By Chelsea Cirruzzo and Ben Leonard

PROGRAMMING NOTE: We’ll be off this Monday for Indigenous Peoples Day but will be back in your inboxes on Tuesday.

BATTLE FOR THE GAVEL — Two Republicans have formally entered the race to be the next speaker of the House after the ousting of Rep. Kevin McCarthy (R-Calif.) from the post — setting up a fight that could drive the chamber rightward.

Potential impact on health policy: Reps. Steve Scalise (R-La.) and Jim Jordan (R-Ohio) launched their bids Wednesday, but other contenders could join the race before the House votes on a speaker next week.

Whoever takes the gavel will be responsible for setting the House's health care agenda, which most immediately includes averting a shutdown before Nov. 17 and possibly re-authorizing key health programs that expired at the end of last month.

House Republicans are also still toying with a health care transparency package pulled from the floor as they try to get Democrats on board. Under McCarthy, the package came together from three committees — Energy and Commerce, Ways and Means and Education and the Workforce.

Although they’re not necessarily health policy wonks, here’s what these two speaker contenders could bring to the table:

Rep. Jim Jordan (R-Ohio)

Jim Jordan is largely focused on red-meat issues related to health care. | Jose Luis Magana/AP Photo

In the past, Jordan pushed for a replacement to the ACA as the first chair of the far-right Freedom Caucus. He now chairs the House Judiciary Committee.

He’s largely focused on red-meat issues related to health care in recent years, including slamming the Biden administration for not doing enough to stop fentanyl from coming into the country. He called vaccine skeptic and Democratic presidential candidate Robert F. Kennedy Jr. before his subcommittee on government “weaponization” and focused on Covid-19’s origins.

In July, he sought information from pharmaceutical company executives as part of an investigation into a “censorship regime.” And when the new House Republican majority took its first votes on abortion this year, Jordan was out front defending the Republicans' position.

Rep. Steve Scalise (R-La.)

When it comes to health policy, Steve Scalise doesn't stray far from the party line. | Francis Chung/POLITICO

In a statement on his speaker bid, Scalise, the House majority leader, pointed to his focus on stricter border control measures, which he says are needed to stem the flow of fentanyl into the U.S. Officials estimate that 109,000 people died of overdoses last year, largely driven by the fentanyl crisis.

In recent years, Scalise has served on the House Coronavirus Select Subcommittee and been critical of the Biden administration’s handling of the pandemic, calling on the White House to lift pandemic restrictions earlier than planned.

On broader conservative health care issues, Scalise hasn’t strayed from the party line. He opposed the Affordable Care Act, sits on the Pro-Life Caucus and, earlier this year, co-sponsored a now-dead Republican-backed Parents Bill of Rights Act that would have required schools to give parental notification on policies related to trans students.

Scalise’s and Jordan’s offices did not respond to requests for comments on the lawmakers’ health care priorities.

WELCOME TO FRIDAY PULSE. I’m spending my weekend going back in time to the Maryland Renaissance Festival. I’ll let you know what it’s like in the past if you keep me updated on the future by sending your tips, scoops and feedback to [email protected] and [email protected] and follow along @_BenLeonard_ and @ChelseaCirruzzo.

TODAY ON OUR PULSE CHECK PODCAST, host Katherine Ellen Foley talks with POLITICO New York health care reporter Maya Kaufman, who reports on the increase of tuberculosis cases in New York City — on track to reach the city's highest levels in more than a decade — and the possible implications of the spike.

A message from PhRMA:

PBMs are siphoning money away from you.  They decide what you pay and what medicines you can get. PBMs steer you toward pharmacies they own that make them more money.  And, they’re creating new fees that pad their profits, but don’t benefit patients. Learn more.

The next three months will test the influence hospitals still wield in Congress. | David Goldman/AP Photo

HOSPITALS FIGHT CUTS — Hospitals appear to have beat back the most significant payment cuts that Congress had proposed, but the next 90 days will test the industry’s influence as it looks to get lawmakers to table the rest, POLITICO’s Megan R. Wilson reports.

The most pivotal proposals revolve around so-called site-neutral reforms, which generally aim to ensure that off-site outpatient departments owned by hospitals are paid the same as independent clinics and doctors’ offices for the same services.

If passed into law, the measures could cost hospitals billions of dollars, which they say would further hurt providers still reeling from the pandemic.

“The power of the hospital industry to beat back cuts seems weaker than in the past,” said Larry Levitt, executive vice president for health policy at KFF. “But it is hardly a fait accompli that an expansion of site-neutral payments will happen this year or clear how sweeping that expansion might be.”

DOWNLOAD THE POLITICO APP: Stay in the know with the POLITICO mobile app, featuring timely political news, insights and analysis from the best journalists in the business. The sleek and navigable design offers a convenient way to access POLITICO's scoops and groundbreaking reporting. Don’t miss out on the app you can rely on for the news you need. DOWNLOAD FOR iOS – DOWNLOAD FOR ANDROID.

MISCONDUCT POLICY OVERHAUL — HHS’ Office of Research Integrity wants to update its 2005 policies on research misconduct in public health as part of its efforts to rebuild Americans’ trust.

Why it matters: Restoring the trust in public health efforts has been a trend in recent administrative action. HHS told the Government Accountability Office last month it also plans to finalize its updated scientific integrity policy early next year as part of an initiative to prevent political meddling in health decisions.

Those proposed changes include:

— Clarifying and updating certain terms to help institutions identify and report research misconduct more easily

— Streamlining the appeals process for respondents who want to dispute research misconduct findings

— Clarifying the responsibilities of HHS, the Office of Research Integrity, and Public Health Service-funded institutions in how they can address, report, document and investigate research misconduct allegations

The comment period on the proposed rule is open until Dec. 5.

A message from PhRMA:

OLDER ADULTS HIT HARDEST BY RSV — Most hospitalizations for respiratory syncytial virus among older Americans between July 2022 and June 2023 were for people ages 75 and older, and 17 percent of patients lived in long-term care facilities, a CDC report out Thursday says.

Why it matters: The number of RSV cases nationwide has ticked upward, according to the CDC, as the respiratory illness season gets underway. This is the first year an RSV vaccine has been available for the most at-risk groups, including older adults.

The CDC report is based on data from the RSV surveillance system. It found that, among adults ages 60 and older, most patients hospitalized with RSV had an underlying health condition, including chronic obstructive pulmonary disease, diabetes or congestive heart failure.

Between Feb. 2022 and May 2023, fewer older adults were hospitalized for RSV than for Covid-19 or the flu — but RSV patients had more serious outcomes, such as ICU admission or noninvasive ventilation.

RISE IN CANNABIS-INDUCED PSYCHOSIS — Cannabis-related hospitalizations in Canada increased after the country relaxed its restrictions on marijuana commercialization in early 2020, according to a new study in JAMA Network Open. But no such increase had occurred after the country legalized marijuana for adults in 2018 under a more restrictive regulatory model, POLITICO’s Mona Zhang reports.

Details: Researchers analyzed the country’s health databases, which include the number of acute care hospitalizations from each province's universal health insurance. About 97 percent of Canadians are covered by this type of insurance.

There were more than 105,000 cannabis-related hospitalizations over the 2015 to 2021 study window. Researchers analyzed three periods: pre-legalization, legalization and commercialization.

Over the seven years, researchers found a nearly twofold increase in cannabis-related hospitalizations. But the first year and a half of legalization was associated with only a modest decrease in hospitalization.

Reasons for hospital visits included acute intoxication, harmful use, dependence, withdrawal and poisoning, the largest relative increase was found in cannabis-induced psychosis.

The impact: The findings have policy implications for any jurisdiction considering legalizing cannabis. The researchers suggested that a restrictive model — like allowing only flower products as was done in Canada — “may even have a modest public health benefit” since cannabis-related health services decreased upon legalization.

A NEW POLITICO PODCAST: POLITICO Tech is an authoritative insider briefing on the politics and policy of technology. From crypto and the metaverse to cybersecurity and AI, we explore the who, what and how of policy shaping future industries. We’re kicking off with a series exploring darknet marketplaces, the virtual platforms that enable actors from all corners of the online world to traffic illicit goods. As malware and cybercrime attacks become increasingly frequent, regulators and law enforcement agencies work different angles to shut these platforms down, but new, often more unassailable marketplaces pop up. SUBSCRIBE AND START LISTENING TODAY.

Brianna Battle is now the legislative affairs manager at America’s Essential Hospitals. She previously led policy advocacy at the Alzheimer’s Association.

Andrea Bild has joined the Advanced Research Projects Agency for Health as a program manager. She previously was a professor of oncology and therapeutics at City of Hope Medical Center.

Patrick Curran, CEO of Health Plan of San Mateo, has been elected chair of the Association for Community Affiliated Plans.

The Washington Post reports that scientists have discovered a series of genes that may lead to autism.

The New York Times reports that gun deaths in children sharply rose from 2011 to 2021, making firearm injuries the leading cause of accidental death in children.

A message from PhRMA:

Health insurers and PBMs can refuse to share savings that should go to you. Now they’ve got another trick. A new report shows  PBMs found new ways to profit off your prescriptions. They’ve doubled the amount of fees they charge on medicines in the commercial market. They tie these fees to the price of medicines. And experts warn this can lead PBMs to cover medicines with higher prices instead of lower-cost options. 

Follow us on Twitter

Follow us

To change your alert settings, please log in at https://www.politico.com/_login?base=https%3A%2F%2Fwww.politico.com/settings

This email was sent to [email protected] by: POLITICO, LLC 1000 Wilson Blvd. Arlington, VA, 22209, USA

Please click here and follow the steps to unsubscribe.