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The biggest health stories to watch in 2023

On tap for 2023: GOP investigations, abortion battles, covid pay-fors

Welcome to 2023, where some of last year’s most politically contentious fights are expected to quickly take center stage.

House Republicans will now have the power to fully launch a flurry of pandemic and health-related probes — and are planning to alter the focus of the select subcommittee on the coronavirus pandemic. State legislatures are starting to convene for the first time in a post-Roe world. And the pandemic enters its fourth year, with a major change to how vaccines and treatments are paid for on the horizon.

Here are the biggest storylines we’re following this year ⬇️

House GOP investigations

It’s a new year, and a newly divided Congress. The 118th Congress begins today, and House Republicans have been open about their plans to investigate everything from the origins of covid-19 to cracking down on prescription drug middlemen to scrutinizing key federal health agencies. Two main panels to watch: The House Oversight Committee and the House Energy and Commerce Committee.

A few bits of news: The House Oversight Committee’s first full committee hearing will focus on fraud within the trillions of dollars Congress approved for pandemic relief spending, Rep. James Comer (R-Ky.), the panel’s chairman-elect, said in a statement to The Health 202.

Early in the new Congress, Comer is also planning to hold a hearing on prescription drug middlemen known as pharmacy benefit managers (PBMs), which he and other lawmakers have accused of contributing to the high cost of medicines.

  • In a statement, the Pharmaceutical Care Management Association — the main PBM lobby — said it’s “ready to engage with any committees that seek to better understand issues of prescription drug affordability,” adding that the focus should be on the entire drug supply chain, “including the drug manufacturers who alone set the price of all drugs.”

Meanwhile, House Republicans are aiming to change the mission of the House select subcommittee on the coronavirus pandemic. This includes a focus on investigating the origins of the coronavirus, the development of vaccines and treatments, the implementation of vaccine mandates, and pandemic-related school closures. The change was contained in the proposed House GOP rules package that was circulated over the weekend and dictates how the chamber governs for the next two years.

Abortion battles

Last year saw a seismic shift in how early in pregnancy states can ban abortions, with over a dozen states restricting the procedure in many instances. Now, the majority of state legislatures will convene this year for the first time since the Supreme Court overturned the nearly half-century right to an abortion.

Antiabortion advocates are itching to push for further restrictions and crack down on the distribution of abortion pills in states with strict bans. They’ve been talking with state lawmakers and introducing model laws, while some Republican allies pre-file bills. One prominent group, SBA Pro-Life America, says it’s particularly targeting Virginia, North Carolina, Florida and Nebraska, according to Stephen Billy, the group’s vice president of state affairs.

At the federal level … House Republicans are planning votes on three abortion-related measures in the next two weeks, House Majority Leader-elect Steve Scalise (R-La.) wrote Friday in a letter to his colleagues.

  • This includes legislation requiring medical care be given to an infant born after an attempted abortion and another bill permanently barring federal funds from being used for abortions, a policy that’s annually tucked into government funding bills.

  • The chamber will also vote on a sense of Congress — meaning the legislation doesn’t have any actual policy impact — condemning attacks on antiabortion facilities and groups.

Reminder: The two pieces of legislation won’t go anywhere in a Democratic-controlled Senate. But it’s common for Republicans when they’re in the majority to vote on antiabortion bills around the time of March for Life, an annual event in January protesting abortion on the anniversary of Roe v. Wade.

A covid shift

The federal government has been purchasing coronavirus vaccines and treatments, making both free to all Americans throughout the pandemic.

That is slated to change this year. The Biden administration is preparing to shift payment and procurement of vaccines and treatment to the commercial market, raising critical questions about access to the products for the uninsured.

“It's a little bit of a black box right now as to how this is all going to play out,” said Jen Kates, a senior vice president at the Kaiser Family Foundation.

In August, the Department of Health and Human Services laid out a tentative timetable. Vaccines could be moved to the commercial market as soon as this month, though there’s been no public notice that a change is imminent. The timeline was later for certain treatments, such as the oral antiviral Paxlovid, which the administration estimated would transition in mid-2023.

  • “Access to vaccines and treatments for anyone who needs them is the highest priority of our whole-of-government COVID-19 response,” an HHS spokesperson said in a statement to The Health 202, adding the department has been working with state and local governments, providers, companies, insurers and others to “drive a smooth transition.” The spokesperson didn’t provide an updated timetable or more concrete dates.

Looking to 2023

Three key questions going into the new year..

Will anything change after Capitol Hill’s Aduhelm investigation?

An 18-month House investigation concluded that the Food and Drug Administration’s collaboration with Biogen, the manufacturer behind the controversial Alzheimer’s treatment Aduhelm was “rife with irregularities” and skirted the agency’s own protocols, our colleague Mark Johnson reports.

Lawmakers on the House Oversight and Reform Committee and the Energy and Commerce Committee suggested several recommendations to improve the agency’s regulatory reviews, such as documenting all communication with drug companies and establishing protocols for the use of joint FDA and drug sponsor briefing documents for advisory committees. But since the recommendations leave it to the agency and the company to change their policies, it’s unclear whether the probe will prevent similar episodes in the future.

How will China’s covid-19 outbreak evolve?

The short answer: It’s really hard to predict.

Outside experts observing China’s coronavirus surge are piecing together scraps of evidence to forecast the trajectory of the outbreak — and what it might mean for the spread and evolution of the virus around the globe, our colleague Joel Achenbach reports.

Scientists say there’s no reason to think that the country’s outbreak creates a special condition for the emergence of a new variant. It’s possible a new variant could emerge, but as Maria Van Kerkhove, an epidemiologist with the World Health Organization put it, “the risk of further variants can come from anywhere.”

What will ultimately be Title 42’s fate?

The Supreme Court granted a last-ditch request by 19 Republican-led states to block the Biden administration from winding down a pandemic-era policy allowing the quick expulsion of migrants from U.S. borders for public health reasons, The Post’s Robert Barnes and Ann E. Marimow report.

In the unsigned order last week, the court said it could consider the dispute in February and that the stay would remain in place in the interim. However, the justices will only consider the procedural issue of whether the objecting states have the legal standing to pursue their challenge against the measure.

Agency alert

ICYMI: From label changes to reversing Trump-era rules, here’s the agency actions you may have missed over the holiday break.

Testing requirements are back for travelers from China: Beginning Thursday, the Biden administration will require travelers from China to show a negative coronavirus test. The decision is partly based on concerns about the lack of data coming out of the country, which recently pulled back its strict zero-covid policies, The Post’s Frances Stead Sellers and Bryan Pietsch report.

Label change: The Food and Drug Administration approved a change in labeling for the Plan B “morning after” pill aimed at clarifying that it doesn’t cause an abortion, our colleagues Laurie McGinley and Lenny Bernstein write.

Undoing Trump-era rules: The Department of Health and Human Services is proposing its conscience rule for providers aimed at partially rescinding a controversial Trump-era expansion of protections for religious health workers that have been blocked by courts.

Authors: Analysis by Rachel Roubein with research by McKenzie Beard


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