The coming White House coronavirus clash

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With Alice Miranda Ollstein

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Quick Fix

— The White House is headed toward a showdown over reopening the nation that could pit Trump’s economic gurus against his public health experts.

— Joe Biden endorsed lowering Medicare’s eligibility age to 60, as he seeks to win over Democrats’ left flank.

— Top Republicans are making the case for including a “surprise“ medical bill ban in the next coronavirus rescue package.

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Driving the Day

WHITE HOUSE CLASH LOOMS OVER REOPENING — Donald Trump is building toward a critical decision that could split his administration, define his presidency and set the course of the nation: Whether to begin restarting the economy in as little as three weeks.

— TRUMP and his economic advisers have grown increasingly antsy over the monthlong shutdown, voicing concerns about its damage to the economy and questioning whether officials misjudged the coronavirus threat.

Both Treasury Secretary Steven Mnuchin and Attorney General Bill Barr expressed hope Thursday that restrictions could ease beginning in May. And another top adviser, Marc Short, has contended the country has already overreacted, the Washington Post reported.

— The administration’s public health experts are more wary. Health officials have consciously avoided speculating about a reopening as deaths continue to pile up, and dismissed arguments amplified by Fox News and within conservative circles that the pandemic was overhyped now that fatalities could come in below the 100,000 projected early on.

“That means that what we are doing is working, and therefore we need to continue to do it,” top infectious disease doctor Anthony Fauci said of social distancing.

— PELOSI sides with the scientists. “I would hope that the scientific community would weigh in and say, ‘You can’t do this, it is only going to make matters worse if you go out too soon,’” House Speaker Nancy Pelosi told POLITICO’s Heather Caygle and John Bresnahan.

— The reality: More Americans died of coronavirus this week than during the entirety of the Iraq War. And while hard-hit areas are showing signs of stabilization, any return to normalcy must be gradual and requires key tools that the nation still lacks: Proven therapeutics and widespread testing.

“Often people say reopen the government like it’s a light switch that goes on and off,” Fauci said. “It’s not going to be one size fits all.”

FEDS TO STATES: RUN YOUR TESTING SITES — The drive-through testing sites touted by the Trump administration as central to the virus response could increasingly become the states’ responsibility, POLITICO’s David Lim reports.

The federal government is encouraging governors to consider taking over the sites currently run by HHS and FEMA — though administration officials clarified Thursday they won’t be forced to do so.

— An initial deadline for the federal-to-state handoff — 5 p.m. Thursday — alarmed governors, who worried about losing supplies and funding. The government will now not hold them to that date, HHS testing czar Brett Giroir said. He also acknowledged ongoing issues with the supply chain for procuring testing supplies.

BIDEN SHUFFLES LEFT ON HEALTH CARE — Joe Biden is taking a step to the left on health care just a day after becoming Democrats’ presumptive 2020 nominee, endorsing a lowering of Medicare’s eligibility age from 65 to 60.

Biden’s plan would give Americans the ability to choose Medicare when they turn 60, as opposed to private health insurance or a public option plan — a move aimed at broadening his appeal to the party’s liberal wing.

— But progressives say it’s more like a half-step. The proposal is far less radical than the “Medicare for All” ambitions that energized Sen. Bernie Sanders’ base, of course.

And while details are scarce, it appears to be more conservative than even the plan then-nominee Hillary Clinton embraced in 2016, which would have allowed Americans to opt into Medicare at age 55.

“It’s Day 1. We expect to see more. He’s got a long way to go,” Justice Democrats’ Waleed Shahid said.

On the Hill

CORONAVIRUS SPARKS FRESH ‘SURPRISE’ BILLING BID — Top Republicans on two congressional committees want to revive legislation ending “surprise” medical bills, in hopes of wrapping the language into Congress’ next coronavirus rescue package, POLITICO’s Susannah Luthi reports.

Senate HELP Chairman Lamar Alexander and top House Energy and Commerce Republican Greg Walden are leading the effort, which they say has gained support in the Senate in recent weeks. The concept of eliminating surprise bills is widely backed by both parties, and ranked as a major priority before the pandemic.

— Yet there are headwinds old and new. Lawmakers still haven’t resolved a standoff between hospitals and insurers that stalled previous attempts to pass surprise billing legislation.

And Congress’ attention is now more focused on helping hospitals and physicians, among a slew of other issues. Notably, Democrats haven’t yet endorsed including surprise billing language in the next package.

— The White House is imposing some surprise bill restrictions in the meantime. Hospitals that take advantage of the new $100 billion bailout fund created by Congress must agree not to balance bill patients for coronavirus treatment. The terms of that fund will mandate that coronavirus patients be charged in-network rates, even if they’re treated out of network.

DEMS PRESS KUSHNER OVER VIRUS SURVEILLANCE TALKS — Three congressional Democrats are seeking answers from White House senior adviser Jared Kushner about the administration’s discussions of building a public health surveillance network.

In a a letter, Sens. Mark Warner (D-Va.) and Richard Blumenthal (D-Conn.) and Rep. Anna Eshoo (D-Calif.) raised concerns about the privacy implications, warning that health security rules “have not aged well” and that they fear efforts using patient data to combat the coronavirus could undermine health confidentiality restrictions.

POLITICO reported earlier this week on the administration‘s talks with health tech companies. The Wall Street Journal also reported Wednesday that several other companies have discussed creating a registry with federal officials.

Public Health

REDFIELD DEMURS ON RECOMMENDING ANTI-MALARIAL DRUGS — CDC Director Robert Redfield refused Thursday to endorse using the anti-malarial drug hydroxychloroquine to treat coronavirus — even as Trump has relentlessly touted the unproven treatment as a possible cure.

“I’m not going to recommend it, and not going to not recommend it,” Redfield said on CNN. “We’re not an opinion organization, we’re a science-based data-driven organization, so I do think this is going to be an independent organization of these health care providers and patients.”

WHO FUNDING IN LIMBO — The federal government is instructing agencies and departments not to send more money to the World Health Organization without getting higher-level approval amid growing GOP anger at the WHO’s handling of the coronavirus crisis, POLITICO’s Nahal Toosi and Dan Diamond scooped.

The U.S. is the top donor to the U.N. global health body. But Trump has threatened to cut off funding over allegations that the WHO’s leaders are too friendly to China and made missteps in handling the coronavirus’ spread early on. Some Republicans in Congress have also called for greater accountability from the organization.

Abortion

COURT PERMITS SOME TEXAS ABORTIONS TO RESUME — A federal district court granted Planned Parenthood and other Texas clinics a narrower restraining order against the state’s pandemic abortion ban — allowing temporary resumption of medication abortions and surgical abortions in cases where a patient is far enough along in pregnancy that any delay would prevent her from obtaining an abortion under Texas law.

Judge Lee Yeakel in his ruling said he was unconvinced by the state’s contention that banning abortion would conserve scarce medical supplies, countering that forcing women to travel out of state or give birth against their wishes would use far more resources and create more risk.

Texas Attorney General Ken Paxton vowed to go back to the 5th Circuit to have the ban reinstated, and said Thursday night that the District Court’s ruling “demonstrates a lack of respect for the rule of law.”

What We're Reading

TIME’s Charlotte Alter spends 24 hours with a New York paramedic on the front lines of the pandemic.

Harvard’s David Cutler breaks down the coronavirus’ impact on the health care economy in a JAMA Forum article.

A new initiative in Indiana is showing promising results in trying to curb the opioid epidemic, The Atlantic’s Beth Macy writes.

Iceland is pursuing a controversial strategy for fighting coronavirus: Keep the country open, but test everyone, the New York Times’ Aimee Ortiz reports.