January 2023

This week, we spotlight state and local-level action to promote equity, global engagement to reduce inequities in care, and new national research that underscores the urgency of these issues. Protect Our Care is committed to making health care a right for every American. 

Addressing systemic racial, ethnic, and other inequities in health care is among the most pressing issues in America. The causes of these inequities, and the corresponding actions needed to tackle them head on, are multi-faceted. As it stands, marginalized communities, including people of color, rural Americans, LGBTQ+ people, and people with disabilities, face worse access to quality, affordable health coverage, which contributes to dangerous health outcomes.

INITIATIVES

Noozhawk: New California Program to Help Promote Better Health Outcomes for LGBTQ+ Individuals. “More than 2.5 million Californian women identify as lesbian, bisexual, transgender and/or queer (LBTQ+), with a growing group of people identifying as nonbinary. However, that roughly 6% share of the population — which includes and intersects with some of the state’s most vulnerable communities — has historically been overlooked by healthcare programs. A new $17.5 million state-funded program will support a first step towards equitable access to health care for LBTQ+ women and nonbinary Californians. The California Department of Public Health’s (CDPH) LBTQ Health Equity Initiative provides a sizeable economic infusion for health services specifically aimed at this population. While prioritizing LBTQ+ women and nonbinary people, the initiative further emphasizes the intersections of historically excluded groups — where inequity is generally exacerbated — including increased aid to youth, the elderly and BIPOC communities. Funding is earmarked for four project areas: healthcare access demonstration, community education and outreach, service provider capacity building and LBTQ+ research.” [Noozhawk, 12/28/22]

The New England Journal of Medicine: The Success of Groups Using the Anchor Strategy to Promote Equity. “An anchor strategy is a place-based business approach to building community health and wealth by means of local hiring, investing, purchasing, and community engagement. In 2016, Rush University System for Health, an academic health system in Chicago, adopted an anchor strategy to tackle the 16-year life-expectancy gap between Chicago’s West Side and the Loop. In 2018, Rush was joined by 5 other health systems — AMITA (now Ascension) Health, Cook County Health, Lurie Children’s Hospital of Chicago, Sinai Chicago, and University of Illinois Health — to establish West Side United (WSU), a racial-equity collaborative aligning investments in economic development, education, health care, and the built environment to benefit Chicago’s 500,000 West Side residents. The combined assets of these health care anchors are larger than those of any Illinois corporation and create potential for major collective impact. Since 2018, WSU members and the American Medical Association have invested $10.8 million through community development financial institutions to finance businesses, nonprofits, and affordable housing; raised $3 million to establish four health care career pathways; launched interventions targeting hypertension and maternal and infant outcomes in West Side hospitals, clinics, and community-based organizations; hired more than 2000 West Side employees; and raised $1.9 million to support local businesses. WSU’s small business accelerator offers business-development support to 150 West Side businesses and 60 community-based organizations.” [The New England Journal of Medicine, 1/7/23]

Regulatory Affairs Professionals Society: Enhancing Diversity in Clinical Trials Can Reduce Inequities in Care. “Historically, many clinical trials have not been representative of the patients most likely to use a medical product upon its approval. There is frequent underrepresentation of people from diverse groups defined by factors such as race, ethnicity, sex, gender identity, age, socioeconomic status, disability, pregnancy status, lactation status, and comorbidity. The lack of diversity in trial participation has created gaps in the understanding of treatment safety and effectiveness across the different populations. Solving the issue cannot be achieved by one organization or stakeholder group. It will require the involvement and participation of the entire medical product development ecosystem. The collaborative discussion at the 2022 RAPS Convergence among FDA, Health Canada, and industry is one such endeavor of many toward this effort. The meeting resulted in greater understanding and appreciation of perspectives. It also revealed that, while stakeholders have different roles and responsibilities, their common goal is achieving health equity for all.” [RAPS, 12/31/22]

CHALLENGES

USA Today: People of Color Are Dying of COVID-19 At Much Higher Rates Than Data Suggests. “It’s not always easy to identify a COVID-19 death. If someone dies at home, if they have symptoms not typically associated with the disease or if they die when local health  systems are overwhelmed, their death certificate might say “heart disease” or “natural causes” when COVID-19 is, in fact, at fault. New research shows such inaccuracies also are more likely for Americans who are Black, Hispanic, Asian or Native. The true toll of the COVID-19 pandemic on many communities of color – from Portland, Oregon, to Navajo Nation tribal lands in Arizona, New Mexico and Utah, to sparsely populated rural Texas towns – is worse than previously known. In Arizona’s Navajo and Apache counties, which share territory with Navajo Nation, COVID deaths among Native Americans drove nation-leading excess death rates in 2020 and 2021. In Portland, deaths from causes indirectly related to the pandemic went up in 2021 even as official COVID deaths remained relatively constant. Black residents were disproportionately impacted by some of these causes, such as heart disease and overdose deaths – despite a county-wide commitment to addressing racism as a public health threat. In Texas, smaller, rural counties served by Justices of the Peace were more likely to report potential undercounting of COVID deaths than larger, urban counties served by medical examiners. Experts point to several reasons for increased inaccurate death certificates among non-white Americans. These include resources available for death investigations, the use of general or unknown causes on death certificates, and how the race and ethnicity fields of these certificates are filled out.

Such barriers to accurate death reporting add on to existing health disparities that made non-white Americans more susceptible to COVID in 2021, despite widespread vaccination campaigns and health equity efforts.” [USA Today, 12/28/22]

Axios: Medical Debt is a Primary Driver of Health Care Inequities. “Black medical trainees were far more likely to carry a heavier debt burden than their peers in other racial and ethnic groups, a study published… in Health Affairs found. Led by the Icahn School of Medicine at Mount Sinai, researchers examined the association between race and debt among roughly 121,000 medical residents between 2014 and 2019. The study found trainees from nearly all underrepresented populations in medicine, including American Indian/Alaska Natives, Hispanics and Native Hawaiian/Pacific Islanders, were generally more likely to have debt compared to white and Asian trainees. Specifically, they found Black trainees were most likely to suffer a debt burden, with 96% reporting some type of debt including premedical education loans, medical education loans and consumer debt, not including mortgages, compared to 83% of trainees overall. 50% of Black trainees had some type of consumer debt, not including mortgages, compared to 25% overall.” [Axios, 1/10/23]

Patient Management HIT: Digital Health Literacy a Driving Factor in Disparities of Care. “New data is shedding light on the digital divide in healthcare, with researchers from The Ohio State University revealing that it’s not just broadband access stymying connectivity for marginalized groups. Rather, digital health literacy and language access will be necessary to support digital health equity. Access to digital health tools has become increasingly important in a modernized medical landscape, with the advent of digital health records, patient portals, and connected health changing the way consumers engage with their health. Looking at a Bhutanese refugee community near Columbus, Ohio, [OSU] researchers were able to zero in on the challenges faced by a traditionally underserved group exposed to numerous social determinants of health. Although this group was very low-income, with an average annual income at $35,000, nearly all had access to the internet (94.5 percent). Even still, folks included in the observational study weren’t utilizing online resources, indicating to researchers that it’s not access to hardware or broadband that’s driving the digital divide in healthcare. Language barriers, for example, were particularly onerous for study participants. Eight in 10 said they used the internet to communicate with family and friends and 68 percent utilized social media, but the internet was virtually useless for digital health engagement. Three-quarters of study participants said they never used the internet to access telehealth, despite having predispositions for certain chronic illnesses like cardiovascular disease and diabetes.” [Patient Management HIT, 1/6/23]

They All Voted Against the American Rescue Plan, the Inflation Reduction Act, and the Affordable Care Act (Every Time They Could)

After the conclusion of a highly-contested Speaker vote, the House Republican Steering Committee is set to meet today to vote on chairs for key panels that are instrumental in protecting and improving American health care. All of the Republican leaders under consideration for chairs of these committees are completely out of step with the American people on health care. The GOP made clear on the campaign trail that their health care plan means it will be more expensive to go to the doctor and more expensive to get the drugs Americans rely on to stay healthy. Under Speaker Kevin McCarthy’s radical leadership, Republicans want to return to attacking people with pre-existing conditions, repealing the Affordable Care Act, slashing Medicare, and hiking drug and health insurance costs. Once again, we will see how a Republican majority means playing politics with people’s lives in order to support Big Pharma and other special interests. 

Kevin McCarthy: Speaker of the House

Kevin McCarthy (R-CA) won the GOP nomination to become the next Speaker of the House.

• As Part Of His Corrupt Bargain To Become Speaker Of The House Kevin McCarthy Agreed To A Balanced Budget Over 10 Years Which Could Lead To Drastic Cuts And Changes To Medicare And Social Security.  As part of Kevin McCarthy’s concessions to conservatives to become Speaker of the House, he agreed that the House GOP will present a budget that balances over 10 years, capping discretionary spending at fiscal 2022 levels or lower. Although specific cuts have not been identified yet, such a budget could force catastrophic cuts and benefits changes to Social Security and Medicare. 
• Kevin McCarthy Is Open To Using Debt Limit Negotiations To Force Cuts To Medicare And Social Security. Kevin McCarthy told Punchbowl News that he would not “predetermine” whether Social Security and Medicare cuts would be part of debt-limit negotiations. Those comments suggested that, unlike in past negotiations, Republicans could demand future cuts to the programs in order to raise America’s borrowing limit and avoid a default on government debt. Mr. McCarthy later told CNBC that he had not brought up the programs and was committed to “strengthening” them, though he did not provide details.
• Kevin McCarthy Is A Relentless Foe Of The ACA And Efforts To Reduce Health Care Costs. Since taking office in 2007, Kevin McCarthy has been a relentless opponent of the Affordable Care Act, including voting against initial passage of the law, and serving in GOP House leadership during at least 60 attempts to repeal or substantially alter the law. McCarthy also led Republican efforts to try to block passage of the American Rescue Plan and the Inflation Reduction Act, which have lowered premiums and established a program to allow Medicare to negotiate lower prescription drug prices for seniors. 

Steve Scalise: Majority Leader

Steve Scalise (R-LA) will serve as Majority Leader in the Republican House. 

• Steve Scalise Led GOP Efforts To Repeal The ACA In 2017 And Now He’s A Cheerleader For The Push To Cut Medicare And Social Security. In 2017, Steve Scalise was the House Majority Whip during the frantic Republican attempt to repeal the Affordable Care Act and rip away health coverage and protections for pre-existing conditions for millions of Americans. Now, Scalise is defending GOP plans to cut Medicare and Social Security. Scalise claims that what Republicans have proposed is “strengthening” the programs, but he’s a member of the Republican Study Committee, which recently released a budget outlining plans to raise the Medicare eligibility age to 67 and convert the program to a “premium support” system where seniors received a subsidy they could use on private plans competing against traditional Medicare. 
• Steve Scalise Has Opposed The Affordable Care Act Since Its Inception. Since taking office in 2008, Steve Scalise has been a relentless opponent of the Affordable Care Act, including voting against initial passage of the law, voting for at least 60 attempts to repeal or substantially alter the law, including serving as GOP Whip during the failed repeal attempts during the Trump administration. Scalise also helped lead Republican efforts to try to block passage of the American Rescue Plan and the Inflation Reduction Act, which have lowered premiums and established a program to allow Medicare to negotiate lower prescription drug prices for seniors. 

Republican Conference Chair

Elise Stefanik was elected to a second term as Republican Conference Chair 

• Elise Stefanik Is A Donald Trump Loyalist Who Belongs To The Medicare-Slashing Republican Study Committee. Elise Stefanik was initially elected to the House in 2014 as a relatively moderate Republican, but in recent years she has transformed herself into an ultra-MAGA Donald Trump loyalist, who is often mentioned as a potential VP pick for Trump’s presidential run in 2024. Stefanik is also a member of the Republican Study Committee, which recently released a budget outlining plans to raise the Medicare eligibility age to 67 and convert the program to a “premium support” system where seniors received a subsidy they could use on private plans competing against traditional Medicare. 
• Elise Stefanik Has Voted Eight Times To Repeal The ACA And Opposes Allowing Medicare To Negotiate Lower Prescription Drug Prices. Since taking office in 2015, Stefanik has voted for at least eight attempts to repeal or substantially alter the Affordable Care Act. Stefanik claims that House Republicans will, “Lower healthcare costs through transparency, choice, and competition,” but she opposed the Inflation Reduction Act and the American Rescue Plan, which lower premiums for millions of Americans and give Medicare the power to negotiate lower drug prices for seniors. Stefanik has also peddled the false claim that Medicare drug price negotiation will harm national security or encourage drug manufacturers to “move to China.” 

Majority Whip

Tom Emmer (R-MN) defeated Jim Banks (R-IN) in the race to be Majority Whip 

• Tom Emmer Is A Member Of The Medicare-Slashing Republican Study Committee And The Point Person For Electing A Republican Anti-Health Care Majority. Tom Emmer is a member of the Republican Study Committee, which recently released a budget outlining plans to raise the Medicare eligibility age to 67 and convert the program to a “premium support” system where seniors received a subsidy they could use on private plans competing against traditional Medicare. Emmer is also the chairman of the NRCC, a position he used to push misleading claims to help elect an extremist GOP anti-health care majority. 
• Tom Emmer Has Has Voted Eight Times To Repeal The ACA And Opposes Allowing Medicare To Negotiate Lower Prescription Drug Prices. Since taking office in 2015, Emmer has voted for at least eight attempts to repeal or substantially alter the Affordable Care Act and he voted against the American Rescue Plan and the Inflation Reduction Act’s measures to lower premiums and allow Medicare to negotiate lower prescription drug prices. 

Budget Committee

Lloyd Smucker (R-PA) and Jodey Arrington (R-TX) are seen as the favorites to serve as Budget Committee chair in a Republican-controlled House. Buddy Carter (R-GA) has also expressed interest in the post. 

• Jodey Arrington Has Opposed The Affordable Care Act Since The Day He Got To Congress. Jodey Arrington’s official website still calls for the repeal of the Affordable Care Act, which he says is a “travesty” that has left America “sick.” Arrington’s first floor speech as a member of the House in 2017 was a jeremiad against the ACA and has never given up on destroying the law, blaming the Senate for hurting the Republican Party by failing to completely repeal during the Trump administration. Since taking office in 2017, Arrington has voted three times to repeal the Affordable Care Act and voted against the American Rescue Plan and the Inflation Reduction Act’s measures to lower premiums and allow Medicare to negotiate lower prescription drug prices. 
• Jodey Arrington Called For “Eligibility Reforms” To Medicare And Social Security. Arrington has expressed interest in holding the nation’s full faith and credit hostage to force cuts to Medicare and Social Security. Arrington told Bloomberg that a bipartisan negotiation on Social Security and Medicare would likely start with Democrats pushing for more revenue, while “Republicans have a list of eligibility reforms, and we don’t like the tax increases.” He has said that an increase in the eligibility age for both programs would be a commonsense change. Arrington is a member of the Republican Study Committee, which recently released a budget outlining plans to raise the Medicare eligibility age to 67 and convert the program to a “premium support” system where seniors received a subsidy they could use on private plans competing against traditional Medicare. 
• Lloyd Smucker Wants To Reduce Benefits For Medicare And Social Security Beneficiaries. Lloyd Smucker has also indicated that he wants to use negotiations over the debt ceiling to impose cuts to Social Security and Medicare. Smucker told Bloomberg that reducing benefits for wealthier Americans via “some sort of means-testing” is a good way to cut costs. Smucker is a member of the Republican Study Committee, which recently released a budget outlining plans to raise the Medicare eligibility age to 67 and convert the program to a “premium support” system where seniors received a subsidy they could use on private plans competing against traditional Medicare.
• Lloyd Smucker Has Voted To Repeal The Affordable Care Act And Opposed Measures To Lower Premiums And Drug Prices. Since taking office in 2017, Lloyd Smucker has voted three times to repeal the Affordable Care Act and voted against the American Rescue Plan and the Inflation Reduction Act’s measures to lower premiums and allow Medicare to negotiate lower prescription drug prices. 
• Buddy Carter’s Top Priority Is Repealing Medicare’s Ability To Negotiate Lower Prescription Drug Prices. Buddy Carter told Fox News in September that increasing prescription drug prices for millions of Americans will be one of his top priorities if Republicans control the House, stating that, “We’ve been asking that question not only about student debt loans, but also about a number of initiatives that have been instigated and put into place by the Biden administration, just like in the Inflation Acceleration Act that I mentioned before with the prescription drug pricing. That is something I’m very interested in as a pharmacist. I’ve been asking my colleagues, ‘How are we going to undo that when we get into the majority?’” Carter also remains a vehement opponent of the Affordable Care Act, insisting on his official website that, “Improving health care in America begins with repealing this disastrous law.” 
• Buddy Carter Wants “Everything On The Table” When It Comes To Social Security And Medicare Cuts. Buddy Carter has said that as chair of the Budget Committee, “Our main focus has got to be on nondiscretionary — it’s got to be on entitlements.” Carter went on to say that “everything is on the table” for Medicare and Social Security and that he plans to use the nation’s debt ceiling and the threat of catastrophic default to force changes to the programs. Carter is a member of the Republican Study Committee, whose recent budget outlined radical proposals like raising the Medicare eligibility age to 67 and converting Medicare to a “premium support” system where seniors received a subsidy they could use on private plans competing against traditional Medicare. Carter is a member of the Republican Study Committee, which recently released a budget outlining plans to raise the Medicare eligibility age to 67 and convert the program to a “premium support” system where seniors received a subsidy they could use on private plans competing against traditional Medicare.
• Buddy Carter Has Voted Eight Times To Repeal The Affordable Care Act And Opposed Measures To Lower Premiums And Drug Prices. Since taking office in 2017, Buddy Carter has voted eight times to repeal the Affordable Care Act and voted against the American Rescue Plan and the Inflation Reduction Act’s measures to lower premiums and allow Medicare to negotiate lower prescription drug prices. 

Education And Labor Committee

Virginia Foxx (R-NC) is seeking a waiver to circumvent term limit rules to serve as chair of the Education and Labor Committee. If she is unsuccessful, the gavel will most likely go to Tim Walburg (R-MI) 

• Virginia Foxx Is Still Committed To Repealing The Affordable Care Act And Opposed Allowing Medicare To Negotiate Lower Drug Prices For Seniors. Virginia Foxx’s official website still states that she remains “committed to replacing ObamaCare with patient-centered health care that works for the American people.” Since taking office in 2005, Virginia Foxx has been a relentless opponent of the Affordable Care Act and other efforts to expand health coverage and lower costs, including voting against initial passage of the law and voting for at least 60 attempts to repeal or substantially alter the ACA. Foxx has strongly opposed granting Medicaid the power to negotiate lower drug prices for seniors, voting against the Inflation Reduction Act and against 2019 prescription drug negotiation legislation, which she called a “socialized drug pricing scheme.” 
• Virginia Foxx Is A Member Of The Medicare-Slashing Republican Study Committee. Foxx is also a member of the Republican Study Committee, whose recent budget outlined radical proposals like raising the Medicare eligibility age to 67 and converting Medicare to a “premium support” system where seniors received a subsidy they could use on private plans competing against traditional Medicare
• Tim Walberg Has Voted Dozens Of Times To Repeal The ACA And Opposed Measures To Bring Down Costs And Allow Medicare To Negotiate Lower Drug Prices For Seniors. Since taking office in 2011, Tim Walberg has voted for at least 60 attempts to repeal the Affordable Care Act and voted against the American Rescue Plan and the Inflation Reduction Act’s measures to lower premiums and allow Medicare to negotiate lower prescription drug prices. 
• Tim Walberg Is A Member Of The Medicare-Slashing Republican Study Committee. Walberg is also a member of the Republican Study Committee, whose recent budget outlined radical proposals like raising the Medicare eligibility age to 67 and converting Medicare to a “premium support” system where seniors received a subsidy they could use on private plans competing against traditional Medicare

Energy And Commerce

Cathy McMorris-Rodgers (R-WA) is the most likely Chair of the Energy and Commerce Committee in a Republican House.

• Cathy McMorris Rodgers Voted Against Lowering Drug Prices For America’s Seniors And Promises Aggressive Oversight To Potentially Derail Prescription Drug Price Negotiations. Cathy McMorris Rodgers voted against the American Rescue Plan and the Inflation Reduction Act’s measures to lower premiums and allow Medicare to negotiate lower prescription drug prices. McMorris Rodgers has promised aggressive oversight of HHS drug price negotiations if she is Chair of Energy and Commerce in a potential effort to delay or derail the program. 
• Cathy McMorris Rodgers Has Voted Dozens Of Times To Repeal The Affordable Care Act. Since taking office in 2005, Cathy McMorris Rodgers has been a relentless opponent of the Affordable Care Act and other efforts to expand health coverage and lower costs, including voting against initial passage of the law and voting for at least 60 attempts to repeal or substantially alter the ACA. 
• Cathy McMorris Rodgers Is A Member Of The Medicare-Slashing Republican Study Committee. McMorris Rodgers is also a member of the Republican Study Committee, whose recent budget outlined radical proposals like raising the Medicare eligibility age to 67 and converting Medicare to a “premium support” system where seniors received a subsidy they could use on private plans competing against traditional Medicare

Ways And Means

Vern Buchanan (R-FL), Jason Smith (R-MO), and Adrian Smith (R-NE) are locked in a tight battle for the chairmanship of the House Ways and Means Committee. 

• Vern Buchanan Has Voted Dozens Of Times To Repeal The ACA And Opposed Measures To Bring Down Costs And Allow Medicare To Negotiate Lower Drug Prices For Seniors. Since taking office in 2007, Vern Buchanan has been a relentless opponent of the Affordable Care Act, including voting against initial passage of the law, voting for at least 60 attempts to repeal or substantially alter the law. Buchanan also voted against the American Rescue Plan and the Inflation Reduction Act’s measures to lower premiums and allow Medicare to negotiate lower prescription drug prices. 
• Vern Buchanan’s Priority For Ways And Means Would Be Extending Donald Trump’s Tax Cuts For The Wealthiest Americans. Vern Buchanan’s top priority on the Ways and Means Committee is making Donald Trump’s tax cuts for the wealthy permanent, a proposal that experts say will only worsen inflation. Buchanan is also a member of the Republican Study Committee, which recently released a budget outlining plans to raise the Medicare eligibility age to 67 and convert the program to a “premium support” system where seniors received a subsidy they could use on private plans competing against traditional Medicare. 
• Jason Smith Wants To Use The Debt Ceiling To Force Joe Biden To “Reverse” His Agenda. Smith told Axios in a phone interview he thinks Republicans should leverage debt limit negotiations to ‘reverse’ the administration’s ‘radical’ policies — including by sending a bill gutting the Democratic agenda to President Biden’s desk and daring him to reject it. ‘If Republicans are trying to cut spending, surely he wouldn’t try to default. If we were trying to bring down inflation … trying to secure our border, surely he wouldn’t default,’ Smith said. 
• Jason Smith Promised To Hold “A Lot Of Hearings” On Cuts To Medicare And Social Security. Asked about Republican plans to overhaul Social Security and Medicare, Jason Smith told Axios, “We’re going to have a lot of hearings on this. I’m not going to get into the inner details.” Smith is a member of the Republican Study Committee, which recently released a budget outlining plans to raise the Medicare eligibility age to 67 and convert the program to a “premium support” system where seniors received a subsidy they could use on private plans competing against traditional Medicare. 
• Jason Smith Has Voted More Than 20 Times To Repeal The ACA And Opposed Measures To Bring Down Costs And Allow Medicare To Negotiate Lower Drug Prices For Seniors. Since taking office in 2007, Jason Smith has been a relentless opponent of the Affordable Care Act, including voting against initial passage of the law, voting for at least 26 attempts to repeal or substantially alter the law. Smith also voted against the American Rescue Plan and the Inflation Reduction Act’s measures to lower premiums and allow Medicare to negotiate lower prescription drug prices. 
• Adrian Smith Wants To Use The Debt Ceiling To Force Spending Cuts. Adrian Smith told the Washington Post, “The debt ceiling is an important tool for addressing debt and deficit. After two years of irresponsible spending by Democrats driving historic inflation, American families can’t afford for us to not have a serious debate about government spending.” Smith is also a member of the Republican Study Committee, which recently released a budget outlining plans to raise the Medicare eligibility age to 67 and convert the program to a “premium support” system where seniors received a subsidy they could use on private plans competing against traditional Medicare.
• Adrian Smith Has Voted Dozens Of Times To Repeal The ACA And Opposed Measures To Bring Down Costs And Allow Medicare To Negotiate Lower Drug Prices For Seniors. Since taking office in 2007, Adrian Smith has been a relentless opponent of the Affordable Care Act, including voting against initial passage of the law, voting for at least 60 attempts to repeal or substantially alter the law. Smith also voted against the American Rescue Plan and the Inflation Reduction Act’s measures to lower premiums and allow Medicare to negotiate lower prescription drug prices. 

Oversight

James Comer (R-KY) is considered the Republican chairman-in-waiting of the Oversight Committee. 

• James Comer Will Use The Oversight Committee To Attack Science And The Nation’s Pandemic Response. James Comer has outlined an oversight agenda that includes attacks on the CDC and the nation’s pandemic response. Comer will use the committee’s resources to investigate the origins of the coronavirus and federal funds supporting research done at Wuhan Institute of Virology as well as pandemic-era guidance from the CDC that Comer calls “confusing.” Comer and other Republicans also plan to lay the blame for high drug prices on prescription drug middlemen known as pharmacy benefit managers in oversight hearings. 
• James Comer Has Voted To Repeal The Affordable Care Act And Opposed Measures To Lower Premiums And Drug Prices. Since taking office in 2017, James Comer has voted three times to repeal the Affordable Care Act and voted against the American Rescue Plan and the Inflation Reduction Act’s measures to lower premiums and allow Medicare to negotiate lower prescription drug prices. Comer is also a member of the Republican Study Committee, which recently released a budget outlining plans to raise the Medicare eligibility age to 67 and convert the program to a “premium support” system where seniors received a subsidy they could use on private plans competing against traditional Medicare.