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Delivered daily by 10 a.m., Pulse examines the latest news in health care politics and policy. | | | | | |  | | By Sarah Owermohle and Adam Cancryn | With Rachel Roubein and Alice Miranda Ollstein Editor’s Note: POLITICO Pulse is a free version of POLITICO Pro Health Care's morning newsletter, which is delivered to our s each morning at 6 a.m. The POLITICO Pro platform combines the news you need with tools you can use to take action on the day’s biggest stories. Act on the news with POLITICO Pro. | | | — Becerra’s cautious border approach rankles the White House as HHS struggles with record levels of unaccompanied children in its care. —Assistant health secretary vote today as the nominee to helm Medicare and Medicaid hangs in limbo. — Health officials’ next vaccination hurdle is sending Covid-19 shots to doctors’ offices seen as key in the next phase of immunization. WELCOME TO MONDAY PULSE — A belated Happy Mother’s Day to all, from a very lucky PULSE writer who got to see her vaccinated mother AND grandmother this weekend. May we all soon! Send tips to sowermohle@politico.com and Adam at acancryn@politico.com. | | | INSIDE BECERRA’s BORDER CHALLENGE — Xavier Becerra joined the administration to oversee an expansive health agenda. Instead, he’s spent his opening months grappling with an immigration influx that’s left him responsible for the care of more than 21,000 migrant children – and under intense scrutiny both inside and outside the White House, Adam reports. The record number of unaccompanied kids in HHS shelters represents a steep test for Becerra, who was an outspoken immigrant-rights advocate in Congress but must now manage the fallout from Biden’s early decision to let migrant children remain in the U.S. HHS is spending tens of millions of dollars per week to house the rising population, an exhaustive effort that’s pulled energy from other policy priorities and is likely to continue for months. And it’s frustrated Becerra, who would rather be spending his time selling Biden’s spending plans and promoting the administration’s vaccination campaign. The HHS chief was among those who argued recently to keep a historically low Trump-era cap on refugee admissions, for fear of stretching his department’s already-thin resources. Still, there are signs of progress following a shaky opening few weeks for Becerra. The number of children held in jail-like facilities at the border has dropped sharply, and HHS has dramatically increased its ability to quickly process and house unaccompanied kids. It’s also slashed the time it takes to discharge them to sponsors — a process that will be critical to eventually getting HHS’ population of migrant children to a more manageable level. | | | | SUBSCRIBE TO "THE RECAST" TODAY: Power is shifting in Washington and in communities across the country. More people are demanding a seat at the table, insisting that politics is personal and not all policy is equitable. The Recast is a twice-weekly newsletter that explores the changing power dynamics in Washington and breaks down how race and identity are recasting politics and policy in America. Get fresh insights, scoops and dispatches on this crucial intersection from across the country and hear critical new voices that challenge business as usual. Don't miss out, SUBSCRIBE . Thank you to our sponsor, Intel. | | | | | ON TAP TODAY: SENATE TO VOTE ON KEY BIDEN HHS PICK — The Senate will vote to clear a procedural hurdle for the nomination of Andrea Palm to serve as deputy health secretary. Palm — who would run HHS’ daily operations as its No. 2 official — received bipartisan support in a 20-8 vote in the Senate Finance Committee vote last month. Not yet scheduled: A vote on Chiquita Brooks-LaSure to head the Medicare and Medicaid agency. The Senate Finance panel deadlocked on her nomination the same day it advanced Palm’s. All of the committee’s GOP members voted against her out of frustration over the Biden administration’s decision to revoke an extension of a Texas Medicaid waiver, which will force Senate Majority Leader Chuck Schumer to file a discharge petition to bring the nomination to the chamber’s floor. LINING UP DOCS TO GIVE COVID SHOTS — The Biden administration and state health officials are rushing to overcome logistical hurdles to get more Covid-19 shots into doctors’ offices, believing that physicians who have largely been excluded from the inoculation effort so far could be key to boosting vaccination rates, Rachel Roubein and Dan Goldberg report. Doctors have lobbied for months for the White House and states to ship them doses, but officials instead focused on mass vaccination sites and other places that could quickly immunize hundreds of thousands of people daily. But as the demand for shots decreases, officials are now trying to steer doses to smaller, local sites like doctor offices. It’s not as easy as it sounds. The vaccines are shipped in huge quantities. Two of the authorized shots have cold storage requirements. And vials can contain between 5 to 15 doses that must be used in the same day, increasing the likelihood that shots could get wasted in small medical offices. The White House says it’s on these issues. Officials haven’t set up a federal stream of doses to doctors offices. Instead, they are working with states to prioritize shots for primary care practices ranking high on CDC’s social vulnerability index. White House officials, on a private call with governors last week, urged them to get more vaccines to pediatricians and family physicians, according to two sources. The White House has also considered encouraging emergency room physicians to administer the vaccine when a patient is discharged, according to three sources with knowledge of the talks. | | | FAUCI: “DRAMATIC DIFFERENCE” WITH MASS VACCINATION — Biden’s chief medical advisor Anthony Fauci on Sunday predicted that the country’s coronavirus situation will be dramatically different a year from now if larger proportions of the population are vaccinated, Jesse Naranjo reports. “I believe that we will be about as close to back to normal as we can, and there's some conditions to that,” Fauci told ABC “This Week” host George Stephanopoulos. “We've got to make sure that we get the overwhelming proportion of the population vaccinated. When that happens, the virus doesn't really have any place to go.” If American continue getting vaccinated and cases keep falling, Americans can expect a relaxation of public health regulations, particularly indoor mask mandates, the long-time National Institute of Allergy and Infectious Diseases director said. But the country’s current daily case counts are still too high. “The CDC will be almost in real time ... updating their recommendations and their guidelines,” Fauci said. “But yes, we do need to start being more liberal as we get more people vaccinated.” NO REGRETS ON J&J VACCINE PAUSE — White House coronavirus response coordinator Jeff Zients said Sunday that it was "not at all" a mistake to place a hold on the Johnson & Johnson coronavirus vaccine, rebuffing the idea that doing so made vaccinating the country any more difficult. If anything, the Food and Drug Administration hold to investigate rare but serious blood clots helped build confidence that people know that the FDA and the CDC are monitoring, he told CNN’s Jake Tapper on "State of the Union." "The FDA is the gold standard in the world," Zients said. "Doing the pause was the right thing." | | | FDA MAY PERMANENTLY LIFT ABORTION PILL LIMITS — The FDA is reviewing decades-old restrictions on dispensing abortion pills by mail and via telemedicine, and may permanently scrap or amend the requirement that people to pick up the pills in person from a medical provider, Alice Miranda Ollstein reports. The Justice Department’s new legal filing late Friday comes just a few weeks after the FDA announced it was suspending enforcement of rules for the pills for the duration of the Covid-19 pandemic, arguing that forcing people to physically come to a clinic to obtain the pills is riskier than sending them to people’s homes or a local pharmacy. That move revived a long-dormant case in which the American Civil Liberties Union argues that restrictions on the pills should be struck down as a medically-unnecessary burden on patients. That federal court has yet to announce whether they will grant the FDA and ACLU’s joint request to stay in the case until November, when the agency will complete its review of the rules. | | | EU PUSHES BACK ON BIDEN’S VACCINE PATENT PLAN — Top European Union officials are questioning Biden’s decision to waive intellectual property rights for coronavirus vaccines, arguing that the U.S. doesn’t have a specific plan for waiving patents that would help with urgent vaccination needs, report POLITICO Europe’s David Herszenhorn and Rym Momtaz. “On the intellectual property, we don’t think in the short term that it’s the magic bullet but we are ready to engage on this topic as soon as a concrete proposal will be put on the table,” European Council President Charles Michel said at a region summit in Portugal this weekend, summarizing a roughly three-hour discussion among leaders on Friday night about the pandemic. French President Emmanuel Macron was even more pointed in calling on the U.S. and the U.K. first to take more important steps: ending de facto bans on vaccine exports; sharing technology needed to ramp up production; and donating existing doses. “The Anglo-Saxons must first stop their export bans,” Macron said. | | | | SUBSCRIBE TO WEST WING PLAYBOOK: Add West Wing Playbook to keep up with the power players, latest policy developments and intriguing whispers percolating inside the West Wing and across the highest levels of the Cabinet. For buzzy nuggets and details you won't find anywhere else, subscribe today. | | | | | | | | Former FDA officials Scott Gottlieb, a Trump administration commissioner, and Luciana Borio, who worked for Bush and Obama on infectious diseases and counter-terrorism, pushed back in the Wall Stree Journal against Biden’s vaccine patent waivers, arguing instead for loosened export limits and expanded manufacturing. Psychiatry is on the cusp of major change as the push for medicinal mushrooms and MDMA grows, fueled by late stage trial results, the New York Times’ Andrew Jacobs reports. Black women are more susceptible to heart failure during pregnancy than other women, and University of Pennsylvania researchers are delving into why—and how to predict risk, writes the Philadelphia Inquirer’s Tom Avril. | | | | Follow us on Twitter | | | | Follow us | | | | |  |
