Oct 28, 2024

Presented by CareQuest Institute for Oral Health

Driving The Day

Fentanyl pills are pictured.

In a rare show of bipartisan agreement, both Democrats and Republicans blame drug traffickers for America's fentanyl crisis. | Courtesy of the Department of the Interior

TREATMENT TAKES SECOND FIDDLE — Democrats and Republicans have found common ground this election cycle: America has a fentanyl problem , and it’s drug traffickers’ fault, POLITICO’s Carmen Paun reports.

Former President Donald Trump and the GOP have slammed Democrats for what they see as lax border policies allowing fentanyl to surge into the country. Vice President Kamala Harris and Democrats have countered that they’ve cracked down on traffickers and want tighter border enforcement, saying Trump killed a deal addressing the border in Congress.

The consensus reflects the resonance of border control among voters — most of the country’s illicit fentanyl comes from Mexico — and a hardening of the nation’s attitude toward addiction. Politicians from Trump and Harris on down the ballot say they’ll crack down.

“It’s one of those things that people don’t want in their community,” said Rep. Jahana Hayes, a Democrat running for a fourth term representing a district including Hartford, Connecticut, suburbs and rural areas to their west, of illicit drugs. “They want a tough-on-crime stance on it.”

The other side: That view worries public health experts and treatment advocates, who see a backsliding toward the law enforcement focus that once looked futile. They fear it bodes ill for additional efforts from Washington to expand addiction care.

“We’ve seen bipartisan efforts to expand access to treatment … I wish they would talk about that more,” said Maritza Perez Medina, federal affairs director at Drug Policy Action, an advocacy group that opposes the law enforcement-first approach.

Looking back: Six years ago, the sentiment in Washington about drug use was more empathetic: A bipartisan majority in Congress passed the SUPPORT Act, adding billions earmarked for treatment and recovery, which then-President Trump signed.

But after it passed, fatal drug overdoses driven by illicit fentanyl skyrocketed, hitting a record 111,451 in the 12 months ending in August 2023 before starting to recede. Homelessness, sometimes tied to drug addiction, also spiked.

When the SUPPORT Act came up for renewal last year, Congress wasn’t as motivated. The Democratic Senate hasn’t voted on a bill, while a House-passed measure from the chamber’s GOP majority offers few new initiatives and no new money.

That attitude has been similar in the states — even deep blue ones. Oregon, where voters legalized drugs for personal use in 2020, reimposed criminal penalties this year. Polls indicate California voters, frustrated, too, by homelessness and crime, are likely to boost penalties for drug users by ballot initiative next month.

On the campaign trail: Trump isn’t talking about the SUPPORT Act, one of his most consequential legislative successes. Harris isn’t talking about treatment policies from the Biden-Harris administration that some public health specialists credit with reducing overdose death rates after years of increases.

Instead, Trump used his first anti-Harris ad this summer to blame her for the more than 250,000 deaths from fentanyl during the Biden-Harris administration.

Harris responded by touting her prosecution of drug traffickers when she was California’s attorney general and a promise to strengthen the border.

WELCOME TO MONDAY PULSE. We hope you got to enjoy fall in the DMV area this weekend. Send your tips, scoops and feedback to bleonard@politico.com and ccirruzzo@politico.com and follow along @_BenLeonard_ and @ChelseaCirruzzo.

Abortion

Arizona for Abortion Access protesters

Voters in Arizona appear ready to reject even moderate restrictions on abortion rights. | Rebecca Noble/Getty Images

15-WEEK BAN POISED TO FALL — Not that long ago, leading Republicans, including former President Donald Trump, argued that allowing abortion through the first 15 weeks of pregnancy was the key to easing voter concerns over restrictive bans.

It was a “compromise,” they argued, that would permit more than 90 percent of all abortions in the U.S. but cut off access well short of Roe ’s viability standard, around 22 weeks.

That was the argument a handful of Arizona Republicans made in May when they joined with Democrats to repeal the state’s 1864 near-total abortion ban before it could take effect. State Sen. Shawnna Bolick, one of a few Republicans to cross the aisle, told her colleagues in a floor speech that it would be far easier to defend a 15-week ban than a near-total ban, and that embracing the Civil War-era law would compel voters to overturn it by ballot measure.

“I want to protect our state constitution from unlimited abortions,” she said. “I am here to protect more babies.”

But POLITICO’s Alice Miranda Ollstein reports that voters in Arizona are poised to handily reject the 15-week ban and add abortion protections to their state constitution, just as voters did in Michigan, Ohio and other red and purple states while facing six-week and near-total bans.

It’s the latest evidence that even voters who tell pollsters they oppose second- and third-trimester abortions will, when given a chance, vote against government-imposed restrictions on the procedure — regardless of the number of weeks.

Rep. Alex Kolodin, a Republican and member of the state’s Freedom Caucus, told POLITICO he feels “rolled” by his colleagues.

“They were essentially buying the premise that it’s desirable to have some amount of abortion on demand,” he said. “I get it. They feel like they got to do it because that’s where the society and the culture and popular opinion are at. But I don’t think you change that popular opinion by buying the premise.”

A message from CareQuest Institute for Oral Health:

Drug prices, mental health, abortion — all health care topics the presidential candidates are debating. But neither is focused on the topic that has support from both parties: extending dental care to millions in the US who lack insurance. A new national poll commissioned by CareQuest Institute and the Oral Health Progress and Equity Network (OPEN) shows voters want better dental coverage in Medicare. Learn more and take action to improve the oral health system.

CAMPAIGN 2024

BIDEN’S DISAPPEARING ACT — President Joe Biden has little involvement in Vice President Kamala Harris’ campaign, the outcome of which will be a key part of his legacy, POLITICO’s Eli Stokols and Jonathan Lemire report.

Biden has largely focused on official events intended to showcase his administration’s accomplishments with a more granular approach to policy, including an event in New Hampshire last week with Sen. Bernie Sanders (I-Vt.) on Democrats’ attempts to lower drug prices through the Inflation Reduction Act.

Given his enduring appeal with older white voters, Biden could be useful to Harris, especially in Blue Wall states. Polling suggests that older adults, like Biden, connected with his arguments about democracy and were particularly pleased with the prescription drug price victories.

But while aides close to Biden see the final trips as key to cementing his legacy, they also underscore how tangential he has become to the campaign.

“There’s really not anything he can do to help at this point,” said one Democratic operative close to the campaign who was granted anonymity to speak candidly. “Maybe some of these events around policy accomplishments make a difference on the margins. But at best, they’re probably a wash.”

In Congress

ILLUMINA LOBBIED UP AMID BIOSECURE TALKS — Genomics firm Illumina hired a pair of former staffers to House Majority Leader Steve Scalise last month as the House prepared to vote on the BIOSECURE Act , which would prevent its Chinese competitors from contracting with the government, POLITICO’s Caitlyn Oprysko reports.

S-3 Group’s Marty Reiser, Scalise’s former policy director, and Matt Bravo, his former floor director, began lobbying for the DNA sequencer on Sept. 1 on issues related to national security, genomic security and the National Defense Authorization Act, according to a disclosure filing.

Just over a week later, the House passed the legislation that would be a boon for Illumina, which already dominates the genomics market.

The path forward: An aide to House Speaker Mike Johnson confirmed to Pulse that the speaker plans to push for the legislation to be included in the NDAA later this year.

AROUND THE AGENCIES

DRUG NEGOTIATION TRANSITION — CMS will work with either president-elect Trump’s or Harris’ team on the next tranche of drugs set for Medicare price negotiations, a top HHS official said Friday.

The new president will have about two weeks after being inaugurated to finalize and announce 15 drugs, HHS Deputy Secretary Andrea Palm said Friday after an event in Woodbridge, Virginia, POLITICO’s Robert King reports. Landing teams for the new administration will have a window into the process and begin as soon as the transition is authorized, Palm said.

“They will let the career staff drive the process in conjunction with whoever the incoming team is going to be,” Palm said.

The background: The Inflation Reduction Act allowing Medicare to negotiate drug prices for the first time imposes a Feb. 1 deadline for releasing the next list of chosen drugs.

A message from CareQuest Institute for Oral Health:

Names in the News

Christopher Semenas is now director for public affairs at L'Oréal. He most recently was senior manager for federal policy and government relations at Pfizer.

Health Democracy Healthy People is merging with the Institute for Responsive Government. HDHP executive director Jeanne Ayers and partnerships director Gnora Mahs will join the institute’s team.

WHAT WE'RE READING

STAT reports on a new threat to profits for UnitedHealth Group.

The Wall Street Journal reports that Pfizer's activist battle might fizzle, but its stock likely won't.

A message from CareQuest Institute for Oral Health:

A national poll shows that adding dental benefits to Medicare is a top health issue for US voters, even over abortion and the ACA. More specifically:

· 9 out of 10 voters want a Medicare dental benefit.
· More than 4 out of 5 voters for Trump in 2016 and 2020 want a dental benefit added to Medicare.
· 99% of those who voted for the Democrat candidate in the last two elections want a dental benefit added to Medicare.

“Far too many people have discovered oral health care is too expensive and out of reach,” says Melissa Burroughs, CareQuest Institute director of public policy. “Yet this issue has been on the back burner when it comes to policy conversations and the political commitment to address it.”

It’s simple: the American people want dental care included in Medicare. It’s time to make this policy change a top priority — our health depends on it.