Texas not too big for Harris

Oct 25, 2024

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With help from Ben Leonard

Driving The Day

Vice President Kamala Harris speaks at a campaign rally.

Vice President Kamala Harris will hold a rally in Texas today to highlight abortion-rights issues. | Julia Demaree Nikhinson/AP

HARRIS HEADS TO HOUSTON — Vice President Kamala Harris is set to hold a rally today in the Republican stronghold of Texas, an unlikely departure from her recent stops through critical swing states, POLITICO’s Megan Messerly reports.

Harris hopes to use the Houston rally, which is expected to feature a performance by Beyonce, as a foil for what can happen if former President Donald Trump retakes the presidency, allies say.

“If we don’t stop Donald Trump, we’re going to have 50 Texases,” said Mini Timmaraju, president and CEO of the group Reproductive Freedom for All, who’ll attend the rally.

Closing arguments: Harris has been leaning on issues such as abortion and the future of democracy to make her closing pitch to moderate Republican voters who might be wary of voting for a Democrat.

She’s expected to highlight the state’s policies on abortion, which are unpopular among local voters. A poll from the Texas Politics Project found 54 percent of likely voters believe Harris will do a better job on abortion compared with 28 percent for Trump.

“Texas is not just a good showcase for how restrictive policies can get on abortion when you leave it to the states, but also the degree to which that kind of restrictive approach gets in front of — and does not align with — public opinion, including public opinion with a sizable share of Republicans,” said Jim Henson, who directs the Texas Politics Project and co-directs the University of Texas/Texas Tribune Poll.

A different audience: Since the Supreme Court struck down Roe v. Wade and left abortion policy to the states in 2022, Texas has installed some of the strictest abortion laws in the nation. The state bans abortion at conception with no exemptions for rape or incest. Exceptions can be made for life-threatening situations — but there have been instances when such exceptions haven’t been granted.

“Texas is the stage, and the audience is the battlegrounds. It definitely arrests people’s attention in a way that is hard to do by just going back to another battleground at this point in the cycle. This is our strategic way to break through the news,” a senior campaign official granted anonymity to discuss internal strategy told POLITICO.

Harris has made a habit of heading to states that she says illustrate the worst of policy impacts. She visited Florida last year to commemorate what would have been the 50th anniversary of Roe and went to Tennessee to discuss gun safety.

WELCOME TO FRIDAY PULSE. This is your local CMS reporter Robert King filling in for Ben and Chelsea today. Who else is excited about the Caps’ hot start to the season? Send your bad local sports takes and any tips, news and scoops to rking@politico.com or bleonard@politico.com and cciruzzo@politico.com. Follow along for health news at @rking_19.

A message from PhRMA:

Drug price “negotiations?” Higher costs and less access to medicines are not what seniors were promised when the Inflation Reduction Act (IRA) was signed into law. Learn more about the IRA’s unintended consequences.

In Congress

Rep. Morgan Griffith speaks during a press conference.

Rep. Morgan Griffith is one of several lawmakers vying to become chair of the House E&C Health Subcommittee. | Anna Moneymaker/Getty Images

E&C HEALTH PANEL RACE HEATS UP — The battle to lead one of the top health-focused committees in the House is starting, Ben reports.

Reps. Gus Bilirakis (R-Fla.), Morgan Griffith (R-Va.) and Buddy Carter (R-Ga.) want the top spot on the House Energy and Commerce Health Subcommittee in the next Congress. Current Chair Rep. Brett Guthrie (R-Ky.) is making a play to lead the full committee but must get past his colleague Rep. Bob Latta (R-Ohio).

The panel holds enormous sway over health issues in the House, and all three have been active members of the Health Subcommittee.

Carter, a pharmacist, has railed against pharmacy benefit managers — the middlemen that negotiate with drugmakers for insurers — during his tenure on the committee. He’s also a major supporter of efforts to extend pandemic-era telehealth rules.

Bilirakis, who has the seniority edge over Carter but not Griffith, has led efforts to reauthorize the FDA’s priority review voucher program to spur development of rare pediatric disease treatments.

Griffith has focused on rural health during his tenure and was a key leader of the SUPPORT Act, which offered funding for states to fight opioid and substance abuse. The bill must be reauthorized every five years and was most recently renewed in 2023.

The subcommittee is set for major turnover next year as stalwarts are set to depart Congress. Reps. Michael Burgess (R-Texas) and Larry Bucshon (R-Ind.), both members of the GOP Doctors’ Caucus, aren’t seeking reelection.

The panel’s top Democrat — California’s Anna Eshoo — is also leaving after this term, as is Rep. Ann McLane Kuster (D-N.H.). Rep. Lisa Blunt Rochester (D-Del.) is expected to win a race for Senate.

AROUND THE AGENCIES

MA PLANS OVERPAID? Medicare Advantage plans racked in an estimated $7.5 billion from a tool critics say they use to get more payments from the federal government.

HHS’ Office of the Inspector General released a report Thursday that showed plans reported diagnoses for 1.7 million people using only health risk assessments — questionnaires used to evaluate a person’s health — and no additional diagnostic tools.

OIG is concerned over a lack of “follow-up visits, procedures, tests or supplies [to support] these diagnoses.” The watchdog speculates that diagnoses could be inaccurate and payments were improper. It also found that in-home health assessments were particularly rife for abuse.

Why it matters: Critics have charged that Medicare Advantage plans can rely on health risk assessments and other tools to make patients appear sicker than they are and get a higher payment from the government.

A Congressional advisory panel, the Medicare Payment Advisory Commission, estimated in January that chart reviews and health assessments were the key drivers of coding intensity . The panel has estimated in 2023 that plans got an excess $17 billion for upcoding in 2021.

Insurers react: The insurer-backed advocacy group Better Medicare Alliance blasted the report as misleading.

“Medicare Advantage is designed to achieve a better overall understanding of individuals’ health, and in-home assessments are a crucial part of this model,” said President and CEO Mary Beth Donahue.

Insurer trade group AHIP also called the report flawed and said CMS uses a range of tools to ensure payment accuracy. The group added that OIG’s estimates show that the risk assessments represented less than 1 percent of total Medicare Advantage payments.

Next steps: OIG recommended CMS impose additional restrictions on using risk assessments and increase audits of suspect diagnoses, which the agency didn’t agree. However, CMS agreed with a recommendation to determine whether certain health conditions are particularly susceptible to misuse. The agency said it is already doing that.

Congress has increased scrutiny of Medicare Advantage overpayments in recent years alongside concerns that the plans deny too much medical care.

A message from PhRMA:

Providers

MULTIPLAN SUED — A new doctor-led lawsuit claims the data analytics firm MultiPlan colluded with insurers to undercut out-of-network payments to providers.

The American Medical Association and the Illinois State Medical Society filed the lawsuit Thursday in the U.S. District Court for the Northern District of Illinois. It calls for reforms to what the groups say is an “unlawful multilateral price-fixing scheme that has operated roughly since 2015.”

“What this lawsuit makes plain is that while many in our health system are striving for improvement, MultiPlan is profiting from price fixing,” said AMA President Bruce Scott. “This is one more example of insurance companies playing by their own rules without regard to patients or the legitimate costs required to care for them.”

The lawsuit argues MultiPlan has a “direct economic stake” in recommending lower out-of-network payment rates to insurers. Payers rely on MultiPlan to deliver out-of-network rates based on their pricing methodology.

“For each claim it reprices, MultiPlan receives a fee from the insurer based on a percentage of the difference between the initial claim amount and what the insurer pays,” an AMA press release said. “In other words, MultiPlan gets paid more as physicians get paid less.”

MultiPlan said this is just the latest of several baseless lawsuits.

“This is another copycat lawsuit of dozens filed by the same plaintiffs’ counsel, all of which are before the same judge handling the multidistrict litigation in the Northern District of Illinois,” the firm said in a statement. “We have consistently stated that these lawsuits are without merit and would ultimately increase prices for patients and employers.”

Names in the News

Dr. Scott Harris will be the next president of the Association of State and Territorial Health Organizations. He was previously state health officer for Alabama’s Department of Public Health.

The FDA’s Acting Chief Scientist David Strauss is stepping down after 14 years with the agency. He’s replaced by Steve Kozlowski, who most recently worked in the Office of Pharmaceutical Quality for the Center for Drug Evaluation and Research.

WHAT WE'RE READING

The San Francisco Chronicle reports the city’s BART transit system must pay $7.8 million after an employee claimed they should have gotten a religious exemption from getting the Covid-19 vaccine.

KFF Health News reports that some voters are worried high medical bills are being ignored in the presidential race.

A message from PhRMA:

Seniors are feeling the true cost of drug price “negotiations.”

Instead of saving money, some Medicare patients will pay more for medicines.

Others may not be able to get their medicines – 89% of insurers and PBMs say they plan to reduce access to medicines in Medicare Part D because of the Inflation Reduction Act.

Higher costs and less access. That’s not what seniors were promised.

Learn more.