The nation’s latest vaccine problem: Decreasing demand — Cornyn stalls Biden’s CMS pick — Fight over fentanyl scheduling heats up

From: POLITICO Pulse - Wednesday Apr 21,2021 02:03 pm
Presented by PhRMA: Delivered daily by 10 a.m., Pulse examines the latest news in health care politics and policy.
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Quick Fix

— States are suddenly finding themselves with too much coronavirus vaccine and not enough demand.

— Texas GOP Sen. John Cornyn is holding up the confirmation of President Joe Biden's CMS pick, after the agency abruptly revoked his state's Medicaid waiver.

— The Biden administration faces a high-stakes decision over its classification of fentanyl, as advocacy groups campaign against a Trump-era move to place it in the most restricted class of drugs.

WELCOME TO WEDNESDAY PULSE . Forget hitting a round ball with a round bat; for the Chicago Cubs and the rest of the Major League teams, the most difficult job in baseball is dodging a Covid outbreak long enough to win a few games. Help us hit one out of the park — send tips to acancryn@politico.com and sowermohle@politico.com.

 

A message from PhRMA:

America’s unique R&D ecosystem delivered multiple COVID-19 medical breakthroughs in record-breaking time. Instead of breaking what works, let’s work together to improve health care – for everyone. We support common-sense, patient-centered reforms to build a stronger, more resilient, affordable and equitable health care system. And we are ready to do our part. Learn more about our plan.

 
Driving the Day

STATES’ LATEST VACCINE PROBLEM: DECREASING DEMAND — Even as states lift remaining eligibility restrictions, open walk-in clinics and devise clever new ploys to get people vaccinated, the supply of shots has begun outpacing demand, POLITICO's Dan Goldberg and Rachel Roubein report.

It’s a jarring twist, when just months ago, vaccine-seekers were crashing appointment websites and stalking pharmacy counters hoping to snag leftover doses. The shift happened even faster than some thought it would, leaving state and federal officials rushing to address the issue with only limited success.

The Biden administration says it’s been aggressive and nimble in targeting vaccine hesitancy. State and local leaders, meanwhile, argue that the White House can’t rely on the same vaccine promotion strategy it used when supply was constrained, and are focusing their efforts now on meeting people where they are.

On Alaska’s Kenai Peninsula, EMS personnel are bringing the vaccine to any house or business with more than three people. Bars in New Orleans have offered a "shots for shots " promotion. And North Dakota, which for the first time last week didn’t order its maximum number of doses, is piloting pop-up clinics at Walmart.

The challenge comes at a crucial point in the pandemic. More contagious variants are surging across the crisis-fatigued nation, and vaccinations are the only way to meet Biden’s goal of returning the country to something closer to normal by July 4th.

Some governors and public health officials are worried the pause of Johnson & Johnson's vaccine will make it even harder to convince people to get their shots, even if overall vaccine supply isn’t as much of an issue.

On Tuesday, Biden officials pushed back on those concerns during a private call with polling showing most Americans agreed with the decision to suspend the J&J shot. Yet a separate poll Tuesday found more than a third of voters citing safety concerns as a reason to wait on getting vaccinated.

The president himself will try to give the vaccine campaign an added boost today. He's scheduled to give a speech this afternoon on the Covid response and vaccination effort, just days after the U.S. hit 200 million doses administered.

CORNYN PUTS BIDEN’s CMS PICK ON HOLD — Cornyn is blocking the Senate confirmation of CMS Administrator nominee Chiquita Brooks-LaSure, in what a spokesperson described as payback for Biden revoking Texas’ Medicaid waiver — and with it, funding to cover poor and uninsured Texans’ health care.

It’s the first sign of GOP backlash to Biden’s decision last week to void a 10-year extension of Texas’ waiver as it tries to convince holdout states to expand Medicaid, POLITICO’s Susannah Luthi and Rachel report. Biden officials justified scrapping it because the Trump administration had approved the extension without first going through the required public comment period.

But the move has enraged Republicans, who see the rescission as politically motivated — to the point that HHS officials this week began calling GOP senators to try to defuse the situation, two sources said.

— Senate Democrats are forging ahead with Brooks-LaSure’s nomination anyway. The Finance Committee will vote on her candidacy Thursday, after Brooks-LaSure sailed through a low-key confirmation hearing.

Still, Cornyn’s hold could delay her floor vote, and with it the installation of a top official critical to fulfilling Biden’s health care ambitions. A Cornyn spokesperson said Tuesday that the senator is still waiting to hear from Brooks-LaSure and the Biden administration about whether they‘ll reverse the waiver decision.

 

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Public Health

FIGHT OVER FENTANYL SCHEDULING HEATS UP AHEAD OF DEADLINE — Advocacy groups are rallying against prolonging the Trump administration’s classification of fentanyl as a Schedule 1 drug, saying it amounts to a continuation of the failed War on Drugs effort.

The Trump order putting fentanyl into the Schedule 1 class of drugs expires early next month. Lawmakers such as Sens. Joe Manchin (D-W.V.) and Rob Portman (R-Ohio) — who both represent states hard-hit by the opioid epidemic — are mounting a push to make the classification permanent before that deadline.

Fentanyl plays an outsized role in overdose deaths amid a national addiction crisis that shows no sign of abating, Manchin and Portman argue.

— But the issue is politically fraught, as evidenced by the Biden administration reportedly slow-walking any decision about extending the Trump policy, Susannah writes. More than 100 organizations, including the ACLU, criminal justice groups and Human Rights Watch have sharply lambasted the policy, contending that it will simply escalate prosecutions and sentencing.

A government watchdog agency also delved into the issue for a new report on options for extending the drug scheduling order — either in its current form, or with tweaks to allow for research or for some forms of fentanyl to be descheduled (for medical use, for instance).

But the public version of the Government Accountability Office study excluded its deep dive into China’s class-wide order on similar substances, which the Justice Department deemed “sensitive.”

Influence

PFIZER SPENT BIG ON BIDEN’s INAUGURATION — The drug company contributed $1 million to Biden’s inaugural committee, making it one of just a handful of donors to drop seven figures on the festivities, according to disclosures made public on Tuesday.

Pfizer made the donation in January to PIC 2021 Inc., which was formed to bankroll the celebration surrounding Biden’s swearing in as president. The organization raised roughly $63.8 million overall, including from several other health care firms — including $500,000 apiece from managed care company Centene Management and drugmaker Amgen.

Otsuka America Pharmaceutical gave $150,000, and insurers Anthem and Independence Blue Cross gave $125,000 and $100,000, respectively. Among the big-ticket individual donations, Bill and Melinda Gates contributed a combined $500,000 to fund Biden’s inaugural.

 

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Inside the Humphrey Building

BECERRA: CHAUVIN VERDICT 'DELIVERED ACCOUNTABILITY' — The HHS secretary applauded the conviction of former police officer Derek Chauvin in a late-night statement as "accountability on the road towards justice" for the murder of George Floyd, though he allowed that it "does not change an egregious wrong."

Becerra also doubled down on HHS' view of racism as a public health issue, adding that the department stands with "marginalized communities to provide support and do our part to ensure that health and well-being are treated as a right."

Opioids

BIPARTISAN POLICY CENTER FORMING OPIOID TASK FORCEThe think tank’s new group will develop policy recommendations for driving down opioid overdose deaths, with plans to publish a final report by early 2022. It will also take a specific look at treatment disparities between states that have opted to expand Medicaid and those that have not.

— Among the task force’s members: former Trump administration Surgeon General Jerome Adams, former Kentucky Democratic Gov. Steve Beshear, former American Medical Association President Patrice Harris and Donna Shalala, the former HHS secretary and congresswoman.

On the Hill

TODAY: DEMOCRATS PITCH MEDICARE EXPANSION PLAN — A trio of Senate Democrats will reintroduce legislation today that would give people the option to buy into Medicare starting at age 50.

The bill — backed by Sens. Debbie Stabenow of Michigan, Sherrod Brown of Ohio and Tammy Baldwin of Wisconsin — is more ambitious than the Medicare expansion plan that Biden has embraced, which would lower the program’s eligibility age to 60. But it stops short of embracing “Medicare for All,” and would keep the expansion population separate from traditional Medicare, so as to sidestep concerns the broader coverage would undermine seniors’ care.

 

A message from PhRMA:

America's unique R&D ecosystem allowed the biopharmaceutical industry to develop COVID-19 vaccines and treatments at unprecedented speed. As we continue our work to help end the pandemic – from researching variants to seeking additional therapeutics – we are committed to common sense policy changes that will improve our health care system for everyone.

We have a plan built on three key pillars to help our country reach that goal: from ending the pandemic and building a more resilient system to making medicines more affordable and creating a more just, equitable health care system. We are ready to do our part. Let’s work together to get it done. Learn more about our plan.

 
What We're Reading

Investors in Emergent BioSolutions are suing the embattled vaccine manufacturer, accusing the company of failing to tell stakeholders about production issues that ruined millions of J&J vaccine doses, Bloomberg Law’s Jennifer Bennett reports.

A federal audit found that health insurer Humana overcharged Medicare by nearly $200 million in 2015, Kaiser Health News' Fred Schulte reports.

Bad news: A large study in Nature suggests that habitually getting fewer than six hours of sleep could increase adults’ chances of developing dementia, New York Times’ Pam Belluck reports.

 

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