Jha’s profitable pre-Covid czar gigs

Jun 24, 2022

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With help from Adam Cancryn

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QUICK FIX

— White House Covid-19 coordinator Ashish Jha made hundreds of thousands consulting on the pandemic before joining the administration.

— Democrats are plotting to save ACA subsidies but running into a familiar West Virginia problem.

— New NIH data could offer a window into Long Covid and pandemic disparities.

WELCOME TO FRIDAY PULSE — Just a Bill, sitting here on Capitol Hill, with another doc. Send news, tips and tweets to sowermohle@politico.com and kmahr@politico.com.

A message from PhRMA:

Did you know that only three insurance company pharmacy benefit managers (PBMs) control 80% of patients' medicines? They decide what medicines are covered, what medicines aren't and what you pay for them, regardless of what your doctor prescribed. Meanwhile, they get tens of billions in rebates and discounts meant for you. PBMs are putting their profits before your medicine. Tell Congress savings belong to patients.

Driving the Day

Ashish Jha listens to a question.

White House Covid coordinator Ashish Jha joined in March. | Anna Moneymaker/Getty Images

JHA's PROFITABLE PRE-COVID CZAR GIGS — White House Covid response coordinator Ashish Jha made more than $440,000 as a corporate consultant and speaker on pandemic-related issues in the months before he joined the Biden administration, new financial disclosures show.

Some of that work with major corporations — including five-figure speaking fees — came while he was serving as an occasional outside adviser to President Joe Biden's Covid team, Adam reports.

Background: Until he was appointed in March, Jha was the dean of Brown University's School of Public Health, where he was best known for his television appearances and Twitter threads on the latest developments in the pandemic.

During that time, Jha also counseled three companies on navigating the pandemic. He collected $141,000 combined from financial firm Bessemer and Fortune 500 energy company AES Corp. for advising on Covid policies and workplace safety and $15,000 from hedge fund D.E. Shaw for Covid modeling consultation.

Jha also collected $24,000 for a speech before the cardiovascular therapeutics division of drug giant (and Covid vaccine developer) AstraZeneca, though he noted in the disclosure that he donated the money.

Some context: Surgeon General Vivek Murthy came under fire last year after his financial disclosures showed he made millions of dollars consulting on Covid policies for a cruise-line company and other firms. Murthy, who advised Biden on the pandemic during his presidential campaign, had also earned thousands of dollars in speaking fees.

Yet, unlike Murthy, whose financial entanglements were made public before joining the administration as part of the Senate confirmation process, Jha did not file his paperwork until May 2 — nearly a month after officially taking over the Covid response.

THE PLOT TO SAVE BIDEN'S ACA SUBSIDIES — Democrats have a plan to preserve Obamacare's enhanced subsidies and avert a politically damaging spike in premiums later this year.

The catch: It requires getting Joe Manchin on board.

Congressional Democrats and party advisers have discussed a temporary extension of the subsidies as part of a reconciliation package, Adam reports. The proposal would keep the aid in place for another few years, averting price hikes for 13 million Americans. But it wouldn't make them permanent, cutting down on the overall cost of the proposal.

Democratic leaders have long hoped to renew the subsidies as part of their broader party-line bill. Manchin (D-W. Va.), though, has demanded at least half of its savings go toward debt reduction — making a cheaper extension perhaps the only viable option for salvaging the Obamacare aid.

House Speaker Nancy Pelosi has emerged as a chief advocate for the subsidies, pressing the issue in private discussions with President Joe Biden and Senate Majority Leader Chuck Schumer . But Schumer has resisted committing to a plan, chiefly because it's unclear whether Manchin will agree.

The two have yet to discuss the potential bill's health elements, and Manchin has sent conflicting signals on whether he's even willing to entertain adding the subsidies to the package.

'ALL OF US' EXPANDS COVID DATA — On Thursday, the National Institutes of Health's real-world data program, All of Us, released its largest tranche yet of Covid-19 information, making health data from nearly 20,000 people who've contracted the virus available to researchers.

What's there: Roughly 6,000 people — including many who had contracted the Delta and Omicron variants — shared results of genomic sequencing, while 600 shared Fitbit records. Thousands of people also logged survey results on their optimism, energy, lifestyle and mental health.

"It's time for people to start digging into it and see what can be found," All of Us CEO Josh Denny told POLITICO. "We create a platform; researchers come in and use it."

Long Covid keys could be there. The program used an algorithm adopted from another NIH project, the RECOVER study, to more easily identify lingering Covid-19 symptoms in electronic health records. That could help researchers better understand long Covid links and challenges, Denny said.

Data collection is back on track. All of Us is still only halfway toward its goal of 1 million volunteers across the country, particularly after studies virtually ground to a halt at the start of the pandemic.

"We were a completely in-person program … when Covid hit," he recalled. "We really had to retool and come up with ways to allow people to contribute in other ways and do it safely."

A message from PhRMA:

At the Agencies

Juul products are displayed at a smoke shop in New York.

The FDA's order includes menthol and tobacco flavors still on the market. | Seth Wenig/AP Photo

END OF THE JUUL ERA — The popular e-cigarette maker Juul has promised to litigate FDA's order on Thursday to take all its vapes off the market.

Juul, owned in part by tobacco giant Altria, is a large-market player in the e-cigarette space and quickly became the center of public health focus on a surge in teen vaping. In 2019, the company discontinued sales of its fruity flavors — especially popular among kids — but continued to sell menthol and tobacco-flavored products.

Now, FDA says no more. The agency's Center for Tobacco Products said the company's toxicity data was lacking and conflicting. Regulators also noted that, to date, there's no way to know what harm could come from using third-party vape juice in Juul pods. However, no data shows that Juul pods are immediately harmful to users, our Katherine Ellen Foley writes.

Cliff Douglas, the director of the University of Michigan's Tobacco Research Network, estimates that roughly 3 million adults use Juul vapes. "As a public health person … all I'm concerned about is that [it] affects millions of people," he said. "Winnowing the market down in ways that may limit access or appeal … is a concern."

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In Congress

FIRST IN PULSE: LAWMAKERS DEMAND DRUG PRICING ACTION FROM BIDEN — The Biden administration needs to wield compulsory licensing and march-in rights to compel lower drug costs, wrote 96 lawmakers, led by Sen. Elizabeth Warren (D-Mass.) and Rep. Lloyd Doggett (D-Tex.), in a letter to Health and Human Services Secretary Xavier Becerra.

While Warren and Doggett have long called for the government to march in on patent rights, their co-signees include a broad swathe of Democrats. The lawmakers cite two pathways — compulsory licensing under Section 1498 and march-in rights under the Bayh-Dole Act — as potential options.

This is about quick action, they argue. The party is still trying to advance Biden-endorsed legislation to fine for pharmaceutical price hikes beyond inflation and allow Medicare to directly negotiate drug prices, the group writes. "But to provide the urgent relief that Americans demand, including patients who would not initially benefit from Medicare drug price negotiations, you must simultaneously use the executive tools readily at your disposal."

What are the chances? Last year, Biden endorsed a narrow patent waiver to allow other countries to produce Covid-19 vaccines, but that never came to fruition. Even though compulsory licensing is sure to face legal challenges, the pharmaceutical industry has argued it can't assure quality if manufacturing is licensed out.

Around the Nation

HHS OKS THE 'COLORADO OPTION' — On Thursday, the agency approved Colorado's plan to lower Obamacare premiums and expand state health insurance to roughly 10,000 people through the Affordable Care Act's section 1332 state innovation waiver process.

How it's going to work: Colorado law requires the plans to achieve a 15 percent premium reduction over their 2021 prices by 2025, adjusted for medical inflation, through a combination of added federal funding, expanded care and boosted competition between insurers.

Colorado officials say the program will use more than $135 million annually in federal ACA funds to reduce health insurance costs in the state. But the state is also establishing premium reduction targets for insurers to hit, which it says will make the marketplace more competitive and further lower costs.

JOIN TUESDAY FOR WOMEN RULE TALK ON THE ECONOMY: The U.S. economy is showing signs of slowing down after a period of robust growth last year. How would an economic slowdown affect women's economic security across socioeconomic, racial, and geographic lines? Join POLITICO's Women Rule for a conversation on what's ahead for the U.S. economy and how it will impact women's livelihoods and economic well-being. REGISTER HERE.

Names in the News

Tom Cotter is the new executive director of nonprofit community disaster preparedness and response group Healthcare Ready. Cotter most recently worked as director of emergency response and preparedness at Project HOPE and joins Healthcare Ready partly expand its capacity-building efforts.

What We're Reading

Dozens of health care "coaching" startups have emerged in recent years, pulling in billions of dollars in venture capital funding but dividing health care professionals over their role in the already fragmented space, Kaiser Health News' Darius Tahir writes.

Public health experts are increasingly concerned that the Biden administration's monkeypox virus response mirrors early missteps in the coronavirus pandemic, The Washington Post's Lena Sun, Dan Diamond and Fenit Nirappil report.

A message from PhRMA:

This may come as a shock, but did you know that only three insurance companies and their pharmacy benefit managers (PBMs) control 80% of patients' medicines? They sure act like it. They use their market power to get tens of billions in rebates and discounts on medicines – rebates and discounts that should be going to patients. They decide what medicines are covered, what medicines aren't and what you pay for them. Regardless of what your doctor prescribed. That's too much control, and it leaves you fighting them for your medications, instead of fighting your illness. PBMs are putting their profits before your medicine. It's time we do better than that for patients. Tell Congress those savings belong to patients.