Lawmakers amp up calls for abortion access

Jul 21, 2022

Presented by

With help from Alice Miranda Ollstein, Ruth Reader and Daniel Lippman

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Which diseases could go untreated if Congress passes government price setting? There is a better way to lower costs without risking new medicines.

Driving the Day

Protesters gather outside the Supreme Court.

The effort to ensure cross-border abortions comes as more states launch bans and restrictions. | Jacquelyn Martin/AP Photo

FIRST IN PULSE: DEMS PUSH FOR CROSS-BORDER ABORTION ACCESS — As post-Roe chaos continues to grip the country, Sen. Gary Peters (D-Mich.), the chair of Democrats' Senate campaign arm, is asking the Biden administration to allow U.S. residents to bring abortion pills across the border or travel to Mexico or Canada for the procedure.

While federal law does not generally allow the importation of drugs from other countries for personal use, heads of agencies have broad discretion to make exemptions, Alice reports.

Peters is demanding updated guidance from the Department of Health and Human Services and the Department of Homeland Security, citing "the urgency of the current moment."

Northern border concerns: Peters represents a state that could ban all abortions with no exemptions for rape or incest later this year, depending on the outcome of pending lawsuits and a constitutional referendum. If that happens, millions of his constituents may seek the procedure in nearby Canada. Michigan Gov. Gretchen Whitmer has also pushed President Joe Biden for the same clarification around importing abortion pills.

In his letter, Peters also demanded the administration make sure Customs and Border Patrol officers are properly trained so that they don't criminalize people who bring abortion pills into the country for personal use.

HHS BREAKS OUT PANDEMIC DIVISION — The Biden administration is elevating the Health and Human Services Department's pandemic and disaster response division after months of discussion about fixing gaps and shortcomings exposed during the coronavirus pandemic, three people familiar with the internal deliberations said.

The decision, shared in an internal HHS memo , would make the Office of the Assistant Secretary for Preparedness and Response its own operating division, putting the assistant secretary, Dawn O'Connell, on par with directors of other sweeping departments, such as the Centers for Disease Control and Prevention and the Food and Drug Administration.

"This change allows ASPR to mobilize a coordinated national response more quickly and stably during future disasters and emergencies while equipping us with greater hiring and contracting capabilities," O'Connell wrote in the memo. "This change is an important next step for our organization which has continued to grow and evolve since its creation in 2006 – the pace of which has quickened over the past year."

The move, first reported by The Washington Post , comes more than two years after the CDC's early stumbles in Covid-19 testing and as challenges tracking case and treatment data remain.

The reaction: "Even early in the pandemic, there were issues around CDC's coordination across the [Health and Human Services] Department," said the office's former director, Robert Kadlec. "They felt like they were the guys in charge."

But others criticized the reorganization as a misguided effort that would undercut the CDC and its efforts to strengthen its response network.

"This is unfortunate. It presupposes ASPR performed well through the pandemic, and it has not," Trump-era FDA Commissioner Scott Gottlieb wrote on Twitter. "The right — but harder approach — is reform CDC; which has to be [the] tip of the spear in pandemic response."

VA GRILLED OVER E-RECORDS — A Senate Committee hearing took the VA to task for its dysfunctional electronic health records modernization program.

Much of the discussion was on a new report from the Office of the Inspector General, which called out alarming safety issues at the VA's Mann-Grandstaff VA Medical Center in Spokane, Wash., Ruth writes.

There is also concern over ballooning costs. A July report from the VA's inspector general found 60 safety issues at that center.

One of the most concerning, which led to the harm of 149 patients, was a technical glitch that sent prescription orders and requests for exams or other services through the new records system to an unknown queue and they were never filled.

When the VA signed a contract with EHR giant Cerner for the system in 2018, it was supposed to cost $10 billion over 10 years. A new estimate from The Institute for Defense Analyses says it will cost $50.8 billion over 28 years.

So far, it's been implemented in just five of the VA's 171 medical centers.

Oracle, which just acquired Cerner last month, promised senators it would upgrade the EHR system by moving it into the cloud for free. Significant improvements are coming in the next six months, the company said.

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In Congress

A healthcare worker prepares to administer a vaccine.

While monkeypox testing and vaccinations are increasing, lawmakers and health experts worry cases are outpacing services. | Joe Raedle/Getty Images

MALONEY PRESSES FOR MORE MONKEYPOX RESOURCES — House Oversight and Reform Chair Carolyn Maloney (D-N.Y.) on Wednesday called for more monkeypox vaccine, treatment and testing access.

"In my own district, I have seen how the spread has threatened the health of my constituents — particularly the LGBTQ+ community and people with less access to health care," she wrote to HHS Secretary Xavier Becerra.

Maloney argued that while the administration has stepped up testing efforts and ordered thousands of monkeypox vaccines, commercial labs still don't have the capacity to test everyone who may have been exposed and many hospitals aren't testing.

She asked for a response from Becerra by Aug. 3 and a committee staff briefing by Aug. 5.

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Around the Nation

CALIFORNIA LAWMAKER URGES EMERGENCY DECLARATION FOR MONKEYPOX — State Assembly Speaker Anthony Rendon (D-Lakewood) urged federal officials Wednesday to declare monkeypox a public health emergency as case numbers rise in the state and around the country.

Rendon wrote to HHS that an emergency declaration would give federal agencies the flexibility to provide maximum funding for state and local efforts to combat the disease, POLITICO California's Alexander Nieves reports.

More than 2,100 cases of monkeypox have been reported in 44 states and Washington D.C. , including 267 originating in California.

Criticisms of federal response: Rendon's letter comes as lawmakers, public health experts and LGBTQ groups express alarm about what they say has been a lackluster federal response to an infectious skin condition that is primarily spreading among gay and bisexual men as well as transgender people.

Around the World

AFRICA WANTS TO MAKE VACCINES. IT NEEDS BUYERS — When South African drugmaker Aspen Pharmacare announced a deal last year to make the continent's first Covid-19 vaccines, African leaders hailed the agreement as a milestone in the continent's effort to set up its own vaccine-production facilities.

But there was a problem — no order came in . By the time the agreement was finalized in March, many African countries couldn't keep pace with the number of shots heading their way from richer countries and COVAX, the global vaccine facility, POLITICO's Carmen Paun reports.

Aspen's challenges highlight a key hurdle: For Africa to be less reliant on others for vaccine production, governments on the continent and international donors must be ready to pay higher prices for African-made shots, experts and pharma industry representatives said.

Africa aims to produce 1.5 billion vaccine doses by 2040 to meet 60 percent of the continent's needs, compared to the less than 1 percent it meets today. The Africa Centres for Disease Control and Prevention estimates that the 20-year plan will cost $30 billion. There are 20 initiatives to expand manufacturing, including plans by BioNTech and Moderna to build facilities in Kenya, Rwanda and Senegal.

But experts say Covid shots aren't the priority. Instead, more suppliers are needed for shots against measles, rubella, cholera and malaria, and for emergency stockpiles of yellow fever and Ebola vaccines, Gavi, the vaccine alliance, said in a report.

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Names in the News

Shalini Wickramatilake is now associate director of intergovernmental affairs for the Office of National Drug Control Policy, Daniel reports. She most recently was policy director at maternal mental health care nonprofit 2020 Mom and worked for eight years at the National Association of State Alcohol and Drug Abuse Directors.

Pritesh Gandhi will serve as the Department of Homeland Security's chief medical officer in the new Office of Health Security. He will lead the agency's medical, workforce and public health work.

What We're Reading

Apple on Wednesday positioned itself as a major force in health care and tech, laying out its plans to expand "science-based technology" in a 60-page report, Bloomberg's Mark Gurman reports .

"It's fine…It's okay to die." The AP's Ebrahim Noroozi assembled a devastating photo series on drug addiction and poverty in Afghanistan.

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.