News: Raimondo rising in race to be Biden’s health secretary — The immigration policy holding back health workers — Covid complicates Congress’ spending push

Thursday, December 3, 2020

Raimondo rising in race to be Biden’s health secretary — The immigration policy holding back health workers — Covid complicates Congress’ spending push

Dec 03, 2020

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By Adam Cancryn and Dan Diamond

Presented by

With Susannah Luthi

Editor's Note: POLITICO Pulse is a free version of POLITICO Pro Health Care's morning newsletter, which is delivered to our subscribers each morning at 6 a.m. The POLITICO Pro platform combines the news you need with tools you can use to take action on the day's biggest stories. Act on the news with POLITICO Pro.

Quick Fix

— Rhode Island Gov. Gina Raimondo is now a top contender to run the health department under President-elect Joe Biden.

— Health groups are urging Biden to reverse immigration policies limiting the ability of thousands of foreign doctors and nurses to help fight the pandemic.

— Congressional leaders are still haggling over a coronavirus relief package, amid a parallel effort to keep the government funded beyond next week.

WELCOME TO THURSDAY PULSE — where a dark horse HHS candidate with an impeccable resume emerges: Elmo.

PULSE has no doubts about his public appeal, but we questions his policymaking experience (and lack of opposable thumbs). Send tips and intel on the health secretary race to acancryn@politico.com and ddiamond@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

RAIMONDO RISING — Rhode Island Gov. Gina Raimondo is now a top contender to be Joe Biden's HHS secretary, just days before the president-elect is expected to announce an initial slate of health care picks, POLITICO's Alice Miranda Ollstein, Adam Cancryn and Tyler Pager report.

The 49-year-old impressed Biden officials during her vice presidential vetting over the summer, and had been under consideration for multiple roles in the new administration. Raimondo — who is in her fifth year as governor — also boasts the management experience seen as necessary to run the sprawling health department.

— Raimondo's rise comes as another governor falls. New Mexico Gov. Michelle Lujan Grisham is now believed unlikely to win the HHS job, after she recently turned down a separate offer to head the Interior Department.

That rejection hurt her chances at other roles within the administration, and a pair of reports Wednesday portraying her as the frontrunner for HHS secretary also didn't sit well with people in Biden's orbit.

Another top candidate, former Surgeon General Vivek Murthy, remains hampered by his lack of management experience — though he's expected to get some kind of high-level role in Biden's administration.

— Raimondo's candidacy drew immediate fire from the left. A former venture capitalist, Raimondo has angered progressives and unions over her role in cutting Rhode Island's pension benefits and seeking to further privatize the state's Medicaid program.

More recently, she granted nursing homes immunity from liability if residents were injured or died during the pandemic. And after being lauded for her aggressive early response to Covid-19, Raimondo has faced criticism of late for reopening schools as the virus surged.

"It would be a disaster for Raimondo to receive any spot in the incoming Biden administration," the Revolving Door Project's Max Moran wrote Wednesday. "But it's especially horrifying — and frankly, stupefying — to consider Raimondo for HHS in the year 2020."

THE IMMIGRATION POLICY HOLDING BACK HEALTH WORKERS — Thousands of foreign doctors and nurses are currently stuck on the sidelines of the pandemic fight due to visa restrictions — a problem that health groups are lobbying the incoming Biden administration to fix, POLITICO's Tucker Doherty reports.

Those hospital operators, medical associations and immigration groups want Biden to immediately reverse visa crackdowns imposed by President Donald Trump and make other changes to immigration policy, arguing that it would allow medical reinforcements to flood the nation's Covid-19 hotspots.

— Roughly 10,000 physicians are on H-1B visas that restrict where they can work, and risk deportation if they fall ill and are unable to do their jobs. Another 15,000 foreign nurses who have applied to immigrate are stuck in limbo due to consulate closures and backlogs.

Legislation stalled in Congress would grant more foreign doctors and nurses permanent residency status, potentially by reallocating unused green card slots.

— The push comes amid staffing shortfalls around the nation. The pandemic's record surge has left many hospitals shorthanded and forced the shutdown of elective procedures to free up staff. And with cases climbing across the nation, health workers who traveled to help with concentrated hot spots in the spring are now having to stay and battle the virus in their backyards.

COVID COMPLICATES CONGRESS' SPENDING PUSH — A fresh effort to strike a coronavirus relief deal is complicating Congress' sprint toward a $1.4 trillion spending deal that needs to come together over the next few days, POLITICO's Caitlin Emma and Heather Caygle report.

The spending measure must pass by next week to keep the government open beyond Dec. 11. But congressional leaders are now also working in parallel to revive negotiations over more coronavirus funding.

— Democrats secretly pitched a $1.3 trillion proposal on Monday, but that offer went nowhere with Republicans. House Speaker Nancy Pelosi and Senate Minority Leader Chuck Schumer are now urging Majority Leader Mitch McConnell to use a bipartisan plan released earlier this week as a starting point for talks.

— But McConnell has shown little enthusiasm for that bipartisan plan. The $908 billion proposal includes $160 billion in state and local aid and another $180 billion in additional unemployment insurance.

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.

In Congress

MCMORRIS RODGERS WINS TOP GOP E&C SEAT — Washington Rep. Cathy McMorris Rodgers will be the top Republican on the House Energy and Commerce Committee next year, making her the first woman to hold a leadership role on the panel, POLITICO's Anthony Adragna reports.

McMorris Rodgers beat out Reps. Michael Burgess and Bob Latta for the top spot, which is being vacated by retiring ranking member Greg Walden. She'll be expected to serve as a check against the more ambitious elements of Biden's health care agenda in a closely divided House.

"From blatant assaults on free speech, to Medicare-for-All, to the Green New Deal, Energy and Commerce is at the very center of the battles for freedom to beat socialism and hope to beat fear," McMorris Rodgers said in a statement after her selection.

— Meanwhile: AOC wants E&C. The liberal Democrat is pushing for a spot on the influential committee, telling POLITICO's Susannah Luthi on Wednesday that she's advanced her nomination for panel membership.

Coronavirus

MONCEF SLAOUI: 100 MILLION GET VACCINE BY FEBRUARY — The Operation Warp Speed chief scientific adviser is predicting that the U.S. will vaccinate 100 million people by the end of February, POLITICO's Zachary Brennan reports.

That would cover those most vulnerable to the virus, though the timeline depends on the FDA following through on expectations it'll authorize one or more shots this month. If so, roughly 20 million people could receive the vaccine later this month — with another 30 million in January and 50 million in February in line for the shot.

— Doses of the vaccine are ready to ship. Roughly 6.4 million doses of Pfizer's vaccine would be sent out around Dec. 15 if it receives authorization by then, with the government preparing to ship another 12.5 million doses of Moderna's vaccine as soon as it gets the green light.

States have until Friday to decide exactly where and how many of those first Pfizer vaccine doses will go.

FEDS BUY MORE DOSES OF LILLY COVID DRUG — The government purchased 650,000 more doses of Eli Lilly's antibody drug for about $813 million, Zachary writes.

The U.S. has now bought nearly a million doses of the drug, with plans to continue distributing it to state health departments for free. But it's unlikely to solve widespread shortages. Demand is continuing to rise as the pandemic worsens, and the government has already allocated more than 215,000 doses of the drug nationwide.

OBAMA URGES TRUST IN VACCINE — Former President Barack Obama is the latest to urge Americans to put their faith in an eventual Covid-19 vaccine, saying Wednesday he trusts the science behind it, POLITICO's Matthew Choi reports.

"So if Anthony Fauci tells me this vaccine is safe, and can vaccinate, you know, immunize you from getting Covid, absolutely I'm going to take it," Obama said during an interview on SiriusXM's "The Joe Madison Show."

— Obama could be a key ambassador to communities of color. The former president suggested he may broadcast his vaccination in hopes of reassuring Americans, noting in particular the skepticism among an African American community victimized in the past by medical malfeasance and abuse.

Former Presidents George W. Bush and BIll Clinton have also volunteered to get their shots on camera, CNN reported.

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.

Medicaid

TRUMP LOSES APPEAL OVER 'PUBLIC CHARGE' RULE — The 9th U.S. Circuit Court of Appeals upheld orders blocking Trump administration rules making it more difficult for immigrants to obtain legal status if they used public benefits like Medicaid, POLITICO's Victoria Colliver reports.

The 2-1 ruling concluded that the regulations would cause financial harm to the states challenging the new policy, while rejecting the administration's argument that the public charge rule would promote self sufficiency.

California, which led the lawsuit against the policy, had contended that the public charge rule would have an outsized impact on the state, since 1 in 4 residents are immigrants.

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

The FDA has 150 people working days, nights and weekends to speed a vaccine authorization, Commissioner Stephen Hahn told The Wall Street Journal's Tom Burton in an interview defending the agency's meticulous review process.

In the New York Times, Carl Zimmer and Noah Weiland write that the success of the Covid-19 vaccine trials is forcing health experts to grapple with a thorny question: Should those who received the placebo get priority access to the real thing?

A recent update to the National AIDS Strategy has advocates wondering whether Biden will simply adopt the current administration's approach, or chart a new course in the effort to end the U.S. HIV epidemic, the Washington Blade's Chris Johnson reports.

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