GOP anti-abortion riders going, going…

Presented by the Coalition to Protect America's Health Care: Delivered daily by 10 a.m., Pulse examines the latest news in health care politics and policy.
Jan 18, 2024 View in browser
 
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By Ben Leonard and Chelsea Cirruzzo

Presented by the Coalition to Protect America's Health Care

With help from Megan Messerly and Robert King

Driving The Day

House Speaker Mike Johnson has speaks during a press conference at the U.S. Capitol.

GOP lawmakers realize that the anti-abortion provisions added to nearly every spending bill are going nowhere under House Speaker Mike Johnson. | Francis Chung/POLITICO

HOPES FADE FOR ABORTION RIDERS House Republicans are watching their best chance for restricting abortion in this Congress slip away, POLITICO’s Alice Miranda Ollstein and Meredith Lee Hill report.

Lawmakers are starting to admit that the anti-abortion riders they’ve attached to nearly every spending bill under negotiation have little to no chance of passage — and, along with their conservative allies, are training their frustration at Speaker Mike Johnson for failing to deliver.

“Those of us who are pro-life, which is the majority of the Republican conference, I would hope would be disappointed and upset if we don’t have pro-life policy riders in place that we fought for and that we’ve worked on in the House over the last several months,” Bob Good (R-Va.), chair of the hardline Freedom Caucus, told POLITICO.

Conservatives viewed the fight over government spending as their best and possibly only vehicle for undoing Biden administration policies expanding access to abortion.

They’ve proposed measures to ban mail delivery of abortion pills, reimpose anti-abortion restrictions on global HIV programs, block the military from funding service members’ travel across state lines for an abortion, cancel coverage of abortion for veterans, kick Planned Parenthood out of various federal health programs and prohibit state Medicaid programs from covering abortion.

But talk of the House GOP’s anti-abortion priorities has largely evaporated amid the rollout of Johnson’s spending deal with Democrats.

Several subcommittee chairs in charge of drafting individual spending bills said GOP leaders have given them no guidance about whether the anti-abortion policies will make it in. And several House lawmakers confirmed to POLITICO that Johnson hasn’t mentioned the fate of specific anti-abortion provisions in any closed-door caucus meetings since the spending deal was announced.

Rep. Tom Cole (R-Okla.), a senior appropriator, is among those tamping down expectations as members wait to see final bill text.

“[Johnson] hasn’t promised us policy wins,” Cole said. “He’s promised us that we can fight for policy wins.”

Meanwhile: HHS Secretary Xavier Becerra embarked on a reproductive health care access tour Wednesday ahead of the 50th anniversary of Roe v. Wade, Chelsea reports.

The trip — to Maryland, Virginia and Pennsylvania, all where abortion is legal — is just the first three of the states he plans to visit, Becerra told reporters. “We have an opportunity to make the point in some states where reproductive health care services are crucial, and we will go wherever we can,” he said.

WELCOME TO THURSDAY PULSE. Are you working on getting policies impacting rural health care into an upcoming spending package? We want to hear from you. Reach us at bleonard@politico.com or ccirruzzo@politico.com. Follow along @_BenLeonard_ and @ChelseaCirruzzo.

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Cybersecurity

MOUNTING CYBER BREACHES — Nearly 133 million people were impacted by health data breaches in 2023, according to a POLITICO analysis of the latest HHS data — well more than double 2022’s total of 56 million.

The 2023 toll reported to HHS includes four hacks impacting at least 8.4 million people each. It also represents more than a third of the U.S. population.

A bar chart shows that health data breaches hit twice as many patients in 2023 than in 2022. Health data breaches hit 34.9M patients in 2020, 59.5M in 2021, 56.6M in 2022 and 132.9M in 2023.

HHS’ Office for Civil Rights has made a bid to Congress for more funding and restructured last year to better handle breaches. It also changed guidance related to tracking technology, prompting a lawsuit from the American Hospital Association.

Health care cybersecurity is a broader problem beyond vulnerable patient data. Hackers are increasingly employing ransomware attacks that have put patients’ lives at risk.

The regulatory angle: HHS has said that CMS will propose new cybersecurity mandates for hospitals through Medicare and Medicaid. Senate Intelligence Chair Mark Warner (D-Va.) has floated health care cybersecurity legislation that could include minimum standards.

 

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Around the Agencies

BOOSTING MEDICAID — The Biden administration has for the past two years been making a quiet trade with states on Medicaid: If you want to invest in nontraditional services, like housing, transportation and nutrition support, you need to boost rates for routine doctors’ visits and other bread-and-butter care, too, Megan and Robert report.

The Centers for Medicare and Medicaid Services has used the waiver process in six states — Arizona, California, Massachusetts, New York, Oregon and Washington — to boost what Medicaid pays for primary, behavioral and obstetric care. It’s part of an attempt to address a longstanding disparity with Medicare rates, and it’s one example of how federal health officials are tangibly delivering on their health equity goals.

“It sends a signal to states about making sure their Medicaid programs are running right,” said Cindy Mann, a partner at Manatt Health and former director of the Center for Medicaid and CHIP Services under the Obama administration. “It also sends a message that access to services is a real priority for the administration and that when they have new regulations in place, they will be paying close attention to whether states meet the new access standards.”

CMS requires the states to raise reimbursement rates by at least 2 percentage points if their current rates are less than 80 percent of what Medicare pays.

 

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Supreme Court

BIG IMPLICATIONS FOR AGENCIES — Conservatives on the Supreme Court appear ready to weaken federal agencies’ power in a key case, POLITICO’s Alex Guillén and Josh Gerstein report.

Conservative justices pushed the Biden administration in oral arguments Wednesday on whether laws from Congress that leave questions unanswered should be interpreted by agencies or judges. The so-called Chevron doctrine says when an agency makes rules based on a “reasonable” reading of statutes, judges must uphold them. The doctrine is aimed at preventing judges from overruling agencies’ expertise.

Why it matters: A ruling against agency power could give courts — and the Supreme Court itself — more expansive authority to shoot down federal regulations in health care and other policy areas. That would mean President Joe Biden and future presidents would have less ammunition to defend their regulations against legal challenges.

Advocates have warned that key changes to federal health programs could be stopped, and longstanding rules could fall. Anti-abortion groups have said that a ruling undermining Chevron could help them in their bid to ban abortion pills, and artificial intelligence regulations could be imperiled.

What they’re saying: Justice Neil Gorsuch intimated that the Biden administration’s solicitor general couldn’t say when courts should defer to agencies.

“Should that be a clue that something needs to be fixed here?” Gorsuch asked Solicitor General Elizabeth Prelogar.

Justice Ketanji Brown Jackson and the court’s two other liberal justices defended Chevron, but it wasn’t clear whether their arguments moved the six-justice conservative majority.

 

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In Congress

SPAR OVER BORDER — Some witnesses and GOP members at a House Energy and Commerce oversight and investigations subcommittee hearing Wednesday said undocumented migrants coming through the southern border bring infectious diseases and illegal drugs into the U.S., burdening health care across the country.

“The migrant crisis has … placed an enormous strain on the city’s public hospital system, with New York City hospitals receiving over 30,000 undocumented migrant visits in the past year alone,” said Republican New York City Council Member Inna Vernikov.

Meanwhile, committee Democrats said Republicans used the hearing to attack the Biden administration in an election year. “The Republican majority continues to push a narrative of blame that deflects from the responsibility to effectively govern,” said New Jersey’s Frank Pallone, the top Democrat on the E&C Committee.

Why it matters: The partisan bickering over immigration has become part of the current political climate, but it’s unusual during an E&C Committee hearing, which historically has worked in a more bipartisan fashion.

Names in the News

Timothy Stenzel, the FDA’s top diagnostic regulator, left the agency at the end of 2023. He helped lead the Covid-19 testing response after joining the FDA in 2018.

WHAT WE'RE READING

The Paragon Health Institute reports that close to half of ACA exchange enrollees have an income below 150 percent of the federal poverty level.

Modern Healthcare reports on Epic’s app market changes.

 

A message from the Coalition to Protect America's Health Care:

Hospitals provide critical care to patients 24 hours a day, seven days a week. They treat sicker patients and are better equipped to handle complications. They care for all patients, regardless of their ability to pay.

While many hospitals struggle, huge corporate insurance companies are banking record profits by often delaying and denying care. Now those insurers are pushing Congress to slash hospital care with new cuts.

Cutting hospital care won’t fix rising health care costs. It will only threaten patients’ access to the care they need. Get the facts: https://actnow.protecthealthcare.org/a/no-cuts-to-care

 
 

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