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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 Dan Goldberg 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.
| | | — Abortion advocates are increasingly relying on digital resources after a pandemic year and a Supreme Court case looming. — Biden’s vision for a cutting-edge health agency is running into bureaucratic questions. — ‘Lab leak’ theory forces Democrats into a balancing act as they push for other hearings and worry about fueling conspiracies. WELCOME TO TUESDAY PULSE — We hope you had a fun, long weekend and got that elusive perfect firework picture. Send that pic and tips to sowermohle@politico.com and acancryn@politico.com. | | | ADVOCATES PREP FOR THE SPECTER OF POST-ROE AMERICA — The Supreme Court’s decision to review Mississippi’s stringent abortion restrictions puts Roe vs. Wade under its roughest stress test yet — and abortion advocates see it as a call to action, Darius Tahir reports. An ‘abortionpocalypse’: The pandemic year has already been tough for people seeking abortions after a wave of red-state restrictions on procedures to terminate pregnancies. But advocates have also acted, recruiting new members and online providers, adding new privacy features that could shield them from law enforcement and organizing. Even before the Covid-19 lockdown prompted advocates to strengthen their networks, many patients were already self-managing their abortions, Darius writes. One 2010 survey from the Guttmacher Institute found 2.6 percent of women saying they’d done so — a figure that many activists believe was understated at the time, and has almost certainly grown as abortion pills have become increasingly available. Pandemic fears pushed people online … and, because of federal and state restrictions, they often turned to underground services, where they could access private internet forums, small internet groups offering assistance in-person and virtually, and mail deliveries from international pharmacies to out-of-the-way mailboxes. Those resources could become essential as advocates brace for the Supreme Court hearing. “Even though our work is legal and we're not doing anything wrong, we operate under the assumption what we do could become illegal at any time,” said a member of one group, the Mountain Access Brigade, of their new work on privacy-supporting technology. The underground community of support groups has been adding services to advise women about self-managed abortions or arrange rides for women who prefer in-person abortions. BIDEN’S NEW MOONSHOT MEETS BUREAUCRATIC BARRIERS — Biden’s proposal for a new health project modeled at the Pentagon’s Defense Advanced Research Projects Agency enjoys widespread support—but has also raised questions about what yet another agency can do that others could not. The Advanced Research Projects Agency for Health, or ARPA-H, and its $6.5 billion annual budget will most likely be housed in the sprawling National Institutes of Health universe. That likelihood is raising concern within the research community and in Congress about whether it will bring a new approach to old problems or become a duplicative bureaucracy with a lofty mandate, Sarah writes. “Most of us did not support putting this in NIH, for the simple reason that if NIH were capable of doing this, it would have done it,” said one person outside the government familiar with the planning who’s worried NIH’s staid culture and leadership will bog down the effort. But the prevailing view is that making the new agency part of NIH's infrastructure will give it a foundation to spring off — and foster communication to head off unnecessary duplication. As Congress prepares for hearings on the first budget proposal, administration officials are expressing confidence ARPA-H can carve out a distinct identity, wherever it is. “[The established NIH culture is] a valid concern, and we have to do everything to prevent that from being the default,” NIH Director Francis Collins told POLITICO. “This is not going to be the 28th institute.”
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‘LAB LEAK’ HEAT FORCES DEMOCRATS INTO A COVID-19 BALANCING ACT — Congressional Democrats are torn between escalating calls to investigate whether Covid-19 escaped from a lab in China and their efforts to investigate the Trump administration’s pandemic response and respond to a new wave of infections, Alice Miranda Ollstein writes.
Democrats who control the congressional agenda are in a bind as they wrestle with the need to understand the virus’ origin and prevent future outbreaks but fear the effort could feed conspiracy theories and xenophobia. “It’s really tough, because whatever is uncovered, it will be used in terrible ways,” said Rep. Pramila Jayapal (D-Wash.), the head of the Congressional Progressive Caucus. “You almost can’t have a legitimate investigation.” Still, Democrats feel they can’t ignore the issue. The House Science Committee plans to hold a hearing later this month, and the Intelligence Committee is conducting its own probe behind closed doors. In the Senate, Democrats are partnering with Republicans on investigations they hope can overcome the bitter partisanship that’s defined the pandemic. But these efforts won’t stop Republican accusations that Democrats are ignoring the issue and fronting for Beijing — a message that’s resonating with the GOP’s base: A recent Morning Consult poll found that 70 percent of self-identified Republicans believe Covid-19 originated in a lab, compared to just 32 percent of Democrats. Republicans were also twice as likely as Democrats to have heard about the “lab leak” theory. ‘WASTING MY BREATH’ — Biden administration and state officials hoped that pastors would play an outsized role in promoting Covid-19 vaccines, but many, burned out from exhaustion, are wary of alienating their congregants and declining requests to be more outspoken. State health officials are conducting informal focus groups and outreach to try to ease pastors’ concerns about discussing vaccinations, but progress is often elusive, they said. Many pastors said they have already lost congregants to fights over coronavirus restrictions and fear, risking further desertions by promoting vaccinations. Others said their congregations are so ideologically opposed to the vaccine that discussing it wouldn’t be worth the trouble. “If I put forth effort to push it, I’d be wasting my breath,” said Nathan White, a pastor at Liberty Baptist Church in Skipwith, Va., a small town near the North Carolina border. | | | LEVINE TALKS VARIANTS, VACCINES AND HER LANDMARK ROLE — HHS assistant secretary — and the nation’s first openly transgender federal official — Rachel Levine sat down with our colleagues at the Recast to discuss her milestone confirmation, Biden’s health goals and fears over the Delta variant. The rise of anti-transgender bills around the country: “I think that those bills are preying upon people's fears and exploiting them.” “I think it's extremely consistent with my role [to speak up about them] because...one of our priorities is health equity. So that means health equity for vulnerable populations.” New variants and old public health measures: “It is that 18-to-26-year-old age group, which does seem to be complacent, that they've been OK so far and so they'll be OK. But that is actually not correct. They are vulnerable to this more serious variant of Covid-19. We want to make sure that they are protected.” “I know that there is pandemic fatigue, that the public has had an extremely challenging and difficult time. Everyone has suffered during this pandemic, but we are not done yet.” Aside from the pandemic: “There are other significant public health issues. One is behavioral health, mental health and substance use disorders and the opioids and overdose crisis, which continues. Another is health equity. And that really needs to cross-cut our work with Covid-19.” ICYMI: SUPREME COURT WILL HEAR A HOST OF HEALTH CASES — The court on Friday said it will review four key health care cases next term, including suits on 340B payments, Medicare costs and anti-discrimination protections. Susannah Luthi gives us a rundown: — Drug payment cuts: The Trump administration’s nearly 30 percent cut in reimbursements for drugs purchased through the 340B discount program is on the table. The American Hospital Association, along with other hospital systems, sought to block the 340B policies, arguing that Medicare needed Congress’ approval to enact such sweeping cuts. — Medicare and Medicaid payments: The justices agreed to weigh in on two hospital reimbursement fights, one pertaining to Medicare payments to hospitals that see a disproportionate share of Medicaid and uninsured individuals. The other case will review whether a state Medicaid program can claim part of a tort settlement for past medical expenses. — Anti-discrimination protections: In CVS Pharmacy v. Doe, the court will consider whether the Rehabilitation Act of 1973, and by extension the Affordable Care Act, allows a “disparate impact” claim from plaintiffs alleging disability discrimination.
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| | | France is already vaccinating cancer patients and other immune-impaired people with a third Covid-19 shot. But Americans with similar health problems are on their own, The New York Times’ Apoorva Mandavilli writes. Alaska’s longtime nurse shortage only worsened during the pandemic as staff burned out, retired early or simply left the profession, Anchorage Daily News’ Annie Berman reports. MIT Technology Review’s Bobbie Johnson, Adriana Fraser and Mia Satoarchive given a rundown of states’ myriad approaches to vaccine passports, proving a patchwork where few have endorsed digital proof of Covid-19 shots. | | | | Follow us on Twitter | | | | Follow us | | | | |  |
