| | | | |  | | By Krista Mahr and Daniel Payne | | | With help from Daniel Lippman, Alice Miranda Ollstein, Carmen Paun
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The White House's ability to mitigate what Biden has repeatedly called a "health care crisis" remains limited absent congressional action. | Anna Moneymaker/Getty Images | STATES LEAVE BIDEN'S POST-ROE MEDICAID OFFER HANGING — Two months ago, President Joe Biden signed an executive order encouraging states to use Medicaid to help cover costs for people who cross state borders for abortions. So far, no state has applied to do so, POLITICO's Megan Messerly writes. Their reluctance to jump on the administration's offer is the latest example of how the White House's ability to mitigate what Biden has repeatedly called a "health care crisis" remains limited absent congressional action. Since the Supreme Court overturned Roe v. Wade in June, the Biden administration has used a federal law governing emergency medical care to challenge Idaho's near-total abortion ban, warned pharmacists not to withhold prescription medications because they can also be used to induce an abortion and requested that mobile providers share information about their data retention and data privacy policies, among other efforts. But the White House has largely been unable to preserve access for people who live in states with anti-abortion laws. While many governors who support abortion rights are also committed to increasing access, health officials are debating whether the byzantine, monthslong process of obtaining a Medicaid waiver is the best way to help low-income, out-of-state residents seeking abortion care. They say it might be easier — and faster — for states to use their own tax dollars to help local organizations facilitate travel for out-of-state residents instead of jumping through the hoops needed to access federal Medicaid funds. WELCOME TO TUESDAY PULSE — We are loving this WaPo data crunch about states' dining option landscapes. Sadly, D.C. is not on the list but it is deep in pizza country. Send your news and tips to kmahr@politico.com and dpayne@politico.com. WANT MORE PULSE? Today in our Pulse Check podcast, Megan Messerly on the Biden administration's slow start on using Medicaid to expand abortion rights. Plus, Megan Wilson on the dialysis patients and providers squaring off with health plans over a coverage bill. Listen to today's Pulse Check podcast.
| | | | A message from PhRMA: Fresh data show the 340B program may be driving up costs for some patients. How? A new analysis finds 340B hospitals prescribe patients more expensive medicines than non-340B hospitals on average. It's time to fix the 340B program. Learn more. | | | | | | | 
Several states are set to receive supplemental funds from the Biden administration for family planning services. | Laura Segall/AFP/Getty Images | $6 MILLION TO FAMILY PLANNING CLINICS — The White House announced in a memo today that it's giving clinics that provide free and subsidized family planning services an additional $6 million, Alice reports. The new grants for the Research-to-Practice, Teen Pregnancy Prevention and Title X programs were announced ahead of President Joe Biden's meeting today with his Task Force on Reproductive Healthcare Access. Title X provides contraception, STD testing and other services to nearly 2 million low-income people each year. Providers in Florida, Maryland, Michigan, New Jersey, New York, North Carolina and Wisconsin will receive the supplemental funds, the Department of Health and Human Services told POLITICO. Of those states, only Florida, North Carolina and Wisconsin have implemented new abortion restrictions since the fall of Roe.
| | | | SUBSCRIBE TO 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. | | | | | | | | FIRST IN PULSE (I): OPPOSITION TO ABORTION RESTRICTIONS CLIMBS — The percentage of people opposed to national legislation restricting access to abortion has climbed six points since the Supreme Court ruling overturning Roe v. Wade , according to a new survey from the Democratic-backed Navigator Research. And that opposition is nearly as strong — including among Republicans and Independents — when voters are asked about a specific proposal by Sen. Lindsey Graham (R-S.C.) to ban the procedure after 15 weeks of pregnancy. Sixty-six percent of voters opposed a generic national ban on abortion, including 47 percent of Republicans, while 65 percent of voters and 44 percent of Republicans opposed Graham's bill. In the new poll of about 1,000 registered voters conducted between Sept. 22 and 26, shared first with Alice, 65 percent of respondents said the proposed 15-week federal ban has made them more motivated to vote — greater than the 57 percent who said the same about the Supreme Court's decision on Roe. DIALYSIS PROVIDERS PUSH FOR COVERAGE BILL — Dialysis providers and groups representing patients with kidney disease are rushing to build support for including a dialysis coverage bill into Congress' end-of-the-year spending package, POLITICO's Megan Wilson reports. Under the plan, employer-sponsored health plans would have to cover dialysis services at the same level they do treatments for other chronic conditions and could save the government money, which policymakers could then use to offset pet projects in the must-pass omnibus package. But insurers and employer groups are also flooding Capitol Hill with meetings and letters in opposition to the legislation. They say it's a cash grab by dialysis giants Fresenius and DaVita, which together command more than 75 percent of the $34 billion dialysis market in the U.S. — giving them the leverage to negotiate costly reimbursement rates with private plans. As POLITICO previously reported, DaVita helped write the legislation. FIRST IN PULSE (II): PROVIDERS PUSH BACK AGAINST CUTS — In a letter thanking Reps. Larry Bucshon (R-Ind.) and Ami Bera (D-Calif.) for introducing a bill to stop Medicare payment cuts, provider groups are pushing for other cuts to also be addressed. More than 100 provider groups signed the letter, sent Friday, supporting Bera and Buschon's recently introduced legislation to stop cuts to the Medicare Physician Fee Schedule. But the groups also nudge legislators on similar reductions, asking for the Pay-As-You-Go and Medicare sequestration cuts to also be considered — arguing that patients will have less access unless the cuts are stopped.
| | | | A message from PhRMA:   | | | | | | EXPERIMENTAL COVID ANTIVIRAL LICENSED FOR WIDER USE — Japanese drugmaker Shionogi licensed its candidate Covid-19 pill to a United Nations–backed mechanism, allowing access to more than 100 low- and middle-income countries if authorized, Carmen reports. The drug, ensitrelvir fumaric acid, reduced Covid-19 symptoms by 24 hours compared with a placebo in a clinical trial in Asia, Shionogi said last week. The trial enrolled nearly 2,000 people with mild or moderate symptoms in Japan, South Korea and Vietnam, most of whom were vaccinated. The study took place when Omicron was the dominant strain. Shionogi has requested approval from the Japanese drug regulator for the pill, which is taken once daily for five days. (Pfizer's Paxlovid, the most effective Covid pill authorized so far, requires three pills be taken twice daily for five days.) The deal between Shionogi and the Medicines Patent Pool will allow generics manufacturers to apply for a license to produce copies of the drug for 118 low- and middle-income countries. Shionogi will not claim any royalties on sales in those countries while Covid-19 remains a public health emergency of international concern, the highest World Health Organization classification for a disease outbreak. That deal was agreed on before the drug was approved to give generics manufacturers time to apply for the license and prepare for their own regulatory approval and manufacturing, said Esteban Burrone, head of policy at the Medicines Patent Pool. If the drug proves to be as good as is hoped, "the next question is going to be: 'When are the generics coming? We want it tomorrow,'" Burrone told Carmen. He said the organization has made similar agreements for the other two Covid-19 antivirals: molnupiravir, developed by Merck and Ridgeback Biotherapeutics, and Paxlovid. Molnupiravir generics are already on the market, and the first Paxlovid copies could be available by the end of the year. FDA CITES LIMITS OF EVUSHELD — The FDA warned health care providers Monday that the only prophylactic treatment for Covid-19 may not protect patients from all circulating variants, POLITICO's Lauren Gardner reports. The agency said that preliminary data shows various degrees of reduced neutralizing activity against certain Omicron subvariants, including BA.5 and BA.4.6, that are widely circulating in the U.S. Nevertheless, the FDA continues to recommend Evusheld as an option since it "still offers protection against many of the currently circulating variants and may offer protection against future variants."
| | | | STAY AHEAD OF THE CURVE: Our Future Pulse newsletter will continue to bring you the biggest stories at the intersection of technology and healthcare, but now five times a week. Want to know what's next in health care? Sign up for our Future Pulse newsletter. If you aren't already subscribed, follow this link to start receiving Future Pulse. | | | | | | | | AI AND HEALTH CARE BIAS — A new white paper published on Monday by the ACLU raises concerns that artificial intelligence, a tool touted as improving medical care for all, could worsen care for those already impacted by medical racism. The paper says medical tools that use AI and algorithms already have a history of exhibiting racial bias that's worsened health outcomes, citing examples of bias shown in the monitoring of postpartum depression and kidney health, among others. Its authors say gaps in regulation of medical devices and algorithms mean many of these technologies haven't been vetted. While the FDA issued guidance last week that widens the scope of AI health care tools it plans to regulate, the ACLU calls on "HHS, FDA and other stakeholders to do more work to help ensure accountability for racial and ethnic bias embedded in clinical and medical AI algorithms and devices."
| | | Tim Swope has joined Johnson & Johnson as director of pharmaceuticals for federal affairs. He was most recently assistant director and lead for public affairs at the federal and state level for the Plasma Protein Therapeutics Association.
| | | A new study published in JAMA raises more questions about the efficacy of the Jynneos vaccine in the current monkeypox outbreak, CIDRAP reports. The Washington Post dives into some of Dr. Oz's medical advice. Sorry to bring it up again, but bird flu is not looking good in California, according to this story in the Los Angeles Times.
| | | | A message from PhRMA: The 340B program grew, yet again, hitting a whopping $43.9 billion in sales at the discounted 340B price in 2021. But there has not been evidence of corresponding growth in care provided to vulnerable patients at 340B covered entities. And making matters worse, fresh data show that 340B may actually be driving up costs for some patients and our health care system as whole. The program of today is having the opposite effect of what Congress intended when they created 340B. That's a problem. It's time to fix the 340B program. Learn more. | | | | | | | Follow us on Twitter | | | | Follow us | | | | |
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