Newly elected Speaker Mike Johnson, a former lawyer and radio talk show host, has used his role on the House Judiciary Committee to voice his anti-abortion views and opposition to gender-affirming care. 

The Louisiana Republican has an A+ rating from Susan B. Anthony Pro-Life America. In 2021, he introduced legislation to prohibit taking minors across state lines to access abortion care without parental consent, reintroducing the measure during this Congress. He has also led repeated efforts to prevent taxpayer dollars from going toward abortion providers.

Last year, in the wake of the Supreme Court’s decision to overturn Roe v. Wade, Johnson sponsored a resolution to condemn attacks on anti-abortion facilities and churches. In his law career, Johnson argued in state courts in favor of a law that barred same-sex marriage and in favor of abortion restrictions and public prayer policies.

The fourth-term lawmaker is known for his messaging skills and has largely stuck with his party, voting with Republicans between 96 percent and 100 percent of the time since his election, according to CQ Roll Call voting data.

Recently, he has used these messaging skills to take on one of the GOP’s hallmark social issues: opposition to gender-affirming care for minors. 

He introduced a bill last year that would prohibit discussion of sexual orientation and gender identity at any institution that receives federal funds — a policy modeled after Florida’s “don’t say gay” bill. He has described the increase in gender-affirming care as radical and misguided. He also last year co-sponsored a bill with Rep. Marjorie Taylor Greene, R-Ga., to criminalize “genital mutilation and chemical castration” of minors.

“The scourge of radical gender ideology is very real, the efforts to cover up what’s being done to children are extreme, and the science is on the side of what we all deep down know is morally and ethically right,” Johnson said during a hearing he led in July on the subject when he was serving as chairman of the House Judiciary Subcommittee on the Constitution and Limited Government.

For the last three Congresses he has received a 0 on the congressional scorecard of the LGBTQ+ advocacy group the Human Rights Campaign.

He also introduced legislation this year to permanently place fentanyl-related substances as schedule I under the Controlled Substances Act, but the legislation has not yet been taken up in committee. 

Expired health programs

Though Johnson’s health policy involvement has typically centered on social issues, he faces a barrage of bread-and-butter funding deadlines and program reauthorizations as he begins his speakership.

The House and Senate are still split over reauthorization of pandemic preparedness legislation, which expired Sept. 30. The House version is currently split into two bills, which Democrats oppose because of the measures’ lack of language addressing prescription drug shortages. 

The reauthorization of the Teaching Health Center Graduate Medical Education program and the National Health Service Corps are also unresolved since they expired Sept. 30, as is the Office of National Drug Control Policy.

Republicans are holding up the routine reauthorization of the Children’s Hospitals Graduate Medical Education program, which pays for residencies and fellowships for medical students training to be pediatricians. 

A bill by Rep. Daniel Crenshaw, R-Texas, would bar any federal funds to hospitals that provide gender-affirming care, including hormone therapy and 19 specific procedures for transgender youth. 

Even before the speaker’s race derailed House legislation for weeks, the House and Senate had a short timeline to get these bills passed. Policy watchers now say it’ll be nearly impossible unless leadership manages to attach these reauthorizations to a year-end spending bill. 

In addition to the expired health care programs and must-pass appropriations bills, stakeholder groups had hoped Congress could tackle legislation to rein in pharmacy benefit managers this year as part of a drug pricing package. 

But this outcome is looking less and less likely.

While the House was embroiled in speaker drama, some outside groups have focused their lobbying efforts on the Senate. The Purchaser Business Group on Health, a major employer group, is encouraging the Senate to tee up PBM legislation for the House to take up once it gets in order.