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Quick Fix
— HHS Secretary Xavier Becerra is grappling with an increase in unaccompanied children arriving at the U.S. border, and top White House officials are growing frustrated with his department’s response.
— It could take weeks for federal health agencies to determine whether there is a link between Johnson & Johnson’s coronavirus vaccine and six reports of rare but severe blood clots.
— Texas’ Medicaid waiver is no more, and that could ramp up pressure on state officials to adopt a Medicaid expansion instead.
WELCOME TO MONDAY PULSE — where your host’s editor is wondering if the Sunday scaries will someday be a thing of the past, thanks to Covid-enforced telecommuting and the upending of traditional workweeks. Prepare for the week ahead by sending tips to Sarah at [email protected] and Adam at [email protected].
DRIVING THE WEEK
BECERRA’S HHS STRUGGLES TO HOUSE MIGRANT CHILDREN — Some White House officials say the health department’s effort to house thousands of unaccompanied minors has been sluggish, amid a record number of children crossing the southern border, Adam, Anita Kumar and Sabrina Rodriguez report.
The administration has scrambled to find new shelters and speed the vetting of adults to care for these children. But a month into Becerra’s tenure, some working on the issue have privately questioned his preparedness for managing such a sprawling emergency — and his willingness to take ownership of a historically intractable and politically divisive problem.
“He did not fully appreciate the issue when he first came in,” said one senior administration official. “It’s been a steep learning curve for him.”
Mark Weber, an HHS spokesperson, conceded that there have been tensions within the administration over the effort generally, but disputed the criticism of Becerra as unfair. “Suggesting he doesn’t have a grasp on the issue … that is not apparent from the inside.”
Though Becerra, a former California attorney general with little health policy experience, has been tasked with one of Biden’s most taxing problems, he’s so far stayed out of the public eye. And that low-key approach has raised suspicions among some involved in the immigration effort that he is reluctant to become the face of the administration’s border woes.
CDC HUNTS FOR CLUES TO J&J BLOOD CLOT MYSTERY — The CDC’s vaccine advisory panel is set to gather for the second time Friday to discuss the concerns about the shot, according to two senior health officials. But officials are unsure about how many additional cases of post-vaccine blood clots they should expect, Erin Banco, Dan Goldberg, Rachel Roubein and Sarah report.
That leaves the CDC to face a logistical challenge. Roughly 7 million Americans have received the J&J vaccine. Federal officials believe that any number of past cases could have been overlooked, and they’re on the lookout for new cases among people vaccinated recently.
Meanwhile: States are scrambling to stem the blow to public confidence. “The longer the pause is, the longer it's going to take for us to convince people that this particular vaccine is safe again,” Arkansas Gov. Asa Hutchinson, a Republican, told POLITICO.
“When you have this kind of anti-vaccine aggression out there,” agreed Baylor College vaccine expert Peter Hotez, “it changes the equation. This will be exploited.”
BIDEN RESCINDS TEXAS’ TRUMP-ERA MEDICAID WAIVER — The Biden administration has revoked a 10-year waiver for Texas’ Medicaid program, which was hurriedly granted in the final days of the Trump administration, Rachel Roubein reports. As justification for pulling back the waiver, CMS cited a break from the customary approval process, which requires a public health period. The Washington Post first reported the news.
The move is politically significant, as the waiver had included substantial funding for health providers to cover the cost of caring for uninsured patients. Biden’s coronavirus relief bill included new incentives for states to take up Obamacare’s Medicaid expansion, but that idea still faces a tough road in the dozen mostly conservative-led states that haven’t expanded — including Texas, which has the highest uninsured rate in the country.
The view from Texas: Gov. Greg Abbott, a Republican, blasted the waiver’s rescission, saying the “Biden administration is deliberately betraying Texans who depend on the resources made possible through this waiver.” A state health department spokesperson wrote in an email that the agency is "currently reviewing the information and determining next steps."
Coronavirus
HALF OF U.S. ADULTS VACCINATED — The Biden administration announced Sunday that half of adults in the country have received at least one Covid-19 shot, the Associated Press’ Hope Yen and Jonathan Mattise reported.
The numbers: Nearly 130 million people 18 or older have received at least one dose of a vaccine, the CDC reported. Roughly 33 percent of U.S. adults have been fully vaccinated.
FAUCI DOUBTS J&J VACCINE WILL BE THROWN OUT — Chief medical adviser Anthony Fauci on Sunday predicted that J&J’s shot could still be used "in some form," though it could come with a warning or restriction, Connor O’Brien writes.
"I doubt very seriously if they just cancel it. I don't think that's going to happen,” Fauci told NBC's "Meet the Press. But there will likely be some constraints on its use, he said, such as warnings to “be careful under these certain circumstances.”
Around the World
FIRST IN PULSE: ADVOCATES PUSH BIDEN FOR GLOBAL VACCINE ACCESS — Sixteen progressive organizations sent a letter to White House Covid-19 response coordinator Jeff Zients this week, pleading for the U.S. government to strip pharmaceutical companies’ coronavirus vaccine patents in order to ensure that shots are accessible worldwide.
“While the U.S. is nearing the end of its own COVID-19 pandemic, the world at large will still need access to this technology for years to come,” the coalition, which includes the Center for Economic and Policy Research, Democracy For America and the Open Markets Institute, wrote.
The landscape: Advocates argue that the U.S. can march in on drugmakers’ patents to greenlight production in other countries. While that is a legal possibility, the government has never exercised it for medicines.
Plus: Trump proposed a rule in January, two weeks before leaving office, that would effectively bar the government from freeing up drug patents because of a given drug’s cost. The Biden administration has not yet acted on this rule.
In the States
STATE BILLS TO RESTRICT TRANSGENDER HEALTH CARE MARCH ON — Republican-backed bills targeting transgender youth are quickly moving through state legislatures against the backdrop of a national debate about LBGTQ rights, Liz Crampton reports in POLITICO Pro’s first Statehouse Trends report.
Just this week, a Texas Senate committee held a hearing on SB 1311, which would make it illegal for doctors to provide gender-affirming medical procedures to anyone under 18. Pro Statehouse Trends, a new analysis of legislative activity in statehouses across the country, offers Pro Premium subscribers a look at the key bills to watch in this space.
Names in the News
Andrea Hechavarria joins digital health company Butterfly Network as the company’s vice president for government affairs.
What We're Reading
Vice President Kamala Harris spoke with Stat’s Nicholas St. Fleur about Black maternal health and fighting implicit biases in care.
Planned Parenthood’s president and CEO, Alexis McGill Johnson, writes about founder Margaret Sanger’s racist history in the New York Times.
Suicides in the U.S. declined overall during 2020 but rose among Black Americans and other people of color in various states, New York Times’ Roni Caryn Rabin reports.
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