Musical chairs for health policy leaders in Congress

Jun 25, 2024

Driving the Day

David Schweikert and others walk in a hallway on Capitol Hill.

Health policy leaders like Rep. David Schweikert face tight races in November, which could affect the makeup of their committees. | Francis Chung/POLITICO

VULNERABLE HEALTH POLICY LEADERS — With a number of top health care lawmakers voluntarily leaving Congress at the end of this term, even more could lose their seats.

House Energy and Commerce Chair Cathy McMorris Rodgers (R-Wash.) and E&C Health Subcommittee ranking member Anna Eshoo (D-Calif.) aren’t seeking reelection, nor are Reps. Michael Burgess (R-Texas), Larry Bucshon (R-Ind.) and Brad Wenstrup (R-Ohio). The departure of decades of experience has raised concerns in health policy circles about losing serious legislators who know how to get bills signed into law.

Now that many states’ primaries have been held, it’s worth taking note of other vulnerable leaders in health policy ahead of November’s election. Here are some of those in Congress most at risk of losing their seats:

— Sen. Jon Tester (D-Mont.) chairs the Veterans’ Affairs Committee and has served in the chamber since 2007. He’ll take on Republican Tim Sheehy in what the Cook Political Report rates as a toss-up.

— Rep. David Schweikert (R-Ariz.), who chairs the Ways and Means Oversight Subcommittee, is expected to face a close race in his Phoenix-area district after a primary next month. He’s been a leading voice on artificial intelligence in health care and is the co-chair of the Telehealth Caucus. CPR rates his race as a GOP toss-up.

— Rep. Donald Davis (D-N.C.), whose district includes part of the Research Triangle, has been one of the lone Democrats pushing to blunt the Inflation Reduction Act's drug-pricing negotiation power. CPR rates his race as a Democratic toss-up.

— Sens. Tammy Baldwin (D-Wis.) and Bob Casey (D-Pa.), who serve on the Senate Health, Education, Labor and Pensions Committee, face tight races that CPR says lean Democratic.

Casey also chairs the Aging Committee and serves on the Finance Committee, and Baldwin chairs the Appropriations Subcommittee for HHS.

— Sen. Sherrod Brown (D-Ohio), who serves on the Finance and Veterans’ Affairs committees, has also attempted to get cannabis banking legislation signed into law as chair of the Banking Committee. He faces a toss-up race, according to CPR.

— Rep. Michelle Steel (R-Calif.), who serves on the Ways and Means and Education and the Workforce committees’ health subcommittees, faces a lean Republican race in her Orange County area district. She’s been a leader in a bid to extend eased telehealth rules for high-deductible health plans ahead of their expiration at the end of the year and serves on the House’s bipartisan AI task force.

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HEALTH INSURANCE

An Obamacare sign is seen on the UniVista Insurance company office.

Whether to permanently expand Obamacare premium tax credits is up for debate in Congress. | Joe Raedle/Getty Images

YAYS AND NAYS FOR PREMIUM TAX CREDITS — The Congressional Budget Office and the Joint Committee on Taxation estimated Monday that making permanent an expanded premium tax credit for Obamacare marketplace plans would add to the deficit by $335 billion over a decade.

The details: In a letter to House Budget Chair Jodey Arrington (R-Texas) and House Ways and Means Chair Jason Smith (R-Mo.), the scorekeepers said that making the credit permanent would also lead to an average of 3.4 million more people being insured yearly. That would come from a 6.9 million-person boost in marketplace coverage and a 3.5 million-person decrease in employer-based coverage, they said.

Those who opt not to get employer-based coverage because of an extension would get an annual tax benefit of $4,350 on average.

The bigger picture: The estimates inject more detailed data into a debate over the future of the tax credits that has been bubbling ahead of the credit’s expiration at the end of 2025, along with Trump-era tax cuts. Republicans have slammed the expanded credits that stemmed from the American Rescue Plan and the Inflation Reduction Act.

“It is unconscionable that Democrats would continue to push for massive taxpayer-funded handouts to the wealthy and large health insurance companies,” Smith and Arrington said in a statement.

Ways and Means ranking member Richard Neal (D-Mass.) said Republicans are “pouncing on the cost of a healthier and more prosperous nation while swindling for more unpaid for tax cuts for the wealthiest” in a statement to Pulse.

Also: The CBO and the JCT said a CMS rule last month making recipients of the Deferred Action for Childhood Arrivals program, or DACA, eligible for Obamacare plans would increase the deficit by $7 billion between 2025 and 2034.

In Congress

THE WEEK AHEAD — The House is in session this week for a busy week in health care, and the Senate is out. Here's what's happening:

— A House Energy and Commerce subcommittee meets Tuesday to tackle anti-doping measures ahead of the Summer Olympics. Former star swimmers Michael Phelps and Allison Schmitt, as well as the CEO of the U.S. Anti-Doping Agency, will testify.

— A House Judiciary subcommittee meets Wednesday to address the Biden administration’s Covid-19 response. It comes after other recent House and Senate hearings on the topic.

— A House Veterans' Affairs subcommittee meets Wednesday to examine the structure of the VA's health care network.

— A House Ways and Means subcommittee meets Wednesday on bolstering value-based care.

— A House Appropriations subcommittee meets Thursday to mark up the fiscal 2025 Labor-HHS-Education bill.

AROUND THE AGENCIES

GUN VIOLENCE ADVISORY— America’s top doctor wants us to view gun violence as a public health issue — and a kids' issue, POLITICO’s Erin Schumaker reports.

That's according to an advisory report Surgeon General Vivek Murthy released Tuesday, calling gun violence “a public health crisis in America.” The advisory, part of the surgeon general’s wider mental health agenda, comes on the heels of advisories he’s issued on youth mental health and social isolation and loneliness.

It’s not only homicides, suicides and accidents Murthy is worried about. Our collective exposure to firearm violence has created a large-scale cycle of trauma and fear that’s perpetuating America’s mental health crisis, he told Erin. “Mass shootings have a profound impact on the psyche of the country,” he said.

Dr. Bruce Scott, president of the American Medical Association, called Murthy’s advisory an “evidence-based public health approach to addressing firearm violence” in a statement. “Firearm violence is indeed a public health crisis,” he said, adding, “The data now show it touches the majority of U.S. adults.”

And while mass shooting deaths account for just 1 percent of firearm fatalities, they play an outsized role in how safe Americans feel. According to the advisory:

— 51 percent of 14- to 17-year-olds worry about school shootings.

— 60 percent of 14- to 17-year-olds have recently thought about what would happen if a person with a gun entered their school or a school nearby.

— 79 percent of adults report stress due to the possibility of a mass shooting.

— 33 percent of adults say fear prevents them from going to certain places or events.

Big picture: Such advisories aren’t issued frivolously. A few have influenced the course of public health, like Surgeon General Luther Terry’s 1964 report on cigarettes, which is credited with changing Americans’ perceptions of smoking.

In the Courts

SCOTUS TO TAKE UP HEALTH INSURANCE CASE — In addition to agreeing Monday to review a case on gender-affirming care, the Supreme Court will also review a lower-profile case that could have ramifications for employer health care benefits.

The case, Stanley v. City of Sanford, Florida, involves a firefighter who was diagnosed with Parkinson’s disease and later had to take disability retirement. When she began the job, the city offered free health insurance until age 65 for those retiring due to disability but later changed it to be only for 24 months post-retirement.

At question now is whether a former employee can sue for discrimination in benefits under the Americans with Disabilities Act. A lower court held that she wasn’t subject to ADA protections because she wasn’t a city employee anymore.

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WHAT WE'RE READING

Kevin Harper has been promoted to head of government affairs at Teladoc Health. He joined the company in 2020 and was previously vice president of government affairs.

Eric Rasmussen, formerly of Sumitomo Pharma, is launching Rasmussen Consulting, focusing on government relations for biopharmaceutical companies.

Ian Allen has joined J Strategies as VP of public affairs. He most recently was director of policy and development at the New Jersey Primary Care Association.

WHAT WE'RE READING

POLITICO's Joseph Gedeon reports on hackers being able to manipulate hospital technology to show fake patient vitals.

KFF Health News reports on how error-plagued, Deloitte-run systems are key for Medicaid eligibility processes.

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