HEALTH CARE BRIEFING: Paid Leave Advocates Turn to HHS’s Becerra

Paid-leave advocates are turning to an old ally to fight for a new entitlement program guaranteeing all workers access to some paid medical and parental leave—Health and Human Services Secretary Xavier Becerra.

Nineteen groups urged Becerra in a letter yesterday, obtained by Bloomberg Law, to advocate for the paid-leave benefit as part of Democrats wide-ranging social spending package now under negotiation. The letter echoes concerns paid-leave supporters have expressed privately that the proposed new program is in danger of getting axed from the spending package, particularly if holdouts like Sen. Joe Manchin (D-W.Va.) insist on keeping the package’s price tag below $1.5 trillion.

Becerra championed paid leave for workers at the Amazon-owned Whole Foods when he was California’s attorney general. As HHS secretary and a champion of equitable access to health care, he now can speak to the health impacts of having to choose between treating an illness and taking unpaid time off from work, the letter said.

The groups—including AARP, the American Heart Association, and the National Partnership for Women & Families—said Becerra has “the unique insight on how a program like this” can improve access to health care.

The groups “represent millions of patients, caregivers, medical professionals, people with disabilities and their families, and other individuals harmed by a lack of paid leave,” according to the letter. Even a slimmed-down paid leave program is better than nothing, advocates say, because the new program would give the administration a foundation on which to expand later.

House Majority Leader Steny Hoyer (D-Md.) said yesterday that a decision on paid family leave hasn’t yet been reached. Read more from Paige Smith and Emily Wilkins.

House lawmakers heading influential caucuses also pushed President Joe Biden to include paid family leave as part of the plan, even if it was less than the full 12 weeks initially proposed. Members of the Black, Hispanic, Asian Women’s and Equality caucus attended a White House meeting last night, Emily Wilkins reports.

Rep. Judy Chu (D-Calif.) chair of the Congressional Asian Pacific American Caucus, said it wasn’t clear whether the asks for paid leave would lead to the proposals’ inclusion. Instead, Biden focused on the bill’s overall impact, calling it transformational. “There are things we all want in the bill, but we cannot let the perfect be the enemy of the good,” she said. “That was the overarching message of the day.”

Chu said the meeting confirmed for her that provisions funding child care and pre-kindergarten would be included in the bill — and tuition-free community college likely would not.

Medicaid Gap Compromise Sought: Two senators who support expanding Medicaid in a dozen holdout states signaled yesterday they’re working on a compromise with detractors. Sens. Raphael Warnock (D-Ga.) and Jon Ossoff (D-Ga.) said they’re meeting regularly with Manchin and other Senate Democrats who oppose creating a federal Medicaid-like program in the 12 states that have declined to expand their low-income health programs to people just above the federal poverty level.

The Medicaid provision is intended for the Democrats’ broad spending package now under negotiation. Manchin said Monday he doesn’t support the Medicaid language proposed so far, calling it “unfair” to states like his that already expanded their programs using both federal and state funds. Read more from Alex Ruoff.

Wyden Says Drug Price Caps to Extend to Private Plans: Caps on drug price increases will extend to private, employer-sponsored insurance plans under Democrats’ drug pricing legislation, Senate Finance Chairman Ron Wyden (D-Ore.) said yesterday. Democrats want to require drugmakers that increase their prices faster than inflation to pay back that excess amount to the federal government. Democrats previously wavered on whether key parts of their drug pricing legislation could apply to private plans but Finance Committee staff have written the provision to survive Senate parliamentarian challenge, Wyden said, Alex Ruoff reports.

Happening on the Hill

Child Obesity Thwarts Military Recruitment: Childhood hunger and obesity that comes from malnutrition are a national security problem that’s thwarting military recruitment, retired admirals and generals argue. Congress needs to act, they wrote in a letter to lawmakers. Several authorities established under the child nutrition law expired more than five years ago. The programs still are in place and cannot be improved without legislation authorizing new policies. Child obesity is the leading medical reason that 71% of young Americans can’t serve in the U.S. military, over 300 retired military leaders said in their letter. Megan U. Boyanton has more.

Covid-19 Prompts Ask for White House Hunger Conference; Urban and farm-state lawmakers want the White House to convene a conference on U.S. hunger, which hasn’t happened since 1969, and intend to pass legislation calling for one before the end of the year. The effort is bipartisan and bicameral, meaning the legislation could easily be included in one of several legislative packages expected to see action in the next few months, including the year-end spending measures. Read more from Megan U. Boyanton.

Electroshock Device Case Prompts Calls to FDA for Fight: The FDA is facing pressure from Democratic lawmakers to continue its fight against electric shock treatment for people with disabilities after a federal appeals court overturned an agency ban. Sens. Chris Murphy (D-Conn.) and Dianne Feinstein (D-Calif.), along with five of their colleagues, penned a letter to acting FDA Commissioner Janet Woodcock calling on the agency to “protect some of our most vulnerable citizens” by defending a 2020 rule barring the use of electrical stimulation devices (ESDs) for patients with self-injurious and aggressive behaviors. Read more from Celine Castronuovo.

Hearings Today:

• Covid-19 Response: The House Appropriations State, Foreign Operations, and Related Programs Subcommittee scheduled a Wednesday to examine the U.S. global covid reponse, the actions taken and future needs.
• VA Patient Safety: The House Veteran Affairs Health Subcommittee will convene for a hearing on patient safety within the veterans health administration.

Letters to Lawmakers:

• Congress Urged to Address Expiration of Telehealth ‘Safe Harbor’

The Coronavirus Pandemic

Pfizer Vaccine for Younger Kids Wins Backing of FDA Panel: The benefits of a Covid-19 vaccine for young children made by Pfizer and BioNTech exceed its risks, according to a panel of U.S. experts, putting a shot for the youngest school-age children on track for a likely clearance. The FDA’s vaccines advisory committee voted 17-0, with one abstention, to back the immunization, intended for children from 5 to 11 years old and is one-third the dose given to those 12 and older. If the FDA issues an emergency authorization as expected, it could pave the way for vaccinations at schools, doctors’ offices and pharmacies in weeks. Fiona Rutherford reports.

• Pfizer’s lower-dose Covid-19 vaccine for kids under 12 appears to offer protection across the board, company officials said, and the drugmaking giant may look into offering lower doses for teenagers who now get the adult dose. Read more from Jeannie Baumann.
• Related: How Soon Can Your Child Get a Covid Shot? Here’s What We Know

Vaccine-Wary Truckers Risk More Supply Chain Jams: Logistics companies in industries ranging from trucking to warehouses are warning that Biden’s vaccine mandate will cause further supply chain backlogs. Groups representing them say substantial numbers of their employees are unvaccinated, and may quit or be let go at the height of the U.S. holiday season. The supply chain is already suffering as a shortage of workers, backlogged ports, and other challenges slow the movement of goods. Read more from Lillianna Byington.

Pediatric Covid-19 Hospital Visits Plunge: Hospital admissions are declining sharply among U.S. children with Covid-19, even more than adults, quieting concerns for now that the return to school could trigger a major uptick in viral transmission. Daily pediatric admissions with confirmed Covid-19 have fallen 56% since the end of August to an average of about 0.2 per 100,000, according to HHS data. Read more from Jonathan Levin.

Pandemic Opens Door to Real-World Data for Drug Decisions: Real-world data will likely play a bigger role in FDA drug reviews as the agency adopts lessons from Covid-19 to future regulatory decisions. The urgency of the pandemic has propelled U.S. health leaders to use data from sources such as patient medical records and mobile devices to help make decisions in real time. The Food and Drug Administration signaled it will further expand use of these sources through the release of two new draft guidance and a partnership to rapidly assess Covid-19 products. Read more from Jeannie Baumann.

Cigarette Sales Climbed for First Time in 20 Years: Cigarette sales in the U.S. climbed last year amid the Covid-19 pandemic, marking the first annual increase in two decades. Major manufacturers sold 203.7 billion cigarettes in 2020, up from 202.9 billion the year prior, according to the U.S. Federal Trade Commission’s Cigarette Report. Cigarette Sales Climbed for First Time in 20 Years, U.S. Says

• Related: Triton May Sell E-Cigs While Appeals Court Reviews FDA Block

More Headlines:

• BioNTech to Start Building Vaccine Plant in Africa Next Year
• Southwest Airlines Vaccine Mandate Can Proceed During Case

What Else to Know

Gun Rights Group Backs Abortion Providers Over Texas Ban: A gun rights group is siding with abortion providers in the Texas dispute over the nation’s strictest abortion ban. The law was designed with procedural quirks that are intended to insulate it from judicial review by allowing private citizens, not government officials, to enforce the ban. The move has been successful, allowing the law to go into effect for nearly two months and halting almost all abortions in the state after six weeks.

But Erik Jaffe, who filed the amicus brief on behalf of the nonprofit group Firearms Policy Coalition, fears the law could be used to limit other constitutional rights, in particular the Second Amendment. “It’s hard to miss the parallels between abortion and guns,” said Jaffe, a former clerk to Justice Clarence Thomas who is also part of the team helping to defend Indiana’s abortion restrictions. Read more from Kimberly Strawbridge Robinson.

DOJ Alleges That Kaiser Permanente Defrauded Medicare: Members of Kaiser Permanente’s health-care consortium defrauded Medicare out of about $1 billion by altering patient medical records to add diagnoses after the fact that either didn’t exist or were unrelated to patient visits, the Department of Justice is alleging. In a complaint filed Monday, the DOJ said Kaiser mined the medical files of Medicare Advantage patients for additional diagnoses and then sought to have the physician add the new diagnoses, as if the new diagnoses had been addressed in some way during the patient visit when it had not. Read more from Lydia Wheeler.

Abortion Laws Blocked in Oklahoma: Oklahoma is barred from enforcing multiple laws restricting abortion that were set to take effect Nov. 1, at least until their constitutionality can be decided, the state’s top court said. Abortion providers won’t be required to comply with a law mandating that doctors who perform abortions be board-certified obstetrician gynecologists. They also aren’t subject at this time to two laws that affect pill-induced abortions, the Oklahoma Supreme Court said. Read more from Mary Anne Pazanowski.

More Headlines:

• J&J Talc Unit Must Defend Keeping Bankruptcy in North Carolina
• Health Official to Face Claims Over ‘Parking’ Mental Patients
• CVS, Walmart Lose Bid for Opioid Mistrial Over ‘Tainted’ Jury
• Holmes Lured Rich Families in Bid to Stay Private, Investor Says
• Zicam ‘Proven to Shorten Colds’ Deception Suit Tossed, for Now
• Transgender Man’s Constitutional Denial-of-Care Claims End
• Novartis Syringe Patent Gets Reviewed on Regeneron Challenge

With assistance from Emily Wilkins and Alex Ruoff

To contact the reporter on this story: Michaela Ross in Washington at mross@bgov.com

To contact the editors responsible for this story: Zachary Sherwood at zsherwood@bgov.com; Giuseppe Macri at gmacri@bgov.com; Brandon Lee at blee@bgov.com