| | | | |  | | By Chelsea Cirruzzo and Ben Leonard | | | | | 
Some conservatives see the possibility of the CDC being broken into two separate agencies under a Trump presidency. | Jessica McGowan/Getty Images | SLICE AND DICE — A second Trump administration could drastically reduce the size of the Centers for Disease Control and Prevention. Fueled by a distrust of the CDC’s handling of Covid-19 and its recommendations on measures like masking and vaccines, many Trump allies have outlined their approach to the agency in the 2025 Presidential Transition Project developed by the conservative Heritage Foundation think tank. Their plan? Split the agency in two: One agency responsible for public health surveillance work, like data collection on outbreaks and another responsible for “limited” public health recommendations — with a strict firewall between them, according to Roger Severino, former director of HHS’ Office for Civil Rights under the Trump administration, told POLITICO. Such a CDC reorganization could hinder the agency’s ability to help prevent or mitigate the spread of disease, according to one former CDC director. “If you have different agencies, you’re not going to make it easier to deal with an outbreak. You’re going to make it harder to deal with an outbreak, and you're going to reduce the likelihood that Americans will be resilient and healthy enough to withstand it,” Dr. Tom Frieden, who led the CDC under the Obama administration, said. Frieden said there’s precedent for improving agency oversight but called the idea that the CDC should only deal with infectious diseases “very dangerous and very wrong.” “We don't split up the military because it's too big. We don't split up corporations because they're too big,” he said. Splitting the agency would require legislation, said Bill Hoagland, senior vice president at the Bipartisan Policy Center, a centrist think tank. “So, it may take a little longer,” he told POLITICO.” If legislation doesn’t move fast enough, Hoagland said he could see the return of an executive order that former President Donald Trump issued in his first term: It designated certain civil servants in policy-related positions as “Schedule F” employees, which allows the administration to fire them more easily. Other ways a Trump-led HHS could change the department include proposing rules that would narrow civil rights protections. Severino and other conservatives oppose a 2022 Biden administration proposal to expand civil rights protections in health care, including a provision that says providers can’t discriminate against someone based on their gender identity. If Biden doesn’t finalize the rule by sometime this summer, it could become subject to the Congressional Review Act, which allows Congress to rescind recent rules. WELCOME TO MONDAY PULSE. Congress thwarted a shutdown this weekend. Now, lawmakers have until March 22 to work out a larger funding deal. Send your tips, scoops and feedback to ccirruzzo@politico.com and bleonard@politico.com and follow along @ChelseaCirruzzo and @_BenLeonard_.
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HHS Secretary Xavier Becerra called on UnitedHealth to take responsibility for the impact of the cyberattack on Change Healthcare. | Alex Wong/Getty Images | CHANGE ATTACK LATEST — HHS told health care leaders Sunday that the agency is urging UnitedHealth Group to take responsibility for the impact of a massive cyberattack that has delayed provider payments, Chelsea reports. HHS Secretary Xavier Becerra wrote to the health care industry Sunday, defending HHS’ actions following the attack and said officials are “asking private sector leaders across the health care industry — especially other payers — to meet the moment.” UnitedHealth, which owns Change Healthcare, one of the country’s largest clearinghouses for medical payments, did not immediately respond to a request for comment but said last Thursday that it will take another couple of weeks to resolve issues with their billing systems. AHIP, a trade group that represents insurers that UnitedHealth isn't a part of, said in a statement Sunday that insurers "took immediate steps" to set up workarounds when the cyberattack occurred. On Saturday, HHS widened the types of providers that can receive advance payment to help them after Senate Intelligence Committee Chair Mark Warner (D-Va.) floated legislation on Friday that would offer “accelerated and advanced payments” to providers and vendors that meet minimum cybersecurity standards, Ben and POLITICO’s Robert King report. In his letter, Becerra called on UnitedHealth to ensure expedited delivery of funds to providers, communicate more frequently and provide Medicaid agencies with a list of impacted providers. He also turned to insurers, calling on them to make interim payments to providers, particularly Medicaid providers, and ease their administrative burden. “In a situation such as this, the government and private sector must work together to help providers make payroll and deliver timely care to the American people,” Becerra wrote. What’s next: Impacted providers can apply for 30 days of relief that must be repaid. 2025 BUDGET COMING — The White House’s 2025 fiscal budget will include proposals to “protect and strengthen” Medicare and propose higher taxes on large corporations and billionaires, according to a White House official. It comes after President Joe Biden pledged to protect Medicare from cuts and said he would ask Congress to expand the number of drugs subject to Medicare price negotiations in his State of the Union address. The budget, set to be unveiled today, will also include proposals to lower child care, prescription drug and health insurance costs, according to the official. It will also have proposals to advance cancer research. HHS Secretary Xavier Becerra will present the proposed HHS budget this afternoon, joined by Lisa Molyneux, the HHS acting assistant secretary for financial resources.
| | | | JOIN US ON 3/21 FOR A TALK ON FINANCIAL LITERACY: Americans from all communities should be able to save, build wealth, and escape generational poverty, but doing so requires financial literacy. How can government and industry ensure access to digital financial tools to help all Americans achieve this? Join POLITICO on March 21 as we explore how Congress, regulators, financial institutions and nonprofits are working to improve financial literacy education for all. REGISTER HERE. | | | | | | | | | AI INITIATIVE WORRIES SMALL COMPANIES — Some startups worry that a plan by a coalition of tech giants and health systems to evaluate AI tools in health care is unfairly designed to benefit the entities running them, POLITICO’s Ruth Reader reports. The Coalition for Health AI, which includes Google, Microsoft, Johns Hopkins University and the Mayo Clinic, announced last week that it will help establish so-called assurance labs to evaluate AI products, likely hosted by universities, by the end of the summer. The initiative has the endorsement of top U.S. officials. Smaller companies and the firms that invest in them are concerned because the universities are developing their own AI or collaborating with tech giants to develop products. “Under CHAI's proposal, several organizations that have been tasked with review authority actually operate their own AI incubator programs,” said Julie Yoo, general partner at venture capital firm Andreessen Horowitz. “Ultimately, the technologies developed in those incubators could be in direct competition with the ones they are tasked to review and validate.” CHAI responds: Dr. Brian Anderson, CHAI’s CEO and chief digital health physician at MITRE, a nonprofit that advises government agencies on technology, told Ruth that if smaller firms and startups want a say in setting the standards for AI, they should join the coalition. “CHAI will be a failure if all it is is academic institutions and big tech leading the effort,” he said. CBO LOOKING AT GLP-1 — The Congressional Budget Office said Friday that it’s examining how much weight-loss drugs could cost the federal government if allowed to be covered under Medicare, Ben reports. In response to a question from Rep. Buddy Carter (R-Ga.) for the record following a House Budget Committee hearing on Jan. 31, CBO said it expects that if the FDA approves GLP-1 drugs for cardiovascular conditions, Medicare would also cover those drugs for obesity. Under those circumstances, the CBO would add coverage costs to its baseline, meaning the cost of legislation to widen coverage for obesity would fall. “CBO is refining its baseline projection of what new indications are likely to be covered by Medicare under current law and will share more information when it is available,” the nonpartisan agency said. The backstory: In 2003, Congress prohibited Medicare from covering obesity drugs, and some lawmakers hope to change that. The drugs have taken off in popularity amid a swell of research supporting their effectiveness, but they can be pricey without coverage.
| | VA LAUNCHES CERNER AT NEW FACILITY — The Department of Defense and the VA launched the DOD’s version of an Oracle Cerner electronic health record system at Captain James A. Lovell Federal Health Care Center in Chicago, Ben reports. The move Saturday marks the final site in the Defense Department’s rollout of the software. Officials hope it will be a boost to the VA’s troubled electronic health record modernization, which is on pause indefinitely after costs ballooned and several veterans’ deaths were tied to the software.
| | Marc Novicoff reports in POLITICO on how raw milk became a conservative staple. The Wall Street Journal reports on the future of Amylyx’s ALS drug amid controversy.
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