How Roe v. Wade could tip the midterms — or not

From: POLITICO Pulse - Tuesday Dec 07,2021 03:01 pm

Dec 07, 2021

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With Carmen Paun

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Quick Fix

— New POLITICO/Morning Consult polling shows most voters favor preserving Roe v. Wade, but don’t envision its fate determining their vote next November.

— The Biden administration will spend $400 million to improve efforts abroad to get Covid-19 shots into arms.

— Female physicians earn nearly 25 percent less on average than their male counterparts over their careers, according to a new Health Affairs study.

WELCOME TO TUESDAY PULSE — where you’ve gotta appreciate the audacity (if not the motive, or the execution) of trying to dodge vaccination by showing up with a clearly fake arm . Send tips to acancryn@politico.com and sowermohle@politico.com

A message from PhRMA:

At a time when the science has never been more promising, the Democrats’ latest drug pricing scheme puts patients in harm’s way by threatening future treatments and cures. Learn more.

Driving the Day

HOW ROE V. WADE COULD TIP THE MIDTERMS, OR NOT — A majority of U.S. voters have a message for the Supreme Court: Leave Roe v. Wade alone.

But they’ve also got a message for the Republican Party: Even if Roe goes, we may still vote you into office.

Those are the paradoxical takeaways from the latest POLITICO/Morning Consult poll, which found clear majority support for the abortion rights codified under Roe v. Wade — and deep skepticism of the laws, like Mississippi’s 15-week abortion ban, that could unravel the longstanding legal precedent.

Yet despite favoring abortion rights, few voters say that taking them away will swing their choices in the midterms, POLITICO’s Alice Miranda Ollstein reports. Just 32 percent of respondents said a candidate’s abortion stance would determine their vote, compared with 42 percent who would be willing to vote for someone whose position didn’t align with their views on abortion.

Another 26 percent said they were unsure or had no opinion on the matter.

The poll is an alarm bell for abortion rights groups that have poured millions of dollars into amplifying the threat to Roe, as well as Democrats facing a conservative majority on the Supreme Court that’s already made clear it’s eager to roll back abortion rights.

Nearly half of those surveyed — 44 percent — said they’d heard “not much” or “nothing at all” about the case. Almost two-thirds had little sense of the likelihood that Roe would be overturned or dismissed the possibility of it being at risk.

That could change, of course. The justices have until June to issue their verdict, and awareness — and anxiety — could rise in the interim. But the tepid polling, conducted right after the Supreme Court oral arguments, appears to so far back up some Democrats’ concerns that even an existential threat to Roe may not prompt the blue backlash the party will need to keep full control of Washington.

U.S. RAMPS UP SUPPORT FOR VACCINE DELIVERIES — The U.S. is making a push to promote vaccine readiness in poor countries and get more shots in arms, a U.S. Agency for International Development senior official told POLITICO's Carmen Paun. That effort was marked by the announcement Monday of $400 million additional U.S. funding for vaccine delivery, local manufacturing and responding to surges in Covid cases across the world.

Because of U.S. vaccine donations and a more constant supply of doses from manufacturers to COVAX, the global vaccine equity effort, many countries are starting to turn the corner from worrying about supplies to ensuring they can receive, store and use Covid vaccines, according to the USAID official.

While countries like Bangladesh, Indonesia and Vietnam are doing “phenomenally well” in getting shots in arms once they have the supplies, others, mostly in sub-Saharan Africa, need more help to get people vaccinated, according to the official.

WHO taps new readiness boss: The World Health Organization is also taking new steps to help. Director-General Tedros Adhanom Ghebreyesus on Monday appointed American-Lebanese Ted Chaiban as global coordinator for country readiness and delivery, where he’ll lead a joint WHO-UNICEF effort to turn vaccines into vaccinations faster.

“This effort will be focused on the 40 to 50 countries at highest risk of missing the target to vaccinate 40 percent of their populations by the end of this year,” Tedros told development ministers gathered virtually by USAID Administrator Samantha Power. Chaiban has been a regional director for UNICEF in the Middle East and North Africa.

Tedros also asked development ministers to meet every two months to ensure adequate financing for vaccine delivery. He also wants to hold an emergency fundraising event early next year to raise $23.4 billion for the global response effort co-led by the WHO, which also includes money for treatments, testing, oxygen and supporting health care systems.

CMS WILL GRADE HOSPITALS ON MATERNITY CARE — The agency plans to create a “birthing-friendly” designation to award to hospitals that participate in a program aimed at improving maternal outcomes and patient safety.

The new quality measure, which CMS is floating as part of today’s White House Maternal Health Day of Action, would be the first at HHS focused on maternity care. The agency envisions highlighting qualifying hospitals as “birthing friendly” on the federal “Care Compare” site designed to help consumers choose the right provider.

CMS is also encouraging states to extend postpartum coverage. The agency will release guidance today aimed at states that want to provide 12 months of postpartum Medicaid coverage — far more than the minimum 60 days required under law.

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Providers

STUDY: WOMEN DOCS EARN MILLIONS LESS THAN MEN OVER THEIR CAREERS — Female physicians earn an average of $2 million — or nearly 25 percent — less than their male counterparts over their careers, according to new estimates published Monday in Health Affairs.

The study, which used data on more than 80,000 physicians to simulate a 40-year career, found that the gender pay gap was largest among surgical specialists ($2.5 million) and nonsurgical specialists ($1.6 million), whereas the difference between men and women in primary care was roughly $900,000.

That’s a gap is established in the first year of practice and increases over a physician’s first 10 years, after which the difference tends to stabilize. The researchers hypothesized that a number of factors have contributed to the disparity, including gender bias and compensation models that disadvantage female practice styles, as well as early-career decisions that disproportionately fall to women, such as child rearing.

Also in Health Affairs: Wisconsin hospitals filed medical debt lawsuits against patients at a rate equal to about one in every 1,000 residents a year between 2001 and 2018, according to a new study led by Yale professor Zack Cooper.

Those suits targeted Black patients and those in low-income areas at higher rates than other demographics. Out of 125 nonprofit hospitals the researchers looked at, 5 percent accounted for a quarter of all lawsuits.

A message from PhRMA:

In Congress

HOUSE GOP LEANS INTO VAX MANDATE OPPOSITION — Declaring the U.S. to be “at the tail end of the pandemic,” 113 House Republicans are calling for the Biden administration to withdraw its vaccine mandate for health care workers — contending that the requirements will prompt a mass exodus from the profession.

The letter, led by Reps. Larry Bucshon (R-Ind.) and Vern Buchanan (R-Fla.), asserts that the mandate risks exacerbating the nation’s health care workforce shortage and hurting patient access. “By subjecting providers to egregious federal overreach, our nation’s most vulnerable populations will be at risk,” the Republicans wrote to CMS chief Chiquita Brooks-LaSure.

But there are a few issues with that argument. If the U.S. is truly at the “tail end” of the pandemic, it’s not showing up in the stats. Cases, hospitalizations and deaths are all up over the past two weeks — with daily new cases topping 100,000 and average Covid-19 deaths each day exceeding 1,000.

And even the Republicans’ claim that those measurements overall decreased since vaccines “became widely available” is questionable, since vaccinations didn’t open up to all adults until April when cases, hospitalizations and deaths were all lower than their current levels.

A last quibble: The letter cites former Trump FDA Commissioner Scott Gottlieb in backing up its assertion that the pandemic is almost over, pointing to his early November prediction that “by Jan. 4, this pandemic may well be over at least as it relates to the United States after we get through this Delta wave of infection.”

So we checked in with Gottlieb to see if he still holds that opinion now that Omicron is spreading within the U.S.

He told PULSE he based his prediction on the widespread belief Delta would remain the dominant variant. Now a month later, “Omicron, which is a product of divergent evolution, throws that forecast into some doubt,” Gottlieb said.

As for what Gottlieb thinks about the vaccine mandate at the core of the letter: “The health care worker mandate always made good sense in my opinion,” he said.

HILL DRUMBEAT GROWS OVER PROVIDER CUTS — Twenty-five Democrats are backing the latest call to avert scheduled provider pay cuts, writing Monday that slashing compensation to specialty providers could disproportionately affect minority patients.

The lawmakers — who represent the Congressional Black Caucus, Hispanic Caucus and Asian Pacific Pacific American Caucus — highlighted specific health inequities that they argued could be exacerbated if rates for certain services are reduced.

That includes cancer and radiation oncology services for ailments like prostate and breast cancer and treatments for kidney failure.

“These reductions cut reimbursement for office-based services — which treat diseases disproportionately impacting minority populations — by 20 percent or more,” the Democrats, led by Reps. Bobby Rush (D-Ill.), Danny Davis (D-Ill.) and Tony Cárdenas (D-Calif.), wrote in a letter to Speaker Nancy Pelosi.

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What We're Reading

Former President Donald Trump’s chief of staff writes in a new book that Trump’s blood oxygen level was dangerously low during his bout with Covid-19, The New York Times’ Maggie Haberman and Noah Weiland report.

South Korea is threatening to deny children ages 12 to 17 entry to restaurants, libraries and after-school academies if they refuse to get vaccinated, The Wall Street Journal’s Dasl Yoon reports.

The WHO is formally advising against the use of convalescent plasma to treat Covid-19 patients, citing no evidence of a “clear benefit,” Carmen writes.

A message from PhRMA:

The Democrats’ hyper-partisan drug pricing plan is a detriment to patients and the future of medical research.

The plan guts the very incentives necessary to encourage investment in further research and development after medicines are approved, giving the government the power to pick winners and losers for lifesaving medicines.

While some would have you believe this is “negotiation,” it isn’t. It’s government price setting that does little to address patient affordability and will decimate the competitive ecosystem in the United States that has brought hope to so many Americans in the form of new medical advances where before there were none. No matter what they call it, this plan will result in the same outcome: negative consequences for the patients with the most need. Read more.