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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 Dan Goldberg and Adriel Bettelheim | | | With help from Adam Cancryn 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. | | | — The Biden administration requires health insurers to reimburse people for as many as eight over-the-counter Covid-19 tests every month beginning Jan. 15. — Hospitals and long-term care facilities let Covid-positive doctors and nurses work in order to keep their doors open during the Omicron surge. — Top Biden health officials will face pointed questions about pandemic messaging and quarantine guidance at a Senate health committee hearing today. It's Tuesday Morning Pulse, where we think it a bit strange that a federal judge in Virginia ruled that Gruyere cheese does not have to come from the Gruyere region to be sold under the gruyere name. We here at Pulse similarly welcome tips regardless of their provenance so please send some to: dgoldberg@politico.com or abettelheim@politico.com. | | | | A message from PhRMA: Did you know more than half of every dollar spent on medicines goes to someone who doesn’t make them? There’s a long line of middlemen, like PBMs and insurers, collecting a significant portion of what you pay for medicine. The share of total spending for brand medicines received by the supply chain and other stakeholders increased from 33% in 2013 to 50.5% in 2020. Learn more. | | | | | | | 
President Joe Biden speaks about the 2021 jobs report in the State Dining Room of the White House, Friday, Jan. 7, in Washington. | Alex Brandon/AP Photo | BIDEN ADMIN LAYS OUT RULES FOR REIMBURSING COVID TESTS — The Biden administration on Monday issued guidance that will require private health insurers to reimburse people for up to eight over-the-counter Covid-19 tests every month beginning Jan. 15. Private health plans were told they can set up programs at preferred pharmacies or retailers where the upfront cost of home tests is covered for beneficiaries. A family of four would be able to have 32 home tests covered by their health plan each month. POLITICO's David Lim writes the initiative is intended to ease the financial burden of utilizing at-home tests to detect and stop further spread of Covid-19. But individuals who purchase home tests outside of their insurers’ preferred network may only get up to $12 per test — a potential problem for consumers who don't live near participating pharmacies or who opt to buy pricier home tests. What they're saying: “This is an unfunded mandate on insurers and consumers,” said Michael Bagel, director of public policy at the Alliance of Community Health Plans. “There's nothing but barriers to get it set up in time. We have essentially 96 hours to get a preferred pharmacy list together and get the operational pieces in place.” | | | | STEP INSIDE THE WEST WING: What's really happening in West Wing offices? Find out who's up, who's down, and who really has the president’s ear in our West Wing Playbook newsletter, the insider's guide to the Biden White House and Cabinet. For buzzy nuggets and details that you won't find anywhere else, subscribe today. | | | | | | | | THE DOCTOR WHO'LL SEE YOU NOW HAS COVID — Hospitals and long-term care facilities are so short on staff that many are compelling Covid-positive doctors and nurses to return to work, arguing that bringing back asymptomatic or even symptomatic staff is the only way they can keep their doors open amid a spike in hospitalizations. POLITICO's Rachael Levy writes the practice, allowed by the most recent guidance from the Centers for Disease Control and Prevention, underscores the dire situation in which many facilities find themselves as more than 120,000 people nationwide are now hospitalized with the virus. — Turning to employees who may still be infectious comes over objections from nurses‘ unions and the American Medical Association, which warned the decision puts patients' health and safety at risk. There are no requirements that patients be notified if their caregiver is sick. — Hospital administrators and other health officials say the CDC guidance allows facilities to bring back workers after five days of isolation, instead of 10, without a negative Covid-19 test. In cases where workforce shortages become extreme, hospitals can bring back staff without any isolation period. | | | BIDEN HEALTH TEAM ON THE HOT SEAT — Top Biden health officials are set to testify today before the Senate HELP Committee and face tough questions from Democrats as well as Republicans on how the federal government plans to lead the country out of its current pandemic woes. Who will be grilled: CDC Director Rochelle Walensky, NIAID Director Anthony Fauci, Acting FDA Director Janet Woodcock, and ASPR Assistant Secretary Dawn O’Connell. Topics to watch: In her opening remarks, shared with POLITICO's Alice Miranda Ollstein, Committee Chair Patty Murray (D-Wash.) will demand answers from the team on “how hard it still is to get a test,” what they’re doing to prevent school closures, and why the CDC halved the amount of time it recommends people stay home after testing positive for Covid-19. Murray will tell the officials she has “heard from people who have found the communication about new isolation and quarantine guidance confusing and frustrating, ” according to prepared remarks. Walking a difficult line: Even as Democrats prepare to demand answers and vent their frustrations with the administration’s handling of the current surge, they’re wary of the hearing turning into a pile-on. Murray’s remarks include a warning to her GOP colleagues against “treating each challenge as a political opportunity.” | | Inside the Humphrey Building | | TOP HHS STAFFER DEPARTS — Anne Reid, who spent the last 11 months as Secretary Xavier Becerra’s deputy chief of staff, has left the health department, three people with knowledge of the matter told POLITICO’s Adam Cancryn. Reid was among the first wave of political appointees to join Becerra’s HHS last February, and one of the top aides charged with steering the department’s policy priorities. One of several Obama administration alums to return to the department, she also served on the Biden transition and before that was chief of staff to Sen. Elizabeth Warren (D-Mass.). An HHS spokesperson did not respond to questions about plans for naming a new deputy chief of staff. | | | | BECOME A GLOBAL INSIDER: The world is more connected than ever. It has never been more essential to identify, unpack and analyze important news, trends and decisions shaping our future — and we’ve got you covered! Every Monday, Wednesday and Friday, Global Insider author Ryan Heath navigates the global news maze and connects you to power players and events changing our world. Don’t miss out on this influential global community. Subscribe now. | | | | | | | | NEW JERSEY GOV WANTS SCHOOL MASK ORDER TO CONTINUE — New Jersey Gov. Phil Murphy said Monday he will extend a controversial mask mandate for the state’s schools and day care facilities. But because it’s not covered under a state Senate resolution covering his pandemic emergency powers, he might have to declare another public health emergency to keep the order in place, POLITICO’s Ry Rivard and Carly Sitrin write. The mandate, which applies broadly to anyone in a school building, began in the early days of the pandemic. Murphy has framed it as the only way to keep schools open and avoid virtual classes. But as of Friday, 934 schools in New Jersey were closed for Covid-related reasons out of 2,679 public schools in the state, according to the state Department of Education. ...Massachusetts also announced Monday that it will extend the mask requirement in public schools through the end of February. DELAWARE ORDERS MASKS IN PUBLIC — Delaware will begin ordering residents to mask up in most public indoor settings, as the coronavirus continues to surge and overwhelm hospitals. The mandate kicks in this morning and applies to convenience stores, grocery stores, gyms, restaurants, bars, hair salons, malls and casinos, the Delaware News Journal reports. Gov. John Carney also announced he will extend mask requirements in schools and will deploy even more National Guardsmen to assist in hospitals. A majority of hospitals on Monday said they were operating under crisis standards of care. NEWSOM BUDGET SEEKS UNIVERSAL HEALTH CARE FOR UNDOCUMENTED IMMIGRANTS — California would offer universal health care access for undocumented immigrants while spending billions of dollars to combat the coronavirus, wildfires, retail theft and homelessness under a $286 billion blueprint Gov. Gavin Newsom unveiled on Monday. POLITICO's Jeremy B. White writes the proposal tracks with immigrant advocates' longstanding push to have the state cover every low-income resident, regardless of immigration status. California has already expanded the state’s Medi-Cal program to undocumented young adults and those 50 and over. The new proposal would include low-income, undocumented immigrants of all other ages. With the Omicron variant vaulting California’s coronavirus infection rates to an all-time high, Newsom also will seek $2.7 billion to fortify the state's Covid-19 response with more testing, an infusion for the healthcare system and an expanded vaccination push. ...Newsom also wants to get into the insulin-making business to reduce prescription drug costs for residents, POLITICO’s Victoria Colliver reports. The details of the plan are scant — in fact, Newsom said he suspected his staff wasn’t “particularly pleased that I even offered this much information.” But he did say the state was working with a potential partner to make the diabetes drug, which can exceed $300 per vial, at a fraction of current market prices. “Private sector uses leverage,” he said. “We should use private sector considerations to leverage our purchasing power.” | | | | A message from PhRMA:   | | | | | | SIGNUP SURGE — Nearly 14 million people have signed up for private health insurance coverage under the Affordable Care Act during this year’s open enrollment period, CMS announced Monday . That’s a 21 percent increase over last year, according to the Biden administration, which attributed the surge to its outreach efforts and the increased subsidies that President Joe Biden signed into law last year. The figure includes more than 9.7 million people who enrolled or were automatically re-enrolled in the 33 states that use HealthCare.gov, the federal marketplace, and more than 4 million people in states that run their own exchange. Open enrollment for HealthCare.gov ends on Saturday. | | | John Littel is in line to be Virginia’s next health secretary, Gov.-elect Glenn Youngkin announced Monday. Littel has also served as a deputy secretary in the Virginia health department and as director of intergovernmental affairs for the White House's Office of National Drug Control Policy. Daniel Spirn has joined URAC, an independent health care accrediting organization, as its vice president of government relations. He previously was senior regulatory counsel at the American Academy of Neurology. | | | People are being locked up for touching fentanyl, when they haven't actually used it, BuzzFeed reports. A 57-year old man received a heart from a genetically modified pig, the first successful transplant of a pig’s heart into a human being, The New York Times reports. David Gorski, a surgery professor at Wayne State University, suggests that Substack is the latest haven for quacks and anti-vaccine conspiracy theorists. | | | | A message from PhRMA: Did you know that PBMs, hospitals, the government, insurers, and others received a larger share of total spending on medicines than biopharmaceutical companies? That’s right, more than half of spending on brand medicines goes to someone who doesn’t make them. Let’s fix the system the right way and ensure more of the savings go to patients, not middlemen. Read the new report. | | | | | | | Follow us on Twitter | | | | Follow us | | | | |  |
