BECERRA: "I DON'T HAVE THE LUXURY TO DEBATE" — Health and Human Services Secretary Xavier Becerra sat down with Sarah at POLITICO's inaugural health care summit to discuss health care access, Covid-19 relief and the administration's case for billions of dollars to support those efforts. The backdrop: The Build Back Better Act stalled amid resistance to its massive price tag, which included coverage expansions for Medicaid and Medicare along with coronavirus support. Meanwhile, Congress is still debating funds to meet immediate coronavirus needs like vaccine and treatment purchases, leaving health officials to insist they have no runway left on key countermeasures. The clock is ticking for a range of Covid-19 programs, Becerra told Sarah at POLITICO's summit. "All I know is that I'm closing down the Provider Relief Fund because I no longer have dollars." Becerra also discussed the potential Medicaid enrollment crisis and the future of Biden's envisioned Advanced Research Projects Agency for Health, which he said would be housed in the National Institutes of Health but report to the health secretary. That plan would give ARPA-H a management structure but let it break the NIH mold, he said. Some other highlights from the summit: Mental health is a top priority. National Alliance on Mental Illness CEO Daniel Gillison said there's a "new generation called the Covid generation," cultivated by the "fear, uncertainty and doubt" caused by the pandemic. "That was a ripple effect, not only with our young people, but also the parents and the caregivers." The administration is setting up a national crisis hotline at 988 to meet some of those concerns. But that's not instant, Anita Everett, director of the Center for Mental Health Services at the Substance Abuse and Mental Health Services Administration, said. "We're doing the best we can to equip those facilities," she said, "But it'll take time." Digital health is booming. But obstacles remain as tech companies strive for equitable and value-based solutions that break usual health-access problems. The biggest obstacle is a hesitancy to progress beyond "protected self-interests on how it's always been" and excuses about payment models, said Ann Mond Johnson, CEO of the American Telemedicine Association. But there's understandable hesitancy plus equity concerns. "Connectivity is the tip of the iceberg," Johnson said. "It's the easiest thing to solve for because then you have to address issues of affordability — the devices, the data plan people use — and then you get into digital and health literacy, bias and trust." SENATE PREPS $10B COVID AID AMID TURMOIL — Key senators are nearing a deal on a roughly $10 billion package of coronavirus relief, setting Congress on a path to deliver funding Democrats had hoped to pass weeks ago — but without $5 billion in global vaccine efforts. That's drawn complaints from several Republicans unhappy with the compromise being negotiated with the GOP, POLITICO's Sarah Ferris, Burgess Everett and Jennifer Scholtes write. That unhappiness could spell trouble in the House, though Senate Democrats said the fight for global vaccine aid continues. "We're close. A few more things have got to be ironed out," said Senate Majority Leader Chuck Schumer in an interview. The $10 billion would omit a major ask to continue funding global efforts from the White House. But Democrats are already pushing against skeptical Republicans who've questioned the use of previous aid — and breaking a Senate filibuster will require at least 10 Republicans' support, a vote that Schumer could call up next week. And it's not over yet: Sen. Mitt Romney (R-Utah) said they're still waiting on a score from the Congressional Budget Office, while Sen. Patty Murray (D-Wash.) said the total amount is still in flux and it's too early to say their work is done. HOUSE ADVANCES INSULIN CAP BILL TO UNCERTAIN FUTURES — The House voted Thursday in favor of a bill to cap out-of-pocket costs on insulin at $35 a month. Democrats hope the policy will give them a concrete win to campaign in November as the rest of their health care agenda remains stalled, POLITICO's Alice Miranda Ollstein writes. Reality check: Despite concerns about the bill's policy and strategy from both sides of the aisle, nearly all House Democrats and a dozen Republicans voted for the measure Thursday. Yet it faces slim odds in the Senate, where Democratic leaders are combining an out-of-pocket cap on insulin — led by vulnerable Sen. Raphael Warnock (D-Ga.) — with a still-in-the-works bipartisan bill from Sens. Jeanne Shaheen (D-N.H.) and Susan Collins (R-Maine) to cut the drug's cost. The insurance industry tried to persuade lawmakers to oppose the measure, arguing it doesn't lower the actual price of insulin and could lead to higher premiums. One insurance industry source close to the negotiations told POLITICO they've stressed that the bill "lets pharma off the hook," calling it a "giveaway" to the drug industry. More than a half-dozen pharmaceutical lobbyists told Alice that the industry hasn't been lobbying on the bill, saying the insurance industry is doing more to oppose the bill than drugmakers are doing to support it. Why? Insurers would likely shoulder the cost of insulin price caps, while pharmaceutical companies have long advocated for reforms that would limit patients' out-of-pocket payments. Meanwhile, skeptics argue this is a narrow reform tackling a unique drug-pricing niche instead of the larger pricing issues. "We aren't putting that burden on Big Pharma, and I don't blame [the insurers] for being upset about that," Rep. Susan Wild (D-Pa.) said.
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