GOP ACA proposal gets cold reception from think tanks

The Senate GOP is already hard at work on a counter-proposal to Democrats' plan to extend enhanced ACA subsidies, but some think tank allies are giving it a tepid reception.

The agreement to vote on legislation to extend the ACA credits was part of the deal to reopen the government. President Trump signed the spending package into law after the House passed it Wednesday night.

Trump has said that he wants to "terminate" Obamacare by converting all the tax credits that the government provides into an equal amount of cash. But some Republican negotiators said they want to leave the original ACA credits alone, and instead deposit money from the enhanced credits into accounts that individuals may use for health care.

Michael Cannon, president of the libertarian Cato Institute, said that approach might actually lead to higher government spending than the Democrats' plan.

The Republican proposal also complicates negotiations between the two parties, which have a little more than a month to agree on a deal. Republicans had wanted to restrict eligibility for the credits based on income, require that people pay a small portion of their premium, and add restrictions of abortion care.

Now they're proposing an entirely new approach, and Democrats are wary of it, according to Bloomberg.

Even if Democrats agreed to go along with the Republicans' plan, there are many complicated details that would need to be worked out, according to Larry Levitt, executive vice president for health policy at KFF. For example, tax credits are calculated using a complicated formula that is partly based on income and that varies by factors like age and family size. It's not clear whether Congress would use that same formula to determine how much money to give people for their accounts.

"This went from a narrow debate over whether to extend enhanced premium tax credits to a discussion of completely upending the ACA," Levitt said.

Maha

When MAHA met MAGA

Vice President JD Vance, health secretary Robert F. Kennedy Jr., and several other top government health officials attended an event dubbed the "Official MAHA Summit" on Wednesday.

Other than Kennedy's televised interview with Vance, the event was closed to the public, so Chelsea Cirruzzo and Daniel Payne staked out the glitzy Waldorf Astoria lobby and talked to attendees as they came and went.

Check out this scene-setter: "Regenerative farmers had coffee at the sleek hotel bar and wellness influencers shook hands and unpacked swag bags. At one point, Food and Drug Administration Commissioner Marty Makary strolled through, with some attendees stopping to say hello."

They learned a lot in that lobby, including how MAHA and MAGA might work together. Read all about it here.

fda

No vaccines for you!

Lizzy Lawrence just published an investigative story about how two top FDA officials are quietly upending vaccine regulation.

She opens with a previously unreported meeting at which Tracy Beth Høeg, a lieutenant of Makary, laid out plans to change the label of all Covid-19 vaccines to warn that its risks outweigh the benefits for men ages 12 to 24, effectively taking it away from this group.

Hoeg backed down after the career scientists at the meeting pushed back and biologics chief Vinay Prasad said the move wasn't necessary because he had already limited access to the shots.

Lizzy interviewed more than 20 current and former FDA employees, contractors, and vaccine experts, and reviewed surveillance data, contracting data, regulatory documents, internal memos, and emails to piece together the ways that Prasad and Høeg are challenging current vaccine regulation.

The FDA, Prasad, and Høeg did not respond to STAT's requests for comment.

drug regulation

An old hand takes the reins at the FDA's drug center

Richard Pazdur has been at the FDA for 26 years. He founded the agency's Oncology Center of Excellence, where he's overseen cancer therapies ever since. Now he will be the agency's top drug regulator, Lizzy reports.

It's been a tumultuous year at the FDA, and Lizzy has expertly followed it all. Pazdur is the third person to lead the drug center this year. The previous director, George Tidmarsh, exited the agency amid accusations of using his regulatory authority to attack a former business associate and amid infighting with biologics center director Vinay Prasad, who also departed the FDA only to return two weeks later.

Read more about how Pazdur's appointment came about.

food

How Kennedy's dietary guidelines might impact school lunches

Kennedy has promised to change U.S. dietary guidelines to encourage consumption of more saturated fat by year's end. Nutrition scientists tell Sarah Todd that the changes could make school lunches, and the kids who eat them, much less healthy.

There are legitimate debates in the nutrition field over the health effects of saturated fat in whole-fat dairy in particular. An HHS spokesperson said Kennedy is committed to new dietary recommendations that are rooted in rigorous science.

But nutrition experts who spoke to Sarah fear the implications of jettisoning 75 years worth of data that show saturated fat raises are linked to a higher risk of strokes and heart disease. Read more.

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

Covid-era rules for addiction medication, Ritalin are extended again, STAT
The Trump-MAHA-Stanford nexus of US health policy, CNN
Opinion: Why Richard Pazdur taking over the FDA's drug division is good for patients — and drug companies, STAT
Detransition is key to politicians' anti-trans agenda. But what is it really like? The 19th