A busy week, despite turkey day

The House and Senate are on Thanksgiving recess, but don't expect the news to slow.

The Trump administration is considering a proposal to extend the ACA's enhanced premium tax credits. It's a head-spinning turn of events. The president had refused, more than once, to back the renewal of the premium subsidies, and Republicans last week couldn't agree among themselves, never mind with Democrats, about how to handle them.

Republicans started pushing back on Trump's proposal before he could even announce it. Read more about the rumored details of the plan, and prepare for a lot of back and forth and fluid details.

This week is also the deadline for unveiling the prices for the 15 drugs in the second year of Medicare drug price negotiations. It's been oddly quiet on that front. It's not clear whether the president will continue to ignore the program, one of Biden's signature accomplishments, or tout the lower prices as his own hard bargain.

The administration already announced price cuts for Novo Nordisk's semaglutide, the highest-profile drug among the 15 up for negotiation this year, and the one Medicare spends the most on. That deal was struck separately from the Medicare-negotiation program, and it included Eli Lilly's GLP-1 treatments, too. (Novo and Lilly each sell multiple GLP-1 treatments with the same active ingredient.)

However, the Medicare-negotiation program likely played a role in the deal. It included a $245 a month price for the GLP-1 drugs in Medicare, and it's expected that that will also be the Medicare-negotiated price.

Maternal health

Caring for babies while Congress threatens to defund you

Eric Boodman wrote about the difficulties of running a program under the constant threat of being defunded by the federal government.

The program, Healthy Start, aims to keep parents healthy and their babies alive. Republican President George W. Bush launched it after learning about America's unusually high infant-mortality rate. But House Republicans are now threatening to yank the program's funding, leaving those who run it with the task of providing a sense of stability to patients while facing instability themselves. Read more.

cannabis regulation

Closing hemp loophole opens can of worms

Congress recently passed a law to crack down on cannabis, specifically products that rely on certain kinds of THC derived from hemp. That worries patients who rely on them for a host of conditions like chemotherapy-induced nausea, chronic pain, anxiety, insomnia, colitis, fibromyalgia, PTSD, and multiple sclerosis, Lev Facher writes.

Public health experts are increasingly worried about the widespread recreational use of cannabis products in an unregulated market, but those products also have come to play an important role in many health and wellness regimens. The ban includes many non-intoxicating CBD products.

Read more about how Congress created the difficult situation.

drug regulation

Letting politicos do career scientists' job

Decisions on whether to approve drugs typically are supposed to come from career FDA scientists who helped review the products.

But Lizzy Lawrence has learned that the process looked different for the first drug from a firm that received a Commissioner's National Priority Voucher. The voting members for that product did not include the review team. Instead, they were leaders from the top of the FDA, according to three agency sources.

The FDA has not announced the approval decisions for any of the voucher recipients, so it's not clear what the outcome was. But it opens the agency to accusations of allowing politics to enter into scientific decisions. Two top Democratic lawmakers raised such worries in a letter to FDA Commissioner Marty Makary on Monday, launching a probe into the program.

What we're reading

CDC moves to end telework for employees, including those with medical needs, STAT
Vaccine-supporting Cassidy declines to speak against RFK Jr., Politico
Medicare backs off plan for quicker clawback of $7.8 billion from hospitals, STAT
Study finds mental health benefit to one-week social media break, The New York Times