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The Health 202

A newsletter briefing on the health-care policy debate in Washington.

The Biden administration is pulling out the stops to get its FDA pick confirmed

The Health 202

A newsletter briefing on the health-care policy debate in Washington.

Good morning — and hope you don't have a case of the Mondays. Today's edition was reported along with Laurie McGinley, The Post's FDA reporter. 

Below: Politico reports that Biden's top science adviser bullied subordinates, and the administration tells Congress key coronavirus funds are dwindling. But first: 

Skeptical Democrats mean Biden needs to win at least five GOP votes for Califf

With Robert Califf's confirmation still on the rocks, top Biden administration officials are dialing up its pressure campaign on Capitol Hill to support the president's pick to lead the Food and Drug Administration.

The latest: Senior aides — like Health and Human Services Secretary Xavier Becerra, coronavirus coordinator Jeff Zients and presidential counselor Steve Ricchetti — are among those talking to senators, a White House official told The Post’s Laurie McGinley and me.

Califf — a cardiologist who led the FDA during the last year of the Obama administration — has met with 43 senators, about evenly split between both parties. Another half-dozen meetings are planned for this week. Meanwhile, HHS is holding daily huddles with Califf and key lawmakers to answer questions and discuss strategy. 

  • “It will be close; it will be bipartisan,” the official, who spoke on the condition of anonymity to discuss internal activities, told us. “We are confident we have the votes.”

But this isn’t how the White House wanted Califf’s confirmation process to go. The nomination, once seen as a seemingly safe bet, has now become imperiled by key issues, like abortion, the opioid epidemic and the nominee’s ties to the pharmaceutical industry. And that’s left the FDA — an agency critical to the country’s pandemic response — without a permanent leader for nearly 13 stress-filled months.

  • The White House’s revved-up support comes after Politico reported in late January that Califf allies believed the White House wasn’t doing enough to secure the votes. (A White House official vigorously disputed this notion.)
The whip count

Now for the question du jour: How many more votes does Califf need to pick up?

The rough water on the Democratic side means the administration will likely need at least five Republican votes. Or depending on timing, that number may be six, given Sen. Ben Ray Luján (D-N.M.) may be out for roughly four to six weeks after suffering a stroke.

Let’s walk through Califf’s support on the GOP side. The Senate HELP Committee advanced Califf’s nomination last month, and he received the support of four Republican lawmakers. 

  • Of those, Sen. Richard Burr (R-N.C.) — the panel’s top Republican — has been supportive, heaping praise on Califf in remarks before the committee.
  • A spokesperson for Sen. Susan Collins (R-Maine) said the senator plans to continue her support. Meanwhile, the office of Sen. Lisa Murkowski (R-Alaska) didn’t respond to a request for comment.
  • A critical get for Califf: Sen. Mitt Romney (R-Utah) told us that he plans to continue his support for President Biden’s nominee, despite pressure from antiabortion advocates calling for him to flip his position. Romney went even further, saying he’d like to see a confirmed leader of the FDA “as soon as possible.”

Other Republicans we have our eye on: Retiring lawmakers, such as Sens. Roy Blunt (R-Mo.) and Rob Portman (R-Ohio). Susan B. Anthony List, an antiabortion group, has said senators voting for Califf will be dinged on the organization’s scorecard on abortion — a penalty those not running for reelection don’t have to be worry about. 

Let’s walk through the Democratic side, where a handful are actively opposing Califf’s nomination.

  • Here are those who plan to vote no: Sens. Richard Blumenthal (Conn.), Maggie Hassan (N.H.), Edward J. Markey (Mass.) and Joe Manchin III (W.Va.). Sen. Bernie Sanders (I-Vt.), who caucuses with the Democrats, also opposes Califf.
  • Their reasoning? Some are suspicious of his prior relationships with the drug industry, while others say they’re upset about what they describe as the FDA’s lax regulation of opioids.

Some Democrats haven’t committed one way or the other. For instance: Sen. Brian Schatz (D-Hawaii) told us that he’s slated to talk to Califf early this week — and that he leans toward voting yes but hasn’t made a final decision. 

  • Private-sector experience is not “disqualifying,” Schatz told us. “But I want to understand how he draws his red lines and how he’s going to make sure that we’re working in the public interest.”

Others, like Senate Finance Chair Ron Wyden (D-Ore.), are seeking more information. On Friday, Wyden sent Califf a letter asking for specifics on how he would hold drug companies accountable for delivering follow-up data under the FDA’s accelerated approval pathway for drugs. But Wyden hasn’t expressed direct opposition to the nominee. 

Want more details? Read the full story here. 

Reproductive wars

Florida GOP ditched a Texas-style ‘heartbeat’ ban

Instead, they've rallied around a 15-week ban modeled in Mississippi, which is now under consideration by the Supreme Court and is less extreme than legislation that would restrict abortions around six weeks of pregnancy.

“Even Gov. Ron DeSantis, a rising hero on the right for his unapologetic opposition to coronavirus restrictions, said he hadn’t read enough about the Texas ban to comment,” Caroline Kitchner writes. “His staff went further. Pointing to the novel enforcement mechanism that allowed citizen watchdogs to sue anyone involved in facilitating abortion access after the legal limit, they said DeSantis ‘didn’t want to turn private citizens against each other.’”

Agency alert

Politico: Biden’s top science adviser bullied subordinates, a White House investigation found

The head of the White House’s Office of Science and Technology Policy violated the White House’s workplace policy, Politico reports this morning, citing interviews and an audio recording obtained by the news outlet on a recently concluded White House investigation. 

What the investigation found: “Credible evidence” that Eric Lander — who is a member of Biden’s Cabinet — was “bullying” toward Rachel Wallace, his then-general counsel.  

  • “Christian Peele, the White House’s deputy director of management and administration for personnel, said that the investigation also concluded that there was ‘credible evidence of disrespectful interactions with staff by Dr. Lander and OSTP leadership,’ according to the roughly 20-minute briefing, which included a representative of the White House Counsel’s office,” Politico’s Alex Thompson writes.
  • The investigation also found “credible evidence of instances of multiple women” having complained about Lander speaking to them in a “demeaning or abrasive way” in front of staff.
  • Lander, a key player in the president's newly unveiled “cancer moonshot,” vowed to create a more “respectful” workplace environment and apologized for speaking to colleagues in a “disrespectful and demeaning way,” Politico reported Friday, citing an email sent to the office’s roughly 150 staffers before the news outlet posted its full story.

Alex Thompson, Politico

From our reporters' notebooks

Administration rallies to Becerra’s defense: Days after a tough Washington Post story on mounting frustrations with HHS Secretary Becerra, the White House is promising more visibility for the low-profile health official — with Biden personally calling Becerra on Friday to give him a vote of confidence, CNN reported.

Becerra is now scheduled to travel this week with first lady Jill Biden for a covid-19 relief event in Minnesota. His allies also are trying to ensure Becerra gets a spot at a White House briefing or has a “substantive meeting with Biden, which he has never done,” CNN reported. 

But the frustrations with Becerra go beyond visibility, our colleague Dan Diamond writes. While CNN wrote that Becerra’s confirmation was hindered “by several Republican senators complaining that he wasn’t a doctor,” the actual criticism was broader: more than a dozen senators — such as Burr, the ranking member on the HELP Committee — questioned whether the longtime congressman and California attorney general had the experience or expertise to lead the $1.5 trillion department.

  • It’s a critique that some Biden administration officials have quietly echoed, telling The Post that Becerra has struggled to coordinate messaging and strategy coming out of HHS. Some of that may stem from an awkward fit between Becerra and the White House covid response team, which duplicates some of the HHS secretary’s traditional functions, as Politico’s Adam Cancryn first detailed last fall.

Regardless of whether the criticism is deserved, The Post reported on how administration officials have openly mused about replacing Becerra — although likely can’t, given political considerations. Instead, expect more effort to try to make the current arrangements work, Dan notes.


Pandemic relief runs dry

Funds are dwindling in a federal pandemic relief program that has been key in the nation’s battle against the omicron variant, The Post’s Tony Romm and Jeff Stein report. 

The $350 billion dollar Public Health and Social Services Emergency Fund from the Department of Health and Human Services has boosted testing, treatments and vaccination efforts across the country since the outbreak of the coronavirus. But by the Biden administration’s account, nearly all remaining dollars in the fund have been used or are locked up in contracts or formal pledges. 

Top officials say they have enough funds to carry the country through the current wave, but have started exploring whether more money is needed to protect against future variants.

Meanwhile, Americans are “mentally over” pandemic life as the two-year anniversary of the outbreak in the United States draws near, prompting a bipartisan group of governors to urge Biden to “move away from the pandemic” at the White House last week.

In other health news

Booster guidelines clarified: The Centers for Disease Control and Prevention is expected to announce today that it will encourage some immunocompromised people to receive a fourth shot of the coronavirus vaccine three months after they receive their third primary shot of the Pfizer-BioNTech or Moderna vaccines — down from the previously recommended five-month waiting period, our colleague Lena H. Sun writes.

Here's what else you need to know:

  • Biden urged all Americans to get vaccinated as the country marked another sobering pandemic milestone: 900,000 deaths, our colleague Annabelle Timsit reports.
  • Mask guide: N95 and KN95 masks lead in effectiveness for preventing the coronavirus and cut down the risk of infection by 83 percent, according to new data from the CDC released Friday.
  • Congress can safely resume more in-person meetings due to a decline in omicron cases in the Washington, D.C.- area, Dan scooped.


Tuesday: A House Energy and Commerce subcommittee is holding a hearing to discuss the future of biomedical research; the Senate Finance Committee will meet to discuss youth mental health; a Senate HELP Committee hearing will focus on implementing pandemic-era innovations in the workplace to help ease employment barriers for people with disabilities.

Thursday: The Senate Special Committee on Aging will convene to discuss ways to improve the health-care experiences of Medicare and Medicaid beneficiaries; a Senate HELP subcommittee will focus on how to revitalize and diversify the health-care workforce amid staffing shortages.

Sugar rush

Thanks for reading! See y'all tomorrow.