Overnight Healthcare

Overnight Health Care: CDC calls for schools to reopen with precautions | Cuomo faces rising scrutiny over COVID-19 nursing home deaths | Biden officials move to begin rescinding Medicaid work requirements

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Welcome to Friday’s Overnight Health Care. Something different under President Biden: Advertising ObamaCare. A three month special open enrollment period starts Monday, along with an advertising campaign.

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The CDC issued new guidelines for reopening schools, likely prompting new fights to school districts and teachers unions. New York Gov. Cuomo is under fire for his handling of nursing home deaths. Meanwhile, the Biden administration is rescinding state waivers for Medicaid work requirements approved by former President Trump’s Centers for Medicare and Medicaid Services. 

We’ll start with schools:

CDC calls for schools to reopen with precautions

The Centers for Disease Control and Prevention (CDC) on Friday released a long-awaited roadmap on safely reopening schools, emphasizing the importance of having schools open as long as proper coronavirus safety precautions are followed.

The guidance states it is “critical for schools to open as safely and as soon as possible,” given the benefits of in-person learning.

The top recommendations for doing so safely:

  • Universal wearing of masks by students, staff and teachers
  • Distancing so that people are six feet apart

Notably not a top priority: Making sure every teacher is vaccinated, which has been a major sticking point in the fights between teacher’s unions and school districts. CDC reiterated that states should prioritize teachers for vaccination, but said it is not a prerequisite for reopening. Still, American Federation of Teachers President Randi Weingarten was largely supportive of the guidance.

Color coding: The CDC breaks transmission levels for communities surrounding schools into four levels. At “low” and “moderate” transmission, all K-12 schools can open for full in-person instruction with distancing “to the greatest extent possible.”

The far more common situation in the U.S. right now, however, is “substantial” or “high” spread.

In “substantial,” schools should be in hybrid instruction, the CDC says. In “high” spread, middle and high schools should be in virtual-only school unless “they can strictly implement all mitigation strategies” and have few cases.

What’s different: The guidelines are not that dissimilar to what came out over the summer from the Trump administration, but the Biden administration is leaning on having more scientific credibility. CDC Director Rochelle Walensky said Friday that there had been no “political meddling” in her agency’s recommendations, though she added she had shared some pieces with the White House to let them know what the CDC was planning.

Read more here.


Cuomo faces rising scrutiny over COVID-19 nursing home deaths

New York Gov. Andrew Cuomo (D) is facing mounting scrutiny over his handling of COVID-19 nursing home deaths after revelations that a top aide said officials “froze” information about the deaths after questions from the Department of Justice (DOJ) last year.

The remarks have set off a renewed firestorm over Cuomo’s handling of the deaths and whether his administration sought to cover up details. They also undermine the star profile the governor developed on the national level at the start of the pandemic as he gave signature daily press conferences and sparred with then-President Trump.

The Cuomo aide, Melissa DeRosa, said on a conference call with state legislators that the freeze of provided information came “because then we were in a position where we weren’t sure if what we were going to give to the Department of Justice or what we give to you guys, what we start saying was going to be used against us while we weren’t sure if there was going to be an investigation.”

The comments were first reported by The New York Post Thursday night and later confirmed by the governor’s office, which released a partial transcript of the remarks as well as a statement from DeRosa. 

“I was explaining that when we received the DOJ inquiry, we needed to temporarily set aside the Legislature’s request to deal with the federal request first,” she said in the statement.

Read more here.


Biden officials move to begin rescinding Medicaid work requirements

The Biden administration on Friday moved to start the process of revoking Medicaid work requirements, one of the signature health care policies of the Trump administration that Democrats have long criticized as leading to coverage losses.

The Biden administration sent letters to states that had previously been approved for work requirements informing them that the federal government is moving to revoke the waivers that had been granted allowing the policy.

The letters from the federal Centers for Medicare and Medicaid Services (CMS) say the agency has “preliminarily” determined to revoke the policy and gives the states 30 days to provide information contesting the decision.

The letters state that the Biden administration “has serious concerns about testing policies that create a risk of a substantial loss of health care coverage in the near term,” and cite the coronavirus pandemic’s impact on health.

Flashback: The Trump administration allowed states to apply for, and then granted, waivers to impose work requirements in the Medicaid program for the first time, a major conservative twist on the health insurance program for the poor.

Officials, led by Trump’s Medicaid chief Seema Verma, argued the move helped lift people out of poverty. But it resulted in massive coverage losses. According to Democratic critics, that was precisely the point. Only one state, Arkansas, ever fully implemented the requirements. They were in effect for just a few months in 2018 before a judge blocked them, but 18,000 people still lost Medicaid coverage.

What’s next: The Supreme Court is set to hear arguments March 29 over whether work requirements are legal, but if they are withdrawn it could render the case moot. 

Read more here


Coronavirus hospitalizations hit lowest level in nearly three months

More than 74,000 people remain in the hospital due to COVID-19 as of Thursday, the lowest level in nearly three months, according to data from the COVID Tracking Project.

The group recorded approximately 74,225 hospitalizations as of Thursday, making it the third straight day the number has remained below 80,000. 

The number of patients in intensive care units — 15,190 — is the lowest number recorded by the group since Nov. 17, 2020.

The new data marks a promising development from January, which saw the greatest number of COVID-19 fatalities and the highest average number of coronavirus hospitalizations of any month since the pandemic first hit the U.S.

But overall, numbers are still much much higher than the summer, and unacceptably high overall.

Read more here.


Case in point: Daily coronavirus cases tip back over 100,000

Daily new coronavirus cases tipped back over 100,000 on Thursday after having fallen below that threshold for the first time since the fall earlier in the week. 

The overall trend in recent weeks is still positive, as cases and hospitalizations have fallen from their January highs. 

But the 103,000 cases on Thursday, as tallied by the COVID Tracking Project, are a reminder that spread of the virus is still at extremely high levels, and more contagious variants threaten to start another surge upward. 

Cases are down 23 percent from last week and 57 percent from the peak in January. But the toll of the virus remains heavy, with about 3,000 people dying every day. Deaths are a lagging indicator, so the drop in cases will take longer to show up there. 

And the threat of more contagious variants, particularly one first identified in the United Kingdom, known as B.1.1.7, threatens to undo downward trends. 

Read more here.


Meanwhile, states are lifting restrictions: Montana’s governor repealed the mask mandate

Montana Gov. Greg Gianforte (R) lifted the state’s mask mandate Friday, fulfilling a campaign pledge, after he said the state has made significant progress vaccinating the most vulnerable against COVID-19.

Gianforte has been a vocal opponent to the mask mandate, which was signed into law by his predecessor, Democratic Gov. Steve Bullock, in July. 

The governor made the announcement Wednesday, during a signing ceremony for legislation that would shield businesses, health care providers, houses of worship and nonprofit organizations from coronavirus-related lawsuits.

Gianforte last month said the legislation was a priority and he would wait to remove the mask mandate until it was signed. His other threshold for removing the mandate was having a vaccine available to vulnerable populations.

“We will continue to provide incentives to protect the health and safety and we will emphasize personal responsibility over mandates,” Gianforte said Wednesday. “When it comes down to it, I trust Montanans, and together we can combat this public health and economic pandemic with personal responsibility and by looking out for one another.”

Read more here.


New book coming soon from our colleague: “Lucky,” by No. 1 New York Times bestselling authors Jonathan Allen and The Hill’s Amie Parnes, explores Joe Biden’s road to the presidency, including the pandemic lockdown that kept him off the campaign trail. Pre-order here for the March release: prh.com/lucky


What we’re reading

COVID-vaccine designer tackles hesitancy – in churches and on Twitter (Nature

As millions get shots, FDA struggles to get safety monitoring system running (The New York Times

Overloaded schedules and ‘Covid cowbells’: For pharmacists, the Covid-19 vaccine rollout brings exhaustion, but some relief (Stat News)

Two officers who helped fight the Capitol mob died of suicide. Many more are hurting (The Washington Post


State by state

Medical groups ask Oklahoma Supreme Court to halt plan to outsource Medicaid (Oklahoman)

Some California fitness trainers got vaccine as ‘health care workers’ (AP)

They have disabilities and serious medical conditions. But under state guidelines, they don’t qualify for early vaccination (Boston Globe)

Tags Andrew Cuomo CDC Centers for Disease Control and Prevention Donald Trump Greg Gianforte Joe Biden mask mandate Medicaid Medicaid work requirements nursing home deaths ObamaCare Reopening schools Rochelle Walensky Steve Bullock
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