with Alexandra Ellerbeck

For the first time in decades, congressional Democrats are moving toward scrapping long-standing restrictions on using taxpayer funds for abortions.

But whether they’re actually willing to wage a knockdown, drag-out fight over the issue remains to be seen.

A House subcommittee has voted to nix the Hyde and Weldon amendments.

Yesterday, the appropriations subcommittee, which oversees Department of Health and Human Services funding, approved a funding bill without the two amendments that long represented a sort of truce between abortion rights advocates and foes.

  • The best-known of these is the Hyde Amendment, which prohibits using federally funded programs like Medicaid from paying for abortions, except in a narrow set of circumstances. It has been tacked onto congressional spending measures every year since 1977, and was historically supported by many Democrats including President Biden (who last year flipped on the issue under pressure from abortion rights groups).
  • Somewhat lesser-known is the Weldon Amendment, which prohibits federal funds from going to any state or local government that discriminates against health-care entities that refuse to provide or refer patients for abortions.

The move didn’t come out of the blue; it’s been brewing for the past few years, as abortion rights groups increasingly targeted the amendments and urged lawmakers to start backing away from them. The Democratic Party first called for repeal of Hyde in its 2016 platform, and it has become increasingly rare for rank-and-file Democrats to express support for the amendments. 

Yet the vote does represent a significant departure from a policy that had allowed two parties with diametrically opposing views on abortion rights to continue funding the federal government without every spending discussion devolving into an all-out war.

The tensions were clear at yesterday’s hearing. 

House Appropriations Committee Chairwoman Rosa L. DeLauro (D-Conn.) acknowledged to members that “many of us disagree” on the topic but argued that Hyde ultimately led to more unintended pregnancies and later, riskier and more costly abortions.

“Quite frankly, allowing the Hyde Amendment to remain on the books is a disservice not only to our constituents but also to the values that we espouse as a nation,” she said. “We are finally doing what is right for our mothers, our families and our communities by striking this discriminatory amendment once and for all.”

As for the subcommittee Republicans, they cited the omission as a top reason they wouldn’t support the measure and warned that ditching the amendments would allow differences over abortion rights to get in the way of keeping the government running. Ranking member Kay Granger (R-Tex.) said she’ll introduce an amendment later in the week to try to introduce Hyde and Weldon back into the bill.

The amendments are “the only way to get our appropriations bills through the House and Senate and signed into law,” Granger said.

At this point, Democrats’ chances of success appear small.

They don’t need any help from Republicans to pass appropriations bill in the House. But in the Senate, it’s a different story. 

Democrats would need votes from at least 10 GOP members — and while Sens. Susan Collins (R-Maine) and Lisa Murkowski (R-Alaska) support the right of a woman to get an abortion, it’s not clear they’re on board with federally funding it.

There could also be some Democratic defectors; both Sens. Joe Manchin III (D-W.Va.) and Robert P. Casey Jr. (D-Pa.) sided with Republicans back in 2019 in a failed attempt to pass legislation making the Hyde Amendment permanent law.

Plus, Democratic leaders and the White House would have to be fully committed to the fight.

As usual, Congress is woefully behind schedule in passing the dozen annual appropriations bills.

So with or without Hyde and Weldon, the individual measure funding HHS is unlikely to make it all the way to Senate passage and a conference between the two chambers. 

Instead, lawmakers are likely to take a different route to keep the government funded past Sept. 30. They might pass a short-term funding bill to prevent a shutdown, which would preserve the status quo. 

There would only be an opportunity to strike Hyde and Weldon only if Congress passes an omnibus bill, setting new spending levels. But in that scenario, Democrats would need to be willing to risk a government shutdown over the issue, with Republicans certain to kick up a fuss.

And polling doesn’t seem to be on their side.

In numerous polls over the past few years, pluralities of Americans have said they support banning public funding of abortions. In a Politico poll, 49 percent indicated they “strongly” or “somewhat” support Hyde, versus 32 percent who opposed it. In a Public Religion Research Institute poll, a large majority of Americans said Medicaid should cover contraception but far fewer said it should cover abortion services.

“One good thing about having debates is it allows both sides to lay out their cases,” said Tom McClusky, a lobbyist for the antiabortion group March for Life. “In this instance, I think the pro-life case is much better and the American people seem to agree.”

But don’t expect the controversy to recede anytime soon.

Amid the nation’s heightened focus on racial disparities, abortion rights groups have returned to an argument long aired by activists before them: that bans on abortion or abortion funding are racist. They’re at least correct that the abortion rates are uneven; Black women have received abortions at a rate nearly four times that of White women for decades, according to data from the Centers for Disease Control and Prevention.

“Abortion restrictions create a harsh burden on people of color and those who can least afford the health care they need,” said Gretchen Borchelt, a vice president at the National Women’s Law Center. “It’s time to remove these barriers to care for good.”

Ahh, oof and ouch

AHH: A Senate subcommittee will examine how anticompetitive conduct drives up U.S. drug costs.

Two drug industry lawyers – along with academics and an activist – will testify at 2:30 p.m. today before the Senate Judiciary Subcommittee on Competition Policy, Antitrust and Consumer Rights. The hearing will focus on how antitrust reforms could address competitive problems in the pharmaceutical industry which lead to higher costs.

“I have always looked at the antitrust issue as bigger than tech,” Sen. Amy Klobuchar (D-Minn.), who chairs the subcommittee, told me over the phone last night. “We also have to look at the bigger issue of what is going on for consumers and the one glaring thing is pharma. The pharma companies have gained for years on the margin.”

The witnesses will include Geoffrey Levitt, a counsel at DLA Piper who will be appearing on behalf of Pharmaceutical Research and Manufacturers of America; and Rachel Moodie of Biosimilars Fresenius Kabi, among others.

OOF: The FDA is adding a new warning label for the Johnson & Johnson vaccine.

The Food and Drug Administration announced that the shot has been linked to a rare autoimmune disorder known as Guillain-Barré syndrome. Around 100 preliminary reports of the syndrome have been detected among the recipients of 12.8 million doses of the shot administered in the United States.

“The latest development comes at an especially fraught moment, as the highly transmissible delta variant sweeps the country and fuels an increase in coronavirus cases in many states. And the new warning could complicate the Biden administration’s efforts to ramp up inoculations in areas where skepticism regarding coronavirus vaccines remains high and the vaccine rate is low,” The Washington Post’s Laurie McGinley and Lena H. Sun report.

The Food and Drug Administration announced a new warning for the Johnson & Johnson coronavirus vaccine on July 12. (Reuters)

Officials and experts emphasize that the benefits of the shot far outweigh the risks. Studies suggest its more likely that people will get Guillain-Barré syndrome following infection with the flu than they will after vaccination.

Jeanne Marrazzo, director of infectious-diseases at the University of Alabama at Birmingham, said the absolute risk of Guillain-Barré remains so rare that “it should not deter people from getting vaccinated.” Anyone who is worried can also opt for the Pfizer or Moderna vaccines. “This news does not provide an excuse to remain unvaccinated!!!!” Marrazzo wrote to The Post in an email.

OUCH: Israel has started to administer booster shots of the Pfizer vaccine.

Israel’s Ministry of Health began on Monday to offer third doses of the Pfizer to immunocompromised patients, including people with cancer or transplant recipients who may not have robust immune response from the standard two-dose regimen. Israel’s move comes as the country is experiencing a surge in cases tied to the highly transmissible delta variant, The Post reports.

The same day, Pfizer met with U.S. health officials to make the case for administering booster doses to some Americans, particularly the elderly and immunocompromised. The Department of Health and Human Services has said that Americans do not need booster shots for now. 

“It remained unclear on Monday where U.S. officials stood on the need for a third shot for vulnerable Americans. While several senior officials believe it will be appropriate to recommend boosters for the elderly and immunocompromised, Pfizer still must receive emergency authorization from the Food and Drug Administration for its third dose and a CDC advisory panel must decide whether and to whom to recommend boosters. That process could take several weeks or months,” The Post’s Shira Rubin, Emily Rauhala, Yasmeen Abutaleb and Tyler Pager report.

Some experts worry that the discussion of booster shots may only increase vaccine hesitancy, and the World Health Organization has stressed that the emphasis should be on getting first doses to the world’s most vulnerable.

“We will look back in anger, and we will look back in shame if countries use precious doses on booster shots, at a time when vulnerable people are still dying without vaccines elsewhere,” Mike Ryan, head of the WHO’s emergency program, said Monday.

More in coronavirus news

  • Over 2,000 schools across the country bought air purifiers during the pandemic — a measure aimed at combating the coronavirus and reassuring worried parents. But the companies selling these devices are subject to virtually no federal regulation and some air purifiers may even create harmful byproducts, Kaiser Health News’s Lauren Weber and Christina Jewett report.
     
  • Emails obtained by BuzzFeed News reveal that Deborah Birx warned Anthony S. Fauci and other top health officials about Trump adviser Scott Atlas last summer. Birx, the White House’s coronavirus response coordinator at the time, called Atlas “dangerous” and said his views on the pandemic were based on “personal opinion formed by cherry picking data from nonpeer reviewed COVID publications.”
  • New York Magazine’s David Wallace Wells argues that it is time to rethink safety protocols for kids. Not only has evidence since the early days of the pandemic consistently shown that they are at low risk from the virus, the high uptake of vaccines among the elderly reduces the risk of collateral damage from infections among the young and healthy.

Hill happenings

Three Democratic senators are seeking a Medicaid-like plan to cover holdout states.

Sens. Raphael G. Warnock and Jon Ossoff of Georgia and Tammy Baldwin of Wisconsin introduced a bill on Monday calling on the federal government to create a health insurance plan that mirrors Medicaid and can be offered in states that refused to expand the safety-net program, the Associated Press's Jeff Amy reports.

The Affordable Care Act envisioned that states would expand their Medicaid program to cover everyone making up to 138 percent of the federal poverty level. But twelve states have refused to expand Medicaid, while an expansion mandated by referendum in Missouri remains in limbo after Republican lawmakers refused to fund it. As a result, more than 4 million Americans who would otherwise be eligible fall in a coverage gap.

The bill would mandate the creation of a new health insurance plan to be offered in holdout states. The bill’s sponsors say it will be paid for by the money already allocated in the Affordable Care Act for Medicaid coverage in all 50 states. 

The new legislation is one of several proposals to guarantee coverage in holdout states. Rep. Lloyd Doggett (D-Texas) led the introduction of a bill last month that would allow local governments to enforce local Medicaid expansions. And President Biden proposed a federal public option for healthcare during his presidential campaign.

House Democrats are demanding documents related to a controversial Alzheimer’s drug.

House lawmakers have requested documents from the pharmaceutical company Biogen as part of an investigation into the Food and Drug Administration’s controversial decision to approve a new Alzheimer’s treatment, the Hill’s Peter Sullivan reports.

House Committee on Oversight and Reform Chair Carolyn B. Maloney (D-N.Y.) and Energy and Commerce Chair Frank Pallone Jr. (D-N.J.) wrote to Biogen CEO Michel Vounatsos requesting documents related to the development of the drug, communications with the FDA and company decisions over pricing. 

“We are concerned by reports of an atypical approval process for Aduhelm amid significant questions about the drug’s clinical benefit, and the steep $56,000 annual price tag, which will have serious implications for seniors, federal health care programs, and future Alzheimer’s research,” the lawmakers wrote. 

The letter referenced reporting by the medical news site Stat that Biogen embarked on a secret campaign, called Project Onyx, to persuade the FDA to approve the drug. 

Medicare officials also announced on Monday that the agency will start a process to review what could be the first step in limiting coverage for the drug.

Sugar rush