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Presented by Kaiser Permanente: Delivered daily by 10 a.m., Pulse examines the latest news in health care politics and policy. | | | | |  | | By Erin Schumaker and Daniel Payne | Presented by Kaiser Permanente | With Megan Messerly and Carmen Paun
| | |  Arkansas Governor Sarah Huckabee Sanders introduced a new Medicaid work requirement earlier this month. | Phelan M. Ebenhack/AP Photo | ARKANSAS’ TALE ON MEDICAID UNWINDING — New data from Arkansas shows Medicaid unwinding is going how state officials had hoped — and many consumer advocates had feared. Nearly 45,000 Arkansans who had remained on Medicaid because of pandemic protections had their coverage terminated in April. Eighty-five percent lost their insurance for procedural reasons — because they failed to return their renewal forms or other requested information, or because the state couldn’t locate them — according to data published by the state Department of Human Services. The announcement comes as states begin to comb through their Medicaid rolls for the first time in three years. In exchange for additional money, the federal government prohibited states from removing anyone from the insurance program due to changes in eligibility. Estimates suggest that as many as 15 million people, including 3.5 million children, could be removed from Medicaid because of this so-called unwinding. National health care experts have been watching Arkansas closely for two reasons. First, they say the state is moving much faster than everyone else. It’s the only state that plans to conduct Medicaid redeterminations for pandemic holdovers in half the time the Biden administration has recommended. Second, they say the state has a past when it comes to kicking eligible people off Medicaid. More than 18,000 low-income adults had their Medicaid coverage terminated in 2018 for failing to show proof they were meeting the state’s new work-requirement rules. Many complained that a confusing system made it difficult to comply with the rules. A 2019 study found that a lack of awareness and confusion about the new rule led to a wave of terminations, despite that 95 percent of an estimated 140,000 affected people should have remained covered. WELCOME TO TUESDAY PULSE, where we’re buckled in for a busy week. Do you have thoughts on the end of the public health emergency on Thursday? Send tips, feedback and fears to eschumaker@politico.com and dpayne@politico.com. TODAY ON OUR PULSE CHECK PODCAST, host Ben Leonard talks with POLITICO's Maya Kaufman about a first-of-its-kind, federally-funded study that will evaluate the impact of overdose-prevention centers in New York City and Providence, R.I., on future public health policy.
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Many Republican lawmakers believe the Covid-19 pandemic started with a lab leak in China's Wuhan Institute of Virology, and they oppose the NIH's decision to renew a research grant to EcoHealth Alliance. | Ng Han Guan/AP Photo | ANGER OVER NIH GRANT — Rep. Morgan Griffith (R-Va.), the chair of the House Energy and Commerce Oversight and Investigations Subcommittee, said Monday the NIH’s decision to renew a grant to an environmental group that worked on coronavirus research was reckless, Carmen Paun reports. The new grant, which will give EcoHealth Alliance $576,000 a year, restores funding the Trump administration cut in April 2020 to study how coronaviruses spread from bats to people. The Trump administration rescinded the grant because EcoHealth Alliance had collaborated with researchers at China’s Wuhan Institute of Virology, from which many GOP lawmakers believe the pandemic originated. The new grant bars such collaboration. The Department of Energy and the FBI back the lab-leak theory, albeit with limited confidence, while other government agencies believe the virus more likely came from a wild animal. Why it matters: In January, the HHS inspector general said in an audit that the NIH didn't effectively monitor or enforce the terms of its grants to EcoHealth Alliance and the group improperly used nearly $90,000 in grant funds. In a statement, Griffith accused EcoHealth Alliance of negligence and breach of contract. EcoHealth Alliance said in a statement that it was disclosing information about the grant to be transparent. What’s next: The decision will likely further antagonize House Republicans, who are investigating the pandemic’s origins and have raised questions about the NIH’s funding decisions.
| | | | GET READY FOR GLOBAL TECH DAY: Join POLITICO Live as we launch our first Global Tech Day alongside London Tech Week on Thursday, June 15. Register now for continuing updates and to be a part of this momentous and program-packed day! From the blockchain, to AI, and autonomous vehicles, technology is changing how power is exercised around the world, so who will write the rules? REGSITER HERE. | | | | | | | | | PHE CHANGES — When the Covid-19 public health emergency ends Thursday, it’s taking pandemic-era rules with it, affecting everything from free vaccines and tests to Covid surveillance data, Daniel and POLITICO's Ben Leonard and David Lim report. A few key changes: — Title 42, which allows the U.S. to deny asylum and migration claims for public health reasons, ends. — The CDC will lose access to some surveillance data it used to assess Covid risk and will no longer have comprehensive vaccination data. — Medicare reimbursement for over-the-counter rapid tests ends, meaning older adults will have to pay for their tests, although laboratory tests ordered by doctors will still be covered. — The DEA has proposed changing pandemic rules that allowed controlled substances like Adderall and buprenorphine to be prescribed via telemedicine. The proposed rules, which came under fire from lawmakers, aren’t finalized.
| | | | A message from Kaiser Permanente:   | | | | | PREPARE TO PONY UP FOR COVID TESTS — The lifting of the PHE means the end of free or low-cost testing — even for those with insurance. While the PHE was in place, private insurers were required to reimburse up to eight at-home rapid tests a month. Without the PHE, patients will foot the bill for at-home tests unless their insurer voluntarily covers the costs, which the Department of Health and Human Services has encouraged private insurers to do. Tests ordered by a doctor in a clinical setting will likely be covered but could be subject to cost-sharing and other measures for which patients pay out of pocket. A new KFF Health News analysis estimates how much insured people might pay for different types of Covid tests. The analysis relied on outpatient claims data, as well as pricing data from major retailers, such as Walmart, Target, CVS, Walgreens, Amazon and Kroger. KFF Health News findings, by the numbers: — At-home rapid tests tend to retail for between $12 and $24 a pack, with an average test price of $11. — For a Covid test in an outpatient setting, the median price was $45 among people who had insurance through large employers. Caveat: Prices varied widely, KFF Health News notes. — Antigen testing, with a median price of $42, was less expensive than PCR testing at $62. — Extra charges associated with office visits can be costly. Getting tested in an outpatient setting could cost upward of $130 to $150 after factoring in charges like office-visit fees.
| | | | DON’T MISS THE POLITICO ENERGY SUMMIT: A new world energy order is emerging and America’s place in it is at a critical juncture. Join POLITICO on Thursday, May 18 for our first-ever energy summit to explore how the U.S. is positioning itself in a complicated energy future. We’ll explore progress on infrastructure and climate funding dedicated to building a renewable energy economy, Biden’s environmental justice proposals, and so much more. REGISTER HERE. | | | | | | | | | Today at 9:30 a.m., the FDA’s independent committees on nonprescription and reproductive drugs convene to evaluate HRA Pharma’s application for its over-the-counter birth control pill, Opill.
| | STAT reports on ketamine as a potential treatment for fentanyl withdrawal symptoms. The New Yorker reports on whether Planned Parenthood’s corporate nature forces independent clinics to take bigger risks. KFF Health News reports on what it’s like to work the night shift as a sexual assault nurse examiner in Missoula, Mont.
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