Mandy Cohen heads to the Hill

Nov 30, 2023

Presented by

Driving The Day

Mandy Cohen

Dr. Mandy Cohen testifies before Congress today for the first time as the CDC director. | Ethan Hyman/The News & Observer via AP

CDC IN SPOTLIGHT — The head of the Centers for Disease Control and Prevention will answer questions about rebuilding public trust in the agency today during her first congressional appearance in her new role, Chelsea reports.

Dr. Mandy Cohen, who took the helm of the agency this summer, will go before the House Energy and Commerce Oversight Subcommittee today. She will face skeptical House Republicans, many of whom critically view the CDC — including questioning Cohen’s predecessor, Dr. Rochelle Walensky, about the agency’s handling of Covid-19.

What’s different this time is that Cohen has spent the first few months of her tenure meeting with lawmakers on the Hill, including Republicans and has traveled the country to show her commitment to restoring confidence in the agency. “I’m trying to turn a new chapter,” she told POLITICO in October.

Here are three areas Cohen will likely be asked about:

— Agency reform and rebuilding trust: A federal government spokesperson told Pulse that Cohen will talk about the new Bridge Access Program that provides free Covid vaccines to uninsured Americans and recent updates to the agency’s website to be more consumer-friendly.

In its hearing memo, the majority committee’s staff expressed doubt that the reforms are working.

“Whether these reforms, which have largely been carried out in secret and without input from Congress, the American people, or even external stakeholders, will be successful remains to be seen,” the memo reads.

— Respiratory illnesses: Committee leaders want to know how the agency is handling this year’s respiratory illness season with the circulation of flu, respiratory syncytial virus and Covid — a confluence dubbed a tripledemic last year. Cohen has told POLITICO that the agency is focused on promoting the updated Covid, flu and RSV shots among vulnerable populations like nursing home residents.

They might, however, ask her about snafus in the first rollout of the Covid vaccine onto the commercial market and shortages of the RSV immunization for infants that led to the agency urging providers to ration shots.

— Biosecurity: The hearing comes amid reports of a surge in respiratory illnesses in China, which officials have pinned to known viruses and a decline in immunity against common illnesses among residents following years of lockdown.

Republican committee leaders Cathy McMorris Rodgers (R-Wash.), Brett Guthrie (R-Ky.) and Morgan Griffith (R-Va.) sent a letter to Cohen Tuesday, asking whether the CDC has talked with Chinese health officials about these cases.

"The American people should not have to rely on the unaccountable and untrustworthy WHO to communicate information about Chinese public health threats,” they wrote. In a statement sent Tuesday evening, Cohen said the CDC has been in touch with Chinese authorities and will continue to monitor the situation.

WELCOME TO THURSDAY PULSE. Are you working on health AI legislation? Reach us at bleonard@politico.com or ccirruzzo@politico.com. We can keep you anonymous. Follow along @_BenLeonard_ and @ChelseaCirruzzo.

TODAY ON OUR PULSE CHECK PODCAST, host Alice Miranda Ollstein talks with POLITICO health care reporter Daniel Payne about the changing face of primary care, why Democrats and Republicans agree that the system needs an overhaul and the push to encourage nurses to take on new duties.

Listen to today’s Pulse Check podcast

A message from PhRMA:

Patients. Not Politicians. The Inflation Reduction Act (IRA) lets politicians decide what medicines are valuable and which diseases get researched. This could risk future treatments, including possible cures. No one should stand between you and your medicine. Get more details.

Congress

House Speaker Mike Johnson (R-La.) emerges from his office.

With the recent departures of top health policy aides, House Speaker Mike Johnson might give committee leaders, staff and other offices in leadership an expanded role to play. | Francis Chung/POLITICO

COMMITTEE POWER SURGE — Health care lobbyists and advocates expect the House leadership shakeup that gave Speaker Mike Johnson the gavel to move more power to committee leaders and high-level staffers, a half-dozen lobbyists told POLITICO’s Megan R. Wilson.

There has been significant staff change since former Speaker Kevin McCarthy was booted from his job. Johnson, who is in his fourth term, opposes abortion and gender-affirming care and supports cutting government health care programs such as Medicare and Medicaid. But he has an otherwise scant record to signal where he falls on other health care policies.

Health care isn’t “his favorite subject,” said Joel White, a health care lobbyist and former House Ways and Means Committee staffer who founded Horizon Government Affairs. But White noted that Johnson led the roughly 175-member Republican Study Committee when it released a 50-page health care policy blueprint crafted after the failed Republican efforts to repeal and replace Obamacare.

“Speaker Johnson is thankful to have such capable health care leaders at the Energy and Commerce, Ways and Means, and Education and Workforce Committees and within the House Republican leadership helping to drive a health care agenda that helps deliver lower costs and better outcomes,” said a spokesperson for Johnson.

GET A BACKSTAGE PASS TO COP28 WITH GLOBAL PLAYBOOK: Get insider access to the conference that sets the tone of the global climate agenda with POLITICO's Global Playbook newsletter. Authored by Suzanne Lynch, Global Playbook delivers exclusive, daily insights and comprehensive coverage that will keep you informed about the most crucial climate summit of the year. Dive deep into the critical discussions and developments at COP28 from Nov. 30 to Dec. 12. SUBSCRIBE NOW.

Antitrust

CIGNA-HUMANA IMPLICATIONS — If Cigna and Humana agree to merge, it would create a health care powerhouse with implications for insurance and pharmaceutical prices and how doctors are paid, POLITICO’s Kelly Hooper, Robert King and Megan report.

The Wall Street Journal first reported on Wednesday that the two health insurance giants were in merger talks and a deal could be finalized by the year’s end. Humana declined to comment to POLITICO. Cigna didn’t return a request for comment.

The deal could draw Washington’s attention for several reasons. It would give the insurers additional pricing power and Cigna more weight in the lucrative Medicare Advantage market. But antitrust enforcers will likely take a long look, and pharmacy benefit managers could face more scrutiny.

The Justice Department recently struck down similar deals: In 2017, it blocked two major health insurance mergers, one between Aetna and Humana and another between Anthem — now called Elevance — and Cigna. However, regulators allowed the $69 billion CVS Health-Aetna merger in 2018.

The antitrust division at the Justice Department will likely examine the merger’s impact on the PBM industry, said Julie Utterback, a senior equity analyst for health care at Morningstar, an investment research firm.

A message from PhRMA:

Obamacare

‘PANDORA’S BOX OF HURT’ — Republicans thought they were done with their Obamacare nightmare. Then former President Donald Trump read a Wall Street Journal op-ed.

Those 543 words, mostly about health care consolidation, piqued the former president’s interest, prompting him to post on Truth Social that he was “seriously looking at alternatives,” and 2017’s failed repeal and replace effort was “a low point for the Republican Party.”

Reality check: There’s still no consensus around what would replace Obamacare, and repeal could be even more politically challenging in 2025 than it was in 2017 because millions more people rely on the Affordable Care Act's exchanges for health insurance, and several more states have expanded Medicaid under the law. Trump’s campaign is drawing up a health care proposal, although it’s unclear when that will be released or whether it will propose a full replacement plan.

Why it matters: For Democrats, Trump’s renewed attacks on Obamacare amount to a political gift that some in the party said they couldn’t have timed better. The threat to “terminate” the signature health law comes amid a Biden campaign effort to highlight what Trump would do if he returned to office and portray his agenda as out of step with the vast majority of Americans.

“It's a story that tells itself,” said Leslie Dach, chair of Democrat-aligned group Protect Our Care. “He's opening up a Pandora’s box of hurt.”

JOIN WOMEN RULE ON 12/12: For centuries, women were left out of the rooms that shaped policy, built companies and led countries. Now, society needs the creativity and entrepreneurship of women more than ever. How can we make sure that women are given the space and opportunity to shape the world’s future for the better? Join POLITICO's Women Rule on Dec. 12 for Leading with Purpose: How Women Are Reinventing the World to explore this and more. REGISTER HERE.

Artificial Intelligence

HEALTH AI HEARING TAKEAWAYS — The House Energy and Commerce Health Subcommittee held a hearing on artificial intelligence in the sector for the first time Wednesday.

Lawmakers heard from industry witnesses about how AI is being used in health care and how potential regulation could impact the technology. Ben had three key takeaways from the hearing:

— No package arriving soon: Lawmakers aren’t close to broad legislation on AI in health care. Subcommittee Chair Brett Guthrie (R-Ky.) told POLITICO that no specific legislative package was being crafted.

Subcommittee ranking member Anna Eshoo (D-Calif.), who also serves as the co-chair of the Congressional Artificial Intelligence Caucus, told witnesses there’s a learning curve.

“I have to admit that there were different parts of your testimony where I really didn’t understand what you were talking about,” she said.

— GOP, Dems agree on a lot but diverge in emphasis: Despite having plenty of common ground, Democrats and Republicans discussed AI in slightly different tones Wednesday.

Lawmakers broadly agreed that AI could potentially help clinicians avoid burnout and navigate workforce shortages — and that it needs guardrails.

But, with some exceptions, Democrats focused on algorithms’ potential to wrongly deny patients care and to discriminate against some populations, while Republicans emphasized avoiding stifling innovation.

— Data privacy a key: Committee leaders agreed on the need for a national data privacy standard to protect patients and consumers.

E&C Chair Cathy McMorris Rodgers (R-Wash.) called such a move a "foundational first step," and committee ranking member Frank Pallone (D-N.J.) was concerned about insufficient regulation of the sale of health-related data.

WHAT WE'RE READING

STAT reports on the Biden administration defending a Trump-era drug-pricing regulation.

The Wall Street Journal reports on insurance giants Cigna and Humana’s talks to merge.

A message from PhRMA:

Government price setting could put patients at a disadvantage. The Inflation Reduction Act (IRA) could have unintended consequences such as: Putting barriers between patients and their prescribed medications. Jeopardizing continued research into approved medicines. Shifting research and development away from pills and tablets. Learn more.