Biden expands Obamacare’s pandemic enrollment period — Murthy confirmed as surgeon general — J&J faces long odds in hitting vaccine goal

By Adam Cancryn

With Rachel Roubein and Susannah Luthi

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— The Obamacare markets will be open for another three months, giving the Biden administration time to drum up publicity for the just-passed subsidy expansion.

— Vivek Murthy will again serve as the nation’s surgeon general.

— Johnson & Johnson's hopes of hitting 20 million vaccine doses this month are fading fast.

WELCOME TO WEDNESDAY PULSE — where there's a health care angle to every story, even the one about a guy finding shrimp tails in his Cinnamon Toast Crunch (he later took the cereal to a clinical lab for examination). Send your favorite non-shrimp cereals and best tips to acancryn@politico.com.

A message from PhRMA:

Did you know more than 90% of all medicines dispensed in the United States are lower-cost generic medicines, compared to 69% in other OECD countries? Or that prices for generics here are lower, on average, than in other countries? Cross-country comparisons create confusion about medicine prices in the United States and abroad. Learn more.

OBAMACARE’s PANDEMIC ENROLLMENT PERIOD ROLLS ON — The Biden administration is lengthening the special enrollment period it opened for the pandemic , POLITICO’s Rachel Roubein reports. That means would-be enrollees will get until Aug. 15 to choose their plans.

This extension comes right on the heels of the largest Obamacare expansion of its 11-year history. The most recent Covid aid package made subsidies more generous for low-income Americans and extended them to middle-income consumers for the first time, and it allowed those who claimed unemployment this year to get covered for free.

— The administration had already planned to spend $50 million on ads to promote the special enrollment period, and will now devote even more to account for the longer sign-up window, though an HHS spokesperson declined to specify an amount.

BIDEN GETS HIS SURGEON GENERAL — Murthy was confirmed by the Senate Tuesday, winning votes from seven Republican senators in addition to every Democrat and independent, POLITICO’s Alice Miranda Ollstein reports. Murthy also served as surgeon general during the tail end of the Obama administration and has since been a close Biden confidant.

— This round went more smoothly than the last. Murthy’s 2014 nomination was held up for more than a year over his view that gun violence was a public health threat. That belief is far more mainstream now, but Murthy still took care to downplay his personal views on the matter during confirmation hearings.

Lawmakers also largely ignored concerns about Murthy’s private-sector dealings, including the millions of dollars he earned advising the cruise industry and other corporations on Covid-19.

— Expect Murthy to quickly make his mark. A top pandemic adviser on the campaign, Murthy has had to sit on the sidelines for months awaiting confirmation.

Now, he’ll likely resume his public role in promoting the Covid response and vaccination campaign; just hours after the Senate vote, Murthy released a video acknowledging the pandemic’s toll and vowing to aid the country’s recovery.

J&J FACING LONG ODDS IN HITTING VACCINE GOAL — The Biden administration will deliver 4 million J&J shots to states and federal partners next week, in the latest sign the company will fall short of its vow to ship 20 million doses by the end of the month, POLITICO’s Rachel Roubein and Erin Banco report.

— Where J&J stands: Just under 4.6 million doses of J&J vaccine have gone out so far. And while the anticipated 4 million shipment would represent J&J’s biggest jump in supply since the first week of allocations, it won’t even get the company halfway to its 20-million goal.

J&J, in the meantime, has grappled with logistical complications and regulatory delays, but insists it’ll make good on its pledge, with a spokesperson reiterating Tuesday that the pharma giant still expects to deliver on the 20 million by month’s end.

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TODAY: BECERRA MEETS WITH BIDEN ON MIGRANT SURGE — HHS Secretary Xavier Becerra’s first meeting at the White House will likely center on the administration’s struggle to manage and shelter a surge of unaccompanied migrant children at the southern border.

Becerra is set to meet with President Joe Biden and Vice President Kamala Harris at 2 p.m. ET, along with Homeland Security Secretary Alejandro Mayorkas and White House immigration advisers.

— HHS has sought additional shelters to house unaccompanied minors, a challenge made even more complicated by the pandemic. The department has requested the use of two Texas military posts as temporary housing, the Pentagon said Tuesday.

SENATE CLINCHES DEAL ON HOSPITAL MEDICARE CUTS — The Senate reached an agreement Tuesday to further delay the Medicare sequester’s hospital cuts through the end of the year, POLITICO’s Susannah Luthi reports.

Majority Leader Chuck Schumer plans to fast-track a voice vote in the upper chamber ahead of a deadline next week, when the 2 percent reduction in provider pay was set to resume.

— The measure to avert the cuts could still run into opposition. But the bill‘s specifics, hammered out by Sens. Jeanne Shaheen (D-N.H.) and Susan Collins (R-Maine), are fairly straightforward: In addition to language delaying the cuts, the legislation only includes some technical fixes and a spending offset. The offset tacks five-and-a-half more months onto the sequester whenever it's eventually allowed to take effect.

PELOSI: DRUG PRICING IN, PUBLIC OPTION OUT — House Speaker Nancy Pelosi is floating Democrats’ sweeping 2019 drug price bill as a key element of the next stimulus package, projecting that it could create $450 billion in savings alone.

During an Obamacare event on Tuesday, Pelosi emphasized the need to slash pharmaceutical costs as part of the broader infrastructure effort, grouping it in with other “human infrastructure” priorities like education and housing initiatives.

She also suggested that some of the savings created by the drug pricing proposal — which would empower Medicare to directly negotiate the price of medicines — could go toward funding new community health centers.

— But despite saying she supports expanding Medicare eligibility in the abstract, Pelosi told reporters she doesn’t think “we get that in this bill.”

“I wanted a public option 11 years ago,” Pelosi said. “I didn’t succeed then. We had it in the House, we couldn’t get it in the Senate. We’ll see where we go from here.”

CMMI CHIEF WILL RECUSE FROM J&J-RELATED WORK — CMS Innovation Center Director Elizabeth Fowler will refrain from working on matters related to Johnson & Johnson for two years because of her prior work as the drug company’s vice president for global health policy, an HHS spokesperson confirmed to PULSE.

Fowler, who spent nearly seven years at J&J before leaving in 2019 for The Commonwealth Fund, also had to divest 2,330 shares in the company when she joined the government — or between $250,000 and $500,000 worth of stock, according to disclosures obtained by PULSE.

— Fowler also invested in two other vaccine-makers. The disclosures show she held between $1,001 and $15,000 of stock each in Moderna and Inovio. (The latter company still has a Covid vaccine in development.)

That stock has also since been sold off, the HHS spokesperson said. Unlike J&J, Fowler won’t be conflicted out of matters tied to those companies because she never did work for them.

A message from PhRMA:

Looking at differences in medicine prices between the United States and other countries can be misleading, often ignoring complexities in the U.S. system and the repercussions of other countries’ reliance on government price setting policies. As the discussion unfolds, here are a few often overlooked facts:

• Americans have the most robust access to lifesaving medicines in the world.
• Americans benefit from robust generic competition.
• The world benefits from U.S. global leadership in biomedical innovation.
• Negotiations between pharmaceutical companies and payers drive down prices, but patients don’t always pay less.
• We need smart, patient-centered solutions for lowering drug costs.

In the Wall Street Journal, cardiologist Eric Topol argues the record development of a Covid vaccine proves we can accelerate scientific efforts in fighting other diseases.

For Marketplace, Sabri Ben-Achour asks: When will we know it’s safe to go back into the office?

Covid cases among people under 50 are rising again after months of decline amid a tourism surge across parts of Florida, the Miami Herald’s Ben Conarck reports.

STEP INSIDE THE WEST WING : The Biden administration is more than halfway through its first 100 days and is now facing a growing crisis at the border and escalating violence against Asian Americans, while navigating the pandemic and ongoing economic challenges. Add Transition Playbook to your daily reads to find out what actions are being considered, as well the internal state of play inside the West Wing and across the administration. Track the people, policies, and emerging power centers of the Biden administration. Don't miss out. Subscribe today.

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