What we’d ask Trump and Harris

Sep 10, 2024

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Driving The Day

Kamala Harris (left) alongside a photo of Donald Trump (right).

The Harris-Trump presidential debate tonight might clarify where each candidate stands on certain health policy issues. | Charles Rex Arbogast/AP

DEBATE, HEALTH POLICY STYLE — Pulse was unfortunately snubbed from moderating tonight’s presidential debate between former President Donald Trump and Vice President Kamala Harris.

That means we likely won’t get answers to our many pressing health care questions, so we reached out to both campaigns with the questions. We heard back from Trump’s campaign on some questions but not from Harris’.

If we were in ABC’s David Muir’s and Linsey Davis’ shoes tonight, here’s what POLITICO’s health care team would ask:

Harris:

— Medicare for All is no longer on your agenda. What changed?

Why we want to know: During her short-lived 2020 presidential bid, Harris offered a modified Medicare for All plan, which would significantly shake up the health care system. It’s unclear what changed in her thinking between now and then.

— Medicare drug price negotiations are allowed under the Inflation Reduction Act. You’ve promised to expand the negotiation program, but that would require Congress. How would you convince lawmakers to expand the number of drugs negotiated and broaden the program to private insurance?

Why: Republicans haven’t shown a willingness to expand the program, and many of them have argued the negotiations amount to price-setting.

— Abortion rights have been a key issue for you. What specific policies would you pursue to further safeguard and expand these rights beyond those the Biden administration adopted?

Why: The Biden administration has taken several steps to safeguard and advance abortion access, but it’s unclear how Harris’ administration would go further. She’s pledged to restore Roe v. Wade, but that would require congressional buy-in.

Trump:

— Drug prices were a major focus during your presidency. How would your administration handle Medicare negotiation? What changes would you want to make? Would you try to incorporate international reference pricing?

Why: Trump hasn’t specified how he’d administer the new Medicare program.

The response: Trump’s campaign didn’t directly address the question, but spokesperson Karoline Leavitt said Trump will boost transparency, choice and competition and establish an independent commission to investigate a rise in chronic illness.

— Medicaid is the largest payer for low-income Americans. You’ve pledged to protect Medicare from cuts, but would cuts to Medicaid also be off the table?

Why: Trump has been largely silent on what he’d do about Medicaid. His administration approved many states’ work requirements for program eligibility.

The response: Leavitt told Pulse that Trump would ensure Medicaid can care for qualified citizens through mass deportations. Most states don’t cover undocumented immigrant adults. Those that do cover them use state money, not federal funds.

— Abortion is on the ballot in your home state, Florida. You have said Florida’s six-week abortion ban is too strict but also that you won’t vote to overturn it. What law should Florida have on abortion?

Why: Trump has been all over the map on abortion, an issue that’s dogged the GOP since the conservative-led Supreme Court overturned Roe two years ago.

The response: Trump said that six weeks is too short, according to Leavitt, and that he has been “consistent on supporting the rights of states to make decisions on abortion.”

Both Harris and Trump:

— Enhanced ACA subsidies expire next year. Do you support extending them?

Why: The subsidies, enacted under the Biden administration, have led to record numbers of Americans having health insurance. Their fate will be a major issue in Congress.

— Telehealth prescribing of controlled substances has taken off since both of your administrations enacted pandemic-era rules allowing drugs like Adderall, testosterone and ketamine to be prescribed virtually. Those rules expire at the end of the year. What drugs should be prescribed without requiring an in-person visit?

Why: The HHS and the DEA are at a stalemate over the fate of the regulations, which could impact how millions of patients can receive medication.

— The opioid crisis continues to ravage the country. What would you do differently to change the course?

Why: Fatal overdoses climbed more than 50 percent during the pandemic and remain at more than 100,000 a year.

The response: A Trump campaign spokesperson didn’t propose new actions but pointed to Trump administration efforts to fight the opioid crisis, including declaring it a public health emergency.

— Mental health is a worsening health crisis for the country. What would you do differently to change the course?

Why: A rising number of Americans deal with mental health issues, and many don’t get treatment due to issues of cost, lack of access, stigma and other reasons.

WELCOME TO TUESDAY PULSE. There’s a new mac ‘n cheese vending machine in the House. If we’re slow to get back to you, we’re probably getting seconds there. Send your tips, scoops and feedback to bleonard@politico.com and ccirruzzo@politico.com and follow along @_BenLeonard_ and @ChelseaCirruzzo.

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In Congress

Rep. Brad Wenstrup (R-OH) walks in a Capitol Building hall with two other men walking behind him

The BIOSECURE Act, sponsored by Rep. Brad Wenstrup, passed in the House by a large bipartisan margin on Monday. | Drew Angerer/Getty Images

HOUSE PASSES BIOSECURE ACT — The House passed legislation that would effectively bar Chinese biotech firms from doing business in the U.S. in a broad bipartisan 306-81 vote Monday.

The BIOSECURE Act from Rep. Brad Wenstrup (R-Ohio) would ban federal money from being used to procure or use products or services offered by “companies of concern” — including five Chinese or Chinese-owned companies named in the text.

The opposition was mostly Democratic — 79 of the 81 votes against it. That included Rep. Jim McGovern (D-Mass.), ranking member of the Rules Committee, who argued the bill didn't give enough due process to companies, and House Minority Leader Hakeem Jeffries and others in leadership. However, Democratic leadership didn’t whip for or against the bill.

Status in the upper chamber: The Senate passed its own version, which advanced out of the Senate Homeland Security and Governmental Affairs Committee in March in an 11-1 vote.

THE HEARINGS WE’RE WATCHING — Congress is back and has a number of health care hearings we’ll be tracking this week.

Here are some highlights and what we’ll be watching for:

Cuomo time: Former New York Gov. Andrew Cuomo is set to appear before the House Select Subcommittee on the Coronavirus Pandemic this afternoon and will face a grilling on his state’s pandemic policies, including those related to nursing homes. GOP lawmakers have signaled they’ll also scrutinize why federal resources like a hospital ship sent to New York City were barely used.

We’re interested to see whether Democrats defend Cuomo. They've made clear the hearing will spotlight Trump’s handling of the pandemic as well.

FDA and tobacco: Brian King, director of the FDA’s Center for Tobacco Products, is among the FDA officials testifying before a House Energy and Commerce subcommittee this morning. Expect questions about a backlog of tobacco product applications.

Congressional Budget Office: CBO Director Phillip Swagel testifies Wednesday before the House Budget Committee in a hearing on improving the agency. Members are expected to focus on the accuracy of the scorekeeper’s estimates and their timeliness. Lawmakers may also push House-passed legislation that would require the CBO to weigh whether a bill would save money over a 30-year budget window instead of 10 if Congress requests it.

Association health plans: The House Committee on Education and the Workforce holds a markup Wednesday on legislation that includes a resolution to overturn the Biden administration’s move to rescind Trump-era rules expanding access to association health plans. The Trump-era rule made it easier for small businesses to team up to buy health insurance and avoid some regulations. We’re watching to see whether there’s any support from Democrats, who have largely argued that AHPs undermine the Affordable Care Act.

VA UPDATE — Congressional Democrats and the White House are hammering Republicans for not including extra funding to fill a VA shortfall, as the Biden administration seeks $12 billion more to maintain VA benefits and medical care into next year, POLITICO’s Jennifer Scholtes and Caitlin Emma report.

House Republicans unveiled a $3 billion veterans’ funding patch that’s expected to pass as a standalone bill so the VA can pay out benefits by Oct. 1.

The Biden administration said that a six-month stopgap as proposed by the GOP would force the VA to cut staff and curb outreach to veterans.

AROUND THE AGENCIES

PARITY LEGAL THREAT — Opponents of the Biden administration’s new mental health parity rules finalized Monday are wasting little time in threatening litigation.

Melissa Bartlett, senior vice president of health policy for the ERISA Industry Committee, which represents the interests of large employers’ benefits, said Monday it’s considering “all possibilities,” including litigation “to prevent further harm.”

“The rule goes far beyond Congress’ clear intent … and, at a minimum, adds complexity to the landscape for employers who choose to offer behavioral health benefits for their workers,” Bartlett said.

The committee and insurers argued that the proposal wouldn’t address workforce shortages and could have unintended consequences.

The Biden administration proposal expands requirements under a 2008 law that requires insurers to cover mental health and addiction care on the same terms as other care. The Supreme Court overturned the so-called Chevron legal doctrine this year, giving more deference to agency interpretation of laws, a move that could make the regulations more vulnerable.

White House press secretary Karine Jean-Pierre told POLITICO on Monday that she wouldn’t get into “hypotheticals” about legal issues.

“It’s a great step forward,” she said. “This will continue to be a priority.”

VIRTUAL PRESCRIBING PUSH — More than 300 organizations, including psychiatry groups, major health systems and hospitals and tech companies, want Congress to extend DEA rules allowing telemedicine prescribing of controlled substances.

The groups are calling on the Congressional leadership and the Biden administration to extend pandemic-era rules allowing the prescribing of controlled substances without an in-person visit for two years. That comes as the DEA and HHS are at odds over a draft rule under White House review. Leaders in Congress have signaled openness to taking action.

The push, led by the Alliance for Connected Care, includes Amazon, the Children’s Hospital Association and the American Psychiatric Association.

A message from Aflac:

Names in the News

Simeon Niles has joined McDermott+ as director. He was previously vice president of health care innovation at JPMorganChase.

Kat Maramba has been promoted to senior vice president of strategic services at Global Situation Room. She was previously vice president of media engagement at the firm.

Pat Geraghty, CEO of Guidewell, has been elected to serve a second term as chair of AHIP’s board.

WHAT WE'RE READING

STAT reports on Apple AirPods soon being able to work as a “clinical grade over-the-counter hearing aid.”

POLITICO’s Mohar Chatterjee reports on the Biden administration proposing new rules that would require tech companies to provide detailed reports on the development and testing of powerful artificial intelligence models, including those relating to health care.

POLITICO’s Jordain Carney and Olivia Beavers write that the GOP spending bill faces significant opposition from conservative Republicans in the House, jeopardizing its passage.

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