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The Health 202

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

Climate change is increasingly viewed as a public health crisis

The Health 202

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

Happy Tuesday, everyone. Yes, there’s a band called the Affordable Rock ‘n’ Roll Act. And yes, a prominent geneticist and White House acting science adviser is a member (h/t Stat)

Today’s edition: The House will vote today on legislation to protect the families of Supreme Court justices. HHS Secretary Xavier Becerra has covid again, the second time in roughly a month. Many baby formula plants were inspected amid the pandemic. But first … 

The warming planet is a public health issue

For the first time, the American Medical Association adopted a policy declaring climate change a public health crisis. 

The nation’s largest physician trade group voted yesterday to put its lobbying heft behind policies aimed at limiting global warming and reducing greenhouse gas emissions. The AMA will also create a strategy detailing what physician practices and the health-care sector can do to combat climate change. 

This comes amid a growing sense that global warming is a threat to the health of people across the globe. And there’s a burgeoning sentiment that the health industry needs to be part of the response. 

The new efforts are coming from the nation’s health department — which recently established an Office of Climate Change and Health Equity, though Congress is yet to fund its work — on down to medical professionals who traveled to Scotland for this year’s United Nations climate summit. 

“Taking action now won’t reverse all of the harm done, but it will help prevent further damage to our planet and our patients’ health and well-being,” Ilse R. Levin, an AMA board member, said in a statement.

The latest

Here’s why advocates say climate change is a public health threat: Increasing temperatures have led to heat-related illness. Climate change has become a persistent danger to food security. El Niño weather patterns cause about 6 million children to go hungry — and could increase as the planet warms.

Over the years, there’s been a notable shift among the health profession in recognizing how rising global temperatures endanger the health of millions of people.

  • The National Academy of Medicine launched a public-private partnership to address the health industry’s environmental impact. As of April, more than 110 organizations have joined the effort.
  • Last year’s U.N. climate change conference framed the issue as a critical public health problem, our Climate 202 pal Maxine Joselow reported.
  • The World Health Organization referred to climate change as “the single biggest health threat facing humanity” in an October special report.
  • Health groups — including the AMA, America's Physician Groups and the American Academy of Nursing — signed onto a 2019 climate change agenda calling the issue “a true public health emergency.”
At the federal government

A case in point for how nascent some of the efforts are: The federal health department’s Office of Climate Change and Health Equity, which was created last summer, doesn’t yet have a dedicated pot of funding. (For a deep dive into that office, read more from Politico’s Sarah Owermohle.)

The Department of Health and Human Services recently established another venture. Late last month, HHS created the Office of Environmental Justice (OEJ), which will be housed inside the climate change office and tasked with tackling long-standing health issues disproportionately impacting marginalized communities, like pollution and other environmental health issues.

But since Congress hasn’t yet funded the effort, that has meant the growing staff — many of whom have previously worked in the environmental justice space — are detailed from other parts of the federal government. 

  • “Once we get our funding, we can actually do more, but we're going to do as much as we can, we're going to do all we can, to really put those communities first,” Sharunda Buchanan, the office’s interim director, recently told The Health 202

Among the office’s first tasks: Sifting through public comments, which are due at the end of the week, on a draft outline of HHS’s environmental justice strategy. The office is also working to find points of contact across the federal health department who are already working on environmental justice efforts to be part of a working group to implement the strategic plan.

  • “Environmental justice and health are inextricably linked,” Buchanan said. “If you find an environmental injustice, you’re likely going to find some health issue.”

Poll check

A majority of Americans say transgender women should stay out of women's sports

Most Americans oppose allowing transgender women athletes to compete against female athletes at the professional, college and high school level, according to a Washington Post-University of Maryland poll.

The poll, conducted among 1,503 people across the United States, finds 55 percent of Americans opposed to allowing transgender women and girls to compete with other women and girls in high school sports and 58 percent opposed to it for college and professional sports, Tara Bahrampour, Emily Guskin and Scott Clement write. About 3 in 10 Americans said transgender women and girls should be allowed to compete at each of those levels, while an additional 15 percent have no opinion.


On tap today: House leaders decided to avoid a brewing partisan fight over security arrangements for families of Supreme Court justices and employees. The chamber will vote today on a Senate-passed bill to extend security to family members of Supreme Court justices, but not family of judicial clerks or staffers.

The shift in strategy came after an unusual public ultimatum from Senate Minority Leader Mitch McConnell (R-Ky.) last night, who threatened passage of the House bill, The Post’s Mike DeBonis reports. “The security issue is related to the Supreme Court justices, not to nameless staff that no one knows,” McConnell told reporters yesterday in a rare Capitol hallway interview.


HHS secretary tests positive for the coronavirus — again

HHS Secretary Xavier Becerra tested positive for the coronavirus for the second time in roughly a month, HHS spokesperson Sarah Lovenheim said in a statement. 

The details: Becerra is currently experiencing mild symptoms and is not considered a close contact of either President Biden or Vice President Harris

Becerra initially tested positive for the virus on May 18, after which he was treated with Pfizer’s Paxlovid — an antiviral drug used to prevent severe illness from covid-19. Some patients who have taken the medication report experiencing a recurrence in their symptoms between 2 and 8 days after completing the treatment. Becerra’s latest positive test is less likely to be classified as a rebound since it falls outside that timeframe, according to HHS. 

Agency alert

Baby formula plants weren’t inspected because of covid-19

Federal regulators didn’t inspect facilities owned and operated by three of the nation's leading infant formula manufacturers — Abbott, Reckitt and Gerber — for up to two-and-a-half years due to the coronavirus pandemic, according to federal records reviewed by the Associated Press.  

The gap in formula plant inspections is under new scrutiny from lawmakers, who are investigating a series of missteps that led to a nationwide shortage and left parents scrambling for a way to feed their children. 

Key context: Federal law requires the Food and Drug Administration to inspect formula facilities every three to five years, but the agency has consistently inspected plants annually until the pandemic. When the agency pulled most of its safety inspectors from the field in 2020, it said it skipped about 15,000 formula plant inspections. 

One of those plants — a facility owned by Abbott Nutrition in Sturgis, Mich. — would later become embroiled in the heart of the national formula shortage after it was shut down for four months by federal regulators who alleged unsanitary conditions at the site. The plant reopened earlier this month. 

The FDA resumed regular inspections in July 2021 but has still yet to return to one key Reckitt plant and two owned by Gerber, according to agency records. All of those facilities are currently operating around-the-clock to boost U.S. formula production, AP’s Matthew Perrone writes. 

HHS lays out post-pandemic audio-only telemedicine guidelines

The federal health department yesterday released new guidelines explaining how health-care providers can stay in compliance with federal medical privacy laws when offering audio-only telemedicine services, including once regulatory flexibilities allowed during the pandemic lapse. 

To comply with the Health Insurance Portability and Accountability Act (HIPAA), health-care workers should conduct appointments in private settings and take steps to verify their patients’ identity, among other safeguards. 

  • The rule does not apply to telemedicine conducted over landlines because the information transmitted is not electronic, unlike mobile technologies that rely on cellular and WiFi networks.

Key context: To quickly expand the availability of remote health-care services in the early days of the pandemic, the agency said it would not impose penalties against telemedicine providers attempting to comply with HIPAA in “good faith.” That policy is expected to end either when HHS lifts its covid-19 public health emergency declaration or it is allowed to expire

Why it matters: Audio-only telehealth has emerged as a critical tool to address virtual care disparities and reach patients in rural communities, individuals with disabilities and those without access to the internet.

Reproductive wars

In Missouri, battles over birth control foreshadow a post-Roe world

Missouri could become the next front in the battle over birth control — and may portend what’s to come from other states in a post-Roe world, the New York Times reports. 

Some state GOP lawmakers have signaled that they may attempt to revive a failed effort to ban taxpayer funding for two common methods of preventing pregnancy: intrauterine devices and emergency contraception, also known as Plan B, should Roe fall.

Experts say the demise of Roe would make the need for effective birth control more urgent than ever. But nearly six decades after the Supreme Court guaranteed the right to contraception — and over a decade after the Affordable Care Act required private insurers cover it — birth control is still not accessible to all Americans.

National leaders in the antiabortion movement say their next push will be to ban medication abortion, and that birth control isn’t on their radar. Some Republicans on the far right have sought to limit access to emergency contraception.

But still, birth control access in Missouri and in other states may be getting harder. In February, the state became the fourth in the nation to eject Planned Parenthood from its Medicaid program, in a move the organization says violates federal law, Sheryl Gay Stolberg reports.

Meanwhile, on Capitol Hill … Congressional Democrats are pushing to expand access to birth control. Last week, they introduced legislation to require insurers to fully cover any FDA-approved birth control pills, including emergency contraception.

More from Sheryl:

Health reads

Covid is making flu and other common viruses act in unfamiliar ways (By Frances Stead Sellers | The Washington Post)

Walensky’s secret coach (By Alex Thompson, Adam Cancryn and Max Tani | Politico)

New York state to protect abortion providers under new laws (By Marina Villeneuve | The Associated Press)

Sugar rush

Thanks for reading! See y'all tomorrow.