Inside Trump's friends-first vaccine distribution plan

Jan 28, 2022

Presented by Humana

With help from Erin Banco and David Lim.

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QUICK FIX

— Inside the Trump administration's global vaccine distribution planthat prioritized wealthy ally countries over low-income nations

— Biden's FDA nominee is in trouble

— Progressives push for BBB passage by Marchas PhRMA fights back

WELCOME TO FRIDAY PULSE — I'm Alice Miranda Ollstein, the Capitol Hill reporter for our mighty health team, pitching in while we work on hiring a new co-author for Sarah. With more snow headed our way this weekend, I hope everyone hunkers down with a gripping read. Might I suggest our own Joanne giving The Daily a run for its money in The Nightly? Send stories and tips to aollstein@politico.com.

A message from Humana:

In 2022, older Americans are getting more out of Medicare Advantage. Many Americans turning 65 or who are new to Medicare have access to plans that provide supplemental benefits tailored to address key social health needs like food security, transportation, and in-home support services. Learn more about how Medicare Advantage plans are helping address members' whole health.

Driving the Day

INSIDE THE TRUMP ADMIN'S VACCINE DIPLOMACY PLAN — Little is known about how the Biden administration decides when and where to send U.S. doses across the world. But now we know what the Trump administration had in mind.

Our Erin Banco reports that the Trump administration created a list prioritizing wealthier U.S. allies such as Israel and Taiwan over low- and moderate-income countries.

According to interviews with five current and former officials, the list reveals how U.S. officials initially planned to distribute the shots based on political preferences rather than serving the neediest first.

The Trump administration's list — created in the summer and fall of 2020 before the vaccine was authorized for use — was split it into several sections, including U.S. strategic allies, countries that helped develop the vaccine, countries with relationships with Gavi (the global vaccine alliance), and all other countries not included in the previous three groups. The "strategic allies" included Israel, Canada, Taiwan, South Korea and some European nations.

After the 2020 election, officials passed both documents on to the Biden administration, including to officials on the National Security Council. A Biden official said the administration doesn't use the list. Still, the list is being held closely by Biden officials.

On the Hill

BIDEN'S FDA PICK IN TROUBLE AS SOME REPUBLICANS AND DEMOCRATS PULL SUPPORT — President Joe Biden's nominee to lead FDA does not yet have the votes in the Senate needed to give the agency its first political leader in more than a year, David Lim, Lauren Gardner and Adam Cancryn report.

A handful of Democratic defections over former FDA Commissioner Robert Califf's track record on opioids and a new GOP push to kill his nomination have sparked deep frustration among top Democrats and touched off a round of finger pointing, with Califf allies privately blaming the White House for doing too little to shore up support for its own nominee.

"If the vote were held today, he would not have the votes," said one person with knowledge of the matter.

CLEAN UP CREW: In recent weeks, Senate HELP Chair Sen. Patty Murray (D-WA) and ranking member Sen. Richard Burr (R-NC) have worked to round up last-minute support for Califf, in hopes of a floor vote by early February. The White House is also dispatching senior aides like chief medical adviser Anthony Fauci, Covid-19 coordinator Jeff Zients and White House staff secretary Neera Tanden to make calls on Califf's behalf.

"We are confident Dr. Califf will be confirmed with bipartisan support, and it is critical to have confirmed leadership at the FDA in the midst of a pandemic," White House spokesperson Chris Meagher said.

PROGRESSIVES DEMAND BBB PASSAGE BEFORE MARCH — With negotiations on a new version of Democrats' social spending bill stalled since Sen. Joe Manchin (D-WV) withdrew his support at the end of 2021, Congressional Progressive Caucus chair Rep. Pramila Jayapal (D-WA) laid down a new marker Thursday in a meeting with the group Evergreen Action: pass a few key pieces of Build Back Better in the next few months and then work on the rest.

"We are calling for President Biden and Senate Democrats to pass the Build Back Better Act by March 1, so the President can use the power of the State of the Union platform to share with the nation the relief that people will soon receive," she said in a statement after the meeting.

Jayapal says she recently spoke with Manchin about the areas of agreement that could go in the first tranche: $550 billion on climate change, universal pre-K, eldercare, child care, lowering prescription drug costs and housing provisions.

While President Biden recently endorsed the strategy of passing his agenda in smaller pieces, it risks leaving behind major health care provisions like closing the Medicaid gap and extending Obamacare subsidies that are set to expire at the end of the year.

As for Jayapal's timeline, some top aides are skeptical.

"Setting arbitrary deadlines clearly didn't work last year," a senior Senate Democratic aide told PULSE. "We're still having discussions about what can get 50 votes."

The pharmaceutical industry, however, is taking the call to action seriously.

On Friday, PhRMA is launching a seven-figure national ad campaign that will run in digital, print, radio and TV outlets blasting the drug price reforms included in Build Back Better as "government price setting" that will "risk access to medicines and future cures."

The group's spokesperson, Sarah Sutton, said in a statement to PULSE that the ads' goal is "reminding policymakers of some of the real dangers of" the package the House passed last year that would allow Medicare to negotiate the prices of some drugs, cap price hikes at the rate of inflation and more. "We think there's a better way that brings real relief to patients without jeopardizing access to medicines and future innovation," she said.

Democrats have long cited Big Pharma's opposition to the bill and its influence in Washington as one of the biggest hurdles standing in the way of its passage.

A message from Humana:

Covid

NEW POLL: VAX RATES INCH UP AFTER FALL STALL-OUT — A new study from the Kaiser Family Foundation found that the number of people getting their first dose of a Covid-19 vaccine has started to tick up again after flatlining for several months last year.

77 percent of respondents told KFF they have received at least one dose, up from 73 percent in November of 2021. Analysts say that increase was driven by concern around the Omicron variant's surge and draws from the camps of people who previously said either they will get vaccinated right away, will wait and see, or will get vaccinated only if required.
Troublingly, the share of people who say they will definitely not get vaccinated has barely budged since the end of 2020.
76 percent of unvaccinated adults say that Omicron's impact has not changed whether they will get the vaccine, and 15 percent even say it has made them less likely to do so.

Other key findings:

Boosters: "Gaps in booster uptake are mirroring early gaps in initial vaccination uptake," Kaiser reports. Adults 65 and older and self-identified Democrats have much higher booster rates than their younger and more conserative counterparts, while Black and Hispanic adults lag White adults in booster uptake. Out of those un-boosted, just four in ten say they want to get a booster as soon as they can.
Testing shortages abound: Six in ten people who tried to purchase an at-home COVID-19 test say the tests were difficult to find, and one-third of those who tried to find an in-person test similarly report difficulty.
Vibe check: A majority of people of every age group, gender, race and ethnicity, and income level report feeling "tired" and "frustrated" during this current state of the pandemic. Four in ten are "angry" and three in ten say they feel "confused."

FIRST IN PULSE: ROCKEFELLER LAUNCHES FREE COVID TEST INITIATIVE — The Rockefeller Foundation is launching a program to distribute five free at-home Covid-19 tests to vulnerable households in six states: Arkansas, Illinois, Maine, Michigan, New Mexico and Ohio. The effort — initially distributing about 1 million home tests from iHealth Labs through CareEvolution and Amazon — builds upon the Biden administration's efforts to send 1 billion home tests to households that request them.

"While the program is currently limited to one order, per residential address during this first phase, The Rockefeller Foundation is actively working to bring in new partners to scale the program to additional states over the coming weeks," the foundation said in a statement.

What We're Reading

Substack is making millions off anti-vaccine content as conspiracy theorist writers booted from mainstream outlets find an audience with the newsletter company, Elizabeth Dwoskin reports for The Washington Post.

Pharmacists and state officials say the Biden administration's free testing rollout is eating up scarce supplies and exacerbating existing shortages, Ariel Cohen reports for Roll Call.

L.A. County Sheriff's deputies working at the city's Twin Towers Correctional Facility have been documented flouting Covid protocols and urging inmates to refuse vaccination, Emily Elena Dugdale reports for LAist.

Sen. Gary Peters (D-MI) opened up about his wife's abortion and argued in support of maintaining Roe v. Wade in an essay for People Magazine.

A message from Humana:

Medicare Advantage plans are evolving to meet the needs of Americans turning 65 or who are new to Medicare. With food insecurity and a lack of transportation making it difficult for many older Americans to seek care, supplemental benefits like transportation support and meal assistance can make a real difference in their lives. In 2022, more Medicare Advantage plans are providing meal assistance and transportation help, and the number of Medicare Advantage plans offering in-home support services doubled from 2021. Learn more about why 40% of people eligible for Medicare choose Medicare Advantage and how Medicare Advantage plans are supporting older Americans beyond the doctor's office.