The White House prepares for an end to the Covid-19 PHE

Dec 13, 2022

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By Krista Mahr and Daniel Payne

Presented by

With Alice Miranda Ollstein

Driving The Day

Ashish Jha speaks to reporters.

Ashish Jha said work is going on behind the scenes to prepare for the end of the Covid-19 emergency. | Drew Angerer/Getty Images

PREPPING FOR THE END — Even as Covid-19 cases are rising across the country, preparations for the end of the public health emergency are in full swing within the administration, Ashish Jha, the White House Covid response coordinator, said during a Health Affairs event Tuesday.

Even as Jha and others talk this week with governors and local health officials about what they need to get through the current rise in cases, "in the background — and not so far in the background — we have a group of people on our team who are thinking about the transition," he said.

Keeping access open: During the transition, the federal government will cease buying Covid vaccines, treatment and diagnostics as the virus, like influenza, becomes integrated into our health system. When exactly that happens "is driven by a few factors, not the least of which is lack of congressional funding," he said.

Jha thinks it's reasonable to "move a lot of this stuff into the normal healthcare market." But, he said, "We want to make sure that people don't all of a sudden wake up one morning and say, 'Oh, I no longer have access to treatment.'"

Among the highest priorities: Making sure treatment and other services remain accessible to the uninsured and at-risk Americans who are insured but still face financial barriers to health care access. "I do not want a low-income senior unable to afford Paxlovid or unable to afford diagnostic testing," he added.

Rising sea levels: The longer-term planning relates to how Covid is expected to become a part of the annual burden that hospitals face, Jha said.

Before the pandemic, respiratory diseases were already "at the top of the seawall, with a little bit of splashing, but we're able to get through every winter." With a winter spike in Covid cases piled on top of viruses like the flu and respiratory syncytial virus, he said, "we are going to for years be challenged to manage multiple highly contagious respiratory viruses."

The current big areas of focus on that front, he said, are improving indoor air quality and looking toward a new generation of vaccines and treatments.

WELCOME TO TUESDAY PULSE — Remember Hunga Tonga, the undersea volcano that erupted earlier this year? New research shows the massive event sent 4 million metric tons of water vapor 93 miles above Earth, catching the attention of scientists who track space weather. While we try and wrap our heads around this, please send your news and tips to kmahr@politico.com and dpayne@politico.com .

TODAY ON OUR PULSE CHECK PODCAST, Katherine Ellen Foley talks with Megan Messerly about the situation inside hospitals as Covid, RSV and flu cases spike. Nearly 30,000 people in U.S. hospitals have tested positive for Covid-19 , according to the CDC, up 30 percent since Thanksgiving.

Listen to today's Pulse Check podcast

A message from PhRMA:

In 2021, Insurers and their pharmacy benefit managers (PBMs) subjected patients to six times the out-of-pocket costs for brand medicines through the use of deductibles or coinsurance compared to patients with only copays — even when these middlemen received a discounted price. That's not fair. Learn more.

In Congress

A vial of the Pfizer Covid-19 vaccine is displayed.

Lawmakers are worried about Pfizer's reported plans to raise the price of the Covid vaccine next year. | Greg Lehman/Walla Walla Union-Bulletin via AP

FIRST IN PULSE (I) — Sen. Elizabeth Warren (D-Mass.) and incoming senator Peter Welch (D-Vt.) are demanding answers from Pfizer CEO Albert Bourla about reported plans to quadruple the price of the Covid vaccine in 2023 and pushing the company to change course, Alice reports.

Slamming the move as "pure and deadly greed" and "unseemly profiteering," the lawmakers said in a letter they're worried it will prompt other Covid vaccine makers, including Moderna and Novavax, to respond with similar increases, making the shots unaffordable for the uninsured and others who may have to pay out of pocket in the future.

They're requesting that the company answer several questions by Jan. 9 — including how much it expects to make as a result of the price hike in 2023, how much it would make without the increase, how many patients have so far used the company's patient assistance program and how much Pfizer plans to charge Medicare, Medicaid and the VA for the vaccine.

"Everyone deserves easy and affordable access to these lifesaving vaccines, and I'm urging Pfizer to reverse this planned price hike and put public health ahead of corporate greed," Warren told POLITICO.

Pfizer spokesperson Sharon Castillo said the company disagreed with the characterization in the letter that it is displaying "pure and deadly greed" and is "unseemly profiteering."

"We will not get ahead of an official response in the media," Castillo said in an email.

EXCLUSIVE: TEACHERS' UNION HEAD REBUFFS GOP REQUEST TO TESTIFY AT FINAL COVID HEARING — Republicans on the House Select Subcommittee on the Coronavirus Crisis sent a letter Monday asking Randi Weingarten, the president of the American Federation of Teachers, to testify at the committee's final hearing Wednesday — an invitation the labor leader is declining, Alice reports.

"It's rare to receive an invitation to testify before Congress … but I look forward to a real discussion — with congressional leadership and appropriate notice — on the challenges educators, students and families faced during COVID and their efforts to help kids recover and thrive," Weingarten told Alice in a statement.

In their letter, the GOP members, led by Rep. Steve Scalise (R-La.), accused her of contributing to an "unprecedented child academic and mental health crisis" by pushing for remote learning during the pandemic. Republicans, who will take the House majority in January and gain subpoena power as the head of committees, are expected to continue to focus on the role of teachers unions in 2023.

Democrats on the committee have invited other officials to speak at Wednesday's hearing , including Rick Bright, former deputy assistant secretary for preparedness and response at HHS; Kizzmekia Corbett , assistant professor of immunology and infectious diseases at Harvard T.H. Chan School of Public Health and former vaccine researcher at the NIH; Rebecca Dixon , executive director of the National Employment Law Project; and Ngozi Ezike , CEO of Sinai Chicago and former director of the Illinois Department of Public Health.

FIRST IN PULSE (II) — Dozens of patient, consumer and employer organizations are calling on the federal government to stand firm following a series of efforts to undermine the No Surprises Act.

In a letter to the Health and Human Services, Labor and Treasury departments, the groups, including the AFL-CIO, Families USA and U.S. Public Interest Research Group, expressed concern over continued litigation efforts attempting to erode patient protections included in the law.

POLITICO AT CES 2023 : We are bringing a special edition of our Digital Future Daily newsletter to Las Vegas to cover CES 2023. The newsletter will take you inside the largest and most influential technology event on the planet, featuring every major and emerging industry in the technology ecosystem gathered in one place. The newsletter runs from Jan. 5-7 and will focus on the public policy related aspects of the event. Sign up today to receive exclusive coverage of CES 2023.

At the Agencies

AN UPGRADE TO OUR WATER QUALITY? The federal government hasn't regulated a new drinking water contaminant in more than 30 years, but the EPA could make up for lost time in one fell swoop with a new rule due out before the end of the month, POLITICO's Annie Snider reports.

Backstory: Two dangerous "forever" chemicals — PFOA and PFOS — have been linked with a host of health ailments, including cancer and immune system disorders. They pose health threats at incredibly low levels and aren't captured by most traditional drinking-water treatment.

What EPA could do: The EPA's proposed rule will be aimed at setting mandatory limits for the chemicals. Any new regulation from the EPA would likely require major water treatment upgrades at utilities across the country, and the leading treatment methods for dealing with PFOA and PFOS would also capture a litany of other contaminants.

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Global Health

HAITI RECEIVES CHOLERA VACCINE — Haiti is set to start a vaccination campaign against its ongoing cholera outbreak after receiving nearly 2 million doses of a cholera vaccine.

More than 1,200 confirmed cases and 14,000 suspected cases of cholera have been reported across Haiti since early October, according to the Pan American Health Organization. The vaccine doses came from the International Coordinating Group on Vaccine Provision, which manages the global cholera vaccine stockpile.

Names in the News

The Commonwealth Fund has announced that Joseph R. Betancourt will become its eighth president in January. Betancourt currently serves as the senior vice president for equity and community health at Massachusetts General Hospital.

Mehul Mehta has been appointed the principal and chair of the Health Solutions practice at the global strategic advisory firm Dentons Global Advisors. Mohan Chellappa, Riaz Adamjee and Bruce Solomon have joined the firm as partners.

Kristen Gil has joined UnitedHeatlh Group's board of directors. Gil is a vice president of business finance at Alphabet, where she has held numerous senior positions since joining the company in 2007.

Adrian Eng-Gastelum is now senior adviser for broadcast and coalitions media at the Department of Health and Human Services, where he was promoted from acting deputy assistant secretary for public affairs and press secretary. He is an alum of the Democratic Congressional Campaign Committee, the Biden campaign and transition and Sen. Elizabeth Warren's presidential campaign.

JOIN THURSDAY FOR A CONVERSATION ON FAMILY CARE IN AMERICA : Family caregivers are among our most overlooked and under-supported groups in the United States. The Biden Administration's new national strategy for supporting family caregivers outlines nearly 350 actions the federal government is committed to taking. Who will deliver this strategy? How should different stakeholders divide the work? Join POLITICO on Dec. 15 to explore how federal action can improve the lives of those giving and receiving family care across America. REGISTER HERE .

What We're Reading

Stat and The Markup joined forces to investigate how virtual care websites leak sensitive medical information, including personal details and answers to medical intake questions about drug use and self-harm, to the world's largest advertising platforms, including Meta, Google and Twitter.

The Washington Post has published the second installment of its Cartel Rx investigation, looking into why the federal government failed to head off the fentanyl crisis.

Pro Publica reports on Google's ongoing quest to access an archive of military tissue samples to create powerful new diagnostic and treatment tools.

A message from PhRMA:

Every day, patients at the pharmacy counter discover their commercial insurance coverage does not provide the level of access and affordability they need. New data from a study by IQVIA reveal the harmful practices of insurers and their pharmacy benefit managers (PBMs) can lead to significantly higher out-of-pocket costs for medicines — causing some patients to abandon their medicines completely. Learn more.