The GOP’s post-election health priorities

By Daniel Payne and Krista Mahr

With Adam Cancryn

Republicans are looking to set a new health plan agenda for 2023. | Chip Somodevilla/Getty Images

A 2023 HEALTH AGENDA — Republicans, poised to take control of the House, are already planning their first moves in the new Congress.

Outside of abortion, healthcare topics — and the pandemic in particular — were conspicuously absent from a number of campaigns during the midterms. But new GOP strategies are likely to change that.

House Republicans are already planning investigations into the government’s pandemic response, according to a House GOP aide granted anonymity to freely discuss the plans with Pulse. Other priorities include addressing fentanyl’s role in the opioid crisis and reigning in the Biden administration’s pandemic responses.

Senate Republicans share many of those targets. The office of Sen. Roger Marshall (R-Kansas), who is on the Senate HELP Committee, told Pulse in a statement Wednesday that a top priority for his GOP brethren is investigating the origins and responses to Covid-19, among plans to lower health costs and spur innovation among drugmakers.

Many of the Republicans’ goals will be out of reach without the power to override a veto, but a few issues still remain top of mind.

Oversight, oversight, oversight: “Thanks for coming out to Dr. Fauci’s retirement party!” Sen. Rand Paul said Tuesday after being reelected to his Kentucky seat. The quip was a sign of the direction Republicans might take next year as they try to keep the investigations into the Biden administration’s response to the Covid-19 pandemic front and center ahead of the 2024 presidential election.

The House Oversight and Reform Committee will likely probe Covid-19’s origins , including the CDC’s pandemic response, how pandemic relief dollars have been spent and Anthony Fauci’s role in approving research programs considered controversial among Republicans. House Republican leadership elections are scheduled for Nov. 15 , and Rep. James Comer (R-Ky.), currently the committee’s ranking member, is in line to take the gavel.

The House Energy and Commerce Committee also plans to look into the Biden administration’s Covid-19 policies, including school shutdowns and HHS Secretary Xavier Becerra’s plans to implement the new drug price controls.

The future of federal Covid responses: Attempts earlier this year to pass legislation for additional funding to fight Covid-19 (and monkeypox) were dealt a blow by GOP leadership , and President Joe Biden’s comment that the pandemic was over added to resistance to allocating more money for the public health response.

“President Biden stated that the pandemic is over: amidst the massive inflation, his administration shouldn’t expect any more emergency funding for the Covid public health emergency,” the Republican aide said in a text to Pulse.

Republicans have repeatedly called for ending the public health emergency, which could have a cascading effect on the healthcare system. GOP lawmakers want to curb spending and say Biden is “clinging to his emergency powers.” Those calls will likely continue, along with attempts to end the national emergency declaration, which is separate from the PHE. Biden has said he would veto the proposal .

WELCOME TO THURSDAY PULSE, where we hope you have some interesting post-midterm plans to share with us. Send them — along with tips and news — to dpayne@politico.com and kmahr@politico.com.

TODAY ON OUR PULSE CHECK PODCAST, Ruth Reader talks with Grace Scullion about a coming Supreme Court decision that could have broad implications for who is accountable for ensuring individual rights to federally funded services. Plus, Chris Murray, director of the Institute for Health Metrics and Evaluation at the University of Washington, on his new study that estimates immunity to Covid-19 by country.

A message from PhRMA:

Fresh data show the 340B program may be driving up costs for some patients. How? A new analysis finds 340B hospitals prescribe patients more expensive medicines than non-340B hospitals on average. It’s time to fix the 340B program. Learn more.

President Joe Biden takes post-midterm questions from the press on Wednesday. | Susan Walsh/AP Photo

DEMS REMAIN HOPEFUL — Biden declared Election Day a “good day for democracy and, I think, a good day for America,” keeping an optimistic tone about his party’s performance.

Exit poll responses indicated voter concerns about abortion rights were a motivating issue.

"If you look at these individual members who succeeded, health care was a huge part of what they stood for and talked about,” Leslie Dach, a former Obama-era senior health official and chair of the Democrat-aligned group Protect Our Care, told Adam.

MORE ITEMS ON THE GOP WISH LIST — Though pandemic oversight and funding are keys to Republican plans, other issues will remain in focus through the next Congress.

Cuts to Medicare? Some Republicans have suggested in recent weeks that they might look at ways to revisit spending on Medicare as part of budget negotiations if they win control of the House. Minority leader Kevin McCarthy declined to say whether Medicare cuts would be part of debt-limit negotiations when pressed on the subject recently. But a House Republican Study Committee budget plan released this summer backed raising the age for the program to 67, among other changes, according to a Bloomberg report .

The move is politically dangerous since Medicare is popular. Don Bolduc, who lost his bid to unseat Sen. Maggie Hassan (D-N.H.), advocated for privatizing Medicare during a campaign town hall in early August, according to a recording of the event obtained by POLITICO . A Bolduc spokesperson later walked back the comments, saying the candidate now opposes privatizing Medicare, Medicaid and Social Security.

Action on fentanyl: Republicans in the House will likely focus on the opioid epidemic, looking to crack down on fentanyl.

The HALT Fentanyl Act — which would make all fentanyl-related substances schedule I drugs — would be central to that effort. Some researchers have opposed the measure , saying it would hinder research that could produce new addiction treatments.

Big tech companies will also probably be brought into a fight over fentanyl, with Republicans already asking for more to be done to stop sales online.

A message from PhRMA:

THE RED WAVE CRASHES INTO ABORTION RIGHTS — Predictions of a Republican takeover were defied by a surge in turnout amid concerns about the future of abortion rights, POLITICO’s Alice Miranda Ollstein and Megan Messerly write .

In races for governor, senator, attorney general and state legislator, Democratic victories will likely enable millions of people to have access to legal abortions — further supporting arguments that reproductive rights is a winning issue for the party.

Beyond seemingly being a winning message for Dems, ballot initiatives on abortion saw significant wins for abortion rights advocates.

It’s another sign of the pressure advocates will put on the Biden administration, especially as the White House has taken a cautious approach in responding to the fall of Roe v. Wade.

ABORTION REMAINS LEGAL IN SOUTH CAROLINA AMID GOP DIVISIONS — South Carolina Republicans failed to enact new abortion restrictions Wednesday, with members of the state House and Senate unable to agree on how far to go, POLITICO’s Megan Messerly reports .

As a result, chances seem slim for meaningful restrictions this year, though a future compromise is possible.

The disagreement hinged on when abortions would be banned, with the House proposing a ban starting at conception with exceptions for rape, incest and risk to the pregnant person's life. But Senate leadership said it has only enough votes to prohibit the procedure starting around six weeks of pregnancy.

The chasm in South Carolina isn’t far from the disagreements within the GOP nationwide over how tightly to restrict abortions — and at which level of government to do so.

TUNE IN TO THE PULSE CHECK PODCAST: Keep your finger on the pulse of the biggest stories in health care by listening to our daily Pulse Check podcast. POLITICO’s must-listen briefing decodes healthcare policy and politics, and delivers reality checks from health professionals on the front lines. SUBSCRIBE NOW AND START LISTENING .

NEW IDEAS ON MENTAL HEALTH FROM SENATE FINANCE — In a discussion draft released this morning, the Senate Finance Committee laid out new ideas for Congress to address mental health, including:

— Integrating mental health services with primary care through increased payment rates and requiring CMS to create best practices around integrating mental health services and primary care

— Standardizing Medicare reimbursements for mobile crisis response services

— Creating bundled Medicare payments for crisis-stabilization services, including observation care and screening for suicide risk

A message from PhRMA:

The 340B program grew, yet again, hitting a whopping $43.9 billion in sales at the discounted 340B price in 2021. But there has not been evidence of corresponding growth in care provided to vulnerable patients at 340B covered entities. And making matters worse, fresh data show that 340B may actually be driving up costs for some patients and our health care system as whole. The program of today is having the opposite effect of what Congress intended when they created 340B. That’s a problem. It’s time to fix the 340B program. Learn more.

SUPPLY CHAIN WOES CONTINUE — Shortages of specialty tracheostomy tubes used in pediatric surgeries threaten the ability of healthcare providers to properly care for children as they recover from serious illnesses, POLITICO’s David Lim reports.

“In the hospital setting, you have children who may be staying on a ventilator longer than otherwise because they can’t be switched onto the tracheostomy tube due to insufficient supply,” Jeff Shuren, the FDA’s top medical device regulator, told David.

Years into the pandemic, supply chain issues still complicate the availability of medical devices. Shortages of the tracheostomy tubes might not be fully resolved for several months.

The New York Times’ Emily Baumgaertner writes about the racial disparity in drug treatment for addiction.

STAT’s Andrew Joseph reports on the first time a fatal enzyme deficiency was treated in the womb.

STAY AHEAD OF THE CURVE: Our Future Pulse newsletter will continue to bring you the biggest stories at the intersection of technology and healthcare, but now five times a week. Want to know what’s next in health care? Sign up for our Future Pulse newsletter. If you aren’t already subscribed, follow this link to start receiving Future Pulse .

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