HEALTH CARE BRIEFING: Biden’s Covid Team Runs Trump’s Playbook

By Brandon Lee and Alex Ruoff

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President Joe Biden and his top advisers have derided the Trump administration’s playbook for distributing coronavirus vaccines, but so far have made only modest changes to the plan that’s meeting their target pace of more than one million shots a day.

Biden has said vaccine distribution was in “worse shape than we anticipated.” White House Chief of Staff Ron Klain said a Trump administration plan “did not really exist.” Adviser Cedric Richmond said they “didn’t leave a plan.” Xavier Becerra, Biden’s choice for health secretary, said it was like taking over a plane in a nosedive.

But while Biden’s approach to the virus — frank warnings about the pandemic, mask mandates on federal property — is a reversal from Trump’s policies, his administration’s distribution of vaccines so far looks little different from that of its predecessor. Before Biden was sworn in, vaccines already were being delivered at a pace to meet his goal of 100 million doses in his first 100 days as president.

The new administration has said they’ll order new doses, but will do so by exercising options in contracts negotiated by the previous administration, which thought it premature to do so. They say they’ll use the Defense Production Act, which Trump used repeatedly. Rather than a total overhaul, they have otherwise made course corrections and modest shifts.

Biden’s ability to sharply change direction is inherently limited. The sheer magnitude of the distribution efforts would make any major changes costly and risk backsliding, even if temporarily. Some aspects of the program don’t offer much wiggle room to begin with, while the trickiest parts are yet to come — and entirely on Biden’s shoulders.

Any efforts by Biden to shape the program also were undercut by Trump, who delayed the transition as he disputed the results of the election and refused to concede. Trump’s team said more than 300 transition briefings were held with health officials, though Biden officials have said the information exchange was limited until just days before the inauguration. Read more from Josh Wingrove and Riley Griffin.

Also in Biden’s Health Agenda

Health Equity Task Force to Spotlight Disparities: Health equity will be in the spotlight as the Biden administration ramps up its Covid-19 response, with multiple public White House briefings a week, including one scheduled today, to give updates on its progress. Advocates say the solutions to societal inequities in health care are a tough challenge. Communities of color, people with disabilities, and other marginalized groups have been disproportionately affected by the coronavirus. Read more from Shira Stein.

Biden Reopens ACA for Pandemic-Stricken Americans: Biden moved to make it easier for Americans to buy health insurance during the pandemic, reopening the federal Obamacare marketplace with an order yesterday that’s a step toward reinvigorating a program that his predecessor tried to eliminate. Biden issued another order yesterday to immediately rescind the “Mexico City Policy,” which barred foreign nonprofits from receiving U.S. funding if they provide counseling for abortions. Read more from Nancy Cook, Sara Hansard and John Tozzi.

  • The move is putting pressure on states with their own exchanges to follow suit, opening the door for more consumer choice as people who are uninsured move to get coverage amid the pandemic. The action could also spark a surge in state Medicaid enrollment as people turn to exchanges to learn if they are eligible for the low-income health program. Read more from Sara Hansard and Christopher Brown.
  • In another health-care order, the Biden administration is canceling a Trump-era plan to let more physicians prescribe an opioid-treatment drug, The Washington Post reports. The White House’s drug policy office wrote in a message that guidelines for the opioid buprenorphine that were announced on Jan. 14 had been made prematurely and can’t be issued at this time. Read more from the Post.

Ex-Obama Official Named Top Aide to Drug Czar: Tom Hill, a former Obama administration staffer, has been tapped as the senior policy adviser to the White House Office of the National Drug Control Policy, according to behavioral health advocates. Hill has currently been serving on the National Council for Behavioral Health over the past four years. Before, he was senior adviser on addiction and recovery at the Health and Human Services Department, Alex Ruoff reports. The Biden administration has yet to fill the director position of the drug control office.

Stimulus Timing: Speaker Nancy Pelosi (D-Calif.) told reporters yesterday the House will vote next week on a budget resolution, the first step in setting up a fast-track plan to push through a stimulus bill without Republican support. “We have to act,” Pelosi said, adding that Democrats won’t “surrender” if Republicans opt to not cooperate on stimulus aid, Erik Wasson reports. Senate Majority Leader Chuck Schumer (D-N.Y.) reiterated his call for a “bold and robust” coronavirus relief package yesterday, Megan Howard reports, adding “The Senate as early as next week will begin the process of considering a very strong Covid relief bill.”

In the Senate, Richard Shelby (Ala.), the top Republican on the Senate Appropriations Committee, told reporters yesterday he’s open to a coronavirus relief bill targeting vaccines if the funds are needed, Erik Wasson reports.

More on the Pandemic

South Africa Variant Identified in U.S.: South Carolina reported two cases of the coronavirus variant first detected in South Africa—the first cases found in the U.S., the state’s Department of Health and Environmental Control found. The department said the infected individuals had no known history of travel, and there was no connection between the two cases. The Centers for Disease Control and Prevention said there’s no evidence yet that the strain causes more severe disease, but it may be more contagious. Read more.

More on the Variants:

E&C to Hold Pandemic Fraud Hearing: The House Energy and Commerce Consumer Protection and Commerce Subcommittee will hold a Feb. 4 hearing about fraud and scams propagated during the pandemic, according to a release.

J&J Covid Vaccine Supply to Start at 2 Million Doses: Johnson & Johnson will deliver about 2 million doses of its Covid-19 vaccine when it receives an emergency use authorization in the U.S., according to a Government Accountability Office report published yesterday. The figure revealed in a footnote to the government audit is the clearest indication yet of the initial supply of J&J’s one-shot vaccine. A spokesman for J&J said in an email that it expected to supply 100 million doses to the U.S. government in the first half of the year. He didn’t comment further on the GAO report. Read more from John Tozzi and Riley Griffin.

GAO ‘Deeply Troubled’ by Trump’s Virus Response: The Government Accountability Office said that the Trump administration failed to act on past recommendations to better respond to the pandemic. “Until the country better contains the spread of the virus, the pandemic will likely remain a significant obstacle to more robust economic activity,” the watchdog said in a report released yesterday. The office says that as of this month, 27 of the watchdog’s prior 31 recommendations hadn’t been implemented, Teaganne Finn reports.

CDC Vaccine System Gets Few Users Among States: A $44 million software system supplied for free to states by the U.S. government to help track coronavirus vaccinations is being used by only nine states, with Virginia phasing out and Connecticut exploring alternatives. The U.S. Centers for Disease Control and Prevention contracted with Deloitte & Touche for the system last spring. Called the Vaccine Administration Management System, it was touted by the CDC as an “easy-to-use, secure, online tool.” Read more from Angelica LaVito.

Vaccine Distribution Delays Point to Liability Limits: Because vaccine supply is limited and distribution has been erratic, there are new concerns people won’t be able to get their second dose in the recommended 21- or 28-day interval, depending on which vaccine they’d received. Though federal compensation programs are in place to help those who are physically harmed by a vaccine, those weren’t created to address a failure to get a second dose in time, and that has many first-dose vaccine recipients worried. Read more from Lydia Wheeler.

Troops, Reserves Likely to Help Deliver Vaccines: A mix of active-duty troops, reserves, and National Guard personnel are likely to take part in a Pentagon effort to help accelerate efforts to get Americans vaccinated against the coronavirus, Pentagon spokesperson John Kirby said yesterday. Kirby said in his first briefing since returning as spokesman that he expects a response within a few days to FEMA’s request for vaccination help across the U.S., Travis Tritten reports.

Warren Slams Bonuses After Nursing-Home Deaths: Sen. Elizabeth Warren (D-Mass.) expressed anger over the “inexplicable and unseemly decision” to pay a $5.2 million “retention bonus” to a nursing home industry CEO, after more than 2,800 residents died of Covid-19 in the company’s facilities. Warren, in a letter to Genesis HealthCare, said that the company authorized “exorbitant” bonuses to executives while also taking over $300 million from CARES Act funds. Read more from Tony Pugh.

More Headlines:

What Else to Know Today

Progressives Seek Tougher Drugmaker Penalties: Progressives in the House and their allies want Democratic leaders to pass again a Medicare drug pricing negotiation bill, only this time with tougher penalties for pharmaceutical companies that refuse to reduce drug prices. They also want to expand the number of drugs eligible for federal negotiation, hasten the timeline for implementation, and revoke patent exclusivity for drug companies that don’t lower prices, lawmakers and outside groups say. Read more from Alex Ruoff.

GOP Senators Reintroduce Bill to Codify Hyde Amendment: Sen. Roger Wicker (R-Miss.) led 46 other senators —nearly the entire Republican caucus in the chamber—in reintroducing legislation that would codify the Hyde Amendment restrictions to not use taxpayer dollars to fund abortions, according to a release. Annual government funding bills have approved the amendment for decades, but Democratic lawmakers have said they do not plan to do so this year.

Gilead Can Challenge Government’s HIV Patents: Gilead can pursue arguments that HHS acted improperly when it came to patents on a treatment method to prevent HIV, a federal judge in Delaware said yesterday. The U.S. has accused Gilead of infringing HHS patents through its HIV-prevention drug Truvada for PrEP and is seeking damages from Gilead’s $3 billion-per-year medicine. Susan Decker has more.

More Headlines:

With assistance from Alex Ruoff

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

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

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