Episode #27 Deep Dive – The Shutdown and the ACA: Lives on the Line
A deep dive into this week's episode of Paging America
Government shutdown politics
Polling from KFF confirms what polling by The Washington Post found last week: The vast majority of Americans want to save the ACA subsidies:
[T]he latest KFF Health Tracking Poll finds three-quarters (78%) of adults say Congress should extend the enhanced tax credits for people who buy their own insurance through the ACA Marketplace. This is more than three times the share of the public (22%) who say Congress should let the credits expire.
This includes 59% of Republicans. Only 22% of Americans would blame Democrats if the ACA subsidies expire.
Yet another poll, this one by Navigator Research, shows that Americans blame Republicans for the shutdown more than Democrats by an 11-point margin:
As the shutdown continues, the Trump administration is using government resources to blame Democrats. Workers at several federal agencies received an email from their leaders late Tuesday blaming Democrats in Congress for the government shutdown. The emails went to at least three agencies: the Department of Veterans Affairs, the Department of Health and Human Services, and the Social Security Administration.
On federal websites, banners appeared with the same message:
CDC: “The Trump Administration is working to reopen the government for the American people. Mission-critical activities of CDC will continue during the Democrat-led government shutdown.”
DOJ, DEA & ATF: “Democrats have shut down the government. Department of Justice websites are not currently regularly updated. Please refer to the Department of Justice’s contingency plan for more information.”
HUD: “The Radical Left in Congress shut down the government. HUD will use available resources to help Americans in need.”
FDA: “Mission-critical activities of FDA will continue during the Democrat-led government shutdown. Please use this site as a resource as the Trump Administration works to reopen the government for the American people.”
U.S. Forest Service: The Radical Left Democrats shut down the government. This government website will be updated periodically during the funding lapse for mission critical functions. President Trump has made it clear he wants to keep the government open and support those who feed, fuel, and clothe the American people.
At least one member of Congress and the nonprofit group, Public Citizen, are demanding an investigation into what appears to be a blatant violation of the Hatch Act.
Becker’s Hospital Review reports that health systems are scrambling to discharge hospital-at-home patients:
Health systems have had to scramble to discharge or move their hospital-at-home patients as CMS reimbursement for the program lapsed with the federal government shutdown.
Healthcare organizations approved for the CMS waiver to provide acute hospital care at home had to discharge or transfer those Medicare beneficiaries to the hospital by midnight Oct. 1, sending many patients back to capacity-strained facilities.
HHS plans to furlough 41% of workforce during the shutdown, NIH research is grinding to a halt, and it’s preventing the FDA from accepting applications for new drugs and medical devices.
Meanwhile, the Democrats’ pressure on Republicans to stop taking away people’s health care is having an impact:
Sen. Susan Collins is reportedly shopping around a potential off-ramp to the government shutdown that has paralyzed Washington, but the Maine Republican is not ready to give in on the primary demand by her Democratic colleagues.
Collins has been circulating a “discussion draft” of a proposal that would include GOP pledges on a deal related to enhanced Obamacare tax credits, Punchbowl News reported.[...]
Sens. Josh Hawley, R-Mo. and Lisa Murkowski, R-Alaska, both support extending the tax credits, as do Reps. Jen Kiggans, R-Va., and Brian Fitzpatrick, R-Pa., Punchbowl reported.
Even far-right Congresswoman Marjorie Taylor Greene says she’s “fighting [for] this issue because all health insurance premiums are already extremely expensive and increasing health insurance premiums is going to crush people.”
Trump told reporters “We have a negotiation going on right now with the Democrats that could lead to very good things. And I’m talking about good things with regard to health care.”
Generic mifepristone approved and MAHA is pissed!
Last week, the FDA approved a generic version of the abortion pill mifepristone. HHS spokesman Andrew Nixon said the FDA “has very limited discretion in deciding whether to approve a generic drug.” He went on to say that the HHS secretary, by law, must approve an application if it demonstrates that the generic drug is identical to the brand-name drug, and generic applications aren’t required to provide evidence proving safety or effectiveness.
The Washington Post reports that anti-abortion zealots are furious about the move:
“This is a wildly disappointing decision. We are extraordinarily disappointed,” said Kristi Hamrick, a spokeswoman for Students for Life of America, in an interview with The Washington Post. “This has to be addressed.” [...]
“It’s a total goat rodeo,” said Marjorie Dannenfelser, president of Susan B. Anthony Pro-Life America, in a dig at how the Trump administration has handled the drug approval.
Missouri Republican Sen. Josh Hawley tweeted that he has “lost confidence in the leadership at FDA” because of the decision.
First-in-the-nation UPL for Enbrel in Colorado
This past week, the Colorado Prescription Drug Affordability Board set a Upper Payment Limit (UPL) for Enbrel, the first UPL in the country:
Colorado regulators have approved a dramatic price cap on one of the nation’s best-selling drugs, cutting its price to less than one-third of its previous level, in a novel attempt by a state to respond to widespread anger over the rising cost of prescriptions.
Maryland, Minnesota and Washington also have passed legislation in recent years that enables state officials to set price caps on specific drugs deemed unaffordable, and they are now expected to follow Colorado’s path. [...]
The Colorado measure approved Friday takes aim at the price of Amgen’s Enbrel, a drug used to treat several autoimmune diseases, such as rheumatoid arthritis and plaque psoriasis. U.S. sales of the drug amounted to more than $3.2 billion last year, and it has commonly ranked among the top 50 best-selling drugs by revenue.
Since the medication was first approved by the Food and Drug Administration in 1998, its wholesale price has increased 1,582 percent, according to the state. One study by the Initiative for Medicines, Access, and Knowledge found that Amgen has filed at least 57 patents covering Enbrel, a maneuver critics call a “patent thicket” that allows the company to extend its monopoly.
The Committee has worked hard for this monumental moment over the past four years.
Extra!
White House spokesperson Karoline Leavitt was asked, “Should ERs check for immigration status before treating a dying patient?” Instead of “of course not!” or “I can’t believe you would even ask such a ridiculous question!”, her answer was, “That’s probably not a question for me to answer. I think that’s a question for health care professionals and legal experts to answer.” Physicians are torching her response.
This week, the CDC made official the recommendations from the recent contentious Advisory Committee on Immunization Practices which includes dropping a broad recommendation that Americans age 65 and older get a COVID-19 vaccine. “Informed consent is back,” CDC Acting Director Jim O’Neill said in a statement. “CDC’s 2022 blanket recommendation for perpetual COVID-19 boosters deterred healthcare providers from talking about the risks and benefits of vaccination for the individual patient or parent. That changes today.”
O’Neill also called on vaccine manufacturers to develop separate shots for measles, mumps and rubella instead of the current vaccine, which combines the three:
O’Neill wrote in a post on X that manufacturers should replace the MMR vaccine with “safe monovalent vaccines,” which only target one virus. His statement referenced a recent comment from President Donald Trump, who advised people last month on Truth Social to “break up the MMR shot into three totally separate shots.”
However, no monovalent vaccines for measles, mumps or rubella are approved in the U.S., and the Centers for Disease Control and Prevention says there is no published scientific evidence that shows a benefit to separating the combined vaccine. It is not clear whether the change O’Neill is calling for is possible or likely to come about.
Links for a deeper dive on Episode #27
KFF: KFF Health Tracking Poll: Public Weighs Political Consequences of Health Policy Legislation
HuffPost: Federal Workers Receive Emails Blaming Democrats For Government Shutdown
Government websites blaming Democrats for the government shutdown: HUD, FDA, CDC, DOJ, DEA, ATF, and the U.S. Forest Service.
Lansing State Journal (via Yahoo! News): Federal websites are blaming Dems for shutdown. Is that legal?
Becker’s Hospital Review: Health systems scramble to discharge hospital-at-home patients
CIDRAP: HHS to furlough 41% of workforce during federal government shutdown
FIERCE Biotech: NIH research grinds to a halt as government shuts down
FIERCE Pharma: FDA avoids the worst amid government shutdown, but new applications put on hold
CNBC: Republicans face pressure to consider Democrats’ health-care demands as shutdown drags on
NBC News: Rep. Marjorie Taylor Greene breaks with the GOP on Obamacare, calling to avoid premium hikes
AP: Trump says he’s open to health care deal but government must reopen first
NPR: FDA approves another generic abortion pill, prompting outrage from conservatives
The Washington Post: Trump administration approval of new abortion drug infuriates the right
Missouri Sen. Josh Hawley’s tweet on the mifepristone approval is HERE
The Washington Post: States fed up with high drug prices are cracking down
White House spokesperson Karoline Leavitt responds to a question about asking ER patients about their immigration status
HuffPost: ‘Grossly Immoral’: Doctors Torch Karoline Leavitt’s ER Immigration Status Answer
MedPage Today: CDC Ends Universal Recommendation for COVID Vaccine
NBC News: Acting CDC director calls to ‘break up’ the measles, mumps and rubella vaccine into three shots
Congressman Mike Levin’s government website is HERE
Rep. Levin explains his support of California’s Prop 50 HERE