Health Policy Snapshot: October 2023

Greg Chesmore
October 05, 2023

Congress moves to avoid government shutdown, sparks revolt in GOP House 

For the first time in history, a sitting Speaker of the U.S. House of Representatives has been removed.  Eight Republican House members joined all Democrats in voting to unseat former Speaker Kevin McCarthy (R-CA). McCarthy had drawn the ire of a handful of Republican members for the concessions he made in order to keep the government open by passing a temporary spending bill funding the government until November 17. Given the slim House majority for Republicans, McCarthy needed virtually all GOP members to vote to keep him as speaker. Many conservative GOP House members wanted more aggressive fiscal restraints in spending packages, arguing that the constant threat of government shutdowns and short-term spending bills were signs of incompetent leadership.  The McCarthy challenge (and defeat) caused extreme anger in the GOP caucus, with many calling for Rep. Matt Gaetz (R-FL), who initiated the formal move to remove McCarthy, to be expelled from the caucus. As House Republicans prepare for what could be a very nasty election for Speaker, Rep. Patrick McHenry (R-NC) has been named interim speaker. Front runners for an eventual permanent replacement include current House Majority Leader Rep. Steve Scalise (R-LA), House Judiciary Chairman Rep. Jim Jordan (R-OH) and Republican Study Committee leader Rep. Kevin Hern (R-OK). Scalise seems to be the favorite at this point, although press reports have said some have indicated concern about his recent multiple myeloma diagnosis. In the meantime, the House is in recess as Republicans plan to meet next week to discuss options for the next speaker. Since it’s almost certain the Democrats will unanimously oppose any Republican nominee, the GOP caucus will have to find a consensus candidate. Interested in learning more about the 8 renegade Republicans? The Hill ran an interesting feature piece you can find here.

Pharma companies agree to participate in HHS price negotiations after request for injunction is denied

While President Joe Biden hailed the fact that all pharmaceutical companies that have medications on the first Medicare Part D Top 10 list for negotiations filed their intent to participate in the landmark price negotiation/price setting process, pharmaceutical companies said they had no choice. The Inflation Reduction Act (IRA) required manufacturers to file official notice of their intent to participate by October 1.  “While we disagree on both legal and policy grounds with the IRA’s new program, withdrawing all of the company’s products from Medicare and Medicaid would have devastating consequences for the millions of Americans who rely on our innovative medicines, and it is not tenable for any manufacturer to abandon nearly half of the U.S. prescription drug market,” a Merck spokesperson told National Public Radio. Some in the industry held out hope that a request for a temporary injunction filed by the Chamber of Commerce in its lawsuit challenging the IRA would be granted before October 1.  On September 29, an Ohio federal judge declined to halt the negotiations. Multiple lawsuits are ongoing in various venues. Without a court decision in favor of the pharmaceutical industry, the government plans to reveal its proposed price for the 10 drugs in early February, allowing companies 30 days to either to accept the price or make a counteroffer. HHS plans to announce its final price decisions in fall of 2024, with prices being effective starting in 2026.

Who is Laphonza Butler? Meet the new Senator from California

With the death of long-serving U.S. Senator Dianne Feinstein last week at the age of 90, the California political landscape shifted.  Feinstein, who served as mayor of San Francisco before being elected to the U.S. Senate in 1992, had long been viewed as a liberal champion on Capitol Hill, while also exhibiting a willingness to compromise with her Republican colleagues.  Governor Gavin Newsom (D) had vowed to appoint a black woman to fill any vacant California U.S. Senate seat. Immediately following Feinstein’s death, he announced his appointment of Laphonza Butler as U.S. Senator.  A native of Mississippi, Butler has a long history in Democratic political circles, serving as a state and national leader of the Service Employees International (SEIU) and the abortion rights political fundraising group Emily’s List. She has not held previous public office. Butler is the third black woman to serve in the U.S. Senate and the first openly gay person to represent California in the U.S. Senate. Analysts expect Butler to lean further left on the philosophical spectrum than her predecessor, with a heavy emphasis on labor issues and the ongoing debate over abortion rights.  Butler has not indicated whether she plans to formally run for election in 2024, but her appointment further complicates the Democratic primary.  Current U.S. House members Katie Porter, Adam Schiff and Barbara Lee have all launched Senate campaigns. Butler’s ultimate decision on whether she will seek election to the seat will further add intrigue to an already extremely competitive (and expensive) U.S. Senate primary in the Golden State.

Farewell to the COVID vaccine card

The coveted COVID vaccination card is going away.  The Centers for Disease Control and Prevention (CDC) announced this week that it will stop printing the cards.  More than 980 million cards were printed and disseminated across the country since 2020, with many establishments requiring customers to show the card in order to enter or be served during the height of the COVID-19 pandemic. The small white wallet card, which included handwritten documentation regarding which vaccine you received and when, will undoubtedly find its home in U.S. public health museum displays for generations to come. Now, let’s see if we can remember where we stored that frayed and folded paper card for the past three years!