Monday, November 30, 2020

Biden's fresh economic take on Covid — The resurgent drug addiction crisis — Vaccine distribution questions loom

Presented by PhRMA: Delivered daily by 10 a.m., Pulse examines the latest news in health care politics and policy.
Nov 30, 2020 View in browser
 
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By Dan Diamond and Adam Cancryn

Presented by

With Susannah Luthi and Dan Goldberg

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Quick Fix

— President-elect Joe Biden's newly named economic advisers are poised to sound a different tone on the pandemic than President Donald Trump's team.

— Biden's also set to inherit a resurgent drug addiction crisis that experts warn has worsened during the pandemic.

— Major decisions are looming on Covid-19 vaccine distribution, with significant authority falling to the states.

IN PRAISE OF JOANNE KENEN — POLITICO's esteemed health care editor is officially moving to a new role as editor at large, where she'll be doing more writing while staying closely involved in projects.

It's impossible to conceive of the health policy beat in Washington without acknowledging Joanne's role in shaping it. Joanne's hired several dozen health care editors and reporters who have since fanned out (including both PULSE co-authors and the author of the Washington Post's own health care newsletter), and she's a well-known speaker at outlets like KHN's "What the Health" podcast.

So what's next for the irrepressible Joanne? PULSE is eagerly anticipating her coming work. Meanwhile, if you've got tips on your own moves around the beltway, flag ddiamond@politico.com and acancryn@politico.com.

 

A message from PhRMA:

Today, there are several promising vaccine candidates in stage three clinical trials. These trials have tens of thousands of participants, from every walk of life. From development to robust clinical trials, and throughout manufacturing, these vaccine candidates follow the same rigorous process of other vaccines that have saved millions of lives. More.

 
Driving the Day

BIDEN's ECONOMIC TEAM: A SHARED FOCUS ON COVID, INEQUALITY The president-elect's picks for key White House economic positions, which were reported on Sunday , share a philosophy on prioritizing the virus and addressing disparities.

"Until COVID is controlled, we can't return to business as usual — one vs. the other is a false tradeoff," Heather Boushey, who leads the Washington Center for Equitable Growth and is set to join Biden's Council of Economic Advisers, tweeted last week.

Cecilia Rouse, tapped to be CEA chief, and Jared Bernstein, also chosen for a CEA seat, have similarly been vocal champions of more relief to prop up the economy amid the outbreak, as well as calling for targeted aid to the most vulnerable sectors.

That's a departure from Trump's economic team, which often battled with public health experts in the White House and repeatedly dismissed the risk of coronavirus surges.

THE HIRE THAT's GETTING THE MOST ATTENTION: NEERA TANDEN FOR OMB CHIEF — A Tanden-led OMB would likely play an outsized role in policymaking and could be a signal of how the White House will rely on executive authority to achieve its objectives, Biden allies told PULSE.

If Tanden gets the Senate-confirmed job — more on that below — she'd have her hands on all the major rules coming out of the Biden administration, a role drawing on her experience as leader of the Center for American Progress and as a veteran of two previous administrations.

She's also struck a pragmatic balance on policy, such as the liberal think tank's rollout of a Medicare expansion plan last year that was less transformative than Medicare for All, seeking to preserve employer-sponsored health insurance. "I don't apologize for having a plan that meets progressive goals like universal coverage and addresses broad interests ... like lowering health care costs all while maintaining choice," Tanden said on POLITICO's "Pulse Check" podcast last year.

The pick got kudos from leading progressives like Stacey Abrams and Democrats who have worked with Tanden.

"Neera is formidable," said Brookings' Kavita Patel. "She knows her way around the West Wing, executive office and all the agencies — and her background in health makes her an incredible asset in the fight against COVID and its aftermath."

— She also understands the virus' toll. Tanden contracted Covid-19 this summer and has spoken about suffering days of fatigue, dealing with a hazy memory and grappling with the uncertainty about taking a turn for the worse.

"I ended up being ill for six weeks," Tanden wrote in USA Today in October. "It made it absolutely clear to me that the idea people infected with coronavirus are fine as long as it isn't fatal, or suffer a short, mild bout of illness when they contract the virus, is a misconception."

— But it's going to be a confirmation battle in a narrowly divided Senate. Tanden's outspoken criticism and often blunt remarks, including on Twitter, have made her a target of both the left and right. Zaid Jilani, a progressive journalist who worked as a staff writer on CAP's now-defunct ThinkProgress, shared criticism of Tanden's management style. "To manage a govt agency you can't constantly antagonize people publicly/privately," Jilani wrote.

"Neera Tanden, who has an endless stream of disparaging comments about the Republican Senators' whose votes she'll need, stands zero chance of being confirmed," tweeted Drew Brandewie, the communications director for Sen. John Cornyn (R-Texas).

JEFF ZIENTS IN MIX TO BE COVID CZAR — Zients, who led OMB during the Obama administration and helped oversee the HealthCare.gov repair job, is a finalist to be Biden's manager of the coronavirus response, POLITICO Playbook first reported last week.

Zients also served as CEO of the Advisory Board, a health care research and consulting firm (where one of your co-authors previously worked, albeit with very limited exposure to Zients).

BIDEN'S OTHER HEALTH CRISIS — The president-elect will inherit not only a global pandemic but a resurgent drug addiction crisis that federal officials say is spiraling out of control, POLITICO's Dan Goldberg and Brianna Ehley report.

"Since the pandemic hit we have not been able to control the opioid epidemic," Nora Volkow, the long-serving director of the National Institute on Drug Abuse, said in an interview. "Our vulnerabilities have just gotten worse."

More than 76,000 people died of a drug overdose between April 2019 and April 2020, according to the most recent preliminary federal data, the most ever recorded during a 12-month period.

— Just how much the pandemic has exacerbated the drug crisis this year is still coming into view. Ohio recorded 543 overdose deaths in May, the most ever in a single month. Oregon reported a 70 percent increase in the number of overdose deaths in April and May compared to the same two months in 2019. In Maine, overdose deaths during the first half of 2020 were up 27 percent from the previous year. Spikes have also been documented in Colorado, Kentucky and Louisiana.

 

TRACK THE TRANSITION: President-elect Biden has started to form a Cabinet and announce his senior White House staff. The appointments and staffing decisions made in the coming days send clear-cut signals about Biden's priorities. Transition Playbook is the definitive guide to one of the most consequential transfers of power in American history. Written for political insiders, it tracks the appointments, people, and the emerging power centers of the new administration. Track the transition and the first 100 days of the incoming Biden administration. Subscribe today.

 
 


White House

THE VAX DISTRIBUTION PLAN — The Trump administration has told states that they have ultimate authority for determining who gets vaccinated first. It has also decided to allocate scarce early doses based on states' total populations, forcing hard choices in states with a greater proportion of residents at high risk — including Black, Indigenous and Latino communities that have suffered disproportionate rates of hospitalization and death from Covid-19, POLITICO's Sarah Owermohle, Rachel Roubein and Zachary Brennan write.

Public health experts say that could undermine already shaky public confidence in the vaccine effort, whose success depends on convincing large numbers of Americans to get immunized.

"States are going to have to pick and choose who gets the first doses," said Josh Michaud, an associate director for global health policy at Kaiser Family Foundation who has reviewed nearly every state's distribution plan. "It's very obvious that states are in different places when it comes to planning and identifying who those people are."

MONCEF SLAOUI MAY DEPART SOON — The Operation Warp Speed head may step down from the government's coronavirus vaccine and treatment accelerator "by the end this year or early next year," he told Zachary in an interview last week.

 

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In Congress

MITCH McCONNELL: WE'LL SUSPEND GOP IN-PERSON LUNCHES — The Senate Majority Leader informed the GOP caucus of the decision Saturday afternoon amid the recent uptick of Covid cases, POLITICO's Marianne LeVine reports.

Senate Republicans have been holding socially distanced lunches in the Senate Hart building since May. Senate Democrats, meanwhile, have held their weekly caucus lunches over the phone.

— PULSE's question: Why were in-person lunches still going on amid the pandemic?

INDUSTRY GROUPS LINE UP FOR FINAL PUSH ON SURPRISE BILLING BAN — Insurers and employers are trying to capitalize on recent congressional talks around an end to "surprise" medical bills and other key reforms, POLITICO's Susannah Luthi and Rachel Roubein report.

Congressional leadership and health committees have met repeatedly in recent weeks to try to reach a long-elusive compromise amid the lame-duck window.

— Ad blitzes coming: A coalition of employers, insurers and unions is launching a D.C.-focused six-figure ad campaign accusing private equity health companies of helping to stymie the compromise reforms.

The move follows a letter last week from a broad coalition of employer groups urging Congress' leaders to move a package with the end-of-year spending bill.

— Fresh optimism after a long, tiring ride. Retiring Senate HELP Chair Lamar Alexander (R-Tenn.) and Sen. Bill Cassidy (R-La.) recently teamed up to tout a compromise between Alexander's sweeping reforms and Cassidy's more physician-friendly solution. While the lawmakers haven't released legislative text yet, the recent leadership meetings have raised hopes that the hold-out House Ways and Means Committee will get on board with this proposal, Susannah and Rachel tell PULSE.

— The caveat: Neither chamber has passed legislation, and industry sources familiar with the meetings say that Ways and Means hasn't signed off on a compromise yet. Lawmakers have a very narrow window to come up with an agreement to hitch a ride on a year-end package — even as staggering medical bills for coronavirus treatment have underscored the need for action.

 

A message from PhRMA:

America's biopharmaceutical companies are making great progress against a common enemy – COVID-19. They're learning from successful vaccines for other diseases, developing new treatments and collaborating like never before.

Today, there are several promising vaccine candidates in stage three clinical trials. These trials have tens of thousands of participants, from every walk of life. From development to robust clinical trials, and throughout manufacturing, these vaccine candidates follow the same rigorous process of other vaccines that have saved millions of lives.

America's biopharmaceutical companies are working day and night until they defeat COVID-19. Because science is how we get back to normal.

 


In the Courts

TRUMP ADMINISTRATION APPEALS APPROVAL OF ACA RUNAROUND PLAN — The Labor Department on Friday appealed a Texas district court's approval of a plan that could let swathes of people leave Obamacare, and that has the backing of seven GOP state attorneys general as an alternative to the individual market, Susannah writes.

The plan was developed in 2018, when a Georgia data-marketing firm teamed up with a Texas company to forge a large self-insured health plan under federal employer laws that aren't bound by the same stringent requirements as the Obamacare markets. In exchange for letting the Georgia firm LP Management Services track all their web data, people could sign up for the plan as qualifying employees.

The Labor Department had already axed the effort, but Judge Reed O'Connor — known for his high-profile rulings favored by the Trump administration — overruled the department, saying the concept mirrored the Trump administration's association health plans.


 

NEXT WEEK - DON'T MISS THE MILKEN INSTITUTE FUTURE OF HEALTH SUMMIT 2020: POLITICO will feature a special edition Future Pulse newsletter at the Milken Institute Future of Health Summit. The newsletter takes readers inside one of the most influential gatherings of global health industry leaders and innovators determined to confront and conquer the most significant health challenges. Covid-19 has exposed weaknesses across our health systems, particularly in the treatment of our most vulnerable communities, driving the focus of the 2020 conference on the converging crises of public health, economic insecurity, and social justice. Sign up today to receive exclusive coverage from December 7–9.

 
 
What We're Reading

CDC advisers have called an emergency meeting for this week to vote on who should get Covid-19 vaccines first, CNN's Maggie Fox and John Bonifield report.

Every open bed inside a Wisconsin hospital fighting coronavirus is a "gift," WaPo's Lenny Bernstein reports.

From Brazil to Yemen, the Lancet offers a tribute to some of the physicians around the globe who have died battling the pandemic.

 

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