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The Health 202
The Health 202

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

Thought the covid funding deal was in the bag? Not so fast.

Analysis by

with research by McKenzie Beard

April 6, 2022 at 8:07 a.m. EDT
The Health 202

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

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Good Wednesday morning — Read about a congressman's “most unusual day on the Hill in 10 years" (spoiler: it involves getting bit by a fox on Capitol Hill, which has now been caught).

Today’s edition: The Biden administration announced a strategy for long covid, while some experts want more. Oklahoma lawmakers passed a bill to make performing an abortion illegal. But first …

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Immigration fights threaten the new covid dollars

Congressional efforts to pass more coronavirus aid have hit yet another snag – this time, over immigration.

Last week, the Biden administration announced it would lift a controversial Trump-era pandemic order that let authorities rapidly expel border crossers. But bipartisan backlash over the move quickly ensued — and has now thrown a wrench into the effort to quickly pass $10 billion in new coronavirus funds, per a story Mike DeBonis and I wrote yesterday.

Republicans are insisting the Senate vote on an amendment to keep the public health order, known as Title 42, in place. But doing so would be a political minefield for Democrats, who have not agreed to allow such a vote.

The obstacle has thrown swift passage of more covid-19 aid into doubt. And it’s raised the specter that lawmakers could leave Friday for a two-week recess without approving the funding package, even as the White House warns it’s already begun scaling back the nation’s pandemic response. 

Here’s the state of play:

  • On Monday, Senate negotiators clinched a $10 billion deal to enable the federal government to buy more therapeutics, tests, vaccines and other supplies.
  • The next day, top GOP leaders said there was a “pretty strong” desire amid the Republican ranks to reverse the administration’s border decision and demanded an agreement to allow for a vote on an amendment to do so.
  • On Tuesday afternoon, a procedural vote to advance the covid-19 funding package failed on a 52-to-47 vote, underscoring the impasse.
Treacherous terrain

Holding a vote on Title 42 is politically tricky for Democrats. Some senators representing border states and others facing reelection have expressed concern about lifting the public health order. This includes Democratic Sens. Mark Kelly and Kyrsten Sinema, of Arizona, and Sens. Raphael Warnock (Ga.) and Joe Manchin III (W.Va.).

Meanwhile, some Democrats have been itching for Biden to end Title 42 for months. They, as well as the White House, stressed the debate should be kept separate from the coronavirus funding package. 

  • “We need a clean covid relief package, and if we’re going to get into amendments, then I might have a few of my own,” said Sen. Robert Menendez (D-N.J.), a leader of the group pushing to lift Title 42, per Mike.

If such an amendment is adopted to the package, it would likely spell trouble in the House. Speaker Nancy Pelosi (D-Calif.) would surely get pressure from the caucus’ left flank not to bring it up for a vote.

  • “I think if we have an amendment process on this emergency $10 [billion] supplemental, we will end up tanking it, and we won’t appropriate anything,” Sen. Chris Coons (D-Del.) predicted.

The Republican argument:

The White House argument:

But…

Even Republicans who brokered the funding deal are demanding amendment votes be allowed. For instance: Sen. Mitt Romney (R-Utah) — a key negotiator of the covid compromise — said, “as soon as we have an amendment process, then we can get onto the bill and proceed.”

Statements yesterday from top leaders reflected the two parties’ opposing views, with no clear compromise in sight. 

  • Senate Majority Leader Chuck Schumer (D-N.Y.) said the bipartisan agreement “should not be held hostage for an extraneous issue.”
  • Meanwhile, Senate Minority Leader Mitch McConnell (R-Ky.) told The Health 202 that there would be "a need for some amendments and hopefully we can work that out.”

Several rank-and-file members — such as Coons and Romney — said it’s up to leadership to resolve the dispute. Complicating matters is the Senate’s tight schedule, as Schumer moves to confirm Ketanji Brown Jackson to the Supreme Court this week and potentially pass new sanctions on Russia. 

That could leave more coronavirus aid sitting stagnant for another two weeks while lawmakers are in their home districts. 

On the Hill

Biden wants to take on long covid

The Biden administration directed government agencies to take more steps to advance the country’s research and treatment of long covid, our colleagues Dan Diamond and Frances Stead Sellers report. 

Key context: Federal watchdogs estimate that between 7.7 million and 23 million Americans are afflicted with the condition, which is linked to fatigue, brain fog and other symptoms that can last long after a covid infection and prevent sufferers from returning to work. 

Under Biden’s memorandum:

  • A $20 million initiative will create “centers of excellence” and multi-speciality clinics nationwide to help deliver better care to long covid patients.
  • The government will also expand long covid clinics already established by the Department of Veterans Affairs.
  • A new HHS project, Health+, will solicit feedback from people living with long covid to standardize practices to be used in clinics across the country.

The White House announcement is “a recognition of the fact that long covid is real and that it does exist. So many people are told it’s psychological,” said Frank Ziegler, who has suffered with symptoms for more than a year since he contracted the coronavirus in January 2021.

But others said more efforts were necessary, particularly pinpointing the $20 million initiative as needing a larger infusion of cash.

Rep. Don Beyer (D-Va.), who introduced a bipartisan act last April to help people suffering with long covid:

White House prescriptions

President Biden released another executive order aimed at making health care more affordable — an effort to highlight his administrative powers, while also pushing Congress to pass his stalled legislative agenda. He did so at a White House event yesterday with former President Barack Obama by his side.

Here are some of the measures — and what we’re watching. 

“Policies or practices that make it easier for all consumers to enroll in and retain coverage, understand their coverage options, and select appropriate coverage” → The Biden administration has already moved to restore funding to groups helping people enroll in Obamacare coverage. We expect such dollars to continue.

“Policies or practices that improve the comprehensiveness of coverage and protect consumers from low-quality coverage” → The Biden administration has indicated plans to roll back a Trump-era expansion of short-term health plans, which typically don’t cover pre-existing conditions.

“Policies or practices that strengthen benefits and improve access to healthcare providers” → The Biden administration has proposed requiring insurers offer standardized Obamacare plan options and implement new reviews to ensure plans have adequate provider networks.

Reproductive wars

Oklahoma lawmakers pass bill to make performing an abortion illegal

The Oklahoma House approved a Republican measure to make performing an abortion a felony and punishable by up to 10 years in prison, our colleague Caroline Kitchener reports. 

The legislation makes an exception if the life of the mother is in danger

  • Shifting strategy: The Oklahoma House passed legislation last month modeled on Texas’s unique enforcement mechanisms, which empowers private citizens to enforce the law through civil litigation. But the bill that advanced Tuesday doesn’t include such a measure.

Next steps: The bill, which passed the state Senate last year, now heads to Gov. Kevin Stitt (R), who has signaled his support for antiabortion legislation. If he signs off and it isn’t blocked by the courts, the bill would take effect this summer. 

  • But yet … its fate could hinge on a Supreme Court decision looming this summer that could undermine Roe v. Wade’s decades-old protections.

The big picture: Since Texas enacted its ban on the procedure once fetal cardiac activity is detected in September, Oklahoma’s clinics have been serving about 45 percent of patients who cross state lines for abortion services — more than any other state. If the state stops providing abortions, women in Texas and Oklahoma will have to seek out the procedure in Arkansas, Kansas or New Mexico.

More from Caroline:

Meanwhile, abortion costs are increasing as restrictions ramp up in more states

Rising abortion costs are outpacing health-care inflation rates nationwide as more states across the United States pass legislation restricting the procedure, Bloomberg News reports. 

From 2017 to 2020, the price of the two most common abortion methods — via pill or a first trimester procedure — increased 13 percent and 21 percent, respectively. That’s according to a University of California San Francisco study published in Health Affairs, which said that most people pay for the procedure out of pocket.

In other health news

  • Rep. Fred Upton (R-Mich.) said he will not seek reelection in November after more than three decades in office. Upton is a former chair of the House Energy and Commerce Committee and co-sponsor of the 21st Century Cures Act to boost medical research and ease drug approvals, our colleague Amy B Wang reports.
  • The monoclonal antibody, sotrovimab, is no longer authorized for use by the Food and Drug Administration after data suggested the current dose is unlikely to be effective against the BA.2 subvariant, which is now the dominant strain circulating in the U.S.
  • Biden’s second global covid-19 summit has been postponed, with one official saying the event could take place next month, Politico reports. 
  • The Environmental Protection Agency proposed to ban the most common type of cancer-causing asbestos, which is linked to about 40,000 U.S. deaths each year, The Post’s Anna Phillips reports.

Sugar rush

Thanks for reading! See y'all tomorrow.

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