What's next on abortion rights

From: POLITICO Pulse - Tuesday Sep 07,2021 02:05 pm

Sep 07, 2021

Presented by

With Joanne Kenen

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Quick Fix

— The Texas abortion law has invigorated Democrats but the president’s pledges to fight it don’t mean much without Congress.

— Parents and doctors want Covid vaccines for kids but the data isn’t there yet, even as more outbreaks loom.

— Universities are switching from carrot to stick, insisting students need a vaccine to have their college experience.

WELCOME TO TUESDAY PULSE — Did you miss us during the week away? Sadly, the news didn’t pause with us. Send tips and good reads from the last week to sowermohle@politico.com and acancryn@politico.com.

A message from PhRMA:

While nine out of 10 Americans said in a recent Kaiser Family Foundation poll that they support drug price negotiation, opposition to the approach soared to 65 percent when respondents were told negotiation could limit people’s access to medicines or result in fewer new treatments and cures . Voters prefer commonsense, patient-centered solutions to address their true concerns.

Driving the Day

WHAT’S NEXT ON ABORTION RIGHTS — With news last week that Texas is banning most abortions, Democrats and public health groups across the country mobilized to denounce the measure and challenge its legitimacy. Will their calls matter? Unclear.

President Joe Biden Friday called the new law, which bans abortions after six weeks, "un-American” and told reporters that the Department of Justice is investigating mechanisms that might block its enforcement.

But: Biden’s comments don’t mean action. The White House is essentially depending on Congress to preserve abortion rights, a situation Biden is familiar with at this point, Anita Kumar and Chris Cadelago write. With razor-thin Democratic majorities and the need for 60 votes to pass relevant legislation in the Senate, Biden’s opportunities for meaningful victories — on abortion, gun control, and other parts of his ambitious agenda — are dimming.

For example: The House is expected to take up a bill that would enshrine in federal law the right to access abortion, but it doesn’t have 60 votes in the Senate, and may not even have all 50 Democrats.

For now, Biden has focused on places he can act immediately, though on certain fronts it’s unclear what action the White House can legally take. He’s launched a so-called "whole of government" effort to respond to the Texas law, leaning on Justice Department officials and the Department of Health and Human Services to help determine what the federal government can do to ensure women in Texas and other states contemplating similar laws have access to safe and legal abortions, Anita and Chris write.

In the meantime: Even some Republicans aren’t sure about the new measure. “I think the Supreme Court will swat it away once it comes to them in an appropriate manner,” Louisiana Senator Bill Cassidy said Sunday on ABC’s “This Week.” He added: “If it's as terrible as people say it is, it‘ll be destroyed by the Supreme Court.”

Read more: The ruling kicked up a storm over private rights to sue because of the specter that private citizens could sue anyone they suspect of helping a pregnant person access the procedure, Alice Miranda Ollstein and Josh Gerstein write.

And more: The real test hasn’t even happened yet, Sarah Isgur writes for POLITICO Magazine. That challenge will come this fall, when the Supreme Court will hear arguments in a case called Dobbs v. Jackson Women's Health Organization about the constitutionality of Mississippi’s ban on abortions after 15 weeks.

Under the Casey v. Planned Parenthood standard, a ban on abortions at that stage is clearly an “obstacle in the path of a woman seeking an abortion of a nonviable fetus.” Many believe that there are at least five votes on the court to change how undue burden is defined and potentially create a new standard — or simply leave it up to states. As of today, 22 states have laws that would further restrict abortion access if Casey is overturned.

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WHERE ARE COVID SHOTS FOR KIDS? Pressure is mounting on the Food and Drug Administration to authorize Covid-19 vaccines for children under 12 — even though the data needed to support the move is still being collected, Lauren Gardner reports.

Politicians and anxious parents have joined some public health groups in calling on federal regulators to accelerate the process. They point to a record number of infections among this age group in recent weeks as schools have reopened.

But those calls are running up against the FDA’s caution and — crucially — a lack of safety and efficacy data. Regulators have already asked vaccine makers to increase the size of their pediatric clinical trials to increase the chances of detecting rare side effects. The first results from one study, Pfizer’s, aren’t expected until later this month. And top federal health officials have said they don’t expect a vaccine will be available for 5-to-11-year-olds until late fall or winter. Authorization for children as young as 6 months will come even later.

But: Hospitalizations among children and teens quadrupled in August in states with low vaccination rates, the Centers for Disease Control and Prevention said in a report released Friday. Hospital admissions for unvaccinated adolescents and kids 4 and under have each risen tenfold since mid-June, when the Delta variant took hold in the U.S., the CDC said.

COLLEGES TAKE A HARD LINE ON VACCINES — After months of coaxing students to get vaccinated with thousands of dollars in prizes — everything from gift cards to sports tickets and free parking — colleges are starting to punish the unvaccinated, restricting campus and even internet access.

On the ground: Unvaccinated Quinnipiac University students will be fined up to $200 a week and lose access to the campus’ Wi-Fi until they get the shot. The University of Virginia booted more than 200 unvaccinated people from its rolls before the semester began. And Rutgers University, the first university in the U.S. to mandate vaccination for students, is threatening to disconnect email access and deny campus housing for students who don’t comply. Some colleges used similar tactics last year to get students to follow testing procedures.

Younger adults have some of the lowest vaccination rates among eligible populations. About 60 percent of people ages 18–24 have gotten at least one dose of the vaccine, compared to about 95 percent of people 65–74, according to CDC data.

"The Delta variant has been a game-changer, and we need to respond accordingly,” said Anita Barkin, co-chair of the American College Health Association’s Covid-19 task force. She noted that schools with immunization requirements have a distinct advantage over schools that have to use incentives to get students vaccinated.

A message from PhRMA:

THE COVID TUG OF WAR — The summer of 2021 began with such promise. On Memorial Day, the traditional start of summer, many Americans thought the worst of Covid might be over, masks were out, and hugs (or more) might be in. But that optimism has yielded to a more somber and uncertain Labor Day as hot vax summer turned into hotspot autumn, Joanne Kenen writes: The narrow window to end the virus slipped through our unvaccinated fingers.

Instead, we’re learning to live with it while slowly gaining strides in a fight that looks more like a tug of war than an epidemiological tank battle.

“It is really important that we convey that success does not equal no cases,” Surgeon General Vivek Murthy told Joanne for her POLITICO Magazine assessment of the current state of the pandemic. “Success looks like very few people in the hospital and very few dying.”

Delta is a genuine danger, but vaccinated people might overestimate their peril, just as unvaccinated people might underestimate it. “This is the dichotomy developing,” Murthy said. “It’s almost like living in two different Americas.”

Yet, the virus’ persistence doesn’t mean we’re stuck in a perpetual pandemic. Over time, human immunity will keep growing through vaccination and natural infection. That’s already started. Scientists will develop new treatments. Eventually, Covid can become one of many diseases that circulates, and sometimes kills without bringing the world to a deadly standstill, Joanne writes.

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PROGRESSIVE PREP FOR MEGABILL FIGHT — Top Democrats are pushing to resolve lingering House-Senate disputes over their massive social spending plan. They’re working to finalize its text by Sept. 15 so they can pass the bill along party lines and make Speaker Nancy Pelosi’s Sept. 27 deadline, though her timeline is largely about the infrastructure package. That gives progressive groups only weeks to defend key elements of the up-to-$3.5 trillion package, Marianne Levine writes.

The party's outside activists are already planning to spend big and escalate their messaging. But matters are trickier on the Hill, where progressive lawmakers are on a collision course with Democratic centrists resistant to such a big price tag.

Unlike their House colleagues, liberal senators are refraining from publicly criticizing their centrist counterparts, even though both Sens. Kyrsten Sinema (D-Ariz.) and Joe Manchin (D-W.Va.) have raised serious concerns with the $3.5 trillion number. Senate Budget Chair Bernie Sanders (I-Vt) Thursday evening reiterated that there would be "no infrastructure bill without the $3.5 trillion reconciliation bill" in response to an op-ed by the West Virginia Democrat about the bill, but he didn’t mention Manchin by name.

“There’s a long list of priorities and investments we want to make. It’s just going to take a while,” said Sen. Bob Casey (D-Pa.), who is focused on the bill’s home and community-based services’ element. He added that the $3.5 trillion top line could change but that he didn’t foresee specific policies getting scrapped entirely. Instead, he suggested that the duration or funding for an individual provision could be altered.

ICYMI: BIDEN ADMIN SOFTENS BOOSTER LAUNCH — Senior Biden administration health officials are delaying the Sept. 20 deadline for making booster doses of some coronavirus vaccines available to most adults as officials are increasingly certain Moderna’s booster approval won’t be ready in time.

Food and Drug Administration Acting Commissioner Janet Woodcock and Centers for Disease Control and Prevention Director Rochelle Walensky told White House officials Thursday they may not have sufficient safety and efficacy data on boosters in time for the target date they and other top health officials announced last month with backing from President Joe Biden.

The booster plan has caused turmoil within the FDA and among public health experts who worry that publicly naming a date before enough data was available would pressure the agency to allow booster vaccines even if they didn't feel the extra doses were justified. Two top FDA vaccine regulators resigned last week, a move that one senior official said was rooted in frustration over how the booster rollout has been handled.

Officials still expect Pfizer, which completed its booster application with the FDA on Aug. 27, to be ready by the late September target. Moderna said Friday that it finished its submission.

What We're Reading

The increase of “corporate interest and influence” in health care is creating a “bloated, complex, and fragmented” system increasingly drawn towards profit over care, American College of Physicians’ top figures said in an Annals of Internal Medicine policy paper.

Texas schools have logged more than 50,000 coronavirus cases among students in a matter of weeks and are leading in child deaths from the virus—and doctors blame Abbott’s administration, Paul Flahive writes for NPR’s Houston Public Media.

A message from PhRMA:

Proponents of government price setting often misrepresent voter opinion on support for allowing the federal government to “negotiate” drug prices. While nine out of 10 Americans said in a recent Kaiser Family Foundation poll that they support drug price negotiation, opposition to the approach soared to 65% when respondents were told negotiation could limit people’s access to medicines or result in fewer new treatments and cures.

Non-partisan, independent public polls have repeatedly demonstrated that once Americans understand what government negotiation is, and what the tradeoffs are, support drops dramatically.

76% of Americans oppose H.R.3-style “negotiation” if it causes delays in access to new prescription drugs, and 72% oppose it if it results in fewer new medicines developed in the future.

62% agree we should keep the current law that prohibits government interference in Medicare plan negotiations because it protects seniors and people with disabilities from losing access to their medicines.