| Welcome to Wednesday's Health 202, where Biden's State of the Union was shorter than we predicted (maybe we all got a few more minutes of sleep?) The speech clocked in at about an hour and two minutes, slightly shorter than the address he delivered last year — and briefer than Trump's average. Today's edition: The White House will unveil details of its coronavirus roadmap to safely get back to normal. And experts fear a "double crisis" of war and disease in Ukraine. But first … | This was clear in last night's SOTU: Biden's health-care wish list is still…a wish list |  President Biden sought a reset on his legislative agenda and the pandemic during last night's State of the Union. Saul Loeb/Pool via REUTERS | | | President Biden wants Congress to cap the cost of insulin. Close the Medicaid coverage gap. And make new Obamacare financial aid permanent. In name-checking those policies, Biden evoked the ghost of Build Back Better. But during last night's State of the Union, Biden was careful not to utter the name of the legislation languishing on Capitol Hill. The subtext: He's prodding Congress to give him wins on smaller bites of the legislative package that wrapped his health-care and economic ambitions into one sprawling bill. It's a capitulation to the reality that his bolder, broader agenda is stymied on the Hill. For a moment, his words felt pointed squarely at Sen. Joe Manchin (D-W.Va.), who has repeatedly cited concerns over the 40-year high inflation rate in his opposition to passing a massive package. | - "I call it building a better America," Biden said. "My plan to fight inflation will lower your costs and lower the deficit."
| | The speech came at an inflection point for Biden's health-care agenda and pandemic response. Democrats are resetting expectations for how much of their legislative ambitions can get done before the midterms. And the White House has taken a cautiously optimistic tone on the next phase of the coronavirus as it seeks its own pandemic reset. | | The speech came at a markedly different point in Biden's presidency than last year's joint address to Congress. His approval rating is at a new low. The cost of groceries and gas has skyrocketed. And the administration is grappling with a war in Ukraine. | | Alexander Bolton, The Hill |  | | | | | On health care, the speech included a list of pledges not yet fulfilled. If some of the big-ticket health provisions sound familiar, it's because Biden called for their passage during last April's address on Capitol Hill. Both speeches urged Congress to let Medicare negotiate drug prices and expand Obamacare subsidies for good. The policies are politically popular and could very well be included in some scaled-back version of Biden's stalled social spending bill. But the list of Democratic health-care goals has been fine-tuned since then. | - For instance: Biden also gave a shout-out to capping the price of insulin and extending Medicaid coverage to 2.2 million poor adults — two measures that weren't a Democratic rallying cry last spring, but were subsequently included in Build Back Better last year.
- "The issue of health care is more front and center, both in the president's agenda and in the public debate and in the legislation that's still alive, albeit by a different name and less robust," said Leslie Dach, founder and chair of Protect Our Care, a Democratic-aligned group.
- Our take: The idea of passing some form of the bill may be alive, but it's hanging by a thread — and the next few weeks are critical to see if lawmakers can jump-start the effort. We're watching whether the committees of jurisdiction announce hearings to appease Manchin's call for any package to move through the legislative process.
| | The scene in the House chamber resembled the pre-pandemic days, with lawmakers ditching their masks, shaking hands and talking within inches of each other. | - "Thanks to the progress we have made this past year, covid-19 no longer need control our lives," Biden said, as he declared a pandemic reset. "We'll continue to combat the virus as we do other diseases. And because this is a virus that mutates and spreads, we will stay on guard."
| | Biden — who was maskless himself — sought to reassure Americans that his efforts to curb the pandemic had made them safer. Yet, he took pains to avoid last summer's premature victory lap just before the delta variant's deadly surge, our colleagues Yasmeen Abutaleb, Lena H. Sun and Dan Diamond write. On tap today: Administration officials will unveil details of their new approach to the pandemic. The roadmap will focus on four goals, per our health team colleagues: 1) protecting against and treating covid-19, including a "test to treat" initiative to give out antiviral pills when people test positive at a pharmacy, 2) prepping for a potentially dangerous new variant, 3) preventing economic and educational shutdowns, and 4) expanding vaccinations worldwide. | | |  | State of the Union | | Biden also briefly mentioned the opioid epidemic, the country's mental health crisis and Roe v. Wade | | On mental health: White House officials laid out a new strategy ahead of the speech as Biden pitches policies he thinks can get bipartisan buy in. The effort includes investing in programs to train behavioral health providers and expanding access to virtual care. | - Starting this summer, Americans can call "988" and reach the national mental health crisis hotline. Officials said Biden's upcoming budget will include a nearly $700 million ask to build up that response.
- Biden wants Congress to pass new protections for children's personal data online and to ban digital ads targeting them, our colleague Cristiano Lima reports.
- A senior administration official declined to outline the full cost of the plan, saying that would come when Biden released his budget.
| | Larry Levitt, Kaiser Family Foundation executive vice president: |  | | | | | On drug addiction: Biden called for increased funding for prevention, treatment, harm reduction and recovery. What's particularly notable is the mention of "harm reduction" — a divisive concept his administration is the first to fully embrace. It includes efforts like increasing access to the lifesaving opioid overdose reversal drug, fentanyl test strips and syringe service programs. | | On abortion: Much like Build Back Better, Biden didn't actually utter the word "abortion." But he alluded to it by saying "the constitutional right affirmed in Roe v. Wade…is under attack as never before." | Guest list: Who went and who skipped the president's first SOTU | | First lady Jill Biden invited seventh-grader Joshua Davis from Virginia, a Type I diabetic and advocate; Refynd Duro, a nurse treating coronavirus patients at an Ohio hospital; and others like Ukraine's ambassador to the U.S. Oksana Markarova. Unlike last year, all 535 members of Congress — but no guests — were invited to attend Biden's address thanks to relaxed coronavirus measures. Also, five of the nine Supreme Court justices and about 20 Cabinet members attended the event. (Gina Raimondo, the Commerce secretary, was the designated survivor.) While the Hill ditched its mandate on face coverings before the event, attendees were required to show proof of a negative PCR test one day before the speech. | - Lawmakers testing positive: Democratic Reps. Jamie Raskin (Md.), Suzan DelBene (Wash.), Pete Aguilar (Calif.), Ted Deutch (Fla.) and Dwight Evans (Pa.), along with Sen. Alex Padilla (D-Calif.), announced they'd tested positive for the coronavirus before the event.
- At least one Republican congressman Rep. Mike Bost (Ill.) also announced that he had tested positive for the coronavirus for a second time ahead of the event.
| | Sen. Alex Padilla: |  | | | | | Meanwhile, the testing mandate caused a rift among some lawmakers. Republicans boycott: Several GOP lawmakers skipped the address because of the mandated coronavirus tests, including but not limited to: Sen. Marco Rubio (Fla.), Rep. Thomas Massie (Ky.) and Rep. Chip Roy (Texas). | | Rep. Thomas Massie (R-Ky.) |  | | | | Lawmakers gathered, embraced, cheered and booed, mostly without masks | | Mask watch: Tiny Ukrainian flags and blue and yellow scarves may have outnumbered masks at Biden's State of the Union address, after the Capitol's attending physician Brian P. Monahan dropped the requirement for face coverings at the event earlier this week. Top Democrats, including Joe and Jill Biden, didn't wear masks to the event, following updated guidance from the Centers for Disease Control and Prevention that said much of the country could go without face coverings in their daily lives. | - House Speaker Nancy Pelosi (D-Calif.) also decided against wearing a mask to the speech, calling it a decision people should make using their own judgment.
| | But others kept their face coverings on to send a message. | | Sen. Ed Markey (D-Mass.): |  | | | | | |  | Global health | | 'Double crisis' of war and disease in Ukraine |  Women and children refugees fleeing the Russian invasion from Ukraine board a bus to Warsaw in Przemysl, Poland. (Visar Kryeziu/AP) | | | As thousands of refugees flee Ukraine, global health officials are raising concerns about the ramifications of Russia's invasion on the country's fragile health-care system amid the pandemic, The Post's Dan Diamond and Loveday Morris report. | - A "health system cannot function during an active bombing campaign," said Rachel Silverman, a policy fellow at the Center for Global Development. "They must evacuate patients from hospitals, all routine services will be put on hold, many facilities will be damaged and health workers will flee."
| | More than half a million people have fled Ukraine in recent days. Some experts worry the regional conflict will trigger new spikes of the coronavirus just months after the country experienced some of the world's highest virus rates. | - Health officials warn that Ukraine is surrounded by countries with some of the lowest vaccination rates in Europe, which could result in new waves of the coronavirus in nearby regions as refugees pour in.
- Ukraine's hospitals are running out of critical medical supplies. The country's health workers and patients are relocating to makeshift shelters. And some experts fear the dynamic could also exacerbate the country's polio outbreak.
- One top U.S. official said as many as 5 million refugees could flee Ukraine in the coming weeks.
| | Meanwhile, Pelosi joined a growing chorus of current and former U.S. and allied officials speculating about the health of Russian President Vladimir Putin. | - "Some people say he has cancer, and some people say he has brain fog from covid, other people just think he's a complete raging bully," Pelosi said yesterday during an interview on MSNBC. "But whatever it is, the people of Ukraine are paying the price for it."
| | |  | In other health news | | - Texas primary: The race that could oust the last antiabortion House Democrat is in a runoff. Nine-term incumbent Rep. Henry Cuellar and immigration lawyer Jessica Cisneros will square off again in May.
- On tap today: The Senate will vote on a Republican measure attempting to nix Biden's vaccine mandate for health-care workers. Per a Senate Democratic aide: "If it passes, this won't go anywhere in the House and President Biden would veto it."
- The Federal Emergency Management Agency will continue to reimburse covid-19 emergency response costs to states, tribes and territories through July 1, the White House announced Tuesday.
| | |  | Health reads | | By Lena H. Sun and Laurie McGinley l The Washington Post ● Read more » | | | | | |  | Sugar rush | | | Thanks for reading! See y'all tomorrow. | |
