with Alexandra Ellerbeck

Rep. Lauren Underwood has become Congress's most outspoken advocate for improving maternal health. 

The 34-year-old Democrat from Illinois won a small victory yesterday as the House approved a bill aimed at improving maternal health for veterans. 

The United States compares poorly to other developed countries on maternal mortality.

It’s still extremely rare for a woman to die because of childbirth in the United States. About 20 women die in the United States out of every 100,000 births. Yet that rate is much higher than in Canada, Japan, South Korean and Western European countries. Even Russia has a slightly lower maternal mortality rate.

The comparison worsens when it comes to Black Americans; these women have a maternal mortality rate of 44 deaths per 100,000 live births, more than double the overall mortality rate.

Underwood noted those realities in recent phone conversation, arguing that lawmakers should make it a top priority to pass the dozen bills folded into what she calls the “Momnibus” package

The measures — two of which have bipartisan support — aim to improve maternal health care and close the health disparities seen between Black and White moms. Some direct more funding to community-based groups that care for low-income women or expand the perinatal workforce, while others support moms with mental health conditions or substance use disorders.

The bill passed yesterday by the House focuses on veterans.

The measure, approved unanimously by voice vote, codifies and strengthens maternity care coordination programs administered through the Department of Veterans Affairs. It also commissions a study of maternal health among female veterans, particularly focusing on racial and ethnic disparities in maternal health outcomes.

But the measure, sponsored by Sen. Tammy Duckworth (D-Ill.) in that chamber, would still need to be passed by the Senate to become law — and that’s a tall order, given all the other competing priorities Senate leaders are juggling right now.

Underwood is convinced maternal health is a winning issue.

She’s not on either of the two major health-care committees in Congress. But she’s from a moderate district in suburban Chicago, previously represented by Randy Hultgren, a conservative Republican. So it makes sense that she’s focusing on ways to build bridges with the GOP.

“Quite frankly this is something I think is a bipartisan political winner,” Underwood told me.

She said she’s “optimistic” that some of the measures will see action this year. Sen. Cory Booker (D-N.J.) is leading the Momnibus effort on the Senate side, with all 12 measures introduced as stand-alone bills in the upper chamber.

“Most times, you don’t hear about the Senate leaning on these types of provisions,” Underwood said. “There is bicameral interest.”

Democrats have been focusing on maternal health, particularly for Black women.

Last week the House Oversight and Reform Committee held a hearing focused on Black maternal mortality.

In his budget, President Biden requested more funding for improving maternal mortality rates. And his administration has approved a waiver from Illinois allowing it to expand its Medicaid program to women not eligible under regular rules for a full 12 months after they give birth.

Correction: An earlier version mistakenly said President Biden didn't include funding for maternal health in his infrastructure proposal. Rather, the American Families Plan does include $3 billion for maternal health.

Ahh, oof and ouch

AHH: CDC advisers endorsed the Pfizer vaccine for young adolescents.

“A federal advisory panel threw its support Wednesday behind the use of the Pfizer-BioNTech coronavirus vaccine in children as young as 12, paving the way for millions of adolescents to get the shots, and making it easier for state and local officials to reopen schools and summer camps,” The Post’s Lena H. Sun and Fenit Nirappil report.

The vote by the Advisory Committee on Immunization Practices, an independent group of experts, was 14 in favor, with one recusal. It came after the Food and Drug Administration cleared the vaccine for emergency use for children ages 12 to 15. Kids in that age group will get the same doses as those already being given to those 16 and older.

As drug companies expand coronavirus vaccine access to children, officials are working to persuade people who are skeptical or unwilling to get vaccinated. (Luis Velarde, Jonathan Baran, Erin Patrick O'Connor/The Washington Post)

Biden called on parents to get their kids vaccinated. “The bottom line is this: A vaccine for kids between the ages of 12 and 15 … [is] safe, effective, easy, fast and free,” he said.

“Vaccinating children is a key to boosting the level of immunity in the population, and reducing hospitalizations and deaths, experts say. As more adults are vaccinated, adolescents 12 to 17 years old are making up a greater proportion of infections, accounting for 9 percent of cases reported in April, according to CDC data presented at the meeting,” Lena and Fenit write.

OOF: Ohio Gov. Mike DeWine is offering $1 million lottery prizes to encourage vaccinations.

“The Republican governor announced Wednesday night that vaccinated adults will be eligible to enter a lottery that will pay out $1 million each to five winners beginning May 26. Separately, DeWine is offering five vaccinated teenagers full-ride scholarships to the state’s public universities, which includes all four years of tuition, room, board and textbooks.” The Post's Colby Itkowitz reports.

DeWine said that the money will come from existing pandemic relief dollars.

“I know that some may say, ‘DeWine, you’re crazy! This million-dollar drawing idea of yours is a waste of money.’ But truly, the real waste at this point in the pandemic — when the vaccine is readily available to anyone who wants it — is a life lost to covid-19,” DeWine said in a statewide address.

The vaccine campaign comes three weeks before state is set to lift pandemic restrictions, including a mask mandate. All coronavirus related orders, except those applying to long-term care facilities, are set to end on June 2.

OUCH: Telehealth advocates are struggling to allay concerns about Medicare costs.

One proposal from Sens. Tim Scott (R-S.C.) and Brian Schatz (D-Hawaii) seeks to remove restrictions that prevent Medicare patients from accessing telehealth services outside of rural areas or from their homes. Other proposals would similarly waive some of the restrictions or extend temporary waivers put in place during the pandemic that allow broader telemedicine use.

“The enthusiasm is tempered by cost concerns stemming from the Congressional Budget Office’s historical view that telehealth increases the use of services and therefore spending. The HHS Office of Inspector General also stepped up enforcement against telemarketing schemes involving medical equipment, lab tests and prescription drugs last year, which totaled billions in losses to Medicare and patients,” Roll Call’s Lauren Clason reports.

Advocates point to recent health-care survey data to argue that telehealth visits are largely replacing in-person care, rather than adding to it.  But the Congressional Budget Office predicts that a bill removing rural and home restrictions for mental health would increase spending by $1.65 billion over 10 years.

More in coronavirus

U.S. epidemiologists are returning to everyday life – but slowly.

In an informal survey of 723 epidemiologists, the New York Times found that 92 percent had run errands in person over the last 30 days, three-quarters had hiked or gathered outdoors with friends, and more than half had gotten a haircut at a salon or barber shop.

“We have surveyed these public health experts periodically throughout the pandemic,” the New York Times’s Margot Sanger-Katz, Claire Cain Miller and Kevin Quealy report. “As a group, they remain conservative in their choices about how to behave safely, and are more cautious than many Americans. But their increasing willingness to return to more prepandemic activities shows that even people most aware of what could still go wrong are starting to become more optimistic.”

“Vaccines have given me freedom,” Dianne Neumark-Sztainer, who leads the epidemiology division at the University of Minnesota, told the Times. “I was very strict all year but am now returning, slowly, to life.”

Still many epidemiologists are holding on to precautions, especially when it comes to indoor activities or socializing with strangers. About a third of those surveyed said that they had attended an indoor dinner party, and only 6 percent said that they had attended a sporting event, concert or play.

On the Hill

Lawmakers reintroduce bill to expand health-care access for immigrants.

Booker and Reps. Pramila Jayapal (D-Wash.) and Nanette Barragán (D-Calif.) reintroduced legislation that would eliminate the five-year waiting period before immigrants can receive coverage under Medicaid or the Children’s Health Insurance Program. The bill would also permit undocumented immigrants to purchase insurance on the Affordable Care Act health insurance exchanges.

The legislation was first introduced in 2015, but advocates are hoping that it has a better shot with Democrats in control of Congress and the presidency.

Ambitious legislative plans hinge on the health of members of Congress.

With the average age of a sitting senator at 64, the threat of illness and death associated with old age could tip the balance of power in a narrowly divided Senate. A single Democratic vacancy could flip control of the chamber, at least temporarily.

History suggests that Democrats have reason to worry. More than 1,160 sitting members and members-elect in Congress have died from accidents, disease and violence since the first Congress met in 1789, according to a Times analysis.

Health problems have already dogged the chamber: “Patrick Leahy, 81, Democrat of Vermont, was briefly hospitalized in January. Thom Tillis, 60, a North Carolina Republican, underwent cancer treatment. Questions have been raised about the health of Dianne Feinstein, 87, a Democrat who has represented California since 1992. Vermont’s other senator, Bernie Sanders, 79, had a heart attack in 2019,” the Times’s Ian Prasad Philbrick writes.

Sugar rush