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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 Adam Cancryn | Presented by |  | | | With Susannah Luthi and Rachel Roubein 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.
| | | — Republican governors’ abrupt repeal of state mask mandates and other Covid-19 restrictions may be the stiffest test yet of President Joe Biden’s bid for a united front against the pandemic. — Highly anticipated safety guidance for vaccinated people from the CDC has been abruptly put on hold. — CMS Administrator nominee Chiquita Brooks-LaSure netted tens of thousands of dollars from health care companies during her time as a consultant. WELCOME TO THURSDAY PULSE — where science has proved what we all knew: Nobody can figure out when and how to gracefully exit conversations. PULSE makes interactions easy; say hi and bye at acancryn@politico.com. | | | | A message from PhRMA: As we usher in a new administration and Congress, there are many things on which we can all agree, like ending the pandemic. America’s biopharmaceutical companies will continue to develop treatments and vaccines to combat COVID-19, and we are working closely with governments, insurers and others to make sure vaccines and treatments are accessible and affordable. | | | | | | WHITE HOUSE, GOP GOVERNORS FACE OFF OVER MASKING UP — Texas and Mississippi both unveiled plans to fully reopen their states on Tuesday, frustrating the president and prompting his health officials to warn they could set back the entire Covid response. — Biden rebuked the states’ Republican governors on Wednesday for their “neanderthal thinking,” prompting Mississippi Gov. Tate Reeves to fire back that “Mississippians don’t need handlers.” The exchange marked a public escalations of tensions between the Biden White House and state leaders — tensions the administration has tried to keep under wraps for weeks, POLITICO’s Adam Cancryn and Anita Kumar report. But it reflected Biden officials’ deep fear that the virus will come roaring back in another surge. Health officials have stressed the need to remain vigilant even as vaccinations accelerate, warning that the spread of new variants could stall the nation’s progress against a disease still killing nearly 2,000 people a day. — There’s little the White House can do to force states to comply with CDC recommendations. And as Texas and Mississippi start to reopen, another seven states — six led by GOP governors — could let their respective mask mandates expire before the end of the month. | 
Diners eat at a restaurant on the River Walk on Wednesday in San Antonio. Texas is one of the states planning to fully rescind its mask mandate in the coming weeks. | AP Photo/Eric Gay | CDC VACCINE GUIDELINES ON HOLD — The CDC will not publish new Covid safety guidance for vaccinated Americans today, after a flurry of discussions with White House and HHS officials culminated in a directive to hold off on its release, POLITICO’s Erin Banco scoops. The CDC had compiled the guidelines over the last several weeks and was preparing to go through the final clearance process. Health officials were originally supposed to sign off on the language on Wednesday. — There’s no evidence suggesting the Biden White House is suppressing or otherwise negating the CDC’s work, but CDC officials are still on edge after repeated attempts at political interference under former President Donald Trump. — The highly anticipated guidelines are meant to answer critical questions about what Americans can safely do after they receive their vaccines. The recommendations described to POLITICO earlier this week suggested small groups of fully-vaccinated people can gather indoors in a home and without masks, but that they should still wear masks and socially distance in public. A CDC spokesperson said the guidance is “not finalized,” and that it will be published once it is — though administration officials did not offer any set timeline.
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BROOKS-LaSURE’s BACKSTORY — CMS Administrator nominee Chiquita Brooks-LaSure’s five years at consulting firm Manatt Health included work that netted tens of thousands of dollars from health care companies, according to financial disclosures and an ethics agreement filed as part of the confirmation process.
— Brooks-LaSure did work totaling $5,000 or more paid to Manatt from each of at least 20 organizations since 2019. That list includes six pharmaceutical companies, among them, Bristol Myers Squibb, Gilead Sciences and Pfizer. Brooks-LaSure’s work involved talking with staff about federal and state policy issues, according to the descriptions listed in her financial disclosure. — The CMS nominee also did consulting work for three states. Brooks-LaSure published reports for Oregon and Nevada on public options and surveyed state policy strategies for health equity for North Carolina. — Her other clients included Arnold Ventures, which has advocated for Democratic drug pricing reforms; Planned Parenthood; and large insurers like Blue Shield of California and Health Care Service Corporation. Three ethics experts told POLITICO’s Rachel Roubein that they saw nothing in those disclosures that might trip up her nomination. The previous CMS administrator, Seema Verma, also entered government after consulting with several states. Under her ethics agreement, Brooks-LaSure would need to request special permission to work on matters involving the three states she advised. She also couldn’t meet individually with companies she’s advised, and will be recused from work specific to them for two years. — An HHS official pointed to Biden’s pledge to build the “most ethically rigorous administration in American history,” saying in a statement that each nominee, including Brooks-LaSure, will “abide by strict ethics and disclosure agreements to avoid any potential conflict of interest.” | | | HEALTH INDUSTRY CASHES IN ON SENATE COVID BILL — The Senate version of Democrats’ Covid aid bill would pour more money into various parts of the health care industry, POLITICO’s Susannah Luthi writes. Among the health-related provisions that differ from the House version: — A 100 percent subsidy of temporary workplace insurance for laid off workers through September, up from the 85 percent subsidy in House Democrats’ proposal. The increase would add an extra $15 billion to the overall price tag, people familiar with the Congressional Budget Office’s estimate said. — Rural hospitals get $8.5 billion. That’s far less than the $35 billion in bailout funds hospital groups had sought (though that sum was their request for the entire hospital industry). The Senate instead opted to target its funding toward rural hospitals only, after they suffered another wave of closures last year. — A yearlong delay in lifting Medicaid’s rebate cap. The measure, designed to allow Medicaid programs to penalize drug companies that hike prices beyond the rate of inflation, would have its start date pushed back to 2024. That could give the pharmaceutical industry more time to lobby for further stalling the policy. — A Medicare wage index for densely populated states’ health systems. States like New Jersey and Rhode Island are now slated for a restoration of the Medicare wage index floor — even though it was originally meant to help rural states, and they don't have any rural hospitals. | | | |   | | | | | | FROM HEAT ISLANDS TO HOT SPOTS — Neighborhoods subjected to the highest levels of extreme heat because of their thanks to high density, large expanses of concrete and scarce greenery have become Covid hot spots during the pandemic — a trend that’s contributed to wide disparities in health outcomes during the pandemic, Victoria Colliver and Nolan McCaskill write for POLITICO’s Recovery Lab series. These so-called heat islands are often home to people with lower average incomes and poorer health. The triple-digit temperatures these places can incur, along with the ever-present threat of Covid, have made it difficult for residents to find refuge. — The phenomenon serves to highlight the health implications of climate change. 2020 was the hottest year on record, tied only with 2016. And after summer came devastating winter storms in Texas and other Southern states, demonstrating in turn how extreme cold disproportionately affects marginalized communities as well. Among the ideas to better shelter residents from the elements: “resilience hubs,” trusted community sites that can serve as gathering places during extreme weather or any number of emergencies. City officials are hoping those buildings, outfitted with backup generators and emergency communications gear, could help provide protection while becoming a central point from which to distribute information and supplies. | | | GEORGIA HOSPITAL MERGER ABANDONED AFTER FTC PROBE — Atrium Health Navicent Inc. and Houston Healthcare System are calling off their merger after Federal Trade Commissioner staff recommended the agency challenge the deal, Susannah writes. Combining the two Georgia hospital systems would “eliminate the intense competition” between them, potentially jeopardizing quality standards and raising costs for patients, the agency said.
| | | | For regulatory affairs professionals: AgencyIQ FDA Forecast 2021. In its inaugural year, AgencyIQ’s FDA Forecast predicts the FDA regulatory changes coming in 2021 and how they will impact the life sciences industry. Follow this link to learn more and download the summary. | | | | |
| | | FIRST IN PULSE: JEROME ADAMS JOINS EHEALTH ADVISORY COMMITTEE — The Trump administration surgeon general will be part of a new public policy advisory committee formed by private health insurance exchange eHealth Inc. The bipartisan panel will focus on developing policy ideas for improving public and private-sector health care, and be chaired by former Kentucky Democratic Gov. Steve Beshear. In addition to Adams and Beshear, the committee includes former Louisiana GOP Gov. Bobby Jindal; Susan Kennedy, the former chief of staff to California Gov. Arnold Schwarzenegger; former New York City health commissioner Woody Myers; and eHealth Senior Vice President of Public Policy and Government Relations John Desser. PRESCRIBING INFO MODERNIZATION GROUP ADDS TWO — Bristol Myers Squibb and Fresenius Kabi are joining the Alliance to Modernize Prescribing Information, a coalition that backs digitizing drug prescribing information currently given in paper form to providers and pharmacists. The companies join the seven that founded the organization last summer: AbbVie, AmerisourceBergen, Johnson & Johnson, Merck, Pfizer, Teva and Viatris. | | | | A message from PhRMA: Despite our divisions, there are many things on which Americans agree. The biopharmaceutical industry is committed to working with Congress and the new administration to:
• End the pandemic. The industry remains committed to getting COVID-19 treatments and vaccines to patients, and we are working closely with governments, insurers and others to make sure they are accessible and affordable.
• Make health care better and more affordable. People want quality, affordable health coverage that works when they need it. We support solutions that will help patients better afford their medicines and protect access to innovation today and in the future.
• Build a more just, equitable society. We must address systemic racism, as has been made clear by the murders of George Floyd, Breonna Taylor, and many others and the outsized impact of the pandemic on Black and Brown communities. We remain committed to this important issue on behalf of our communities, the patients we serve and our employees. | | | | | | MIA HECK joins the Joseph Rainey Center for Public Policy. Heck, a former director in the Trump HHS’ Office of the Assistant Secretary for Health, will be the organization’s vice president for external affairs and a fellow for health care policy. | | | The RNA vaccine technology used in Pfizer and Moderna’s Covid vaccines could also hold the key to developing a long-sought vaccine for malaria, Vox’s Kelsey Piper writes. Anthony Fauci will donate his bright blue 3-D model coronavirus to the National Museum of American History, which is collecting pandemic items for a future exhibition on U.S. medicine, The New York Times’ Allyson Waller reports. Booking a vaccine appointment is “one of the most important human-vs.-machine battles of our time” — one made worse by broken systems and shoddy websites, The Wall Street Journal’s Joanna Stern writes. | | | | Follow us on Twitter | | | | Follow us | | | | |  |
