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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 Adam Cancryn and Sarah Owermohle | | | 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 Biden administration's plea that people begin wearing masks indoors risks falling on deaf ears in the hardest-hit states. — The CDC's latest Covid-19 research reinforces both the Delta variant's danger and the success of the vaccines. — The Senate’s infrastructure package would delay a Trump-era Medicare rebate rule by three years. WELCOME TO MONDAY PULSE — where if you've yet to see it, start your day with this incredible video of Dutch Olympian Sifan Hassan falling in the women's 1,500-meter race, only to come all the way back to win. Send tips and Olympic highlights to acancryn@politico.com and sowermohle@politico.com. | | | | A message from PhRMA: In Washington, there’s often a big difference between what politicians say and what they mean. Politicians are saying they’ll negotiate medicine prices in Medicare. But it really means the government could stand between you and your medicines. There’s a better way to help patients. See how. | | | | | | COVID MESSAGING GETS MORE COMPLICATED — The Biden administration is ringing the alarm over Covid-19’s comeback — but in the places that need to hear it most, it’s unclear anyone’s still listening. Health experts and leaders in hard-hit states across the country warn that weary Americans are losing patience with the ever-shifting orders coming down from the federal government, making it increasingly difficult to convince people to return to public health precautions like mask wearing, POLITICO’s Dan Goldberg and Erin Banco report. Federal and state officials already faced an uphill climb trying to get a significant chunk of the population to take Covid-19 seriously, after months of Trump-era politicization — and a more recent spate of misinformation – turned the virus into a partisan issue. But confusing messaging hasn’t helped. It was just months ago that the CDC triumphantly dropped its mask-wearing recommendations. And up until recently, health officials were still insisting that the vaccines offered near-total protection. Now masking requirements are suddenly back, driven by new evidence even the vaccinated can pass on the virus. It’s a whipsaw that’s provided fodder for critics and contributed to rising tensions within the administration. The masking decision put some in the White House at odds with the CDC over whether the situation was dire enough to warrant such a significant reversal , POLITICO’s Natasha Korecki, Erin and Adam report. There remain concerns internally about how the new approach will work. “We declared ourselves to be somewhat successful when we were able to say vaccinated people don’t have to mask,” an administration official said. “It’s hard to seem like we’re going back.“ What does seem to be getting through to people: The sheer rise in serious Covid-19 cases of late. Vaccinations overall have trended steadily upward over the last week, and states like Missouri and Mississippi are doling out shots at their fastest pace in nearly three months.
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WHAT THE CDC’s DELTA DATA TELLS US — Fully vaccinated Americans can contract the Delta variant of Covid-19 and transmit it to others more readily than any prior versions of the virus. But they’re still less likely to catch it in the first place compared with an unvaccinated person — and way less likely to suffer any serious symptoms.
Those are the takeaways from the research that helped convince the CDC to revise its mask-wearing guidance, and that was released to the public on Friday. The data, collected in partnership with Massachusetts’ health department, focused on a Covid-19 outbreak on Cape Cod following July Fourth. What it found: Of 469 cases that the CDC investigated, 74 percent occurred in fully vaccinated individuals. And the vast majority of the vaccinated people in that cluster developed symptoms. But only five people were hospitalized (one of whom was unvaccinated). And none ended up dying from the disease, according to the research. Those results are both alarming and reassuring, depending on how you look at it. The Delta variant is clearly far more transmissible than prior Covid-19 strains, allowing it to circulate faster and more widely – putting a greater population of unvaccinated people and, in rare cases, vaccinated people at risk. But it’s also proof that the vaccines are working as intended. Even while carrying similar levels of the virus as unvaccinated people, all but a few of the fully vaccinated cases were mild enough to avoid a trip to the hospital — and there were no deaths. That latter point is what the Biden administration has since amplified. In the hours after the data’s release, White House officials chastised media outlets for focusing on the large percentage of infections in vaccinated people within that cluster — rather than that so-called breakthrough cases are an extremely small percentage of infections overall. Yet the reaction also served to further highlight the administration’s recent messaging woes. After reviving masking recommendations on Tuesday, it took the CDC three days to release the data that justified it. And then once it did — in the form of a dense scientific report — neither the CDC nor the White House held a press conference to walk the public through it, opting instead to fight over the wording of various tweets after initial stories on the data had been published. The White House Covid-19 team is slated to brief this afternoon, in what could be an attempt at cleanup. President Joe Biden is also expected to give another speech Tuesday on the pandemic response. WHAT’S IN — AND OUT — OF THE BIPARTISAN INFRASTRUCTURE BILL — The long-awaited bill unveiled Sunday evening secures victories for both the pharmacy benefit and provider lobbies. — The package delays a Trump-era Medicare rebate rule for three years, which is expected to save tens of billions of dollars. — Providers successfully fought against using tens of billions of dollars from the provider relief fund to pay for the legislation. — And the legislation also saves several billion dollars by reducing Medicare spending on discarded medications from single-dose drug vials. | | | CDC UNDER FIRE TO BETTER TRACK BREAKTHROUGH INFECTIONS — The agency’s limited tracking of coronavirus cases in vaccinated people is hindering public health officials’ attempts to stem the nationwide surge of the highly transmissible Delta variant, POLITICO’s Rachel Roubein and David Lim report. In May, CDC stopped routinely tracking breakthrough infections that didn’t lead to hospitalization or death — a decision that prompted variation in how states keep tabs on the cases. — At least 30 states are monitoring all breakthrough infections, according to a POLITICO survey of state officials. Another eight — including Ohio, Texas and South Carolina — said they’re following CDC’s approach and only collecting data on severe cases. Two, Iowa and Missouri, said they are having trouble reliably tracking infections in vaccinated people. Now some public health experts and lawmakers are pressuring the CDC to reverse its decision and collect comprehensive data on infections in vaccinated people — from mild to severe. They argue that the data can help state and local officials make better, more targeted, decisions about when masks are warranted and whether to limit the size of gatherings. But CDC has defended its decision. Asked about its breakthrough policy, the agency said focusing on cases where patients have severe disease helps “maximize the quality of the data collected on cases of greatest clinical and public health importance.” Walensky has called it a “misconception” that her agency is not doing enough to understand the patterns of infection in vaccinated people. The agency is gearing up to release data on “tens of the thousands” of people across the country who have caught Covid-19 after vaccination. | | | |   | | | | | | GEORGIA’s PARTIAL MEDICAID EXPANSION DELAYED — The state is postponing the start of its partial Medicaid expansion program likely until the end of the year , amid negotiations with the Biden administration over controversial policies included in the plan, POLITICO’s Rachel Roubein reports. The move sidesteps a public fight between CMS and Georgia Gov. Brian Kemp, a Republican, over a Trump administration-approved plan to extend coverage to 65,000 low-income adults but require people to work or volunteer to get coverage. The Biden administration has opposed the concept of tying work to Medicaid coverage. — Meanwhile, Georgia’s Democratic delegation in Congress wants the state to instead adopt Obamacare’s broader expansion of Medicaid, which would cover hundreds of thousands of people. This is the second time Georgia has delayed its expansion; it earlier pushed the start date from July 1 until at least Aug. 1, and now could give itself several more months to work with CMS to “find a mutually agreeable path forward,” according to a letter signed by the head of the state’s Department of Community Health. | | | | Be a Policy Pro. POLITICO Pro has a free policy resource center filled with our best practices on building relationships with state and federal representatives, demonstrating ROI, and influencing policy through digital storytelling. Read our free guides today . | | | | | | | | FIRST IN PULSE: BIDEN COVID TEAM ADVISER DEPARTS — Lauren Silvis has wrapped up a five-month stint at HHS, where she was an adviser to the Covid-19 response, PULSE has learned. A former senior FDA official, Silvis was brought on earlier this year to aid the Biden team’s work ramping up vaccine production and supply, as well as its planning for the next phase of Covid-19 therapeutics. She is currently also the senior vice president of external affairs at health technology firm Tempus. IHS TAPS CHIEF MEDICAL OFFICER — Loretta Christensen is the Indian Health Service’s new chief medical officer, making her the agency’s top expert on medical and public health issues affecting American Indians and Alaska Natives. Christensen is a member of the Navajo Nation and previously spent four years as chief medical officer for the Navajo Area Indian health Services. | | | | A message from PhRMA: Under Medicare Part D, seniors and people with disabilities have coverage for a vast number of prescription medicines they pick up at the pharmacy. Wide choice of plans and robust coverage of medicines is possible, in part, because of a protection in the Medicare statute known as the non-interference clause. Now, some want to repeal this provision, saying the government will “negotiate” lower medicine prices. What they really mean is they want to repeal the part that protects robust coverage and choice of plans for seniors and people with disabilities. People want choice, access and affordability when it comes to their medicines in Medicare, not barriers. There’s a better way to help patients. See how. | | | | | | Social media influencers have become an integral part of federal and state campaigns to get more young people vaccinated, The New York Times' Taylor Lorenz reports. The Los Angeles’ Times Kim Christensen traces how a botched surgery sparked a push in California for legislation requiring doctors to tell patients if they’ve taken money from drug and medical device makers. The U.K.’s Delta-driven coronavirus surge is unexpectedly dying out, and health experts are trying to figure out if the same could happen in the U.S., New York magazine’s David Wallace-Wells writes. | | | | Follow us on Twitter | | | | Follow us | | | | |  |
