Wednesday, November 18, 2020

HHS kills celebrity Covid campaign — 'Most Favored Nation' coming as soon as today — Distribution challenges await vaccine

Presented by the Partnership for America's Health Care Future: Delivered daily by 10 a.m., Pulse examines the latest news in health care politics and policy.
Nov 18, 2020 View in browser
 
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By Dan Diamond and Adam Cancryn

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Quick Fix

— HHS has scrapped a plan to use celebrities in Covid-19 ads and canceled the accompanying contract amid scrutiny and controversy.

President Donald Trump is set to announce a long-promised drug price plan to link U.S. government payments to international prices, although the rule may be stymied in court.

— The administration's pledge to quickly distribute coronavirus vaccines is facing significant operational and technical hurdles.

WELCOME TO WEDNESDAY PULSE — Where Duke University is being celebrated for its considerable efforts to keep Covid-19 rates low and keep school open. Its secret? In part, test, test and test some more, detailed in this new MMWR.

PULSE may have to rethink its long-held stance on those Cameron crazies. In the meantime, send tips to acancryn@politico.com and ddiamond@politico.com, and send cheers to the Blue Devils' basketball rivals.

A message from the Partnership for America's Health Care Future:

When it comes to what's next in health care, let's build on and improve what's working, where private coverage, Medicare and Medicaid work together, not start over with a one-size-fits-all new government health insurance system. Learn more.

 
Driving the Day

IT's OFFICIAL: HHS KILLS CELEBRITY COVID CAMPAIGNA senior official told a House watchdog that the administration has scrapped a planned ad campaign featuring celebrities discussing Covid-19, following an internal review prompted by POLITICO stories and Democrats' probes.

"The review has been completed," Sarah Arbes, the HHS assistant secretary for legislation, wrote on Friday to Rep. Raja Krishnamoorthi (D-Ill.), who chairs the House Oversight subcommittee on consumer and economic policy, in a letter shared with POLITICO. "The work with members of the entertainment industry conducted by Atlas Research will not continue and that contract will be canceled."

Atlas won a $15 million contract from HHS in August to produce public service announcements with celebrities, with political appointees pushing to get the ads on air. Democrats alleged that the ad push, part of a larger $300 million campaign to "defeat despair" about coronavirus, was an effort to boost perception of Trump's handling of the virus before Election Day.

The Atlas-run campaign never produced a single ad, securing interviews with just three celebrities, all of whom backed out amid scrutiny.

HHS' handpicked subcontractor, led by a business partner of HHS spokesperson Michael Caputo and which had never produced a public health campaign, also struggled to make inroads in Hollywood and meet the contract's deadlines.

The House Oversight Committee released documents last month that found hundreds of celebrities were vetted for their political views as part of the contract. And career officials also raised concerns that Trump appointees were viewing the planned ad blitz more like a political campaign than a public health effort.

Democrats applauded the administration's decision to cancel the contract, calling it a "thinly-veiled propaganda campaign to try to help President Trump politically."

"We are pleased that following our investigation, HHS finally pulled the plug on this corrupt scheme and committed to moving forward with a 'new approach' for educating the American people about the pandemic based on rigorous science and public health principles," House Oversight Chair Carolyn Maloney (D-N.Y.), coronavirus select panel chair Jim Clyburn (D-S.C.) and Krishnamoorthi said in a joint statement.

In a statement to POLITICO, Atlas defended its work, pointing to its track record across multiple administrations.

"It is unfortunate that the contract was cancelled, as much of the work we were focused on would have been beneficial as the country continues to deal with the COVID-19 pandemic," the Atlas statement read, in part. "We hope to have another opportunity to serve our fellow citizens by delivering life-saving public health messages in the midst of this unprecedented pandemic."

— Meanwhile: A separate $250 million ad campaign with FORS MARSH can move forward, HHS' internal review board determined. House Democrats have spent weeks probing the Fors Marsh contract too but haven't announced any irregularities.

"The public health need is urgent," Fors Marsh CEO Ben Garthwaite told POLITICO in a statement. "Our team is working quickly to conduct important market research and develop a comprehensive campaign to reach all Americans with an emphasis on those most affected by COVID-19."

PULSE's questions: Will the $15 million in taxpayer funds awarded to Atlas be recouped? HHS and Atlas didn't respond to those questions.

And while the value of public health messaging is clear, why did HHS' sweeping ad campaign follow such an unorthodox path from the start?

' MOST FAVORED NATION' IS IMMINENT — The Trump administration could announce a long-delayed plan to tie U.S. drug prices to an international index as soon as today, POLITICO's Sarah Owermohle and Dan Diamond report.

Senior officials worked through the weekend to craft a version of the policy that Trump plans to announce as soon as Wednesday — positioning it as an interim final rule to leapfrog the monthslong process of releasing a draft and gathering public feedback.

— It's not targeted at Pfizer, despite talk circulating on K Street that it's Trump's "revenge" on the company, two officials told POLITICO. But it is seen as a bonus that it hits the drug industry after Trump and his advisers contend Pfizer (and Moderna) sat on positive data about vaccines until after Election Day.

— And it may be legally DOA, with the White House scrapping a proposed rule last week in favor of what will be an interim final rule.

That approach has been panned by health legal experts, who are sure that the rule will be challenged in court on procedural grounds, and even administration officials question the legal justification.

"Leaving office and not having time to go through the right process, like a proposed rule, does not an emergency make," said one HHS official who's been briefed on the plan.

But expect Trump to tout it as a drug pricing win. The president promised to lower drug costs in his 2016 campaign, and after four years of oft-frustrated attempts, his administration is trying to put a final stamp on prices before the term is out.

THE NEXT VACCINE CHALLENGE: DISTRIBUTION Trump has pledged to deliver tens of millions of doses of Covid-19 vaccines to the state s as soon as December — an accomplishment that would mark the beginning of the end for a pandemic that's killed nearly a quarter-million Americans.

The only problem: States may not be ready. There are unresolved logistical challenges, little federal guidance about who should be prioritized for vaccination, ongoing technical spats between states and the feds, critical funding shortages and a growing vaccine hesitancy that health officials are still reckoning with, POLITICO's Dan Goldberg and Rachel Roubein report.

— No single issue is insurmountable. But taken together, they underscore just how difficult it will be for states to make good on the Trump administration's pledge to have needles in arms within 48 hours of the FDA authorizing a vaccine.

"If those vaccines were available today, I'm not confident that we could get even the first batch out," said Barry Bloom, an infectious disease expert and public health professor at Harvard.

 

HAPPENING THURSDAY - A CONVERSATION ON COVID-19, MENTAL HEALTH AND FLORIDA: The coronavirus pandemic—and the anxiety, isolation and disruption of routines and support that it has wrought—has exacerbated the mental health crisis in America. Join POLITICO for a forward-looking conversation on how we can emerge from this crisis with a strong approach to mental and behavioral health. Florida—one of the hardest-hit states in the nation—will be our case study. REGISTER HERE.

 
 


Eye on FDA

FDA GREENLIGHTS AT-HOME COVID TEST — The first at-home coronavirus test to receive FDA authorization generates results in 30 minutes or less, and can be used when a health provider suspects someone has Covid-19, POLITICO's David Lim reports.

The authorization is a milestone in the push to expand coronavirus testing, making it possible for people to test themselves outside of lab or health care settings.

— Lucira Health developed the at-home test, which correctly identified 94 percent of positive samples and 98 percent of negative samples in a study. The testing process involves swabbing the inside of the nose and then placing the swab in a vial and swirling it before putting the vial in a "test unit."

The FDA had previously granted emergency authorization for kits that let people take samples in their homes and send them to a lab for testing. But some public health experts have zeroed in on the potential of completely at-home testing, arguing it could help bring the pandemic under control.

— The lingering questions: How many tests Lucira can make, and how much it will cost. It remains unclear how fast the company can ramp up manufacturing. But on its website, Lucira says the the test is "intended to cost less than $50."

 

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In Congress

CONGRESS' COVID CAUCUS GROWS — At least five members of Congress have now tested positive for Covid-19 in the past week — just the latest sign of both the pandemic's resurgence across the country and Capitol Hill's particular vulnerability to the fast-spreading virus.

— The latest: CHUCK GRASSLEY. The 87-year-old Republican learned of his exposure on Tuesday, POLITICO's Marianne LeVine reports. Grassley is the second-oldest member of the Senate and its president pro tempore — meaning he's third in the presidential line of succession. His absence also means he snapped a record streak of nearly 9,000 uninterrupted votes dating back to 1993.

Rep. Ed Perlmutter (D-Colo.), who is 67, also announced on Tuesday that he'd tested positive, adding that he's currently asymptomatic and is isolating in his Washington, D.C., apartment.

— The running tally: 82. That's how many members of Congress have contracted Covid-19, quarantined or come into contact with someone with the disease this year, according to GovTrack. More than two dozen of those members tested positive or were diagnosed with a presumed infection.

— Congress continues to drag its feet on testing. The House only recently announced a significant expansion of Covid testing for lawmakers. But Senate leaders have not indicated whether they will follow suit.

Transition 2020

BIDEN's COVID TEAM STEPS UP TRANSITION PRESSURE — The leaders of Biden's coronavirus advisory board are appealing again for the Trump administration to officially begin the transition, warning that the delay is hurting its pandemic planning, POLITICO's Alice Miranda Ollstein writes.

The team remains locked out of federal agencies — meaning it has to rely on piecemeal data from state and local officials and public sources to track the virus' progression. That's prevented it from evaluating potential mask shortages and pinpointing hot spots, as well as readying for the distribution of Covid-19 vaccines.

Among the key federal metrics it needs to stand up a response: Real-time data on hospital bed availability, supply figures for items in the National Strategic Stockpile and nonpublic information on the status of coronavirus therapeutics.

— TODAY: Biden meets with frontline health care workers. The president-elect is hosting a virtual roundtable with health care workers in Wilmington, Del.

In the Courts

COURT REJECTS UNION DUES RULE FOR MEDICAID WORKERS — A California-based judge on Tuesday set aside a Trump administration rule making it harder for Medicaid home-health workers to unionize, POLITICO's Rebecca Rainey reports.

The 2019 rule sought to prohibit states from allowing a portion of Medicaid payments to providers to be diverted to unions that represent health care aides — forcing workers instead to opt in to having their union dues deducted from their paychecks or making contributions to a retirement fund.

In the order , U.S. District Judge Vince Chhabria ruled the administration made a "legal error" in issuing the rule. The administration said it determined the policy wasn't authorized by the Medicaid statute — but Chhabria said the law didn't provide any "clear prohibition" on deducting things like union dues from workers' payroll under the program.

A message from the Partnership for America's Health Care Future:

Today, 54 million Americans living with pre-existing conditions have access to care, almost 2.3 million young adults are able to stay on their parents' health insurance plans and nearly 150 million Americans have access to free preventative services with no out-of-pocket costs.

We still have work to do to ensure every American has access to affordable, high-quality health coverage and care. Let's build on and improve what's working in health care, where private coverage, Medicare and Medicaid work together to ensure every American is able to access the high-quality coverage and care they deserve – not start over. Learn more.

 
Safety

FIRST IN PULSE: SENIOR GOP MEMBERS ASK CDC TO EXPLAIN BIOSAFETY LAB CAPACITYHouse Republicans want the agency to clarify details about national BioSafety Level (BSL)-3 and Animal BSL (ABSL)-3 lab capacity, in a letter shared first with PULSE.

"It is critical for the nation's response to the pandemic to have the best understanding of the totality of such research assets," write Reps. Greg Walden, Michael Burgess and Brett Guthrie, who serve as the top Republicans on the Energy and Commerce committee and two of its subcommittees, respectively.

Labs with elevated safety protocols are necessary to perform research into Covid-19 vaccines and treatments. But the Republicans say that limited lab capacity appears to have stymied necessary research into coronavirus and could cause problems for future pandemics.

 

KEEP UP WITH THE GLOBAL HEALTH AGENDA IN 2021: If nothing else, the past year has revealed how critical it is to keep up with the politics, policy, and people driving global health. A new Biden administration comes with the expectation that America will reclaim its leadership on global health. But will it be that easy? What impact could Joe Biden's presidency have on global vaccine access and the international response to the pandemic? Our Global Pulse newsletter connects leaders, policymakers, and advocates to the people, and politics impacting our global health. Join the conversation and subscribe today.

 
 


What We're Reading

More than 900 Mayo Clinic staff have contracted coronavirus in the past two weeks, as the virus rages across the midwest, Paul John Scott reports for the Pioneer Press.

One in every 1,000 North Dakotans has now died with Covid-19, Adam Willis writes for the Grand Forks Herald.

Writing at Reason, Elizabeth Nolan Brown and Liz Wolfe compare what it's been like to move across the country during the pandemic, and how their experiences illustrate the nation's cultural and political divides.

 

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