Rep. Anna G. Eshoo’s decision to retire at the end of this term will leave a key Democratic vacancy on the powerful Energy and Commerce Health Subcommittee, and while it’s unclear who will take over her post, early signs point to longtime committee member Diana DeGette of Colorado.
Eshoo, a California Democrat who has been in Congress for three decades, has been a stalwart on the subcommittee, serving as chair beginning in 2019 and becoming ranking member this Congress when Republicans took control of the House.
With Republicans holding a narrow majority, the 2024 House elections could be anybody’s game at this point, according to an analysis from Inside Elections with Nathan L. Gonzales. If Democrats again take control of the House after the 2024 elections, whoever fills Eshoo’s shoes would have considerable influence.
Energy and Commerce Democrats traditionally choose leadership based on seniority. At the beginning of the new Congress, the committee will hold an organizing meeting to decide who will lead the subcommittee. The makeup of subcommittees changes year to year, but their leaders are decided by full committee rank.
After Eshoo, the top-ranking Democrats on the committee, in order of seniority, include DeGette, Jan Schakowsky of Illinois, Doris Matsui of California and Kathy Castor of Florida.
Multiple Democratic staffers say that DeGette is the most likely successor on the Health panel.
“That’s the understanding, that DeGette is going to take it and get it,” one Democratic staffer said.
But there’s still more than a year before subcommittee leadership changes hands, and lots could change between now and then. The full panel’s top Democrat, Frank Pallone Jr. of New Jersey, noted that the panel still has a lot of work to do in the next year, bringing several of their committee-approved health bills to the floor.
“Oh no. I don’t want to comment on those things,” Pallone said with a sigh when asked about who might succeed Eshoo on the Health Subcommittee.
Eshoo, who turned 81 on Wednesday, has been a key subcommittee player in her party’s efforts to lower the cost of prescription drugs, expand access to health insurance and expand public health infrastructure during the pandemic. Her efforts on the 2022 reconciliation bill led to passage of legislation to allow Medicare to negotiate drug costs.
Recently she helped launch President Joe Biden’s new biomedical research agency — the Advanced Research Projects Agency for Health, or ARPA-H — and she was very involved in the 2016 passage of legislation to advance cancer research.
DeGette, meanwhile, the most senior member of the committee behind Eshoo, is currently the top Democrat on the Energy, Climate, and Grid Security Subcommittee, but the Health panel is considered the more coveted slot. DeGette, who is not currently on the Health Subcommittee, declined to say whether she is interested in the position.
“I’m going to wait until after the election to see what’s going on,” she said Tuesday.
Still, the 14-term congresswoman has demonstrated an interest in health policies. Like Eshoo, she was one of the co-sponsors of the sweeping 2016 law that launched then-Vice President Biden’s “Cancer Moonshot” initiative, increased research funding for other diseases like Alzheimer’s and created expedited pathways for biologic drugs and breakthrough medical devices.
DeGette also has strong connections across the aisle, with Health Subcommittee Chairman Brett Guthrie, R-Ky., pointing to their work together on ARPA-H.
“We definitely have a good relationship,” he said.
DeGette, the former vice chair of the Energy and Commerce Committee and former chief deputy whip in the House, helped usher through the 2010 health care law.
Her relationship with industry is stronger than that of many other Democrats, especially on issues like tech. But her more progressive views on topics like drug prices have also alienated a number of lobby groups, according to several lobbyists.
Last Congress, DeGette worked to pass a follow-up bill to the landmark cancer law that would authorize $25 billion for research institutions. The measure also included language ensuring Medicare coverage of breakthrough medical devices, in a broader version of the Biden administration’s proposal in June.
She also co-sponsored legislation from Indiana Republican Larry Bucshon that would strengthen Food and Drug Administration oversight of diagnostic labs. The bill has stalled in the face of weak GOP support but is likely to receive more attention as the FDA moves forward with a less popular proposal scheduled for April.
A staunch abortion rights advocate, DeGette co-chairs the House Pro-Choice Caucus and co-sponsored a bill that would eliminate the so-called “Hyde amendment,” which blocks federal programs from covering abortion-related services.
DeGette also co-chairs the Congressional Diabetes Caucus and co-sponsored a bill that would require Medicare coverage of obesity drugs. She supports a Senate bill that would overhaul the system of drug rebates that manufacturers offer as discounts to pharmacy benefit managers.
As chair of the Energy and Commerce Oversight and Investigations Subcommittee in 2019, she presided over a hearing with the three major insulin manufacturers and pharmacy benefit managers on the cost of insulin.
“It seems to me what’s happening is that every component of the drug system is contributing to an upward pressure on the list price,” she said then.
The sixth-most-senior Democrat on the full committee, Castor says she’d like to throw her name in the ring for a leadership position but thinks she won’t get the gig.
“I would love to lead the Health Subcommittee. I may not be directly in line, but I’m going to play a leadership role on health issues,” Castor said.
The Gulf Coast Democrat has been on Energy and Commerce since 2009 and the Health Subcommittee for much of that tenure. When she first ran for Congress in 2007, she made health care a focal point of her campaign, as many Floridians lacked health insurance.
In the next Congress, Castor wants the panel to focus on lowering drug costs through price negotiations, making insulin available to all who need it and examining decreasing life expectancy, among other issues. She also hopes to marry her interests in health care and climate policy.
Schakowsky, the fourth-most-senior Democrat on the committee, hopes to join the subcommittee in the next Congress and play a big role in steering health policy but said she does not plan to go for the gavel.
But she has brought progressive health policies to the forefront during her time on the Energy and Commerce Committee, advocating to increase transparency among drugmakers and make health insurance affordable to all.
“Next Congress is going to be an opportunity to have one of the most progressive Congresses,” a Schakowsky staffer said. “She’s very confident in the Democrats winning the House and having a strong majority.”
Matsui is currently the top Democrat on the Communications and Technology Subcommittee and the fifth most senior Democrat on the full committee. She has been on Energy and Commerce since 2008.
While on the committee, she has helped usher through President Barack Obama’s signature health care law. One of her bills became the basis for the 2010 law’s Prevention and Public Health Fund, which provides money to programs aimed at preventing tobacco use, obesity, heart disease, stroke and cancer.
Matsui said she’s currently focused on her work on the tech panel and “hasn’t given serious thought” to taking over the Health Subcommittee.
“I’m just trying to get over the fact that Anna is not going to be with us next Congress,” she said.