MedPage's political team gathers details about potential Democrat presidential VP picks.

https://www.medpagetoday.com/publichealthpolicy/healthpolicy/111340

Where Harris' VP Options Stand on Healthcare

— A look at the healthcare track records of Shapiro, Kelly, Walz, and Buttigieg

by Kristina Fiore, Shannon Firth, Joyce Frieden, Jennifer Henderson      |     Last Updated August 2, 2024

Democratic presidential candidate Kamala Harris is said to be announcing her vice presidential candidate imminently, and major news organizations have homed in on a few top candidates: Pennsylvania Gov. Josh Shapiro, Arizona Sen. Mark Kelly, Minnesota Gov. Tim Walz, and Transportation Secretary Pete Buttigieg among them.

MedPage Today examined the healthcare track records of each of these candidates, finding common threads on topics including support of abortion rights and the need to tackle high drug prices.

Here's where they stand on popular healthcare issues, along with some of their personal ties to health policy.

Josh Shapiro

Shapiro, a moderate Democrat with populist appeal, took office in January 2023 after 2 decades in government.

In 2022, Shapiro beat Doug Mastriano, a state senator and Republican Trump ally, by framing the race as a referendum on abortion rights and election integrity, winning the vote with the largest margin of any swing state race that year.

In July, Shapiro reaffirmed his support for reproductive rights by filing a notice in a lawsuit in the Commonwealth Court, explaining that Pennsylvania will not defend a state law banning Medicaid coverage for abortion services because it forces women to shoulder an unsustainable burden and it violates the state's constitution.

"As Governor, I will always uphold our state's constitution and protect a woman's right to make decisions over her own body and have the healthcare services she needs," he said.

He proposed investing $100 million to improve mental health services in K-12 schools and another $100 million to address gun violence in his 2024-2025 budget request, with more than a third of the latter funding dedicated to the Violence Intervention & Prevention Program, according to a press release.

Shapiro also has urged the General Assembly to pass legislation banning untraceable and unregulated "ghost guns" and requiring background checks.

The Pennsylvania governor has also made tackling high healthcare costs and ensuring access to care a priority. He signed legislation expanding telemedicine services and in February, he floated a plan to use $4 million in state funding to buy and erase medical debt for thousands of Pennsylvanians. In July, Shapiro signed legislation that aims to better regulate pharmacy benefit managers (PBMs) -- middlemen that decide which drugs are covered by insurers and what costs patients pay for medications.

"Pennsylvanians are getting screwed by the high cost of prescription drugs and too many rural pharmacies have been forced to close their doors, while the few PBMs that dominate the market are raking in billions," Shapiro said in a statement.

As attorney general in 2019, Shapiro negotiated a 10-year contract between UPMC Health System and Highmark Blue Cross Blue Shield, preventing massive disruptions to patient care for Pittsburgh residents and those in other parts of Western Pennsylvania.

In December 2022, he also helped negotiate settlements with CVS and Walgreens as part of a multi-state investigation into the pharmaceutical industry over its role in the opioid epidemic. The $2.2 billion earmarked for Pennsylvania out of the total $54.1 billion settlements will be used to invest in more recovery beds, to link patients to care, to ensure patients can secure housing after leaving treatment facilities, and to pay substance use disorder professionals more, Shapiro said in a 2021 press conference, prior to the settlement.

As a child, Shapiro lived for a time on a Navy base where his father served as a medical officer. His mother worked as an educator. He credits his parents with inspiring him to a career in public service.

If elected, Shapiro would be the nation's first Jewish vice president.

Mark Kelly

The Democratic senator from Arizona is generally seen as middle-of-the-road on most issues. On abortion, for example, he aligns with the party's pro-choice stance, as mentioned in a May 29 AZ Mirror story, which says he wants to codify Roe v. Wade into federal law. "We've got to get these rights back," he said at a news conference held shortly after he toured Planned Parenthood Arizona's Tempe clinic. "We've got to codify Roe at the federal level," he said. "I think that is truly the path forward."

Kelly has also spoken out about preserving the use of in vitro fertilization (IVF); his wife, former Arizona Democratic congresswoman Gabby Giffords, had been scheduled to have the procedure 2 days after she was shot and seriously injured outside a Tucson, Arizona, supermarket. He has cosponsored bills that would protect access to IVF as well as contraception.

Kelly also supports laws to curb gun violence. "I'm a gun owner. I'm a supporter of the Second Amendment, but we make it so easy for irresponsible people and criminals to get access to firearms," Kelly said during a 2023 interview on "Face the Nation." "How about more background checks?"

In other areas of healthcare, Kelly recently touted $3 million of infrastructure money that the federal government was granting to Arizona to support 359 Public Health AmeriCorps workers coming to the state. "These investments will provide much needed support for the essential health care workers across our state," Kelly said in a press release. "By strengthening our public health workforce, we are bolstering the quality and accessibility of care for everyone in Arizona."

Regarding Medicare, Kelly sponsored a bill to increase access to plasma-based medicines under the Medicare Part D program and also signed onto a bill tightening requirements for use of prior authorization in the Medicare Advantage program. At the same time, Kelly "fought against efforts by the Medicare agency to undermine [the Medicare Advantage] program with harmful cuts and other changes," according to one of his constituents.

Tim Walz

Walz was first elected Governor of Minnesota in 2018 and won reelection in 2022. Prior to this tenure, the former National Guard member and high school educator served six terms in Congress as a member of the House. During that time, he represented a rural part of Minnesota that had typically skewed conservative.

In Congress, Walz took up issues affecting veterans, including mental health and pain management, the Star Tribune reported. For instance, he called for funding research on the safety and effectiveness of medical cannabis in treating veterans diagnosed with post-traumatic stress disorder and chronic pain.

Walz has also sided with reproductive rights and issues affecting the LGBTQ+ community.

In April 2023, as Governor of Minnesota, Walz signed three bills into law protecting individuals seeking or providing abortions in the state, banning the practice of conversion therapy, and protecting people seeking or providing gender-affirming care.

"Today, we're protecting the rights of Minnesotans and making sure our state remains a place where people have the freedom to get the care they need to live their fullest lives," Walz stated at the time. "We're also protecting young and vulnerable Minnesotans from the harmful and discredited practice of conversion therapy. We're putting up a firewall to ensure Minnesotans have the freedom to make their own healthcare decisions."

Additionally, during his tenure as Governor, Walz signed into law universal free meals for students.

He has also pushed for 100% clean electricity in Minnesota by 2040, as well as created a statewide paid leave program, legalized marijuana for adults, and passed stricter gun laws, the Star-Tribune reported.

And back in 2020, Walz signed a bill into law aimed at providing relief to Minnesotans struggling to afford their insulin.

Walz has, however, received criticism and pushback from Republicans regarding his COVID-19 response, according to the Star-Tribune, including nursing home deaths in the state, and shutdown orders that affected businesses and schools.

Recently, speaking on CNN, Walz responded to additional criticisms that some may view him as being too liberal, ABC News reported.

"What a monster!" Walz reportedly quipped. "Kids are eating and having full bellies so they can go learn and women are making their own healthcare decisions ... So, if that's where they want to label me, I'm more than happy to take the label."

Pete Buttigieg

While Transportation Secretary Buttigieg is considered a long-shot at being Harris' running mate, he's been stumping for her and is one of the most visible members of the Democratic party today.

Much of what we know about Buttigieg's healthcare positions comes from his attempted run for the presidency in 2020. At the time, his "Medicare for all who want it" plan drew lots of attention, as it was a more moderate version than the "Medicare for all" plan supported by further-left members of the party.

The plan supported an optional government insurance plan, into which the uninsured would automatically be enrolled. People would be able to keep their employer-sponsored insurance if they chose.

Buttigieg also wanted to expand federal subsidies for private insurance purchased on Affordable Care Act marketplaces, to limit out-of-pocket costs for traditional Medicare, and to cap patients' out-of-network charges at two times the Medicare rate.

Perhaps Buttigieg's most radical healthcare policy was his drug price negotiation plan, which called for forcing drugmakers to give up as much as 95% of a drug's revenue if it refused to negotiate on prices. "Worst offender" companies could also forfeit patent rights under the plan, according to an article in STAT at the time. Buttigieg also supported using march-in rights for the federal government to produce generic drugs that are still patent-protected.

Buttigieg clearly supports abortion rights with few limits, as was made evident in a 2019 Fox News town hall that garnered attention for how Buttigieg answered questions about late-in-pregnancy abortions. He noted that the proportion of third-trimester abortions is exceedingly small, at less than 1% of all abortions each year – and when they do occur, it's typically due to a serious fetal anomaly or for the health of the woman.

"Let's put ourselves in the shoes of a woman in that situation," Buttigieg said. "Families ... get the most devastating medical news of their lifetime ... That decision is not going to be made any better, medically or morally, because the government is dictating how that decision should be made."

Conservatives have tried to equate his stance with supporting dilation & extraction (D&X, commonly referred to as partial-birth abortion by abortion opponents), but there's a federal ban against that procedure in the U.S.

Finally, as the first openly gay person confirmed to serve in a president's cabinet, Buttigieg has voiced concerns about an ongoing attack on LGBTQ+ rights in the U.S. – including those of the transgender community.

"I think we're actually in an exceptionally ugly moment in terms of some figures deciding that there's utility, political utility, in targeting trans people and LGBTQ people more generally," Buttigieg told TIME last year.

"The situation of an upper-middle-class, married white gay dude is not the same as a trans kid in Texas, or any number of LGBTQ people of color trying to survive right now," he continued. "They see political value in this. I see not only distraction, but a very real harm that's being done. And that's gonna persist until they figure out that it is not rewarding politically for them."

Speaking of federal health policy.

What would politics be without expediency, to say nothing of hypocrisy?

A slight tangent from the thread topic, but certainly relevant in its details.

https://www.medpagetoday.com/infectiousdisease/covid19/111709

An Unwelcome Souvenir From the Democratic National Convention: COVID

— Multiple cases reported on social media; few precautions in evidence at the convention

by Joyce Frieden, Washington Editor, MedPage Today    |    August 28, 2024

People often leave political conventions with lots of good memories and fun souvenirs, but some participants in the recent Democratic National Convention (DNC) in Chicago also brought home an unwelcome visitor: COVID-19.

"Ugh: DNCovid-24," Doug Sovern, a political reporter at San Francisco's KCBS, wrote on X, adding a photo of his positive test result. "I brought home an unfortunate souvenir from #DNC2024. And so did many of my fellow convention crew. I guess 4 hours of sleep a night + endless work + close indoor proximity to so many people = my first COVID since the NBA Finals in 2021."

"Oh man! I brought home so much sweet swag from the DNC!" said Fred Wellman, a retired Army officer, in a social media post that has since been deleted. "Coffee mugs, stickers, t-shirts, poster, buttons, bags, pins, and...COVID!"

"I arrived at the DNC healthy and hopeful and left very sick and disillusioned," wrote Yasmine Taeb, a human rights lawyer, who, like Sovern, also posted a photo of her positive test on X.

Former Secretary of State Hillary Clinton -- one of the event's marquee speakers -- also came down with COVID. The illness forced her to drop out of a Democratic fundraiser she had planned to attend.

The Democratic National Committee, which hosted the convention, gave convention-goers conflicting guidance regarding masking, one of the prime COVID prevention strategies. In its convention FAQ, the "Public Health and Safety" section says the following regarding COVID: "The 2024 Democratic National Convention Committee adheres to current guidance from relevant public health authorities regarding COVID-19. Masking is not required at convention events, but any participant desiring to wear a mask is welcome to do so."

However, in the "Accessibility" section of the same document, a question about whether attendees are allowed to wear masks at the two main convention venues is answered as follows: "Yes, masks will be allowed if necessary due to a disability. You may be asked to remove your mask when going through security." The committee did not respond by press time to an email asking about whether any COVID precautions were taken at the event, at which very few masks were visible.

Public health experts were not surprised by the COVID reports. "There's not much attention right now on COVID in the public sector, so its presence is easy to ignore -- until a super spreader event occurs," said Rebecca Bartles, DrPH, MPH, executive director of the Centers for Research, Practice, and Innovation at the Association for Professionals in Infection Control and Epidemiology. "Looking at the current numbers and trends, it's not all that surprising to see DNC attendees returning home with COVID."

"Two of the main strategies used in large-group settings to reduce COVID spread are pre-event testing and masking," she told MedPage Today. "It is clear that we are not at a point where masking is palatable to most folks, and requiring testing prior to an event in a time where rates are still relatively low might also be a hard requirement to get compliance with. Not knowing what the protocols were at the DNC, their minimum strategies should have been asking folks not to attend if they were sick, providing well-stocked, accessible hand hygiene and respiratory hygiene stations, and ensuring air quality of the venue in advance."

Katelyn Jetelina, PhD, MPH, the author of the "Your Local Epidemiologist" newsletter, told MedPage Today that she was "not surprised at all."

"We are in the middle of a massive infection wave and, presumably, a national gathering like this provides new social networks for the virus to explore," said Jetelina, who is a senior scientific consultant to the CDC. "There are a lot of things people could do to prevent this from happening, including wearing a high-quality mask to the event. Unfortunately, when I was watching from television, I saw very few utilizing this tool."

There appeared to be fewer reports on social media of COVID cases contracted by Republican National Convention participants, although a person on X did note a bump in COVID detection in wastewater in Milwaukee -- where that event was held -- during the convention period in mid-July. Like the Democratic National Committee, the Republican National Committee did not respond by press time to an email asking about whether any COVID precautions were taken at the event.