Top HHS official warns of ‘medical refugees’

Feb 06, 2024

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the Coalition to Protect America's Health Care

Driving the day

Department of Health and Human Services Assistant Secretary for Health, Admiral Rachel Levine speaks at the Health and Human Services Humphrey Building.

As GOP-led states move to restrict gender-affirming care for minors, Levine, the highest-ranking transgender public official in the U.S., said the government shouldn’t be getting involved in such care. | Mark Schiefelbein/AP

LEVINE DISCUSSES PRIORITIES — Rachel Levine came to HHS in 2021 to oversee the department’s post-pandemic pivot.

The assistant secretary for health — also admiral in the Public Health Service Commissioned Corps — has established the Office of Long Covid Research and Practice as well as the Office of Climate Change and Health Equity and has spoken in favor of youth access to gender-affirming care.

In an interview with Chelsea, Levine explained that integrating climate change into HHS is important because “climate solutions are health solutions” and warned that states limiting gender-affirming care and abortion are forcing people to flee to other states and creating “medical refugees.”

Here are some outtakes of the conversation:

On long Covid: HHS is working with the National Academies of Sciences, Engineering and Medicine to get to a working definition of long Covid, Levine said. Deputy Assistant Secretary Michael Iademarco said the idea is to cover the range of symptoms patients experience and give them a reimbursement pathway for care.

On criticism that NIH-led long Covid research isn’t focusing enough on treatment: “Sometimes research takes as long as it takes to have results,” Levine said. “It takes longer than people want, but we want to make sure that we have robust results that will actually help patients.”

Levine added that the long Covid office brought on a new director last month, and that the office is developing an advisory committee on long Covid to help make recommendations on the federal response to long Covid. The office plans to release a report to detail next actions.

On gender-affirming care: As GOP-led states move to restrict gender-affirming care for minors, Levine, the highest-ranking transgender public official in the U.S., said the government shouldn’t be getting involved in such care — but has pushed back on what she termed “politically motivated” attacks.

“Transgender medicine is medical care. But transgender medicine is also a mental health care,” she said. “I want to make it clear that the mental health challenges that transgender youth face are due to the discrimination and the harassment and the bullying that they face. So, these state laws and actions are making everything worse.”

On the role of health systems in climate change: Last month, HHS launched its “catalytic program,” which includes a number of informational sessions to give health systems support on how to use Inflation Reduction Act incentives to reduce their carbon emissions.

“The health sector, the United States, if you think of it large, writ large, accounts for 8.5 percent of carbon emissions,” Levine said.

— On protecting HHS’ climate focus going forward: “This work is really important,” Levine said. “It is a critical aspect of our public health work and so we'll do the best we can to inculcate it and embed it into the work that the Office of the Assistant Secretary for Health is doing and the work HHS is doing.”

WELCOME TO TUESDAY PULSE. SAMHSA and ONC are launching a $20 million behavioral health IT initiative. Reach us at bleonard@politico.com or ccirruzzo@politico.com. Follow along @_BenLeonard_ and @ChelseaCirruzzo.

A message from the Coalition to Protect America's Health Care:

New Infographic: Hospitals Put Patients First While Corporate Insurers Profit At Patients’ Expense. https://protecthealthcare.org/latest/who-cares-for-you

Congress

Rep. Lloyd Doggett (D-Texas).

“The Biden Administration must make substantial revisions to increase transparency," Lloyd Doggett said in a statement. | Chip Somodevilla/Getty Images

FIRST IN PULSE: MARCH-IN PUSH — A group of more than 40 House and Senate Democrats led by Rep. Lloyd Doggett (D-Texas), Sen. Elizabeth Warren (D-Mass) and Angus King (I-Maine) is pushing the Biden administration to further assert its authority to seize certain drug patents.

The move will come in formal remarks in response to a request for public comment on the framework the administration proposed in December.

“The Biden Administration must make substantial revisions to increase transparency, remove Big Pharma fear-mongering language, and assume the responsibility of proactively reviewing all taxpayer-funded inventions to determine whether licensees are meeting their obligation to provide a product on reasonable terms,” Doggett told Pulse in a statement.

Progressives have long called for the administration to assert so-called march-in rights on drugs — giving patent licenses for drugs developed using public funds to others or taking them — to curb drug prices. The administration has not endorsed widespread use of such rights.

The pharmaceutical industry has blasted the proposal, saying it would hamper innovation and hurt patients. PhRMA CEO Steve Ubl has said drugmakers are weighing legal options if the administration moves forward. Senate HELP ranking member Bill Cassidy (R-La.) has said the administration doesn’t have the authority to assert march-in rights.

QALY BILL CLEARS RULES — The House Rules Committee along party lines advanced legislation that would ban a health care metric, setting up a floor vote later this week.

The legislation would prohibit the use of quality-adjusted life years, or QALYs, in federal programs. The metric assesses a drug’s impact on health outcomes and quality of life.

Its use is banned in Medicare and the bill from Energy and Commerce Chair Rep. Cathy McMorris Rodgers (R-Wash.) would extend the ban to Medicaid, the VA and other programs.

Proponents of such a ban argue that the statistic discriminates against people with disabilities by discounting how much treatments can help them.

Democrats were skeptical, pushing back against the pay-for — the Prevention and Public Health Fund — which Democrats have used before for other priorities. They also said it could undermine efforts to lower drug costs.

“The argument on the pay-for is pretty weak,” Rodgers said. “We are not going to cut any funding.”

E&C ranking member Rep. Frank Pallone (R-N.J.) said the bill language was vague, which would enable legal challenges from the pharmaceutical industry. The Biden administration also came out against the bill, saying the pay-for would undermine “critical investments in health.”

Rodgers said she still wants to work on a bipartisan deal.

REPUBLICANS RALLY AGAINST PANDEMIC TREATY — Two GOP House members who lead health panels demanded Monday that the Biden administration submit to the Senate for ratification an agreement on pandemic prevention and response, which is being negotiated at the World Health Organization, Carmen reports.

Rep. Chris Smith (R-N.J.), who chairs the House Foreign Affairs’ subcommittee for global health, said he worries about demands included in the text being negotiated in Geneva for sharing future tests, vaccines and drugs developed in response to an outbreak for global sharing.

Rep. Brad Wenstrup (R-Ohio), the chair of the Select Subcommittee on the Coronavirus Pandemic, demanded that any potential treaty doesn’t infringe on U.S. sovereignty and protects intellectual property.

That’s in line with the Biden administration’s position in the negotiations, saying it opposes waiving patent rules in future pandemics.

Why it matters: Republican opposition to a treaty, which is under a May deadline, would make it virtually impossible for the U.S. to become party to the agreement.

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At the Agencies

ORGAN TRANSPLANT OVERHAUL — The Health Resources and Services Administration today opened applications for proposals to run parts of the nation’s organ transplant system, but how much awards will be for is dependent upon funding from Congress, Chelsea reports.

How we got here: Since it was established in 1984, the Organ Procurement and Transportation Network has been run by the United Network for Organ Sharing. President Joe Biden signed a law last year that ordered that the single-entity approach be broken up to allow for multiple contractors to update portions of the donor-transplant network.

HRSA Administrator Carole Johnson told POLITICO that funding talks on Capitol Hill give the agency an additional $2 million for the modernization, far below the $36 million it requested — and the agency continues to plead with lawmakers for more.

HRSA’s applications opened Tuesday are for two solicitations. One asks for a non-profit that would help create an independent board of directors over the whole system — which UNOS agrees is necessary. The second is a larger multi-vendor solicitation for vendors that would help maintain operations as the transition to a new network gets underway.

This summer is also when a larger contract solicitation that includes finance and logistics — which Johnson called the “next-gen system” — will take place.

A message from the Coalition to Protect America's Health Care:

Names in the News

Freeland Ellis has been promoted to be communications director for the Senate HELP Committee. Ellis most recently was deputy communications director for chair Sen. Bernie Sanders (I-Vt.).

Eduardo Cisneros is now principal deputy director of HHS’ Office of Intergovernmental & External Affairs. He previously was a senior adviser to the White House Office of Intergovernmental Affairs.

A message from the Coalition to Protect America's Health Care:

Hospitals care for patients 24 hours a day, seven days a week – making sure they get the care they need. Corporate insurers bank record profits at patients’ expense, with 62% of patients reporting delayed medical care by corporate insurers in the last two years. Get the facts: https://protecthealthcare.org/latest/who-cares-for-you

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