Robert F. Kennedy Jr.'s focus on chronic disease conflicts with some GOP efforts to refocus the CDC on infectious disease. | Anna Moneymaker/Getty Images
CLASHING APPROACHES TO CHRONIC DISEASE — Robert F. Kennedy Jr. — President-elect Donald Trump’s pick to lead HHS — wants to refocus health agencies on chronic disease. But House Republicans and conservative think tanks have repeatedly suggested refocusing the CDC on infectious disease — setting up an apparent conflict between the two camps, Sophie reports.
The potential rift underscores the ways Trump’s health nominees, and their priorities, are shaking up Congress’ policy and budget fault lines.
“President Trump and Bobby Kennedy have made clear that we have to have best-in-class infectious disease preparedness, but we should be shifting our health care agencies to focus as much as possible on the chronic disease epidemic,” said Calley Means, a close Kennedy ally and health care entrepreneur.
When announcing Dr. Dave Weldon as his pick to lead the CDC, Trump expressed similar goals: “Given the current Chronic Health Crisis in our Country, the CDC must step up and correct past errors to focus on the Prevention of Disease,” Trump wrote in a statement. “Dave will proudly restore the CDC to its true purpose, and will work to end the Chronic Disease Epidemic, and Make America Healthy Again!”
Neither a Kennedy spokesperson nor Weldon responded to requests for comment.
Key context: The CDC’s chronic disease center sends most of its allotment to state and local communities to fund initiatives that combat chronic disease. Those include programs to discourage smoking and drinking and to encourage healthy eating and exercise.
What’s next: Kennedy, who is expected to have hearings in the weeks to come, could advocate shifting funding from infectious disease work to chronic. He’s proposed a yearslong break in infectious disease research at NIH to focus on chronic conditions — though Means also noted that while “As Kennedy and Trump have said, the emphasis of all of our health apparatuses should be chronic disease,” that “doesn’t necessarily mean more spending.”
“One of the best ways to reverse chronic disease is to cut funding to bureaucrats that are ‘trying to help,’” Means said.
A law firm's FDA attorney and a top Capitol Hill staffer are reportedly being considered for top FDA positions. | Manuel Balce Ceneta/AP
ZETA INVOLVED WITH FDA TRANSITION — Lowell Zeta, an FDA attorney at Hogan Lovells, is helping lead President-elect Donald Trump’s FDA landing team and is in the mix to be chief of staff for FDA commissioner nominee Dr. Marty Makary, two people familiar with the discussions granted anonymity to discuss personnel moves told POLITICO’s David Lim.
A top Capitol Hill staffer, Grace Graham, is being considered for a top FDA job, according to four sources familiar with the situation granted anonymity to discuss the role. She recently was chief health counsel on the House Energy and Commerce Committee for former Rep. Cathy McMorris Rodgers (R-Wash.).
Zeta and Graham did not respond to requests for comment.
In Congress
RECONCILIATION LATEST — Speaker Mike Johnson told House Republicans at a retreat Saturday that President-elect Donald Trump wants one reconciliation package instead of the two Republican leadership has been pushing, three people in the room during the discussions told POLITICO.
Republicans met behind closed doors at Fort McNair in Washington to strategize for their plan to pass a sweeping package skirting the Senate filibuster key to implementing Trump’s agenda.
Trump’s one-bill pitch is a break from Senate Majority Leader John Thune’s push for a two-bill strategy and aligns with House Ways and Means Chair Jason Smith’s (R-Mo.) wishes.
House Energy and Commerce Chair Brett Guthrie (R-Ky.) spoke at the retreat Sunday and outlined potential reconciliation options, including on health care, energy and telecommunications issues like spectrum, a spokesperson for Guthrie told Pulse, declining to be more specific.
“The retreat was an opportunity to continue conversations amongst the Conference on how to achieve our reconciliation goals,” the spokesperson said in a statement. “Chairman Guthrie, along with the Members of Energy and Commerce, look forward to providing solutions during this reconciliation process to achieve the goals of the Republican Majority and President-Elect Trump.”
Some Republicans have eyed the reconciliation package to change Medicaid and reduce spending, which could help pay for other priorities like tax cuts. Guthrie previously told POLITICO he’s always supported per capita allotments for Medicaid, which could lead to lower Medicaid spending by allocating money based on population, not the cost of care.
“It doesn’t cut Medicaid,” Guthrie said. “It allows Medicaid to grow … if you lose population, you lose money, and if you gain population, you gain.”
What’s next: Committee chairs and other House Republicans are set to travel to Mar-a-Lago to meet with Trump at the end of this week.
NEW LIFE FOR PBM REGULATION? With the backing of Senate Finance Committee Chair Mike Crapo (R-Idaho) and President-elect Donald Trump, Congress’ bid to further regulate pharmacy benefit managers has new life this Congress despite falling off a government funding package last month.
Crapo’s legislation that would change business practices for the drug-pricing middlemen in Medicare with then-Finance Chair Ron Wyden (D-Ore.) passed out of the committee 26-0. A spokesperson for Crapo told Pulse that the senator “remains committed” to moving his health care priorities across the finish line.
Days after meeting with pharmaceutical executives last month, Trump said he supports reducing drug prices by cracking down on PBMs.
That’s despite Trump and Department of Government Efficiency leader Elon Musk helping kill a stopgap measure late last month to fund the government that included a sizeable health care package with sweeping new PBM regulations.
WHAT YOU NEED TO KNOW ABOUT THE RULES PACKAGE —After the narrowly divided House reelected Speaker Mike Johnson on Friday, the chamber adopted a rules package that will make it harder for members to oust the speaker.
It will now take nine members to trigger a motion to vacate the speaker instead of just one, which led to former Speaker Kevin McCarthy’s ouster last Congress. That should provide more stability for Johnson, though Friday’s vote underscored frustration with the speaker among GOP hardliners.
It also tees up several bills for consideration in the coming weeks, including one aimed at cracking down on fentanyl and another that would reaffirm the rights of infants born alive after rare botched abortions and would threaten medical providers with up to five years in prison if they fail to provide the same level of care as they would to other newborns.
The package also limits bills considered under suspension of the rules — an expedited process that requires a two-thirds vote to pass — to Mondays, Tuesdays and Wednesdays. House lawmakers have used the maneuver to pass stopgap funding legislation late in the week under time pressure. That could make it more difficult to get bills through at the last minute.
IN THE STATES
PRIVATE EQUITY BILL ON THE PRECIPICE —Massachusetts Gov. Maura Healey is weighing signing legislation that would add new regulations for private equity in health care.
The Democrat has until Thursday to sign or veto the bill, which would require investors to make more financial disclosures and increase penalties for noncompliance with reporting requirements. It would also give the state’s attorney general more power to obtain information from private equity investors.
It comes after hospital system Steward Health Care’s bankruptcy last year. Several hospitals in Massachusetts were caught up in the bankruptcy, and the state intervened to keep them open.
Private equity firm Cerberus Capital Management owned Steward for a decade before selling it to doctors at the system. Cerberus maintains that it saved a failing system and that it was financially healthy in 2020 when it sold it.
If Healey signs the legislation, it would be a significant win for advocates of a crackdown on private equity in health care. Bills aimed at cracking down on private equity have stalled in Congress and several states.
Supporters of more oversight have made the case that private equity firms’ desire for short-term profit could harm patients and consolidation tied to the firms drives up costs.
Private equity supporters argue the firms inject much-needed investment into the sector and have lowered costs.
Names in the News
Sara Karrakchou has joined the Healthcare Leadership Council as director of communications. She was previously at the Healthcare Distribution Alliance.
WHAT WE'RE READING
The Associated Press reports on New York Gov. Kathy Hochul pushing for expanding mental health laws in the wake of subway violence.
Fierce Healthcare reports on Aetna suing drugmakers, saying they overcharged the insurer and the federal government for generics.
