Trump, Harris square off on abortion, ACA, Covid

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Sep 11, 2024 View in browser
 
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By Chelsea Cirruzzo and Ben Leonard

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With Sophie Gardner and Daniel Payne

Driving The Day

Former President Donald Trump shakes hands with Vice President Kamala Harris at the presidential debate.

Tuesday night's debate marked the presidential candidates' first direct confrontation on issues including health care reform and pandemic response. | Alex Brandon/AP

HEALTH CARE, REVISITED — Former President Donald Trump and Vice President Kamala Harris relitigated the handling of the pandemic, plans for the Affordable Care Act and abortion in a historic presidential debate Tuesday night.

It was the first time Harris and Trump have met on the debate stage since Harris became the Democratic presidential candidate.

Here are three takeaways from last night’s debate: 

What they didn’t say on abortion: Trump refused to say whether he would veto a national abortion ban, saying it would be impossible for Congress to pass, while Harris wouldn’t say which restrictions she would support on the procedure.

Tuesday night’s debate offered a sharp contrast between the two candidates and their approaches to abortion. But both seemed to fear alienating their bases, POLITICO’s Megan Messerly reports.

Trump, instead, praised the six Supreme Court justices who overturned Roe v. Wade and reiterated his support for his leave-abortion-to-the-states approach. He also said he hasn’t discussed the issue with his running mate, Ohio Sen. JD Vance, who has claimed that the former president would veto a national ban.

Harris, who declined to say what limits she would favor on abortion, said she wants to restore Roe, which would protect abortion access until fetal viability, which is around the 22nd week of pregnancy. States could still restrict abortion beyond that point, though not all do so.

According to a poll by health research group KFF, most Americans would prefer a federal law restoring a nationwide right to abortion, similar to Roe.

Trump still has no ACA plan: Trump, who shook up the campaign last year by floating that he was “seriously looking at alternatives” to the Affordable Care Act, said he has only the “concepts of a plan” to replace the ACA, despite his administration failing to repeal the law seven years ago.

The ACA, which took effect in 2010, enjoys broad support.

Kamala Harris went after Trump for trying to get rid of the ACA and cast doubt on his claims of a plan to replace it. “You have no plan,” Harris said.

Different takes on the pandemic: Harris accused Trump of leaving the Biden administration with “the worst public health epidemic in a century.” Trump claimed that during his administration the U.S. made ventilators for “the entire world.”

The nation struggled to meet the demand for ventilators at the outset of the pandemic, and polling has generally shown Trump’s handling of the pandemic was less popular than President Joe Biden’s, though Biden’s approval on the issue declined as the pandemic went on.

Harris hit Trump for thanking Chinese leader Xi Jinping for his transparency about Covid-19 in January 2020. Both parties have since criticized China for not being transparent about Covid’s origins.

WELCOME TO WEDNESDAY PULSE. Is it too early in the season to recover from debate night with a pumpkin spice latte? Send your tips, scoops and feedback to ccirruzzo@politico.com and bleonard@politico.com and follow along @ChelseaCirruzzo and @_BenLeonard_.

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In Congress

A liver and kidney transplant cart sits inside an operating room.

Congress is monitoring HHS' progress on reforming the Organ Procurement and Transplantation Network. | Molly Riley/AP

FIXING THE TRANSPLANT SYSTEM — HHS’ push to overhaul the U.S. organ transplant system is drawing congressional scrutiny.

The House Energy and Commerce Oversight and Investigations Subcommittee holds a hearing this morning to check in on HHS’ progress in implementing a bipartisan effort to improve the organ transplant system.

How we got here: More than 100,000 people await an organ to become available, according to HHS.

Since the 1980s, one nonprofit, the United Network for Organ Sharing, has been in charge — including in charge of the federal network’s board of directors. Committee leaders launched a bipartisan inquiry into UNOS last March.

Under the law, the organ transplant network was decentralized by restructuring the system into manageable parts with multiple vendors. At least one contract has been awarded to a nonprofit, the American Institutes for Research, that will be responsible for setting up a new board of directors.

However, as POLITICO previously reported, the reform has hit snags in recent months as members of Congress, the federal government and providers have sparred over oversight. On Wednesday, a patient advocate and two transplant doctors will urge Congress to prevent what they say are bad actors involved in the current system from electing a new board of directors.

“Reconstituting a newly named board with the same group of individuals from previous governances is not reform,” Dr. Seth Karp, a transplant surgeon at Vanderbilt University Medical Center in Nashville, writes in his witness statement.

According to a hearing memo, officials from the Health Resources and Services Administration, which is overseeing the reform, and the president of the Organ Procurement and Transplant Network declined invites, citing short notice.

The trajectory reform has similarly garnered interest in the Senate where Bill Cassidy (R-La.), ranking member of the Health, Education, Labor and Pensions Committee, wrote to HRSA leadership Wednesday, asking for more urgency in implementing reforms.

“HRSA has been slow to implement these much-needed reforms. In fact, it just recently issued final requests for proposals (RFPs) to support multiple contract awards related to board of directors’ support and operations in May and formally incorporated an independent board of directors in June,” he wrote, asking HRSA to answer when it plans to hold a special election for a new board as well as how it will ensure board members don’t have conflicts of interest.

IN SENATE CROSSHAIRS — Steward Health Care faces new Senate scrutiny this morning with Sen. Ed Markey (D-Mass.) releasing a 10,000-word report claiming the system gutted hospitals and left patients behind in pursuit of profits, Daniel reports.

Patients in several Steward-owned hospitals nationwide faced longer ER wait times and, in some instances, worse outcomes compared with national averages, according to the report — which also noted the impact of closures on employees and patients.

Background: The report comes the day before Steward’s CEO, Dr. Ralph de la Torre, was subpoenaed to testify before the Senate HELP Committee.

Through his lawyers, de la Torre said he wouldn’t comply, saying a court order bars him from discussing closures. A spokesperson for the CEO has denied wrongdoing.

The big picture: The report suggests the problem goes beyond Steward Health Care, implicating private equity investment as putting profits before patients and workers. Similar investors have been targets of other Democrats in Congress, including Sen. Elizabeth Warren’s focus on their effects on nursing homes.

But the concern about bad corporate behavior in U.S. health care goes beyond party. Leaders on both sides of the aisle have been dismayed over what they say are the added cost and complexity conglomerates bring to the system.

Cold water: Drafting legislation that has bipartisan support, a clear path to the president’s desk and a significant impact on how the system functions remains elusive.

 

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Public Health

HEALTH INSURANCE RATE STILL HIGH IN 2023 — The percentage of Americans who had health insurance in 2023 remained unchanged from 2022 at 92, according to data released today from the U.S. Census Bureau. It’s a slight increase from 2021 when the rate was 91.7, Sophie reports.

FACTORS EXACERBATING SUICIDE RISK? Certain demographic factors, like access to broadband internet, health insurance coverage and household income, are tied to suicide rates, according to a CDC Vital Signs report released Tuesday.

CDC researchers used data from the 2022 National Vital Statistics System to analyze differences in suicide rates from county to county, Sophie reports.

The findings: The overall suicide rate in 2022 was 14.2 per 100,000 people, but it was lower in certain counties with more resources, such as broadband internet access, higher incomes and health insurance.

The rates were lower than the average in counties in the top one-third for people or households with health insurance coverage, at 13 percent. Rates were also lower in counties with access to broadband internet and counties with higher incomes.

The suicide rate was also much higher for American Indian/Alaska Native people, at more than 27 percent, and the overall suicide rate for men was nearly four times the rate for females.

WHAT WE'RE READING

STAT reports that lawmakers are wary of giving the FDA more money to crack down on e-cigarettes.

The Associated Press reports that doctors are running into coverage limits deterring cancer patients from anti-nausea medications.

Reuters reports that the weight-loss market could see more than a dozen new drugs by 2029.

POLITICO’s Nick Reisman reports on the Covid-19 scrutiny former New York Governor Andrew Cuomo faced from House Republicans on Tuesday.

A message from Aflac:

Most people who experience a major medical event will end up with unexpected expenses such as transportation and unexpected hospital and doctor charges. As health care costs continue to rise, even those with major medical insurance are struggling to afford care and exhausting their savings to cover medical bills. Supplemental insurance can offer financial protection by helping to cover out-of-pocket costs like copays and deductibles.

Learn more about how supplemental insurance helps with the unexpected.

 
 

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