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The Health 202

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

GOP balks at covid funding after Biden declares pandemic is over

The Health 202

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

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Today’s edition: Puerto Rico’s medical providers are gearing up to respond to Hurricane Fiona’s devastation. House Democrats are introducing legislation aimed at shoring up abortion access for servicemembers. But first …

Democrats are pushing for covid funds in a stopgap bill this month, but that's off the table for some GOP

President Biden’s impromptu remarks that the “pandemic is over” are complicating an already arduous path for more coronavirus aid on Capitol Hill.

Congressional Republicans are seizing on the comments as they continue to question the necessity of funding the administration’s $22.4 billion request for more testing, treatments and next-generation vaccines. This comes as congressional negotiators are hashing out the details of a stopgap spending bill to keep the government’s lights on past Sept. 30 — and top White House officials have pushed lawmakers to attach more money for covid-19 to the must-pass vehicle.

  • “The president said the pandemic is over,” said Sen. Richard Shelby (Ala.), the top Republican on the Senate Appropriations Committee, adding that covid funding wasn’t the highest priority. One Senate GOP aide, who spoke on the condition of anonymity to be candid, went as far as to say it’s off the table, while Democrats said negotiations on a short-term spending bill are ongoing.

The administration's ask earlier this month for more dollars was already a long shot. The GOP has been reluctant to approve more funding without securing a way to finance the new spending, and has been wary of the need for more dollars as the administration shifts existing funds in recent months.

Some federal officials sought to add nuance yesterday to Biden’s comments on “60 Minutes,” touting the country’s progress but acknowledging that challenges still persist, our colleague Dan Diamond reports. Over 30,000 Americans are hospitalized with covid-19, and more than 400 are dying each day from the virus, according to seven-day averages tracked by The Post.

Josh Michaud, of the Kaiser Family Foundation:

The prospects

Since the spring, covid aid has been mired in politics.

A quick refresher: In March, House Democrats stripped covid aid from a broader package to fund the government after some in the party were upset over an effort to redirect money set aside for some state governments to address their pandemic needs. A few weeks later, a bipartisan deal came together in the Senate, but hit a snag when Republicans insisted the chamber vote on keeping pandemic border restrictions in place.

Even before Biden’s comments, a breakthrough on the six-months-long impasse didn’t appear to be in sight. Yet, the president’s remarks gave further ammo to Republicans resisting the new spending.

Well, if it’s over, I wouldn’t suspect they need any more money,” Sen. John Cornyn (R-Tex.) quipped.

More from Dan:

But some Democrats pushed back on the GOP’s argument, contending it’s an oversimplification of Biden’s remarks.

  • “He made it clear that his comment was, ‘here we are at a large public event where people aren't wearing masks,’ not we are done with covid,” Sen. Chris Coons (D-Del.) told The Health 202. “He makes it clear that he understands there is still significant work to do with regards to public health both in our country and around [the world].”
  • A senior Democratic aide, who spoke on the condition of anonymity to describe negotiations, said Republicans are “very resistant” to more funding to combat the coronavirus, but that “Biden’s point is obviously what is possible when we have the tools and resources to keep covid in check, which Republicans are jeopardizing.”
Beyond covid aid

Some Republicans are swinging even wider, pushing back on other long-standing pandemic-era programs.

In a letter to Biden, Sen. Richard Burr (N.C.) — the top Republican on the Senate health committee — demanded details on when the administration would end the emergency declarations for covid-19 and halt vaccination requirements for federal workers and contractors, Dan notes. Burr requested a response by Sept. 30; the White House didn’t comment on the letter by our publication time this morning.

Top health officials have said they would give states 60-days notice before ending the public health emergency declaration, meaning it’s on track to be renewed another three months when it expires in October.

Meanwhile, some public health experts worry the messaging could make it difficult to convince a pandemic-weary public to get doses of a new booster shot targeting omicron.

“If I'm somebody in the public who’s already confused about this pandemic, and I just hear the president tell me that it's over with, why am I going to go get a booster shot?” Michael Osterholm, who leads the University of Minnesota’s Center for Infectious Disease Research and Policy and advised Biden’s transition team, said.

Sarah Lovenheim, Department of Health and Human Services spokesperson:

In the territories

Puerto Rico’s medical providers confront Hurricane Fiona

Health-care providers in Puerto Rico are racing to respond to victims of Hurricane Fiona, which, since making landfall Sunday, has resulted in “catastrophic” flooding, the evacuation of hundreds of people across the island and the deaths of at least two residents.

Fiona struck two days before the fifth anniversary of Hurricane Maria, the Category 4 storm that left Puerto Rico in the dark for months, killing more than 3,000 people.

State-of-play: Currently, all but two medical facilities across Puerto Rico have regained power, since hospitals are now required by law to be equipped with backup generators to supplement the storm-battered island’s power grid, Gov. Pedro Pierluisi (D) said at a news conference yesterday. He added that everything has been working as it should in terms of the island’s medical facilities.

Pierluisi announced at the same briefing that he had signed a new executive order granting immunity to all medical personnel who assist in the emergency, in an effort to encourage all local providers to get involved with relief efforts. The order also temporarily expanded prescriptive authorities to include health-care providers other than primary care doctors to ensure displaced residents can access their medication.

Zooming out: Officials emphasized they are accepting aid in the form of first responders, but do not need other forms of humanitarian support at this time. 

Biden promised Pierluisi yesterday that the number of federal support personnel in Puerto Rico would “increase substantially” beyond the 300 rescue workers currently assisting on the ground. Biden on Sunday approved Puerto Rico’s emergency declaration, freeing up additional resources and authorizing the Federal Emergency Management Agency to coordinate disaster relief efforts. The agency’s administrator, Deanne Criswell, will travel to the island today, The Post’s Amy B Wang reports.

More from Biden:

On the Hill

First in The Health 202: Democrats want to shield female servicemembers from abortion retaliation

Democratic Reps. Jason Crow (Colo.) and Jackie Speier (Calif.) are introducing legislation aimed at codifying and expanding existing Army and Air Force policies preventing commanders from denying servicemembers leave because they were seeking an abortion.

Key context: It can be complicated for women in the military to get an abortion. Military treatment facilities don’t perform the procedure except in the cases of rape, incest and when the patient’s life is at risk. They also may need to travel when stationed in states where the procedure is restricted. The bill is the latest push by Democrats to protect abortion access for women in the military.  

If passed, the legislation would:

  • Consider abortion as time-sensitive, and therefore approve leave.
  • Allow servicemembers to request and receive leave without disclosing to the commander the nature of the procedure.
  • Require the Defense Department to reimburse travel expenses when abortion care is not provided in a servicemember’s jurisdiction.
  • Prohibit retaliation against any servicemembers who request leave under the legislation’s parameters.

Rep. Jason Crow (D-Colo.): 

Industry Rx

Centene will pay Texas $166M in Medicaid drug pricing settlement

The major health insurer will pay Texas $165.6 million to resolve claims that it overcharged the state’s Medicaid program for pharmacy services, Kaiser Health News reports.

This isn’t the first time St-Louis based Centene has settled pharmacy billing claims. The agreement makes it at least the 12th state to do so. 

But it’s the largest known payout from the nation’s largest Medicaid insurer specifically over its drug pricing practices. The deal — which was signed July 11 — hadn’t been made public until KHN obtained a copy of the settlement through a Texas public records request. 

The company didn’t respond to multiple requests for comment from KHN’s Andy Miller and Samantha Young. 

In the past, it’s denied wrongdoing in several settlements, with a top official last year saying settlements in Ohio and Mississippi reflected the company’s “commitment to making the delivery of healthcare local, simple and transparent.”

In other health news

  • On the move: David Merritt has been named the Blue Cross Blue Shield Association’s new senior vice president of policy and advocacy. He currently leads public affairs and strategic initiatives at AHIP, the major insurer lobby.
  • On the move: Jeanette Thornton was promoted to serve as AHIP's new executive vice president of public policy and strategy. The association also announced that, following the departure of Merritt, Kristine Grow will become interim leader.
  • A review of the Food and Drug Administration’s actions and decisions on opioids will be conducted by a group of external experts associated with Ohio State University, the agency’s commissioner, Robert Califf, announced in a series of tweets detailing the initiative yesterday.
  • The Title X family planning program served an additional roughly 126,000 Americans last year, according to a recent Department of Health and Human Services Office of Population AffairsFamily Planning Annual Report.

Health reads

Minimal compliance, or meaningful change? Epic faces a crossroads as new rules put pressure on health data sharing (By Casey Ross and Mohana Ravindranath l Stat)

Medicare is using one of its biggest hammers to try to fix the dialysis system: how providers are paid (By Isabella Cueto | Stat)

A Rural Doctor Gave Her All. Then Her Heart Broke. (By Oliver Whang | The New York Times)

Sugar rush

Thanks for reading! See y'all tomorrow.