Senators trade barbs ahead of planned vote on abortion rights bill

May 10, 2022

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With help from Alice Miranda Ollstein and Rachael Levy

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QUICK FIX

— Senators are locking horns ahead of a planned vote on a Democratic bill to protect abortion rights.

— The CDC is not the only public health authority facing legal challenges, a nationwide trend experts say is dangerous.

— Democrats have agreed to leave Covid aid out of a Ukraine funding deal in a blow to the White House's plan to fight the virus.

WELCOME TO TUESDAY PULSE — People are back on the Metro in D.C., with ridership exceeding projections. Good news for the urban planners, bad news for anyone still squeamish about exchanging droplets with fellow riders. See you in the bike lane. Send news and tips to kmahr@politico.com and sowermohle@politico.com.

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Driving the Day

Sens. Susan Collins (R-Maine) and Lisa Murkowski (R-Alaska)

Sens. Susan Collins (R-Maine), left, and Lisa Murkowski (R-Alaska) are among the last Republicans in Congress who support abortion rights. | Drew Angerer/Getty Images

SENATORS SPAR ON RELIGIOUS RIGHTS AHEAD OF ABORTION VOTE — Tensions are rising ahead of a planned vote on Wednesday on a Democratic bill to protect abortion rights, which is widely expected to fail, Alice reports.

The bill, nearly identical to one that failed in a February vote, would go beyond codifying Roe v. Wade by banning states from enacting restrictions on the procedure deemed "medically unnecessary," like mandatory waiting periods and regulations on clinics known as TRAP laws.

Sens. Susan Collins (R-Maine) and Lisa Murkowski (R-Alaska), who are among the last remaining Republicans in Congress who support abortion rights, have their own narrower bill that would codify the Roe and Casey decisions the Supreme Court is expected to overturn.

But Democrats have dismissed their effort as insufficient and aren't planning to bring it up for a vote.

"We are focused on solutions that actually meet the moment," a Senate Democratic aide told reporters on a Monday night call about the differences between the bills.

With only the more sweeping bill scheduled to come to the floor, Collins and Murkowski are planning to vote no. Collins told reporters Monday night that the Democratic bill "supersedes all federal and state laws including the Religious Freedom Restoration Act" and would lead to medical providers who oppose abortion being compelled to perform one.

Democrats vehemently disputed this claim.

"No one would be required to provide an abortion against their will under this bill in violation of their religious or moral beliefs. Anyone who claims otherwise is misreading the bill," the aide said. "The bill does not place any affirmative requirement on any health care provider to provide an abortion if they don't want to."

Asked about this argument, Collins shot back that Democrats "must have misread their bill."

A 'TSUNAMI' OF LEGAL CHALLENGES — Mounting legal challenges to pandemic public health rules — and judges' increasing willingness to overrule medical experts — threaten to erode the influence of the Centers for Disease Control and Prevention and other government health authorities, Krista reports.

In the last year, four court rulings against the CDC, including one from the Supreme Court, have forced the agency to stop or reverse course on its pandemic mitigation orders.

"Litigation invites litigation invites litigation," said Wendy Parmet, faculty co-director at the Center for Health Policy and Law at Northeastern University. It's a cycle that "creates enormous uncertainty about what CDC could do going forward should the pandemic worsen again or should another pandemic or even a more regional outbreak arise."

The high-profile challenges to the CDC sit atop thousands more lawsuits against state and local health authorities filed during the pandemic, seeking to end localized social distancing and mask orders, vaccine mandates and business closures.

The constant threat of being dragged into court is having a chilling effect on local health officials that may last well beyond the Covid-19 crisis, leading health commissioners or board of health members to think twice about enacting public safety measures.

"It's a tsunami," says James Hodge, a law professor at Arizona State University's Sandra Day O'Connor College of Law. "Anything that limits you as an American from doing something you don't want to do," he says, has been challenged.

NOT IN THE UKRAINE FUNDING DEAL: COVID AID — Democrats agreed to drop billions of dollars in pandemic aid in pursuit of a bipartisan deal to send $39.8 billion to Ukraine, POLITICO's Sarah Ferris and Burgess Everett report.

Senate Democrats had hoped to combine the Covid and Ukraine bills, but chamber Republicans signaled they wouldn't provide the votes to clear an all-but-guaranteed filibuster of that two-part proposal.

On Monday, President Joe Biden said in a statement that he was "prepared to accept" the decoupling of Ukraine and Covid aid.

Noting the "several Congressional Republicans" who had resisted the pairing, he added: "However, let me be clear: as vital as it is to help Ukraine combat Russian aggression, it is equally vital to help Americans combat COVID. Without timely COVID funding, more Americans will die needlessly."

Biden is still hopeful that a bill providing billions for treatment, tests and vaccines can clear Congress in the coming weeks, as he and his administration warn that new variants and another coronavirus wave could tax the country's national resources.

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Coronavirus

COVID CASES CONTINUE TO RISE — Forty states saw an increase over the previous week in Covid cases for the week ending May 1, according to data compiled by the CDC. Georgia saw a 137 percent increase, the most of any state, reports POLITICO's Taylor Miller Thomas.

See the full DataPoint graphic here.

WHAT WILL LONG COVID COST THE COUNTRY? U.S. officials in charge of forecasting the country's future health care spending say they have no estimates on how much long Covid will cost America's health care system, Rachael reports.

The Centers for Medicare and Medicaid Services earlier this year released its forecast for national health care expenditures. Notably absent were the predicted costs of treating the millions of Americans with long Covid, a post-viral syndrome that can cause a range of debilitating symptoms ranging from cognitive dysfunction to extreme fatigue, according to federal estimates.

CMS officials told POLITICO they can't yet estimate costs because the syndrome is too new and the data too scarce. One official noted that long Covid lacks a consistent definition, highlighting the uncertainty around the syndrome.

Anthony Fauci, the president's chief medical adviser, has estimated that somewhere between 5 to roughly 30 percent of people who become infected with the coronavirus will get long Covid. That's potentially millions of Americans; the CDC recently estimated that around 60 percent of the U.S. population has been infected so far. The U.S. government estimates that as many as 23 million Americans already have long Covid, though patient advocates believe that's an undercount.

Vaccinated people suffer from long Covid also, posing long-term health concerns for health policymakers. To what degree, if any, vaccination prevents long Covid is still under study; the findings that have been released so far at times contradict one another.

David Putrino, a researcher at the Mount Sinai Health System who is studying long Covid, said it's "challenging" to say with certainty how likely a vaccinated person will get long Covid, given the lack of consistent data. He pointed POLITICO to two studies: One found that vaccination cuts infection risk to around 10 percent — "which is still a big risk," he added — and the other found that vaccination didn't change the likelihood. The effect of boosters is "still unknown," he said.

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In Congress

EXTENDING MENTAL HEALTH CARE — Sens. Chris Murphy (D-Conn.) and Bill Cassidy (R-La.) are expected to introduce legislation today that would extend several mental health programs set to expire this fall, POLITICO's Megan Wilson reports.

The Mental Health Reform Reauthorization Act intends to build on provisions that Murphy and Cassidy had tucked into the 21st Century Cures Act passed in 2016 and that will expire in September.

The legislation would impact the Mental Health Services Block Grant program within the Substance Abuse and Mental Health Services Administration by increasing funds for states to provide mental health services, among other things. It would also reauthorize a Health Resources and Services Administration program that integrates behavioral health professionals in primary care offices.

If passed, it would reauthorize a SAMHSA program for children with "serious emotional disturbances" and also reauthorize and expand another federal program that uses telehealth platforms to connect pediatricians with mental health providers. Additionally, it would expand the program so schools could receive those grants and give school nurses access to mental health professionals.

Around the Agencies

CLYBURN: FDA OPEN TO MOVING KIDS' VACCINE PANEL — The Food and Drug Administration is open to moving up the tentatively held meeting dates of its independent vaccine advisory panel for pediatric Covid-19 vaccines, POLITICO's Lauren Gardner reports.

Rep. James Clyburn (D-S.C.) released a statement on Monday saying that the agency will consider the bump if its reviewers complete their data analyses on the vaccines faster than expected.

Pressure continues to build on the FDA to quickly authorize Covid vaccines for emergency use in children under 5, the only age group still without an immunization option against the coronavirus more than two years into the pandemic.

STEP INSIDE THE WEST WING: What's really happening in West Wing offices? Find out who's up, who's down, and who really has the president's ear in our West Wing Playbook newsletter, the insider's guide to the Biden White House and Cabinet. For buzzy nuggets and details that you won't find anywhere else, subscribe today.

What We're Reading

Utah public health officials were warned that giving out Covid drugs based on race violated federal law, but they did it anyway, reports The Washington Free Beacon.

The government's treatment addiction finder is full of old information and short on good guidance for people seeking care, writes Kaiser Health News' Aneri Pattani.

In an op-ed for Cosmopolitan, Sen. Tammy Baldwin urges readers to tell their senators to vote in favor of the Women's Health Protection Act on Wednesday.

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According to data just released, insurance isn't working for too many patients. Despite paying premiums each month, Americans continue to face insurmountable affordability and access issues:

Roughly half (49%) of insured patients who take prescription medicines report facing insurance barriers like prior authorization and "fail first" when trying to access their medicines.
More than a third (35%) of insured Americans report spending more in out-of-pocket costs in the last 30 days than they could afford.

Americans need better coverage that puts patients first. Read more in PhRMA's latest Patient Experience Survey.