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Delivered daily by 10 a.m., Pulse examines the latest news in health care politics and policy. | | | | |  | | By Daniel Payne and Krista Mahr | With David Lim and Ben Leonard
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Sen. Bill Cassidy has legislative plans to address the health workers shortage. | Alex Brandon/AP Photo | MORE WORKFORCE LEGISLATION PLANS — Sen. Bill Cassidy (R-La.) told Pulse Wednesday he plans to introduce a bill to address the health workforce shortage, an early effort to target a health care issue that’s a top priority for many lawmakers, providers and patients alike. “I had an advanced practice nurse who was with me last Congress and left us legislation,” Cassidy said. “I’d rather not talk about the particulars until we actually introduce, but it's something which she, as an academic advanced practice nurse, conceived of that we thought would help.” Though he wouldn’t share details, Cassidy said “part of it” came from some strategies proposed during last week’s Senate HELP committee hearing on the health workforce shortage. During the hearing, Cassidy, the committee’s ranking member, said the existing workforce should be dispatched “more efficiently,” adding that those already working in health care need more opportunities to expand their skillset and education. He also noted the importance of reducing administrative tasks for doctors, which he said increased physician burnout. Cassidy’s planned legislation comes after HELP Chair Bernie Sanders (I-Vt.) told Pulse last week that he’s also looking to address the workforce crisis with legislation in the future. But that doesn’t mean both legislative solutions will be the same. Cassidy said he and Sanders haven’t “compared legislative notes” on the issue yet. Still, senators across the HELP committee signaled optimism about coming up with bipartisan solutions when discussing it at a hearing last week. At that hearing, senators discussed ideas — boosting funding to training programs, offering more visas for health workers, making the work less stressful and more — but exactly how lawmakers will approach the issue remains to be seen. TODAY ON OUR PULSE CHECK PODCAST, host Ruth Reader talks with U.S. Surgeon General Vivek Murthy about his desire to help kids who struggle with mental illness and his office’s guidelines for how to support young people's mental health.
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Health care unions want more staffing standards. | Karen Ducey/Getty Images | FIRST IN PULSE: A MILLION-DOLLAR MESSAGE — Health care unions are starting a multiyear national campaign pushing for more staffing standards, whether through state and federal laws or bargaining agreements with employers. The American Federation of Teachers, which counts nurses and health care workers among those it represents, says it’s the fastest growing health care union, will launch the campaign along with its affiliates in Oregon, specifically pushing for the passage of state legislation that would “enshrine staffing standards,” the group said. The efforts, which aim to connect the health workforce shortage with patient-care quality and outcomes, will span the country and include advertisements and investments in union affiliates.
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Abortion rights supporters will meet with Vice President Kamala Harris today. | Pool photo by Greg Nash via Pool | BIDEN ADMIN BRACES FOR ABORTION PILL RULING — A Texas judge could rule as soon as today to outlaw abortion pills nationwide, including in blue states where their use is currently protected. Vice President Kamala Harris is meeting at the White House today with reproductive rights advocates, abortion providers and legal defense groups to discuss what the administration can do should the judge strike down the FDA’s two-decade-old decision to approve abortion pills for sale. A White House official told our Alice Miranda Ollstein that the meeting will go over how the federal government can respond to what they see as “unprecedented attacks to undermine the authority of the FDA and take away access to reproductive health care for women no matter where they live.”
| | | MEDICARE DOUBLES DOWN — Medicare isn’t looking back on its earlier stance on covering certain Alzheimer’s drugs, leaving patients not enrolled in further studies with the bill for the therapies themselves, POLITICO’s Katherine Ellen Foley reports. “There is not yet evidence meeting the criteria for reconsideration,” the Centers for Medicare and Medicaid Services said in a statement. “CMS will expeditiously review any new evidence that becomes available that could lead to a reconsideration.” The decision comes after the Alzheimer’s Association, a patient advocacy group, asked CMS in December to reconsider its coverage determination for monoclonal antibodies that target the proteins thought to cause Alzheimer’s. CMS said last year it would cover only those therapies that received accelerated approval from the FDA for patients in a randomized trial. CMS decided to limit coverage for the entire class of drugs in 2021 after the FDA granted accelerated approval to Biogen’s Aduhelm. It now also applies to Leqembi, a similar therapy from Eisai and Biogen that received accelerated approval earlier this year and could apply to future therapies.
| | | DATA SHARING PLEDGE 2.0 — The Department of Veterans Affairs on Thursday announced a relaunching of its pledge to standardize health data practices that it initially rolled out under the Trump administration, Ben reports. Shereef Elnahal, the VA’s under secretary for health, said Thursday at the Health Datapalooza conference in Arlington that the agency is launching the “Open API Pledge 2.0.” The announcement was light on details, but the original pledge called on providers to work with VA to speed up aligning health data with industry standards and offered API access to developers for apps. “The foundation that has been laid for interoperability up to this point has led us to a point now where we can finally take advantage of the technology infrastructure currently present,” Elnahal said. “We need your help.”
| | | PATENTLY SKEPTICAL — Merck’s efforts to obtain new patents for blockbuster drug Keytruda, which treats multiple types of cancer, may face hurdles, David reports. A blockbuster drug generates more than $1 billion in revenue annually. Top progressive lawmakers wrote in a Wednesday letter to USPTO Director Kathi Vidal that the patents should be carefully reviewed by the U.S. Patent and Trademark Office. “Should the USPTO approve new patent applications for the drug, biosimilar competitors could be shut out of the market until 2036, giving Merck a total period of nearly 35 years of patent protection for Keytruda,” wrote Sens. Elizabeth Warren (D-Mass.) and Bernie Sanders (I-Vt.) and Reps. Katie Porter (D-Calif.) and Pramila Jayapal (D-Wash.), adding the protections would extend beyond the intent of the law. PRESSING CMS ON IRA SPENDING — Top Republicans are asking CMS Administrator Chiquita Brooks-LaSure and HHS Secretary Xavier Becerra for transparency and quarterly updates about how the Biden administration uses $3 billion in Inflation Reduction Act funds allocated to help set up the Medicare drug negotiation program, David reports. “By sidestepping regular order and bypassing the standard appropriations process, proponents of the IRA set aside billions in taxpayer dollars with no reporting requirements or tools to prevent waste, fraud, and abuse,” wrote House Energy and Commerce Committee Chair Cathy McMorris Rodgers (R-Wash.), House Ways and Means Committee Chair Jason Smith (R-Mo.) and Senate Finance Committee ranking member Mike Crapo (R-Idaho). The lawmakers are asking for updates on projected spending from the fund and how much unused money will remain over the next decade so Congress can “as appropriate, adjust the IRA’s statutory spending level.”
| | | HOSPITAL MARGINS AND MEDICAID EXPANSION — A new report from KFF found the finances of rural hospitals were worse in states where Medicaid wasn’t expanded than in states where it was. On average, from July 2021 to June 2022, being in a Medicaid-expanded state was the difference between a positive and negative operating margin when relief funds aren’t included. When including relief funds, the operating margin of rural hospitals in a state with an expanded program was 3.9 percent, compared with a 2.1-percent margin for those in states where Medicaid wasn’t expanded. The analysis found that increased margins from funding boosts are again falling to lower pre-pandemic levels.
| | | Danielle Carnival has been promoted to deputy assistant to the president for the White House’s Cancer Moonshot initiative and deputy director for health outcomes for the Office of Science and Technology Policy, POLITICO’s Daniel Lippman has learned. She most recently was Cancer Moonshot coordinator and senior adviser to the director of OSTP. Linda Rouse O’Neill has been promoted to senior vice president for supply chain policy at the Health Industry Distributors Association. Joseph R. Impicciche, CEO of Ascension, will fill a vacancy on the American Hospital Association’s board of trustees. Bill George has joined FGS Global as a senior adviser. He was previously chair and CEO of Medtronic.
| | | Jeneen Interlandi, for The New York Times’ Opinion section, goes deep into a new approach to handling the opioid crisis. KHN reports on states seeking a crackdown on toxic ingredients in cosmetics. The Economist writes about a worrying amount of fraud in scientific research.
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