POLITICO Pulse-Biden administration vs the anti-vax movement

With help from Robert King

When Robert F. Kennedy Jr. launched his insurgent presidential bid earlier this spring, it confirmed what many Biden officials had feared: The anti-vaccine movement, long relegated to the fringes of society, was on the rise.

Yes, anti-vaccine sentiment had long existed, notably in pockets of New York and the Pacific Northwest, but Kennedy’s name and candidacy was about to give it significant oxygen.

Worse, the Biden administration had to confront the uncomfortable truth that it has no clear sense of how to combat it, POLITICO’s Adam Cancryn reports.

“There’s a real challenge here,” said one senior official who’s worked on the Covid response, and was granted anonymity to speak candidly. “But they keep just hoping it’ll go away.”

The increasing appeal of anti-vaccine activism underscored by Kennedy’s campaign and fueled by prominent factions of the GOP has horrified federal health officials, who blame it for seeding dangerous conspiracy theories and bolstering a Covid-era backlash to broader public health practices.

But as President Joe Biden ramps up a reelection campaign centered on his vision for a post-pandemic America, there’s little interest among his aides in courting a high-profile vaccine fight — and even less of an idea of how to win.

Biden officials have felt handcuffed for the past two years by a Republican lawsuit over the administration’s initial attempt to clamp down on anti-vaxxers, who claimed the White House violated the First Amendment when it encouraged social media companies to crack down on anti-vaccine posts. That suit, the officials believe, has limited their ability to police disinformation online.

Congress is also clawing back Covid funds once earmarked for vaccine education and outreach. And Biden has largely ignored Kennedy’s campaign, concluding there’s no political benefit to engaging.

The consequences: As another Covid vaccination bid begins, fewer Americans than ever are up to date on their shots, especially children. Recent polling shows Republicans now are twice as likely to say childhood shots should be optional than they did in 2019.

“We can see a long-term future where kids aren’t going to get vaccinated in schools, diseases that we once thought had ended will roar back and kids will get sick and die from 100 percent preventable conditions,” said Lawrence Gostin, a Georgetown University public health professor who has advised the White House. “This will cost lives in the long term.”

The White House and Department of Health and Human Services declined to comment on the record. But in a statement, an HHS spokesperson said the administration knows “how important it is for people to have accurate, science-based information to protect themselves and their loved ones.”

HHS also outlined a range of activities aimed at reinforcing that vaccines are safe and effective, and promoting factual information — including monitoring social media for misinformation, working with local health officials to identify and correct misconceptions, and publicizing its own online resources to address common questions and concerns.

WELCOME TO WEDNESDAY PULSE. The Congressional Pickleball Caucus welcomed professionals to the Dirksen Senate Office Building Tuesday. We’d like to play pickleball at work, too. Reach us at [email protected] or [email protected]. Follow along @_BenLeonard_ and @ChelseaCirruzzo.

TODAY ON OUR , host Lauren Gardner talks with POLITICO health care reporter Erin Schumaker about YouTube’s plans to become an authority on medical information.

SCOPE OF PRACTICE BATTLE — Providers sparred over potential new national standards of practice during a Tuesday health subcommittee hearing of the House Committee on Veterans’ Affairs, Ben reports.

The fight over scope of practice, or the work that a licensed health care professional is allowed to do, is a familiar one in the sector — and it’s playing out in the VA. The agency is weighing allowing providers like optometrists and certified registered nurse anesthetists to provide other care to help facilities that may not have sufficient staff.

VA officials emphasized a team-based approach to care, including physicians, and added that safety would be of utmost importance. But the American Medical Association warned against allowing non-doctors to do procedures beyond their current scope, and the American Society of Anesthesiologists said that allowing nurse anesthetists to do work previously reserved for anesthesiologists could lower the quality of care.

Lawmakers on both sides of the aisle said they are concerned that providers with less rigorous training who take on more types of care could cause safety issues.

“If we have to have surgery, would we not want to make sure we have a trained physician conducting that?” said Rep. David Scott (D-Ga.). Subcommittee Chair Mariannette Miller-Meeks (R-Iowa) argued there’s a difference between optometrists and more specialized ophthalmologists.

The pushback: Leaders of groups representing optometrists and nurse anesthetists argued that their clinicians can safely perform more advanced care.

“Physician groups have a vested financial interest in limiting the scope of practice for others,” said Janet Setnor, president-elect of the American Association of Nurse Anesthesiology.

What’s next: The VA is holding the last of several listening sessions on the issue on Thursday, and is expected to release new data from an independent analysis on nurse anesthetists in the coming weeks.

DELUGE OF MEDICARE ADVANTAGE ADS — Seniors are about to face an annual blitz of ads featuring celebrities to sign up for Medicare plans, but a new report finds some of the marketing can be misleading, Robert reports.

Think tank KFF released a report on Wednesday that examined more than 1,200 television ads that aired more than 643,000 times during Medicare’s 2023 open enrollment session last fall. The report offers a window into which types of ads seniors might see during the 2024 session expected to start on Oct. 15, especially as Medicare Advantage enrollment has surged past 30 million.

KFF said the ads often didn’t discuss potential coverage limitations or traditional Medicare, leaving viewers with an “incomplete view” of tradeoffs. An accompanying report also showed that seniors in several focus groups feel overwhelmed and confused by the ads.

“As enrollment in Medicare Advantage plans has grown, the annual marketing madness can create confusion for people who are trying to make difficult decisions about coverage,” KFF President and CEO Drew Altman, said in a release.

More than 85 percent of the ads were for Medicare Advantage and the remainder were for Medigap or stand-alone prescription drug plans, the report said.

The report found that ads relied heavily on the use of celebrity endorsers, with former New York Jets quarterback Joe Namath the most popular option. Namath appeared in about 10 percent of all airings of Medicare Advantage ads last open enrollment, KFF said.

More than 80 percent of the ads urged viewers to call a Medicare hotline and another 27 percent included images of an official Medicare card. The hotline, though, was run by a third party and not the official one used by the government.

A new rule going into effect for this year’s open enrollment bans use of such card images.

SITUATIONAL AWARENESS — The clock is ticking on a government shutdown, and House Speaker Kevin McCarthy doesn’t appear to be any closer to a funding deal.

McCarthy on Tuesday punted on holding a vote on Republicans’ short-term spending bill later this week, POLITICO’s Sarah Ferris, Olivia Beavers and Jordain Carney report. McCarthy is now without a viable plan to fund the government, with just 11 days left to avoid a shutdown.

And later on Tuesday, Republican rebels blocked the annual defense appropriations bill in a procedural vote, POLITICO’s Connor O’Brien reports. That was a stunning loss for McCarthy and defense hawks who’d sought to use the defense bill to break the impasse over federal spending.

Five conservatives withheld their votes on the Pentagon bill to force Republican leaders to take a harder line on a short-term funding patch.

For now, Senate Democrats are letting McCarthy make the first move to avert a shutdown.

When asked Tuesday when the Senate might need to stop waiting and take action, Appropriations Chair Patty Murray (D-Wash.) said, “talk to me in a couple days.”

STAT reports on artificial wombs getting closer to human testing.

Healthcare Dive reports on a secret shopper survey finding hospitals offered different prices online than they did on the phone.