Capitol Insights Newsletter
Authors: Luke Schwartz, Parker Krex, and Matt Reiter
What happened in Congress this week?
On Tuesday, July 23rd, Congress held three important hearings related to health policy:
CEOs of the three largest PBMs testified before the House Oversight and Accountability Committee. Lawmakers attacked PBMs for using tactics such as claw-back fees and favoring PBM-owned facilities, thus driving local pharmacies out of business. The Committee largely blamed PBMs for the high prices Americans pay for drugs. Despite the House passing PBM transparency legislation last year, Senate action on similar reforms remains stalled.
Six Centers for Disease Control and Prevention (CDC) officials testified before the House Energy and Commerce Health Subcommittee on the agency’s priorities. In a very partisan meeting, Republicans questioned the CDC’s need for more funding while Democrats said funding the CDC was instrumental to improving public health.
The House Administration Committee held a hearing to better understand how Congress should draft legislation in the wake of overturning Chevron deference. Some solutions included hiring more staffers with policy expertise (particularly for congressional committee staff), creating a new congressional office tasked with regulatory guidance, and furthering collaboration between lawmakers and regulators when drafting bills.
100 Day Presidential Election Countdown
This week we are taking a brief break from writing exclusively about health policy to provide an update on the Presidential election. The purpose of this newsletter is to help keep people informed about important policy topics. The winner of the Presidential election will have a huge influence on what those topics are next year. Plus, this election is too fascinating to avoid covering.
To help you stay up to date on important election news, Capitol Insights will begin including the election as a featured topic every few weeks. We expect to feature the election (Presidential and Congress) as a topic more regularly as we get closer to election day (November 5, 2024).
We originally planned to publish our first election update on June 28th, the day after the first Presidential debate between President Biden and President Trump. When we arrived in the office that morning, we knew we could not publish the article that was written. We knew President Biden’s poor debate performance would disrupt all previously-held notions about the election.
The election is now coming into focus with Vice President Kamala Harris replacing President Biden as the presumptive Democratic nominee.
In the past month, the landscape of this race has completely changed. President Biden had his terrible debate performance. The US Supreme Court ruled that President Trump is largely immune from the various criminal lawsuits brought against him. There was an assassination attempt on President Trump which was literally one second/one inch away from succeeding. President Trump selected Ohio Senator JD Vance as his running mate. The Republicans held their nominating convention in Milwaukee. President Biden defiantly resisted calls to drop out of the race for three weeks before finally announcing he would do so under immense pressure from elected officials, donors and poor polling data. He immediately endorsed his Vice President, Kamala Harris who quickly lined up support in such effective fashion that no other Democrat is seeking the nomination. She is expected to officially become the Democratic nominee at the Democratic National Convention which begins August 19th.
All of this news has completely changed the outlook of the race. Now, with Vice President Kamala Harris as the new presumptive Democratic nominee (and already faring better than President Biden did in the polls), what are the experts saying?
Polling firms have begun to release their initial polls that represent predictions for election outcomes. All polls are conducted differently, and sometimes the difference between some can be drastic.
The latest New York Times/Siena College poll reveals a closely contested race between Vice President Kamala Harris and former President Donald Trump, with Harris only one percentage point behind Trump among likely voters. Conducted from July 22 to 24, 2024, right after Harris announced her candidacy, the poll highlights Harris’s increasing support, particularly from younger and nonwhite demographics, and she enjoys a strong backing of 93% from Democratic voters. While Trump’s favorability has improved, especially after a recent assassination attempt, Harris is quickly gaining ground compared to President Biden’s low polling numbers.
However, Tony Fabrizio, a pollster for Donald Trump, warns people to be wary of recent polls involving Vice President Harris. The possibility of a “Harris Honeymoon” suggests that Kamala Harris may be experiencing a surge in public support due to extensive positive media coverage following the announcement of her candidacy. Fabrizio believes that temporary boosts in polling could see her gaining on or even surpassing former President Trump in national surveys, especially in the next few weeks recently following her announcement. However, Fabrizio believes this honeymoon phase will be short-lived, as voters will soon refocus after the Democratic Convention on her record and the ongoing issues affecting the electorate. We will have to keep an eye on the polls in the week ahead to see if Fabrizio’s view of a Harris honeymoon is true.
National polls are a helpful gauge for where the race stands but the focus is mainly on the “swing” states. The last two elections saw essentially six competitive swing states: PA, GA, WI, MI, AZ, NV. A case can be made for adding others to this list. In the weeks following the debate, Fabrizio confidently claimed President Trump was not only leading in all of these states but that other competitive states that have leaned blue the last few presidential cycles were also in play for Trump (such as VA). We are only six days removed from President Biden dropping out of the race and VP Harris becoming the presumptive nominee. It is a little early to know the full effect the change in candidates will have on polling. However, polls have started to show VP Harris running essentially tied with President Trump in many of the swing states.
Don’t wait for us to share another update on polling. Follow along yourself.
American University professor Allan Lichtman has taken a completely different approach to predicting election outcomes with his “thirteen keys to the White House.” Lichtman judges the election on thirteen yes/no questions relating to scandals, incumbency advantage, foreign military successes, and charisma. Using this analysis, Lichtman has correctly predicted nine out of the last ten presidential elections, only wrongly (or rightly depending on your view of Bush v. Gore…) predicting Al Gore in 2000. Lichtman believes that Kamala Harris winning by three keys, and that “a lot would have to go wrong for the Democrats to lose this election.”
Lichtman says he will make his official prediction after the DNC. Based on where things stand today, he believes VP Harris will win the election based on his methodology.
All of this goes to show that there is no singular correct way to predict a presidential election. What we do know is that the presidential election will be decided in the few swing states. Three of these states (WI, AZ, and GA) decided the 2020 election by a combined 50,000 votes (roughly the capacity of Yankee Stadium). Five swing states voted for Trump in 2016 but flipped to Biden in 2020 by very small margins. These states are widely expected to decide this year’s election as well.
Barring any significant changes, all indicators point to this being a very close presidential race, including the fact that multiple election experts do not agree on the predicted outcome. It is important to remember that a lot can still change in the 102 days before the election.
Questions we are paying attention to include:
- Can VP Harris grow and/or sustain her momentum beyond the Convention? She is clearly enjoying a surge in popularity and will likely benefit from a post-convention polling bump which is common for national candidates after their convention.
- Who will VP Harris select as her running mate? Political reporters suggest she is mostly considering governors from swing states. One Senator, Mark Kelly (D-AZ), is also reportedly in the running.
- Will the Vice President nominees debate each other?
- How will the race impact down-ballot races and control of Congress?
Meanwhile, do not expect any notable content in the “What Happened in Congress” section of this newsletter until after the election. The House is out of session until after Labor Day. The Senate will be in next week before starting its summer recess. Congress comes back in September with a primary goal of funding the federal government before October 1st. Congress will certainly try to pass the 12 appropriations bills but the most likely scenario is that Congress will pass a short-term Continuing Resolution (CR) to fund the government until after the election or perhaps into early 2025. Congress will then be out of session again until after the election.
Lastly, regardless of which “team” you are on in this election, we can all come together to cheer on our USA Olympians when the 2024 Summer Olympics kick off this afternoon.
Top Stories in Healthcare Policy
Capitol Associate’s own Matt Reiter was featured in a story about balancing work with time for his hobby as a musician.
Stat News is running a series of articles and videos on UnitedHealth Group. The articles are paywalled but the YouTube videos are not.
Patients are having trouble with asthma treatment after the discontinuation of Flovent. PBMs are refusing to include Flovent generics in their formularies.
The Joint Economic Committee released their report on the threat of private equity on quality of care. Legislation curtailing the problem is expected to follow.
Senator Ron Wyden introduced a bill Wednesday that would fine agent or brokers who knowingly submitting incorrect information on Affordable Care Act enrollments. The fines would be between $10,000 and $50,000.
The FDA has released guidance on electronic health data usage in the drug industry.
CVS and their PBM have agreed to pay a $45 million fine to the state of Illinois to settle allegations that rebates were not passed. This comes as government entities take greater interest in the actions of PBMs.
The Senate HELP Committee has voted to authorize an investigation into the bankruptcy of Steward Health Care. The Committee has subpoenaed the company’s CEO.
HHS has announced a reorganization that will bolster technology, cybersecurity, data, and AI strategy.
CMS is hosting a National Leadership Call on August 1st from 3:30 p.m. ET – 4:30 p.m. ET to discuss its Strategic Plan and recent regulatory topics. RSVP here.