| Good morning! Do you and your significant other order the same dish at a restaurant, like the Bidens? Let us know your thoughts on dining out battle plans (health care tips also accepted): rachel.roubein@washpost.com. Was this forwarded to you? Sign up here. Today's edition: The Food and Drug Administration's advisers back Pfizer's RSV vaccine for older adults, with a vote on GSK's shot up today. A recent manufacturing plant closure in Illinois is poised to prolong a shortage of a medicine used in hospitals to treat asthma and RSV in kids. But first … | President Biden is now framing Republicans as a threat to Medicaid, Obamacare |  President Biden talks about health care during a visit to the Kempsville Recreation Center in Virginia Beach yesterday. (Susan Walsh/AP) | | | It's pretty clear: President Biden believes health care is a potent campaign message. No, he hasn't yet announced whether he's running for a second term. But if the past few weeks serve as a preview, then the White House believes portraying Republicans as a threat to Americans' health care is a political winner. After hammering Republicans on Medicare and Social Security for weeks, Biden pivoted yesterday to framing the GOP as a danger to Medicaid and Obamacare. "Look, make no mistake: If MAGA Republicans try to take away people's health care by gutting Medicaid and the Affordable Care Act, I will stop them," Biden said during a speech in Virginia Beach. When it comes to health care, Democrats have long believed they have the advantage over Republicans, and both Medicaid and Obamacare have proven to be broadly popular. Republicans failed to repeal the law in 2017 after repeatedly pledging to do so. The party ran into resistance for attempting deep cuts to Medicaid, with several GOP governors even up in arms at the proposals, and some health experts have since dubbed the safety net program a "potential new third rail" of American politics. | | The Kaiser Family Foundation's Larry Levitt: |  | | | | | There are two major fights looming: Some Republicans have threatened to vote against raising the debt ceiling — which limits how much the government can borrow to pay for spending — unless Biden agrees to significant cuts in federal spending, our colleague Matt Viser reports. | | | | | | | BCBSA's Affordability Solutions can cut health care costs by $767 billion over the next 10 years by improving competition, lowering drug costs and prioritizing high-quality care. Learn more. | | | |  | | | | | Meanwhile, House Republicans have said they want to produce a blueprint that balances the budget over the next 10 years. To do so without raising taxes would likely necessitate major spending cuts. Trump's former budget director, Russell Vought, has quietly emerged as one of the central voices shaping the looming showdown over federal spending and the national debt, our colleagues Jeff Stein, Josh Dawsey and Isaac Arnsdorf recently reported. His budget proposal circulating on Capitol Hill calls for cutting $9 trillion over the next decades from various domestic programs. | - The plan consists of $2 trillion in cuts to Medicaid, the nation's public health insurance program for low-income Americans.
- It includes more than $600 billion in cuts to the ACA.
- The proposal also contains over $400 billion in cuts to food stamps and a halving of the State Department and the Labor Department and other federal agencies.
| | It's unclear if Republicans with their slim majority would be able to unify around such a plan or other proposals to alter the programs. A Republican aide, who spoke on the condition of anonymity to be candid, said policies to change how Medicaid is financed, such as through a per capita cap, could risk political backlash if they weren't carefully crafted and worked through. | | The Post's Jeff Stein: |  | | | | | Although the path forward is murky, White House officials — in arguing the GOP wants to broadly cut the programs — contend the public should go no further than to look at Republicans' past proposals. In a call with reporters Monday, aides pointed to several plans, such as one released last year from the Republican Study Committee, a large bloc of conservative House Republicans. For instance: The blueprint proposed converting Medicaid, the Children's Health Insurance Program and Obamacare subsidies into block grants, which would cut roughly $3.6 trillion over a decade. The White House's rhetoric comes as Biden prepares to unveil his budget on March 9, an annual exercise every presidential administration uses to lay out its priorities while fully knowing the document will go nowhere on Capitol Hill. During his remarks yesterday, Biden prodded Republicans to "lay their proposal on the table" so "we can sit down, and we can agree [and] disagree." Biden's budget will outline his plans to build on Obamacare, as well as bolster Medicaid. But White House officials didn't explicitly say whether cuts to either program were off the table during the looming spending battles. | | |  | Agency alert | | FDA advisers back Pfizer's RSV vaccine for older adults |  RSV kills up to 10,000 older adults in the United States each year. (Eric Lee/The Washington Post) | | | Pfizer's respiratory syncytial virus (RSV) vaccine should be approved for people 60 and older, independent advisers to the Food and Drug Administration recommended yesterday. The endorsement from the key panel puts the shot on track to become one of the first approved vaccines for the virus, which kills between 6,000 and 10,000 older adults in the United States annually. The FDA is expected to decide on approval by May and typically follows the recommendations of its outside experts. The advisory committee voted 7-4 in favor of the drug, finding that data from the clinical trial conducted by Pfizer shows that its shot is safe and effective at preventing lower respiratory tract illness disease caused by RSV in people 60 and older. During the meeting, several FDA advisers raised concerns about two cases of Guillain-Barre syndrome among nearly 20,000 trial participants that received the vaccine. Pfizer said the cases have other possible explanations, but it agreed to conduct a safety study on the syndrome after a potential approval, Spencer Kimball reports for CNBC. On tap today: The same panel of advisers will consider GSK's RSV vaccine for older adults. Pfizer and the London-based pharmaceutical company have been neck and neck in the crowded race to develop the first shot for the virus. | | The FDA announced yesterday that it's cracking down on the illegal importation of xylazine, an animal sedative that is increasingly being mixed into illicit drugs like fentanyl and heroin, The Post's David Ovalle reports. | | The agency's import alert allows authorities to stop shipments of the finished drug and its ingredients to ensure they're meant for legitimate use. Xylazine is legal and commonly used by veterinarians to sedate large animals, but it is now being found in blood samples of overdose victims across the country. Health officials are particularly concerned that xylazine, which isn't an opioid, may hinder the use of an opioid overdose reversal drug. | | FDA Commissioner Robert Califf: |  | | | | | |  | Industry Rx | | The albuterol shortage is about to get worse |  Nebulizers turn liquid albuterol into mist so it can be easy consumed. (iStock) | | | Children's hospitals nationwide lost a supplier of a common respiratory medicine with the sudden shutdown of an Illinois manufacturing plant last week. Now, specialists are warning that the closure will prolong existing shortages of an important treatment for kids with asthma and RSV, our colleague Christopher Rowland writes. Akorn, a company that has struggled under bankruptcy for two years and had been the subject of FDA enforcement actions, shut down its U.S. operations on Thursday. Its Illinois facility made liquid albuterol, which is used by hospitals for nebulizers, common devices that turn medicine into mist to be inhaled to treat respiratory diseases. The shutdown of the Illinois plant leaves just one remaining domestic supplier of the drug. Catch up quick: Albuterol has been on the FDA's shortage list since last fall, although hospitals have been able to manage the issue thus far and say patients haven't been affected directly. However, recent outbreaks of covid-19 and RSV have made the shortages worse, pushing children's hospitals to modify doses of albuterol in their own pharmacies to suit their needs. Wholesalers have barred hospitals from ordering more than their usual supply to avoid hoarding. The bigger picture: Health system leaders say the albuterol shortage is another example of the fragile domestic supply of vital generic drugs, a problem that was exacerbated by the pandemic. Profit margins are so low on some generic drugs that they have few manufacturers, so a single failure can have a major impact on the health system, Christopher notes. | | |  | State scan | | Mississippi bans certain services for transgender minors |  Mississippi Gov. Tate Reeves (R) signs a bill to ban gender-transition care in the state for anyone younger than 18. (Rogelio V. Solis/AP) | | | Transgender minors in Mississippi can no longer receive gender-transition services in the state after Gov. Tate Reeves (R) signed a bill yesterday barring physicians from providing hormone treatments and surgical procedures to anyone younger than 18. The law, which took effect immediately, also bans public funding from going to any institution or individual that provides such services to minors. Health-care workers risk having their licenses revoked if they are found to be in violation of the law, which enables patients to sue their provider up to 30 years after receiving care. The move comes amid a broader push in conservative states to limit what gender transition services minors can access. Mississippi is the sixth state in the nation to adopt a law banning gender-transition services for minors, and the third to have done so this year. | | More from Reeves: |  | | | | | The Human Rights Campaign: |  | | | | | |  | In other health news | | - On the move: Theo Merkel has been named director of the Paragon Health Institute's Private Health Reform Initiative. Merkel was previously the legislative director for former Sen. Pat Toomey (R-Pa.), as well as a special assistant to the president for economic policy during the Trump administration.
- FBI director Christopher Wray said yesterday that covid-19 "most likely" originated from a lab accident, which were his first public comments on his agency's position on the virus's origins, The Post's Anumita Kaur and Dan Diamond report.
- In 2021, Medicare Advantage plans reported at least double the profits per enrollee compared with insurers in the individual and group markets in a return to pre-pandemic levels, according to a new analysis by the Kaiser Family Foundation.
- Reps. Anna Eshoo (D-Calif.) and Richard Hudson (R-N.C.), both senior members of the House Energy and Commerce Committee, are asking for input on how to best reauthorize and revise the nation's Pandemic and All Hazards Preparedness Act as Congress prepares to do so by the Sept. 30 deadline.
| | |  | Health reads | | | |  | Sugar rush | | | Thanks for reading! See y'all tomorrow. | |
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