HEALTH CARE BRIEFING: Congress Braced for Fight Over More Aid

Congress has pumped out almost $3 trillion to deal with the coronavirus pandemic, mostly on a bipartisan basis. But there is a bruising election-year confrontation ahead over the next, and perhaps final, round of aid for the economy.

House Speaker Nancy Pelosi (D-Calif.) is gathering a long and expensive wish list from her fellow Democrats that would expand the social safety net as well as provide $500 billion to struggling state and local governments.

Senate Majority Leader Mitch McConnell (R-Ky.) hasn’t yet committed to another big aid package and indicated that he’s girding for a massive fight over aid to states, a central issue for Democrats. He and other Republicans also say they want to tap the brakes on the blistering pace of new deficit spending.

The next phase of economic stimulus likely will be the last before the 2020 elections, and any stalemate will escalate the political consequences with control of the Senate, House and White House at stake.

Democrats may have an unlikely ally: President Donald Trump. His re-election may hinge on the economy turning around in the last critical months of his re-election bid, and he’s indicated willingness to include state aid and other spending in another stimulus.

There is a risk that the effort to write a comprehensive rescue bill gets bogged down for months or falters given how far apart both parties are now as well as the increasingly bitter exchanges over what should come next and who will be to blame if the economy doesn’t rebound.

One of the biggest battles ahead will be over aid to state and local governments, which are seeing tax revenue plummet and expenses escalate as a result of the pandemic. Read more from Laura Litvan, Erik Wasson and Steven T. Dennis.

Progressives Push for Affordable Treatment: Progressive groups are looking to create pressure on lawmakers to put serious drug pricing measures into the next coronavirus relief package after Congress cleared the interim stimulus bill absent such provisions. Lower Drug Prices Now, a group of Democratic-aligned organizations, launched a social media campaign yesterday that will host town halls with members of Congress in Iowa, Illinois and Nevada and talk about the need for a law to ensure that coroanvirus vaccines and drugs are affordable as well as conduct public opinion polling on the issue.

Groups like Public Citizen also say they’re trying to gather support for proposals by Democrats, such as Reps. Jan Schakowsky (Ill.) and Lloyd Doggett (Texas), that would deny any drugmakers exclusivity on a coronavirus vaccine. Similarly, Ezra Levin, executive director of Indivisible, urged Democrats to vote against the interim relief measure yesterday, saying it didn’t have funds for states and frontline health-care workers, as well as other major progressive priorities, Alex Ruoff reports.

Democrats Press for Reopening Strategy: Sixty members of the New Democrat coalition are asking House leadership to include policies in the next coronavirus stimulus bill to help communities start to reopen. In a letter to Pelosi and Minority Leader Kevin McCarthy (R-Calif.), the group details proposals on testing, surveillance and contact tracing, Emily WIlkins reports.

“Congress must put the measures and standards for a National Recovery Strategy in place now so that widespread, economically challenging countermeasures are not needed again,” lawmakers said in the letter.

Virus Testing & Tracing Efforts

N.Y. Study Says Cases Could Be Far Higher: A New York state study seeking to find out how many people have been infected by the novel coronavirus learned that 13.9% of people tested across the state had signs of infection, in one of the biggest U.S. reviews to date. In New York City, the country’s epicenter, 21.2% of people tested positive for a blood marker showing that they had been infected at some point. Statewide, 2.7 million people may have had the new coronavirus at some point, Gov. Andrew Cuomo (D) said yesterday. That’s over 10 times the official count based on the state’s testing of mostly very sick patients.

There are broad ramifications of the new study, which will need to be analyzed further by experts to give a clearer picture of the infection’s prevalence. But it appears to confirm predictions that the novel coronavirus has spread to far, far more people than New York has been able to diagnose so far. It also means the fatality rate of the virus is likely much lower than the figure that’s based only on confirmed cases and deaths. Drew Armstrong and Angelica LaVito have more.

• Also yesterday, Cuomo said the number of new coronavirus patients who need hospitalization has been “remarkably flat” at about 1,300 per day. It’s better than an increase, he said at his daily briefing, but it’s still “not great news.” New York reported 438 new deaths, down from more than 700 per day a few weeks ago. Read more.
• Meanwhile in Europe’s epicenter, Italy’s number of recoveries from Covid-19 overtook new coronavirus infections for the first time today, a hopeful sign that a nationwide lockdown is significantly checking the virus. Figures from civil protection authorities showed 2,646 new cases for the 24-hour period, down from 3,370 a day earlier. The number of recoveries was 3,033.

Senators Say Minorities Must be Part of Testing: Pharmaceutical companies managing clinical trials for a Covid-19 vaccine or therapeutic drugs must include minorities, women and other under served populations, senators said in a letter to Abbott Labs, AbbVie, AstraZeneca, Bayer and other drug companies. Possibly dangerous outcomes will result for those not represented in clinical trials due to differences in drug metabolism across race and sex. Given the disproportionate impact of Covid-19 on minority populations, it is more important than ever that these groups be represented in any clinical trials, according to the letter from 15 Senate Democrats. Read more from Rossella Brevetti.

CDC Doles Out $631 Million for Tracing: Over 60 jurisdictions nationwide will get $631 million from the CDC to track and trace the coronavirus, as they plan how to reopen their economies safely, U.S. health authorities announced. The Centers for Disease Control and Prevention received $6.5 billion through a pair of congressional relief measures last month. As of yesterday, the CDC has doled out roughly $1.6 billion to states, tribes, and other jurisdictions. The latest round of funding announced will help local areas test for the virus and conduct contact tracing and other types of virus surveillance. Jacquie Lee has more.

CDC Pushed on National Testing: Sens. Mitt Romney (R-Utah) and Kyrsten Sinema (D-Ariz.) are pressuring the CDC to quickly come up with a real-time national system for tracking the pandemic. The two senators told CDC Director Robert Redfield that they are deeply concerned that federal health officials are “behind the curve in assessing public health threat levels,” because they “lack immediate visibility into population health data” regarding the coronavirus, Kim Chipman reports.

More Headlines:

• U.S. Coronavirus Cases Rise 2.5% Compared With 4.1% Last Week
• EEOC Backs Employer Virus Testing to Combat ‘Direct Threat’
• Fake Covid-19 Products Sold on Facebook, Other Sites, EPA Says

Research, Treatment & Coordination

Hospitals Still Ration Critical PPE: Most hospitals are still rationing masks and other equipment, front-line health-care workers say, a sign that protective gear remains hard to come by as states consider opening back up their economies in coming weeks. Rationing shows how under-resourced some regions are, health-care unions argue. They want Congress to compel federal workplace standards that mandate hospitals and other employers to outfit their workers with proper safety gear, even as the pandemic has created an unprecedented need for new masks and gowns. Read more from Alex Ruoff.

States Get Telehealth Barriers Eased: The Centers for Medicare and Medicaid Services released a telehealth toolkit yesterday aimed at helping states remove barriers to telehealth services in their Medicaid and Children’s Health Insurance Programs amid the coronavirus crisis. The goal is to make it easier for Medicaid and CHIP enrollees to receive health care at home instead of at a doctor’s office or emergency room, where they could become exposed to—or pass along—the virus. Read more from Christopher Brown.

Wilkie Urged to Stop Hydroxychloroquine Use: House Appropriations Labor-HHS-Education Subcommittee Chairwoman Rosa DeLauro (D-Conn.) called on Veterans Affairs Secretary Robert Wilkie to stop the use of hydroxychloroquine on veterans diagnosed with the coronavirus after officials and medical experts said the “drug could increase the risk of death.” Read the letter here.

More Headlines:

• Coronavirus Dies Fastest in Sunlight, Humidity, Heat, Study Finds
• Gilead Analysts Spar Over Leaked Chinese Data Claiming Drug Flop
• Higher State Matching Rates Strains State Medicaid, Study Finds
• China Likely Hacking U.S. Labs for Virus Cure, DOJ Official Says
• Covid-19 Liability Shields for Nursing Homes Only Go So Far
• USDA Inspector Reported to Die Amid Meat-Plant Viral Outbreaks

Distancing vs. Re-Opening the U.S.

Trump Muddles His Virus Response: Trump’s evolving public statements and ad hoc policy swings on the coronavirus have the administration on defense as surveys show increased doubts around his leadership in crisis. On Wednesday, Trump rebuked the first governor to try to re-open his state economy, Georgia Gov. Brian Kemp (R), after encouraging state leaders for weeks to push forward toward resuming a normal social and business life.

Trump, eager to proceed with an economic recovery as fast as possible, claimed incorrectly that CDC Director Robert Redfield had been misquoted as saying the pandemic could be worse this winter. The president declared at his Wednesday news conference it was “possible it doesn’t come back at all,” and that if Covid-19 does return, it “won’t be coming back in the form that it was.” His own public health advisers in the same briefing said the virus will still be active this fall.

Trump’s recent vacillation is only compounded by prior declarations that never came to fruition: his proposed quarantine of the New York metropolitan region; his hope to have the country “opened up and raring to go” by Easter; a national website purportedly being built by Google to direct citizens to test sites in parking lots. Trump and his advisers say that his statements are intended to be optimistic, while his shifting comments about the balance among states and the federal government on re-opening were never meant to preclude collaboration with governors. Read more from Justin Sink.

More Headlines:

• Trump Says May Extend Social Distancing Guidelines Until Summer
• 80% of Americans Favor Strict Shelter-in-Place Orders, Poll Finds
• D.C., Maryland, Virginia Leaders Ask U.S. to Keep Workers at Home
• OSHA Virus Emergency Regulation Not Needed, Labor Chief Says
• Virginia Hospital Group Urges Lifting of Non-Emergency Order
• Patchwork Approach to Reopening States Reveals a Red-Blue Divide
• Georgia County Steels Itself to Reopen Despite 10% Death Rate

What Else to Know

Eshoo Plans to Call In Bright: House Energy and Commerce Subcommittee on Health Chairwoman Anna Eshoo (D-Calif.) said she plans to summon ousted Biomedical Advanced Research and Development Authority official Rick Bright to testify before the panel, CNN reports. Eshoo hopes to hold hearings as soon as “feasible” and would return to Washington to review the matter, reports CNN. She also says she wants to hear from HHS Secretary Alex Azar and Robert Kadlec, assistant secretary for preparedness and response.

• Eshoo and Oversight Subcommittee Chairwoman Diana DeGette (D-Colo.) separately told Office of Management and Budget Acting Director Russell Vought yesterday they want an explanation for Trump’s decision to suspend funding for the World Health Organization. In the letter, they said Trump’s halt on funding is “dangerous and irresponsible” and an “apparent attempt to distract the public” from the administration’s “failures.” Read the letter here.

Arkansas Abortion Clinics Seek Block on Ban: Abortion providers in Arkansas must be allowed to perform surgical procedures for women whose pregnancies will be too advanced to have an abortion when an emergency coronavirus order expires in May, they told a federal court in the state. Little Rock Family Planning Services and other groups asked the U.S. District Court for the Eastern District of Arkansas for a second temporary restraining order or preliminary injunction to block the state from broadly enforcing a directive labeling abortions as elective surgeries that must be delayed. Mary Anne Pazanowski have more.

• Alabama will remain partially blocked from imposing new restrictions on abortions in name of public health during the coronavirus pandemic, the Eleventh Circuit said. The new ruling doesn’t entirely block the state from enforcing the order against abortion providers. But it does bar the state from “failing to allow healthcare providers to consider and base their decisions as to whether to provide an abortion without delay on certain factors,” including whether a delay would cause the patient to lose her legal right to an abortion under Alabama law after 20 weeks of pregnancy. Read more from Brian Flood.

More Headlines:

• ACA Health Plan Suit Sent Back to Ohio Court on Residence Issue
• Oklahoma Drug Law Challenge Resumes After Virus Delays SCOTUS
• Washington State ‘Public Option’ Health Plan Faces Pushback
• EPA Steps Up Health Protocol for Cleanup at Toxic Waste Sites
• Immunomedics Jumps After FDA Approval ‘De-Risks Entire Pipeline’
• Health Tech Companies Advised to Prep for Data Sharing in Delay
• White House-Linked Oscar Health Laying Off 5% of Staff

To contact the reporter on this story: Brandon Lee in Washington at blee@bgov.com

To contact the editors responsible for this story: Giuseppe Macri at gmacri@bgov.com; Zachary Sherwood at zsherwood@bgov.com; Michaela Ross at mross@bgov.com