Biden’s CMS pick faces a stiff Senate test — Covid funeral claims are inundating FEMA — First in PULSE: House Dems revive sweeping drug price bill

From: POLITICO Pulse - Thursday Apr 22,2021 02:10 pm

Apr 22, 2021

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With Rachel Roubein and Erin Banco

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Quick Fix

— A Senate panel will vote on advancing Chiquita Brooks-LaSure's nomination to run CMS, just days after the agency angered Republicans by pulling Texas' Medicaid waiver.

— FEMA is struggling to keep up with thousands of claims pouring into a new Covid-19 program from Americans seeking aid for family members' funeral expenses.

— House Democrats are reintroducing their sweeping drug price bill amid a growing debate over which health care provisions should go into President Joe Biden's infrastructure package.

WELCOME TO THURSDAY PULSE — where taking a few days from work every now and then is good for your health, but taking 15 years off is a whole other level. Tips to acancryn@politico.com and sowermohle@politico.com.

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Driving the Day

BIDEN's CMS PICK FACES STIFF SENATE TEST — The Senate Finance Committee will decide whether to advance Chiquita Brooks-LaSure’s nomination to run CMS today, in a vote that could be closer than first expected amid GOP criticism over the agency’s decision to rescind Texas’ Medicaid waiver.

CMS' abrupt move came a day after Brooks-LaSure’s confirmation hearing last Thursday, potentially complicating her path through the Senate after an outraged Sen. John Cornyn (R-Texas) put a hold on her nomination.

Brooks-LaSure met with Cornyn on Wednesday to discuss the issue, multiple sources told POLITICO’s Rachel Roubein and Susannah Luthi. But an aide said the senator is still awaiting some answers from Brooks-LaSure’s team, and plans to address his concerns during the vote.

An HHS spokesperson defended Brooks-LaSure earlier this week, calling her “immensely qualified and ready to lead CMS.” And CMS has justified its Texas rescission by saying it “erred” in granting the Trump-era waiver extension before going through the required comment period.

But the episode is a preview of the battles ahead. Even if Brooks-LaSure makes it through the Senate, she’s likely to face more resistance as head of an agency that has already begun withdrawing conservative policies like Medicaid work rules, reasoning they don’t comply with the program’s statute.

In addition to voting on Brooks-LaSure, the Finance Committee is also set to decide today on advancing Andrea Palm, who is Biden's nominee to be HHS deputy secretary.

COVID FUNERAL CLAIMS ARE INUNDATING FEMA — The Biden administration has received more than 100,000 applications for federal aid to help cover the funerals of relatives who died from Covid-19, overwhelming FEMA and creating new difficulties in implementing the nascent program, POLITICO’s Erin Banco reports.

The agency typically handles applications for similar situations after natural disasters like hurricanes or floods. But the Covid-focused reimbursement program is the largest that FEMA has ever managed, senior administration officials said, with the agency fielding close to 20,000 calls a day.

— FEMA is also grappling with deep logistical difficulties. The funeral assistance program requires applicants to hand over death certificates indicating their family member died of Covid-19.

But early on in the pandemic, many doctors didn’t list the disease as a cause of death because they didn’t know what to look for — and the CDC hadn’t yet told states how to code for the virus. That means thousands of Americans died of Covid, but didn’t have it listed on their documents.

So far, FEMA has told applicants they need state officials to amend those death certificates before they can qualify for aid. That requirement may also help officials head off instances of fraud — an issue that FEMA has long worried about.

Yet, two senior administration officials said the agency is now coming under pressure over that policy from congressional Democrats, who argue it places additional burden on families.

BIDEN RAMPS UP BID TO REACH VACCINE SKEPTICS — The administration is pouring resources into convincing skeptical Americans to get their Covid shots as evidence of a demand slowdown mounts, POLITICO’s Eugene Daniels reports.

Still, even top health officials concede the effort may not work – especially after the government paused Johnson & Johnson’s vaccine over reports of rare blood clots. Polling has shown that close to 30 percent of both Republicans and white evangelicals are opposed to getting the vaccine, and insistent that no message will break through with them.

“I don’t mean to in any way say that I have a total amount of confidence that that 30 percent is going to get their minds changed,” said NIH Director Francis Collins, one of a handful of officials deployed to reach evangelical groups. The administration has

In addition to Collins, chief medical adviser Anthony Fauci and Surgeon General Vivek Murthy have sought specifically to reach conservatives – including appearing on Fox News to promote the vaccines. The administration is also running ads on Fox and NewsMax, and has enlisted non-political figures to target skeptical communities.

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On the Hill

FIRST IN PULSE: HOUSE DEMS REVIVE SWEEPING DRUG PRICE BILL — Senior House Democrats are reintroducing legislation empowering the government to negotiate the cost of certain costly drugs, in a revival of one of the party’s centerpiece drug pricing proposals, an aide familiar with the matter told PULSE.

The bill will be backed by Energy and Commerce Chair Frank Pallone, Ways and Means Chair Richard Neal and Education and Labor Chair Bobby Scott, and mirror the plan that House Democrats passed in late 2019.

— It also comes as Democrats debate whether to include a series of health care priorities in their forthcoming infrastructure package. Though progressives favor including the sweeping drug price bill, which would also create roughly $456 billion of savings over a decade, some centrist Democrats are instead advocating for more modest drug pricing reforms.

The legislation being reintroduced today will not address what provisions those savings should offset, a senior Democratic aide said.

In addition to allowing the government to negotiate drug prices, the proposal would also cap Medicare beneficiaries’ out-of-pocket spending on prescription drugs and penalize companies that hike their prices faster than the rate of inflation.

GOP’s INFRASTRUCTURE OFFER DEAD ON ARRIVAL — Senate Democrats are rejecting Republicans’ infrastructure counteroffer before it’s even finalized, in the latest development that could push the majority toward abandoning any attempt at a bipartisan bill, POLITICO’s Burgess Everett and Marianne LeVine report.

Democrats balked primarily at the GOP’s plan to spend less than $1 trillion and focus largely on brick and mortar infrastructure — a far cry from the broad $2.5 trillion spending package that Biden has proposed.

Still, Republicans are hammering out the final elements of their proposal in hopes of negotiating directly with the White House, which has asked them to submit their own offer by May. The parties are still far apart on how to pay for the package if they were to reach a bipartisan deal on its contents, with Democrats calling for an increase to the corporate tax rate.

FIRST IN PULSE: WHAT MODERATE DEMS WANT BIDEN TO PURSUE — Members of the moderate New Democrat Coalition left Biden officials with a parting gift at the end of their meeting Wednesday: A letter outlining a range of health policies the group wants Biden to prioritize in his infrastructure package.

The list includes ideas aimed chiefly at further building out Obamacare, including provisions that would simplify enrollment and permanently expand new subsidies passed as part of the most recent Covid aid package.

The coalition is also seeking a return to the use of value-based care models and fresh efforts to expand telemedicine and stem provider shortages in rural areas and underrepresented communities.

“As you work to develop and advance the American Families Plan, we respectfully request that you work with us to include several NDC priorities to strengthen and expand on the ACA,” more than four-dozen lawmakers wrote in the letter delivered to top Biden aides Ron Klain, Steve Ricchetti and Louisa Terrell.

Inside the Humphrey Building

HHS SCRAPS TRUMP-ERA VACCINE INJURY RULE — The department is rescinding a policy issued during the Trump administration’s final days that would have made it more difficult for those who suffer shoulder injuries or faint after vaccination to get compensated.

In its rescission, HHS cited concerns about its impact on the Covid vaccination campaign, warning that it “could have a negative impact on vaccine administrators” by eliminating a no-fault route for injured people to be compensated without filing suit.

The move means that vaccine-related shoulder injuries and fainting will remain on a list of conditions covered by the National Vaccine Injury Compensation Program.

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What We're Reading

Pfizer identified the first confirmed cases of counterfeit versions of its vaccine in Mexico and Poland, The Wall Street Journal’s Jared Hopkins and José de Córdoba report.

An early analysis of vaccine safety data found no evidence that the Pfizer or Moderna vaccines posed any serious risks to pregnant people, according to a new study published in the New England Journal of Medicine.

Michigan’s Covid case rate appears to have peaked after a statewide surge that ranked the worst in the nation, the Detroit Free Press’ Kristen Jordan Shamus writes.

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.