Not so Midwest nice

Vice presidential debates don't usually matter much, but this one might. It's probably the last chance for a one-on-one matchup between the two parties' tickets in a very close race.

Abortion is the ever-present health care issue in this race, and it offers a stark contrast between the two parties. But there's a long list of other health care topics that could come up in the debate between Sen. JD Vance and Gov. Tim Walz, my colleague John Wilkerson notes.

Affordable Care Act: Former President Trump has been vague about his plans for the ACA, saying during his debate with Vice President Harris that he has "concepts of a plan." Vance later added details for Trump, but Vance also was vague, giving Democrats an opening to characterize Republicans' plan as a threat to coverage of pre-existing conditions. ACA subsidies — and their looming expiration — could also come up.

Drug pricing: Medicare drug price negotiation, which no Republican voted for, was supposed to be a slam dunk for Democrats, but it's turned into a jump ball. Only 38% of senior voters know there is a law directing Medicare to negotiate the prices of some drugs, and just one-third realize Democrats capped their annual drug costs in Medicare. Many more seniors are aware of the cap on monthly insulin costs in Medicare, but Trump has taken credit for that measure.

IVF: Walz was nearly the perfect person to both drive home the threat of Republicans' abortion ban on access to in vitro fertilization and to make it a higher priority voting issue for men. But his wife, Gwen Walz, underwent intrauterine insemination, which isn't threatened by abortion bans. Vance has accused Walz of lying about the subject.

Covid-19: Walz's response to Covid-19 as Minnesota governor could be a target for Vance. Walz extended an emergency stay-at-home order that ran from April through mid-May. Trump's response on the social media platform X was "LIBERATE MINNESOTA!" After easing the stay-at-home order, Walz issued an indoor mask mandate.

NIAID news

Infectious disease chief talks 'scientific diplomacy,' outbreak concerns

Jeanne Marrazzo is one year into a job that Anthony Fauci held for nearly four decades, and there is a lot to talk about. Last week, the NIAID director spoke with STAT's Helen Branswell about the infectious diseases that worry her, stepping into Fauci's shoes, and wrestling with public trust in health care institutions after the Covid-19 emergency.

One thing I learned: She doesn't want the Fauci comparisons. (Read the interview to find out why.)

FDA policy

Senator pushes FDA on patent clarity

Sen. Bill Cassidy (R-La.) is urging the FDA to provide more guidance on listing patents for drug-and-device combination products (like asthma inhalers and auto-injectors) in the Orange Book.

In a letter dated yesterday, Cassidy accused the agency of failing to take responsibility for a longtime barrier in making lower-cost generics. More patent information helps those drugmakers know which products are fair play for competition.

The agency has maintained its staff lacks expertise in patent law to sift through such situations and therefore it plays only a "ministerial" role in ensuring that listed patents correctly claim a drug or method of using a drug, Ed Silverman writes. More from him.

state policy

California's PBM reform killed

California Gov. Gavin Newsom this weekend vetoed a bill that would have required price transparency from pharmacy benefit managers, axing reforms passed by several other states. He also rejected legislation that would make it easier for the state to block health care deals involving private equity and hedge funds.

In a message about the PBM veto, Newsom said changes to bring down drug costs are needed, but he's "not convinced" that this legislation would do it. The state needs "more granular information to fully understand the cost drivers," he added.

Separately, Newsom did sign IVF protections into law and took a shot at Republicans for blocking IVF access, echoing Senate Democrats and VP Harris' attacks. Republican lawmakers have said they support IVF but won't back broad protection bills because there is no threat to access.

hospital policy

Senator open to site-neutral tweaks to pass

Sen. Maggie Hassan (D-N.H.) is pushing to reform Medicare payments to ensure the program pays the same amount for the same services, no matter where patients get care — and she might be willing to cut a deal with Republicans to do it, she told STAT's Rachel Cohrs Zhang during our Thursday STAT in DC event.

One of the hospital lobby's talking points on so-called site-neutral payments is that a broad policy could hurt rural hospitals. Hassan said she's been in talks with a key Republican, Sen. Bill Cassidy (R-La.), about this very thing and "there are ways, I think, that we can get at the needs of rural hospitals." More on Sen. Hassan's conversation with Rachel.

preparedness & response

Emergency response chief responds to GOP backlash

I sat down with Dawn O'Connell, HHS assistant secretary for preparedness and response, on Thursday morning to discuss the myriad health threats the agency is navigating, from H5N1 outbreaks in cattle to the ongoing Covid and mpox responses.

O'Connell forcefully defended her office from Republican criticisms and said ASPR is trying to cut through the red tape that can keep officials from replenishing stockpiles quickly and being nimble for the next threat — or a "polycrisis" of multiple outbreaks and disasters pulling the federal response in different directions.

One potential polycrisis trigger, a devastating hurricane, hit the southeast this week and left swathes of the Carolinas and Appalachia without power and resources. HHS declared a public health emergency in North Carolina on Sunday, following similar declarations for Florida and Georgia. The response efforts — which include ensuring Medicare beneficiaries with electronic health equipment can keep using them in an outage — come as another potential hurricane, Tropical Storm Kirk, brews in the Atlantic.

More around STAT

Check out more exclusive coverage with a STAT+ subscription

Read premium in-depth biotech, pharma, policy, and life science coverage and analysis with all of our STAT+ articles.

What we're reading

Biden administration axes proposal to mandate more drug price transparency in Medicaid, STAT
Millions could lose insurance subsidies, depending on the election, The New York Times
Health care CEOs dialed back their pay in 2023. They still made $3.5 billion, STAT
VA staff got into Vance, Walz medical files, sparking investigation, The Washington Post