Making sense of Trump's health agenda

Seven months before the presidential election, Donald Trump's health care priorities remain fuzzy at best. But one thing is certain: A second Trump administration would put its own stamp on a host of critical issues that are top of mind for voters.

The former president has seesawed on federal abortion bans, the prospect of repealing the Affordable Care Act, and ways to lower drug costs. But while Trump's messaging on abortion and insurance has shifted in recent months, Medicare negotiating power could work in his favor as he resurrects first-term efforts to reform drug pricing policies, experts tell STAT.

Trump has heard from a cadre of think tankers and first administration veterans, from former White House aides to Health and Human Services officials now placed at Paragon, America First Policy Institute, and the Heritage Foundation, among others. But what does that mean for ACA, drug prices, and abortion? More from me.

on the hill

Key Senate committee poised to release drug shortage bill

The Senate Finance Committee is expected to release a draft bill aimed at stemming drug shortages as soon as this week, according to five people who spoke to John Wilkerson about the committee's plan.

There are now more drugs, including chemotherapies, in short supply than there were a decade ago, according to an April 11 report by the pharmacist group ASHP. The Finance Committee released a paper in January that includes multiple bipartisan ideas for fixing the drug shortage crisis. One of the big concepts in that paper was to hike Medicare payments to hospitals that use business practices that mitigate shortages, such as committing to sufficient purchase volume in long-term contracts.

The White House this month also published a drug shortage plan that includes rewarding hospitals for business practices that stem shortages. Unlike the White House plan, the Senate Finance bill might also reward hospitals that achieve desired outcomes, regardless of how they get there, according to a March 9 committee document that outlines policies that were under consideration at that time.

CMS action

Market says meh to nursing home rules

The Biden administration this week finalized minimum nursing home staffing rules, over a cacophony of industry opposition from nursing home companies saying that workforce shortages could make the proposition unworkable.

But despite their complaints, the stock market didn't react much at all, my co-author Rachel Cohrs writes. Of three of the largest for-profit, publicly traded nursing home companies, the stock prices of two of them (Brookdale Senior Living and Encompass Health Corporation) were up at the end of the day.

The stock price of The Ensign Group dipped a bit, but the change was less than a single percentage point. It's a signal of investor confidence in the industry's ability to rise to the challenge.

money moves

Drug companies, start your lobbying engines

PhRMA, drug companies, and universities are revving up their lobbying on the BIOSECURE Act, according to the latest lobbying disclosure reports.

The Biotechnology Innovation Organization has gotten most of the attention for reversing its position on the bill, which aims to stop U.S. biotechs from doing business with companies linked to China's military and the Chinese Communist Party. PhRMA has mostly avoided attention, though both PhRMA and BIO now take a similar position. A PhRMA spokesperson told my colleague John Wilkerson the trade group is "working constructively with Congress to help protect national and economic interests and make sure patients are not unintentionally impacted with potential drug shortages or disruptions to medicine R&D."

The Chamber of Commerce, whose members include drug companies, is now actively lobbying on the legislation, according to its first quarter filing.

There are more than a dozen companies lobbying on the BIOSECURE Act, including AstraZeneca, Biogen, Jazz Pharmaceuticals, Vertex Pharmaceuticals, Thermo Fisher Scientific, Beigene USA, Otsuka America Pharmaceutical, and Amgen. Amgen has in-house and contract lobbyists working on it.

The Association of American Universities also added the BIOSECURE Act to its lobbying disclosure. Academics often use Chinese biotech companies for research. A bipartisan group of House lawmakers last week cautioned a separate group, the Association of American Medical Colleges, against hiring Chinese companies for genomic sequencing services.

reproductive rights

Readying for the next abortion hurdle

Biden officials are still pressing to shore up abortion protections amid an onslaught of legal challenges, one of which is slated for Supreme Court arguments this week. HHS on Monday released a final rule that would put abortion services under the same federal privacy protections as other health care data covered by HIPAA. The rule effectively allows providers to deny access to health care data that could be used to prosecute people in abortion-restrictive states.

Federal lawyers will also be at the Supreme Court Wednesday to defend another HHS attempt to bolster reproductive rights by protecting emergency services. The administration has sued Idaho, arguing its abortion ban — which only allowed for abortion in the event of a mother's likely death, but not for serious injury or disability — violated this law.

"We have no illusion that everything that the president has urged us to do with our authorities is going to undo Dobbs," HHS Secretary Xavier Becerra told reporters on Monday. "Dobbs took away rights. Until we have a national law that reinstitutes Roe v. Wade, we're going to have issues." More from me.

money moves

Lobbying bits and bobs

The AMA spent more than a half million dollars more on lobbying this quarter compared with last year amid a brutal lobbying battle over pay for doctors in March appropriations bills, going from a $6.7 million spend to $7.3 million.
While Congress fought over PBM policy that ultimately stalled, PhRMA upped its lobbying spend by 20%, dropping $9.6 million in the first quarter of this year.
They've been lobbying for a few years, but we just noticed that the scrubs company FIGS has been lobbying on health care workforce issues. According to the company, it spends its time on the Hill promoting loan and scholarship assistance for health care professionals, asking lawmakers to pass workforce protections for health care workers, and requesting funding for mental health support programs.

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