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Presented by HCA Healthcare: 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 and Alice Miranda Ollstein 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.
| | | — Democrats have kicked off an ambitious, and potentially torturous, effort to craft a $3.5 trillion spending package stuffed with health priorities. — The White House is signaling a willingness to take a harder line with GOP governors over school masking requirements. — The administration struck down three more Medicaid work requirements and picked a battle with Tennessee over a block grant plan. WELCOME TO WEDNESDAY PULSE — It’s not the most important part of vaccination, but it’s one of the strangest: Vaccine cards are the wrong size. Send tips to acancryn@politico.com and sowermohle@politico.com. | | A message from HCA Healthcare: HCA Healthcare prioritizes investing in our communities. We contributed to community infrastructure and economic development through $4.1 billion federal, state and local taxes incurred in 2020. Additionally, we returned or repaid early approximately $6 billion in CARES Act funds. We employ 275,000+ colleagues across 20 states, and in 2020, we provided an estimated $3.4 billion in the delivery of charity care, uninsured discounts and other uncompensated care.
See how we show up for our communities. | | | | | | ONE DOWN, ONE TO GO — President Joe Biden finally got what he’d spent months chasing: a bipartisan infrastructure deal shoring up the nation’s roads and bridges that also proved Washington can still come together to get things done. Yet while Biden took his victory lap Tuesday afternoon, Hill Democrats were gearing up for an even bigger lift that’s sure to test the party’s leaders — and go a long way toward determining the scope of this administration’s health care ambitions. The opening drive toward Democrats’ planned $3.5 trillion spending package stretched into the wee hours of the night, with the Senate taking vote after vote on amendments to the party’s budget resolution. They were mainly messaging exercises, but they gave lawmakers an opportunity to put one another on the spot on a range of hot-button issues, POLITICO’s Alice Miranda Ollstein reports. Among the early health-related amendments: — A Tim Scott -authored provision requiring all schools to open for in-person instruction, which was defeated 49 to 50. — An amendment from Sen. Roger Marshall making it illegal to transport undocumented immigrants who test positive for Covid-19 (except for the purposes of deportation) and a resolution from Sen. Michael Bennet expressing support for permitting Medicare to negotiate drug prices. The vote-a-rama marked the first, but not the last, hurdle for the spending effort. Democrats are jockeying to get their favored provisions into the package, with lawmakers hoping to make progress in all manner of areas, from climate change to child care and immigration. All along the way, party leaders will have to calibrate negotiations to ensure it can get past centrist senators like Joe Manchin and Kyrsten Sinema, who are already skeptical of the entire enterprise. The package's health provisions will be critical. Democrats anticipate a major source of savings will come from their drug-pricing plan — meaning the more they can lower pharmaceutical costs, the more they can spend on other priorities. But major savers such as Medicare negotiation are controversial within the party, and Democrats don’t yet have a clear path to 50 votes. Also sparking tension: The prospect that Biden’s call for $30 billion in pandemic preparedness funding could get scaled back to as little as $5 billion — worrying some lawmakers who say it'd show Congress didn't learn anything from the current pandemic.
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BIDEN SLAMS ‘DISINGENUOUS’ GOVS OVER MASK BANS — Republican governors’ efforts to block schools from requiring masks are “totally counterintuitive and, quite frankly, disingenuous,” Biden said Tuesday — marking the latest in a string of criticisms of the GOP state leaders opposed to Covid-19 precautions.
The remarks came as cases climbed in places like Florida, where Gov. Ron DeSantis has threatened to withhold funds from school districts that try to mandate mask-wearing. Biden didn’t single any governors out, emphasizing instead that he’s grown “very concerned” about the rising percentage of school-aged children testing positive. But the White House has hinted at more definitive action. Press Secretary Jen Psaki earlier Tuesday suggested that Covid relief money not yet distributed to Florida could instead be directed to schools to replace any state funding they lose because of mask requirements. “We’re continuing to look into what our options are to help protect and help support these teachers and administrators,” she said, praising those schools that opted to defy DeSantis. BIDEN REVOKES MEDICAID WORK RULES IN THREE MORE STATES — CMS is pulling the plug on work requirements in three Republican-led states, as the Biden administration continues to roll back one of former President Donald Trump’s signature health policies. On Tuesday, CMS Administrator Chiquita Brooks-LaSure quietly sent letters to health officials in Ohio, Utah and South Carolina, informing them that the administration had scrapped the federal government’s approval for states to mandate that Medicaid enrollees work or volunteer to get coverage. Democrats fiercely oppose work rules, arguing they’re intended to shrink the safety net, Rachel Roubein writes. The Biden administration has already revoked most Trump-era approvals, but the agency’s decision could spark a backlash, as officials in the three states had appealed to CMS earlier this year to let them keep the work rules in place. CMS OPENS COMMENT PERIOD ON DIVISIVE TENN. MEDICAID PLAN — The Biden administration Tuesday told Tennessee that it intends to solicit public comments on its plan to implement what’s been referred to as a Medicaid block grant — though it said doing so won’t delay implementing the controversial waiver that advocates are fighting in court. The agency said in a letter to the state that those suing the administration agreed to press pause on the lawsuit if the agency opened a new, month-long public comment period. The Trump administration approved Tennessee’s Medicaid waiver in its final weeks, and in April, a group of 13 Medicaid beneficiaries and health law groups sued the administration over Tennessee’s plan, arguing it allows the state to restrict coverage of prescription drugs and permits other “troublesome” policies. | | | |   | | | | | | The administration has made clear it will nix any Trump-era measures that Biden’s CMS views as harming the safety net program. Notably, the agency didn’t indicate whether it planned to revoke approval for Tennessee’s plan, as it did with Medicaid work requirements. A spokesperson did not comment on whether the agency supports the state's waiver. GOP, INDUSTRY SIGNAL FIGHT OVER POTENTIAL BIDEN VACCINE THREAT — Republicans and some industry groups are indicating they would oppose any effort from the Biden administration to withhold federal funds to push some employers — like nursing homes and health facilities — to mandate Covid vaccines, Rachel reports. If Biden goes that route, the move would mark the first time his administration has used the power of the purse to increase vaccinations. But as federal officials discuss whether to withhold dollars from certain institutions, critics argue that threatening to pull federal funding to push employers to require vaccines is a step too far that could instead harm institutions by costing them millions of dollars. A Biden administration official didn’t rule out the idea — first reported by The Washington Post— but cautioned that discussions are in the early stages. This comes as administration officials have struggled for months to find new ways to jumpstart immunizations, and amid a politically charged debate over mandating coronavirus vaccines. POLL: MOST PARENTS OPPOSED TO SCHOOL VAX MANDATES — That includes 58 percent of parents of kids between 12 and 17 who are already eligible for a Covid-19 vaccine, according to the latest Kaiser Family Foundation poll, which drew on answers from 1,259 representative parents of children under 18 years old across the U.S. Roughly 41 percent of eligible teens are already vaccinated while 20 percent of parents refuse to let their children get the shot and others are adopting a “wait-and-see” approach to school requirements. Democrats were more likely than Republicans to report that their children are vaccinated or that they would back requirements. Mask mandates garner more support. While most parents don’t want schools to implement vaccine requirements, 63 percent do want schools to mandate masks for unvaccinated students and staff. Safety and cost concerns linger. The vast majority of hesitant parents say they’re worried about long-term safety though no serious side effects have been reported. Hispanic and Black parents are roughly three times more likely than white parents to express concerns about out-of-pocket costs though the vaccines are free. But many respondents say they’re also worried about taking time off and finding a trusted place to get their child vaccinated.
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PROVIDERS PRESS FOR REST OF PANDEMIC FUNDING — Long-term care providers are calling on Biden health officials to release billions of dollars left in a pot of Covid-19 relief funds — though it’s unclear just how much remains.
“The costs associated with routine testing, personal protective equipment (PPE), and staffing have pushed many facilities to the brink,” American Health Care Association and National Center for Assisted Living CEO Mark Parkinson wrote in a letter to HHS Secretary Xavier Becerra. Nursing homes spent roughly $30 billion on PPE and additional staffing in 2020, a trend the group doesn’t expect to let up among the Delta variant surge, Parkinson said. The CARES Act created the Provider Relief Fund last year with $178 billion to disperse to health care providers. But Parkinson’s group argues that nursing homes received just $13 billion from the fund in 2020. The remaining stash — as much as $43 billion, according to lawmakers, though HHS said at least half of that is already allotted — was nearly siphoned into bipartisan infrastructure savings before providers railed against the move. | | A message from HCA Healthcare: At HCA Healthcare, investing in the communities where we work and live is a priority. We are proud to contribute to community infrastructure and economic development through the $4.1 billion federal, state and local taxes we incurred in 2020. In addition, HCA Healthcare returned or repaid early approximately $6 billion in CARES Act funds because it was the right thing to do.
We invest in other ways, as well. We employ over 275,000 colleagues across 20 states, and made $2.8 billion in capital investments last year. We also provide significant financial benefits to patients throughout our communities; in 2020, we provided an estimated $3.4 billion in the delivery of charity care, uninsured discounts and other uncompensated care.
We are committed to the health and well-being of all of our patients and communities. Learn more about how HCA Healthcare shows up to create healthier tomorrows. | | | | | | At least 1 million people in the U.S. have received unauthorized third doses of coronavirus vaccines, according to an internal CDC document reported by ABC News’ Emily Shapiro and Ivan Pereira. It’s still early days for the HHS climate change office envisioned by President Biden, but outside experts say the agency is making positive early moves to line up priorities and potential leaders, Joyce Frieden reports for MedPage Today. Moderna will build a vaccine manufacturing plant in Canada, vastly expanding its production as it sets its sights on similar factories in Europe and Asia, The Wall Street Journal’s Felicia Schwartz reports. | | | | Follow us on Twitter | | | | Follow us | | | | |  |
