HEALTH CARE BRIEFING: Biden’s Promised Health Jobs Set to Vanish

Billions of federal dollars to bolster public health departments nationwide may not have a lasting impact when the pool of cash dwindles, officials worry.

President Joe Biden outlined a plan to create thousands of new public health jobs, a vision Democrats sought to make reality as part of the American Rescue Plan (Public Law 117-2) signed into law last year. The administration last May vowed to spend $7.4 billion from the law to recruit new public health workers. Most of the money, $4.4 billion, was targeted to expand state and local health departments.

But health departments must compete with hospitals and other private enterprises for high-demand workers like nurses and epidemiologists. And they’re often offering less money for harder jobs—and ones that may disappear in a year or two, public health leaders say. That’s raised fears many of these departments will end up where they were before 2020: short-staffed and unprepared for a pandemic.

“The issue we face isn’t as much the number of dollars we see today, as sustainability,” said Umair Shah, secretary of health for Washington state. What the public health sphere needs is a long-term vow by Congress to expand their workforce, officials say.

Public health departments were already shrinking heading into the Covid-19 pandemic: there were 91,540 full-time positions at state health agencies in 2019, down from 101,619 in 2012—a drop of nearly 10%, according to data from the Association of State and Territorial Health Officials. Since then, health departments have been stretched thin trying to track the spread of Covid-19 and distribute vaccines to protect people from the virus. This shortage made it hard for health agencies to properly assess how many people have the virus, and complicated response times.

One analysis from the de Beaumont Foundation, which advocates for a larger public health system, recommended the federal government fund 80,000 new public health workforce jobs to prepare for the next pandemic. Alex Ruoff has more.

Happening on the Hill

Biogen Battle Forecasts Changes to Fast FDA Approvals: Lawmakers could revamp the fast-track FDA process used to approve Biogen’s drug to treat Alzheimer’s under must-pass legislation to reauthorize the agency’s user fees. The House is considering a proposal to renew the Prescription Drug User Fee Act, which lets the Food and Drug Administration collect fees from brand-name pharmaceutical companies to help fund agency operations. Lawmakers spent much of the first hearing on the matter focused on the Aduhelm approval that had attracted renewed scrutiny to the accelerated pathway program.

At the core of the Aduhelm controversy was the FDA’s move to put the drug on the market based on questionable evidence and against the recommendation of its scientific advisory panel. The accelerated approval mechanism is not directly tied to the rates the FDA negotiates with industry, but PDUFA often includes policy riders that go beyond user fees. Possible changes may include improving clinical trial endpoints used under expedited approval.

The House Energy and Commerce Committee plans additional hearings on PDUFA next month, ahead of the reauthorization deadline of Sept. 30. Celine Castronuovo and Jeannie Baumann have more.

Republicans Call On Biden to End Emergency: The House Energy and Commerce Committee’s top Republican Cathy McMorris Rodgers (R-Wash.) and over 70 House Republicans pressed Biden and the Department of Health and Human Services “to accept that COVID-19 has become endemic, recognize that current heavy-handed government interventions are doing more harm than good, and immediately begin the process to unwind the Public Health Emergency.” Doing so may present significant ramifications, such as loosening federal authority on vaccine mandates. Read their letter here.

• At the same time, the Federation of American Hospitals called for an extension of the Public Health Emergency past its current expiration date in April. FAH also requested a minimum 60-day notice before the Biden administration ends the PHE designation. In a letter to HHS Secretary Xavier Becerra, the FAH cited Covid-19’s “sustained damage, unpredictable nature, and the threat of new variants that can quickly emerge” in its request for an extension. Read the letter here.

Biden, Becerra to Speak to Community Health Centers: Biden and Becerra will deliver virtual remarks to community health center leaders from around the country at the National Association of Community Health Centers 2022 Policy and Issues (P&I) Virtual Forum today. Thousands of Community Health Center professionals, who help provide primary care to nearly 29 million patients a year, are expected to join, according to a statement.

Also from NACHC ahead of a Senate hearing on labor shortages across the health care industry, the group unveiled a report calling for federal investment and policy changes. Read it here.

Senate Floor: Senate Majority Leader Chuck Schumer (D-N.Y.) filed for cloture on the nomination of Robert McKinnon Califf to be commissioner of the Food and Drug Administration at the Department of Health and Human Services and votes on the nominee are expected to occur as early as tomorrow.

White House Shifts to Deficit Reduction to Get Manchin’s Vote: The White House is considering reworking Biden’s economic and social spending plan to emphasize deficit reduction in a bid to secure support from Sen. Joe Manchin (D-W.Va.) a person familiar with the administration’s discussions said. Top congressional Democrats have also in recent days discussed adding deficit reduction measures. While Biden’s administration has insisted that the president’s agenda would be fully paid for, Manchin has stalled the $2 trillion package of climate, tax and social spending initiatives, citing his concern about the effect on federal debt as well as inflation. Read more from Jennifer Epstein, Erik Wasson and Laura Davison.

The Coronavirus Pandemic

FDA Delays Meeting on Pfizer Shot for Young Children: Federal health officials postponed a key meeting on Pfizer’s Covid-19 vaccine for children under 5, after the drugmaker said it has new data to add to its shot application. The FDA’s vaccine advisory committee had been planning to consider a two-dose regimen of the vaccine. The delay is to allow the company and its partner BioNTech to gather and evaluate more information on the impacts of a third dose, FDA officials said in a statement, yet another swerve on the roller-coaster ride for parents eager to get their kids vaccinated amid the omicron spike. John Lauerman has more.

Sotomayor Rejects N.Y. School Workers on Vaccine Rule: U.S. Supreme Court Justice Sonia Sotomayor refused to intervene on behalf of 15 people who said they are about to be fired from their jobs as New York City school employees because they refuse to get vaccinated against Covid-19. Sotomayor, who handles emergency matters from New York, rejected the group’s requests that she block the city from firing people who claim a religious objection to getting the shot. She made no other comment and opted not to refer the matter to the full court, suggesting she didn’t view the matter as a close call. Read more from Greg Stohr.

Biden Vaccine Mandate for Contractors Blocked in Arizona: An Arizona judge issued a final judgment in a challenge to Biden’s executive order requiring vaccinations on federal contractors, shielding the state’s employees and firms doing business with the government from the rule. Judge Michael Liburdi of the U.S. District Court for the District of Arizona in Phoenix last week granted a permanent injunction against the executive order, after a previous order from January that temporarily blocked its enforcement and didn’t define its full scope. Erin Mulvaney has more.

More Headlines:

• Here’s What the Pandemic Has in Store for the World Next
• CDC Says Boosters Protect Against Severe Disease Over Time
• Covid-19’s Great Uncoupling: Gap Widens Between Cases and Deaths
• In Canada, Frustrations Linger Even as Bridge Reopens to Traffic
• Gilead: Veklury Generally Well-Tolerated in Pediatric Patients
• AstraZeneca Awarded $855 Million Modification for Covid-19 Pill
• Europe Dumping Curbs Puts Its Travel Rebound Ahead of Asia

What Else to Know Today

J&J Starts Trial on Bankruptcy Strategy: The controversial Johnson & Johnson bankruptcy strategy that’s drawn scrutiny from Congress faces a fresh trial today, with the consumer products giant set to argue that settling billions of dollars of talc liabilities in a single case is better for cancer victims than fighting thousands of individual claims. A week-long court hearing begins today to decide whether J&J wrongly manipulated the bankruptcy system by putting a unit into Chapter 11 solely to force a negotiated end of over 38,000 lawsuits. Read more from Steven Church.

Teenage Fentanyl Deaths Are Soaring: Overdose deaths linked to synthetic opioids like fentanyl tripled among teenagers and went up five times among Black teens in the past two years, according to provisional data from the Centers for Disease Control and Prevention. The nonprofit group Families Against Fentanyl compiled the data from the CDC, which said the 2021 figures are incomplete because overdose deaths have a six-month lag in reporting time. Margaret Warner of the CDC’s National Center for Health Statistics, said given the spike in drug use during the pandemic, it’s likely the 2021 death count will only rise.

It’s on Congress’ radar too: at a hearing last week of the Senate Finance Committee on youth mental health during the pandemic, Sen. Mike Crapo (R-Idaho) cited a “staggering rise” in teenage overdose deaths. Read more from Madison Muller and Ella Ceron.

More Headlines:

• Court Says Off-Label Nausea Drug Needs Medicare Coverage
• N.Y.’s High Court Rules Against Retirees Battling Health Cuts
• Veteran’s Estate Loses Medical Negligence Case Against U.S.

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