New Covid funding frozen amid Democrats’ divides

Mar 10, 2022

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QUICK FIX

— Funding for Covid-19 therapies and vaccines has stalled even as experts warn they have just months left with current purchases.

— There are highs and lows in the latest budget, from Biden's health agency vision to stagnant family planning spending.

— Americans largely support Biden's pandemic exit plan, a promising sign despite low approval figures.

WELCOME TO THURSDAY PULSE — An interesting read last night: Joanne Kenen writes on "pandemic theater" and where we go from here. Thoughts? Plus, send tips and news to sowermohle@politico.com and kmahr@politico.com.

A message from PhRMA:

According to a new poll, Americans would like to see Congress focus more on reducing the overall costs of health care coverage such as premiums, deductible, and copays (71%) over reducing the costs of prescription drugs (29%). This extends across party lines; 73% of Democrats and 64% of Republicans would like to see Congress focus on reducing overall costs of coverage. Read more.

Driving The Day

COVID RELIEF LANGUISHES WITH DIVIDED DEMS — What was going to be an overdue but settled House vote on $1.5 trillion in government spending descended into chaos Wednesday, prompting Democratic leaders to pull Covid-19 relief funds out of the sprawling budget package.

What happened: Lawmakers had already whittled down the White House's $30 billion request — to continue buying coronavirus vaccines, therapies and tests while researching variants and new treatments — to $15.6 billion. That would sustain drug, vaccine and research needs for a few more months, as POLITICO's Adam Cancryn and Sarah reported.

But while Republicans have been skeptics of new coronavirus funding, it was Democrats who threw a wrench in the proposed spending Wednesday as several revolted over proposed cuts to their states' unused coronavirus aid.

What's next: Biden officials expressed frustration with House Democratic leaders, venting to Pulse that they could have headed off these concerns. But, most of all, they worry about the next vehicle for exhausted Covid-19 funds.

"People just aren't getting it," said one health official. "If more funding doesn't come, Americans will be without the vaccines, treatments and tests they will need if we have another surge or variant — or even if we don't."

The House still plans to advance its $1.5 trillion appropriations bill, including $14 billion in bipartisan emergency aid to Ukraine. But that leaves Covid-19 funds untethered and vulnerable to mounting Republican questions about how previous aid was spent.

"It is heartbreaking to remove the Covid funding, and we must continue to fight for urgently needed Covid assistance, but unfortunately, that will not be included in this bill," SpeakerNancy Pelosi said Wednesday.

OMNIBUS BRINGS SOME HEALTH WINS — The legislation unveiled Wednesday morning included provisions to create Biden's proposed health agency, boost Puerto Rico's Medicaid and provide small funding bumps across the health department.

Some highlights from the $1.5 trillion package:

$1 billion for the Advanced Research Projects Agency for Health, a fraction of Biden's $6.5 billion request but a clear step toward realizing the president's longtime priority. The money isincluded in National Institutes of Health funding, signaling for now that independent agency advocates lost their fight. Rep. Anna Eshoo (D-Calif.) is still planning to introduce legislation for a standalone agency, people familiar with the matter tell Pulse.

A $200 million boost for Puerto Rico's Medicaid program as long as the territory establishes a reimbursement floor for providers. The measure would also increase federal contributions to the program through December after longtime requests from Puerto Rico for more support.

A delay in rescheduling fentanyl,extending its restrictive Schedule 1 status at least through the end of the year. Not everyone agrees with that stance: While many lawmakers want to see the status made permanent, civil rights groups and drug reform advocates argue it could exacerbate criminal-justice and racial-disparity issues instead of improve care. Schedule 1 also makes it challenging to research a drug.

Maritza Perez, director of the Drug Policy Alliance's Office of National Affairs, said classifying such a large group of fentanyl-like substances as illegal is not only not working — the U.S. saw record drug overdose deaths last year — it could get in the way of helping people at risk. In a congressional hearing in December, an FDA official said at least one of the fentanyl-related substances that fell under the temporary classification could have effects comparable to naloxone, the lifesaving drug that reverses an opioid overdose's effect.

"We have been saying from the start that this policy is harmful and unnecessary," Perez said. "Because this policy has not been made permanent, I think we still have time to change hearts and minds."

No family planning boosts this year,a blow to clinics who had hoped to rebuild the Title X program after an exodus under the Trump administration, POLITICO's Alice Miranda Ollstein notes. The program, which provides free and subsidized birth control, STD screenings, prenatal care and other services to millions of Americans with low incomes, is set to receive $286.5 million, the same amount as in 2021.

SUBSCRIBE TO NATIONAL SECURITY DAILY : Keep up with the latest critical developments from Ukraine and across Europe in our daily newsletter, National Security Daily. The Russian invasion of Ukraine could disrupt the established world order and result in a refugee crisis, increased cyberattacks, rising energy costs and additional disruption to global supply chains. Go inside the top national security and foreign-policymaking shops for insight on the global threats faced by the U.S. and its allies and what actions world leaders are taking to address them. Subscribe today.

Coronavirus

POLL: VOTERS SUPPORT BIDEN'S PLAN — American voters appear to be broadly onboard with large swaths of the Biden Administration's new pandemic plan, according to the latest Morning Consult/Politico poll, assuming officials can convince Congress to fork over the funding.

The two big winners were President Joe Biden's test to treat plan, in which pharmacists could prescribe antiviral pills on the spot to customers who test positive for Covid-19, and a measure to improve ventilation in public buildings. Both had 71 percent support among Democrats and Republicans alike.

Voters were also asked about increasing funding for long Covid treatments, strengthening CDC data surveillance to track new variants and donating vaccines to other countries, which all clocked in with an average of 66 percent support among voters of both parties.

The most divisive issues? CDC funding and vaccine donation had over 80 percent Democrat backing, but Republicans had reactions that were more lukewarm at 48 and 50 percent, respectively.

PHARMACISTS PUSH TO LIFT PRESCRIBING LIMITS ON COVID PILLS — Fourteen pharmaceutical industry groups sent a letter to Biden on Wednesday urging him to overrule the parameters of the Food and Drug Administration's authorization for oral Covid-19 therapeutics, POLITICO's Katherine Ellen Foley reports.

The letter, signed by the American Society of Health-System Pharmacists, the American Pharmacists Association and the National Community Pharmacists Association, among others, noted that the terms of the FDA's authorizations of those drugs prevent pharmacists from prescribing them directly — meaning a limited number of pharmacies that employ health care providers licensed to write and authorize prescriptions can serve patients as a one-stop shop.

In his State of the Union address last week, Biden announced that pharmacies will be able to both test and treat patients for Covid-19.

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In Congress

SENATORS LAUNCH HOME CARE BILL — Sens. Tom Carper(D-Del.) and Tim Scott(R-S.C.) will introduce a bipartisan bill to extend a CMS waiver program that has allowed Medicare beneficiaries to receive hospital-level care in their homes during the pandemic.

The Hospital Inpatient Services Modernization Act would let patients and providers continue to have access to the Acute Hospital Care at Home waiver program, launched in November 2020 when hospitals were overwhelmed with patients, for two years after the end of the Covid-19 public health emergency. It would also require CMS to issue regulations to establish health and safety requirements for Hospital at Home programs.

Around the World

NUCLEAR FEARS AFOOT — Ukraine's state nuclear regulator warned Wednesday that the power loss at the decommissioned Chernobyl nuclear power plant could trigger a radioactive release, though the International Atomic Energy Agency has said the situation doesn't pose any immediate risk, our colleagues in Europe write.

Russian attacks in the area damaged two power lines, taking the old plant offline. Some 20,000 spent fuel assemblies, or bundles of spent fuel rods, are stored at the site in holding pools and need to be constantly cooled, but the IAEA said the pools could do the job without power and "sees no critical impact on safety."

Those assurances aside, people are understandably spooked by consecutive events at nuclear facilities — and Russian President Vladimir Putin's announcement earlier this month that he had put his nuclear arsenal on alert. People are making runs on iodide tablets . And the WHO, meanwhile, updated its online guidance this week on both radiation and health and the use of potassium iodide for thyroid protection "during nuclear or radiological emergencies." Just in case.

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.

Names in the News

The White House nominated Shereef Elnahal to serve as Veterans Affairs undersecretary for health quality, safety and value. He previously served as New Jersey's health commissioner and currently works as president and CEO of University Hospital in Newark.

Dan Torrens has been named CEO of eHealth Technologies. Torrens, who most recently was ConnectiveRx's chief operating officer, succeeds Jeff Markin, who remains in an advisory role.

What We're Reading

Russia's invasion of Ukraine prompted an exodus of international companies from retailers to oil producers. But pharmaceutical manufacturers aren't following suit, Kaiser Health News' Sarah Varney reports.

Nurses, sidelined for years in discussions about health care reform, have growing political agency in Washington, D.C., amid the pandemic's devastating and ongoing impact, Stat News' Lev Facher reports.

It's time: The Washington Post's Dan Diamond writes about why lawmakers have been stuck on eliminating daylight saving time and how much it has to do with health.

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.