genomic data for nefarious purposes.

The companies impacted, including Complete Genomics, say lawmakers have bought into misinformation about their work and shouldn’t be included.

Rob Tarbox, vice president of product and marketing at Complete Genomics, told Pulse the company’s data is “always local,” and there aren’t ways for it to be compromised.

“There’s no denying the ownership of CG is Chinese,” he said. “But then again, we buy a lot of things from China … fundamentally, we don’t … belong in the bill.”

The legislation is expected to pass in bipartisan fashion, but there could be some opposition. Rules Committee ranking member Rep. Jim McGovern (D-Mass.) said in a letter obtained by Pulse that he plans to circulate to colleagues that, while he supports shielding Americans’ personal data from foreign adversaries, the bill doesn’t have sufficient due process for the companies.

“Congress does not just pick companies to punish at random,” said McGovern, who was sanctioned by China in July.

WuXi AppTec, a company named in the bill, announced plans in January to build a major manufacturing facility in Worcester — in McGovern’s district — but that was put on pause.

A spokesperson for McGovern said he's been speaking out against China's human rights abuses "for a long time — long before this facility or company existed. … Our team had a problem with this legislation from the start because it's a bad bill."

Also this week: The chamber is expected to vote on legislation that would require the Department of Homeland Security to research and craft technology to help law enforcement tackle the illicit trafficking of drugs, including fentanyl.

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Public Health

ANOTHER HUMAN BIRD FLU CASE — An individual hospitalized in Missouri last month tested positive for avian influenza, the Missouri Department of Health and Senior Services announced Friday, David reports. The person subsequently recovered.

The CDC confirmed the infection, detected through the state’s influenza surveillance program. Additional analysis of the virus is “underway at CDC,” according to the state health department.

Notably, the individual wasn’t exposed to animals, but the state health department said the risk of “sustained transmission or infection among the general public remains low.”

“DHSS continues to closely monitor available data from influenza surveillance systems, and there has been no sign of unusual influenza activity in people, including no increase in emergency room visits for influenza and no increase in laboratory detection of human influenza cases in Missouri,” the state health department said in a press release.

Names in the News

Dr. Dora Hughes is now chief medical officer at CMS. She was previously in the same role at the CMS Innovation Center.

Corinna Cline has joined the Peterson Health Technology Institute as an associate. She was previously a research assistant at the Medicare Payment Advisory Commission.

Ryann Hill has launched Indigo Hill Strategies, a government affairs and policy firm specializing in healthcare, aging and disability policy. Hill was most recently vice president of federal affairs for the Federation of American Hospitals.

WHAT WE'RE READING

The Wall Street Journal reports on why a mammogram isn’t always sufficient to rule out cancer.

NBC Montana reports on Planned Parenthood confirming it was hit by a cybersecurity attack.

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