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Presented by PhRMA: Delivered daily by 10 a.m., Pulse examines the latest news in health care politics and policy. | | | | |  | | By Ben Leonard and Chelsea Cirruzzo | | | | | | | 
In a 2019 State of the Union address, Trump pledged to eliminate the HIV epidemic in the U.S. in 10 years. | Pool photo by Doug Mills | THROWING IN TOWEL — When Donald Trump proposed ending HIV in the United States by 2030, he expected that a prevention-led strategy could drive new infections below 10,000 by 2025. The U.S. is not on track to get there, and now House Republicans want to give up on Trump’s plan. Progress report: There were 36,700 new diagnosed cases of HIV last year, according to preliminary CDC data. That's compared to 38,300 cases in 2017, five years earlier. That’s despite a steadily increasing budget for Trump’s program, which has grown from $266 million in fiscal 2020 to $573 million in the last fiscal year. Republicans are proposing a $542 million cut for fiscal 2024, saying the program hasn’t made sufficient progress, POLITICO’s Evan Peng reports. A House Appropriations Committee report accompanying the bill said the Trump effort “has demonstrated a lack of performance data based on outcomes, insufficient budget justifications, and vague spend plans. The initiative has not met its original objectives.” Explained House Appropriations HHS subcommittee Chair Robert Aderholt (R-Ala).: “It’s one of those things where it’s like, what do you have to have and what would be nice to have?”
| | 95 percent How much of former President Donald Trump’s Ending the HIV Epidemic in the U.S. initiative a House GOP funding bill would cut | | Even so: Advocates expect the results would be better if a global pandemic hadn’t hit amid the program rollout, and they point to better numbers in the 50 counties and seven states where HHS has focused its efforts. They’re lobbying Congress to stay the course, arguing it should be time for a doubling down on the effort — not retreat. “I’m more optimistic than not that we’re going to continue to make progress here,” said David Stacy, the government affairs director at the Human Rights Campaign, the country’s leading LGBTQ advocacy group. “The possibility of ending the epidemic in the United States is within sight, and that was not true in the past.” Reasons for hope: Drugs known as PrEP are easy to take and effective at preventing HIV infection. Simply getting them to the people who could benefit could make a major difference. What’s next? Even if Republicans move forward with the cut, as they plan to this week, they’ll have to negotiate with President Joe Biden and Senate Democrats, who want to increase the program budget. WELCOME TO MONDAY PULSE. We hope you had a good Veterans Day. The VA said that it's generated more than 80 percent awareness of the PACT Act, which expands VA health care for veterans exposed to toxic substances. Reach us at bleonard@politico.com or ccirruzzo@politico.com. Follow along @_BenLeonard_ and @ChelseaCirruzzo. TODAY ON OUR PULSE CHECK PODCAST , host Kelly Hooper talks with POLITICO's Evan Peng about a dramatic change in House Republican support for an initiative by former President Donald Trump to commit millions in funding toward ending AIDS.
| | | | | | | A message from PhRMA: The most profitable 340B hospitals provide the least amount of charity care. A new report shows the top performing 340B hospitals collected nearly $10 in profit for every $1 invested in charity care in 2021. 340B program discounts are meant to help hospitals care for their most vulnerable patients. Instead, 340B hospitals are making record profits while free and discounted care remains low. It's time to reset the balance with 340B. | | | | | | | 
Johnson’s proposal has quickly received substantial resistance from many conservatives. | Francis Chung/POLITICO | JOHNSON’S FUNDING PLAN — With government funding set to expire Friday sans action from Congress, new House Speaker Mike Johnson is giving into demands from the right with a two-tiered spending plan, POLITICO’s Congress team reports. But Johnson’s proposal has quickly received substantial resistance from many conservatives, who have pushed for significant cuts in spending. The plan would extend current funding levels. Johnson's plan would set up two deadlines for funding parts of the government — one on Jan. 19 and another on Feb. 2, which would include the Labor-HHS bill that has proven difficult to pass. The proposal increases the chances of a shutdown, unless Democrats buy in since some Republicans are skeptical. The Rules Committee is scheduled to consider the spending plan Monday, eventually deciding whether it can come to the House floor. What’s in it for health: The bill would extend funding for community health centers, teaching health centers and the National Health Service Corps through Jan. 19, POLITICO’s Robert King reports. It would also delay cuts to certain safety-net hospitals under Medicaid also through Jan. 19. The cuts were instituted in the Affordable Care Act but have never gone into effect because of delays by Congress. The proposal also would continue funding a diabetes research program that runs out of money on Nov. 17.
| | | | JOIN US ON 11/15 FOR A TALK ON OUR SUSTAINABLE FUTURE: As the sustainability movement heats up, so have calls for a national standard for clean fuel. Join POLITICO on Nov. 15 in Washington D.C. as we convene leading officials from the administration, key congressional committees, states and other stakeholders to explore the role of EVs, biofuels, hydrogen and other options in the clean fuel sector and how evolving consumer behaviors are influencing sustainable energy practices. REGISTER HERE. | | | | | | | | THE TEMPLATE FOR GOP? — With less than a year left until the election, some insiders think that Republican presidential candidate Nikki Haley may have provided a template for others in the party to follow on abortion. In the spring, Haley opted against calling for a federal 15-week ban on the procedure and instead discussed finding "national consensus" on the issue, leading to concerns among anti-abortion groups that her approach would alienate GOP base voters, POLITICO's Natalie Allison and Meridith McGraw report. But in the GOP primary debate last week, Haley gave a similar line, declaring that she remains personally opposed but does not “judge anyone for being pro-choice." “It feels like everyone’s kind of heading in the same direction, and it’s toward the position Nikki has articulated from the beginning,” said Republican strategist David Kochel, a longtime fixture of Iowa politics. Haley had “the answer that most Republicans should be learning how to articulate, because it makes so much sense ... We need people in our coalition who have diverse opinions about abortion.” The current runaway GOP favorite for president, Donald Trump, has repeatedly warned that the Republican Party risks electoral calamity if it comes off as too doctrinaire. That Haley has staked out a softer approach, too, suggests there is currently little political downside in doing so. Democrats argue Haley's moderation isn't on substance, but on rhetoric. As governor and state legislator in South Carolina, she supported anti-abortion laws. The Biden campaign quickly slammed Haley's GOP debate response, framing her as an extremist.
| | | | A message from PhRMA:   | | | | | ABBOTT SIGNS VAX MANDATE BAN — Texas Gov. Greg Abbott has signed legislation preventing private employers from having Covid-19 vaccine mandates in Texas. The law, passed during a special session of the Texas legislature, would subject violators to a $50,000 fine and potential lawsuits. Abbott signed a law that went into effect earlier this year that bars local governments from requiring masks or Covid vaccines. “It's long past time to put COVID behind us and restore individual freedom to all Texans,” Abbott said in a statement Friday. Although the push for vaccine mandates has largely faded, Abbott and the state legislature’s push on the issue underscores how anti-vaccine mandate sentiment is continuing to be a motivating political force.
| | | | A NEW POLITICO PODCAST: POLITICO Tech is an authoritative insider briefing on the politics and policy of technology. From crypto and the metaverse to cybersecurity and AI, we explore the who, what and how of policy shaping future industries. We’re kicking off with a series exploring darknet marketplaces, the virtual platforms that enable actors from all corners of the online world to traffic illicit goods. As malware and cybercrime attacks become increasingly frequent, regulators and law enforcement agencies work different angles to shut these platforms down, but new, often more unassailable marketplaces pop up. SUBSCRIBE AND START LISTENING TODAY. | | | | | | | | | SURESCRIPTS APPLYING TO DATA EFFORT — Surescripts, the health information and e-prescribing giant, is applying to become part of a major HHS data sharing initiative — the Trusted Exchange Framework and Common Agreement. Surescripts is aiming to become a qualified health information network, or QHIN. Under TEFCA, organizations can become QHINS — allowing them to share patient health information electronically — by signing a data-sharing agreement and adopting necessary infrastructure. The project’s goal is to make health data sharing more ubiquitous, and accelerate public health agencies’ information exchanges with doctors, hospitals and other health care providers. A number of major players in this space, including electronic health records firm Epic and the CommonWell Health Alliance, are also on track to be involved. If Surescripts is accepted, it would be another significant addition to the project. The company helped prescribers fill billions of prescriptions in 2022, and adding Surescripts to the effort would help more data move. What’s next: The Office of the National Coordinator for Health IT has said that TEFCA is set to go live by the end of the year.
| | ‘FOOD IS MEDICINE’ POLICY PRESCRIPTIONS — With ‘food is medicine’ — a concept that employs prescribing medically tailored meals to tackle chronic diseases like diabetes and heart disease — gaining steam, the Bipartisan Policy Center on Monday released policy recommendations. The recommendations, crafted with the help of former Senate Majority Leader Bill Frist and former HHS Secretary Donna Shalala, include: — Congress boosting Medicare coverage for specialized medical nutrition therapy; — CMS bolstering data collection efforts and testing ‘food is medicine’ payment models; — Undergraduate and graduate medical program accreditation groups establishing “nutrition-specific competencies” to ensure compliance. | | The Washington Post reports on how the raid of a Texas hemp shop underscores issues with safety and the law. CNN reports on the world's first successful transplant of a whole eye.
| | | | A message from PhRMA: 340B hospitals charge patients more. The average costs per prescription for a patient was more than 150% greater at a 340B hospital. 340B program discounts are meant to help hospitals care for their most vulnerable patients. Instead, 340B hospitals make record profits while patients often pay more. It's time to reset the balance with 340B. | | | | | | | Follow us on Twitter | | | | Follow us | | | | |  |
