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HHS Secretary Alex Azar. Photo: Chip Somodevilla/Getty Images

The Department of Health and Human Services formally rolled out a proposal yesterday that would require drug companies to include their products’ list prices in their TV ads, similar to the way they disclose side effects.

The big picture: There’s a legitimate debate about how this would work and how big a difference it will make. But it is, notably, the first real showdown with the pharmaceutical industry since the administration released its drug-pricing plan earlier this year.

  • "It has taken them five months ... to start skating to where the puck is going," HHS Secretary Alex Azar said yesterday.

Details: Drugmakers will have to disclose the list prices — the wholesale acquisition cost, to be specific — in TV ads for every drug reimbursed by Medicare or Medicaid, as long as the price is more than $35 for a month’s prescription.

  • The regulation ended up coming from Medicare and Medicaid, rather than the FDA, because those agencies have a mission to control costs — which may help put the rule on more solid legal footing.
  • Price disclosures will only have to be in text, not voiceover. Officials said that would make the rules less onerous for drug companies.
  • HHS would enforce the rules by publishing a list of companies and products that didn’t comply, and noncompliance could also trigger lawsuits.

What’s next, from the industry side: The pharmaceutical industry suggested yesterday that it's likely to challenge the rules in court once they're finalized, alleging a First Amendment violation.

What's next, from the regulatory side: The administration is considering more rules cracking down on pharmacy benefit managers (PBMs). The White House is reviewing a proposal to rein in their lucrative rebates.

  • “We believe today's rebates, which helped drive list prices skyward, are not necessary to a strong negotiating ecosystem,” Azar said yesterday. “They could be replaced with fixed-price up-front discounts.”

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Data: Chamberlain, 2020, "United States of America Cabinet Appointments Dataset" Chart: Will Chase/Axios

It's harder now for presidents to win Senate confirmation for their Cabinet picks, an Axios data analysis of votes for and against nominees found.

Why it matters: It's not just Neera Tanden. The trend is a product of growing polarization, rougher political discourse and slimming Senate majorities, experts say. It means some of the nation's most vital federal agencies go without a leader and the legislative authority that comes with one.

Exclusive: Hundreds of kids held in Border Patrol stations

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More than 700 children who crossed from Mexico into the United States without their parents were in Border Patrol custody as of Sunday, according to an internal Customs and Border Protection document obtained by Axios.

Why it matters: The current backup is yet another sign of a brewing crisis for President Biden — and a worsening dilemma for these vulnerable children. Biden is finding it's easier to talk about preventing warehousing kids at the southern border than solving the problem.

Pompeo plots 2024 power play

Mike Pompeo in Washington on Feb. 12. Photo: Samuel Corum/Getty Images

Mike Pompeo has quickly reentered the political fray, raising money for Republicans, addressing key political gatherings and joining an advocacy group run by Donald Trump's former lawyer.

Why it matters: The former secretary of state is widely considered a potential 2024 presidential contender. His professional moves this week indicate he's working to keep his name in the headlines and bolster a political brand built largely on foreign policies easily contrasted with the Biden White House.