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Presented by PhRMA: Delivered daily by 10 a.m., Pulse examines the latest news in health care politics and policy. | | | | | |  | | By Sarah Owermohle and Adam Cancryn | | | With Rachel Roubein Editor’s Note: POLITICO Pulse is a free version of POLITICO Pro Health Care's morning newsletter, which is delivered to our s 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.
| | | — The administration is running out of options for convincing Americans to get vaccinated against Covid-19 as overall rates slow. — The White House is putting brakes on its weekly Covid call with governors, making it biweekly and switching to other subjects. — Congressional Democrats have three potential Medicaid proposals but little consensus on the path forward. WELCOME TO MONDAY PULSE — Like Italy making the final point in a 90-minute and some Euro Cup, Pulse is coming to you with extra care and late-breaking news. Send tips to sowermohle@politico.com (still devastated for England) and acancryn@politico.com. | | | | A message from PhRMA: Out-of-pocket costs shouldn’t be out-of-this-world confusing. If we fix insurance, we can fix out-of-pocket medicine costs. See how. | | | | | | BIDEN LOW ON OPTIONS TO JUICE VACCINATIONS — The nation’s Covid-19 vaccination rate is dropping by the day – and six months in, the Biden administration is running out of ideas for reversing that trajectory, Adam writes. What began as a sprint to get shots in arms has turned into a marathon with no clear end in sight, Adam reports, as federal and state officials battle rising partisanship and deep resistance among the 91 million adults who remain unvaccinated. Even as the administration kicks off a “neighborhood-by-neighborhood” vaccination push, there is little belief any of the outreach efforts with supercharge vaccination rates – and an acknowledgment that there are few new tactics left to try. The slowdown was inevitable, Biden officials contend, and a side effect of its faster-than-anticipated rollout of vaccines that reached nearly 68 percent of adults eager to get one. But it raises the prospect more than a quarter of U.S. adults could remain vulnerable to Covid-19 into the fall – and means the government is in for a grinding campaign to convert unvaccinated people one by one. What’s left in the toolbox: Full FDA approval of the vaccines could convince some to get the shots – but administration officials are skeptical most of the holdouts will be moved. Primary care doctors could play a role in accelerating vaccinations, too, though that effort hasn’t expanded as quickly as hoped. The White House is also coordinating with schools and businesses to encourage students and employees to get shots. Still, any success from here on out is likely to be incremental, with no single strategy spurring a wave of vaccinations. In the meantime, officials are bracing for increasing backlash from conservative lawmakers, governors and pundits who have turned against the vaccination drive – and could contribute to hardening resistance among those still unvaccinated. WH COVID TASK FORCE CALLS WITH GOVERNORS MOVE TO BIWEEKLY — Since Biden came into office, his coronavirus task force had held calls with governors every Tuesday to brief them on vaccine distribution, as well as other Covid-19 updates, like the spread of variants. But the Covid-19 focused calls will now move to every other week, and discussions during the off weeks will instead focus on other topics, according to three sources with knowledge and confirmed by a White House spokesperson. The biweekly decision was mutual between the White House and the National Governors Association. But it comes as states face hardened resistance to shots among their unvaccinated population and the rise of the infectious Delta variant. Jeff Zients, Biden’s coronavirus czar, told governors last week that the White House would continue working with governors’ teams on a daily basis and holding weekly calls with state public health officials. | | | | THE ROAD TO TOKYO 2020 – A TUESDAY CONVERSATION WITH FIRST VICE PRESIDENT OF THE IOC ANITA DEFRANTZ: The Tokyo Olympics kick off July 23, 15 months after being postponed. One problem … Japan's capital city is in a Covid state of emergency and has prohibited fans from attending. With financial pressure to push forward and potential punishment for any athletes involved in protests or demonstrations during the sporting event, these Olympics Games will be unlike any other. Join Global Translations author Ryan Heath for a POLITICO Live conversation with Anita DeFrantz, First Vice President, International Olympic Committee, on what's at stake in the Tokyo Olympics, as a global health crisis, sports and politics all come to a head. REGISTER HERE. | | | | | THE DILEMMA BEHIND PLUGGING OBAMACARE’S BIGGEST HOLE — Democratic lawmakers are coalescing around three options to extend health insurance to millions of poor Americans in states that refused the health law’s Medicaid expansion, believing that Biden’s “human infrastructure” package poses the best chance to close the Medicaid coverage gap. Momentum for a fix has grown in recent weeks, but congressional staff are still hashing out thorny policy questions over how to expand coverage to poor adults in the dozen Medicaid expansion holdout states, Rachel Roubein and Alice Miranda Ollstein write. After months of behind-the-scenes discussions, the options include: — Allowing poor adults to get free private coverage through Obamacare’s insurance marketplaces, — Requiring the Biden administration to create a new coverage program, — Creating a hybrid model, where customers could quickly receive free coverage on the marketplaces until federal officials stand up a new program that would likely provide better benefits. Yet, plugging the Medicaid gap in Democrats’ next major package is far from certain. The costly effort faces competition from other Democratic health care priorities that could be folded into infrastructure legislation, including an expansion of Medicare benefits and permanently increasing financial aid to people who purchase Obamacare coverage. Coming soon : Sen. Raphael Warnock (D-Georgia) plans to introduce legislation as soon as this week that would direct HHS to create a new Medicaid-like program to cover those in the holdout states. The legislation would also substantially boost financial incentives — first included in Biden’s coronavirus relief bill this spring — for holdout states to expand on their own, according to a draft bill obtained by Rachel and Alice. | | | FAUCI: MORE LOCAL VACCINE MANDATES NEEDED — Biden chief medical advisor Anthony Fauci on Sunday advocated for more schools and businesses to require Covid-19 vaccinations, telling CNN’s Jake Tapper that “there should be more mandates” as U.S. deaths top 600,000. There is some lingering vaccine hesitation because the coronavirus vaccines are not yet fully approved by the FDA, but instead were authorized for emergency use by the agency — and approval could open the door for more mandates, the nation’s top infectious disease expert said. Full approval is imminent, Fauci separately told ABC’s “This Week,” where he also raised hesitation from people concerned the shots have only received emergency use authorization. “Although it's understandable — quite understandable that some people might say, ‘Well, we want to wait for the full approval,’ that's really only a technical issue,” Fauci told George Stephanopoulos. “It's the FDA dotting the i’s and crossing the t’s. But there's no doubt in my mind that these vaccines are going to get full approval because of the extraordinary amount of positive data.” In April, Fauci told the POLITICO Dispatch podcast that the federal government would not require vaccine passports to show proof of Covid-19 vaccinations for travelers or businesses, but that he expected businesses and schools might require them. The Biden administration reiterated this week that it has no plans to issue a federal mandate for schools, businesses or states to require the vaccine. The public remains split on the issue. A new POLITICO-Harvard survey showed that Americans are sharply divided along party lines on whether schools or most private employers should require coronavirus vaccinations, with Democrats supporting a government-issued document certifying their vaccination status, and Republicans opposing the government or most businesses mandating a vaccine passport of any kind. | | | |   | | | | | | ICYMI: FDA CALLS FOR PROBE INTO ITS ALZHEIMER’S DRUG APPROVAL — The agency’s acting commissioner Janet Woodcock asked Friday for a government watchdog to investigate FDA’s dealings with the drugmaker Biogen prior to last month's accelerated approval of Aduhelm, Katherine Ellen Foley reported. The review by the Department of Health and Human Services inspector general will establish “whether any interactions that occurred between Biogen and FDA review staff are inconsistent with FDA policies and procedures,” Woodcock wrote in a letter adding that it would assuage concerns about any inappropriate relationship between the agency ang a drugmaker.
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| | | FIRST IN PULSE: BETH LYNK TO RUN CMS COMMS — The HHS official is moving to CMS to direct the agency’s office of communications. She’ll also be a senior adviser to Administrator Chiquita Brooks-LaSure focused on external affairs. Lynk, a Planned Parenthood alum, joined HHS earlier this year as its deputy assistant secretary for public affairs. | | | Pfizer is briefing top government officials this week on the possibility of a coronavirus booster shot after public dissent late last week between the drugmaker and federal agencies about whether a booster was necessary, the Washington Post’s Yasmeen Abutaleb, Tyler Pager, Laurie McGinley and Lena Sun reported. South Dakota Gov. Kristi Noem on CNN questioned other GOP governors who enacted public health measures like mask mandates and business closures amid the pandemic, accusing them of “rewriting history” on their Covid-19 measures. North Dakota currently ranks third in the country for coronavirus cases. A breathalyzer for disease could be imminent, say scientists who have worked for years on a portable device that can detect the chemicals someone exhales and distinguish between problems based on machine learning, Emily Anthes writes for the New York Times. | | | | A message from PhRMA: Getting to what you pay for medicines shouldn’t be a maze. Let’s make out-of-pocket costs transparent, predictable and affordable. And let’s do it without sacrificing access to medicines and innovation. See how we can make the system work for patients. Not the other way around. | | | | | | | Follow us on Twitter | | | | Follow us | | | | |  |
