Becerra's backseat role on Covid

From: POLITICO Pulse - Tuesday Sep 21,2021 02:04 pm
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Quick Fix

— HHS Director Xavier Becerra has played a minor role in Covid-19 response even as agencies spar over their lanes.

— Vaccine supply fears partially motivated the booster timeline as U.S. officials worried they could run out of doses right when third shots were needed.

Democratic leaders are now tying the budget to lifting the debt ceiling, further crowding the agenda this month.

WELCOME TO TUESDAY PULSE, where our cats’ main hobbies include napping on computers and waking us at 4 a.m., neither of which are plague risks. Send tips and cat photos to sowermohle@politico.com and acancryn@politico.com.

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Driving the Day

BECERRA’s BACKSEAT ROLE ON COVID — President Joe Biden assembled what he’s called a “world-class” team of health experts to lead the fight against Covid-19.

But his top health official, HHS Secretary Xavier Becerra, has played only a minor role in steering the crisis response so far , Adam reports. Over his first six months in office, Becerra’s had little involvement in major pandemic decisionmaking. He’s kept out of internal policy debates between HHS’ scientific agencies. And he’s yet to make an appearance at a White House Covid-19 briefing.

Becerra’s low profile is part by design. The White House has consolidated power over the response under Covid coordinator Jeff Zients, who oversees his own team and often works directly with top public health officials at the CDC and FDA.

Yet it’s also a recognition of Becerra’s own lack of public health experience. Without a medical background or scientific expertise, Becerra’s ability to contribute to in-depth debates driving pandemic decisionmaking has been limited, administration officials said. Instead, he’s spent nearly every other week on the road, promoting Biden’s broader health agenda and response efforts in local communities.

That’s created problems of late, as the White House sparred with CDC officials over vaccine research and the CDC and FDA clashed over the Covid-19 booster rollout. Amid the infighting, some officials questioned why Becerra hasn’t taken a stronger hand in managing relations between the various factions.

In an interview, Becerra defended his role in the Covid response – calling HHS “an integral part” that’s been involved in every facet of the effort. He also defended the administration’s decision to roll out a booster plan before the science was settled.

Even his allies, though, worry that Becerra’s quieter presence on the pandemic foreshadows future difficulties getting the White House to invest in the rest of his health ambitions. HHS has only recently gotten more involved in Congress’ efforts to craft a drug pricing plan.

And despite harboring a lengthy agenda, Becerra acknowledged there’s only so much that can get done until the pandemic is defeated. “You really can’t get to the other things if Covid is still surrounding you,” he said.

SUPPLY CONCERNS SHAPE BIDEN BOOSTER PLAN — Top advisers to President Joe Biden pushed for his administration to announce a broad booster rollout for September partly because of fears the U.S. could run short of doses needed to offer the shots to its entire population if vaccines’ protection decreased suddenly, two senior officials with knowledge of the matter told POLITICO’s Erin Banco.

Biden’s team wanted to ensure the U.S. would have enough supply for the 40 percent of eligible Americans who still needed their first shots and those who would eventually need a boost, the officials said — despite the country’s deep vaccine stockpile.

“No one wants to be the person responsible for not having the doses when we need them,” one individual familiar with the deliberations told Erin.

Similar concerns led the administration to delay its first vaccine donations this spring despite an abundance of doses at home, prompting criticism that the U.S. was hoarding shots while the world suffered. But the White House’s booster balancing act comes as the Biden administration this week hosts a global vaccine summit at the U.N. General Assembly, where U.S. officials will push other international leaders to commit more resources to increase vaccination worldwide.

In a series of meetings over the past two months, Biden’s chief medical adviser, Anthony Fauci, and some of the most senior White House officials argued the U.S. needed to protect itself, pointing to data from Israel that showed the Pfizer-BioNTech vaccine was becoming less effective against infection and severe disease. And if domestic data had yet to catch up to the distressing reality in Israel, it soon would, those officials argued.

DEMS TIE DEBT TO FUNDING, SETTING UP A FIGHT — Congressional Democrats are proposing lifting the debt ceiling through the 2022 midterm elections as part of their plans to fund the government into December, leaders said Monday afternoon, POLITICO’s Caitlin Emma and Sarah Ferris report.

The problem: That measure, set for a House vote this week, faces an uncertain future as Senate Republicans remain unwilling to help Democrats neutralize the looming crisis over the nation’s debt limit when their party controls Congress and the White House.

Democratic leaders are sticking with their hardball tactics to pressure the GOP, still unwilling to publicly discuss possible alternatives to tackle the debt limit unilaterally. But those conversations are happening privately as the House returns Monday for the first time since mid-August, with just 10 days until the funding deadline and just a few weeks until a possible debt default, Caitlin and Sarah write.

 

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TODAY: BIDEN ADDRESSES GLOBAL LEADERS ON COVID, COOPERATION — President Joe Biden will make his first presidential address to the United National General Assembly today — and he’s already in a careful balancing act on Covid-19 vaccine boosters, production and patents.

What to expect: Biden will call for international cooperation on the pandemic along with climate change, technology overhauls and economic investments, according to a senior administration official who said the “main areas” for announcements will be Covid-19 efforts like vaccine access.

One thing Biden may not mention — but something that’s top of mind for several leaders in the audience — is who can manufacture coronavirus vaccines. South African and Indian officials are pressing for manufacturer patents to be waived so their nation and others can produce shots themselves. But while Biden has signaled he would back a narrow patent waiver, European countries are vehemently opposed.

Up next: The White House will drill down on Covid-19 goals in a virtual summit Wednesday where, according to an outline obtained by POLITICO, American officials will press global leaders and nongovernment organizations to chip in towards $12 billion toward funding global vaccination, fixing oxygen shortages and boosting treatment access.

FIRST IN PULSE: AMA REPORT SHOWS DECLINING OPIOID PRESCRIBING — A new report released today by the American Medical Association shows a 44 percent decrease in opioid prescribing over the past decade by doctors amid improved monitoring efforts, POLITICO's Tucker Doherty reports.

The report instead highlights the role of illicit drugs like fentanyl as a driver of the rising overdose mortality rate, which has surged during the pandemic. According to the CDC, more than 93,000 Americans died of drug overdoses in 2020, a 30 percent increase over the previous year.

—PRO ANALYSIS: Read more in the new Pro Analysis on the opioid crisis after Covid , with an overview of the latest trends and a look at what's coming next for the policy response.

SCOTUS TO HEAR ROE CHALLENGE IN DECEMBER — The Supreme Court Monday set Dec. 1 arguments on Mississippi’s ban on abortion after 15 weeks of pregnancy, a direct challenge to Roe v. Wade.

In taking the case, the Supreme Court’s conservative supermajority signaled its openness to revisiting and potentially overturning the landmark 1973 decision that legalized abortion nationwide, with a ruling expected next year, POLITICO’s Alice Miranda Ollstein writes. Justices said they want to hear arguments on whether all bans on abortion before a fetus can survive outside the womb are unconstitutional.

A ruling is likely to come down next summer — just a few months ahead of midterm elections that will decide control of Congress.

The state law has so far been blocked by lower courts because it directly violates Roe’s protections for previability abortions.

The White House spoke up Monday in support of the Women’s Health Protection Act, H.R. 3755, a bill aimed at another restrictive abortion law — Texas’ S.B. 8 effectively barring abortions across the state. The measure “blatantly violates existing Supreme Court precedent” and “turns private citizens into bounty hunters” who can sue neighbors or friends they suspect got an abortion or helped someone to do so, the budget office said in a statement of administrative policy.

 

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In Congress

SANDERS RALLIES OUTSIDE PhRMA OVER DRUG PRICING — Sen. Bernie Sanders (I-Vt.) is hosting a rally outside PhRMA headquarters today to press lawmakers on drug pricing provisions now in jeopardy under the reconciliation talks.

Sanders and the progressive group People’s Action will line up patient speakers under a banner emblazoned with the text "STOP PHARMA GREED" and a giant pill bottle surrounded by shackles. Sanders, who leads the Senate Budget Committee, is speaking at the event and delivering a letter signed by more than two dozen progressive advocacy groups.

FIRST IN PULSE: SENATORS LAUNCH BIPARTISAN MATERNAL HEALTH BILL — New Hampshire Democrat Maggie Hassan and North Carolina Republican Thom Tillis will introduce legislation today that would broaden maternal health to encompass postpartum depression, anxiety and suicide treatment.

The bill would create a federal task force to expand mental health resources for new mothers and direct HHS to work with states on prevention efforts.

Names in the News

Becerra has brought on former Obama-era health official Leslie Dach as a temporary adviser to assist with HHS messaging on the pandemic response . Dach served as a senior counselor to then-HHS Secretary Sylvia Burwell during the Obama administration, where he helped manage the implementation of the Affordable Care Act.

He told Adam he’ll spend the next several weeks helping to coordinate Covid-19 policy and messaging across the department — including working with the White House and agencies like the Centers for Disease Control and Prevention. His official HHS title is Covid-19 strategic planning director.

The National Academies of Sciences, Engineering, and Medicine announced that Monica Feit will be the executive director of its Health and Medicine Division starting in November. Feit has been deputy executive director for National Academies’ behavioral and social sciences and education unit since 2017.

Sarah Meek joined BlueCross BlueShield as director of government affairs, responsible for developing CareFirst’s advocacy strategy. Meek previously worked for Lutheran Services in America Disability Network and the Alliance for Retired Americans.

Scott Weier returned to Finsbury Glover Hering as a partner in the health practice. He most recently spent six years at Kaiser Permanente.

 

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What We're Reading

At least three doctors play an outsized role as “superspreaders” of Covid-19 disinformation but have faced no disciplinary action or suspension from medical boards, Kaiser Health News’ Victoria Knight writes in TIME.

“Frankly, I’m not concerned about that reputational side of things”: The New York’s Patrick Radden Keefe takes us inside the secret meeting between Purdue Pharma’s David Sackler and opioid addiction advocate Ryan Hampton, whose memoir is out soon.

While the pandemic brought most of the world to a halt, Siberian reindeer herders kept moving. The New York Times’ Maxim Babenko tracked health officials’ efforts to follow and vaccinate them.

A message from Blue Cross Blue Shield Association:

Nearly 60 million Americans live in remote areas and lack consistent access to the health care they need. See how Blue Cross and Blue Shield companies are using their roots in local communities to fill the rural health care gap.

 
 

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