GOP’s big bet on transgender issues

Presented by CareQuest Institute for Oral Health: Delivered daily by 10 a.m., Pulse examines the latest news in health care politics and policy.
Nov 01, 2024 View in browser
 
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By Chelsea Cirruzzo and Ben Leonard

Presented by CareQuest Institute for Oral Health

With help from Robert King

Driving the Day

A protester holds a poster calling for lawmakers to protect trans children.

The GOP has heavily invested in a messaging campaign that opposes transgender youth rights, but some Republicans advocate for less government intervention. | Rogelio V. Solis/AP

CLOSING LINE — Republicans are spending big on an issue that rarely rises to the top of the list of voter concerns: the rights of transgender kids, POLITICO’s Daniel Payne reports.

Former President Donald Trump is spending more on ads criticizing Vice President Kamala Harris’ support for transgender rights than he is on any other subject in the campaign’s closing days — and down-ballot Republicans are following suit, believing the issue can tip close races.

Campaign strategists see the ads, often focused on transgender girls in women’s sports leagues or Democrats’ support of gender-affirming care, as a play to voters beyond their base. One adviser said they’ve seen their messaging “move the needle a substantial amount” among undecided voters, leading to “a lot of money” being put into ads doubling down on the issue.

But that’s causing concern in the party about the feasibility of the policies some GOP states have pushed in recent years and whether those policies signal a drift in the party from its small-government values.

Some Republicans have split with party leaders, saying conservatives should advocate for less government intervention in transgender kids’ medical and educational decisions.

And nationwide, some Republicans find it easier to oppose trans rights in theory than in reality — when it means kicking a child off a team or blocking parents from proceeding with medical care recommended by a doctor.

“Why would you want the state to be making these decisions?” said Barbara Comstock, a Republican who represented a northern Virginia House district for two terms ending in 2018. “It opens a Pandora’s box when you don’t allow the parents and the doctors to make this decision.”

The majority of Americans are split across the specific issues, according to polls: Most are uncomfortable with gender transitions generally but oppose gender-affirming care bans, in favor of protecting transgender people’s rights but also want sports to be divided by sex assigned at birth.

In the meantime, transgender kids and their families face being a central issue in a historic election.

“They go to restaurants, and the TVs are on, and they see the ads. They turn on the TV at home, and they see the ads,” Jay Brown, chief of staff at the Human Rights Campaign, the nation’s leading LGBTQ advocacy group, said. “It’s in their faces all the time.”

WELCOME TO FRIDAY PULSE. Enjoy your last preelection weekend and get some rest — but also send all your election-related tips, scoops and feedback to ccirruzzo@politico.com and bleonard@politico.com and follow along @ChelseaCirruzzo and @_BenLeonard_.

 

A message from CareQuest Institute for Oral Health:

Drug prices, mental health, abortion — all health care topics the presidential candidates are debating. But neither is focused on the topic that has support from both parties: extending dental care to millions in the US who lack insurance. A new national poll commissioned by CareQuest Institute and the Oral Health Progress and Equity Network (OPEN) shows voters want better dental coverage in Medicare. Learn more and take action to improve the oral health system.

 
ELECTION 2024

Robert F. Kennedy Jr.

Former President Donald Trump's potential alliance with Robert F. Kennedy, above, on health policy is alarming agricultural industry groups. | Stefan Jeremiah/AP

KEEPING RFK JR. AT BAY — Powerful agriculture industry groups, including lobbyists and trade groups representing farmers, are defending their interests as former President Donald Trump’s campaign embraces Robert F. Kennedy Jr.’s health claims, POLITICO’s Marcia Brown, Grace Yarrow and Brittany Gibson report.

Why it matters: The reaction to Kennedy’s agenda marks one of the ways the agricultural industry world is bracing for the possibility of a Trump return.

As one food industry lobbyist put it, Kennedy has “taken on a whole life of his own in the last few weeks.”

Kennedy claims “control” over health: On Monday, Kennedy claimed at a virtual event that Trump promised him “control of the public health agencies,” which he said included HHS.

Trump transition co-chair Howard Lutnick said on CNN Wednesday night that Kennedy “is not going to be in charge of HHS,” though he suggested the noted anti-vaccine conspiracy theorist could get a role examining health and vaccine data. People familiar with the transition conversations have told POLITICO that Trump would be more likely to name Kennedy to some sort of food and health “czar” role that doesn’t require Senate confirmation.

Kennedy declined to directly answer Pulse’s questions but said in a statement that he’s grateful to Trump for his commitment to end chronic disease.

Steven Cheung, the Trump campaign’s communications director, said that “formal discussions of who will serve” in a Trump administration are “premature.” Cheung didn’t deny Trump promised Kennedy control of health and food agencies.

A former Trump HHS official cautioned that no one knows how much influence Kennedy would wield if the former president wins next week. For now, the Trump team is engaging Kennedy on his “healthy living” aims rather than “aggressive FDA ideas,” said the former official, granted anonymity to talk freely about campaign conversations.

Sen. Bill Hagerty (R-Tenn.), who’s expected to be influential in a potential Trump administration , said he wouldn’t speculate on potential roles but left the door open to Kennedy.

“As someone who has met with Bobby Kennedy on multiple occasions, I think President Trump utilizing his extensive work on improving America’s health and our government’s role in this effort is smart,” Hagerty said in a statement to POLITICO. “It shows that Republicans are a big-tent party willing to embrace innovative ideas and new partners in order to tackle the serious health challenge facing our nation.”

FORMER HHS DEPUTY TAPPED FOR TRANSITION — A former Trump administration deputy chief of staff is helping the Trump campaign with transition plans, Chelsea and POLITICO’s David Lim report.

That’s according to two people familiar with the Trump transition and a third person close to the campaign granted anonymity to speak freely about the effort.

Paul Mango, former HHS deputy chief of staff, worked closely with then-HHS Secretary Alex Azar on Operation Warp Speed in the early days of the pandemic. He is now a public adviser at Paragon Health Institute, a conservative think tank.

Steven Cheung, a spokesperson for the Trump campaign, confirmed that there’s a transition leadership group “to initiate the process of preparing for what comes after the election.” But he didn’t reply to a direct question about whether Mango is a part of that team.

Mango comes with deep institutional knowledge of the department — before becoming deputy chief of staff, he was chief principal deputy administrator and chief of staff at CMS in the Trump administration. At one point, Mango was rumored as a possible replacement for Seema Verma, Trump’s CMS administrator, who often clashed with Azar. He also worked for several decades at McKinsey & Company.

Mango didn’t respond to multiple requests for comment.

 

A message from CareQuest Institute for Oral Health:

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In Congress

FIRST IN PULSE: SEEKING A SITE-NEUTRAL PAY CUT — Sens. Bill Cassidy (R-La.) and Maggie Hassan (D-N.H.) are releasing a bipartisan plan to stop hospitals from getting more payments from Medicare for the same services delivered at the doctor’s office, POLITICO has learned.

Robert reports that the two senators will release a legislative framework Friday detailing a plan to impose site-neutral payments for hospitals’ outpatient departments. The goal is to generate savings that can then be used to help rural and so-called safety-net hospitals.

“If the same care can be safely provided in different settings, patients should not pay hundreds more simply because their doctor works in a hospital,” Cassidy, the top Republican on the Senate Health, Education, Labor and Pensions Committee, said in a statement to POLITICO.

Hassan added that the measure could save taxpayers billions of dollars because of lower costs.

However, their plan faces long odds of passing both chambers during the lame-duck session, even as it comes amid broader efforts to reduce Medicare spending. And it will likely face blowback from hospital groups, which argue they need to charge the additional rates to compensate for added costs such as stricter licensing requirements.

If enacted, the framework would install one rate for common services provided outside of a hospital. It would also remove a grandfathering exception for a separate site-neutral pay cut installed in the Bipartisan Budget Act of 2015.

Cassidy and Hassan seek to use the savings to invest in rural and safety-net hospitals that have been slammed by closures over the years.

Names in the News

Clare Pierce-Wrobel will be health policy and analytics director at the Oregon Health Authority. She previously was director for delivery system reform at the White House Domestic Policy Council.

WHAT WE'RE READING

The New York Times reports on a study showing that restricting sugar early in life reduced the risk for diabetes and heart disease later.

STAT looks into Apple’s claims that its new AirPod hearing aid feature is “clinical grade.”

The Associated Press reports on the mixed results of Bristol Myers Squibb’s schizophrenia drug.

 

A message from CareQuest Institute for Oral Health:

A national poll shows that adding dental benefits to Medicare is a top health issue for US voters, even over abortion and the ACA. More specifically:

· 9 out of 10 voters want a Medicare dental benefit.
· More than 4 out of 5 voters for Trump in 2016 and 2020 want a dental benefit added to Medicare.
· 99% of those who voted for the Democrat candidate in the last two elections want a dental benefit added to Medicare.

“Far too many people have discovered oral health care is too expensive and out of reach,” says Melissa Burroughs, CareQuest Institute director of public policy. “Yet this issue has been on the back burner when it comes to policy conversations and the political commitment to address it.”

It’s simple: the American people want dental care included in Medicare. It’s time to make this policy change a top priority — our health depends on it.

 
 

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