Welcome to POLITICO’s West Wing Playbook, your guide to the people and power centers in the Biden administration. With help from Allie Bice. Send tips | Subscribe here | Email Alex | Email Max JOE BIDEN’s appointments to the Federal Trade Commission have been interpreted as a sign of his seriousness about tackling anticompetitive and unfair business practices. But now, that tough anti-monopoly approach is running squarely into an issue with deep personal significance to the president: battling and ultimately eliminating cancer. In two recent letters sent to the Biden administration, dozens of congressional Democrats have urged the administration to push for expanded access to a multi-cancer early detection (MCED) device developed by Grail. The medical device startup developed a first-of-its-kind blood test that it says can screen for dozens of different types of cancer. The company was recently acquired by Illumina, the leading maker of gene-sequencing machines, which would analyze those MCED tests and potentially save thousands of lives from the early-stage detection of cancers that are often diagnosed at later, more dangerous stages. But Ilumina’s purchase of Grail has come into the crosshairs of the FTC amid the Biden administration’s push for stronger antitrust enforcement in sectors like tech, pharmaceuticals, and agriculture. The regulatory agency has brought an antitrust case against Ilumina, arguing that by purchasing Grail, which is ahead of competitors in developing MCED tests, it could severely disadvantage other companies hoping to make MCED tests. Potential future competitors, the agency notes, would almost certainly rely on Ilumina’s gene-sequencing technology as well. And that, in turn, could incentivize the company to raise costs on others who use its technology, which the FTC argues will drive up the price for tests, and reduce future competition. “Allowing Illumina to purchase Grail and act on the incentives created by the acquisition would cause substantial harm to U.S. consumers, who would experience reduced innovation, as well as potentially higher costs and reduced choice and quality for these life-saving products,” a March 2021 FTC filing stated. The aggressive stance on antitrust has pleased many on the left, who felt that recent Democratic administrations have not been nearly aggressive enough on that front. But other Democrats are not convinced that this is the merger where the FTC should flex its muscles. In a March 15 letter addressed to Biden obtained by West Wing Playbook , 18 House Democrats referenced Ilumina’s purchase of Grail (though not by name), saying regulators are “delaying “access to MCED screening tests to most Americans, especially those reliant on Medicare and Medicaid,” and that the holdup would disproportionately affect nonwhite communities. “Many of these deaths in underserved communities of color are preventable through early screening and detection,” the letter reads. “[W]e must make these ‘cutting-edge’ technologies available to all Americans, as soon as possible." It wasn’t the first time that congressional Democrats have touted the technology to the administration, and protested the current regulatory battle. In a December letter to HHS Secretary XAVIER BECERRA, several dozen members of the Congressional Black Caucus, the Congressional Hispanic Caucus, and the Congressional Asian Pacific American Caucus also took issue with federal regulators, focusing primarily on issues unrelated to health care and health disparities. Like most letters, the mission is largely symbolic. The White House doesn’t have authority to interfere in FTC cases. But one person familiar with the company’s thinking said Ilumina and other proponents of the merger hope the White House will publicly voice its support for Grail’s tests. Cancer mitigation and prevention is one of the president’s top priorities, and represents one of the issues where he remains most personally invested. During his speech announcing his “Cancer Moonshot” initiatives in February, the president noted that cancer is often diagnosed too late, particularly among nonwhite and underprivileged communities. Proponents of the merger are now using Biden’s own comments to attempt to convince him to back their cause and overlook — at least in this one case — his pledge to get tough on corporate mergers. “And here’s what we’re fighting and how we know what cancer looks like today: a disease where we often diagnose it too late and we have too few effective ways to prevent it,” Biden said. “The stark inequities based on race, disparity, ZIP Code, sexual orientation, gender identity, and other factors still persist.” TEXT US — Are you LINA KHAN, FTC Commissioner and antitrust innovator? We want to hear from you (we’ll keep you anonymous). Or if you think we missed something in today’s edition, let us know and we may include it tomorrow. Email us at westwingtips@politico.com or you can text/Signal/Wickr/WhatsApp Alex at 8183240098 or Max at 7143455427.
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