Overnight Health Care: White House to send 'surge teams' to delta variant hot spots | St. Louis recommends vaccinated wear masks indoors | 120K people in Oklahoma gain Medicaid coverage

Overnight Health Care: White House to send 'surge teams' to delta variant hot spots | St. Louis recommends vaccinated wear masks indoors | 120K people in Oklahoma gain Medicaid coverage
© Greg Nash

Welcome to Thursday’s Overnight Health Care.  The delta variant is in big trouble. The Washington Post Tik Tok Guy explains why.

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Today: The White House is sending "surge teams" to hot spot communities in an attempt to blunt the spread of the delta variant. St. Louis is recommending everyone wear masks indoors, and Oklahoma's Medicaid expansion took effect.

We’ll start with the administration:

White House to send 'surge teams' to delta variant hot spots 

The White House is readying COVID-19 "surge teams" to send to communities with low vaccination rates to help combat the rapidly spreading delta variant of the coronavirus, officials announced Thursday.

The teams will work with local public health authorities to conduct contact tracing, and will distribute supplies as needed or requested by states, such as therapeutics and additional tests. 

The teams will also help augment staffing at local vaccination sites.

White House coronavirus coordinator Jeff ZientsJeff ZientsBiden says announcement coming next week on free high-quality masks Overnight Health Care — CDC won't change mask recommendation US ordering 500K more courses of AstraZeneca COVID-19 antibody cocktail MORE said the administration will also increase advertisements about the benefits of vaccinations in hot spot communities.


A warning: CDC Director Rochelle WalenskyRochelle WalenskyThe Hill's Morning Report - Presented by Facebook - Biden talks, Senate balks The Hill's Morning Report - Presented by Facebook - Voting rights week for Democrats (again) Overnight Health Care — Biden faces pressure from Democrats on COVID-19 MORE warned that the highly contagious delta variant is the most serious risk to unvaccinated communities. She said an estimated 25 percent of all infections nationwide are attributed to the delta variant which was originally found in India. 

Walensky said there are about 1,000 counties in the country that have vaccination coverage of less than 30 percent, primarily in the south, east and Midwest.

No mask change: Walenksy and Anthony FauciAnthony FauciLet's stop saying 'breakthrough cases' — it isn't helping The Hill's Morning Report - Presented by Facebook - Voting rights week for Democrats (again) Trump-DeSantis tensions ratchet up MORE reiterated that there will be no change in CDC guidance about mask wearing. Getting vaccinated means you are mostly protected from severe illness and death, even from the delta variant. It's the unvaccinated who have to worry. Walensky said initial data from the past six months has shown 99.5 percent of deaths from COVID-19 in a select group of states occurred in unvaccinated people.

Read more here.

But it's different at the local level: St. Louis will recommend everyone wear masks indoors

St. Louis’ county and city health departments recommended on Thursday that vaccinated residents wear masks indoors when among people whose vaccination statuses are unknown.

Both health departments issued a joint public health advisory that adjusted their mask guidance for fully vaccinated individuals, pointing at rising COVID-19 cases and the spread of the highly transmissible delta variant. 

“This pandemic is not over,” Faisal Khan, the acting director of the St. Louis County Department of Public Health, said in a statement. “The virus and its variants present a real and imminent danger to the health of people in the St. Louis region.”

The advisory acknowledges that the available COVID-19 vaccines are “highly effective against the disease” but warned vaccinated individuals can still contract COVID-19 and spread it to unvaccinated people, including children younger than 12, who are not eligible to get the shot.

Also: Nearby Jefferson County Health Department also released a similar health advisory, citing a 42 percent increase in new cases, with most among 10- to 19-year-olds. 

Follows: St. Louis's announcement follows the Los Angeles County Department of Public Health’s recommendation for all people to wear masks indoors “as precaution” no matter their vaccination status. 

Los Angeles had been considered an outlier straying from the CDC guidance that fully vaccinated people could go maskless in most outdoor and indoor settings.

Read more here

120K people in Oklahoma gain Medicaid coverage as expansion takes effect


About 120,000 people in Oklahoma are gaining Medicaid coverage effective Thursday, as the state's expansion of Medicaid takes effect, according to the federal Department of Health and Human Services (HHS).

Oklahoma voters passed Medicaid expansion last year in a ballot measure, and the expansion takes effect starting Thursday. Oklahoma is now the 37th state, plus D.C. to expand the program under the Affordable Care Act, and the 5th to expand it at the ballot box. Missouri voters adopted expansion as a constitutional amendment, but the governor and the state legislature refused to implement it

Since applications opened on June 1, more than 120,000 people have applied for and been determined eligible for Medicaid coverage, HHS said. An additional 70,000 people who have not yet applied are also eligible, the department said.

More money coming: The American Rescue Plan, passed earlier this year, provides an additional 5 percentage points of the federal share of Medicaid funding for a state, as an incentive to expand. The money wasn't on the table when voters initially passed expansion, so the extra infusion is a bonus of sorts, though it only lasts for the next two years. According to the Center on Budget and Policy Priorities, Oklahoma will see an addition $860 million.

Read more here.

Missouri AG requests Supreme Court review of blocked abortion law

Missouri Attorney General Eric Schmitt (R) requested Thursday that the Supreme Court review a state law that widely restricts abortions after it was blocked by a federal appeals court.


Schmitt, who is running for the U.S. Senate in 2022, submitted a petition asking the highest court to weigh in on the law. 

In 2019, the Missouri Legislature passed the law in question, which outlaws abortions after eight weeks of pregnancy as well as abortions conducted “solely because of a prenatal diagnosis” indicating a child might have Down syndrome.

Doctors who violate the law, which has not gone into effect due to legal challenges, could face up to 15 years in prison.

The attorney general in his petition cited a “circuit split” on court decisions over legislation prohibiting abortions based on the prenatal diagnosis of Down syndrome. He called on the Supreme Court to reverse lower court decisions that labeled these laws as “categorically unconstitutional.”

The petition follows a ruling from the 8th U.S. Circuit Court of Appeals last month that blocked the Missouri law, citing that it amounted to a ban instead of a restriction on abortions. The federal appeals court upheld a lower court’s ruling prohibiting the state from enforcing the law.

Trending: The petition comes as Republicans in several states have pushed to pass abortion restrictions in the hopes of getting the conservative majority in the Supreme Court to override the landmark reproductive rights case Roe v. Wade. 

Read more here.


Biden officials release first rules implementing ban on surprise medical bills

Remember surprise billing? Now that the law is passed, the regulations are coming out. 

The Biden administration on Thursday issued the first regulations to implement a major law passed by Congress last year to protect patients from massive, “surprise” medical bills. 

The new regulation, which will go into effect Jan. 1, implements provisions protecting patients from getting stuck with bills for thousands of dollars when a doctor happens to be outside their insurance network. 

The rules apply to both emergency room care, as well as non-emergency situations, like when an anesthesiologist happens to be out-of-network even though the surgeon is in-network. 

Lobbying battle watch: The issue has also set off fierce lobbying, with employers and insurers on one side and hospitals and doctors on the other side trying to shape the regulations, concerned about how much the insurer will have to pay the doctor once patients are protected. 

The law gives many of those decisions to an outside arbiter to determine payment amounts, and many of the closely-watched details of that arbitration process are still to come in future regulations. 

One employer group, the ERISA Industry Committee, was happy with the regulations on Thursday, though. 

“Because of the strong regulations released today, January of 2022 will mark the end, once and for all, of these predatory billing practices – and will do so without burdening patients with higher health insurance premiums,” said James Gelfand, the group’s senior vice president of health policy.

Read more here

What we’re reading

Biden behind on global vaccine sharing, cites local hurdles (The Associated Press)

The delta Covid variant’s urgent message for America (The New Republic)

Frontline health care workers aren’t feeling the ‘summer of joy’ (The New York Times)

Damage to children’s education — and their health — could last a lifetime (Kaiser Health News)

State by state

St. Louis area health officials want to turn around dismal teen vaccination rates before school starts (St. Louis Post-Dispatch)

Several Houston-area kids infected with COVID Delta variant, hospitals say (Houston Chronicle)

How one rural town without a pharmacy is crowdsourcing to get meds (Kaiser Health News)

Op-eds in The Hill 

COVID vaccine lotteries are working — let's apply the model to other diseases