Could this be Roe v. Wade’s last anniversary?

Jan 21, 2022

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With Darius Tahir and Alice Miranda Ollstein

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Quick Fix

— Abortion rights advocates are using the anniversary of Roe v. Wade to warn Democrats they're not fighting hard enough to preserve widespread abortion access.

— Senate Democrats are hitting reset on their agenda, meaning another vote on their social spending package is likely several weeks away.

— The Supreme Court dealt another blow to abortion clinics' challenge of Texas' six-week abortion ban.

WELCOME TO FRIDAY PULSE — where we'll start with a farewell note from Adam:

After two (extremely) eventful years and hundreds of newsletters, this is my final time authoring PULSE. It's been an extraordinary privilege to bring you the day's biggest news during such a consequential period in health care, and I only hope I've managed to make your weekday mornings easier, more informed and a little more fun.

PULSE is only going to get bigger and better from here; send your tips and scoops to sowermohle@politico.com.

A message from PhRMA:

Did you know more than half of every dollar spent on medicines goes to someone who doesn't make them? There's a long line of middlemen, like PBMs and insurers, collecting a significant portion of what you pay for medicine. The share of total spending for brand medicines received by the supply chain and other stakeholders increased from 33% in 2013 to 50.5% in 2020. Learn more.

Driving the Day

ROE'S LAST ANNIVERSARY?— It's Roe v. Wade's 49th anniversary, and abortion rights advocates are marking it by sounding the alarm — warning Democrats at the state and federal level aren't doing enough to respond to the biggest emergency for abortion rights in half a century.

Nearly half of states are expected to ban abortion should the Supreme Court overturn Roe later this year. Many red states are already pushing forward new restrictions. Yet progressive leaders say the Democratic Party is not putting up enough of a defense, POLITICO's Alice Miranda Ollstein reports.

A lopsided fight: Republicans control more than half the country's governorships and nearly two-thirds of state legislatures. But even in blue states, abortion rights advocates say officials haven't always made it a priority to shore up abortion — or ensured that voters know Roe's demise would affect them as well.

"People look at Texas and Mississippi and think: 'I'm sitting pretty in my blue state. That's their problem,'" said Kristin Ford, the vice president of communications and research at NARAL Pro-Choice America. "But when you have a wave of people coming across state lines, that's going to strain the health care system in your state. Our fates are intertwined."

Conservatives on the march: Thousands are gathering on the National Mall today for the anti-abortion March for Life ahead of an anticipated ruling against Roe in June. Anti-abortion groups are expected to use the event to tout the state bans on the procedure they're pursuing.

WHP-lash: Federal intervention is likely not forthcoming. The Women's Health Protection Act, a bill that would block states from imposing new abortion restrictions, has languished in the Senate for months, lacking the votes to move forward.

More than 225 advocacy organizations including Planned Parenthood signed an open letter to the Senate today calling for action on the bill. And even though Majority Leader Chuck Schumer promised in October that the chamber would vote on it "soon," a vote has yet to be scheduled.

SENATE DEMS LICK THEIR WOUNDS — In a single week, Senate Democrats suffered two big setbacks: failing to pass a sweeping voting rights bill and effectively giving up on their $1.7 trillion social spending package. They're not eager for a third any time soon, POLITICO's Burgess Everett and Marianne LeVine report.

Democrats are instead likely to pivot toward more bipartisan priorities, putting their partisan spending bill on the back burner while lawmakers try to figure out a new path forward. When the Senate returns from a weeklong recess, it's expected to more immediately take up efforts to fund the government and tackle antitrust reform — areas that have plenty of cross-aisle support.

"We've been negotiating with two senators for two months, and it has gotten us nowhere, so we need a new course of action," Sen. Bernie Sanders (I-Vt.) said.

That means it could take many more weeks for progress on the health provisions included in the Build Back Better bill. Both President Joe Biden and Democrats on the Hill concede the package will need to be scaled back significantly to win enough support.

But Sen. Joe Manchin (D-W.Va.) — one of the key holdouts — has already indicated he wants the party to start all over again and rebuild the bill piece by piece.

"What Build Back Better?," Sen. Chris Coons (D-Del.) said of the bill's fate. "At this point, Sen. Manchin needs to sit down and get clarity about what's got 50 votes."

SCOTUS DEALS ANOTHER BLOW TO TX ABORTION BAN CHALLENGE — The U.S. Supreme Court rejected a plea from Texas abortion clinics to send what remains of their challenge back to the federal district court that previously blocked the state's six-week ban, POLITICO's Alice Miranda Ollstein reports.

Earlier this week, the 5th Circuit Court of Appeals decided to hand the case over to the Texas Supreme Court for further interpretation, effectively prolonging enforcement of a law that's halted most abortions in the state since September.

That meant the clinics' last hope for getting the case back to a more favorable venue rested with the U.S. Supreme Court. But the justices dashed it Thursday in a 6-3 ruling that fell along ideological lines.

The high court had previously closed off most of the clinics' avenues for challenging the law, which empowers private citizens to sue anyone suspected of performing an abortion or helping someone obtain one.

In a dissent, Justice Sonia Sotomayor wrote that Texas' law has "devastated access to abortion care … through a complicated private bounty-hunter scheme that violates nearly 50 years of this Court's precedents." She argued that, by not intervening, the court's majority aided "egregious violations of [Texans'] constitutional rights."

JOIN NEXT FRIDAY TO HEAR FROM GOVERNORS ACROSS AMERICA : As we head into the third year of the pandemic, state governors are taking varying approaches to public health measures including vaccine and mask mandates. "The Fifty: America's Governors" is a series of live conversations featuring various governors on the unique challenges they face as they take the lead and command the national spotlight in historic ways. Learn what is working and what is not from the governors on the front lines, REGISTER HERE.

Vaccines

VETS' HOMES AHEAD ON BOOSTER PACE — Nursing homes for elderly veterans are boosting patients faster than their civilian counterparts', according to VA data shared with POLITICO's Darius Tahir.

Seventy-one percent of patients in both community living centers and state veterans homes — which are nursing homes and long-term care centers run by the federal VA and state agencies, respectively — have gotten their booster shots, the agency says. (The percentage for state veterans homes is out of patients eligible to get boosted; the percentage for the centers is out of their overall population.)

That compares to 64.8 percent of nursing home residents who have been boosted, according to the CDC. The figures are a reversal of previous trends: As POLITICO previously reported, the veterans homes had an elevated death rate and were marred by political scandal. They also suffered from crossed wires that prevented accurate reporting of case and death data.

A message from PhRMA:

Coronavirus

HOW INSURERS ARE COVERING COVID TESTS — Just six of the nation's 13 largest insurers directly cover the cost of rapid at-home Covid tests by allowing enrollees to purchase them from certain pharmacies without paying upfront, according to a new Kaiser Family Foundation analysis.

The rest of the group requires their customers to purchase the tests and then submit for reimbursement — a step that complicates the process and could discourage people from seeking out more testing.

Of the insurers without a direct coverage option, four require a mailed form and receipts to get reimbursed. Only two let their enrollees submit reimbursement requests online.

Meanwhile the six companies already offering direct coverage require enrollees to purchase the tests at specific in-network pharmacies — though United Health Group will also pay for tests bought at Walmart and Sam's Club.

Industry Intel

THE HEALTH SECTOR ISN'T DRIVING INFLATION — Health care prices grew far more slowly than the rest of the economy in 2021 even as overall inflation hit its highest point in decades, according to a new Altarum analysis of federal economic data.

The Health Care Price Index rose just 2.3 percent in December compared with the prior year, continuing a monthslong trend of small increases. That occurred despite a jump in the overall Consumer Price Index, which hit 7 percent year over year in December.

"Overall health care prices growth may eventually follow economywide inflation upwards, but we have yet to see a significant uptick in health prices at all comparable to overall inflation," Altarum analysts wrote.

Physician services were the fastest growing category in December, at 4.1 percent year over year. But prices across many other areas saw only small increases — including prescription drugs, which grew for the first time in more than a year, but only at a 0.001 percent rate from a year ago.

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What We're Reading

The company Center for COVID Control, which received $124 million in federal funds to aid testing, is facing a lawsuit and investigations over claims it faked test results, sent delayed results or in some cases never provided them to people at all, Block Club Chicago's Kelly Bauer reports.

In STAT, public health experts Céline Gounder, Rick Bright and Ezekiel Emanuel argue that the government's Covid-19 response should eventually expand to focus on guarding against a wider array of respiratory viruses.

The White House's rapid test site allots four tests per home. But nearly a quarter of Americans live in households with five or more residents, Kaiser Health News' Hannah Recht and Victoria Knight write.

A message from PhRMA:

Did you know that PBMs, hospitals, the government, insurers, and others received a larger share of total spending on medicines than biopharmaceutical companies? That's right, more than half of spending on brand medicines goes to someone who doesn't make them. Let's fix the system the right way and ensure more of the savings go to patients, not middlemen. Read the new report.