| Good morning — it's Friday, and that's no joke. Today's edition: Some lawmakers aren't pleased with HHS Secretary Xavier Becerra's decision about where to house a new agency aimed at speeding medical breakthroughs. The House passed a measure to cap insulin at $35 per month last night. But first … | More coronavirus dollars have tailwinds |  Sen. Mitt Romney (R-Utah) has been a lead negotiator on more pandemic aid. (Elizabeth Frantz/Reuters) | | | On Capitol Hill, there's real traction on a deal to put another $10 billion toward the nation's pandemic response. Key senators said they'd agreed on a framework to continue funding coronavirus vaccines, antiviral treatments and other supplies for Americans, per a report Dan Diamond and I filed yesterday. But first: Lawmakers need to finalize a compromise, get cost estimates from congressional scorekeepers and hammer out legislative text. Republicans have demanded the legislation be fully paid for, so the two sides must agree on how to do that. They're racing against a tight Senate calendar, as Biden administration officials warn they've already had to scale back critical pandemic programs, like funding for providers to test and treat the uninsured. The Senate is likely to consider the Supreme Court nomination of Ketanji Brown Jackson next week, eating time into the chamber's calendar. Congress is then set to begin a two-week recess on April 9, raising fears that failing to secure a deal could stall the country's pandemic response in May. Yet clinching such a deal would end a three-week stalemate on new coronavirus cash, after the dollars were stripped last month from a long-term plan to fund the government. | - Senate Minority Leader Mitch McConnell (R-Ky.) told The Health 202 he was "optimistic" a final deal would be reached. His posture was echoed by Senate Majority Leader Chuck Schumer (D-N.Y.) in remarks on the Senate floor.
- On the other side of the Capitol, House Speaker Nancy Pelosi (D-Calif.) said, "this is not enough money," estimating it probably wouldn't last past June 1. However, she didn't say that House Democrats would oppose a pared-back package. Some in her caucus are already threatening to withhold their support if funds to help with vaccinations abroad drop out of the package.
| | More from Dan: |  | | | | | In a sense, the potential deal is sure to be a disappointment to White House officials who were seeking more than double that amount. Funding to support global vaccinations could be set at $1 billion, down from the Biden administration's $5 billion request. But still, the effort represents the administration's best chance to get the funds it's desperately seeking. Here's what we know so far — with the caveat that there's not a deal until it's in ink. | - About half of the money, $5 billion, would go toward covid-19 therapeutics, per Sen. Roy Blunt (R-Mo.).
- The Department of Health and Human Services would have some "discretion" over the other half.
- About $750 million could go toward research and development of new vaccines and treatments, a Republican aide said.
| | As of yesterday afternoon, funding for global aid appeared to be in flux. Lawmakers acknowledged that they're still negotiating here, while several Democrats lobby for more. Sen. Chris Coons (D-Del.) is among those pushing to include some funding for the global response after some lawmakers moved to exclude it entirely from the package. He'd like to increase the potential compromise's top-line number, so as to secure more foreign aid, though he said he recognizes there's broader dynamics at play. Dropping this provision entirely could be a problem for some Democrats, who have called for as much as $17 billion in global covid funds. For instance: Rep. Tom Malinowski (D-N.J.), vice chair of the House Committee on Foreign Affairs, told Dan that he wouldn't support a funding package if it didn't include some money for the global response. | - "I recall the president saying that the United States should be, would be, the 'arsenal of vaccines,' " he said. "And I'm extremely disappointed that ever since that statement, and at every possible opportunity, this has been deprioritized."
| | Rep. Raja Krishnamoorthi (D-Ill.): |  | | | | | |  | Agency alert | | ARPA-H finds a home, but not everyone is happy |  Health and Human Services Secretary Xavier Becerra testifies before a House Energy and Commerce subcommittee Thursday. (J. Scott Applewhite/AP) | | | President Biden's new research agency to speed up medical breakthroughs will be a wing of the National Institutes of Health, HHS Secretary Xavier Becerra said during a House Appropriations subcommittee hearing yesterday. The decision comes after extended debate among lawmakers over whether the Advanced Research Projects Agency for Health (ARPA-H) should be an independent branch of HHS or housed within NIH, amid bipartisan concerns about its autonomy. The agency's director will report directly to Becerra, rather than the head of NIH — an effort to show "autonomy," Becerra said — and will likely only serve in the role for three to five years. Stat first reported the news. But some lawmakers are already voicing their displeasure. | - "The decision to place ARPA-H within the NIH, I believe is a mistake and will hamper the agency's ability to achieve these breakthroughs," the panel's chair, Rep. Rosa L. DeLauro (D-Conn.), said at the hearing.
- "Today's decision to place ARPA-H in the organizational chart of NIH is an opportunity squandered," Rep. Anna Eshoo (D-Calif.), the chair of the House Energy and Commerce health subcommittee, said in a statement.
| | The defense: Becerra said housing the new entity within NIH will allow it to use the administrative framework already in place rather than start from scratch. But the new agency will have its own separate physical location. | - "We don't want them to worry about who's going to run HR … instead of who's going to come up with the next innovation," Becerra told lawmakers.
| | Rep. Anna G. Eshoo (D-Calif.): |  | | | | | |  | On the Hill | | House passes bill to cap insulin prices at $35 per month | | In a 232-to-193 vote, the chamber passed the measure aimed at curbing how much patients spend on a lifesaving medication that's long been the poster child for high drug prices. The move will also give Democrats a politically popular measure to campaign on. One in 5 people who take insulin and have health coverage through a large employer would save money under such a proposal, per the Kaiser Family Foundation. The measure garnered support from only a dozen Republicans, with some in the GOP characterizing the policy as "price fixing." Some — such as the insurance industry — contended the policy doesn't actually lower the price of insulin, and could instead lead to higher premiums. But the Senate is hashing out a broader insulin proposal. Sens. Jeanne Shaheen (D-N.H.) and Susan Collins (R-Maine) are working on legislation aimed at driving down the list price, which would also include the $35 cap proposal from Sen. Raphael Warnock (D-Ga.). Schumer's goal is to bring such a measure up for a vote sometime after the Easter recess. | | Rep. Dean Phillips (D-Minn.) |  | | | | | |  | From our reporters' notebooks | | | Our colleague Akilah Johnson, who covers health disparities for The Post, sends us this dispatch on the latest on maternal health: Louisiana will join Illinois, Virginia and New Jersey in extending Medicaid coverage for a full year after a woman gives birth, the Centers for Medicare and Medicaid Services plans to announce today. The background: All states provide Medicaid coverage to low-income women who are pregnant, and the safety-net program covers 42 percent of the country's births. But coverage runs out 60 days after delivery, causing many women to become uninsured shortly after giving birth. Democrats' coronavirus relief bill, passed last year, let states extend health insurance benefits to 12-months postpartum and federal funding is provided to do so. By the numbers: Nine states are seeking CMS approval to extend postpartum coverage, the agency said. | - The United States has one of the highest rates of maternal mortality of high-income countries, with one-third of maternal deaths occurring between one week to a year after pregnancy. The situation is more dire for Black, American Indian and Alaska Native women, who are five times more likely to die from pregnancy than their White peers.
| | Also on tap today: An announcement of $4.5 million in funding to hire, train, certify and pay community-based doulas in areas with high rates of adverse maternal and infant health outcomes as to further address the nation's Black maternal mortality and morbidity crisis. | | |  | Mental health | | Teen mental health is in steep decline, CDC says |  Biden health officials warn about rising rates of poor mental health among minors. (iStock) | | | Officials at the Centers for Disease Control and Prevention are raising the alarm about a worsening mental health crisis among adolescents, with more than 4 in 10 teens reporting they feel "persistently sad or hopeless" in a survey released Thursday, our colleague Moriah Balingit reports. The findings come from a survey of a nationally representative sample of 7,700 teens conducted in the first six months of 2021, when they were in the middle of the first full pandemic school year. By the numbers: | - 1 in 5 teens said they had contemplated suicide.
- Nearly half of LGBTQ students said they had contemplated suicide during the pandemic, compared with 14 percent of their heterosexual classmates.
- Girls were twice as likely to report that they'd seriously contemplated suicide compared with boys, and also disclosed higher rates of drinking and tobacco use.
| | Teens have been reporting higher rates of poor mental health for years. Between 2009-2019, the percentage of teens saying they have continuous feelings of sadness or hopelessness rose from 26 percent to 37 percent. But last year, that figure climbed to 44 percent. | | |  | In other health news | | - William Burns, director of the CIA, tested positive for the coronavirus on Thursday — a day after wearing an N95 mask in a socially distanced meeting with Biden — and is experiencing mild symptoms.
- State health departments need 2,196 more epidemiologists in order to be able to provide basic public health services, the CDC said in a report yesterday, underscoring the public health workforce's unmet need.
- Starting April 11, U.S. citizens will be allowed to select an "X" as their gender marker on passport applications, the Biden administration announced Thursday alongside a slate of actions mark transgender visibility day, The Post's Eugene Scott and John Wagner report.
| | Secretary of State Antony Blinken: |  | | | | | |  | Quote of the week | | | Janis Orlowski, Association of American Medical Colleges' chief health care officer | "It's not vaccine hesitancy, it's vaccine strategy," Orlowski said of Americans' new tactic of waiting to get another booster shot until a life event, such as a vacation. | | | | | | | |  | Sugar rush | | | Thanks for reading! See y'all Monday. | | | | | | | |
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