In a Republican-led House, probing science agencies tops the agenda

WASHINGTON — The Covid-19 investigations are coming.

When Republicans take control of the House of Representatives in January, as the AP projected Wednesday, they’ve made it clear that probing President Biden’s response to the pandemic will be their top priority. Holding the majority gives them new powers to subpoena officials and others and to set the agenda for key committees.

Republicans across the country campaigned on anti-science rhetoric, lobbing intense criticism of the Biden administration’s vaccine and mask mandates and its spending on the pandemic response.

Rep. Cathy McMorris Rodgers (R-Wash.), who is set to chair the Energy and Commerce Committee, has signaled particular interest in probing the origins of the pandemic, along with research funded by the National Institutes of Health, and remote schooling recommendations.

After his vilification on the campaign trail, National Institute of Allergy and Infectious Diseases Director Anthony Fauci could be another target, and health officials including health secretary Xavier Becerra, and Centers for Medicare and Medicaid Services administrator Chiquita Brooks-LaSure could also face more heat from the House in oversight hearings.

House Republicans’ power will be limited, however, now that Democrats managed to retain control of the Senate. Divided government will force Republicans to focus more on oversight and bipartisan bargaining than they might have otherwise.

House Democrats’ efforts to examine the Trump administration’s handling of the early days of the pandemic will also likely wind down, as the current coronavirus oversight subcommittee of the House Committee on Oversight and Reform could be disbanded under a Republican majority. The party in charge has broad authority to determine the panel’s structure.

It will be a radical change from House Democrats’ approach to the pandemic. During their four-year tenure in control, they unilaterally passed billions of dollars in Covid-19 relief funding, backed Biden administration officials, and broadly supported more public health spending.

The switch in House leadership to GOP control will lift up a new generation of Republican leaders who haven’t chaired committees before, as the former Republican chairmen of both major health care committees will have retired by January.

It’s unclear exactly who will chair the powerful Ways & Means Committee. One candidate for the slot, Rep. Vern Buchanan (R-Fla.), hasn’t laid out his health care priorities in great detail. However, he introduced a bill last month that would force Medicare to make coverage decisions on individual drugs, not classes of drugs — a clear rebuke to Medicare’s restrictive, wide-ranging coverage decision based on data related to Biogen’s Alzheimer’s drug, Aduhelm.

Now that Republicans will have more leverage in negotiations over government funding and the debt ceiling, they also will have more influence to demand changes to Medicare overall.

Republicans’ official campaign platform provides scant detail about the issue, beyond a vague promise to “save and strengthen” Medicare and ensure its financial solvency.

But a large caucus of House Republican lawmakers produced a policy paper earlier this year that outlined several concrete changes that would upend the status quo for the entire health care industry, and beneficiaries as well. The proposals include raising the eligibility age for the program, encouraging more competition between traditional Medicare plans and private plans, decreasing what Medicare pays hospitals for off-site services, and slashing subsidies to insurers and hospitals.

McMorris Rodgers is also hoping to tackle telehealth policy, onshore manufacturing, and regulations on pharmacy benefit managers, which are middlemen between insurers and drug makers that weren’t regulated in Democrats’ drug pricing reforms.

One other new issue Republicans could pursue is more aggressive regulation of nonprofit hospitals. Rep. Jim Banks (R-Ind.) last Congress released a substantive hospital pricing reform plan that would regulate what hospitals charge commercial insurers, beef up the Federal Trade Commission’s scrutiny of hospital mergers, and reduce financial incentives for hospitals to buy up physician practices.

A fellow Republican lawmaker from Indiana, Rep. Victoria Spartz, has leveraged her post on the House Education and Labor Committee to introduce a spate of hospital regulations and a crackdown on anticompetitive contracting practices.

Many Republicans oppose the Inflation Reduction Act’s policies on drug pricing reform, but it’s unclear whether they will aggressively pursue repeal of the policies, as they’re politically popular and save the federal government money.

The transfer of power in January will also eliminate the possibility of passing partisan health care legislation like Democrats’ drug pricing reforms, as Democrats will be unable to use the budget reconciliation process to accomplish their legislative agenda.

The win also throws the House Democrats’ leadership into chaos, as it’s unclear whether House Speaker Nancy Pelosi (D-Calif.), who has overwhelmingly driven House Democrats’ health care agenda in recent years, will stay in Congress if she would be leading the minority.

Correction: A previous version of this article misstated Rep. Victoria Spartz’s committee membership.