Oct 21, 2024

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With Alice Miranda Ollstein

Driving The Day

Side-by-side photos Vice President Kamala Harris and former President Donald Trump speaking into microphones.

With the presidential election looming, attention turns to the prospective Cabinet lineups for Vice President Kamala Harris and former President Donald Trump. | AP

HEALTH CARE HOPEFULS — With just over two weeks left until the election, POLITICO is looking at who’s in the running for key Cabinet positions in a potential Trump or Harris administration.

The next Health and Human Services secretary will have to deal with a wide range of issues upon assuming the post, from overseeing the ongoing Medicare drug price negotiations to contending with the expiration of Affordable Care Act enhanced subsidies to regulating how artificial intelligence is used in health care.

And at the Department of Veterans Affairs, the next leader will take the helm of an agency that provides health care for more than a quarter of the 16 million veterans in the U.S. The secretary will oversee the beleaguered effort to replace the VA’s decades-old electronic health records system , which is set to resume next year after it was tied to at least four veterans’ deaths and went billions over budget. The agency is also dealing with the financial strain stemming from the PACT Act, which has led to billions of dollars in shortfalls.

Here’s POLITICO’s snapshot of the leading HHS and VA contenders in a potential Trump or Harris administration:

HHS secretary, Harris:

— Michelle Lujan Grisham, the New Mexico governor, is well known to Harris’ team after President Joe Biden vetted her for the HHS post four years ago. She previously served as New Mexico’s health secretary, and she’s been outspoken on reproductive rights since the Supreme Court overturned Roe v. Wade.

— Dr. Mandy Cohen, the CDC director, was previously floated as a potential pick to be Biden’s HHS secretary. Cohen also was a top official for the Centers for Medicare and Medicaid Services in the Obama administration and the head of North Carolina's health agency during the height of the Covid-19 pandemic.

HHS secretary, Trump:

— Bobby Jindal, former Louisiana governor and representative, is the chair of the Center for a Healthy America, a wing of the Trump-aligned America First Policy Institute. His more recent focus on ACA reforms and new price transparency measures — as well as having held leadership roles — could boost a nomination to lead HHS.

— Brian Blase, former special assistant to Trump for economic policy, leads the Paragon Health Institute, a Virginia-based think tank that has become a leading voice in conservative health policy, emphasizing the need to reduce overpayments and stop what he sees as unnecessary government subsidies in the system.

VA secretary, Harris:

— Tanya Bradsher, a combat veteran who served 20 years in the U.S. Army, was confirmed last year as deputy secretary of the VA. Bradsher has been instrumental in implementing the PACT Act and has overseen the VA’s electronic health records overhaul.

— Sen. Tammy Duckworth (D-Ill.), a retired Army National Guard lieutenant colonel, formerly ran Illinois’ Department of Veterans Affairs. In 2009, then-President Barack Obama appointed her to serve as the VA’s assistant secretary of public and intergovernmental affairs. She has focused on veterans’ issues since being elected to Congress.

VA secretary, Trump:

— Robert Wilkie was Trump’s VA secretary from 2018 until the end of his term. As secretary, Wilkie helped implement legislation expanding access to care outside of the VA. He ultimately signed the deal with Cerner to lead the electronic health records project as acting VA secretary.

— Rep. Matt Rosendale (R-Mont.) isn’t seeking reelection and has been floated as a potential pick to lead the VA in a second Trump administration. He serves on the House Veterans Affairs Committee and chairs its subcommittee on technology modernization.

WELCOME TO MONDAY PULSE. I’m Kelly Hooper, filling in for Ben and Chelsea. Send your tips, scoops and feedback to khooper@politico.com and follow along at @kelhoops. And don’t forget to send your ideas to our regular Pulse hosts at bleonard@politico.com and ccirruzzo@politico.com, and follow them @_BenLeonard_ and @ChelseaCirruzzo.

A message from PhRMA:

Drug price “negotiations?” Higher costs and less access to medicines are not what seniors were promised when the Inflation Reduction Act (IRA) was signed into law. Learn more about the IRA’s unintended consequences.

At the White House

A one-month dosage of hormonal birth control pills is displayed.

The White House is pushing to ensure insurance companies cover over-the-counter birth control methods. | Rich Pedroncelli/AP

EXPANDED CONTRACEPTION COVERAGE — The Biden administration proposes an expansion of the forms of contraception covered by insurance under the Affordable Care Act, Alice reports.

Once finalized, the rule would require private insurance companies to cover over-the-counter birth control — including the hormonal drug Opill, emergency contraception like Plan B and condoms — with no cost-sharing and more kinds of prescribed contraception than mandated by law.

On a call with reporters Friday, top Biden administration officials framed the new policy as part of their broader response to the elimination of abortion access in much of the country and said it would make birth control more affordable for tens of millions of people on private plans.

“Since the Supreme Court overturned Roe v. Wade , reproductive health care has been under attack,” said HHS Secretary Xavier Becerra. “That means preventative services like contraception are more important than ever, and when health care plans and issuers impose unduly burdensome administrative or cost-sharing requirements for services, access to contraceptives become even more difficult.”

Democratic lawmakers have been lobbying the administration and the insurance industry to take such action for years, citing congressional investigations that found widespread noncompliance among insurers with the ACA’s contraception mandate.

A message from PhRMA:

2024 ELECTION

ADS HIT GOP ON BIRTH CONTROL — A progressive advocacy group is spending millions on ads targeting Republicans who have opposed pro-contraception bills, Alice reports.

The Americans for Contraception Victory Fund PAC is launching YouTube and streaming ads this week opposing Texas Sen. Ted Cruz and Ohio Senate hopeful Bernie Moreno, citing Cruz’s vote against the Right to Contraception Act earlier this year and Moreno’s criticism of that bill, which would have codified Americans’ right to obtain birth control and the right of medical providers to dispense it.

Reagan McCarthy, a spokesperson for the Moreno campaign, said, “Bernie supports comprehensive access to birth control for women but not the far-left gimmicks in this bill.”

The Cruz campaign did not respond to a request for comment.

The group, through billboards and digital ads, will also target Republican lawmakers in Arizona, North Carolina and Wisconsin who have opposed pro-contraception bills.

Why it matters: The ads will run in the final weeks of the 2024 election and are intended to be a closing message that boosts Democrats and convinces voters that Republicans pose a threat to contraception access.

The group believes the contraception-focused ads have a chance at reaching voters who may have tuned out warnings over abortion that have saturated the country for more than a year — especially moderates, younger voters and women of color who Democrats need to turn out in big numbers this November.

“There isn’t a race I wouldn’t use it in at this point,” said Stephanie Schriock, the former president of EMILY’s List who supports the effort. “The immediate loss of abortion access in so many places in this country is really at the forefront of the debate, but as we go into these last weeks, it’s incredibly important to remind the voters that birth control is also on the chopping block at the state level and possibly at the federal level, because this is a deep splinter issue between Republican elected officials and their own constituents.”

Cruz, Moreno and other GOP candidates targeted by the group say they support access to contraception but dispute that it’s under threat and accuse Democrats of exploiting voters’ fears for political gain.

In Congress

POTENTIAL DEAL ON AI CONCERNS — Congressional leaders in the House and Senate are working to secure a deal on a lame-duck bill that would address rising concerns about artificial intelligence, POLITICO’s Ursula Perano reports.

The details are in flux as Democratic and Republican leadership negotiate the bill. While AI research and workforce training bills have passed through committees on a bipartisan basis, more contentious subjects like AI’s role in misinformation, elections and national security would likely be more difficult to include in a deal.

Why it matters: Lawmakers have been exploring ways to address AI amid the technology’s increasing role in everyday life, including in elections and politics. The negotiations come as HHS also considers how to regulate AI in the multibillion-dollar health care sector after President Joe Biden signed a broad executive order heightening AI safety standards last year, which Trump has since vowed to repeal.

What’s next: Congress returns the week after the November election, and lawmakers must clear government funding legislation to avoid a shutdown in mid-December. The potential AI package would likely be tacked onto other must-pass legislation, like government funding or the upcoming National Defense Authorization Act.

Even so: The outcomes of the presidential and congressional elections could significantly impact which policy gets through.

WHAT WE'RE READING

POLITICO’s Elena Schneider and Myah Ward report on how Harris’ abortion-rights campaign could widen the voter gender gap.

The Seattle Times reports on Washington state's first presumptive human bird flu cases.

Bloomberg reports on Cigna reviving efforts to merge with Humana after the initial talks fell apart last year.

The New York Times reports on the VA’s investigation of whether one of the country’s largest chains of psychiatric hospitals is defrauding government health insurance programs.

A message from PhRMA:

Seniors are feeling the true cost of drug price “negotiations.”

Instead of saving money, some Medicare patients will pay more for medicines.

Others may not be able to get their medicines – 89% of insurers and PBMs say they plan to reduce access to medicines in Medicare Part D because of the Inflation Reduction Act.

Higher costs and less access. That’s not what seniors were promised.

Learn more.