Andrew Siddons

A decade after Congress gave the Food and Drug Administration the authority to regulate tobacco products, there is a growing sense that the law should be revisited to address a product that lawmakers barely knew about in June 2009: electronic cigarettes.

The tension lies in how to balance e-cigarettes’ potential benefits with their clear risks. While e-cigarettes may offer a less harmful alternative for adults who smoke combustible cigarettes, they can appeal to young people who never would have smoked.

Senate Majority Leader Mitch McConnell on Monday introduced a bill to raise the federal age for purchasing tobacco products, including e-cigarettes, to 21, increasing the chances that Congress will clear a significant smoking-related bill for the first time since a major tobacco control law was enacted a decade ago.

The bill comes amid growing concerns about the youth use of e-cigarettes, which reached record levels in 2018. That marked a troubling reversal of declines in smoking traditional cigarettes.

This was supposed to be a good week for the makers of low-cost generic drugs, as a bill that is one of their top priorities gets a House floor vote. Instead, the industry finds itself clouded by allegations of price fixing, and its signature bill is being packaged with two measures they oppose.

The bill that the House will take up Thursday combines three drug pricing measures with bills to strengthen the individual health insurance market.

The promise of higher federal Medicaid payments is giving eight states the chance to show that one-stop mental health clinics with 24-hour crisis care could offer patients a better option than the de facto safety net of police departments and emergency rooms.

But the two-year experiment is drawing to a close now, leaving the program with an uncertain future if Congress doesn’t extend it.

Supporters of “Medicare for All” often cite systems in other industrialized countries to illustrate how putting health care funding in government hands could work in the United States.

Some of the benefits are clear. Besides expanding access to health insurance, the system could eliminate many complexities for patients, doctors and hospitals.

Congress in recent years has pumped billions of dollars into health preparedness to handle infectious disease outbreaks like Ebola, but the current outbreak in an unstable part of Africa is posing problems that might not be solved by investments alone.

Top Trump administration health officials on Thursday told the Senate appropriations panel overseeing discretionary health funding that the biggest challenges to controlling the Ebola outbreak underway in the Democratic Republic of Congo are a lack of security and a lack of trust for health care workers and government within the local population.

Federal officials are examining potential barriers, such as a fear of retaliation from employers, that may explain why only about one-third of coal miners participate in a program to screen for black lung disease even as the number of workers suffering from the deadly condition is rising.

The lack of participation concerns lawmakers and the federal agency that administers the program, the National Institute for Occupational Safety and Health. The institute, part of the Centers for Disease Control and Prevention, plans to issue a congressionally-mandated report on the issue by the end of March.

Seven drug industry executives appearing before the Senate Finance Committee on Tuesday blamed a large part of the drug price problem on the way health insurance is designed, even though lawmakers warned the industry to focus on its own actions rather than those of other companies.

“We’ve all seen the finger pointing,” said Finance Chairman Charles E. Grassley of Iowa. “Like most Americans, I’m sick and tired of the blame game.”

The number of young people using tobacco products has reached its highest level in years, as e-cigarette popularity is reversing recent progress on other products that contain nicotine, the Centers for Disease Control and Prevention reported Monday.

In recent years, the overall proportion of high school students using any tobacco products fell, mainly due to fewer students smoking cigarettes and cigars, the CDC said. But from 2017 to 2018, the number of high school students reporting e-cigarette use within the past month nearly doubled from 11.7 percent to 20.8 percent. That pushed their overall tobacco use rate from 19.6 percent to 27.1 percent in 2018.

A bold stance on drug pricing will be a prerequisite for any candidate who wants to win the 2020 Democratic presidential nomination, but one challenge will be differentiating the contenders from each other.

The main distinction among candidates could be between those pushing bipartisan policies and those promoting more liberal ideas that currently stand little chance of enactment. But in most cases, the bills have a list of co-sponsors that could resemble a future primary debate stage.

The leader of the Ways and Means Health Subcommittee on Thursday offered a proposal to require the Department of Health and Human Services to negotiate prices for drugs covered by the Medicare prescription drug benefit.

Rep. Lloyd Doggett, D-Texas, is set to formally introduce the bill later Thursday with more than 100 House co-sponsors. A companion bill was introduced in the Senate backed by Sens. Sherrod Brown, D-Ohio; Amy Klobuchar, D-Minn.; and Tammy Baldwin, D-Wis.

President Donald Trump’s plan to eliminate HIV transmission in the United States by 2030, which he announced Tuesday night, would be an ambitious goal that would require his administration to reverse course on a number of policies that potentially hinder access to HIV/AIDS care.

“Together, we will defeat AIDS in America,” Trump said in his State of the Union address. He said that his budget will “ask Democrats and Republicans to make the needed commitment to eliminate the HIV epidemic in the United States within 10 years.”

Lawmakers emphasized the steep cost of the diabetes treatment insulin and ways to use Medicare and Medicaid to discourage companies from setting high prices as Congress kicked off a series of drug price hearings Tuesday.

Hearings before the Senate Finance and the House Oversight and Reform committees featured academics and patient advocates as lawmakers in both chambers investigate why drug prices are high and what Congress can do about it.

Sen. Charles E. Grassley’s return to the helm of the Finance Committee could put him in a position to address high prescription prices, although former aides say his biggest initial contribution to the drug debate will be his zeal for accountability.

Mark Hayes, a former Finance chief health counsel under Grassley, said the Iowa Republican’s well-earned reputation for oversight can be a catalyst for action.

The Food and Drug Administration, seeking to prevent nicotine addiction in young people, plans to ban flavored e-cigarette sales in gas stations and convenience stores and will propose banning menthol flavoring in traditional cigarettes.

E-cigarettes and their liquid nicotine flavors would continue to be sold in dedicated vape stores, where the FDA believes age verification procedures are more reliable. Gas stations and convenience stores will be able to keep selling e-cigarettes and liquid nicotines flavored like tobacco and menthol.

The Health and Human Services Department is in a dispute with a union representing 14,000 employees, which risks exacerbating staff shortages among doctors and scientists involved in prescription drug reviews, food safety and other public health responses.

The labor spat is drawing attention from lawmakers as some employees plan to picket at HHS headquarters briefly Thursday afternoon.

Democrats are making the cost of prescription drugs a pillar of the party’s health care agenda in the midterms, but if they win a majority for the 116th Congress, the party will have to grapple with internal divisions over the issue that might be magnified next year.

This campaign season has been notable for candidates pushing the party to reject corporate influence. For emboldened progressive Democrats, the party’s current plans might not be enough. Their views compete with those of new candidates from politically moderate areas with a big pharmaceutical industry presence that might be more inclined to join with longtime incumbents who sympathize more with the industry’s perspective.

As President Donald Trump gave a stem-winding press conference Wednesday on refusing to meet with the Canadian prime minister, getting laughed at by the United Nations, and what will happen to his embattled Supreme Court nominee, the House was passing legislation.

The chamber voted, 361-61, in favor of a measure that would allocate most of the fiscal 2019 appropriations that Congress controls, along with a continuing resolution to keep much of the rest of the government operating into December.

The Food and Drug Administration on Wednesday announced it may force e-cigarette manufacturers to stop selling flavored products, citing what Commissioner Scott Gottlieb called an “epidemic” of youth use.

Five companies, including JUUL Labs, Inc., maker of the popular, USB-drive shaped device with nicotine flavors, will have 60 days to give the FDA a strategy on how they will curb youth use — “or face regulatory consequences,” Gottlieb said.

Democrats working to regain control in Congress this fall are making the cost of prescription drugs a centerpiece of the party’s message. The path to a majority, however, runs through some places where the pharmaceutical industry employs a lot of potential voters.

Southern California, New Jersey, and the Philadelphia suburbs are among the areas where Democrats have the strongest chances to turn red House seats blue. Yet since these states are some of the biggest pharmaceutical hubs in the United States — the industry estimates it directly employs 44,000 people in Pennsylvania, 65,000 people in New Jersey, and 131,000 in California — candidates there tread a little more cautiously on the issue of drug prices.