With Rachel Roubein, Dan Goldberg and Joanne Kenen
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— Hundreds of thousands of foster children and unaccompanied minor immigrants could qualify for Covid vaccines. But actually getting shots in young arms could prove tricky.
— HHS Secretary Xavier Becerra is heading to a G-7 summit this week, where he will speak with a who’s-who of health officials and pharmaceutical executives.
— Democrats are looking to push Medicaid expansion on red states that have resisted it.
WELCOME TO MONDAY PULSE — We hope you had a lovely long weekend. Send pictures of your safe-tasting weekend cookouts and health news tips (or cooking ones) to [email protected] and Adam at [email protected].
VACCINES FOR CHILDREN ROLL OUT, AND SO DO THE CHALLENGES — The first vaccine authorized in the U.S. for children as young as 12, the Pfizer-BioNTech shot, has not received full regulatory approval yet, just an emergency use authorization. That puts it in a murky category compared to the battery of routine vaccinations recommended by federal agencies. And it means kids in many states can only receive it with a parent or guardian’s consent — a hurdle that’s impossible to meet for many children separated from their parents, such as unaccompanied immigrant minors and foster children.
All of this has put government officials are in uncharted territory. CDC says that it can recommend unlicensed vaccines, such as authorized Covid-19 shots, for use, and an HHS spokesperson said that eligible unaccompanied minors have received the Pfizer vaccine.
But state consent laws are a patchwork, with many states requiring parental consent for non-routine care and even most vaccines. The dilemma poses a major test for the Administration for Children and Families — a little-known part of the Health and Human Services Department that is responsible for keeping unaccompanied minors at the border safe, along with overseeing programs for child care, foster children and family services.
It’s critical that these children and their guardians have easy access to information about the vaccines, said acting ACF secretary JooYeun Chang. “We are educating their parents, their caregivers — whoever has legal authority to make that decision for them so that we don’t leave any child or family behind as these vaccines become available.”
But that requires striking a careful balance. “We need to think about the flipside of it, to make sure that there is no coercion in getting people to get the vaccine because they are in federal custody,” said Ranit Mishori, senior medical adviser for Physicians for Human Rights. This pressure, she said, is “unique to this vaccine.”
THIS WEEK: HEALTH OFFICIALS, CEOS DINE AT G7 — Becerra will jet to the United Kingdom this week for a meeting of G-7 health ministers. It will be one of the secretary’s first international events, aside from a World Health Organization address last month.
The meeting kicks off Thursday in Oxford, where Becerra will attend a “working dinner” seated with top U.K. regulator June Raine, Abbott CEO Robert Ford and Roche CEO Severin Schwan, according to a seating plan obtained by POLITICO’s David Lim.
Other big names at the dinner: Pfizer CEO Albert Bourla and AstraZeneca CEO Pascal Soriot (at the same table); Gilead’s top executive, Daniel O’Day, and German health minister Jens Spahn sharing a spot; and Novartis CEO Vas Narasimhan, sitting with European Health Commissioner Stella Kyriakides and J&J’s chief science officer, Paul Stoffels.
DEMOCRATS PLOT BACKDOOR ROUTE TO MEDICAID EXPANSION IN RED STATES — Congressional Democrats are rallying around a new federal effort to increase health coverage rates in states that have so far refused to voluntarily expand Medicaid, believing they have a limited window to help millions who’ve been unable to get coverage, Rachel Roubein and Susannah Luthi write.
— President Joe Biden’s election and the promise of new federal cash from the recent Covid relief package would, Democrats hoped, move at least some of the dozen remaining holdout states. But they don’t appear to be budging, which has energized liberal support for a federal workaround to give health coverage to the roughly 2.2 million Americans in the so-called Medicaid coverage gap.
Yet the effort carries risks, people involved tell Rachel and Susannah. It’ll be difficult to design a program that won’t invite backlash from a health care industry ready and willing to do battle, or inadvertently reward states that blocked Medicaid expansion for years. And any plan would also come with a steep price tag.
Biden’s budget on Friday called for creating a federal public-run health insurance option in the holdout states that would offer free coverage modeled after Medicaid. Democratic lawmakers, meanwhile, are weighing a few options that could potentially get wrapped into a major economic package they hope to pass along party lines this year.
WHAT’S IN A NAME? The World Health Organization announced “simple, easy to say” labels for key Covid-19 variants on Monday in an effort to quickly identify strains without causing misperceptions about countries where they were first found.
The Greek system. The global health group is assigning Greek letters to the major variants of concern, starting with “Alpha” for B.1.1.7, the highly transmissible and more deadly version first found in the United Kingdom. The strain found in South Africa, B.1.351, is Beta, while the similar P.1 is Gamma and B.1.617.2, the strain dominating in India, is Delta.
The original scientific names “can be difficult to say and recall, and are prone to misreporting,” WHO said in a statement. “As a result, people often resort to calling variants by the places where they are detected, which is stigmatizing and discriminatory.”
NEVADA TAKES BIG STEP TOWARDS A PUBLIC OPTION — The Nevada Assembly late Sunday backed a plan for a public option starting in 2026.
The rules: Health plans participating in Medicaid would bid to offer the public option. Their plans would have to cost less than most plans offered on the exchange, with savings deepening over the first four years, writes Joanne Kenen. The option would only be available to people and small businesses who qualify for Affordable Care Act subsidies. Gov. Steve Sisolak, a Democrat, is expected to sign the bill.
Nevada would become the second state to proceed with a form of a public option, after Washington.The sense of urgency around the state bill declined somewhat after the American Rescue Plan expanded ACA subsidies, say some health policy analysts.
THE PUSH TO PRESERVE POPULAR PANDEMIC PERKS — From drive-thru margaritas to marijuana deliveries to virtual doctor visits, the pandemic prompted states to ease rules to make life at home more bearable. POLITICO’s Dan Goldberg and Sam Sutton report that the looming end to Covid-era emergency orders has teed up a lobbying frenzy in state capitals from industry insiders looking to make these Covid conveniences permanent.
Polls show most Americans want their cocktails to-go and prefer dialing up their doctor from home, putting pressure on lawmakers to oblige their constituents. Last week, Nebraska GOP Gov. Peter Ricketts signed legislation allowing alcohol to-go, the 14th state to do so.
Texas lawmakers passed legislation permanently allowing Medicaid to cover telehealth, including audio-only services, which are more accessible to access in low-income and rural parts of the state with low broadband connectivity.
VACCINE HESITANCY AMONG BLACK, LATINO JERSEY RESIDENTS ON THE DECLINE — A growing number of Black and Hispanic New Jerseyans now say they are willing to get vaccinated against Covid-19, even as vaccination rates among minority communities lag that of the overall population, writes Sam Sutton.
The poll figures from the Newark-based nonprofit Project Ready signal what could be a promising trend. Sixty-nine percent of Black New Jerseyans and 80 percent of the Latino population are now willing to get vaccinated, up from 60 and 55 percent polled by the same group in November.
Stat News is starting a reporting fellowship named for Sharon Begley, a longtime science reporter and original Stat writer who died in January. The nine-month Sharon Begley-Stat Science Reporting Fellowship is aimed at early-career journalists, especially those from racial and ethnic groups historically underrepresented in the field.
Dangerous but rare blood clots linked to the J&J vaccine are raising questions about similar — and more common — blood clots in women taking hormonal birth control pills, the New York Times’ Apoorva Mandavilli wrote.
It is past time to retire the idea of herd immunity and replace it with a focus on local vaccination levels and case rates — but to do so, we need better data, writes former acting CDC Director Richard Besser for CNN.
Government officials are moving away from mass-vaccination sites to small clinics and hyper-local efforts — and barber shops could play a key role, writes the Washington Post’s Lena Sun.
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