Republicans are keeping health care at arms length this election

Republicans are staying vague on health policy in the midterms

Republicans have spent plenty of elections promising to ditch Obamacare and overhaul the U.S. health-care system. Not anymore. 

When House Minority Leader Kevin McCarthy (R-Calif.) formally rolls out his campaign season agenda today at an event in Pennsylvania, it will be light on health policy details. The one-page document — called a “Commitment to America” — is vague, pointing to broad ideas like price transparency and competition, instead of a bold vision for the future of health reform.

That’s by design. As one conservative health expert put it, the GOP still has “PTSD” from its failed effort in 2017 to repeal and replace the Affordable Care Act.

Health care has repeatedly shown to be a toxic issue for Republicans. In just the last couple of months, Sen. Ron Johnson (R-Wis.) walked back comments suggesting he wants to see Republicans take another crack at repealing Obamacare; Don Bolduc, New Hampshire’s GOP Senate nominee, backtracked after saying he’d like to privatize Medicare; and the campaign of Blake Masters, Republican candidate in Arizona, removed references to strict antiabortion positions from his website.

Roughly 77 percent of Democrats and Democratic-leaning voters say health care is “very important” to their vote in the 2022 congressional election. But just 43 percent of Republican and Republican-leaning voters agree. And Democrats recently passed a popular health measure allowing Medicare to negotiate the prices of some drugs, which polls show a broad swath of voters support.

• “Democrats have historically maintained a sizable advantage on the issue of health care,” said Ken Spain, who worked at the National Republican Congressional Committee in 2010, the year the GOP won the majority. “For the midterm elections, Republicans don’t have to win on the issue … but they cannot get destroyed over it. They must find a way to close the gap and the key to doing so is by talking about cost and quality of care.”

House Republicans’ messaging memo went up online yesterday. (Well, it unintentionally published Wednesday, but was taken down). Here’s what the document says on health:

• “Personalize care” so as to provide cheaper and higher quality options.
• Lower prices through transparency and competition, create “lifesaving” cures and boost access to telemedicine.
• “Save and strengthen” Medicare.
• “Protect the lives of unborn children and their mothers.”

Saying more competition and choice is the easy part, said Thomas Miller, a senior fellow at the American Enterprise Institute, a conservative-leaning think tank. “The harder complication is figuring out what policies get you there.”

The document is purposely short on specifics in all policy areas, an acknowledgment that the broader conference is divided on which legislative proposals would be best for a number of issues, our colleagues Marianna Sotomayor and Leigh Ann Caldwell report.

But staying vague on health policy likely won’t matter for the midterm elections, where Republicans are instead hammering Democrats on crime, inflation and gas prices. “They’re not going to win those extra voters or even turn out their base by saying something more elaborately or energetically about health policy,” Miller said. “At the same time, say the wrong thing, you don’t understand what you’re talking about, and it could be a liability, so why bother to do that.” 

On abortion, the memo also isn’t prescriptive. There’s no mention of nationwide restrictions on the procedure, which comes after many in the Senate balked at the idea of a federal 15-week limit last week. 

Last year, McCarthy unveiled seven task forces charged with crafting policies on various issues. Reps. Brett Guthrie (Ky.) and Vern Buchanan (Fla.) — the top Republicans on the Energy and Commerce and Ways and Means health subcommittees, respectively — were charged with overseeing the 17-member health group.

Though McCarthy’s memo released yesterday was vague, what the task force drummed up could forecast the policies GOP-led health panels may pursue. It included the sweeping Republican priority of investigating the origin of covid-19. But the proposals also consisted of an array of wonkier, more incremental policies, like codifying rules requiring hospitals and insurers disclose their prices, setting data standards for electronic health records and making clinical trials more widely available.

In an interview, Guthrie also pointed to Democrats’ health bill, arguing it will lead to fewer innovative drug therapies, another likely campaign target. He insisted Republicans would still run on health care, with the message of “we want people to have a personalized health-care system,” though conceded “it’s hard to explain that in just a few minutes.”

We want to hear from you: What does aging mean to you?  The Post is working on a special section next month on “aging well,” but how do you define that phrase? What qualifies as aging well vs. aging poorly? Tell us here.

DOJ: States can’t penalize VA medical workers for federally authorized abortions

The Justice Department vowed to protect Veterans Affairs medical workers who perform abortion services to save a patient’s life, protect their health or in instances when the pregnancy is a result of rape or incest — even if that abortion is performed in a state where the procedure is illegal in those circumstances, The Post’s Perry Stein reports.

Officials in Alabama have already threatened to punish VA workers who perform abortions, arguing it would violate state law. But in an internal government opinion posted yesterday, the Justice Department’s lawyers said that the VA’s new policy permitting employees to provide abortion services to veterans and their eligible relatives is legally sound and can continue. 

The narrow policy underscores just how few legal tools the Biden administration has to shore up the nation’s abortion access in a post-Roe world. In this case, the administration argues that the Veterans Health Administration has a federally mandated duty to provide proper medical care to the nation’s veterans. Restricting abortion access, according to the opinion, in these circumstances would prevent VA facilities from providing necessary medical care to its patients.

Rep. Lauren Underwood (D-Ill.) on the VA’s new abortion policy:

Indiana judge temporarily blocks near-total abortion ban

A judge in Indiana temporarily blocked the state’s new ban on almost all abortions a week after it took effect, our colleague Katie Shepherd reports. 

A preliminary injunction granted by Owen County Judge Kelsey Hanlon paused enforcement of the ban, which prohibits most abortions from conception with few exceptions, while a legal challenge against the law winds its way through the courts. As a result, providers can once again offer the procedure up to 22 weeks after the last menstrual cycle.

In the court’s opinion, Hanlon found that Planned Parenthood and other plaintiffs in the case had demonstrated a “reasonable likelihood” that the ban imposes a “significant restriction of personal autonomy” that violates the Indiana Constitution’s right to privacy and equal protections. The state’s Attorney General Todd Rokita (R) said yesterday that his office plans to appeal Hanlon’s decision. 

Caitlin Bernard, an Indiana OB-GYN at the center of a viral story about a 10-year-old rape victim:

Avoiding pink slips: Leaders of the Senate and House health panels reached an agreement on a deal to renew the Food and Drug Administration’s user fees, which fund a significant portion of the agency’s budget, according to multiple congressional aides.

The agreement has some policy riders but is “practically clean,” as an aide to Sen. Patty Murray (D-Wash.), the chair of the Senate HELP Committee, put it. The idea is to hitch the five-year reauthorization onto a stopgap spending bill to keep the government’s lights on past the end of the month and avoid the prospect of sending furlough notices to FDA staff.

But there’s a wrinkle. Senate Minority Leader Mitch McConnell (R-Ky.) supports a clean user fee bill without “extraneous items,” meaning party leaders will need to sort out whether all the policy riders are stripped from the legislation. Politico first reported the news.

Surprise! Texas Medical Association sues over surprise billing rule … again

The Texas Medical Association filed its second lawsuit in less than a year against certain portions of a rule establishing the process for resolving disputes between insurers and providers over “surprise” medical bills.

The lawsuit comes days after the American Medical Association and the American Hospital Association dropped their first legal challenge to the interim rule, which became moot when the administration released a revised final rule governing the federal surprise billing arbitration process on Aug. 26. Both the AMA and the AHA support the new Texas lawsuit.

The issue revolves around payment disputes over stopping insured patients from getting slapped with hefty bills for inadvertently getting care from an out-of-network provider. The Biden administration’s rulemaking has been divisive even among those who drafted the law, and the Texas Medical Association is arguing the new regulation “unfairly” advantages insurers.

• New this a.m.: The Biden administration announced new actions and funding to address the opioid epidemic and support the nation’s addiction services, including $1.5 billion in grants to states and territories.
• A federal watchdog found that fraudsters may have stolen $45.6 billion from the nation’s unemployment insurance program during the pandemic, our colleague Tony Romm writes.
• By a vote of 56-40, the Senate confirmed Arati Prabhakar to be director of the Office of Science and Technology policy.
• The Centers for Medicare and Medicaid Services approved a 12-month extension of postpartum Medicaid coverage in North Carolina.

Health apps share your concerns with advertisers. HIPAA can’t stop it. (By Tatum Hunter and Jeremy B. Merrill | The Washington Post)

Biotech aims to detect cancer early. But tests have a long way to go. (By Pranshu Verma | The Washington Post)

Some Who Rushed to Covid-19 Vaccine Hold Off on Boosters (By Jared S. Hopkins | The Wall Street Journal)

Thanks for reading! See y’all Monday.