BIDEN TAKES ON THE TRANSGENDER HEALTH CARE BATTLE — The president has ordered the Department of Health and Human Services to begin efforts to ban conversion therapy and expand access to gender-affirming treatment in one of his administration’s first major decisions against moves by red-state governors. Biden signed an executive order on Wednesday instructing HHS to deny federal funding to programs that offer discredited conversion therapy and to draft guidance for states to improve transgender and broader LGBTQ health care practices. The order also directs health officials to bolster access and care in the foster system, where disparities leave LGBTQ youth especially vulnerable. “Right now, there are young people sitting in their bedroom, doors closed, silent, scrolling through social media, staring at the ceiling, wondering if they'll ever be loved, ever have a family, ever be accepted by their own families,” Biden said at a White House event to sign the order. Biden continued to turn around family rhetoric that some conservatives have used to raise concerns about minors seeking gender-affirming care: “I don't have to tell you about the ultra-MAGA agenda attacking families and our freedoms.” Some background: Biden was surrounded by teens from Texas and Florida as he signed the order. Earlier this month, Florida Gov. Ron DeSantis moved to end gender-affirming care for minors and separately banned Medicaid from covering treatments such as hormone replacement therapies and sex reassignment surgery. Texas Gov. Greg Abbott in February compared gender-affirming care to “child abuse” and ordered the state’s child protective services to investigate families with youth seeking the care. What’s next: Biden’s order “will advance long-sought, LGBTQ-inclusive policies and practices that will help save young LGBTQ lives,” said Amit Paley, CEO and executive director of LGBTQ mental health organization The Trevor Project. But legal and political challenges are sure to follow. Texas Rep. Brian Harrison, HHS chief of staff during the Trump administration, sent a letter Wednesday to the HHS Deputy Assistant Secretary for Women’s Health Dorothy Fink asking, “what is a woman?” The Republican state lawmaker argued that many regulations, grants and health policies include the word “woman” and could be impacted by the answer. Meanwhile, Democrats rallied to pass the Equality Act — barring discrimination based on gender and sexual identity — which has stalled among a slew of other legislative priorities. “People should not have to risk their health and safety because of who they are,” said House Education and Labor Committee Chairman Bobby Scott(D-Va.) in a statement urging senators to advance the bill. SCOTUS REJECTS 340B PAYMENT CUTS — The Supreme Court in a unanimous decision Wednesday said that nearly 30 percent cuts in drug reimbursements to the 340B program were unlawful. Hospitals in the program — which receive significant drug price discounts because they primarily serve low-income and disadvantaged patients — strongly opposed the 2018 payment change. But a lower court upheld HHS’ authority to slash reimbursements. What the court said: Supreme Court justices argued that HHS didn’t do enough to justify its cut : “If HHS believes that this Medicare reimbursement program overpays 340B hospitals, it may conduct a survey of hospitals’ acquisition costs to determine whether and how much the data justify varying the reimbursement rates by hospital group,” Justice Brett Kavanaugh wrote in the opinion. But the ruling also avoided a looming decision on environmental policy that could swiftly impact federal agencies’ breadth to interpret the law without congressional orders. “Regardless of the scope of HHS’s authority to ‘adjust’ the average price up or down under the statute, the statute does not grant HHS authority to vary the reimbursement rates by hospital group unless HHS has conducted the required survey of hospitals’ acquisition costs,” Kavanaugh wrote. “[If] the statute’s requirement of an acquisition cost survey is bad policy or is working in unintended ways, HHS can ask Congress to change the law.” FDA ADVISERS BACK COVID SHOTS FOR YOUNGEST KIDS — The FDA’s independent vaccine advisers voted unanimously Wednesday to recommend the agency authorize two Covid-19 vaccines for babies, toddlers and preschool-age children, putting the country’s youngest age group one step closer to immunizations nearly two-and-a-half years into the pandemic, Lauren Gardner writes. The FDA is expected to quickly authorize for emergency use the Pfizer-BioNTech vaccine for kids under 5 and the Moderna vaccines for kids under 6. Both options could be used in children as young as 6 months old. What’s next: The Centers for Disease Control and Prevention’s panel of expert advisers will consider whether to recommend the shots’ administration during meetings on Friday and Saturday. Once CDC Director Rochelle Walensky signs off on a recommendation, children are expected to begin receiving shots by Tuesday. Children under 6 who receive the Moderna vaccine will get two 25-microgram doses, four weeks apart. The Pfizer vaccine is two 3-microgram doses three weeks apart, followed by a third dose eight weeks later. Now, convincing parents. Peter Marks, the FDA’s top vaccine regulator, started off the daylong meeting pointing to the burden of Covid hospitalizations for young children during the Omicron wave. “The intervention we’re talking about here is one that is something that we have accepted in the past to try to prevent deaths from influenza,” he said. “Here we have a different pathogen, but one that has created a lot of havoc just the same.” Still, the Biden administration is girding for a slog to convince parents to quickly vaccinate their young children. Summer vacations — and young children receiving various levels of schooling before age 5 — and misinformation about vaccines could depress early turnout. Many young children also contracted Covid during the Omicron surge, which could convince parents to hold off on immunizing them until they’re further removed from their natural infections.
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