CDC makes a new map

Feb 25, 2022

By Sarah Owermohle and Katherine Ellen Foley

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On Tap

— New metrics focused on hospitalized Covid cases will move the bar for easing local pandemic restrictions.

— Medicare is evolving a Trump-era model for private companies, installing new patient and equity requirements.

— People with disabilities need more accessible tests and masks, the White House says as it sketches out a new plan.

WELCOME TO FRIDAY PULSE — No cheery chatter today: I hope this ends soon. Send tips to sowermohle@politico.com.

Driving the Day

CDC's NEW COVID TRACKER PAINTS SUNNIER PICTURE — The Centers for Disease Control and Prevention will unveil new guidelines this afternoon that are expected to significantly change the color of its longtime Covid-19 map.

The shift from a case-centric formula — in which just 3 percent of the country isn't experiencing the "moderate," "substantial," or "high" Covid-19 transmission — to a calculation driven by hospital rates and local capacity to better reflect the risk the virus poses to communities now that vaccinations are more widespread, four people with knowledge told POLITICO's Adam Cancryn and Sarah.

That'll also mean a significant drop in the percentage of the country where the CDC recommends stringent masking, the people with knowledge of the matter said. The shift will mean roughly 20 percent of the country can now pull back on mask mandates and social-distancing limits, one senior administration official said.

"It's going to be much more on what the responsibility of the people at the local level is," the official said, characterizing the approach as "less mandating and more leave it up to the local authorities. We're just going to give you the data."

Why? The recalculation comes weeks after state and local officials began forging ahead with their own plans to drop mask measures and vaccination requirements and amid pressure from Democrats for the administration to provide a clearer guide for how states should return to normalcy.

While the U.S. is still averaging almost 2,000 Covid-19 deaths a day, cases and hospitalizations have plummeted from the height of the Omicron surge. That decline — combined with widespread vaccination and the growing availability of post-infection treatments — fueled a push within the administration over the last several weeks to reevaluate its recommendations on masking and other restrictions.

BIDEN REVAMPS MEDICARE PROGRAM — The Biden administration is redesigning an experimental Trump-era Medicare program that came under fire from prominent progressive Democrats after Obama-era health officials and lobbyists rushed in to save it.

The Centers for Medicare and Medicaid Services, which administers the program known as direct contracting, said Thursday the revamp includes a new name, governance goals and a focus on health equity beginning next year, POLITICO's Rachael Levy reports.

What's changing: Known as the Global and Professional Direct Contracting Model, which allowed private companies to offer Medicare services through direct contracting with the agency, the program will morph into the Accountable Care Organization Reach Model.

The revamped model requires that providers make up 75 percent of participating organizations' governing boards, up from 25 percent in the old model. The boards must include a beneficiary representative and a consumer advocate who each hold voting rights.

And all participating entities will also have to develop health equity plans, among other changes, an official told reporters. Participants in the previous, now defunct, model will have to comply with the new rules to continue in the program, they said.

CMS also announced it canceled a separate direct contracting program, known as the "geo model." That program had been on pause since last March and the subject of controversy from those opposing the direct contracting model.

WHITE HOUSE UNVEILS COVID PLAN FOR PEOPLE WITH DISABILITIES — The Biden administration late Thursday outlined steps to ensure people with disabilities and older individuals have access to Covid-19 testing, masks and other resources.

Some of the administration's plans:

— Distributing masks to people with disabilities through community organizations and calling on states to aid in the effort

— Expanding HHS's disability hotline to assist with finding and using at-home tests

— Releasing new Covid-19 testing guidance in American Sign Language

— Re-upping efforts to develop new and accessible at-home coronavirus tests through the National Institutes of Health's RADx program

— Incentivizing manufacturers to prioritize producing those tests and making both the products and their instructions accessible

Public Health

PILLS ACCOUNT FOR MOST U.S. ABORTIONS FOR THE FIRST TIME — Abortion pills are the most popular method for ending a pregnancy in the U.S. for the first time since their approval more than two decades ago, Alice reports. According to preliminary data from the Guttmacher Institute, in 2020, medication abortion accounted for 54 percent of U.S. abortions, up from 39 percent in 2017, when the last survey was conducted.

A federal push to make the drugs more accessible is running into a wall of red states restricting or banning their use. Dozens of states have laws designed to make it harder to obtain the pills, and at least 16 states have introduced bills this session to create further restrictions — including proposals to ban their distribution by mail, mandate that only physicians and not other medical professionals can prescribe them and limit their availability on college campuses. But despite the opposition, the pills' popularity has surged amid surgical abortion restrictions in GOP-controlled states.

Industry Intel

DOJ, STATES SUE TO BLOCK UNITEDHEALTH GROUP HEALTH IT DEAL — The Justice Department and two states on Thursday sued to block the proposed merger between insurer UnitedHealth Group and Change Healthcare, POLITICO's Leah Nylen reports.

The plaintiffs said the merger would give UnitedHealth insight into its rivals' rates and contracts, increasing the insurer's ability to deny insurance claims or tweak admission criteria. The companies, meanwhile, argue the deal would increase efficiency in the health care system and help reduce costs.

In Congress

FIRST IN PULSE: LAWMAKERS INTRO COVID TEST BILL — House Energy and Commerce Chair Rep. Frank Pallone (D-N.J.) and Education and Labor Chair Rep. Bobby Scott (D-Va.) on Friday launched a bill that would extend free coronavirus testing past the current public health emergency.

The No Surprises for Covid-19 Tests Act would extend coverage through the end of 2023, a move the Democrats said would ensure people aren't stuck with unknown bills for the tests after the emergency declaration ends, which could happen as soon as this summer.

HOUSE LAWMAKERS INTRODUCE BIPARTISAN RESOLUTION FOR WOMEN'S HEART HEALTH — Reps. Lori Trahan (D-Mass.) and Brett Guthrie (R-Ky.) introduced a resolution today supporting heart health initiatives for women.

The resolution endorses federal efforts to increase women's participation in cardiovascular clinical trials and collaboration among health care providers, drug and device companies and patient advocacy groups focused on women's heart health. Reps. Peter Welch (D-Vt.), David Trone (D-Md.), Terri Sewell (D-Ala.), Buddy Carter (R-Ga.), Brian Fitzpatrick (R-Pa.), Don Bacon (R-Neb.) and Seth Moulton (D-Mass.), as well as nonprofit patient group HER FATE and peer-support group the Mended Hearts, also support the resolution.

Names in the News

— Wyatt Ronan has joined Crosscut Strategies as a strategic communications manager. He most recently was senior press secretary for the Human Rights Campaign and is an alum of campaigns for Beto O'Rourke, Deval Patrick, Chris Pappas and New Hampshire Democrats.

— Kevin Dawson is now health policy adviser for Sen. Bill Cassidy (R-La.). He most recently was a professional staff member for the Senate Budget Committee.

— Jeannine Bender is now legislative director for Rep. David McKinley (R-W.Va.), focusing primarily on health care and telecom. She most recently was a legislative policy staffer for Rep. Debbie Lesko (R-Ariz.).

— Kate Jahries is joining the Glen Echo Group as a director. Jahries most recently was a communications manager at the National Council for Mental Wellbeing.

What We're Reading

For Intelligencer, Sam Adler-Bell writes about how David Leonhardt, the author of The New York Times' morning newsletter, became the chief Covid correspondent for 5 million Americans — for better or worse.

Idolizing the long hours we put in at jobs that don't love us back is killing us, Scott Koeing argues for Nautilus.

In a two-part series for Stat News, Usha Lee McFarling unpacks why efforts to improve health equity have fallen short in the last 20 years — and spotlights those who are doggedly moving the needle.

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