| | | | |  | | By Chelsea Cirruzzo and Ben Leonard | | Presented by |  | | | With help from Sophie Gardner
| | |  Measles outbreaks are increasing in the U.S. due to declining vaccination rates among children. | Elaine Thompson/AP | A NEW MEASLES NORMAL? Measles, once declared eliminated in the U.S., is making an alarming comeback. With 13 measles outbreaks already reported this year — compared with four last year — public health officials are concerned, Sophie reports. In the years since the height of the Covid-19 pandemic, measles, mumps and rubella vaccine coverage for kindergarteners fell 2 percent and hasn’t recovered — meaning that “76,000 more children are not up to date on their vaccinations,” a CDC spokesperson told POLITICO. The latest data available is from the 2022-2023 school year. Outbreaks have popped up nationwide this year, with the largest occurrences in California, Florida, Illinois, Minnesota, New York, and Oregon. “Most of the time, people are protected by the fact that nobody else has it — but measles is here now,” said Dr. Paul Cieslak, medical director of communicable diseases and immunizations at the Oregon Health Authority. Oregon is seeing its largest case load of measles in years. The vaccination coverage rate in kindergarteners has hovered around 93 percent for the past few years — below the 95 percent that health experts say is needed to maintain herd immunity against the virus. Behind the shift: Public health officials say some decline could still be a lingering consequence of people staying away from doctors’ offices during the pandemic’s height. But they also cite vaccine hesitancy as another reason — and some say misinformation around the Covid vaccine exacerbated the issue. Pre-pandemic, MMR vaccines already attracted a fair amount of skepticism — because of a now-retracted 1998 article in The Lancet that suggested the vaccine was tied to autism. State-by-state: One of the biggest challenges containing the virus, public health officials said, is the drastic state-to-state and even country-to-country variation. “The biggest risk still remains in these persistently underimmunized, more close-knit communities,” said Dr. David Sugerman, CDC’s team lead for measles, rubella and cytomegalovirus, noting that some communities are more opposed to vaccination than others. How easy it is to get a nonmedical exemption for a child varies drastically by state. Some states require parents to first sit through an info session on vaccines or get a doctor’s signature, while in others, it’s as simple as signing a form. “All [measles] needs is for a spark to find an unvaccinated pocket, and it'll spread like wildfire,” said Katelyn K. Jetelina, epidemiologist and scientific consultant to the CDC. WELCOME TO MONDAY PULSE. And a very warm welcome to autumn! Bring on the changing leaves, cool nights and apple cider. Send your tips, scoops and feedback to ccirruzzo@politico.com and bleonard@politico.com and follow along @ChelseaCirruzzo and @_BenLeonard_.
| | | | A message from the Alliance for Fair Health Pricing: Rising costs, driven by consolidation in the health care market, are hurting American businesses. As large health systems buy up hospitals and physician practices, they use their monopoly power to drive competition out and prices up, raising costs for employers providing health insurance. These inflated prices stifle economic growth and lower wages, hitting small businesses and low to middle-income workers hardest. Congress: Stand up for employers. Pass legislation to address hospital consolidation. More. | | | | | | | 
HHS awarded contracts to reform the U.S. organ transplant system, prompting some questions from advocacy groups. | Molly Riley/AP | QUESTIONS LINGER ON ORGAN CONTRACTS — HHS awarded the first round of contracts to overhaul the U.S. organ transplant system to a mix of private consultant groups and government contractors last week. However, patient advocate groups and the Association of Organ Procurement Organizations are asking for more information on the contracts’ scope and how federal officials will tamp down conflicts of interest, Chelsea reports. Background: Last year, President Joe Biden signed a law to decentralize the organ transplant system, which has been run by a single nonprofit contractor, the United Network for Organ Sharing, since the 1980s, into manageable parts. That allowed different entities to oversee certain functions of the system and the appointment of a new board of directors. A Health Resources and Services Administration spokesperson told Pulse that the fourteen awards announced last week include: — $1,526,800 to Guidehouse Digital, a management consulting company, to improve the development and management of the system’s budget. — $1,607,624 to Arbor Research Collaborative for Health, a research institute, to support patient safety and policy compliance systems. — $1,652,638 to Maximus Federal, a government contracting group, to improve public engagement and transparency in the system. — $1,669,823 to General Dynamics Information Technology, an IT management company, to modernize the network’s IT system and inform the next steps. — $770,737 to Deloitte, a government contractor, to focus on improving communications with patients and their families. UNOS also told Pulse it had been awarded a contract to work on transitional operations. Patient advocates told Pulse they’re waiting for more information from HRSA about what rules and guidelines the contractors will operate under, especially when it comes to personnel who might have conflicts of interest. Earlier this year, HRSA finalized a policy preventing people with connections to vendors in the network from sitting on the Organ Procurement and Transplantation Network’s board of directors. “Anything that starts to move this system away from monopoly control is good for patients, and HRSA needs to ensure that these contracts are being managed and overseen correctly,” Greg Segal, a patient advocate and co-founder of Organize who testified before members of Congress earlier this month on needed changes to the system. The Association of Organ Procurement Organizations urged HRSA in a statement that the contractors chosen — which, for the first time since the organ network was created, are for-profit organizations — put patients and donors first.
| | | | A message from the Alliance for Fair Health Pricing:   | | | | | SHORT-TERM SPENDING AGREEMENT — A deal reached by congressional leaders on Sunday would fund the government through Dec. 20 and extend an FDA voucher program for pediatric rare diseases. The short-term spending bill, expected to be voted on midweek, comes as GOP leaders drop a push to attach a conservative immigration proposal backed by former President Donald Trump, POLITICO’s Jordain Carney and Jennifer Scholtes report. It includes an extension of the FDA’s priority review voucher program for rare pediatric diseases, set to expire at the end of the month. A House committee passed legislation last week to fund the program for five years. SENATE HELP’S LOOK AHEAD — Coming off the heels of a vote to hold the CEO of a bankrupt hospital system in contempt, the Senate health committee has another busy week ahead. What we’re watching: Novo Nordisk CEO Lars Jørgensen will testify before the Health, Education, Labor and Pensions Committee about his company’s prices for the class of products known as GLP-1s in the U.S. compared with other countries on Tuesday. Last week, committee Chair Bernie Sanders (I-Vt.) said CEOs of “major” generic companies told him they could manufacture and sell copycat versions of Novo Nordisk’s diabetes drug Ozempic for less than $100 a month and still profit, POLITICO’s Lauren Gardner reported. Why it matters: Sanders has taken credit for pushing pharma executives to cut consumer costs for commonly used items like inhalers and insulin since he took the gavel. Demand for diabetes and weight-loss medication is high. The committee is also scheduled to mark up six pieces of health care legislation Thursday, including: — A bill to strengthen oversight and reporting protocols of contamination in infant formula manufacturing, coming after a formula crisis in 2022 left children sickened and parents scrambling for formula. Families have decried the slow action of federal officials, POLITICO reported. — A bill to reauthorize the FDA’s priority review voucher program for rare pediatric diseases, set to expire at the end of the month. A House committee passed a similar legislation last week.
| | RETURNING TO PRE-PANDEMIC ILLNESSES — Whooping cough is on the rise in the U.S., the CDC said Friday, as cases return to pre-pandemic pattern where more than 10,000 cases are typically reported a year. Early data shows that, as of 37 weeks into 2024, as many as five times the number of whooping cough, or pertussis, cases have been reported compared with the same period in 2023 — also higher than seen in 2019. Why it matters: The rise in cases comes as some infectious illnesses that saw lower case rates during the pandemic return to pre-pandemic levels — but vaccination rates for common illnesses, particularly among children, lag. The vaccination for whooping cough, or pertussis, is effective, the CDC said, but protection is known to fade over time, so officials expect to see cases in both vaccinated and unvaccinated individuals. The vaccination, given in conjunction with the diphtheria and tetanus vaccine, is recommended for infants. Health officials say early signs of pertussis can look like the common cold but progress into rapid, violent and uncontrollable coughing fits, which could last up to several months.
| | Michael Ward is now director of U.S. alliance development at AstraZeneca. He most recently was VP of public policy and government relations at the Alliance for Aging Research.
| | ProPublica and NPR report on “ghost networks,” or inaccurate provider directories. The Washington Post reports on the impact racism can have on heart health for Asian Americans.
| | | | A message from the Alliance for Fair Health Pricing: From large companies to small businesses to entrepreneurs—rising health care costs are squeezing employers.
Right now, Congress has an opportunity to protect employers and workers from excessive costs by advancing policies that promote competition and rein in hospital consolidation that drives up prices.
Codifying hospital and insurer price transparency requirements will hold health systems accountable for fair and reasonable pricing. At the same time, comprehensive site-neutral payment reform will ensure patients aren’t overcharged for routine services and reduce the incentives for hospitals to buy up physician practices. These actions are critical for safeguarding the financial health of American businesses and workers’ access to quality, affordable health care. The AFFHP is calling on Congress to advance transparency and site-neutral reforms to make health care more competitive and affordable. Employers, providers and consumers agree, now is the time. Congress: Take action against rising health care costs. Read our message. | | | | | | | Follow us on Twitter | | | | Follow us | | | | |
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