| | | | |  | | By Alice Miranda Ollstein and Krista Mahr | | | With help from Sarah Owermohle and Daniel Payne Editor's Note: POLITICO Pulse is a free version of POLITICO Pro Health Care's morning newsletter, which is delivered to our subscribers each morning at 6 a.m. The POLITICO Pro platform combines the news you need with tools you can use to take action on the day's biggest stories. Act on the news with POLITICO Pro . WELCOME TO TUESDAY PULSE — Your regular author Krista is taking a well-deserved vacation (very important for health!), so send tips and stories to aollstein@politico.com .
| | | | A message from PhRMA: Which diseases could go untreated if Congress passes government price setting? There is a better way to lower costs without risking new medicines. | | | | | | | 
A group of Texas residents and employers are challenging a key piece of Obamacare in court today. | Joe Raedle/Getty Images | OBAMACARE GOES BACK TO COURT — A key piece of the Affordable Care Act goes on trial today, your host reports , before Judge Reed O'Connor at the District Court for the Northern District of Texas, who's ruled against Obamacare multiple times over the past few years. In this latest challenge to the law, a group of Texas residents and employers argue that the ACA's preventive care mandate violates their religious freedoms and that requiring people to pay for health plans that cover screenings for sexually transmitted diseases and HIV prevention drugs will "facilitate and encourage homosexual behavior, prostitution, sexual promiscuity, and intravenous drug use." While that piece of the lawsuit goes after coverage of only STD services and the drug PrEP, which prevents HIV transmission, the case also argues that Congress never gave the civil servants and outside advisers at the Department of Health and Human Services the authority to come up with the list of preventive health services all insurance plans have to cover, meaning a win for them could wipe out all preventative care coverage from vaccines to prenatal screenings. What's at stake: An analysis released Monday by the Urban Institute found a ruling in the Texans' favor could threaten coverage of preventive services for nearly 168 million people insured by their employer's health plan or Obamacare's individual market. The study predicts that such a ruling could reverse health gains made since Obamacare was enacted, such as a decrease in unintended pregnancies and an increase in cancer screening rates. The suit also comes amid record rates of STDs and uneven progress on HIV. Health experts and advocates say that makes the threat of coverage loss for preventive care particularly damaging — not only for the people who become infected but also for everyone whose premiums could rise to cover the cost of treating them. What's next: No matter which way O'Connor rules, the case will likely be appealed to the right-leaning 5th Circuit Court of Appeals and then the Supreme Court, which has upheld the Affordable Care Act multiple times but hasn't considered the issue since Justice Amy Coney Barrett replaced Justice Ruth Bader Ginsburg, giving conservatives another voice on the court. HHS ROLLS OUT NEW RULE TO PROTECT LGBTQ PATIENTS AND PEOPLE SEEKING ABORTIONS — The Health and Human Services Department on Monday proposed bolstered safeguards in federally funded health programs for LGBTQ patients and people seeking abortions amid efforts by some states to limit both. What it would do: The rule would reinstate civil rights protections for gender identity and sexual orientation narrowed during the final months of the Trump administration, Sarah writes. It also would reiterate the Biden administration's view that discriminating against someone for having an abortion violates civil rights protections on the basis of sex. The policy would also "refine" religious freedom protections from the Trump era that gave providers blanket authority to refuse to perform abortions or other procedures. The backdrop: Thirteen states have limited or banned abortion following the court's decision, while at least seven others have signaled plans to do so. Many have also proposed bans on gender confirmation procedures and other trans health services. What's next: The rule is certain to face legal challenges, and conservative groups like Becket Law are already signaling they'll sue.
| | | | A message from PhRMA:   | | | | | | BIDEN WILL BE BACK, BETTER — The president hopes to return to the West Wing later this week, the White House said Monday , if he tests negative after five days. Following isolation, he will follow CDC guidance and wear a mask around others. Reporters asked White House officials why Biden's doctor wasn't available for questions in the briefing room Monday, noting that earlier administrators offered press availability in similar circumstances. White House press secretary Karine Jean-Pierre argued the administration has been transparent through Biden's illness, citing the regular letters from his doctors detailing his treatments and condition but said there was "no resistance" to bringing Biden's doctor to a future briefing.
| | | TIME CRUNCH THREATENS DEMS' DRUG PRICING, ACA BILL — After 18 months of trying to eke out progress from a 50-seat Senate majority, Democrats are running out of time to do all the things their party hopes to accomplish before the midterms, our colleague Burgess Everett reports . Democrats are now tweaking the language in their drug pricing plan after squaring off with Republicans before the Senate parliamentarian at the end of last week, delaying a final ruling on whether they can pass the bill with fewer than 60 votes until at least Wednesday, aides told POLITICO. And with August recess just days away, several senators also said on Monday that they recently tested positive for Covid, likely prompting further delays. Democrats are "trying to do the best we can," Senate Majority Leader Chuck Schumer told Burgess on Monday. "It's tough with Covid and everything. We're going to get things done." REPUBLICANS REQUEST AUDIT OF BIDEN'S VAX CAMPAIGN — A group of House and Senate Republicans sent a letter to the Biden administration Monday night demanding details of its spring 2021 vaccination outreach campaign, particularly whether groups invited to be part of the "Covid-19 Community Corps" received federal funding or access to Americans' contact information or other personal data. Led by Sen. Richard Burr (R-N.C.), the top Republican on the HELP Committee, the group takes issue with the inclusion of advocacy groups supportive of the Biden administration, such as the Center for American Progress and NextGen America and labor unions like AFL-CIO and SEIU. Why it matters: Democrats have for months conducted oversight of the Trump administration's response to the Covid-19 pandemic, and Republicans have signaled a desire to turn the tables should they win control of one or more chambers of Congress this November. Should that happen, expect a proliferation of probes like this one.
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Thousands of abortion rights demonstrators swarmed into the Indiana state capitol yesterday as state senators consider an abortion ban. | Michael Conroy/AP | INDIANA BEGINS DEBATE ON ABORTION BAN AMID PROTESTS — On Monday, Indiana became the first state to kick off a special legislative session to consider an abortion ban since the Supreme Court overturned Roe v. Wade, POLITICO's Adam Wren reports . As thousands of abortion rights protesters swarmed into the state capitol, the state senate heard hours of testimony on a bill that would ban all abortions except in cases of rape, incest and the life of the mother. A small group of anti-abortion rights demonstrators was present but "vastly outnumbered," Adam writes. The state recently became a flashpoint in the country's abortion battle after a 10-year-old rape survivor traveled there for the procedure from Ohio, which had already banned abortion, and the Indiana Attorney General threatened the doctor who treated her with prosecution. What's next? Because Republicans have supermajorities in both chambers of the state legislature and the state has a Republican governor, the ban's enactment is seen as inevitable — prompting outrage from advocates and Vice President Kamala Harris, who was in the state Monday to call attention to the debate. Yet some conservatives think the proposal doesn't go far enough because it fails to impose penalties on doctors who performed abortions and includes more exemptions than they support. NYC STRUGGLES WITH MONKEYPOX RESPONSE — New York's massive public health system is faltering in its attempts to contain the emerging monkeypox epidemic, our colleagues in the Empire State report . Once the epicenter of the country's Covid-19 crisis, New York City now accounts for more than one-third of the 2,900 monkeypox infections nationwide , making it once again critical to stanching the spread of a continent-hopping virus. Monkeypox cases are exploding in New York , siphoning resources away from the ongoing response to Covid, but officials argue monkeypox is still "containable."
| | | MEANWHILE, IS A MONKEYPOX EMERGENCY DECLARATION ON THE HORIZON? — That's up to HHS Secretary Xavier Becerra, White House Covid-19 response coordinator Ashish Jha told reporters at a Monday briefing. The option is being discussed, Jha confirmed, as are other federal tools such as using the Defense Production Act to increase the vaccine supply. The administration is also "working day and night" to make resources more accessible, he said, particularly 1.3 million doses of antivirals the government already has on hand. Officials are also bracing for a surge. "I would not be surprised if we see an increase in cases as testing becomes more robust," Jha said. "That's a very normal part of any outbreak response."
| | | | INTRODUCING POWER SWITCH: The energy landscape is profoundly transforming. Power Switch is a daily newsletter that unlocks the most important stories driving the energy sector and the political forces shaping critical decisions about your energy future, from production to storage, distribution to consumption. Don't miss out on Power Switch, your guide to the politics of energy transformation in America and around the world. SUBSCRIBE TODAY . | | | | | | | | The Trevor Project, an LGBTQ mental health advocacy group, has been roiled by the recent revelation that their CEO formerly worked as a McKinsey consultant who helped Perdue Pharma boost sales of Oxycontin, Fortesa Latifi and Versha Sharma report for Teen Vogue . Jared Kushner received treatment for thyroid cancer while working in the White House and is only revealing it now, The New York Times' Maggie Haberman reports . Nonprofit hospitals get massive tax breaks but skimp on the charity care they're required to provide in exchange, The Wall Street Journal's Anna Wilde Mathews, Tom McGinty and Melanie Evans report .
| | | | A message from PhRMA: Today, there are 90 medicines in development for Alzheimer's disease, 119 medicines for breast cancer, 26 medicines for childhood diabetes… But government price setting could mean fewer medicines in the coming years. Which diseases could go untreated if Congress passes government price setting? There is a better way to lower costs without risking new medicines. | | | | | | | Follow us on Twitter | | | | Follow us | | | | |
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