| |  | | | | |  | By Megan R. Wilson | - Virginia’s next health care fight: Democrat Abigail Spanberger’s gubernatorial win in Virginia will kick off a renewed fight over whether to establish an advisory board in the state to tackle prescription drug costs.
- Redrawing power in Congress: California’s new district map gives Democrats a few more seats and could offset GOP redistricting gains elsewhere — a shift that could reshape what gets traction on health care in the House.
- State moves on care and safety: Washington state voters backed letting its long-term care fund invest more aggressively, while Maine approved a new red flag gun law.
Good afternoon, and welcome to the Health Brief. Today is going to be an election-focused issue of the newsletter, looking at some of the victories and top issues — what the results could mean for health policy in the future. Let’s get into it. Send all your best health policy intel, tips, scoops and thoughts on the health-related election to megan.wilson@washpost.com or message me on Signal at megan.434. This newsletter is published by WP Intelligence, The Washington Post’s subscription service for professionals that provides business, policy and thought leaders with actionable insights. WP Intelligence operates independently from the Washington Post newsroom. Learn more about WP Intelligence. |  | | Virginia Gov.-Elect Abigail Spanberger greets people during an election night event. (Matt McClain/The Washington Post) | | | |  | The Lead Brief | Virginia elected Democrat Abigail Spanberger to lead the state as its first female governor, following a campaign that largely focused on affordability — including talk of lowering health care costs for people throughout the state. “Now that the campaign is over, the real work begins, because this was never about just winning an election. It was about what comes next,” said Spanberger in her acceptance speech. “We’re going to lower health care costs. We are going to crack down on predatory pharmaceutical practices and surprise billing.” Exit polling from CNN shows that Spanberger won 81 percent of voters who reported health care as their top issue. So, what does that mean in practice? In part, Spanberger’s win — and Democrats’ expanded majority in the legislature following the election — will almost certainly spur legislative movement around the creation of a panel to review prescription drug prices and cap prices on the most costly medicines. They’re called prescription drug affordability boards, or PDABs, and roughly a dozen states have established one. Some set upper payment limits on drugs, while others recommend policies to lower costs. (In 2020, Maryland was the first in the country to set one up.) → The boards are part of a larger effort that’s happening on federal and state levels in an effort to reduce the cost of medicines. The boards have drawn intense opposition from the pharmaceutical industry, which argues that they decrease patient access to medicines and harm investment in new treatments. Here’s the state of play: - The Virginia legislature has twice passed legislation with bipartisan backing to create a five-person board to review prescription drug prices — with the power to put a limit on how much they can cost. Republican Gov. Glenn Youngkin vetoed legislation both times.
- Del. Karrie K. Delaney, a Democrat who represents part of Fairfax County, has spearheaded the effort in the House of Delegates in recent years — and says she’s going to be doing it again.
“I absolutely plan to reintroduce PDAB [legislation] next session,” she told me in an emailed statement this morning. Delaney added she’s “looking forward to speaking” with Spanberger about the issues during the transition. “As she said in her victory speech last night, we need to hold pharmaceutical companies accountable and lower health care costs for hard working Virginians,” Delaney said. During the campaign, Spanberger didn’t put weight behind endorsing a prescription drug affordability board for Virginia, wary of the challenges some other states have experienced with theirs, per the Virginia Mercury. A spokesperson for her campaign didn’t respond to inquiries about where she stands on them. | | | | | | Strategy File | The uncertainty about Spanberger’s position means lobbying is already ramping up. Virginia’s General Assembly starts work in January — but supporters aren’t waiting. “We have a very robust pre-general assembly ramp-up that we’re doing,” said Jim Dau, state director for AARP Virginia — mentioning an online advertising campaign and AARP-branded buses driving around the state capital to make the case for the affordability boards. “It’s literally going to be inescapable, whether you're on your computer or just out on the street,” he said. Polling from AARP in Virginia showed that 84 percent of adults in the state support creating an affordability board, including 76 percent of people who identify as conservative. Jared Calfee, state advocacy director for AARP Virginia, tells me that support has only been growing over time: In 2023, the group’s polling showed that 75 percent of adults in Virginia supported the creation of a PDAB, he said. PhRMA, a major industry group representing name-brand drugmakers, wouldn’t answer questions about its advocacy plans in Virginia. The industry has lobbied state policymakers during past efforts, and many companies are pledging to invest billions of dollars in research facilities and factories in Virginia, including a recent $4.5 billion investment from AstraZeneca in Charlottesville. Drugmakers could use investments as additional leverage in pushing back on the measure. “Biopharmaceutical manufacturing and innovation have a bright future in the commonwealth with the recent announcements of significant investments that will create thousands of jobs for Virginians,” Stami Turk, a PhRMA spokesperson said in an email response to questions about its advocacy on the issue. “In the midst of these growing life sciences partnerships, we hope the incoming administration would avoid costly bureaucratic schemes and look to other states where PDABs are failing and being repealed.” | | | |  | State scan | Beyond Virginia, voters across the country weighed in on ballot measures and political shifts that could shape the health policy landscape in the months and years ahead. - California: Voters gave the green light to a ballot measure that allows the state to draw a new congressional district map that would give Democrats five additional seats in Congress — effectively canceling out a recent redistricting effort in Texas that would result in the same number of new Republican House districts.
California Democrats view the policy — and a potential shift in a balance of power in the elections next fall — as a way to act as a check on the Trump administration, which could inevitably apply to influential health care bills following the 2026 midterms. → In context: Missouri, North Carolina and Ohio have also redrawn their congressional maps ahead of the midterms, most of which are seen as a boon for Republicans. But the future is unclear, as lawsuits and other challenges mean that the overall score is uncertain. Normally, redistricting schedules are tied to the once-per-decade census. - Washington: The state appears poised to allow its public long-term care fund, called the WA Cares Fund, to invest in the stock market.
The fund, financed by payroll taxes, is currently restricted to investing in bonds and fixed-income securities, which are viewed as less volatile. Opponents argued it would be “financial roulette,” but the measure’s supporters say it would maximize returns. Established in 2019, the WA Cares Fund is the nation’s first mandatory long-term care insurance program to help workers to pay for care related to chronic health issues or disabilities. The services — including certain equipment, in-home caretaking and help with meals — fall outside of most commercial insurance coverage and aren’t covered by Medicare. Other states are likely paying close attention. - Maine: Voters passed a referendum with nearly 60 percent of the vote to expand its “red flag” gun law in the state.
It allows law enforcement, family or household members to petition courts to temporarily ban a person from having dangerous weapons if they can show the person “poses a significant danger of causing physical injury to themselves or others.” Before the update, the law only allows police to petition a judge to begin the process to remove a person’s firearm. There are 22 states with these laws on the books. | | | | | | What We’re Reading | A Washington Post investigation from Lisa Rein, Craig Whitlock, Caitlin Gilbert and Aaron Schaffer: “The unregulated industry that coaches veterans to pile on benefits.” “A pill is raising hope for one of the deadliest cancers. The question is how fast patients should get it,” reports Daniel Gilbert at The Washington Post. “Sleep Apnea Linked to Brain Microbleeds,” Crystal Phend writes for MedPage Today. “US FDA cleared pricey rare disease drug over reviewer objections,” Patrick Wingrove reports in a Reuters exclusive. “Democrats face possible ACA letdown,” Peter Sullivan writes at Axios. “Despite recent turmoil at FDA, White House praises the agency's leader,” David Lim and Lauren Gardner report for Politico. “Arena BioWorks, an ambitious biomedical institute backed by billionaires, abruptly shuts down,” Stat’s Allison DeAngelis and Jason Mast scoop. “The Editor Got a Letter From ‘Dr. B.S.’ So Did a Lot of Other Editors: The rise of artificial intelligence has produced serial writers to science and medical journals,” writes Gina Kolata at the New York Times. | | | | | | | | | | |
_tstmp_1756933376-1920-1080.png)
