Congress readies new Covid funds in spending bill

Mar 09, 2022

Presented by

With Alice Miranda Ollstein, Megan Messerly, Katherine Ellen Foley and Joanne Kenen

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QUICK FIX

— Congress plans to clear $15 billion for Covid in its spending bill, a drop from the more than $30 million the administration requested last month.

— A bipartisan group of House Energy and Commerce Committee lawmakers is asking the Substance Abuse and Mental Health Services Administration about the Covid-19 pandemic's impact on mental health.

— The Food and Drug Administration and the medical device industry finally reached an agreement on the contours of a five-year extension of a key user fee program.

It's Wednesday. Welcome back to Pulse. Your hosts are taking note of an uptick in Covid-19 infections and hospitalizations in the United Kingdom.

Send tips and feedback to David Lim (dlim@politico.com or @davidalim) or Krista Mahr (kmahr@politico.com or @kristamahr).

A message from PhRMA:

ICYMI: A decisive majority of Americans (86%) agree Congress should crack down on abusive health insurance practices impacting patients' access to care. Voters overwhelmingly support policies that would lower out-of-pocket costs and bring greater transparency and accountability to the health insurance system. Read more in new poll.

Driving The Day

CONGRESS TO CLEAR $15 BILLION IN COVID SPENDING — Congress plans to give $15.6 billion to the Biden administration's fight against Covid-19 in its spending bill, a significant drop from the more than $30 million the White House requested last month, Alice reports.

"We cannot let it be said that America, after the third or fourth variant hits our shores, is unprepared, does not have adequate testing, therapeutics, vaccines," Senate Majority Leader Chuck Schumer said in a floor speech Tuesday, urging lawmakers to approve the funding.

Lawmakers said the new amount includes $10.6 billion for domestic spending on testing, therapeutics and vaccinations, and $5 billion for global pandemic efforts.

Sen. Roy Blunt (R-Mo.) told reporters earlier this week that the $15.6 billion is only enough to keep Covid operations funded for the short term, and the administration is likely going to have to come back and ask for more.

"They've never pretended that they thought this money would last for very long," Blunt said.

That money may get increasingly difficult to get, as Republicans have opposed more spending on a pandemic they have recently voted to declare a thing of the past.

OMNIBUS INCLUDES DECADES-OLD BAN ON ABORTION FUNDING DESPITE DEMS' PLEDGE TO END IT — Congress' spending bill will include an extension of the longstanding ban on federal funding for abortion despite Democratic promises to repeal it, Alice reports.

Blunt, the Senate's top Republican appropriator for health care funding, told reporters what lawmakers have privately acknowledged for weeks — that to get 60 votes in the Senate, Democrats were forced to concede on the issue.

"All the language that has been in the Labor-HHS bill for the last 10 years — that will all be in there," he said, referring to the Hyde and Helms amendments that prevent Medicaid and other federal health insurance plans from covering abortions.

A handful of more conservative Democrats, including Sens. Joe Manchin (D-W.Va.) and Tim Kaine (D-Va.), also oppose lifting the funding ban.

House Democrats, who passed a budget last year that dropped the ban for the first time since it was enacted in the 1970s, have vowed to keep trying.

"It makes me angry," Rep. Andy Levin (D-Mich.) told reporters. "But I have no great illusions that it will be eliminated in this omnibus bill."

LAWMAKERS AIM TO CLOSE SYNTHETIC NICOTINE LOOPHOLE — Lawmakers slipped legislation into the omnibus funding bill that would grant the FDA the ability to regulate lab-made nicotine, Katherine reports. Currently, the agency's Center for Tobacco Products has authority only over products with tobacco-derived nicotine — which is how the agency came to regulate e-cigarettes in 2016.

WHO ISSUES FIRST-EVER RECOMMENDATIONS ON TELEMEDICINE ABORTIONS — On Tuesday, the World Health Organization released updated guidelines for abortion care that included, for the first time ever, recommendations for abortion pills prescribed via telemedicine, Alice reports.

WHO officials said they were motivated to update their guidance based on new data about the safety and effectiveness of abortion pills and the desire to reduce what they say are 25 million unsafe abortions that occur worldwide each year. They particularly noted that telemedicine abortions have played an important role in keeping patients safe during the Covid-19 pandemic when it was riskier to go to a clinic in person.

The international body's recommendations come as several U.S. states controlled by Republicans work to ban the use of telemedicine to obtain abortion pills. Though their new release doesn't address it directly, WHO's announcement criticizes governments attempting to block access to abortion, writing that "restrictions are more likely to drive women and girls towards unsafe procedures."

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In Congress

PANDEMIC'S IMPACT ON MENTAL HEALTH — A bipartisan group of lawmakers on the House Energy and Commerce Committee is asking the Substance Abuse and Mental Health Services Administration to answer questions about the Covid-19 pandemic's impact on mental health.

In a letter to SAMHSA on Tuesday, lawmakers posed a long list of questions to the agency, including what involvement it had in developing and implementing national Covid-19 response strategies, whether it's participating in studies looking at the pandemic's mental health impact — including mitigation efforts and long Covid's effects — and how the agency is responding to the stress and trauma frontline health care workers have experienced during the pandemic.

A message from PhRMA:

Eye on FDA

FDA, INDUSTRY REACH MEDICAL DEVICE USER FEE DEAL — The Food and Drug Administration and the medical device industry reached an agreement on the contours of the fifth iteration of the Medical Device User Fee Amendments, David reports.

Around the Agencies

SINGLE SIGN-IN FOR MEDICAL RECORDS — The Department of Health and Human Services is working with 19 health care organizations — including health care systems like Kaiser Permanente and Providence, health plans like CVS Health and Cambia and credential service providers like ID.me — on a single sign-in system for patients to access their medical records, POLITICO's Ben Leonard reports.

Ryan Howells, principal at Leavitt Partners and program manager at the CARIN Alliance, which is spearheading the efforts, said Tuesday at the ViVE health tech conference in Miami Beach that the launch later this month will set up a test environment to integrate the technology. The organization will issue a public report on how the system worked by the end of the year.

Around the Nation

SUBTWEETING FLORIDA — Yesterday's surprise announcement by Florida's Surgeon General that the state would go it alone and advise parents against vaccinating their children 5 and older has not gone unnoticed.

Though it didn't mention the Sunshine State by name, the Association of State and Territorial Health Officials issued a statement Tuesday to reaffirm its position that children 5 and up should be vaccinated against Covid-19, in line with the CDC and medical associations, including the American Medical Association and the American Academy of Pediatrics.

"Data show that vaccines are one of the most effective ways to keep people, including children, safe from COVID-19 by preventing serious illness, hospitalization, and death," Nirav D. Shah, ASTHO president and director of the Maine Center for Disease Control and Prevention said in the statement. "Now is the time to help more families and communities protect themselves through vaccination."

Surgeon General Joseph A. Ladapo, who made the announcement yesterday at a roundtable alongside Gov. Ron DeSantis, is listed as a member of the group on its website.

FIXING SOCIAL DETERMINANTS, ONE CLICK AT A TIME — The U.S. health care system may have come to appreciate the importance of social drivers of health, but it's not particularly adept at addressing them, POLITICO contributing editor Joanne Kenen reports. Too often, patients are left on their own — or their care manager left on hold — as they try to navigate the myriad agencies that may or may not be able to help them with food, housing, transportation and the like.

But states, Medicaid plans and health systems are turning to online referral systems — and the pandemic sped up that trend as needs soared just as agencies pared back or went virtual. The dominant company in the burgeoning new market is called Unite Us — and by the start of this year, it had at least some presence in 43 states. Multiple referrals can be made at once; requests can be tracked to make sure someone on the other end follows through.

DON'T MISS POLITICO'S INAUGURAL HEALTH CARE SUMMIT ON 3/31: Join POLITICO for a discussion with health care providers, policymakers, federal regulators, patient representatives, and industry leaders to better understand the latest policy and industry solutions in place as we enter year three of the pandemic. Panelists will discuss the latest proposals to overcome long-standing health care challenges in the U.S., such as expanding access to care, affordability, and prescription drug prices. REGISTER HERE.

What We're Reading

For The Atlantic, Ed Yong breaks down the circumstances and sociology that have led the U.S. as a society to accept the nearly 1 million lives lost to Covid-19.

Anming Hu, a nanotechnology researcher at the University of Tennessee, Knoxville, returned to his lab two years after accusations from the U.S. government that he had hidden ties to China were dropped. Natasha Gilbert documents his story — and the fallout of the federal government's China Initiative — for Nature magazine.

A message from PhRMA:

According to a new poll, voters overwhelmingly support policies that would lower out-of-pocket costs and bring greater transparency and accountability to the health insurance system.

We need to make the cost of medicine more predictable and affordable. Government price setting is the wrong way. The right way means covering more medicines from day one, making out-of-pocket costs more predictable and sharing negotiated savings with patients at the pharmacy counter.

Learn more.