Mapping out an end to the Covid PHE

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Jan 10, 2023 View in browser   By Krista Mahr and Daniel Payne Presented by With help from Ben Leonard and Alice Miranda Ollstein Driving The Day For President Joe Biden, who campaigned on eliminating the virus, ending the PHE would symbolize a measure of progress toward an early pledge. | Andrew Harnik/AP Photo GETTING READY FOR THE END OF A CRISIS — Senior Biden officials are targeting an end to the emergency designation for Covid as soon as the spring, POLITICO's Adam Cancyrn reports. The decision, which has not yet been finalized amid efforts to manage a recent spike in Covid cases, would mark a major pivot in the country's battle with the pandemic. Under the current tentative plan, health officials will quietly renew the emergency declaration for another 90 days before its scheduled expiration on Wednesday. That would give the administration until early February to alert states and health industry representatives that it plans to end the designation. It means Covid's crisis stage could be declared over as early as April. The administration could still issue additional short-term extensions if it needs more time to manage the transition — or grapple with the emergence of yet another variant. What happens then? Ending the PHE would trigger a complex restructuring of major elements of the federal response — and set the stage for the eventual shifting of greater responsibility for vaccines and treatments to the private market. It would kickstart a transition from the White House–led crisis operation toward treating the virus as a continuous long-term threat. Officials have focused on building out a sustainable response that can eventually be managed under the sprawling umbrellas of HHS and the CDC, including figuring out when to wind down the White House Covid team. Why now? The internal planning for the end stage of the crisis also amounts to an acknowledgment that the White House is more limited than ever in its ability to keep up the fight. Little federal funding is left to fuel its vaccination campaign after Congress refused to allocate more money at the end of last year, and even less hope a GOP-led House will entertain future requests. State leaders who were once enthusiastic partners have dropped their Covid precautions and shifted their attention to other matters. As for the broader population, officials said they recognize that much of America has moved on. WELCOME TO TUESDAY PULSE — Still struggling with how to pronounce the name of the new variant taking over the world? Jimmy Fallon is here to help. Send news and tips to kmahr@politico.com and dpayne@politico.com. TODAY ON OUR PULSE CHECK PODCAST, Ben Leonard talks with Lauren Gardner about the debate over HHS' directive requiring doctors to send patients test results before they have a chance to explain them. 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.   Abortion FIRST IN PULSE: ANTI-ABORTION GROUP VOWS PROTESTS, BOYCOTTS TARGETING WALGREENS AND CVS — The group Progressive Anti-Abortion Uprising is launching a national campaign of boycotts and demonstrations targeting CVS and Walgreens pharmacies over the chains' recent announcement that they'll stock and dispense abortion pills in accordance with new FDA policy. The campaign plans, first shared with Alice, include demonstrations in at least eight cities on Feb. 4: Washington D.C., San Francisco, Los Angeles, New York City, Detroit, Seattle, Austin and Atlanta. The group is also urging its members to call CVS and Walgreens' individual locations and corporate headquarters and to boycott the two retail pharmacy chains to pressure them to change course on their decision to fill prescriptions for the drugs in states where abortion remains legal. "These powerful corporations need to feel the pressure of losing brand loyalty in pro-life parts of America," the group's campaign website reads. Why it matters: The Biden administration has taken several steps to protect and expand access to abortion pills, which recently became the most popular method of terminating a pregnancy in the U.S. In January, the FDA cleared the way for pharmacies to dispense the drugs. That won't increase access for people in the 18 states that either ban abortion or have specific restrictions on the pills. Now, pressure campaigns like PAAU's could deter both chain and independent pharmacies from participating even in states where abortion remains legal, further limiting access for patients. At the Agencies Taylor Miller Thomas SAMHSA'S BIG OMNIBUS BUMP — HHS will receive $1.25 trillion — most of this year's funding — in the 2023 omnibus package. The Office of the Secretary and SAMHSA saw the biggest increases over last year, as the Biden administration remains focused on combating the mental health and drug overdose crises. The Department of Defense is launching a new plan to keep troops safe from emerging biological threats. | Getty Images DoD READIES FOR NEW BIOLOGICAL THREATS — The Defense Department is overhauling its approach to countering biological and chemical weapons, POLITICO's Lara Seligman and Erin Banco report. Officials are launching a new plan to develop medical treatments, vaccines and personal protective equipment that can adapt to a range of evolving biological and chemical threats, said Ian Watson, DoD's deputy assistant secretary for chemical and biological defense. That's a change for DoD, which traditionally has developed tools to counter a specific list of biological and chemical threats. Why now?   Recent advances in technology allow potential adversaries to manipulate existing pathogens and toxins and create new ones, leading to an almost infinite number of new hazards for troops. Adding to the problem's complexity, those dangers can be naturally occurring, accidental or deliberate, Watson said. Russia and China have the technology needed to both create new weapons and tweak current threats to make them more deadly, he said. CMS AWARDS 200 MORE RESIDENCY SLOTS — The Centers for Medicare and Medicaid Services awarded the first 200 Medicare-funded residency slots Monday, the start of a larger effort to shore up workforce woes for providers. This year's openings, starting July 1, will be in 100 teaching hospitals across 30 states, Washington, D.C., and Puerto Rico — focusing on areas with the largest provider shortages. Most slots will go to those working in primary care or mental health, two sectors hit particularly hard by workforce shortages. The slots come from Congress' 2021 Consolidated Appropriations Act, which offers 1,000 new slots over five years. Applications for the second round of residency slots will open this month. In Congress THE NEW WAYS AND MEANS —Rep. Jason Smith emerged from a tight and contentious race for the House Ways and Means Committee gavel that pitted the Missouri Republican against Vern Buchanan (R-Fla.). The House Republican Steering Committee voted Monday afternoon. The full GOP caucus still has to confirm Smith to the post but typically goes with the Steering Committee's choice. Ways and Means has significant influence on health care policy with jurisdiction over Medicare, Medicare Advantage and Medicare prescription drug benefits, as well as a recently extended provision allowing high-deductible health plans to cover telehealth pre-deductible. Reading the tea leaves: Smith, who has served on the Ways and Means Health Subcommittee, has advocated for expanding telehealth access in the Medicare program, introducing legislation to make audio-only telehealth access permanent. He co-sponsored legislation with Rep. Judy Chu (D-Calif.) in December aimed at bolstering access to psychologists for Medicare patients and sponsored legislation in September that would direct HHS to report on behavioral health integration services in Medicare. He has also opposed the Biden administration's Covid vaccine mandates and what he saw as a "discriminatory" Merit-based Incentive Payment Systems Rule designed to change the way Medicare pays doctors. As ranking member of the Budget Committee, he conducted oversight on the Biden administration's health care priorities and their potential cost.   A message from PhRMA:   IN THE STATES Thousands of nurses went on strike in New York City on Monday. | Craig Ruttle/AP Photo NURSES STRIKE IN NYC — More than 7,000 nurses across New York City went on strike Monday morning, demanding increased staffing levels at Montefiore Medical Center and Mount Sinai Hospital, POLITICO's Maya Kaufman reports. The New York State Nurses Association's negotiations with the hospitals' management reached a deadlock overnight following months of bargaining for the union's first new contracts since before the start of the Covid-19 pandemic. Both hospitals said they paused or rescheduled elective procedures slated for Monday, requested ambulance diversions and started discharging as many patients as safely possible. Mount Sinai also transferred babies from its intensive care unit to hospitals outside its network. What's next: Negotiations resumed Monday afternoon between the New York Nurses Association and Montefiore Medical Center. A Mount Sinai spokesperson said hospital management hasn't returned to the bargaining table since union negotiators walked out at about 1 a.m. Monday. Names in the News Shea McCarthy has been named a partner in Thorn Run Partners' Washington, D.C., office. He previously served as senior vice president at the firm. Dental clinic chain Tend has appointed Cynthia Hiskes as its chief people officer. Hiskes was previously at Oak Street Health. Anna Perng has been named a senior adviser for the Office of Public Engagement at the White House where she will manage both the disability and seniors portfolios. She most recently was at the HHS' Administration for Community Living. What We're Reading Moderna is considering pricing its Covid-19 vaccine in the neighborhood of $110 to $130 a dose when it starts selling the shots, The Wall Street Journal reports. Stat reports on how the continuing lack of oversight in India's massive pharmaceutical sector puts the lives of people across the world at risk. The New Republic reports on how a well-organized Texas-based anti-abortion group made its way to Europe.   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.     Follow us on Twitter Dan Goldberg @dancgoldberg Katherine Ellen Foley @katherineefoley Lauren Gardner @Gardner_LM Ben Leonard @_BenLeonard_ David Lim @davidalim Krista Mahr @kristamahr Megan Messerly @meganmesserly Alice Miranda Ollstein @aliceollstein Carmen Paun @carmenpaun Megan R. Wilson @misswilson Daniel Payne @_daniel_payne Ruth Reader @RuthReader   Follow us

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