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McCarthy's Debt Limit Bill Passes House; Biden Addresses Age Issue; Dr. Nadia Ahmad is Interviewed about Tirzepatide; Heat Eliminate Bucks in Playoffs. Aired 6:30-7a ET

Aired April 27, 2023 - 06:30   ET



LAUREN FOX, CNN CONGRESSIONAL CORRESPONDENT: The floor yesterday according to a source familiar with his thinking. Went to the floor pretty confident he was going to have the votes, but there was still a question whether or not they were going to be able to pull this off. This was the culmination of work months in the making, trying to bring disparate factions together from the conservative and moderate wing of his party. There were more than a dozen listening sessions with the whip team over the course of the last two and a half months. And this is really just the beginning of the negotiation.

Like you noted, this proposal is not going anywhere in the Democratic- controlled Senate. The big question mark this morning, how is the White House -- specifically whether Joe Biden is going to sit down once again with Kevin McCarthy. It has been almost 90 days since the two met. And there is new detail that we are getting that this debt ceiling could need to be increased as early as June, Kaitlan.

So that doesn't leave a lot of time. And we just don't know what the path forward is going to be. This was all about rallying Kevin McCarthy's troops, showing he had unity behind him, but where does that go from here and where does that lead? We just don't have the answer as of this morning.

KAITLAN COLLINS, CNN ANCHOR: Yes. And President Biden was asked about this yesterday in the Rose Garden. He said, you know, he's happy to sit down with Kevin McCarthy, but he still is insisting on a debt ceiling without all of those conditions and strings attached it to.

I think, Lauren, one question I have is, it was so hard for Republicans to make sure they kept everyone on board to get this passed this time. If McCarthy does sit down with Biden and Schumer, and they do negotiate, how does he keep Republicans on board for whatever it is they agree to? Is that a possibility that that could be a big roadblock for him?

FOX: Yes. I sat down yesterday with a number of Republicans who had worked on this proposal and they were asked repeatedly that very question, what do you do, if Kevin McCarthy comes back to you with a proposal that's so different than the one that you guys worked so hard to get passed and across the finish line? And their argument was, they didn't want to deal in hypotheticals, that they believe in the speaker, that he's going to be able to negotiate with the president.

But one interesting moment that happened yesterday behind closed doors in the conference is Ralph Norman, a conservative member, who has at times been at odds with Speaker McCarthy. He asked him, how do I know that this bill isn't going to change significantly? He said that what he heard from the speaker yesterday was that he is not going to bring down too watered-down version of this bill, Kaitlan. And I think that that is so interesting and so significant because how do you thread the needle here? We just don't know the answer.

COLLINS: Yes. Those hypotheticals might become a reality very soon.

Lauren, thank you so much.

POPPY HARLOW, CNN ANCHOR: President Biden taking on a key issue in this race for the White House again. It's his age. He talks about how it factored into his own decision to run again. That's ahead.

COLLINS: Also, this.


COLLINS: Holy hail! Severe weather hit central Texas yesterday with hail the size of tennis balls. The man who shot this video says the bull you see there is fine. It was headed for cover, though. The hail smashed windows and cars as it poured down. It is not the last of the severe weather this week though. There is a storm threat right now across the Gulf Coast. We're going to check in with the CNN Weather Center. Stay with CNN for updates.



HARLOW: Welcome back.

We do have an update for you on this story we've been following. One of four inmates who escaped from a Mississippi jail has been found dead. Police say the charred remains of Dylan Arrington were pulled from a home about an hour north of jail - of the jail where he escaped from following a two hour standoff with law enforcement Wednesday. Officials believe the 22-year-old also killed a pastor while on the run earlier this week. They're still searching for the three others who escaped from the Hinds County Jail. Their names are Jerry Raynes, Casey Grayson and Corey Harrison.

COLLINS: Also this morning, three major national newspapers are running a full page ad pushing for the release of Evan Gershkovich. Of course, he is wrongly detained in Russia right now. Yesterday actually marked a full month in captivity for "The Wall Street Journal" reporter who Russia is accusing of espionage. Today's full page ad is signed by the editors and publishers of "The Journal," "The Washington Post" and "The New York Times." It calls for his immediate release and notes, quote, reporting is not a crime.

HARLOW: Turning to 2024 and the race for the White House. President Biden says he, in his words, took a hard looked at his own age before making a decision to run. Listen to this.


JOE BIDEN, PRESIDENT OF THE UNITED STATES: With regard to age, I can't even say - I guess how old I am. I can't even say the number. It doesn't - it doesn't register with me. And - but the only thing I can say is that, one of the things that people are going to find out, they're going to see a race and they're going to judge whether or not I have it or don't have it.


HARLOW: Here's a number, 80. Biden at 80 is the oldest president in American history. And if re-elected he'd be 86 by the end of his second term.

Natasha and John are back us with.

And we know from Karine Jean-Pierre at the White House, just clearing things up, he intends to, if he wins, fulfill his full term, right?


HARLOW: There was some hubbub about that earlier.

What do you make of how he addressed it?

AVLON: It was not very artful. I mean, look, I know that President Biden is frustrated by the constant questions about his age, but they exist for a reason. I mean, you know, ending a second term at age 86 is unprecedented territory. Eisenhower was in his 60s.

HARLOW: Yes. Even Jim Clyburn said this is a really legitimate question to ask.

AVLON: It absolutely is. And it doesn't help matters when, you know, you see him getting cheat sheets for, you know, questions and interviews and things like that. He has been a consequential president, but this is a totally legitimate area of concern. And polls bear that out.

COLLINS: And what you're referencing there is he was holding this card in that press conference yesterday that suggested one of the questions he was going to get from an - from an "L.A. Times" reporter. The "L.A. Times" said the reporter did not submit it to the White House in advance.

I don't think it's unusual for the White House to prepare briefing materials for the president, but, anyway, we'll get to that in a moment.


COLLINS: But on the age thing, you know, President Biden was saying is -- the number doesn't really register with him.


It does register with voters because you see polls where a lot of Democratic voters who approve of his job and say he's done a good job still say they don't really want him to be the nominee again.

NATASHA ALFORD, CNN POLITICAL ANALYST: Right. There's the ideal and then there's the reality though. And I think that ideally a lot of Democratic voters in particular would prefer a younger president. But when they look at the choices, when they look at the alternative, they say, I would still rather -- this president that feels competent, that feels, you know, that he genuinely cares, and that he won't go off the rails, we prefer that. And we have to remember, Donald Trump is also in his 70s as well. He may not get the same scrutiny because of the confidence with which he speaks when he goes in front of a podium, but he has his moments where he says some things that are pretty off the wall and you -- you wonder. You wonder about his mental acuity as well.



HARLOW: I wonder what you think about - Charles Blow has this really interesting piece in "The New York Times" this morning. And he talks about exactly the point you brought up, which is sort of enthusiasm in young voters. The headline is, Biden's highest hurdle isn't age, it's his passion. And he points to pretty low polling among young voters in this Harvard/Kennedy school poll, 18 to 29-year-olds, so really young voters, about enthusiasm for President Biden. Do you think there's merit to that?

ALFORD: Yes. I think it's difficult when you have a star like Obama, right? He was a star orator. But these are sort of, you know, once in a generation type of characters that come out, that leave that sort of impression. And for a lot of younger voters, they are still thinking of, you know, that era that really made so many younger voters activate and want to come out.

And the reality is, it was older black voters in South Carolina who helped Joe Biden even be in the conversation. Younger voters of color, Joe Biden was not their top pick when we were talking about this, you know, four years ago. So, yes, I think it makes sense.

COLLINS: To his - to his benefit, more older voters vote than younger voters?

ALFORD: That's right. So, we'll see who shows up.


AVLON: Well, and as Biden says, you know, don't - don't compare me to the almighty, compare me to the alternative.

HARLOW: My God, their favorite line.

AVLON: That's his favorite line, and there's a reason for it.

COLLINS: Yes, clearly, it helped him get to the White House.

AVLON: That's right.

COLLINS: All right, Natasha, John, great having you here this morning. Thank you.

HARLOW: Also new this morning, I'm sure in your friend circles, whatever age you are, you've been talking about these weight loss drugs, right, Ozempic and their competitors. Well, a weight loss and diabetes injectable from Eli Lilly, they're now moving to try to get the FDA to fast track it for obesity. We'll talk to a lead doctor on this ahead.



HARLOW: Welcome back.

It could be the next big weight loss drug. Eli Lilly, this morning, reporting another round of results in its Tirzepatide drug. It's a once weekly injection currently used to treat type two diabetes under the name Mounjaro. But Eli Lilly is now seeking FDA approval to use it to treat obesity. According to the company's latest clinical trial, participants with type 2 diabetes who are obese or overweight lost up to 34 pounds over 16 months on this drug. The company says the most common side effects, though, are nausea, diarrhea and vomiting. There are some other side effects we'll get into in a minute. They say that they expect to finish the submission to the FDA in a few weeks. The company says the FDA is then likely to rule as early as the end of this year on whether they can - people can use it for obesity officially. We should note, this data has not been pier reviewed or published in a medical journal. There are several questions. A big one is affordability, side effects.

Let's talk about all of these, try to get some answers to these big questions with Dr. Nadia Ahmad. She is the medical director of their - of Tirzepatide obesity at Eli Lilly.

It's good to have you. Thanks very much, Doctor, for joining us.


HARLOW: One question is, this study was done, obviously, by the drug company, funded by the drug company. Has any independent study been done of this drug to treat obesity that has in no way been funded by Eli Lilly?

AHMAD: So, no. These are phase three clinical trials, which are the trials that you do in order to test how safe a drug is and how well it works before you're able to get approval for a certain indication. So, these are the first trials that are - that are typically done. And they are - they are a standard done by the companies. HARLOW: Can we talk about side effects? I just named the most

prevalent ones according to your company. But Mounjaro, right, which is the brand label name I think most people will know in terms of using this for diabetes, also lists side effects including tumors in the thyroid, thyroid cancer. Other side effects, pancreatitis, serious allergic reactions, kidney failure, severe stomach problems, changes in vision.

Given those exist, is it still appropriate to market it for weight loss solely?

AHMAD: So, important to understand, Tirzepatide is approved as Mounjaro for type 2 diabetes, for blood glucose control. So right now it's being investigated for weight management. And as part of that investigation, we look at both how effective it is, how well it works, and the side effect profile. And so we've seen a couple things. First, we've seen up to 16 or almost 16 percent weight reduction in a type 2 diabetes population that typically has a much harder time losing weight compared to people without type 2 diabetes. And then the side effect profile is actually very reassuring because it's very similar to what we saw in our type 2 studies for Mounjaro. So, like you said, nausea, vomiting, diarrhea, a little bit of constipation. And -- so very manageable side effects when you think about sort of the history of weight loss therapeutics in the past.

HARLOW: But there is a possibility of some of those other side effects I noted, correct?

AHMAD: So, as with any agent for any disease at all, there's possibility of the more rare side effects indeed.


With this class of medication, what you mentioned is certainly accurate. So, this is a - the incretin base class of medications. And in that class there is a rare incidents of pancreatitis, which you mentioned, the thyroid tumors that are being referred to are seen in rodents, they're seen in the animal studies for this class of medications and not yet seen in humans, but certainly people who have a history of a certain kind of thyroid cancer shouldn't get this medication, but that's very rare.

HARLOW: One of Eli Lilly's competitors in this space is Novo Nordisk. And earlier this year they revealed that patients that had been on their weight loss drug, a similar one called Wegovy, risked regaining all their weight back in five years. Is this something people should understand, if you get this FDA approval, your drug is one that they're going to have to take for life?

AHMAD: This is such an important question. And I think it's really interesting for us to reflect on why this question gets asked so much. Why do we ask this for weight management and for obesity? If you go to the doctor for high blood pressure, for heart disease, asthma, arthritis, even HIV, we don't as the question, do I have to take the medication for life? And I think that's because, as a society, we understand that those are chronic diseases that need chronic treatment. And I think we really need to embrace and acknowledge, as a society, that when we're talking about weight management, we're talking about obesity, a chronic, serious medical disease that deserves treatment.


AHMAD: And so (INAUDIBLE) treatment is often chronic.

HARLOW: OK, so that sounds like a yes to me, but you're justifying why it's - why it's a yes.

OK, let's move on to the cost. You guys don't have a price tag out there yet, is that right?

AHMAD: Yes, I can't really speak to the price. I'm on the development side of the company. But - but, yes, not - not yet.

HARLOW: OK. OK. OK, similar drugs, just a point of comparison for people to understand. Similar drugs on the market for obesity now cost between $1,300 and $1,500 a month without insurance. And we don't know if insurance is going to cover this for most folks. Will Eli Lilly help cover that cost -- it's a ton of money -- for low-income individuals?

AHMAD: So, I think - I think it's really important to understand how complex the issue is about access, right? So, I think -- we're committed to getting access to the - to -- for the people that need it. And that's going to require all of us to work together, right? Obesity is the largest disease epic we have in society today, and probably in the history of mankind. So, we're working with advocacy organizations, pair (ph) organizations. We have to come together as a government, as a society to really figure out, how are we going to get the therapies that are being innovated today to the right people that need them around the world? And we are -- we're committed to that and a lot of efforts in that space.

HARLOW: But - but help us understand what that means because, obviously, there will be lobbying to get it covered by Medicare, for example, Medicaid. But you guys stand to make a ton of money on this. And the thought that it may be only accessible by the richest folks I think is troubling to some people. Are there steps that Eli Lilly would take to lower the cost for those that just don't have that much money?

AHMAD: Well, I think, again, we are - you know, obesity effects, as you're saying, the low-income minority populations. And, you know, even more so the (INAUDIBLE) we're very cognitive of that and - as a society and as a (INAUDIBLE) and myself as a clinician as well. And I think, again, this is why we are so committed to working on the access. It's not as simple as price, right? It is - it is about the coverage. It is about providers prescribing it. It's about being able to take it long term and really manage the disease.

So, again, a very complex issue. And I think that, you know, we have to work together and we are working together with the organizations that I - that I mentioned in order to do our part as well as, you know, work with others to help them do theirs.

HARLOW: All right, Dr. Nadia Ahmad, thank you. As I said, a lot of people are talking about this, so we'll watch closely and see what happens with the FDA process. I really appreciate your time this morning.

AHMAD: Thanks. A pleasure.

COLLINS: Absolutely.

HARLOW: Thanks.

COLLINS: Yes, something everyone will be watching definitely very closely.


COLLINS: Also this morning here in New York City, we're soon going to feel the Heat. Miami beating out the Bucks in an explosive overtime win. They are now going to face the Knicks. We'll show you game highlights, next.


UNIDENTIFIED MALE: And overtime in game five.






UNIDENTIFIED MALE: And the Miami Heat become the sixth in NBA history to win as an eighth seed in the first round.

UNIDENTIFIED MALE: What a ballgame! You talk about being connected.


COLLINS: What a ballgame is right. Jimmy Butler and the Heat eliminated the top-seeded Bucks from the NBA playoffs in an overtime stunner.

Andy Scholes is here.

Andy, one of the biggest upsets that we have seen I think in NBA history.


Jimmy Butler, I mean, I feel like I've been talking about him all week, but that was amazing play calling. HARLOW: She has been talking about it all week, by the way.

ANDY SCHOLES, CNN SPORTS ANCHOR: It's what - yes, guys, it's what - yes, that's why we call him play-off Jimmy, right?