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The Health 202

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

Democrats are searching for a health-care win this month

The Health 202

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

Good morning, happy Monday. ☀️ If you’re wondering the potential impact of miscommunication over a news release, look no further than President Biden’s Build Back Better. Send tips and scrapped press releases to rachel.roubein@washpost.com.

Today’s edition: A more traditional coronavirus shot is on its way, as FDA advisers are slated to debate Novavax’s vaccine this week. The baby formula plant at the center of the shortage resumed production. But first …

Mental health, an economic package and covid funding are on the table

Welcome to Congress’s very tough June. 

  • A bipartisan group of senators is searching for compromise on a long-elusive gun package, which may include new spending on mental health.
  • Democrats don’t have much more time to strike an agreement on a framework for a scaled-back economic package.
  • Congress will need to rework parts of its still-stalled coronavirus aid package as White House officials plead for more dollars.

The three-week work period before July Fourth recess is a particularly perilous time for Democrats. Roughly a year and a half into their majority rule, the party is searching for something they can point to as a win on health care ahead of the midterms — a far cry from the sweeping reforms promised during the 2020 election.

Mental health

There’s growing momentum on Capitol Hill around delicate talks to craft a bipartisan response to recent mass shootings. Expect efforts around guns to be an intense focus the next few weeks, though any effort is likely to fall short of the parameters President Biden laid out Thursday, The Post’s Mike DeBonis reported last night.

House Democrats are gearing up to vote on bills that aren’t expected to pass the Senate. But on the other side of the Capitol, lawmakers are hashing out a more narrow bipartisan compromise with the goal of forging a deal by the end of this week. The Senate group is also working to find agreement on new spending for mental health. 

  • “There's a number that's too low, that wouldn't be significant enough for many colleagues who want to see a big mental health title,” Sen. Chris Murphy (Conn.), the lead Senate Democrat working on the gun compromise, told our pals at The Early 202. “There's also a number that's too big, that would cause some conservatives to balk.”

They’re not the only lawmakers working to craft mental health legislation. During the week of June 20, the House will vote on bills from the House Energy and Commerce Committee and the House Education and Labor Committee. And the Senate Finance Committee is eyeing a potential markup of its upcoming package before August recess, and may release more discussion drafts of various components of the bill before the Fourth of July break, according to two Senate aides.  

More from Mike:

An economic package

It’s crunch time, yet again, for Democrats to secure a deal on a scaled-back economic package.

The latest: Talks have been rekindled between Sen. Joe Manchin (D-W.Va.) — an obstacle to the legislation — and Senate Majority Leader Chuck Schumer (D-N.Y.), our colleagues Jeff Stein and Tyler Pager reported over the weekend. (Read their deep dive on how the White House lost Manchin on a more sweeping plan to transform America.)

But can a new framework be hammered out before July Fourth? That’s TBD.

Manchin doubled down last week on his support for Democrats’ drug pricing proposals. Advocates also think extending enhanced financial aid for those who buy Obamacare plans is ripe for inclusion. In recent weeks, state marketplace officials have told Congress they ideally need to know by July whether the boosted subsidies will continue. And there’s really not a ton of time left on the congressional calendar before the midterms.

  • “The health-care components are the most popular parts of it, and it’s really important for Democrats politically to get it done,” said Eliot Fishman, the senior director of health policy at Families USA, a left-leaning consumer health lobby.
Covid cash

The path to passing billions more dollars in pandemic aid has gotten even more complicated.

For one, a deal would need to be renegotiated. Back in April, the Senate clinched a $10 billion deal that repurposed funding from previous stimulus packages. But some of that money has now been spent since the package has languished for over two months, according to a Senate GOP aide. Bloomberg News was the first to report that some of the pay-fors have dwindled.

Backlash to the Biden administration’s decision to relax pandemic restrictions at the border — which a federal judge has since halted — stalled the compromise. Republicans refused to move forward without a vote on keeping the public health order in place. 

Now there’s also the issue of which chamber would move first. Late last month, Schumer reiterated the “urgency” to passing more dollars, but said “we’re waiting for the House to send us something.”

Meanwhile, the “greatest obstacle” to coronavirus funding is the Senate’s 60-vote threshold to approve the new aid, a senior House Democratic aide told The Health 202. 

Politico's Burgess Everett:

Coronavirus

A more traditional coronavirus shot is on the way

A new vaccine that relies on decades-old technology is on the verge of being authorized by the federal government more than a year after Americans began receiving cutting-edge coronavirus shots, our colleague Carolyn Y. Johnson reports

If federal regulators green light the shot, developed by the Maryland biotechnology company Novavax, it will become the fourth coronavirus vaccine in the nation. For company executives, one of the shot’s main selling points has been the promise of helping to close the vaccine hesitancy gap among some Americans who might be holding out for a more traditional shot. 

The newer mRNA vaccines instruct cells inside the body to build the coronavirus spike protein. Novavax, by contrast, employs an older, more familiar technology that manufactures and purifies the coronavirus spike proteins in a laboratory. 

  • But yet… Hopes were dashed Friday that the vaccine would offer an alternative for people worried about rare heart inflammation associated with mRNA vaccines, after an FDA review found five cases, mostly among men, within two weeks of being vaccinated in the company’s trials, “raising concern for a causal relationship.”

The Novavax vaccine is poised to hit the U.S. market as more than three-quarters of people 18 and older are already fully vaccinated. The company plans to seek expanded authorization for use of the shot in adolescents and as a booster. 

Industry Rx

Baby formula plant at heart of shortage reopens

Abbott Nutrition resumed production at its shuttered Sturgis, Mich., baby formula factory, a sign that the nationwide shortage that left parents scrambling to find sustenance for their children could ease in the coming weeks, The Post’s Laura Reiley reports. 

The company said Saturday that it was reopening the factory “after meeting initial requirements” laid out by the Food and Drug Administration last month, which included obtaining an independent expert to review operations and compliance with the law.

  • Key context: The plant, which is one of the country’s leading producers of specialty formula, was closed this year after an inspection by the FDA alleged unsanitary conditions. Its closure severely curtailed the nation's formula supply.

Next steps: Abbott said previously that it would take two weeks for production to fully resume and an additional six to eight weeks to get the product on store shelves. The plant will prioritize the production of EleCare, a specialty formula for children with multiple allergies, before it ramps up production of mainstream products. The company said it expects to release EleCare “to consumers beginning on or about June 20.”

More from Abbott:

What we're watching

Long covid could change the way America thinks about disability

The coronavirus pandemic has created a mass-disabling event and has the potential to have lasting effects on health policy in the United States, The Post’s Frances Stead Sellers reports. 

Yet, the influx of individuals with disabilities has also underscored the challenges of creating common cause among people who have sometimes battled over limited resources. 

Those tensions resurfaced as some who share similar symptoms with covid long-haulers, including persistent fatigue, saw research dollars pour into long covid. Some advocates emphasized the importance of joining forces, believing that long covid patients could help force the conversation of more resources out into the open.

Key context: As many as 61 million adults in the United States live with some form of disability, per the Centers for Disease Control and Prevention. Those numbers are being bolstered by between 7 and 23 million long-haulers — including a million who can no longer work — according to recent government estimates.

The pandemic has provided some evidence of new legislative attention to disabilities: While there was minimal reference in the initial covid relief bills, the American Rescue Plan — passed last year — provided direct support for programs that assist people with disabilities. Democrats' now-defunct Build Back Better bill attempted to go even further. 

In other health news

  • The D.C. health department yesterday said it had identified the district’s first potential case of monkeypox in a resident who had recently traveled to Europe. The case is currently under review by the CDC for further confirmation.
  • The Justice Department is cracking down on companies that it alleges are adding outdated and irrelevant diagnoses to Medicare Advantage beneficiaries’ medical records to increase profits, our colleague Christopher Rowland writes.
  • Former hedge fund CEO David McCormick on Friday conceded to Mehmet Oz in the Republican primary for U.S. Senate in Pennsylvania, clearing the way for the celebrity doctor backed by former president Donald Trump to advance to the general election, per The Post’s Hannah Knowles.

Daybook

Here’s what’s on tap this week:

Tuesday: FDA advisers will debate whether a shot developed by the Maryland biotechnology company Novavax is safe and effective. 

Wednesday: The Senate HELP Committee will mark up its FDA user fee reauthorization package. Lawmakers will also consider legislation aimed at increasing the flexibility in how community health centers can use their grant dollars. 

Health reads

Inside John Fetterman’s changing health-scare story (By Michael Scherer and Hannah Knowles | The Washington Post)

Baby formula shortage life-threatening for some older kids and adults (By Frances Stead Sellers | The Washington Post)

Equal mental health insurance coverage elusive despite legal guarantee (By Lenny Bernstein | The Washington Post)

Sugar rush

Thanks for reading! See y'all tomorrow.

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