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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 Krista Mahr and Daniel Payne | | | With help from Ben Leonard and Daniel Lippman
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Monkeypox cases have dramatically declined in recent months. | Joe Raedle/Getty Images | WHITE HOUSE MAY END MPOX PHE — The Biden administration looks to end its public health emergency declaration for mpox — the virus formerly known as monkeypox until recently — a sign that officials believe they’ve brought the unprecedented outbreak under control, POLITICO’s Adam Cancryn reports . Health officials are likely to issue a 60-day notice later this week for winding down the declaration, two people with knowledge of the matter told POLITICO, putting it on track to expire by Jan. 31. The decision isn’t yet final and could still change, the people cautioned. Backstory: The Biden administration first declared the mpox outbreak a public health emergency in August, amid growing criticism over its sluggish early attempts to contain the virus. The health department opted to renew the emergency declaration for another 90 days in early November, keeping it in place through the beginning of next year. Why now? The discussion comes as U.S. cases of mpox have hit new lows, with the Centers for Disease Control and Prevention recording just a handful of new infections a day, down from more than 400 average daily cases at the outbreak’s peak. A test run for Covid: Some administration officials see the potential unwinding of the mpox emergency declaration as a test run for eventually ending the yearslong Covid emergency — a more complex challenge — that Biden aides expect to happen at some point next year. WELCOME TO THURSDAY PULSE — Where we are mourning the impending loss of Date Lab as The Washington Post gets ready to end the print edition of its Sunday magazine on Christmas. Send your favorite DL debacle (and news and tips) to kmahr@politico.com and dpayne@politico.com . TODAY ON OUR PULSE CHECK PODCAST , Megan Messerly talks with Megan Wilson about North Carolina's and Kansas' latest attempts to expand Medicaid — and how increased federal incentives and Medicaid expansion advocates have gradually worn down traditional GOP opposition.
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PhRMA failed to stop Democrats’ drug-pricing measures in the Inflation Reduction Act from becoming law. | Uriel Sinai/Getty Images | PHRMA’S SOUL-SEARCHING — The Pharmaceutical Research and Manufacturers of America has commissioned a report that looks at its advocacy in the run-up to its most consequential legislative loss in decades, Megan R. Wilson reports. Who’s in charge: PhRMA hired top lobbying firm BGR Group to examine the organization’s failure to stop Democrats’ drug-pricing measures in the Inflation Reduction Act from becoming law, according to individuals with knowledge of the effort. Bob Wood, BGR Group’s chair and CEO, is leading the report, said three of those people. He declined to comment. “Like most organizations, it’s our standard operating procedure to do an after-action review following a large-scale, organization-wide advocacy effort,” said Brian Newell, a PhRMA spokesperson, in an emailed statement to POLITICO. Backstory: The passage of the measure, which for the first time allows Medicare to negotiate drug prices, amounted to a historic defeat for the industry, which has long been able to use its influence to stave off policy proposals it viewed as threats.
| | | PROVIDERS PUSHING TO STOP PAYGO CUTS — America’s largest provider groups are pressuring Congress to forestall billions in looming reimbursement cuts, but a deal is far from near, Daniel and Megan report. Hospital and physician groups are worried about the 4 percent pay-as-you-go, or PAYGO, cuts worth $38 billion, according to a calculation by the American Hospital Association. The estimated cost of fully averting the full 4.5 percent cut for one year isn’t publicly available. But three lobbyists granted anonymity to speak about the work said they’ve heard it would be more than $2 billion. Several of the largest health groups, including the AHA and the American Medical Association, sent a letter to House and Senate leaders Wednesday asking for the PAYGO cuts to be stopped, but much of those negotiations hinges on the top-line spending numbers that leadership in both parties must agree on first.
| | | | A message from PhRMA: In 2021, Insurers and their pharmacy benefit managers (PBMs) subjected patients to six times the out-of-pocket costs for brand medicines through the use of deductibles or coinsurance compared to patients with only copays — even when these middlemen received a discounted price. That’s not fair. Learn more. | | | | 
Republican lawmakers are demanding information from NIH related to Covid-19's origins. | Lauren DeCicca/Getty Images | GOP DEMANDS ANSWERS FROM NIH ON COVID ORIGINS — On Wednesday, Republican lawmakers sent a letter to Lawrence Tabak, acting director of the NIH, asking that the agency respond to outstanding requests for information related to the Covid 19’s origins. Reps. Cathy McMorris Rodgers (R-Wash.), GOP leader of the Energy and Commerce Committee; Brett Guthrie (R-Ky.), GOP leader of the Subcommittee on Health; and Morgan Griffith (R-Va.), GOP leader of the Subcommittee on Oversight and Investigations, requesting information about the National Institute of Allergy and Infectious Diseases’ grant to EcoHealth Alliance and subgrant to the Wuhan Institute of Virology, among other matters. WYDEN ON TELEHEALTH — Sen. Ron Wyden (D-Ore.), who chairs the Senate Finance Committee, told Ben he’s looking for an “as-long-as-possible” extension of Medicare telehealth flexibilities in a potential omnibus spending package. The committee is looking at a possible one-year extension, POLITICO reported earlier this month. Earlier this year, the House passed legislation from Rep. Liz Cheney (R-Wyo.) that would extend the pandemic era rules through 2024, but the Senate hasn’t yet taken it up. SENATORS TO PUSH FOR BILL ON KIDS’ MENTAL HEALTH — During a Senate HELP Subcommittee on Children and Families hearing on students’ mental health Wednesday, the panel’s top Democrat and Republican said they would push for legislation to alleviate a mental health crisis in children, POLITICO’s Ruth Reader reports. Subcommittee Chair Bob Casey (D-Pa.) and ranking member Bill Cassidy (R-La.) back the Health Care Capacity for Pediatric Mental Health Act to create grant programs that would expand mental health integration into pediatric care. They’ve also co-sponsored the Respond, Innovate, Succeed, and Empower Act to streamline administrative processes that would ensure smooth transitions from high school to college for students with disabilities. Casey is also a sponsor with Sen. Rob Portman (R-Ohio) of the Investing in Kids’ Mental Health Now Act, a bill that would increase Medicaid reimbursement for children’s mental health services and ensure timely access to care. GOP DEMANDS VOTE ON MILITARY VAX MANDATE — Thirteen Republican senators wrote to their party’s leaders Wednesday to say they would oppose moving forward with the annual defense authorization bill if they’re denied the opportunity to vote on an amendment to end the military’s Covid-19 vaccine mandate, POLITICO’s Grace Scullion reports. The senators cited the military’s recruitment challenges and the cost of recruiting and training a service member. CASSIDY: CYBERSECURITY DEAL LOOKS GOOD — Cassidy told POLITICO Wednesday he is optimistic that legislation to enhance cybersecurity coordination between the Health and Human Services and Homeland Security departments will pass as part of year-end spending legislation, Ben reports. The Healthcare Cybersecurity Act, which Cassidy co-sponsored with Sen. Jacky Rosen (D-Nev.), would mandate that HHS work more closely with the Cybersecurity and Infrastructure Security Agency within DHS.
| | | CDC TO EXPAND POLIO SURVEILLANCE — The CDC is expanding its surveillance for potential polio transmission by testing wastewater in communities that are undervaccinated or have links to the areas of New York where a case of paralytic polio was identified this summer. The Michigan Department of Health and Human Services (MDHHS) and Philadelphia Department of Public Health will be among the first states to collect wastewater samples and send them to the CDC’s polio lab for analysis. They can then focus their vaccination efforts on areas where the samples showed virus shedding in sewage or wastewater. The agency is also discussing working with other state and local health departments.
| | | | A message from PhRMA:   | | | | | | CONTAMINANTS IN UNREGULATED NYC WEED — Unregulated marijuana purchased from New York City’s burgeoning illicit cannabis market is rife with contaminants like E. coli, pesticides and heavy metals, POLITICO’s Mona Zhang reports. An investigation led by New York’s Medical Cannabis Industry Association involved purchasing products from 20 unlicensed dispensaries in August. Lab testing revealed that 100 percent of those products would fail New York’s proposed regulations, according to its according to its report . FLORIDA SCHOOL OFFICIALS THAT BACKED MASKS GET THE BOOT — Conservative school board candidates backed by Gov. Ron Desantis are now in office — and purging some educational leaders who enforced Covid-19 mandates, POLITICO’s Andrew Atterbury reports . School boards with ties to DeSantis pushed out three superintendents in November alone. DeSantis used his clout to endorse more than two dozen school board candidates during the 2022 election cycle, a rare move for a Florida governor. Most of the candidates DeSantis endorsed won their elections. They’re now transforming the makeup of school district leadership and will have a huge influence over policies affecting hundreds of thousands of students in the state.
| | | | POLITICO APP USERS: UPGRADE YOUR APP BY DECEMBER 19! We recently upgraded the POLITICO app with a fresh look and improved features for easier access to POLITICO's scoops and groundbreaking reporting. Starting December 19, users will no longer have access to the previous version of the app. Update your app today to stay on top of essential political news, insights, and analysis from the best journalists in the business. UPDATE iOS APP – UPDATE ANDROID APP . | | | | | | | | Sarah Lovenheim has told her colleagues she’s leaving the Department of Health and Human Services, where she’s assistant secretary of public affairs, Daniel reports. She’s overseen communications at HHS and its sub-agencies through nearly half of the Biden administration. AMN Healthcare announced Cary Grace will be the company’s next president and chief executive officer to succeed Susan Salka, who announced her retirement earlier this year. Grace is the former CEO of global retirement, investment and human capital at Aon. Waxman Strategies has promoted Claire McAndrew to senior vice president, Zara Day to vice president in the health care practice and Aliya DeGeneste-Wheeler to vice president of people and culture.
| | | KFF breaks down why most Covid deaths right now are among the vaccinated. The Washington Post reports on the growing prevalence of fentanyl on social media sites.
| | | | A message from PhRMA: Every day, patients at the pharmacy counter discover their commercial insurance coverage does not provide the level of access and affordability they need. New data from a study by IQVIA reveal the harmful practices of insurers and their pharmacy benefit managers (PBMs) can lead to significantly higher out-of-pocket costs for medicines — causing some patients to abandon their medicines completely. Learn more. | | | | | | | Follow us on Twitter | | | | Follow us | | | | |  |
