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Delivered daily by 10 a.m., Pulse examines the latest news in health care politics and policy. | | | | |  | | By Daniel Payne and Krista Mahr | With David Lim Welcome to Thursday Pulse, where we’re wishing the best to the mother who gave birth to a healthy baby girl in a car outside the Hart Senate Office Building. We want to hear from you. Send news and tips to us at dpayne@politico.com and kmahr@politico.com. Want more Pulse? Check out the latest episode of our Pulsecheck podcast. Today, Krista Mahr on the many unknowns around monkeypox vaccine efficacy and Professor Robert Blendon on the most important top lines from the newest POLITICO-Harvard survey. Listen to today’s Pulsecheck podcast.
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Doctors have joined forces to share knowledge about long Covid. | Carl Court/Getty Images | THE STATE OF LONG COVID CARE — Health providers around the country are working to figure out the uncharted waters of long Covid, Krista reports. With little official guidance and various treatment approaches, doctors have tried to pool knowledge in an ad-hoc group that includes providers at more than 40 long Covid clinics. They’ve met for over a year, but effective treatments are elusive. “We’re one organization that is trying to bring in 41 centers,” said Monica Verduzco-Gutierrez, a physiatrist from the University of Texas Health Science Center at San Antonio. Verduzco-Gutierrez runs two long Covid clinics and is part of the collaborative run by the American Academy of Physical Medicine and Rehabilitation. “It’s wonderful the administration said long Covid is a public health issue. … It’s like, ‘OK, what’s really going to happen now?’” The U.S. government has boosted funding to speed research, but the disease continues to affect many people. A new report from the Brookings Institution estimates 16 million Americans between ages 18 and 65 have long Covid, with a few million likely out of work because of the condition. For the millions affected now, even getting into a specialized clinic can take weeks or months. And the disease’s burden could continue growing, experts say. “I think all of us in chronic care are quite worried that we’re going to have a really significant population of people burdened by long Covid for years to come,” said Bradley Schlaggar, president and CEO of the Kennedy Krieger Institute, which runs a pediatric long Covid clinic. “It shouldn’t be a surprise at this point.”
| | | JUDGE RULES AGAINST ACA PREP PROVISIONS — A Texas judge ruled Wednesday that the Affordable Care Act’s coverage mandate for HIV prevention drugs violates religious rights, Alice Miranda Ollstein writes. The key Obamacare provision that requires insurers to cover STD screenings and HIV prevention drugs is now in limbo. But it’s unclear whether the ruling will affect just those suing, all Texans or everyone in the U.S. The George W. Bush appointee, Judge Reed O’Connor, ruled that the group challenging the law had a valid belief that preventive coverage would “facilitate and encourage homosexual behavior, intravenous drug use, and sexual activity outside of marriage between one man and one woman.” O’Connor ultimately decided the Justice Department didn’t “show a compelling interest in forcing private, religious corporations to cover PrEP drugs with no cost-sharing and no religious exemptions.” HHS is expected to appeal the decision.
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Sens. Elizabeth Warren and Bernie Sanders are among a group of Democratic lawmakers who want to know whether health insurers are charging patients for PrEP drugs. | John Locher/AP Photo | SENATE DEMS EXAMINE INSURERS’ PrEP PRACTICES — Several Senate Democrats plan to send a letter to AHIP, an association of health insurers, about allegations that some insurance companies aren’t properly covering PrEP (short for pre-exposure prophylaxis) for those enrolled in their plans. Sens. Jeff Merkley (D-Ore.), Tina Smith (D-Minn.), Chris Van Hollen (D-Md.), Elizabeth Warren (D-Mass.) and Bernie Sanders (I-Vt.) are expected to be among those who sign the letter, which was shared with Pulse. In the letter, the senators allege some enrolled in insurance plans are being charged for PrEP and care against standing government rules. “In light of this clear guidance from CMS, we are alarmed by continual reports that patients are routinely billed, either for payment-in-full or for cost-sharing practices, related to medically-appropriate medications and essential services,” they write in the draft letter, which requests more information from insurers on the issue. Insurers have previously said that the issue often lies with providers who aren’t properly coding the visits, adding insurance companies work to quickly address issues.
| | | FIRST IN PULSE — Three House Democrats have sent a letter to the Centers for Medicare and Medicaid Services, calling for the extension of audio-only telehealth coverage through Medicare. CMS recently published a proposed rule, which includes plans to cut coverage for audio-only visits. Representatives Lori Trahan (D-Mass.), Ann McLane Kuster (D-N.H.) and Peter Welch (D-Vt.) requested that CMS rethink the proposal, citing the need for more access to care even where in-person or video appointments aren’t possible. The coverage of audio-only telehealth began during the pandemic with the understanding it would continue while there was a public health emergency, CMS said in the draft rule. Now, as the Biden administration looks to the future beyond a PHE for Covid-19, exceptions and special rules like this are up for debate. FIRST IN PULSE (II) — Sens. Chris Murphy (D-Conn.), Tina Smith (D-Minn.) and Ben Ray Luján (D-N.M.) plan to introduce a bill that would allow the Department of Labor to penalize insurers that don’t cover mental health in the same way they cover physical health. The bill would allow monetary penalties for failing to follow the law and comes after a government report found some insurers aren’t complying. “It’s already the law that insurance companies must cover mental health just like they cover physical health, and yet they’re still finding ways to dodge compliance and deny coverage of care,” Murphy said in a statement. “This bill would give the Department of Labor new tools to enforce mental health parity laws, incentivize compliance, and hold insurers accountable.” CONGRESS’ FIRST MONKEYPOX HEARING — The Senate Health, Education, Labor and Pensions Committee will hold a hearing about the federal response to the monkeypox outbreak, POLITICO’s Nancy Vu reports. The meeting is scheduled for Wednesday, Sept. 14, at 10 a.m. and will include testimony from CDC Director Rochelle Walensky, chief medical adviser to the president Anthony Fauci, FDA Commissioner Robert Califf and Assistant Secretary for Preparedness and Response Dawn O'Connell. The hearing comes as the White House has requested nearly $4 billion to respond to the virus domestically and another $600 million for global responses.
| | | BECERRA EMPOWERS FDA TO AUTHORIZE EMERGENCY USE OF MONKEYPOX TESTS — On Wednesday, HHS Secretary Xavier Becerra issued an emergency declaration that allows the FDA to issue emergency use authorizations for monkeypox and orthopoxvirus tests — a move that the federal government says will expand testing capacity for the virus, David reports. Notably, the administration said it will allow labs to continue offering tests they developed without having to submit an EUA request as long as they’re “appropriately validated” and labs notify the agency within 30 days of the validation. The FDA also issued final guidance on its regulatory approach to monkeypox tests for labs and test makers. “It is important that all tests be appropriately validated prior to use, as false results can have a negative impact on both the individual patient and the public health broadly,” the FDA said in a press release. “Currently, only lesion swabs have been shown to be an appropriate specimen type for diagnosing monkeypox.”
| | | A NEW MOONSHOT VISION — Next week, President Joe Biden will lay out his vision for his Cancer Moonshot program on the 60th anniversary of John F. Kennedy’s moonshot speech at Rice University, according to a White House official. Biden will travel to the JFK library in Boston on Sept. 12 to speak about the program, which aims to cut the death rate of cancer in half over the next 25 years.
| | | 170,000 MORE MONKEYPOX JABS FOR THE EU — The EU has signed a contract for more than 170,000 additional monkeypox vaccine doses from Bavarian Nordic, POLITICO’s Sarah-Taïssir Bencharif reports. That brings the total number of doses secured by the EU to about 330,000. The total case count in the region has grown to more than 18,000, though the number of new reported cases has decreased in recent weeks, according to the EU health commissioner.
| | | Preeya Noronha Pinto is now an adjunct professor of law at the Catholic University of America. She is a partner at King & Spalding and a Bush 43 HHS alum. Cheryl Fish-Parcham is now director of private coverage at Families USA, where she has worked since 1994. She was previously director of access initiatives.
| | | STAT’s Olivia Goldhill goes inside Philip Morris’ investments in health care. Transplants are up, but the agency overseeing donations is under fire, Blake Farmer reports for Kaiser Health News and NPR. | | | | Follow us on Twitter | | | | Follow us | | | | |  |
