The future of health care in the House

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Another committee could join the drug shortage bandwagon

The Senate Finance Committee is testing the waters for action to address drug shortages, my colleague John Wilkerson and I scooped yesterday afternoon.

The talks are worth watching, as the committee has jurisdiction over Medicare and Medicaid payment policies for hospitals. Other committees that have tried tackling the issue have jurisdiction mostly over the FDA.

They’re tentatively planning a hearing for next month, but steps beyond that remain fuzzy. Here’s what we know, and don’t know.

The future of health care in the House

A lot has happened in the House of Representatives since our Tuesday morning edition, and things are changing fast. But as of right now, two Republicans are officially running for Speaker of the House: Reps. Steve Scalise (La.) and Jim Jordan (Ohio). Neither of them have been particularly active on health care issues recently, but they’ve had some interesting history.

Scalise is a longtime member of the Energy & Commerce Committee, a position on one of the chamber’s top health care committees, though he gave up that slot when he became Majority Leader in 2023. He was also a vocal proponent of the Republican alternative to Democrats’ major drug pricing reforms.

Jordan, meanwhile, went to bat for pharmaceutical executives as ranking member of the House’s oversight committee, back in 2019. The late Rep. Elijah Cummings had requested information from pharmaceutical companies in a drug pricing investigation, but Jordan wrote letters to drugmakers warning them not to comply because Cummings could publicly release the information they submitted.

Both also supported House Republicans’ Trump-era efforts to repeal and replace the Affordable Care Act — Scalise as part of the GOP leadership team, and Jordan as a conservative antagonist pushing to make the bill more extreme. Both also have firm anti-abortion stances — Scalise received an “A” rating from the conservative anti-abortion group Susan B. Anthony List, while Jordan got an “A+.”

The next step forward will be Tuesday when the House GOP conference holds a candidate forum.

How one Senate Republican is thinking about health care

I recently sat down with Sen. Marsha Blackburn (R-Tenn.) to chat about her positions on health care, as she’s a recent addition to the Senate Finance Committee. She’s been increasingly active on health care issues, including sponsoring a bill that will regulate the financial relationship between pharmaceutical companies and pharmacy middlemen.

Here are a few key takeaways from our conversation:

• While her bill on PBM fees was included in a recent Finance committee package of PBM reforms, she’s still pushing to add a bill she’s working on with Sen. Joe Manchin (D-W.Va.) to expand PBMs’ pharmacy networks.
• On potentially capping costs for commercially insured patients who use insulin, Blackburn was noncommittal. “I prefer a free market approach. I want to see what they’re going to come forward with and then how it’s going to affect access in the state,” she said.
• Blackburn said she’s been concerned about some of the site-neutral pay policies floating around the Hill this Congress, but characterized a House proposal on payments for administering medicines “less harmful” than some alternatives.

Moon or bust

The second-stage booster in President Biden’s moonshot to halve cancer deaths doesn’t have a ton of fuel, at least when it comes to funding from Congress. Biden’s updated plan also differs in many ways from the original that kicked off in late 2016, as my colleague John Wilkerson reports this morning.

If lawmakers want to renew funding for the program, there are some questions they might want to answer first, according to nonpartisan congressional researchers.

Among them is whether the new program should focus on researching new drugs or expand out to other areas that include cancer screening, prevention, and equitable treatment. There’s also the question of where to house the moonshot program. Historically, the program has been run by the National Institutes of Health, but the Biden administration is placing a lot of emphasis on the new Advance Research Projects Agency for Health. Read more from John.

What we’re reading

• How a big pharma company stalled a potentially lifesaving vaccine in pursuit of bigger profits, ProPublica
• Gene therapy makers wonder if they can make a profit in Europe. Patients fear being left behind — again, STAT
• Inside the Menendez indictment: a Mercedes and a secretive fatal crash, New York Times
• FDA cites Fresenius Kabi for contamination problems that CDC linked to deadly sepsis cases, STAT