| | | |   | Happy Thursday, D.C. Diagnosis readers! We hope you’re well-rested after a long midterms Tuesday night and the Love is Blind finale last night. The hits, they just keep coming. Send news, tips, midterms and TV thoughts to sarah.owermohle@statnews.com. | | | Red wave, ripple, or trickle – midterms shook expectations Water metaphors aside, there are still a lot of unknowns as votes are tallied in this year’s midterm elections. The House, long-thought to be a solid win for Republicans, is still likely to tip their way, but with a surprisingly narrow majority. Just a few counts in Arizona, Georgia, and Nevada will decide the Senate majority.
What does this mean for health agendas? House Republicans are still primed to launch investigations into the origins of the coronavirus, pandemic spending and top health officials. But they’re sharply aware that if they want any health legislation to happen, they’ll likely have to work across the aisle – especially if Democrats defend their Senate majority.
Speaking of that chamber, Sen. Rand Paul unsurprisingly re-won his Kentucky seat, but it remains to be seen whether Republicans pull ahead and earn him a committee chairmanship. Even if Democrats maintain control, Paul is positioned to be the highest ranking member on either the HELP Committee or the Committee on Homeland Security and Government Affairs.
Other Republicans who have criticized the Biden pandemic response and questioned vaccine safety, like Wisconsin incumbent Sen. Ron Johnson, narrowly beat competitors. In Arizona, Republican contender for the Senate Blake Masters is locked in a dead-heat battle that wasn't called by the time D.C. Diagnosis hit your inbox. Similarly, a hotly contested race for Arizona governor — where Republican candidate Kari Lake has capitalized on vaccine misinformation and ire for public health figures — remains uncalled. | A referendum (or five) on abortion rights 
Wilson Ring/AP One clear signal in the wake of the Tuesdays’ votes is that many Americans support at least some abortion rights. Voters in Vermont, Michigan, and California approved ballot measures codifying abortion as a constitutional right, while Kentucky voters rejected a proposal to do the opposite and explicitly say it is not a right.
While Vermont and California’s outcomes were expected because of their large progressive populations, abortion rights and anti-abortion advocates both told STAT that Michigan and Kentucky would be key tests of broad voter sentiments.
Besides being a swing state (where Democratic Gov. Gretchen Whitmer also defended her seat) Michigan is now an important Midwestern island for abortion care, as neighboring states pass more restrictions, Planned Parenthood’s Ianthe Metzger said. There also was record voter turnout in the state this year, especially for a midterm election without a presidential race.
Meanwhile Kentucky’s vote suggests that while many people are opposed to broad abortion access, they aren’t comfortable with shutting it down, either. Republican candidates for office have reflected this too, softening their hard-line abortion stances as voters bristle at broad bans.
“That alone is an indication that they know that abortion rights are popular,” said Metzger. | Some other midterms notables: Californians voted overwhelmingly Tuesday to ban all flavored tobacco products in the state, including menthol cigarettes. While some smaller east coast states have passed similar measures, California is by far the largest so far to ban the products, Nick Florko writes.
Arizona passed a first-of-its-kind ballot measure to cap medical debt interest at 3% and shield people dealing with economic hardship. More than 70% of voters approved of the measure.
Oregon also had a first-ever ballot measure that would enshrine citizens’ rights to health care in the state constitution. But as of publishing, that proposal is in a deadlock, with votes still being tabulated.
Another too-close-to-call vote is in Colorado, which could be the first state to decriminalize psychedelic plants and mushrooms if a very narrow lead in the ‘yes’ votes holds.
In South Dakota, voters approved a measure to expand Medicaid to people with income below 113% of the federal poverty line, joining 38 other states in broadening the program, with significant federal funding, in the wake of the Affordable Care Act. Republican lawmakers had opposed the move, but it was ratified with 56% of the vote. | How do healthcare distributors support 20,000 independent pharmacies across the country? Distributors provide logistics expertise and administrative services, helping independent pharmacists navigate change, optimize business performance, implement the latest technologies and learn about new industry trends. Through Pharmacy Services Administrative Organizations (PSAOs), healthcare distributors amplify the voices of independent pharmacists to interact with healthcare insurers and PBMs, ultimately creating administrative efficiencies for these small businesses. Learn more about the critical services that enable pharmacists to better focus on patient care and serve their communities. | The public health emergency remains The Biden administration is expected to extend the Covid-19 public health emergency as soon as today, two HHS officials told STAT. However questions are building over whether this will be the last renewal.
HHS has pledged to give hospitals, pharmacies, and pharmaceutical companies a 60-day notice for extending each PHE because of the flexibilities and policy nuances wrapped up in the emergency, from freezes on booting people off of Medicaid to liability protection for drug and device developers who made Covid-19 related products. Emergency use authorizations wouldn’t expire, but the expiration could launch a quagmire of potential regulatory confusion.
Still, Republicans have been harping on the Biden administration to end the administration, though people largely projected it would last until at least early 2023. | With abortion options narrowing, gestational age takes new weight States’ increasingly restrictive laws around when someone can abort a fetus suppose there are specific moments when gestation and viability begin — a scientific guess, at best, that can have devastating consequences for families searching for options and care, STAT’s Eric Boodman writes.
Gestational age is a well-informed estimate, using a combination of menstrual cycles, hormones and ultrasounds that compare fetuses to an average size. But it’s an imperfect measure that nevertheless has taken on new urgency as state governments limit legal abortion to 20, 10, and even six weeks.
Case in point: Stephanie Dworak, a Nebraska woman who struggled to find an abortion clinic after receiving a severe fetal diagnosis at roughly 20 weeks and five days, drove across multiple states and clinics and eventually found a provider in Colorado.
“If you want to clear up what counts as a life-threatening condition, you would probably write a thousand-page textbook,” said Annie Dude, a North Carolina specialist in high-risk pregnancies. Read more here. | What we're reading - After years of lax oversight, the NIH is starting to contact institutions about unreported clinical trial results, STAT
- A tiny lab finds danger on drugstore shelves while the FDA lags behind, Bloomberg
- Clovis Oncology warns of likely bankruptcy filing following years of scandal and financial losses, STAT
- Americans with disabilities need an updated long-term care plan, say advocates, NPR
- The U.S. Supreme Court will review a contentious Amgen patent case, but not one involving Bristol. Why?, STAT
| Thanks for reading! More next week,  | | | |
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