Cassidy throws water on Trump's ACA repeal refrain

Just hours after former President Trump repeated his assertion that he's working on ideas to repeal and replace the Affordable Care Act during Tuesday's presidential debate, a top Republican in the Senate dismissed the possibility out of hand.

Wednesday morning, I caught up with Sen. Bill Cassidy (R-La.), who could lead the Senate health committee if Republicans retake the chamber. He said he's only interested in pursuing health care reforms if they're bipartisan, and that Democrats aren't interested in replacing the Affordable Care Act. He did say, however, that some smaller policies on the margins could pass.

Cassidy also voiced concerns about proposals to equalize Medicare payments between hospital outpatient departments and other sites of care, called site-neutral payments, but also outlined ways to make them more politically palatable. More on his remarks here.

business

How hospitals could make money off of medical debt relief

One of the big ideas on health care in Vice President Harris' policy plan is working with states to relieve medical debt for patients. A new model pioneered in North Carolina shows how hospitals could make money off of a larger national program.

In North Carolina, hospitals are set to collect billions in federal money to cancel patients' medical debt and implement new policies to help prevent debt from accumulating in the first place. The funding comes as part of the state's Medicaid expansion.

Hospitals have significant political power to work federal programs to their advantage, and the template opens the door to other creative ways to use taxpayer funds to pay providers for medical debt. Read the full case study here.

agencies

Califf brushes off criticism of Duchenne gene therapy approval

FDA Commissioner Robert Califf said critics of the agency's decision to approve a controversial Sarepta Therapeutics treatment for Duchenne muscular dystrophy are taking a "very simplistic view of clinical evidence," STAT's Brittany Trang reports.

This summer, the FDA expanded the accelerated approval for the therapy, called Elevidys, despite the drug failing its Phase 3 trial. In doing so, Center for Biologics Evaluation and Research director Peter Marks overruled his staff.

Given a controversy over a different Sarepta drug during his first tour as FDA Commissioner during the Obama administration, Califf said the company is "like a curse on me." Read more.

science

The NIH scientist taking on ultra-processed food

As one of his swan song stories for STAT, my colleague Nick Florko profiles Kevin Hall, an NIH scientist tackling the big issue of studying ultra-processed food with a comparatively small part of the agency's budget.

Hall is taking any help he can get — including pleading with food conglomerates to help him with his research at a recent conference of industry scientists. Nick explains Hall's research, and why it's an uphill battle.

capitol hill

When a vote count is both strong and weak

The BIOSECURE Act was passed with a strong bipartisan vote on Monday, but support for it was weaker than expected, my colleague John Wilkerson reports.

Under most circumstances, the 306-81 vote would be a stunner, but in this case it showed that a significant number of lawmakers were willing to vote against a bill that is touted as a national security measure against China. All but two of those no votes were from Democrats. The two Republican no votes came from Rep. Thomas Massie (Ky.) and Paul Gosar (Ariz.).

Stephen Rademaker, a member of Covington & Burling's public policy group, described Monday's vote as "negative but not fatal" to the bill's prospects. Nielsen Hobbs, an analyst at Citeline, said the vote might make it easier for Senate Democrats to make changes to the bill.

When the bill was marked up by Senate and House committees, just one member on each panel voted against it.

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