News : Trump's closing argument: I'll fire Fauci — Biden's closer on covid: I'm not Trump — Georgia gets permission to quit HealthCare.gov

Monday, November 2, 2020

Trump's closing argument: I'll fire Fauci — Biden's closer on covid: I'm not Trump — Georgia gets permission to quit HealthCare.gov

Nov 02, 2020

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By Dan Diamond and Adam Cancryn

Presented by

With Susannah Luthi

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Quick Fix

— President Donald Trump suggested he'd soon fire infectious-disease expert Anthony Fauci in rally remarks on Sunday night.

— The Trump administration gave Georgia permission to quit HealthCare.gov, an unusual Sunday decision coming on the same day that Obamacare markets opened.

— The president's promised drug cards remain in limbo, and there's no definite plan to roll them out after the election, three officials told POLITICO.

WELCOME BACK TO ELECTION WEEK — Less than 24 hours to Election Day. Ten weeks to Inauguration Day. And tips to PULSE at 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

TRUMP's CLOSING ARGUMENT ON COVID: I'LL FIRE FAUCI — That's what the president hinted at a Miami-area rally on Sunday night, after the crowd chanted for Trump to fire the renowned government scientist.

"Don't tell anybody, but let me wait til a little bit after the election," Trump responded, going on to allege that Fauci had "been wrong on a lot." See video.

While Fauci has civil service protections that would prevent his abrupt firing, Trump has pushed to weaken those protections across government. Trump's remarks came after the White House spent the weekend attacking Fauci for an interview he did with the Washington Post. (More on that below.)

Trump has previously suggested to his campaign staff that firing Fauci — whose public approval rating on the virus is far better than his own — could backfire politically.

— Trump also spun his optimistic view on the virus in stump speeches and in swing states across the weekend, asserting again and again that the pandemic is waning and a vaccine is imminent.

"We'll eradicate more quickly the virus, wipe out the China plague once and for all," Trump said in Pennsylvania on Saturday, one day after the state appeared to hit a record number of new daily cases. "And it's back to work, back to work, back to work which is what we want," the president said.

And in Michigan on Sunday — one day after that state also recorded a record number of new coronavirus cases — Trump insisted that the country is "rounding the turn."

— The reality is that the pandemic is worse than ever, with the United States recording nearly 100,000 new cases per day, which appears to be a world record for any country. Anad while the death rate has declined, there are still nearly 1,000 Americans dying per day from Covid-19.

Meanwhile, most Americans likely won't have access to a coronavirus vaccine until next year, experts have cautioned, and it's still not clear when the first vaccine will be authorized. And Trump's rival Joe Biden continues to hammer the administration for its handling of the virus, with polls showing that more than half of voters disapprove of Trump's response. Fifty-five percent of registered voters also say the worst of the coronavirus is yet to come, according to an NBC News/Wall Street Journal national poll released Sunday

— Trump also reiterated his baseless claim that "doctors get more money if someone dies from Covid," aggravating medical groups and driving headlines throughout the weekend. A senior adviser, Jason Miller, also amplified the accusation Sunday.

"I intubated a relatively healthy 86 year old man with covid in the ER at 4:30 this morning," emergency physician Daniel Tonellato tweeted on Sunday . "He was alone, I was the last person he spoke with and he was confused. He'll likely die in the ICU, alone. I don't make any extra money for that @realDonaldTrump"

BIDEN's CLOSING ARGUMENT ON COVID: I'M NOT TRUMP — The Democratic nominee continued his months-long push to draw a contrast with Trump's handling of the virus.

"Imagine where we'd be if this president just wore a mask instead of mocked it from the beginning," Biden told a rally in Pennsylvania on Sunday. "I can tell you this, we wouldn't have 9 million confirmed cases of Covid in this nation. We wouldn't have over 230,000 dead -- almost 9,000 here in Pennsylvania. We wouldn't be seeing those new record numbers of cases we're seeing every day now."

WHITE HOUSE DUMPS ON FAUCI — Prior to Trump's Sunday night attack on Fauci, administration officials picked a fight over the weekend with the infectious disease expert after he gave an interview to the Washington Post.

— What Fauci said on Friday: "You could not possibly be positioned more poorly" heading into the winter, Fauci told WaPo's Josh Dawsey and Yasmeen Abutaleb in a buzzy interview. The career civil servant also credited Biden's campaign for "taking [coronavirus] seriously from a public health perspective" while saying that Trump was looking at the virus from a perspective of "the economy and reopening the country."

— What the White House said on Saturday: "It's unacceptable and breaking with all norms for Dr. Fauci, a senior member of the President's Coronavirus Taskforce and someone who has praised President Trump's actions throughout this pandemic, to choose three days before an election to play politics," White House deputy press secretary Judd Deere said in a statement.

— PULSE points out: Fauci has consistently warned about the pandemic's toll this winter, but he usually dodges questions about Biden and Trump, rather than take the bait as he did with WaPo's Dawsey and Abutaleb.

— SCOTT ATLAS took a shot at Fauci too , after Fauci told WaPo that the president's hand-picked coronavirus adviser, a radiologist, is a "smart guy who's talking about things that I believe he doesn't have any real insight or knowledge or experience in."

"#Insecurity #EmbarrassingHimself #Exposed #CantThrowABall #NoTimeForPolitics," Atlas tweeted minutes after the WaPo interview was published.

But on Sunday, it was Atlas apologizing for his own interview with Russia Today, a registered foreign agent, saying that he didn't realize the network had foreign ties. In the RT interview, taped this weekend, Atlas said there was evidence to be "cautiously optimistic here rather than fearful" about the state of the pandemic.

SCOTT GOTTLIEB: 'DECEMBER IS PROBABLY GOING TO BE OUR TOUGHEST MONTH' — Trump's former FDA commissioner broke with Atlas and the president in an interview on CBS' "Face the Nation" on Sunday, saying that the national situation was worsening rather than turning the corner.

The U.S. is "right at the beginning of what looks like exponential growth" in areas such as the Midwest and the Great Lakes region, Gottlieb said. Every state also has an R-naught of above 1, meaning that the pandemic is expanding, he added. "This is very worrisome as we head into the winter," Gottlieb said.

KEEP UP WITH THE PEOPLE AND POLITICS DRIVING GLOBAL HEALTH IN GLOBAL PULSE: This year has revealed just how pivotal it is to keep up with the politics and policy driving global health. Our Global Pulse newsletter connects leaders, policymakers, and advocates to the people and politics making an impact on our global health. Join the conversation and subscribe today.

MEANWHILE: TRUMP's DRUG CARDS ARE STILL IN LIMBO — The administration missed its goal of sending out millions of announcement letters and even some cards by Election Day, and three officials with knowledge of the plan saidthere are still unresolved concerns about its legality and logistics, POLITICO's Dan Diamond reported.

And there are no current plans to roll out the cards. "We haven't heard anything in days," said one health official whose team at the Health and Human Services department would be involved in the program.

CMS, which would manage the program, didn't respond to a request for comment. The White House maintains that the cards are still coming after the election.

WHITE HOUSE CONSIDERING SECOND-TERM LEADERSHIP PURGE — Administration officials have started to vet names of health care experts who could take over the agencies running many elements of the government's pandemic response and overseeing the country's health insurance system, POLITICO's Nancy Cook reports, citing two Republicans close to the White House.

Inside the White House, there's debate over whether to make changes to the health care team in the middle of a once-in-a-century global pandemic — but aides also have repeatedly clashed with or criticized officials like HHS Secretary Alex Azar, CDC Director Robert Redfield and FDA Commissioner Stephen Hahn during the crisis.

SPEND ELECTION NIGHT WITH POLITICO FOUR SQUARE: People have been voting for weeks, but Election Day is finally upon us! Join us for a special election night episode of POLITICO "Four Square," where host Eugene Daniels will break down the latest developments from across the country with Chief Political Correspondent Tim Alberta, Chief Washington Correspondent Ryan Lizza, and one of our top political reporters and CNN contributor Laura Barrón-López. Joined by colleagues from across the newsroom throughout the show, expect the group to share the latest exit poll readouts, analyze the closing Trump and Biden campaign strategies, and to share their favorite moments of this long and winding election. Tune in at 9:00 p.m. EST here.

Around the Nation

REPORT FROM THE ROAD: HOW MASK MANDATES DIVIDED IOWA — The White House passed the decision to states, Iowa's governor passed it to municipalities, and now neighbors have spent three months fighting over it, Dan reports from Dubuque County, Iowa.

The ongoing debate comes as the county has seen its coronavirus cases surge in recent days, at one point hitting levels of spread that are about 10 times the current rate in Washington, D.C., but some residents insist that local government doesn't have the power to impose a mandate.

— Local officials say they don't want this fight, acknowledging that the mask-mandate debate is testing their limits. Many officials who are now feuding also lack health care credentials or only work part-time or as volunteers in their roles.

"In the absence of a national or state mandate this has fallen on our Board of Health," said Tom Bechen, a retiree from the local John Deere factory who chairs the all-volunteer health board. "I don't believe that is how it should be."

— The issue has energized some Democrats, who are hammering state and national GOP officials like Trump and Gov. Kim Reynolds for not doing more on Covid-19. Those Democrats also have loudly advocated about the need for regular face coverings to slow the spread. "Lives and livelihoods are at stake," state Rep. Chuck Isenhart warned in September.

But the fight has spooked others, including two Democratic county supervisors on the local board who earlier this year voted against the mandate and appear likely to oppose it again.

It's also seemingly scared off national figures. A spokesperson for Rep. Abby Finkenauer, the Democrat who represents Dubuque County in the House and is locked in a tight race for re-election, also declined to comment on a mask mandate.

OBAMACARE ENROLLMENT IS UNDERWAY — But for the first time since Obamacare coverage began in 2014, the sign-up window is occurring in a battered economy, POLITICO's Susannah Luthi writes. And CMS, which years ago slashed funding for HealthCare.gov outreach, isn't ramping up enrollment efforts as the worst public health crisis in a century intensifies across the country.

The Trump administration is also barely touting sign-ups under a law it's asking the Supreme Court to throw out just 10 days later, Susannah writes. For instance, CMS Administrator Seema Verma tweeted more than three dozen times on Sunday, but never mentioned that the ACA open-enrollment period had begun.

— Advocates are trying to fill the gap. Joshua Peck, a former CMS official who led HealthCare.gov marketing under the Obama administration, said his group Get America Covered for the first time is running a six-figure digital ad campaign to promote open enrollment.

The onset of winter — and the likely spike in the Covid-19 pandemic — is even more reason to sign up for an ACA plan, warns Heather Korbulic, who oversees Nevada's exchange.

BUT GEORGIA GETS CMS APPROVAL TO LEAVE HEALTHCARE.GOV — The first-of-its-kind move, which the Trump administration approved on Sunday, isn't a surprise, Susannah writes. Verma said she would approve the policy during an event with Georgia Gov. Brian Kemp last month, where she officially greenlit the state's limited Medicaid expansion paired with a work requirement.

— Why it's contentious: The state's exit from Healthcare.gov means Georgians won't have a central clearing house for all Obamacare plans. Instead, agents, brokers and other private entities will individually sell Affordable Care Act plans alongside skimpier short-term plans. The state will only work on the back-end to make sure people are matched with the right subsidies.

Critics say it's almost certainly going to lead to a drop in the number of people with compliant coverage, which isn't allowed under the ACA's state innovation waiver system. Verma already acknowledged the policy will likely spur lawsuits.

STILL NOT A FAN OF THE ACA: AOC — Obamacare plans require too much spending out of pocket, Rep. Alexandria Ocasio-Cortez tells Vanity Fair in a cover story, saying that her congressional colleagues don't realize the ACA's limitations.

"The main reason why I feel comfortable saying that the ACA has failed is because it failed me and it failed everyone that I worked with in a restaurant," Ocasio-Cortez told the magazine — even as Democrats campaign on the need to preserve the health law.

Coronavirus

'60 MINUTES': CMS INSPECTION SLOWED RESPONSE DURING EARLY COVID OUTBREAK — The news magazine on Sunday night reported that CMS inspectors descended on Life Care's skilled nursing facility in Kirkland, Wash., even as the facility was dealing with the nation's first major outbreak in February, which ultimately killed 38 of the facility's patients and sicken 67 staff.

The CMS inspection was time-consuming and distracted from trying to get the virus under control, a Life Care executive told "60 Minutes," and the company said that more than 400 hours of staff time were diverted from patient care.

"It was infuriating," said Life Care's Nancy Butner. "They didn't truly understand Covid or what the facility was going through or what we had been through." State health officials also tried to get CMS to call off the inspection. CMS ultimately fined Life Care more than $600,000.

Verma's office "declined multiple requests for an on-camera interview," said "60 Minutes" correspondent Bill Whitaker.

— But Verma hit back on Twitter on Sunday night, posting 32 tweets attacking the report's "revisionist history" and criticizing Life Care for its "checkered track record of quality."

"@CMSGov's responsibility as a regulator is to hold nursing homes accountable for keeping nursing home residents safe," Verma wrote. "Life Care failed to report the outbreak timely & keep its residents safe, & we refuse to apologize for holding Life Care accountable for its failures."

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.

What We're Reading

"A $200 card is better than a sharp stick in the eye, but it won't be that meaningful," former CMS chief Tom Scully tells Harris Meyer, dissing Trump's planned cards in Modern Healthcare.

Republicans may have hurt their own legal case against Obamacare by repeatedly expanding on and amending the signature health law since 2017, Lydia Wheeler writes for Bloomberg Law.

Amy Acton, Ohio's ousted public health official, opens up on her fears about partisan politics shoving aside public health, Paige Williams details in the New Yorker.

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