BIDEN’S SURGE TEAMS SLOW TO LAND AMID RISING HEARTLAND CASES — The administration dispatched dozens of federal employees to Nevada in recent days, but similar surge teams have yet to materialize in states across the Midwest and South where the highly contagious Delta variant is leading to a rapid rise in hospitalizations, four state health officials and two senior administration officials told Erin Banco and Dan Goldberg. How can we help: In many instances, the White House and state officials are still sussing out what resources are needed. The president’s call for a “door-to-door” vaccination campaign earlier this month drew swift rebukes from Republican governors, but there are less obtrusive ways the administration can help, the two senior administration officials said. But privately, some administration officials are skeptical that federal personnel can do much to boost vaccination rates, especially in conservative areas where skepticism of Covid vaccines and government run high. The next few weeks and months of the vaccine push will be slow, two officials said, and should fall largely on political and health leaders trusted by the local community. For example: Missouri Gov. Mike Parson said he opposed any federal officials coming to Missouri to help with the vaccination campaign, while South Carolina Gov. Henry McMaster warned state agencies against working with anyone from the White House who is promoting vaccination. In Tennessee, the health department this week fired Michelle Fiscus, the state’s top vaccine official, after legislators alleged the department was encouraging teenagers to get vaccinated even without their parents’ permission. A White House official said the administration is working with governors and local public health officials “to ensure that they have the support they need to curb the spread of the virus and increase vaccinations in their state.” HOUSE PANEL ADVANCES DIVISIVE HEALTH SPENDING BILL — The Appropriations Committee approved a more than $253.8 billion spending bill for fiscal 2022 after nearly two hours of debate on a measure that would roll back the Hyde amendment, a longstanding ban on federal funding for abortions — including Medicaid coverage. The Labor-HHS-Education package , approved 33-25 largely along party lines, aims to shore up federal health agencies as they continue to deal with the effects of the pandemic and prepare for future outbreaks, Alice Miranda Ollstein and Sarah write. The details: — The bill designates $3 billion for President Joe Biden's proposed Advanced Research Projects Agency for Health, or ARPA-H — less than half of what the president proposed in his budget plan. — It allotts nearly $120 billion for HHS, $129 million below Biden's budget request. CDC funding would be $10.6 billion, $1 billion more than Biden proposed. — Substance abuse treatment and prevention would also get a $1.6 billion bump, to $5.5 billion total, as overdose deaths surge. And yet: The legislation’s prospects in the Senate could be grim. And in the House one Democrat, Texas’ Henry Cuellar, already voted against the Hyde amendment changes in committee, and the party needs lockstep support in its next stages. The bill now heads the House floor as part of a "minibus" later this month, but Republicans committee members predicted Thursday that disagreements between the chambers on abortion provisions would create an impasse requiring a stopgap to keep the government funded. WANTED: SENATE INFRASTRUCTURE BILL — The Senate left town Thursday with the fate of a bipartisan infrastructure package uncertain — despite Majority Leader Chuck Schumer's attempt to force it forward with a vote next Wednesday, Marianne Levine and Burgess Everett write. Negotiators face issues from funding mechanisms to spending priorities, but say they plan to work through the weekend after a Thursday afternoon huddle with White House officials. Besides the Wednesday vote Schumer planned, he imposed a deadline that same day for Senate Democrats to coalesce around a budget resolution setting up the $3.5 trillion plan. Speaker Nancy Pelosi has vowed that the House will not move forward on the bipartisan infrastructure package until the Senate passes a budget setting up the $3.5 trillion social spending package. PRICE WATCHDOG GROUP SEES NO BENEFIT FROM ADUHELM — An expert panel convened by the Institute for Clinical and Economic Review said Thursday that Biogen’s Alzheimer's drug does not work better than existing forms of care — and isn’t worth the $56,000 price tag, POLITICO’s Katherine Ellen Foley writes. “Looking at the data, if I had to guess, the data is stronger for net harm than it is for net benefit,” said Sai Lee, a geriatrician at the University of California San Francisco and one of 15 voting members of Thursday’s panel, who voted unanimously. Though ICER can’t determine drug prices or coverage, it can be an influential voice for lawmakers and other stakeholders. Currently, ICER has estimated that Aduhelm is more likely worth $2,500 to $8,300, based on the limited benefit it showed in two Phase III clinical trials. Meanwhile, CMS is meeting to discuss whether Medicare will cover the drug. | 
