President Joe Biden delivers remarks Nov. 15, 2021, on the south lawn of the White House (Official White House photo by Cameron Smith).

WASHINGTON — Among the most potentially transformational changes in the Democrats’ massive social and climate bill pending in the Senate are a set of long-sought changes intended to tamp down the fast-rising cost of prescription drugs.

The $2 trillion spending package would ensure Americans don’t pay more than $35 when they pick up a new vial of insulin from their pharmacy, and would penalize drugmakers if they hike medicine prices faster than the inflation rate.

It also would, for the first time, allow Medicare to negotiate the prices of some of the most expensive drugs it provides to seniors.

But it’s not clear if several of the provisions aimed at finally taking substantive action on soaring drug prices will remain in the final version of the bill, known as “Build Back Better.”

That decision will be up to the Senate parliamentarian, who has been meeting privately with senators from both parties to issue guidance on whether certain pieces of the massive bill comply with the chamber’s rules.

The path forward is tricky logistically because Democrats are using the reconciliation process to advance the measure with just 50 votes instead of the typical 60 needed. That means they can push through legislation without winning support from any Republicans.

The closed-door discussions have not been publicly relayed by lawmakers in the room. But reports from Politico and other news outlets have suggested that GOP opponents are challenging whether aspects that apply to private insurance plans comply with a Senate rule requiring provisions in a reconciliation bill to directly affect federal spending or revenue.

Democrats have said they are cautiously optimistic the provisions will survive, and have defended them as long overdue help for those struggling to afford health care.

“They’re way out of step with the American people if they somehow think that a $35 insurance copay (for insulin) … is somehow not something the American people approve of,” said Sen. Ron Wyden, an Oregon Democrat and the top lawmaker on the Finance Committee, which is heavily involved in crafting the proposal.

Sky-high drug prices

Should the drug-pricing provisions survive, experts say the proposed set of policy changes would make a start toward price reductions, though the effort won’t entirely solve the drug-pricing crisis

“The pharmaceutical industry is perhaps the most powerful lobby of any of the lobbies in the country,” said Dr. Paul Ginsburg, a professor of health policy at the University of Southern California and a nonresident senior fellow at the Brookings Institution.

“They are a formidable opponent. Some people are pleasantly surprised that anything can be done that lowers drug prices.”

Some proposals are recycled from past legislation, such as capping out-of-pocket drug costs for those enrolled in Medicare Part D, and the inflation cap, which previously passed out of the Senate Finance panel but never were taken up on the floor.

The out-of-pocket cap for Medicare Part D would start at $2,000 in 2024. Drugmakers also would be required to pay rebates to patients if they raise prices faster than inflation.

On negotiating drug prices, the Democrats’ package doesn’t go as far as a recent House measure, H.R. 3, which Ginsburg characterized as changing minds about what the federal government could do to implement pricing reforms.

That earlier measure would have made deeper price cuts, tying prices to cheaper ones abroad, and more drugs would have been reviewed. Still, the version in Build Back Better, which would begin in 2025, would start with negotiations over 10 high-priced drugs, and increase the number over time, reaching 100 in six years.

“I think it will be a building block,” Ginsburg said, noting the strong public support for continuing to find ways to reduce rising costs.

House Democrats touted the pending provisions when they released a scathing report recently blasting the business practices of drug manufacturers that have led to the soaring prices.

“The evidence overwhelmingly supports the need to pass the Build Back Better Act, which will empower Medicare to negotiate for lower prices, restrain price increases, and cap out-of-pocket patient costs for insulin and other drugs,” wrote House Oversight Committee Chairwoman Carolyn Maloney, (D-N.Y.).

The bill wouldn’t address some practices criticized in the House report, such as manufacturers making small tweaks that allow them to avoid competition for longer periods of time.

Still, the spending package has drawn strong opposition from the pharmaceutical lobby, which has said it ignores the role of insurance companies in rising prices, and would curtail research investments needed to make breakthroughs on new treatments.

“The bill inserts the heavy hand of government into America’s medicine cabinet, and we know when government bureaucrats set the price of medicine, patients ultimately have less access to treatments and cures,” said Stephen Ubl, president and CEO of Pharmaceutical Research and Manufacturers of America, the largest drugmaker lobbying group.

‘We will wait for a call’

It’s unclear when the Senate parliamentarian, Elizabeth MacDonough, may offer guidance on the drug-pricing provisions.

MacDonough, who is nonpartisan and provides advice and help on Senate rules and procedures, already nixed a set of immigration proposals from the bill. That section was aimed at providing temporary protections for undocumented immigrants.

“The parliamentarian is the umpire,” Wyden told reporters during a recent Capitol hallway scrum. “We will wait for a call, and then we’ll make decisions.”

President Joe Biden has urged the Senate to get the bill to his desk, holding a recent event at the White House with a young woman who has struggled to afford her insulin.

“We can agree that prescription drugs are outrageously expensive in this country,” Biden said at the White House. “It doesn’t need to be that way.”

Dr. Robert Califf, shown here in a file photo from November 2015, is President Biden’s nominee to lead the U.S. Food and Drug Administration (Photo by Win McNamee/Getty Images).

WASHINGTON — President Joe Biden’s pick to lead the Food and Drug Administration drew praise from a top Senate Republican, as well as critical questions from conservatives and others during a Tuesday confirmation hearing.

Dr. Robert Califf fielded queries on his ties to the pharmaceutical industry, the pandemic-loosened rules around abortion drugs, and frustrations involving COVID-19 rapid tests.

Califf, 70, is familiar with the role he’s been tapped for: He ran the FDA during the last year of the Obama administration. A cardiologist by training, Califf also served as the agency’s deputy commissioner for medical products and tobacco.

Before those stints with the FDA, he was a professor of medicine at Duke University in North Carolina, where Califf ran the Duke Translational Medicine Institute and the Duke Clinical Research Institute. More recently, he has served as an adviser to San Francisco-based Verily Life Sciences and Google Health.

“I’m not sure you could write a resume of somebody more qualified to be considered for commissioner of the FDA than Rob Califf,” said Sen. Richard Burr, (R-N.C.), the ranking member of the Senate Health, Education, Labor and Pensions Committee. Burr said that he will be urging his GOP colleagues to back the Biden nominee.

If confirmed by the evenly divided Senate, Califf would become the first permanent head of the FDA under the Biden administration — nearly one year after the president took office.

He would helm an agency that has faced mounting criticism for decisions throughout the pandemic, with rebuilding public trust likely to be a key task.

Criticism over pharma ties

During Tuesday’s hearing, Califf’s work with major pharmaceutical companies drew sharp words from Sen. Bernie Sanders, (I-Vt.), who fumed that nine out of the last 10 FDA commissioners have gone on to work for the pharmaceutical industry.

“Unfortunately, Dr. Califf, you are not the exception to that rule,” Sanders said, noting the nominee’s consulting work and tallying up to $8 million in pharmaceutical stocks on his financial disclosure form. “How can the American people feel comfortable you’re going to stand up to this powerful special interest?”

Califf responded by pointing to the Biden administration’s ethics pledge, saying he’s agreed to abide by strict ethics guidelines and will be held accountable if he falls short.

He also stated that he is on record with his support of allowing Medicare to negotiate with drug manufacturers in an effort to reduce soaring prescription costs.

Sanders isn’t the only senator to have viewed Califf’s pharma ties skeptically: Sen. Joe Manchin III, a West Virginia Democrat, has said he will oppose Califf’s nomination.

Manchin also opposed Califf in 2016 because the senator believes “correcting the culture at the FDA is critical to changing the tide of the opioid epidemic.” According to the West Virginia attorney general’s office, the state has “one of the highest rates in the country of non-medical use of prescription pain relievers among 19-to-25-year-olds.”

Eased access to medication abortion

Several Republican senators, including Sen. Roger Marshall of Kansas, attempted to nail down Califf on whether he supports continuing or undoing the easing of restrictions that allowed for mail-order medication abortion during the COVID-19 pandemic.

A lawsuit last year prompted the FDA to suspend during the public health emergency a requirement that mifepristone must be dispensed in person. Marshall referred to the suspension as a “casual attitude” by the agency to making mifepristone available.

A review of the regulations surrounding those abortion drugs is currently underway, and Califf noted that he’s not yet a part of any discussions.

“I think the FDA has to make this decision based on the latest data in the scientific principles,” he said, adding that he trusts the agency staff to make good decisions.

Sen. Patty Murray, (D-Wash.), who is the panel’s top Democrat, returned to the issue at the end of the hearing, telling Califf that she expects any decision on access to medication abortion to be “governed by data, not by politics.”

Rapid test availability 

Much of the agency’s work will remain focused for some time on snuffing out future variants of COVID-19, and ensuring access to the vaccines and tests necessary for the nation to fully return to normal.

Califf acknowledged the difficulties surrounding the lack of access to testing, which the Biden administration has proposed to ease through insurance reimbursement and free tests for those lacking insurance.

He offered few specific policy steps, but described rapid testing as a personal issue for him. His son, Sam, had been feeling a little off ahead of traveling to D.C., but was able to get a rapid test at a pharmacy.

“It was negative, and then we all felt okay about Sam getting on the plane,” Califf said. “And so I think we really have got to redouble our efforts now with omicron.”

Califf also emphasized that more testing allows for catching infections earlier, which can increase the effectiveness of newer antiviral treatments, like a COVID-19 pill touted by Pfizer earlier on Tuesday as highly protective against severe disease.

“There’s a saying: In God we trust. All others must bring data,” Califf quipped, adding that he looks forward to reading the agency’s evaluation of the new antiviral pill.

The deaths data, which the department calls “probable” COVID-19 fatalities, is being added eight months after the department began reporting antigen-identified infections in its daily report (image courtesy of CDC).

Former Sen. Elizabeth Dole rests her head on the casket of her husband and former Sen. Bob Dole, R-Kan., Thursday in the Rotunda of the U.S. Capitol building, where he lays in state. (Jabin Botsford-Pool/Getty Images)

WASHINGTON — Former U.S. Sen. Robert J. Dole arrived at the U.S. Capitol for the final time on Thursday, for a Rotunda ceremony in which former colleagues and congressional leaders from both parties honored the life and career of the late Kansas political icon. 

President Joe Biden and others remembered Dole — who died Sunday at age 98, after being diagnosed earlier this year with stage 4 lung cancer — as a World War II veteran, a public servant, an acerbic comedian, and an advocate for the disabled.

“He too was a giant of our history. That’s not hyperbole,” said Biden after listing many of the former presidents and other icons memorialized in the U.S. Capitol — including another notable Kansan, former President Dwight D. Eisenhower, whose bronze sculpture is on display in the Rotunda.

Like Washington, Lincoln and those other towering figures, Biden said, Dole was a man “of wit and grace, of principle and persistence, of courage and conviction.”

The ceremony as Dole’s body lay in state — an honor bestowed on former presidents, senators and some military leaders — was witnessed by a limited, bipartisan crowd. Usually, the public also is allowed to pay their respects as well, but a broader viewing was eschewed due to the pandemic.

Still, the audience of invited guests reflected the across-the-aisle respect for Dole: much of the current Senate was seated surrounding his casket, as were a number of U.S. House members and an array of former lawmakers who served with the senator, close aides, and other friends.

First lady Jill Biden also joined her husband, along with Vice President Kamala Harris and second gentleman Doug Emhoff.

Other attendees included the full current congressional delegation from Kansas, as well as former Sens. Pat Roberts, R-Kan., Tom Daschle, D-S.D., Dan Coates, R-Ind. and Trent Lott, R-Miss., according to a list provided to the reporter pool.

His longtime wife, Elizabeth, and daughter, Robin, were escorted by service members for the formal arrival of his casket.

Praised for bipartisan approach

Top congressional leaders from both parties offered tributes to the Republican from Russell, Kansas, who served four terms in the House and more than four terms in the Senate, including more than a decade as the Senate Republican leader.

He stepped away from that political role after winning the Republican Party’s presidential nomination in 1996. He previously was the vice presidential nominee, running with President Gerald Ford in 1976.

In a legislative building grappling with a level of polarization and distrust among lawmakers that has paralyzed progress on many issues, Dole was praised as someone who worked with colleagues from both parties, and on a range of challenges facing struggling Americans. 

Biden, a Democrat, said that he and Dole disagreed on some matters, “but not on the fundamental things.”

“We still found a way to work together. We genuinely, we genuinely respected one another as colleagues, as fellow Americans,” Biden said. “It was real. It wasn’t fake. And we became great friends.”

House Speaker Nancy Pelosi (D-Calif.) lauded his efforts on expanding access to food stamps and his critical efforts in passing the landmark Americans with Disabilities Act. Dole suffered combat injuries during World War II that limited the mobility of his right arm for the rest of his life. 

“Bob Dole was a champion of those whose lives were marred by struggle, who came not from citadels of privilege, but from humble origins like his own,” said Senate Majority Leader Chuck Schumer (D-N.Y.).

They also remembered Dole’s penchant for humor. Senate Minority Leader Mitch McConnell (R-Ky.) recalled then-Majority Leader Dole quipping that if he “had known we were going to win control of the Senate, we’d have run better candidates.”

Schumer riffed on the oft-cited quote from Dole about the “danger” of standing between Schumer and a reporter: “Don’t worry, Bob. It’s safe to be between me and the cameras today.”

He also described the emotional moment that unfolded when late Hawaii Sen. Daniel Inouye was given the same Capitol honor in 2012. Dole had recuperated from the wounds he suffered in World War II at the same military hospital as Inouye, and when he approached the casket, Dole rose from his wheelchair to offer a salute.

“As Bob approaches the pearly gates, let us take comfort he can reunite with his old friend once again,” Schumer said.

D.C. funeral on Friday, and a return to Kansas

After the words of remembrance, Biden and congressional leaders placed wreaths next to the casket. Biden put his hand on his heart while he stood by the wreath, and grabbed both of Elizabeth Dole’s hands on his way back to his seat.

When she approached the flag-draped casket, Elizabeth Dole briefly put her hand and then her head to the casket. 

Dole’s remains will remain overnight in the Rotunda, where other lawmakers and Capitol staffers were allowed to pay respects Thursday afternoon. At one point, Sen. Tammy Duckworth (D-Ill.), a combat veteran who was wounded during the Iraq War, offered a salute.

On Friday morning, there will be a formal departure ceremony, and then a funeral service at Washington National Cathedral.

His casket is set to arrive in Kansas on Friday evening, followed by a public memorial service and a ceremony at the Kansas statehouse on Saturday.

The Center for Medicare and Medicaid Services announced Thursday that eligible pharmacies and participating organizations will begin distributing the tests in the coming months to individuals on either original Medicare or in Medicare Advantage plans (Laura Olson/States Newsroom).

WASHINGTON — State health officials on Thursday welcomed the Biden administration’s plan to require private health insurers to reimburse Americans for the cost of rapid, at-home COVID-19 tests — though the officials also raised questions about whether the process will be burdensome.

Making those tests more accessible will allow Americans to get results quickly and in the privacy of their own homes. That change may encourage more people to swab their nose when they first notice potential symptoms, experts from the Association of State and Territorial Health Officials told reporters.

“In this next phase of the pandemic, rapid access to rapid testing will be key,” said Nirav Shah, director of Maine’s Centers for Disease Control and Prevention, adding that it can help to combat potential surges and to pinpoint infections quickly so antiviral treatments can be used.

But several challenges could limit the impact of the cost reduction.

That includes lingering problems with sufficient supplies, uncertainty about the details of the reimbursement process, and questions about any potential effect on the data that’s reaching state and local health departments about infections in their communities.

Official guidance in January

Under the proposal that President Joe Biden announced Thursday, three federal departments — Health and Human Services, Labor and the Treasury — will issue official guidance by Jan. 15 that will detail what exactly private insurers must cover when it comes to rapid COVID-19 tests.

Those insurers already are required to pay for the PCR tests that must be sent to a laboratory for processing and take longer for results.

The upcoming change requiring insurance coverage of rapid, at-home tests, won’t be retroactive. That means Americans who have been shelling out roughly $25 for a package containing two of the popular Abbott BinaxNOW rapid tests can’t submit receipts for tests they’ve already purchased.

Other details of that requirement were unclear Thursday, including if there will be any limitations on the number of at-home tests that must be covered.

While the Biden administration has sought to reduce supply bottlenecks in producing those tests, Shah said some states are still having difficulty acquiring large volumes of the Abbott at-home tests.

That brand, which has been found to be highly accurate, has been relied on heavily even as more options have come on the market. Part of that demand comes from familiarity: Those administering tests in large settings have become familiar with their use.

What if you test positive?

Another challenge with increasing the use of at-home tests will be ensuring that individuals know what to do if they test positive.

Michael Fraser, ASTHO’s chief executive officer, said state health officials have been discussing whether those at-home tests should include an insert to help explain who to call and other next steps, so that contact tracing can occur.

“There is some concern that with the increase in at-home testing, getting those results reported to state health departments might be difficult, because the result doesn’t automatically go to public health authorities,” Fraser said.

However, there won’t be many results to get to state and local health officials if Americans with private insurance balk at fronting the money for tests while they await reimbursement.

Shah said a more accessible model would be to have individuals show their insurance card at a pharmacy as they would when getting a flu shot or picking up a prescription, rather than being charged at the register.

Having to pay for the tests, then wait for repayment, “introduces an access challenge for a lot of folks,” he said.

The Biden administration also plans to boost the number of free at-home tests distributed at community health centers and rural clinics, though those are intended to aid those who are not covered by private insurance.

President Joe Biden delivers remarks Nov. 15, 2021, on the south lawn of the White House (Official White House photo by Cameron Smith).

WASHINGTON — Reimbursements for at-home rapid COVID-19 tests. Tougher testing requirements for international travelers. More emergency response teams to aid states combating infection spikes.

And another big push to get Americans vaccinated.

Those are the latest steps to fight COVID-19 that President Joe Biden will be announcing Thursday, according to senior administration officials who briefed reporters Wednesday night on the efforts to stay ahead of a new, unknown variant of the virus and the next wave of infections.

Most significant for Americans who have been shelling out $25 for a package of two rapid COVID-19 tests will be the upcoming requirement that private health insurers reimburse the cost of those at-home tests.

The U.S. has lagged far behind other countries in the production and use of those tests. The Biden administration has sought to speed up both the approval and manufacturing processes, and to lower the cost.

By Jan. 15, officials with the departments of Health and Human Services, Labor and the Treasury will issue guidance to ensure that the 150 million Americans with private insurance can seek reimbursement for the cost of those rapid tests, according to a background memo ahead of the president’s announcement.

Federal officials also will increase the number of rapid tests that are distributed at no cost through community health centers and rural clinics.

Biden is scheduled to deliver remarks on the plan Thursday afternoon at the National Institutes of Health in Bethesda, Md.

New travel rules

Little remains known about the new omicron variant of COVID-19, which was first identified in South Africa late last month. Federal health officials said Wednesday that the first U.S. case has been identified in California, where a traveler who returned from South Africa tested positive on Nov. 29.

Early next week, the federal government will tighten testing protocols for all inbound international travelers, who will need to test within one day of their departure for the U.S., regardless of their nationality or vaccination status.

Domestic travelers also will need to keep wearing their face masks a little longer, with a masking requirement on public travel extended through March 18.

Next phase of vaccine push

Public health officials believe the current vaccines will continue to offer at least some protection against the new variant. Boosters are expected to further increase that protection, and administration officials say they are urging all eligible adults to get a booster shot.

That message will be reinforced through outreach campaigns by pharmacies, AARP and Medicare.

To increase vaccine uptake among eligible children, Medicaid will pay health care providers to talk to families about getting their kids over 5 vaccinated. New family vaccine clinics will launch to encourage adults and children to get their shots at the same time.

Help for schools, states

The new actions also will include a review of school quarantine policies, in an attempt to minimize disruptions to classroom time and parents’ work schedules.

The Centers for Disease Control and Prevention is expected to release in the coming weeks its review of alternatives to a 14-day quarantine that some districts have tried, such as allowing students to remain in school after a potential exposure if they pass a rapid test.

States also will be able to tap more help as they battle rising case counts.

Some 60 emergency response teams will be on call to aid state officials, with clinical staffers, teams trained in using monoclonal antibody treatments, and epidemiological experts to conduct outbreak infections.

Similar teams assisted 27 states during the summer and fall surge, according to the administration.

The U.S. Supreme Court in Washington, D.C. (Laura Olson/States Newsroom).

WASHINGTON — The Supreme Court is weighing potentially sweeping changes to the right to an abortion, after two hours of arguments Wednesday morning on a Mississippi law that bans most abortions after 15 weeks of pregnancy.

The court’s conservatives, who hold a 6-3 majority, appeared through their questions to be sympathetic to Mississippi’s arguments that its law should be upheld—and they also seemed open to the possibility of undoing other precedent-setting abortion cases.

Supporters of the Mississippi law argued not only that it should be upheld, but that two key cases that have determined when a woman has the right to seek an abortion also should be overturned: the 1973 Roe v. Wade decision as well as the 1992 Planned Parenthood v. Casey ruling.

That would allow states to decide if they want to allow the medical procedure within their borders, the lawyers contended.

“When an issue affects everyone, and when the Constitution does not take sides on it, it belongs to the people,” said Mississippi Solicitor General Scott Stewart, arguing that the precedents set in prior landmark abortion cases “have failed.”

Attorneys arguing on behalf of Mississippi’s only abortion clinic and of the federal government told the justices that the right to an abortion was correctly established in the Roe v. Wade decision and then reaffirmed in the Planned Parenthood v. Casey ruling.

Undoing that right would have devastating consequences for people seeking abortions throughout the country, they said.

Some may be forced to travel out of state to seek care. If they lack the money and time off from work to do so, they may have no option beyond carrying a child to term, even if it is not in their best interest or that of their family, the lawyers said.

“There is no less need now than there was 30 years or 50 years ago for women to be able to make this fundamental choice for themselves about their bodies, lives and health,” said Julie Rickelman, senior director of litigation at the Center for Reproductive Rights.

“Why is 15 weeks not enough time?” Chief Justice John Roberts asked Rickelman.

She noted that the Mississippi law would ban most abortions nine weeks earlier than the current legal standard, giving patients less time to navigate an array of regulatory barriers that some states have enacted to make it harder to seek an abortion.

The Roe decision established a legal right to an abortion during the first two trimesters of pregnancy, or 26 weeks. In the Casey decision, the court ruled that people can obtain an abortion until viability, or the point when a fetus can survive outside the womb — generally about 24 weeks.

The case argued Wednesday is Dobbs v. Jackson Women’s Health.

Ramifications for dozens of states   

Wednesday’s hearing came after the top court already has been grappling with abortion rights.

Since announcing in May that the justices would take up the Mississippi case, the court has heard arguments over a Texas law designed to skirt the court’s past decisions and ban abortions about six weeks after a woman’s last menstrual cycle.

The pair of legal battles has thrust the contentious social issue back into the national spotlight, and thousands of activists in both support of and opposition to abortion rights flooded the sidewalks around the court on Wednesday to chant and wave signs.

Dr. Nisha Verma, an obstetrician-gynecologist who practices at Emory University in Atlanta, said she regularly attends local protests in support of abortion access, and is worried about what will happen in her state if Roe is overturned.

Many of her patients don’t know until their second or third trimester that they or their fetus have developed a medical issue that requires terminating a pregnancy, Verma said.

“A lot of times this is an act of compassion, that people are trying to do the right thing in their pregnancy or [for] their existing children,” she said.

The pending abortion case could spur a cascade of legal changes across two dozen states if justices back the restrictive Mississippi law — and potentially dismantle the landmark 1973 ruling affirming the right to an abortion.

A dozen states — including Louisiana, Tennessee, Missouri and Idaho — have “trigger laws” that would go into effect banning abortions if Roe v. Wade is overturned, according to the Guttmacher Institute, an organization focused on reproductive health and rights.

Michigan, Wisconsin, Arizona and five others still have abortion bans that pre-date Roe v. Wade on the books, which would become enforceable again if the case is overturned.

Amanda Davis, of Virginia, said during an interview outside the court on Wednesday that she’s been attending protests against abortion rights since the 1990s. Her faith as a Christian helped her decide.

“The Bible says do not murder, and I consider abortion murder,” Davis said.

Debate over precedents

During Wednesday’s arguments, the court’s liberal members repeatedly emphasized the implications of undoing the prior rulings.

“Will this institution survive the stench that this creates in the public perception that the Constitution and its reading are just political acts?” Justice Sonia Sotomayor asked at one point.

Justice Brett Kavanaugh, one of the justices appointed by former President Donald Trump, giving the court its conservative majority, noted that if the Mississippi law is upheld, states would not be barred from allowing abortion.

He listed a long line of major cases in which the Supreme Court overruled precedents, including Brown v. Board of Education, which found that racial segregation in schools violated the Constitution.

If the court had adhered to its earlier decisions in those cases, Kavanaugh said, “the country would be a much different place.”

Solicitor General Elizabeth Prelogar underscored how deeply the Roe decision has been woven into everyday American life, noting that while some people don’t agree with the decision, they know what the court ruled and what it means if they have an unintended pregnancy.

“For the court to reverse course now, I think would run counter to that societal reliance and the very concept we have of what equality is guaranteed to women in this country,” Prelogar said.

Missouri Attorney General Eric Schmitt presents an award to three St. Charles County police officers on April 21, 2021 (photo courtesy of Missouri Attorney General’s Office).

WASHINGTON — Enforcement of the Biden administration’s vaccine mandate for millions of health care workers was blocked in 10 states on Monday, after a ruling by a federal judge in Missouri.

The ruling by U.S. District Judge Matthew Schelp affects the states involved in the lawsuit, including Missouri.

The others are Iowa, Kansas, New Hampshire, North Dakota, South Dakota, Nebraska, Arkansas, Wyoming and Alaska.

At issue is President Joe Biden’s campaign to ensure that workers throughout the country are vaccinated against COVID-19.

Many private sector employees will be required to get vaccinated or undergo weekly tests, while some 17 million health care providers at facilities participating in the federal Medicare and Medicaid health insurance programs must be vaccinated — with no option to choose weekly testing instead.

Under the requirement, health care workers were to be vaccinated by Jan. 4, 2022.

In his 32-page opinion granting a preliminary injunction while the lawsuit proceeds, Schelp wrote that the state attorneys general challenging the mandate appear likely to succeed in their argument that federal health officials lack the authority to implement the requirement.

He also agreed with claims from the plaintiffs that health care facilities will suffer staffing shortages due to the requirement.

“The public has an interest in stopping the spread of COVID. No one disputes that,” Schelp, who was nominated by President Donald Trump in 2019, wrote in the 32-page opinion. “But the court concludes that the public would suffer little, if any, harm from maintaining the ‘status quo’ through the litigation of this case.”

In a statement after the ruling, Missouri Attorney General Eric Schmitt described the injunction as “a huge victory for healthcare workers in Missouri and across the country, including rural hospitals who were facing near-certain collapse due to this mandate.”

“While today’s ruling is a victory, there’s more work to be done, and I will keep fighting to push back on this unprecedented federal overreach,” said Schmitt, who is running in the GOP primary for U.S. Senate.

SEIU Healthcare Missouri State Director Lenny Jones decried Monday’s ruling.

“This injunction is rooted in misinformation and the political aspirations of some elected officials rather than in responsible public health policy,” Jones said. “Vaccine mandates are an opportunity for employers and workers to come together to provide education, listen to workers’ concerns, and address safety issues in facilities.”

Several other lawsuits from states are pending in federal courts, challenging both the mandate on health care workers and the broader mandate on most private sector employees.

White House press secretary Jen Psaki told reporters Monday that the administration is “obviously going to abide by the law and fight any efforts in courts or otherwise” to prevent health care facilities from protecting their work forces.

President Joe Biden delivers remarks on COVID-19 on June 2, 2021, in the Eisenhower Executive Office Building at the White House (Official White House photo by Adam Schultz).

WASHINGTON — President Joe Biden sought to reassure Americans on Monday about the latest COVID-19 variant, describing it as “a cause for concern, not a cause for panic.”

Biden did not announce any new travel restrictions or other federal actions during his brief remarks from the White House.

Instead, he urged Americans to get a booster shot to increase their immunity against COVID-19 — and to be patient while scientists gather more data on what exactly the new omicron variant will mean.

“We have the best vaccine in the world, the best medicines, the best scientists, and we’re learning more every single day,” Biden said. “We’ll fight this variant with scientific and knowledgeable actions and speed, not chaos and confusion.”

The White House already had restricted travel from eight nations, including South Africa, which first identified the new variant.

Other countries also have restricted travel as cases involving the new variant have been detected in a growing number of countries, including Canada and parts of Europe.

So far, U.S. public health officials say they believe the current COVID-19 vaccines will provide protection against the new variant. But it likely will take several weeks to gather data on how the mutations in the new variant make it easier to transmit or cause more serious disease.

Biden said his administration will share the information it gathers “candidly and promptly.” He also said that top health officials are working with the three authorized vaccine manufacturers to ensure they are preparing in case they need to tweak their products to adapt to the variant.

The president also said he will be announcing on Thursday a detailed strategy for fighting the  COVID-19 pandemic throughout the winter, including more widespread vaccinations, boosters and testing.

“We have moved forward in the face of the delta variant,” Biden said, referencing the variant that caused a surge in infections over the summer. “And we move forward now in the face of the omicron variant as well.”

The Biden administration first announced last year that it would try to curb the rise in coronavirus infections by implementing stricter standards on workplaces (Official White House photo by Adam Schultz).

WASHINGTON — Congressional Democrats cheered on the floor of the U.S. House after approving President Joe Biden’s massive social spending and climate bill.

But a major struggle lies ahead in the coming month in the U.S. Senate, where Democrats cannot lose any votes within their party if they are to send the so-called Build Back Better measure to Biden’s desk.

That gives any individual Democratic senator virtual veto power over the bill—and some are already declaring what they won’t accept.

The Congressional Budget Office has estimated the bill would spend about $1.7 trillion over 10 years. Budget analysts project another roughly $500 billion in tax breaks, putting the total cost at about $2.2 trillion over a decade, higher than earlier estimates from the White House.

The measure already has been the subject of months of negotiations, intended to make peace between moderates skeptical of the legislation’s price tag and progressives who are frustrated that it doesn’t go further in addressing longstanding problems with child care, health care, immigration and other policies.

Any changes made in the Senate will mean the bill must return to the House for another vote before it could be signed into law—and its cost will increase or decrease as well. And time is running short, with the number of session days dwindling as the end of the year approaches.

Here’s more on the proposals in the House bill that are most likely to disappear once the Senate gets to work:

Paid leave

Biden’s initial proposal called for 12 weeks of paid leave for parents and other caregivers who need to take time away from work to take care of a new baby or another family member, or to recover from an illness.

That new benefit was scaled back to four weeks, then removed from the bill entirely — before four weeks of paid leave was added back into the final House version.

But paid leave, which is popular among Americans, faces significant opposition from Sen. Joe Manchin III, (D-W.Va.), who has said for weeks that he does not support including a new national paid leave program in the bill.

Manchin has said he doesn’t believe that such a program should be created through the reconciliation process, which is what the evenly divided Senate will use to pass the legislation by simple majority.

He’s also said he prefers a paid leave program that’s funded by contributions from both employers and employees, and Manchin has expressed concerns about the solvency of a new benefit program.

“To expand social programs when you have trust funds that aren’t solvent, that are going insolvent — I can’t explain that, it doesn’t make sense to me,” Manchin said, according to The Washington Post.

Under the House-passed bill, the paid leave program would start in 2024, and would be available to most employed or self-employed workers.

Money would be paid out either through a new federal benefit or through existing state or employer-based leave plans, and those non-federal leave programs would receive some reimbursement from the federal government.

The U.S. is one of only a few countries in the world — and the only wealthy country — that does not have a national paid family leave program.

The four-week benefit in the House-passed bill also is far shorter than what most nations provide, and less than the 12 weeks of unpaid job protection offered to some workers under the Family and Medical Leave Act.

Cap on SALT deductions

Senate Democrats across the ideological spectrum oppose a provision in the House bill they consider a tax break for wealthy residents of high-tax states. The measure would lift a cap on the federal deduction people can take for state and local taxes, commonly called the SALT deduction.

The provision was the biggest reason for moderate Maine Democratic Rep. Jared Golden’s vote against the bill in the House, but also needed to win the votes of members like Rep. Josh Gottheimer of New Jersey.

Sen. Bernie Sanders, a Democratic Socialist from Vermont who caucuses with Democrats, has railed against the “hypocrisy” of Democrats providing tax breaks to the wealthy.

It’s not only Sanders’ wing of the Democratic caucus that opposes the measure. Sen. Michael Bennet, (D-Colo.), noted in a tweet last week that 70% of the SALT benefits would go to the wealthiest 5% of the population.

“The American people didn’t send us to Washington to cut taxes for rich people,” he tweeted.

But with Senate Democrats led by New Yorker Chuck Schumer — who has many constituents who would benefit from the tax break — the provision may not be completely scrapped, even with members from Sanders to Montana moderate Sen. Jon Tester opposed. Instead, a compromise may emerge, those close to the process in the Senate say.

Sanders and Sen. Robert Menendez, (D-N.J.), are working on language that would limit the new deduction cap to those making more than $400,000 per year.

Immigration 

An immigration proposal House Democrats wrote into the bill is in danger more from the Senate’s nonpartisan parliamentarian than opposition from Democratic senators.

The measure would allow people in the United States in violation of immigration laws to retain work permits and be safe from deportation for five years.

Immigration activists had sought more permanent relief, which was included in an earlier draft of the bill that the parliamentarian, Elizabeth MacDonough, rejected in September.

Because Democrats are moving the entire package through reconciliation, it must comply with a rule for that process prohibiting provisions that have little impact on the federal budget.

Methane fee

Manchin has reportedly objected to the piece of the bill that would impose a new fee on methane emissions from fossil fuel production.

The proposal would ramp up fees, from $900 per metric ton in 2023 to $1,500 per metric ton in 2025.

Methane is among the most potent greenhouse gases that lead to climate change. Biden and other world leaders pledged at the United Nations climate conference earlier this month to reduce methane emissions by 30% by the end of the decade.

Manchin, whose family has ties to West Virginia’s coal industry, is often out of line with his fellow Democrats on energy issues.

Under pressure from Manchin, the White House dropped another major climate proposal in an earlier version of the bill. That measure would have created a program to reward utilities for reaching clean energy goals and punish those that don’t.

A spokeswoman for Manchin declined to comment.

Already out: Gold-mining royalty

Before the bill even reached the Senate, the House removed a section adding a federal royalty rate for miners of gold and other hard rock minerals. Sen. Catherine Cortez Masto, (D-Nev.), took credit for getting rid of the measure that would mostly affect gold producers in her state.

Hard rock miners operate on federal lands under an 1872 law that shields them from paying the kind of royalties levied on the oil, gas and coal industries.

The House proposal, authored by Natural Resources Committee Chairman Raul Grijalva, (D-Ariz.), would have imposed an 8% royalty rate on new mines and a 4% rate on existing operations, affecting about $5 billion to $7 billion per year.

Environmentalists and fiscal hawks have long sought a royalty rate for hard rock mining, but Cortez Masto objected to the disproportionate effect it would have on Nevada.

A spokesperson for her office called the initial proposal “a nonstarter” for Nevada’s senior senator, adding “Cortez Masto ensured that the House’s original provision was not included in the legislation that just passed the House.”

The $1.5 trillion government funding section of the bill includes the first round of earmarks in more than a decade (Getty Images).

WASHINGTON — U.S. House Democrats united around a landmark $1.85 trillion social spending and climate bill on Friday, sending the major plank of President Joe Biden’s economic agenda to the Senate.

Democratic leaders in the House heralded the 220-213 near party-line vote on the so-called Build Back Better bill, touting its provisions on child care, education, health care, taxes and the environment as monumental policy advances—though they are expected to be revised or removed to gain support from Democratic moderates in the Senate.

The lone House Democratic holdout was Maine’s Rep. Jared Golden. Pennsylvania Republican Rep. Scott Perry, who announced Tuesday he has tested positive for COVID-19, did not vote.

In a statement, Biden touted the bill’s provisions on prescription drugs, universal child care, taxes and climate action.

“Above all, it puts us on the path to build our economy back better than before by rebuilding the backbone of America: working people and the middle class,” he said.

Senate Majority Leader Chuck Schumer said Build Back Better would be considered as soon as the parliamentarian has completed a review.

“We will act as quickly as possible to get this bill to President Biden’s desk,” the New York Democrat said in a statement.

Democrats’ triumphant moment on the eve of the Thanksgiving Day recess was delayed by an all-night filibuster-style speech by House Republican Leader Kevin McCarthy, who took the floor at 8:38 p.m. Thursday and spoke until 5:10 a.m. McCarthy railed against the cost of the legislation, President Joe Biden, inflation, and China, and veered into topics such as baby carrots, swimming competitions and the dollar menu at McDonald’s.

As a House leader, McCarthy was allowed to speak as long as he wanted—and his eight hours and 32 minutes beat an eight-hour record set by House Speaker Nancy Pelosi in 2018 advocating for immigration reform.

He told Democrats that he had “all night,” to which Democrats responded, “So do we.”

Walking into the U.S. Capitol early Friday morning, Pelosi said she had “no idea” what McCarthy achieved with his filibuster-style speech, according to Capitol Hill pool reports.

“With the passage of the Build Back Better act, we, the Democratic Congress, are taking our place in the long and honorable heritage of our democracy with legislation that will be the pillar of health and financial security in America,” Pelosi said on the House floor shortly before lawmakers voted. As the final tally was announced, Democrats cheered and applauded.

They huddled around Pelosi, chanting her name and clapping.

Friday’s win for House Democrats followed months of intense negotiations with the White House and Senate, infighting between progressive and moderate Democrats and a dramatic scaling back of an even more sprawling social safety net plan from Biden earlier this year. But they finally coalesced.

“For decades, Congress has based economic policy on trickle-down economics, eviscerating America’s middle class in the process. But today we reject that approach,” said Rep. Mary Gay Scanlon, D-Pa.

She described the bill as “investing in American families, not hedge funds, in ways that will benefit all of us.”

The legislation was held up two weeks ago when moderates insisted on seeing detailed impartial cost estimates for the legislation from the Congressional Budget Office before they could vote in favor of it.

But by Thursday, almost all the moderates had fallen in line, including Reps. Stephanie Murphy of Florida, Josh Gottheimer of New Jersey, Kurt Schrader of Oregon, Elissa Slotkin of Michigan and Abigail Spanberger of Virginia.

Golden, though, voted no, objecting to a provision that gives a tax break to high-earners in high-tax states.

The legislation now faces a tough and lengthy path — and some likely changes — in the evenly divided Senate, where Democrats will need every vote in their caucus for the measure to reach Biden’s desk.

The Senate will use a legislative procedure known as budget reconciliation, which allows Democrats to bypass the Senate’s normal 60-vote threshold and pass the measure without any Republican support.

Moderate Sens. Joe Manchin III, D-W.Va., and Kyrsten Sinema, D-Ariz., are expected to have an outsized influence on which provisions remain in the final bill. Both were heavily involved in months of negotiations that cut the measure’s initial $3.5 trillion price tag over 10 years in half.

If congressional Democrats can successfully clear the measure through both chambers, it would give them a second major legislative win after the $1.2 trillion infrastructure measure signed into law this week.

House Republicans opposing the social spending package decried it as too expensive and harmful to the economy.

“This bill should be called the ‘Bad Bad Bad’ bill,” said Rep. Tom Cole, an Oklahoman who is the top GOP legislator on the House Rules Committee, in a quip that played on the bill’s “Build Back Better” moniker.

“It’s a wishlist of radical policy provisions and reckless spending that would lead to massive tax increases, trillions added to the national debt, and more and more government control of our lives,” Cole added.

The Biden administration has argued the bill will pay for itself through tax increases on the wealthy, big corporations and companies doing business abroad.

An analysis from the Congressional Budget Office released Thursday night projected that the bill would add $367 billion to the deficit over a decade.

The bill would remove the cap on federal deductions taxpayers can take for what they pay in state and local taxes, essentially a tax cut for the wealthy in high-tax states including New Jersey and Maryland—drawing opposition from Golden.

The CBO deficit estimate doesn’t account for possible revenue from increased IRS enforcement, which CBO analysts projected at $207 billion in savings and the Treasury has said could save some $400 billion.

Child care, universal pre-K

Among the bill’s sweeping policy provisions are significant changes to how parents pay for child care.

It allocates $400 billion to pay for universal pre-K for 3-and-4 year-olds, and would provide subsidies to limit how much of a family’s income goes toward daycare costs for younger children.

It also expands the child tax credit so that parents could get a maximum of $3,600 per child under 6, for another year. Under the 2021 tax credit, parents can get up to $300 a month per child age 6 and under and $250 per child ages 6 to 17.

For new parents and other caregivers, Build Back Better includes four weeks of paid leave — a scaled-down provision that’s unlikely to survive in the Senate due to objections from Manchin.

On health care, it would for the first time give Medicare the ability to negotiate with pharmaceutical companies on the price of some prescription drugs, and offer coverage of hearing aids for seniors.

It also would address the insurance coverage gap for those living in states that refused to expand Medicaid eligibility under the Affordable Care Act, by offering tax credits for premium-free health coverage on the Obamacare health exchanges through 2025.

Battling climate change

Progressive Democrats and environmental groups consider the bill a much stronger climate measure than the $1.2 trillion bipartisan infrastructure law.

Even as the bill’s topline price tag was halved, most of the climate spending remained. The White House has said the measure includes $555 billion in climate spending and tax credits.

The largest category of climate action in the bill is $320 billion in new and extended clean energy tax credits.

The bill would provide a consumer tax credit for electric vehicles. Emissions from transportation make up nearly one-quarter of greenhouse gas emissions in the U.S., the largest of any single sector.

The bill also includes funding for a new climate conservation corps program that would create entry-level jobs in conservation and climate resiliency work. Sen. Michael Bennet and Rep. Joe Neguse, both Colorado Democrats, have championed the climate jobs program.

The bill would also make changes to oil and gas development. It would increase royalty rates and end noncompetitive leasing for energy companies operating on federal lands and establish royalties for hard rock mining.

It would also impose a fee on emissions from methane, one of the most powerful greenhouse gases. Methane is largely a byproduct of oil and gas development, agriculture and landfills.

The bill is likely to cut more than a gigaton of greenhouse gas emissions, Robbie Orvis, the senior director of energy policy design at the nonprofit think tank Energy Innovation, said in an interview last month. The United States must cut 2 gigatons of emissions to reach its commitment under the Paris Climate Agreement.

Immigration attempts

Included in the $1.85 trillion social package is $100 billion that the Biden administration set aside for immigration policy that would help reduce backlogs, expand legal representation and help with processing at the border.

Democrats have tried to include a pathway to citizenship for millions of undocumented people through the reconciliation package, but were blocked by the Senate parliamentarian from including those provisions.

Immigration advocates also spent this week lobbying Congress to include basic work permits for undocumented essential workers, as well as protections from deportations.

University of Missouri Sinclair School of Nursing student Hannah Tipton administers a COVID-19 vaccine to Clifford Nevins during MU Health Care’s vaccination clinic in the Walsworth Family Columns Club at Faurot Field in Columbia on Feb. 4, 2021 (Photo courtesy of MU Health Care).

WASHINGTON — Federal health officials are expected as soon as Friday to expand access to COVID-19 booster shots to all American adults.

But some states aren’t waiting for a green light from D.C.

At least six states already have opened up eligibility for the boosters from Pfizer and Moderna beyond the categories specified by federal health agencies: anyone 65 and older, as well as those 18 to 64 with underlying health conditions or who are at higher risk because of their workplace.

Those states instead have told adult residents that they can seek another shot as long as they meet the other part of the federal rules—they must have received their second Pfizer or Moderna shot at least six months ago. (Anyone who received the one-dose shot from Johnson & Johnson already can receive an additional dose at least two months later under the federal rules.)

Maine became the latest state to expand booster eligibility on Wednesday, joining Colorado, California, New Mexico, West Virginia and Arkansas. New York City officials also have encouraged all adults who meet the timing requirements to seek another shot.

“With Maine and other New England states confronting a sustained surge, and with cold weather sending people indoors, we want to simplify the federal government’s complicated eligibility guidelines and make getting a booster shot as straightforward and easy as possible,” Maine Gov. Janet Mills said in Wednesday’s announcement.

Missouri is not among them, with state health officials continuing to follow federal recommendations that call for boosters for those  over 65, with an underlying medical condition or in a high risk profession. So far, just over 50 percent of all Missourians have completed vaccination.

As state officials did in Colorado and New Mexico, Maine officials are justifying the action by simply determining that all of their adult residents live or work in high-risk settings, in order to align with the federal rules.

“Because disease spread is so significant across Colorado, all Coloradans who are 18 years of age and older are at high risk and qualify for a booster shot,” stated the Nov. 10 executive order from Colorado Gov. Jared Polis.

Determining who exactly needs to receive a booster dose has been contentious.

Pfizer initially sought to offer booster doses to all American adults, and the Biden administration proclaimed in mid-August that it would launch a national booster campaign by Sept. 20.

But vaccine experts who advise the Food and Drug Administration and Centers for Disease Control and Prevention recommended narrower eligibility requirements, expressing skepticism that the available data shows a need for everyone to receive another dose. The CDC’s vaccine panel declined to recommend including employees at higher risk of exposure to the virus at their workplace, but the top CDC official added them back in the agency’s official guidance.

Polis has been critical of federal health officials, saying during an appearance Sunday on the CBS show “Face the Nation” that he has “been very frustrated with the convoluted messaging” from the CDC as well as the FDA.

During a press briefing Wednesday, Dr. Rochelle Walensky, who heads the CDC, sidestepped a question about the states that are forging ahead of her agency on booster-shot policy.

“FDA is currently evaluating data on the authorization of booster doses for all people over age 18,” she said. “As we’ve done before, CDC will quickly review the safety and effectiveness data and make recommendations as soon as we hear from FDA.”

Walensky added that those who are currently eligible for a booster shot are encouraged to seek one as soon as they can.

The New York Times has reported that the FDA is aiming to authorize booster doses of Pfizer’s  vaccine for all adults as early as Thursday. A CDC panel that crafts vaccine recommendations is scheduled to meet Friday.

U.S. President Joe Biden talks to House Speaker Nancy Pelosi (D-Calif.) after signing the Infrastructure Investment and Jobs Act, surrounded by lawmakers and members of his Cabinet during a ceremony on the South Lawn at the White House. The $1.2 trillion package will provide funds for the country’s transportation networks, increasing rural broadband access, and projects to modernize water and energy systems (Alex Wong/Getty Images).

WASHINGTON — President Joe Biden on Monday signed into law his $1.2 trillion bipartisan infrastructure bill during a ceremony at the White House packed with some 800 supporters, heralding what he said was a “truly consequential” spending bill that will improve Americans’ day-to-day lives.

But Democrats also emphasized that there is more to come—a $1.85 trillion social spending measure that still faces a close final vote in the U.S. House and  major changes in the evenly divided Senate, where passage will have to come without GOP support.

Biden said the infrastructure legislation— backed by nearly all congressional Democrats, as well as 19 Senate Republicans and 13 House Republicans — is a signal that polarized public officials in Washington can come together to create jobs and solve long-lingering problems.

“My message to the American people is: America is moving again. And your life is going to change for the better,” Biden said during the South Lawn ceremony attended by federal and state legislators, governors, mayors, labor leaders, business leaders, and other supporters.

The signing marked a significant victory for the president’s economic agenda.

But the tougher step still looms, as Democrats attempt to rally their narrow majorities to pass the accompanying bill that would spend trillions more on new programs to expand access to child care and preschool and combat climate change.

Two senators critical to reaching agreement on the infrastructure plan, Democratic Sen. Kyrsten Sinema of Arizona and Republican Sen. Rob Portman of Ohio, joined Biden on stage for the bill signing and spoke ahead of the president’s remarks.

“Our legislation represents the substantive policy changes that some have said are no longer possible in today’s Senate,” Sinema said. “How many times have we heard that important policy can only happen on a party line? Our legislation proves the opposite.”

Portman also lauded the bipartisan work involved in approving the infrastructure measure, saying the deal became possible after the group of lawmakers involved in negotiations agreed to shrink the package down to physical infrastructure — and separate out Biden’s proposals for new social and climate-change programs.

“Mr. President … you and I will disagree on the tax and spending (provisions) in the other priority you have, the reconciliation bill, but I think we can both agree that this infrastructure investment shouldn’t be a one-time bipartisan accomplishment,” said Portman, who is retiring at the end of his term next year.

“This should be the beginning of a renewed effort to work together on big issues facing this country,” Portman added.

In his remarks before signing the bill, Biden praised Portman as well as Senate Minority Leader Mitch McConnell, (R-Ky.), who voted for the bill but did not attend Monday’s ceremony.

The new law, Biden said, is “proof that despite the cynics, Democrats and Republicans can come together and deliver results.”

Provisions of the new law include $110 billion to repair and rebuild roads and bridges; $90 billion for public transit; and $66 billion for passenger rail improvements.

Airports and ports also will see an infusion of federal funding, as will the country’s electric grid.

Billions more will pay for electric vehicle charging stations and the purchase of buses and ferries that run on electricity.

Another $65 billion will go toward expanding access to broadband internet access across the country, a provision touted during the signing ceremony by Donneta Williams, president of the United Steelworkers Local 1025 at a Wilmington, N.C., plant producing optical fiber needed for broadband upgrades.

“To paraphrase one of my favorite former vice presidents, it’s a big effing deal,” said Senate Majority Leader Chuck Schumer, (D-N.Y.)

Before heading to the White House, U.S. Sen. Jon Tester, a Montana Democrat who was among the 10 senators who wrote the bill, told reporters on a press call that the signing was the culmination of several months of negotiation.

“This is one of the best days I’ve had in Washington, D.C.,” Tester told reporters. “This is something that, for six months we met and we argued and we fought and we worked and in the end we got something that is the biggest non-emergency investment in infrastructure in our nation’s history.”

The legislation drew some bipartisan support in both chambers. But the 13 House Republicans who joined Democrats in support of the bill have faced backlash for that vote from constituents and some of their colleagues.

Rep. Marjorie Taylor Greene, (R-Ga.), tweeted that they were “traitors,” and posted their office phone numbers.

GOP opponents of the measure have decried it as part of a “spending spree” by Democrats.

“Tennesseans want real infrastructure investment, not frivolous left-wing programs that add to our nation’s debt,” Sen. Marsha Blackburn, (R-Tenn.), fumed in a press release ahead of the bill signing, slamming it as the “gateway” to the human infrastructure bill Democrats are still seeking to pass.

A half-dozen progressive House Democrats also opposed the physical infrastructure bill.

Those “no” votes included Reps. Ilhan Omar of Minnesota, Rashida Tlaib of Michigan and Cori Bush of Missouri, who wanted the $1.85 trillion social safety net and climate bill, known as “Build Back Better,” to be voted on at the same time as the infrastructure bill.

House Democrats have voted to set the terms of debate over the social reform package, and have aimed to hold a final vote as soon as this week.

“This is a great accomplishment, and there’s more to come,” House Speaker Nancy Pelosi, (D-Calif.), said at the White House.

Environmental advocacy groups and their allies in the Congressional Progressive Caucus also have sought to present the infrastructure bill and the $1.85 trillion social spending plan as a package deal.

“This is scene one of a two-act play,” Manish Bapna, the president and CEO of the Natural Resources Defense Council, said in a statement. “It sets the stage for Congress to pass the Build Back Better Act. That’s the centerpiece of President Biden’s strategy to drive equitable recovery with climate action in a moment the country urgently needs both.”

Asked about the social spending and climate bill, Tester stressed that it and the physical infrastructure bill are separate measures.

His priorities in the larger spending plan include making child care more accessible and affordable, providing federal housing funding and addressing climate change, he added.

During Monday’s ceremony, Vice President Kamala Harris also framed the two infrastructure bills as a set that is to be completed.

“This legislation, as significant as it is, as historic as it is, is part one of two,” Harris said. “Congress must also pass the Build Back Better Act.”

The new infrastructure bill includes $11 billion in grants for states, tribes, and utilities to boost the resilience of electric infrastructure against extreme weather and cyberattacks (Photo by Matthew Henry, via Unsplash).

WASHINGTON — Federal officials on Tuesday offered details about how money from the recently passed bipartisan infrastructure bill would be spent, emphasizing the pending law’s potential to add clean energy capacity.

Department of Transportation officials highlighted the $1.2 trillion bill’s record funding for public transit like buses and subways, as well as for Amtrak. They framed the commitments as a way to bring greater equity to disadvantaged communities and address climate change.

Energy officials said the money to be doled out by that agency will create jobs while delivering cleaner electricity to more Americans.

“With the investments from the bipartisan infrastructure deal,” Energy Secretary Jennifer Granholm said, “we’re going to finally begin building an energy system that’s fit for the 21st century, with innovations that allow us to lead a global clean energy market.”

A bipartisan House vote last week sent the bill to President Joe Biden’s desk. The White House was central to the bill’s passage and Biden is expected to sign it, but it has not yet become law.

Speaking to reporters Tuesday, Energy and Transportation officials made no firm commitments on when money from the bill would flow to states. Funds from existing programs would come faster than from programs created by the bill, they said.

Officials from both agencies said more details would be worked out in the next six months.

“S​ome of it will go out sooner,” said Granholm. “Hopefully within the next six months you’ll start to see some activity, particularly with respect to roads and those formula dollars, and then some of it will be longer term.”

Climate change, equity

​​Transportation Deputy Secretary Polly Trottenberg highlighted portions of the bill that the administration hopes will fight climate change and improve equity in historically disadvantaged communities.

The $90 billion in funding for transit represented a record and would help both goals, Trottenberg said. The funding would allow transit agencies to swap out 10,000 fossil fuel-powered buses for those that run on battery electricity or other lower emissions fuels.

Transit also helps provide lower-income communities with access to jobs and services.

The level of funding would be “transformational” Trottenberg said, and would have major effects on systems outside the large cities where transit is readily available.

“As someone who’s worked on transit issues, a $90 billion investment in transit agencies is going to be transformational,” Trottenberg, a former New York City transportation official, said. “Those dollars are going to make a big difference in smaller and rural and tribal communities.”

Some line items in the bill include less funding than earlier proposals.

For example, the new Reconnecting Communities program meant to help reverse the effects of highways and other transportation projects that have isolated some neighborhoods will receive about $1 billion, down from $15 billion proposed in a bill earlier this year sponsored by U.S. Rep. Anthony Brown, (D-Md.).

Transportation Principal Deputy Assistant Secretary for Policy Christopher Coes and Transportation Deputy Undersecretary Carlos Monje said state and local transportation agencies could use other funding in the bill to meet the goals of the Reconnecting Communities program.

Other transportation items in the bill include:

• $66 billion for Amtrak to address the maintenance backlog and create new passenger rail corridors.
• $17 billion for ports and waterways. Officials hope that funding will help ease supply chain problems.
• $25 billion for airports. Portions of the airport and port funding will be used to counter the effects of pollution and environmental degradation in nearby communities, Trottenberg said.
• $13 billion for road safety, including a new $6 billion Safe Streets for All program within DOT that will focus on people who walk or bike.
• Funding to renovate 10 of the nation’s most economically important bridges.

• $7.5 billion to create a nationwide network of 500,000 electric vehicle charging stations. The Energy Department lists about 51,000 charging stations in use now.

• $65 billion for upgraded energy transmission systems.

 Clean energy projects

Other portions of the infrastructure package are aimed at bolstering a range of clean energy and energy-efficiency projects across the country, primarily through $62 billion that will be distributed to states, cities, tribes and others by the U.S. Department of Energy.

Granholm emphasized those projects — aimed at overhauling how the country produces, stores and transmits energy — would lower electricity costs, reduce pollution and create new opportunities for workers.

“We not only get a country using more and more clean energy, meaning less carbon pollution, obviously cheaper energy bills, cleaner air, better health outcomes, lower health care costs, particularly for low-income households, and especially within communities of color, but these investments are going to deliver jobs, jobs and more jobs,” she told reporters.

The legislation includes money to help train American workers for those jobs in new energy technologies.

As with the transportation funding, the energy dollars will be distributed through a mix of formula-driven funding, which administration officials said will give some certainty to states and localities on the amount of money they can expect to receive, as well as through competitive grant programs.

The energy section of the pending law includes:

• $21.5 billion in funding for clean energy demonstrations and research hubs focused on carbon capture and clean hydrogen. It includes money specifically for projects in rural areas and economically hard-hit communities.
• $11 billion in grants for states, tribes, and utilities to boost the resilience of electric infrastructure against extreme weather and cyberattacks.
• $7 billion to improve the supply chain for batteries, including sourcing and recycling critical minerals.
• $5 billion to replace thousands of diesel-powered school buses with electric buses.
• $3.5 billion to reduce energy costs for low-income households through the Weatherization Assistance Program.
• $750 million for a new grant program to support energy technology manufacturing projects in coal communities.
• $500 million for energy efficiency and renewable energy improvements at public school facilities.
• $550 million in the Energy Efficiency and Conservation Block Grant Program and $500 million in the State Energy Program to provide grants to cities and states to develop and implement clean energy programs and projects.

(Getty Images)

WASHINGTON — Many private employers beginning in January will have to ensure their workers either are fully vaccinated against COVID-19 or that they will undergo weekly testing and wear a face covering, under a new federal rule announced Thursday by the White House.

The policy from the Occupational Safety and Health Administration is set to affect 84 million workers across the U.S. Employers who refuse to comply could face hefty fines.

Final details of the new rule were released almost two months after President Joe Biden announced the vaccination requirement for all private companies with at least 100 employees.

Other workers also must comply with new vaccination rules.

Another 17 million health care providers at 76,000 facilities participating in the federal Medicare and Medicaid health insurance programs must be vaccinated under a separate policy announced Thursday. Those health care workers will not have the option of weekly tests.

Federal contractors also must ensure their employees are vaccinated, under another rule announced earlier this week. That requirement had been set to kick in Dec. 8, but Thursday’s announcement by the White House stated that all three of the vaccination requirements will go into effect on Jan. 4.

Senior Biden administration officials who briefed reporters Wednesday evening touted vaccination requirements already in place by private companies and local governments as having slashed the number of unvaccinated Americans by nearly 40%.

The new OSHA rule will save thousands of lives and prevent hospitalizations, they argued.

But the policy has already sparked vocal outcry and legal challenges from Republicans.

Before it will fully go into effect, officials in 21 states that enforce their own workplace safety rules also will need to take action.

Those states — which include Nevada, Arizona, New Mexico, Minnesota, Iowa, Michigan, Tennessee, North Carolina, Virginia, and Maryland — will have 30 days to approve their own policies that are at least as stringent as the new federal policy.

Potential fines for not complying

Being fully vaccinated against COVID-19 means receiving both doses of the two-shot vaccine from either Pfizer or Moderna, or getting the one-shot version from Johnson & Johnson. (The booster doses recently approved for some Americans are not required to be considered fully vaccinated.)

The new OSHA rule also requires employers to provide paid time off for workers to get vaccinated and recover from any side effects. That policy, and another requiring unvaccinated workers to wear a face mask, will go into effect on Dec. 5.

Refusing to comply could mean fines for the employer.

Federal OSHA officials say the cost would depend on the number and magnitude of any violations, but a single violation could bring a fine of nearly $14,000 — and those deemed to be “willful” could cost as much as $136,000.

Hospitals or long-term care facilities that do not comply with the vaccination requirement for their workers also could face penalties from the Department of Health and Human Services’ Centers for Medicare and Medicaid Services.

Facilities could be fined, denied federal payments or even removed from the Medicare and Medicaid programs. But federal officials emphasized that they will be seeking first to bring any negligent businesses and health care providers into compliance.

Timing the vaccination requirement to kick in after the December holidays is intended to make it easier for businesses and workers to comply, according to the Biden administration.

But administration officials said they hope that employers will not wait until the deadline approaches to begin enforcement.

Republican-led lawsuits

As employers prepare to comply with the new federal workplace rules, legal battles over the vaccination mandate will be playing out in the court system.

Republican attorneys general from 19 states already have filed four separate lawsuits arguing that the vaccination requirement for federal contractors violates federal law.

Iowa, Missouri, Montana and New Hampshire have signed on to one lawsuit filed in a federal district court in Missouri. Another involves a group of states that includes Georgia, Idaho, and Kansas. Florida officials also have filed their own lawsuit.

Several dozen Republican U.S. senators also have said they will seek to use the Congressional Review Act to overturn the new regulation. But that effort is unlikely to succeed because it would require a resolution to pass both Democratic-controlled chambers and be signed by the president.

COVID-19 vaccine is stored at -80 degrees celsius in the pharmacy at Roseland Community Hospital on Dec. 18, 2020, in Chicago, Illinois (Photo by Scott Olson/Getty Images).

WASHINGTON — Within minutes of the U.S. Food and Drug Administration’s announcement Friday giving the green light to Pfizer’s COVID-19 vaccine for kids aged 5 to 11, a massive logistics operation launched to prepare for the final regulatory step.

Some 15 million doses of the vaccine began to move from Pfizer’s freezers to distribution centers, requiring dry ice, tracking labels and specialized shipping containers for their journeys to vaccination sites across the country.

Over the next few days, several million of those doses will arrive at the offices of local pediatricians and family doctors, as well as hospitals, pharmacies and other health centers.

Those logistics are intended to ensure that if the Centers for Disease Control and Prevention gives its approval after a panel of vaccine experts meet Tuesday, vials of the vaccine formulated for kids will be ready to go later this week.

Biden administration officials overseeing the rollout shared more details of that process on Monday, telling reporters that Pfizer vials will be packed and shipped and delivered every day over the next week or so.

“We are planning on some vaccinations towards the end of this week,” said Jeff Zients, the White House’s COVID-19 response coordinator, adding that they expect “the program for kids ages 5 through 11 really hitting full strength the week of November 8.”

The number of sites offering the vaccine will increase throughout the month, and will be searchable on vaccines.gov if the CDC grants its approval.

Zients reiterated that the Biden administration has secured enough doses of Pfizer’s pending vaccine to inoculate each of the 28 million children in that age group.

The long-anticipated decision on a COVID-19 vaccine for those younger than 12 will come as the country hit new milestones for vaccines among adults: Federal officials said that as of Monday, 80% of adults have received at least one shot against the deadly virus and 70% of adults are now fully vaccinated.

Roughly 20 million fully vaccinated Americans also have received a booster dose to increase their protection against infection, hospitalization and death.

As with Pfizer’s shot for teens and adults, the version for children also requires two doses spaced three weeks apart. The dosage for the younger age group is much smaller: 10 micrograms for kids, compared to 30 micrograms for adults.

It had a 90.7 percent efficacy rate in preventing symptomatic COVID-19 in a clinical trial of children ages 5 to 11.

Dr. Rochelle Walensky, director of the CDC, emphasized that efficacy rate during Monday’s briefing, and said she’s “looking forward to the scientific discussion and deliberation that will take place” when the agency’s Advisory Committee on Immunization Practices meets tomorrow.

While kids have been at lower risk of infection and severe complications from the virus, the nearly 100 deaths among 5- to 11-year-olds mean it is one of the top 10 causes of death for that age group.

“For many families, the possibility of vaccines for our children will provide a great deal of comfort with every dose administered,” Walensky said. “Parents should feel comforted not just that their children will be protected, but that this vaccine has gone through the necessary and rigorous evaluation that ensures the vaccine is safe and highly effective.”

Syringes of COVID-19 vaccinations are filled during MU Health Care’s mass vaccination clinic at the Walsworth Family Columns Club at Faurot Field in Columbia on Feb. 4, 2021 (Photo courtesy of MU Health Care).

Democrats and Republicans in Congress differ on how best to reduce the number of passengers bringing guns to airports (Russ Rohde/Getty Images).

WASHINGTON — President Joe Biden’s sprawling social spending and climate package has been slimmed down into a still-massive $1.75 trillion plan that he and top congressional Democrats are attempting to wrestle through after months of negotiations.

Snipped from that proposal are a number of key priorities for Democrats, including an attempt to create the first paid family leave program for parents and other caregivers.

But the framework announced Thursday includes other sweeping policy changes, such as universal pre-K for U.S. children, help with skyrocketing daycare costs, expanded health care coverage for millions of people, and a major clean-energy investment aimed at combating climate change.

Democrats also tucked in an immigration provision that would update the green card registry from 1972 to 2010, making undocumented people who entered the country before 2010 eligible for the cards that extend permission to reside and work in the U.S.

“No one got everything they wanted, including me, but that’s what compromise is,” Biden said in a White House speech Thursday morning after meeting with congressional Democrats on Capitol Hill. “That’s consensus.”

But a firm agreement among Democrats remained elusive. Two Democratic senators who objected to the broader, more expensive plan that Biden initially outlined — Sens. Kyrsten Sinema of Arizona and Joe Manchin III of West Virginia — have not yet publicly committed to voting for the measure.

Progressive Democrats also have eyed the proposal skeptically after high-profile policy changes they lobbied for were nixed. They want to ensure that the expansion of social programs isn’t left behind if Congress moves first on a pending infrastructure bill to repair the nation’s aging roads, bridges and rails.

The House was set to vote Thursday night on an extension on transportation funding to Dec. 3 to give lawmakers more time to hash out Biden’s social reform package.

Here’s some of what’s in, and what’s out, of the social spending and climate bill, according to the White House and members of Congress:

WHAT’S IN

• Money to combat climate change — The largest chunk of the bill, $550 billion, would pay for tax breaks for electric vehicles and improvements to clean-energy transmission and storage, as well as money to help make communities more resilient to extreme weather events.
• Universal pre-K; subsidies to reduce daycare costs — Another $400 billion would pay for a new, six-year program to guarantee free preschool for 3- and-4-year-olds. The proposal also would limit child care costs to no more than 7% of income for families earning up to 250% of a state’s median income.
• Extension of expanded Child Tax Credit — The major tax change that has given millions of parents monthly checks instead of an annual credit on their tax bills, and extended that relief to more parents, would continue for another year.
• End the gap in Medicaid coverage — Those living in states that refused to expand Medicaid eligibility under the Affordable Care Act could get tax credits to receive premium-free health coverage on the Obamacare health exchanges through 2025.
• Hearing coverage for Medicare recipients.
• Reduced premiums for health insurance bought on the ACA marketplace.
• Improved Medicaid coverage for home care services.
• $150 billion to expand access to affordable housing.
• Bigger Pell Grants for low-income college students.
• Expanded free school meals.

WHAT’S OUT

• Paid family and medical leave — The 12 weeks of paid leave for new parents and other  caregivers was pared back during negotiations to four weeks, and then ultimately removed from the proposal.
• Dental and vision care for Medicare recipients.
• Efforts to rein in prescription drug prices — though Rep. Frank Pallone, a New Jersey Democrat who leads the Energy and Commerce panel, says he is “committed to finalizing an agreement” that would include changes like allowing price negotiations.
• Funding for two years of tuition-free community college ($109 billion).
• The Clean Energy Performance Program, which provides financial incentives to utilities to transition away from fossil fuel uses ($150 billion).

The social spending bill would be paid for through a 15% minimum tax on large corporations, as well as a new surtax on the income of multi-millionaires and billionaires, the wealthiest 0.02 percent of Americans, the White House said. Biden has pledged that no one earning less than $400,000 annually will pay more in taxes.

The plan also relies on revenue raised from rolling back some of the Trump administration’s 2017 tax cuts, and more IRS efforts to combat tax evaders.

The Biden administration released details of the framework Thursday morning as the president gave an in-person sales pitch to House Democratic legislators before departing on a long-planned trip to Italy and Scotland.

The latter half of that trip involves a global climate conference, and Biden’s arrival without congressional action on any meaningful U.S. steps to combat climate change would undercut efforts to ask other countries to also reduce greenhouse emissions.

‘Betting on America’

Biden framed debate over the proposal as deciding between “competitiveness vs complacency,” urging lawmakers to support investments he depicted as necessary to restore the U.S. as a leader among nations.

“That’s what these plans are about: betting on America, about believing in America, about believing in the capacity of the American people,” Biden said.

Biden and Democratic leaders in Congress also got some help from former President Barack Obama, who described the deal as “the best chance we’ve had in years to build on the progress we made during my administration and address some of the most urgent challenges of our time.”

Progressives’ votes

But progressives were not budging on their stance to not vote for an infrastructure package without the complete legislative text for Biden’s social reform package, as well as a guarantee that Manchin and Sinema will back it, the leader of the caucus, Rep. Pramila Jayapal, (D-Wash.) said in a statement. Progressives also want the social reform package to be scheduled for a floor vote along with the infrastructure bill.

“There is too much at stake for working families and our communities to settle for something that can be later misunderstood, amended, or abandoned altogether,” she said. “That is why dozens of our members insist on keeping both bills linked and cannot vote only for one until they can be voted on together.”

Rep. Cori Bush, D-Mo., said that she would not vote on the infrastructure package based on the framework the president pitched to lawmakers.

Rep. Ilhan Omar, D-Minn., added that House Speaker Nancy Pelosi does not have the votes from the House Progressive Caucus to pass Biden’s infrastructure package.

House Democrats were also frustrated by a lack of commitment from Sinema and Manchin, who have not stated that they plan to vote on the framework Biden provided.

“After months of productive, good-faith negotiations with President Biden and the White House, we have made significant progress on the proposed budget reconciliation package,” Sinema said in a statement. “I look forward to getting this done, expanding economic opportunities and helping everyday families get ahead.”

Pelosi held a press conference late Thursday afternoon, where she defended the president’s framework. She said even though it did not include everything that Democrats wanted, it was still an historic social reform bill.

“I’m still fighting for paid leave,” she said, adding that the federal government provides paid family leave for Department of Defense federal employees.

In the 2020 National Defense Authorization Act, the Trump administration included 12 weeks of paid family leave for federal employees, a bill that Manchin voted for.

Pelosi did not answer questions whether she was certain that Manchin and Sinema would vote for the Build Back Better package.

“I trust the president of the United States,” she said.

Fine print

Minutes before the press conference, the House Rules Committee released a nearly 2,000-page draft text of Biden’s social reform package.

The Rules Committee later held a hearing on the bill, where Republicans criticized Democrats for the meeting’s quick timing and objected that they did not have enough time to read the legislative text.

The committee’s chair, Rep. James McGovern, D-Mass., made it clear that the meeting was not a markup of the bill and that the House had no plans to bring the bill to a floor vote on Thursday.

Pallone, who also chairs the House Energy and Commerce Committee, said during the Rules Committee meeting that he would push for an inclusion of prescription drug pricing such as a cap on seniors’ out-of-pocket spending and penalties for pharmaceutical companies that unfairly raise drug prices.

“I hope that it would have been in there,” he said. “We’ve got to make these investments to deal with the public health crisis.”

Immigration and the Senate

On the immigration provision on green cards, it’s still up to the Senate parliamentarian to give an opinion on whether it would be allowed under the reconciliation process Democrats plan to use because it requires a simple majority in the evenly divided Senate.

The parliamentarian has already ruled against Democrats’ plans to create a pathway to citizenship for millions of undocumented people.

The Biden administration set aside $100 billion for immigration policy—separate from the social reform package—that would help reduce immigration backlogs, expand legal representation and help with processing at the border.

House Judiciary Committee Chair Jerry Nadler, D-N.Y., said in a statement that the framework will help improve immigration policy.

“With this framework, Congress is taking a key step forward in our effort to modernize our immigration system, and there is no doubt that our country will benefit from the resulting economic gains for decades to come,” he said.

“The immigration provisions in the Build Back Better framework include advancing the registry date, a move last championed by President Ronald Reagan, to allow those who have lived and worked in service to our communities for more than 11 years an opportunity to apply for permanent residence.”

COVID-19 vaccine is stored at -80 degrees celsius in the pharmacy at Roseland Community Hospital on Dec. 18, 2020, in Chicago, Illinois (Photo by Scott Olson/Getty Images).

WASHINGTON — A federal vaccine advisory panel on Tuesday recommended authorizing Pfizer’s COVID-19 vaccine for children ages 5 to 11, a decision that means as soon as next week everyone in the U.S. over age 5 is expected to be eligible for a shot.

The vote by the Food & Drug Administration panel, with 17 yes votes and one abstention, followed a day-long hearing on whether the benefits of the vaccine outweigh any potential risks for children. 

“To me, the question is pretty clear: We don’t want children to be dying of COVID, even if it is far fewer children than adults, and we don’t want them in the ICU,” said Dr. Amanda Cohn, chief medical officer at the Center for Disease Control and Prevention’s National Center for Immunization and Respiratory Diseases.

The next step lies with top FDA officials, who aren’t bound to follow the panel’s advice but typically do so. 

If they grant the emergency use authorization, then the CDC would weigh in early next week with additional guidelines before shots may be administered to the 28 million kids in the new age group.

That green light could help boost the number of people vaccinated as families plan for indoor holiday gatherings this winter, where the virus causing COVID-19 can spread more easily.

While kids have been at lower risk of infection and severe complications from the virus, CDC experts said Tuesday that the nearly 100 deaths among 5- to 11-year-olds mean it is one of the top 10 causes of death for that age group.

There have been more than 1.9 million infections in children ages 5 to 11, with the rate of those infections rising sharply over the summer. 

By mid-October, infections for the age group represented 10.6% of U.S. cases — a higher-than-expected rate, given the number of children in that age group. It’s also likely an under count based on antibody tests on children, with a study presented by the CDC projecting as many as 40% of kids in the age group may have already been infected.

More than 8,300 COVID-19 hospitalizations have occurred among children between 5 and 11, with one-third of those hospitalizations involving a stay in an intensive care unit, according to the FDA.

“Our hospital has been full for the last month or so with children who’ve been critically ill — not all of them have COVID, but many of them do,” said Dr. Jay Portnoy, an allergist at Children’s Mercy Hospital in Kansas City and a member of the panel. “I am looking forward to being able to actually do something to prevent that.” 

Public health experts, as well as the Pfizer officials seeking FDA approval, also emphasized that COVID-19 infections can result in other consequences for children, such as school quarantines and closures that have caused chaos for school districts and working parents.

In addition to preventing infections and deaths in children who receive the shot, the vaccine “is also likely to confer additional benefits, including reduced transmission, improved herd immunity, and increased in-person learning, supporting child development,” said William Gruber, Pfizer’s senior vice president for vaccine clinical research and development.

As with Pfizer’s shot for teens and adults, the version for children also requires two doses spaced three weeks apart. The dosage for the younger age group is much smaller: 10 micrograms for kids, compared to 30 micrograms for adults.

Data from Pfizer that was analyzed by FDA regulators indicates that the company’s vaccine would offer strong protection. The two-shot regimen had a 90.7 percent efficacy rate in preventing symptomatic COVID-19 in a clinical trial of children ages 5 to 11, with similar side effects to those in adults, such as headache and fever.

One risk weighed by the vaccine panel Tuesday was myocarditis, a rare condition involving inflammation of the heart muscle that has been linked to the Pfizer and Moderna vaccines in older boys and young men. A COVID-19 infection also carries a risk of triggering myocarditis. 

The FDA’s analysis evaluated the chance of that rare inflammation against several scenarios in order to compare the number of COVID-19 hospitalizations prevented by a vaccine against the number of potential myocarditis cases.

In nearly all of those scenarios, the hospitalizations and deaths prevented outnumbered the potential instances of myocarditis. At a very low rate of community spread of the virus, that tradeoff flipped. 

However, analysts said the model relies on a rate of myocarditis that occurs in older children, and that rate is likely higher than what will be seen in younger children.

FDA officials also reiterated the intense safety surveillance systems that the agency uses to identify any adverse reactions that may occur.

One unanswered question from the hearing is whether kids also will eventually need a booster shot, like the ones recently approved for adults six months after their second dose.

Pfizer’s officials said they will be gathering data on the antibody response at six months after inoculation.

Data from Pfizer that was analyzed by FDA regulators indicates that the company’s vaccine would offer strong protection. The two-shot regime had a 90.7 percent efficacy rate in preventing symptomatic COVID-19 in a clinical trial of children ages 5 to 11 (Getty Images).

COVID-19 vaccine is stored at -80 degrees celsius in the pharmacy at Roseland Community Hospital on Dec. 18, 2020, in Chicago, Illinois (Photo by Scott Olson/Getty Images).

WASHINGTON — Tens of millions of additional Americans are now eligible to receive a booster dose of one of the COVID-19 vaccines, after federal health officials gave the green light late Thursday to follow-up doses of the shots made by Moderna and Johnson & Johnson.

Anyone who received the one-shot J&J vaccine is now eligible for a second dose at least two months after their shot.

Moderna recipients who are over age 65 or at higher risk due to their medical condition or work environment also are eligible for a partial third dose at least six months after their second shot.

Those who received Pfizer’s vaccine already were eligible to receive a booster dose.

The recommendation from the Centers for Disease Control and Prevention also allows individuals to receive a booster dose from a different company than the one that manufactured the initial vaccine that they received.

Some have wanted a different followup dose due to adverse reactions to a certain vaccine. Others have been concerned about  the J&J shot, which studies have shown to have a lower efficacy against infection compared to the ones from Pfizer and Moderna.

The three vaccines against COVID-19 “are all highly effective in reducing the risk of severe disease, hospitalization, and death, even in the midst of the widely circulating delta variant,” Dr. Rochelle Walensky, director of the CDC, said in a statement Thursday night.

A Pfizer study released Thursday showed that a booster dose of the company’s vaccine was 95.6% effective in the trial of more than 10,000 participants.

The newly authorized booster shots come as the sharp spike in infections and deaths caused by that delta variant has begun to wane.

But the country is still seeing about 75,000 new cases every day, and about 1,300 COVID-19-related deaths, according to CDC tracking data.

A COVID-19 vaccine clinic at University of Missouri Hospital in Columbia (Justin Kelley/MU Health Care).

WASHINGTON — The U.S. Food and Drug Administration has given a green light to Americans who want to receive a booster dose of a COVID-19 vaccine manufactured by a different company than the one that produced the initial shot they received.

The announcement Wednesday on allowing “mix-and-match” shots from different manufacturers will give more flexibility to state and local officials overseeing vaccination campaigns and to providers administering shots.

The decision was part of the agency’s decision to authorize booster doses of the COVID-19 vaccines from Moderna and Johnson & Johnson.

It’s likely not the last step in the national booster shot effort, which is intended to ensure better protection against infection and hospitalization.

In Wednesday’s statement announcing the newly authorized boosters, Peter Marks, director of the FDA’s Center for Biologics Evaluation and Research, noted that the agency is gathering data to “further assess the benefits and risks of the use of booster doses in additional populations.”

An FDA advisory panel last week recommended a partial third dose of Moderna’s shot to older and higher-risk Americans between ages 18 and 64 who initially received the company’s two-dose vaccine. That booster dose would be given at least six months after receiving the last shot — the same eligibility requirements as the booster doses recommended of Pfizer’s two-shot vaccine.

The FDA panel also recommended a second dose of J&J’s one-shot vaccine for anyone over age 18, at least two months after their shot.

But while the companies have sought approval of additional doses of their own vaccines, some Americans have wanted to receive a different shot.

Some have had adverse reactions to a certain vaccine. Others have been concerned about the efficacy of the J&J shot, which studies have shown to have a lower efficacy against infection compared to the ones from Pfizer and Moderna.

The mRNA-based Pfizer and Moderna vaccines rely on a different approach than the J&J vaccine to spur the immune response.

A study from the National Institutes of Health found people who received the Johnson & Johnson vaccine produced stronger antibody levels after they got booster shots made by Moderna or Pfizer, than if they received a booster dose from Johnson & Johnson.

The FDA authorization moves the booster issue to the Centers for Disease Control and Prevention for that agency’s signoff. A CDC panel is expected to weigh in Thursday, and millions of Americans could be lining up for additional shots later this week.

COVID-19 vaccine is stored at -80 degrees celsius in the pharmacy at Roseland Community Hospital on Dec. 18, 2020, in Chicago, Illinois (Photo by Scott Olson/Getty Images).

WASHINGTON — Smaller needles. Redesigned shipments to ease the storage needs in pediatricians’ offices. And enough vials of the COVID-19 vaccine to inoculate the 28 million U.S. children between ages 5 and 11.

Those are among the plans announced by the White House on Wednesday as federal and state officials prepare for a regulatory decision to be made on the COVID-19 shot that Pfizer reformulated for younger children.

A long-awaited decision on a vaccine for that age group is expected in the coming weeks. A Food and Drug Administration advisory panel is set to consider authorizing the shot on Oct. 26, and after the FDA’s green light, the Centers for Disease Control and Prevention then will issue its guidelines for use.

“We know millions of parents have been waiting for COVID-19 vaccine for kids in this age group,” said Jeff Zients, the White House’s COVID-19 response coordinator, during a briefing Wednesday morning. “And should the FDA and CDC authorize the vaccine, we will be ready to get shots in arms.”

Making another age group eligible for vaccines could be significant in preventing another spike in infections this winter.

The rate of infections and deaths has been falling after a summer surge caused by the delta variant, but colder weather and the winter holidays will lead to more indoor gatherings, where the virus that causes COVID-19 can spread quickly.

“If we can get the overwhelming majority of those 28 million children vaccinated, I think that would play a major role in diminishing the spread of infection in the community,” said Dr. Anthony Fauci, President Joe Biden’s chief medical adviser.

Shipments to states

Should the FDA authorize Pfizer’s shot for kids, 15 million doses will begin to ship to states, so providers will be ready to launch the next phase of the vaccination campaign as soon as the CDC weighs in.

The doses for children between 5 and 11 will be different from the ones approved for those 12 and older.

Pfizer has sought authorization for that younger age group to receive one-third of the amount given to adults and teens, and the vials will have a different color cap to distinguish them from the adult version.

Instead of the larger shipments of the adult version that initially were sent out, spurring concerns about potentially wasted doses in areas with fewer residents or less demand, the cartons shipping to pediatricians will include just 10 vials with 10 doses each. Those doses can be stored for up to 10 weeks at standard refrigeration temperatures.

The shipments also will come with all the supplies needed to administer shots to kids, the Biden administration emphasized in a memo outlining its operational plans. That includes needles designed for smaller arms.

Once the shipments go out to states, the doses will be distributed to providers, including pediatricians, children’s hospitals, pharmacies, and community health centers.

Zients said officials are seeking to ensure parents and children can go to a trusted and familiar site to get their vaccine. More than 25,000 pediatric and primary care provider sites will provide vaccinations, he said.

The administration also is working with state and local officials to set up vaccination sites at schools, and with children’s hospitals and other sites to host clinics during evenings and on weekends to inoculate kids at times that don’t require missing work or school.

State reimbursements

States can receive reimbursement through the Federal Emergency Management Agency to cover their costs related to setting up vaccination sites, buying supplies, and conducting outreach campaigns.

The White House’s planning efforts also include ways to ensure parents are receiving scientifically sound information about the vaccines amid waves of misinformation, and to create forums for them to ask questions.

A third of parents, or 34%, say they will vaccinate their 5-to-11-year-old child “right away” once a vaccine is authorized for that age group, according to a September survey by the Kaiser Family Foundation.

Another third say they will “wait and see” how the vaccine is working, and one in four say they definitely won’t get their children in that age group vaccinated.

After restrictions on abortion left Missouri with one in-state abortion clinic in St. Louis, residents turned to neighboring states for abortion services (Photo by Astrid Riecken/Getty Images).

WASHINGTON — A six-week abortion ban in Texas enacted in September forced those seeking abortion services in the Lone Star State to look across state lines for care.

But the timing couldn’t have been worse for Texans living near the state’s eastern border.

The law took effect as neighboring Louisiana was reeling from the destruction of Hurricane Ida, which shut down two of the state’s three abortion clinics for several days. The growing number of patients seeking help had to wait until the clinics could restore power, or travel hundreds of miles to other providers.

But that was just a preview of the obstacles that would emerge if the Supreme Court upholds a Mississippi law that bans most abortions after 15 weeks. For example, Louisiana’s own law would shift to the same 15-week ban, advocates say.

The landmark abortion case that will be heard by the nation’s top court on Dec. 1, Dobbs v. Jackson Women’s Health Organization, could spur a cascade of legal changes across two dozen states if justices back the restrictive Mississippi law — and potentially dismantle the landmark 1973 ruling affirming the right to an abortion.

Access would be most severely restricted in a long band of neighboring states stretching across the South and Midwest, according to the Center for Reproductive Rights, which is challenging the law.

The process would be far more time-consuming for those who have the means to travel elsewhere. And states with fewer restrictions would be bombarded with patients seeking out a shrinking number of providers.

The organization has identified 24 states as “hostile” to abortion rights, meaning those states could immediately or very quickly prohibit abortion. They have laws that were on hold but would automatically go into effect or could be enforced again, or lawmakers there are likely to attempt new bans.

Among those are: Arizona, Georgia, Idaho, Louisiana, Michigan, Missouri, North Carolina, Ohio, Pennsylvania, Tennessee, and Wisconsin.

A dozen states — including Louisiana, Tennessee, Missouri and Idaho — have “trigger laws” that would go into effect banning abortions if Roe v. Wade is overturned, according to the Guttmacher Institute, an organization focused on reproductive health and rights.

Michigan, Wisconsin, Arizona and five others still have abortion bans that pre-date Roe v. Wade on the books, which would become enforceable again if the precedent is overturned. That list shrunk by one earlier this year, when New Mexico repealed its pre-Roe ban.

On the opposite end of the spectrum are 15 states that have laws protecting the right to abortion, a tally that includes Maine, Maryland, Nevada and Oregon, according to Guttmacher.

In Kansas, a state Supreme Court decision in 2019 found the right to bodily autonomy embedded in the state Constitution guaranteed access to abortion. But state voters could change that next year, when a constitutional amendment will be on the ballot to reverse that ruling.

Narrower ruling also would mean new bans

While the Mississippi case will be heard by a Supreme Court with a new conservative majority following the addition of Justice Amy Coney Barrett, it’s not clear that it will lead to a complete reversal of Roe.

But a narrower ruling favoring the Mississippi law also would spur restrictions. A 2019 Georgia law that would outlaw most abortions once fetal cardiac activity is detected — about six weeks into a pregnancy and before many women know they are pregnant — has been on hold, pending the outcome of the Mississippi case.

Louisiana also has a pending law that’s nearly an exact replica of Mississippi’s 15-week ban, and it is explicitly tied to the outcome of the Mississippi case, said Michelle Erenberg, executive director of Lift Louisiana, which advocates for abortion access.

If the Supreme Court backs that neighboring ban, Louisiana’s pending 15-week law also will take effect.

“We’ve grown accustomed to this sort of ping-ponging back and forth, and waiting on judicial review and judicial rulings as these laws have made their way through state legislatures and through the courts,” Erenberg said. “But it is really difficult to feel that you can fully prepare for this inevitability.”

The Supreme Court’s recent rulings suggest it may support the Mississippi law, which was blocked by a lower federal court.

It will be the first time the court will rule on the constitutionality of a pre-viability abortion ban since Roe. That decision forbid states from banning abortions before the fetus can survive outside the womb, or about 24 weeks.

The court’s justices announced in May that they would take up the Mississippi case. Since that announcement, they also voted in a 5-4 decision against preventing the more-strict Texas law from taking effect.

That Texas law bans abortions once cardiac activity can be detected, or typically around six weeks after the patient’s most recent menstrual cycle. It also allows private citizens to file lawsuits against abortion providers and anyone who aids an abortion.

That law was briefly paused by a federal district court, but then reinstated by an appeals court.

Since the Ida-related closures, Louisiana’s abortion providers have seen a substantial rise in the number of Texans seeking abortion services.

Amid the legal chaos and uncertainty, Erenberg said the phone calls from potential patients are “increasingly panicked.”

Record year for state restrictions

The battle at the U.S. Supreme Court is playing out during a year when state legislatures have approved a record number of abortion restrictions, according to tracking data compiled by Guttmacher. As of October, 19 states have enacted 106 restrictions, including 12 abortion bans.

Four states, including Idaho, adopted bans on abortion at six weeks of pregnancy. A Florida lawmaker already has filed a bill for the session beginning in January based on the Texas law, replicating its six-week ban and the ability for citizens to sue people who provide or enable abortions.

“The passing of abortion bans is not slowing down,” said Quita Tinsley Peterson, co-director of Access Reproductive Care-Southeast, an abortion fund working in Georgia, Florida, Alabama, South Carolina, Tennessee and Mississippi.

Residents across most of those states already are living in “a post-Roe reality,” Tinsley Peterson said, describing the myriad of limitations that have been enacted on abortion access across the South. (Florida is the only state in ARC-Southeast’s region that has passed any abortion protections.)

When the Texas law went into effect, ARC-Southeast worked with another abortion fund to help support people who may be seeking services across the group’s region.

But “people weren’t really calling us,” Tinsley Peterson said. Texans seeking help in other states faced a number of other challenges in states where abortion was technically available, such as waiting periods in Tennessee and Alabama that require multiple appointments or a lengthy trip to get to less-restricted clinics in Georgia or Florida.

“That’s not a decision that anyone should be forced to make: Are they going to drive or fly hundreds of miles for a simple, safe health care procedure?” Tinsley Peterson said.

Longer wait times in states with fewer restrictions

One of the few states that has acted to back abortion rights is New Mexico, where earlier this year state legislators repealed the state’s pre-Roe abortion ban, so it cannot be enforced if the Supreme Court overturns the Roe case.

That effort was driven by “the understanding that a federal protection is not the end-all be-all,” said Charlene Bencomo, executive director of Bold Futures New Mexico, one of the groups that worked to repeal that dormant ban.

But while the state has a more-favorable legal landscape, “actual access is pretty scarce” across the large, rural state with only a handful of providers, Bencomo said.

That’s become even more apparent since the Texas law took effect, which has resulted in New Mexico providers becoming inundated with calls, the same prospect predicted for other abortion-rights states if the Mississippi law holds.

Providers in New Mexico have described an “overwhelming sense of fear and panic,” including among New Mexico residents unsure if the Texas law would mean changes in their state, she added.

One consequence will be longer wait times for patients and longer work days for providers. Some people may need to travel to neighboring Colorado to obtain abortions, she said.

For states and residents seeking abortion services, legal clarity on what comes next also will be a matter of waiting.

The Mississippi case will be heard by the Supreme Court in a few weeks, but a decision isn’t likely until next year, potentially as late as the end of the court’s session in June.

Until then, abortion providers and activists who support abortion rights will be left to watch the court weigh arguments on whether a state law banning abortions much earlier than the Roe standard can be constitutional.

A nearly four-hour U.S. House hearing was the first public effort by Congress to question several key Arizona officials and other election experts about the questionable procedures involved in the months-long, GOP-led ballot review and the ramifications for public faith in the election process (Getty Images).

WASHINGTON — It didn’t take long for Thursday’s congressional hearing about a controversial ballot review in Arizona to demonstrate the persistent misinformation about the validity of last year’s presidential election.

Rep. Jamie Raskin, a Maryland Democrat, asked his colleague, Arizona Republican Andy Biggs, if he accepts the findings of the GOP-led review of ballots in Maricopa County. That so-called audit did not dispute the state’s certified result that President Joe Biden won Arizona’s electoral votes.

“Who won the election in Arizona? Donald Trump or Joe Biden?” Raskin asked Biggs.

“We don’t know,” Biggs incorrectly claimed, adding: “There are a lot of issues with this election that took place.”

Raskin expressed exasperation as he resumed his opening statement to the rest of the House Oversight and Reform Committee.

“There’s the problem that we have,” Raskin said. “Donald Trump refused to accept the results. And unfortunately, we have one of the world’s great political parties, which has followed him off of the ledge of this electoral lunacy, and it’s dangerous for democracy.”

The nearly four-hour U.S. House hearing was the first public effort by Congress to question several key Arizona officials and other election experts about the questionable procedures involved in the months-long, GOP-led ballot review and the ramifications for public faith in the election process.

Absent from that interrogation was Doug Logan, CEO of Cyber Ninjas, the Florida-based firm that was hired to conduct the ballot review.

Logan told the committee this week that he was refusing to testify, a decision that comes after his company also has repeatedly refused to cooperate with document requests from lawmakers in D.C. and in Arizona.

During Thursday’s hearing, the witness table included a name tag and empty seat reserved for Logan, and Democrats berated him for declining to participate. Committee leaders have not yet said whether they will subpoena Logan to compel his testimony, which is within their power.

“Mr. Logan’s refusal to answer questions under oath is just one more sign that the dark-money-fueled audit that he led should never have happened in the first place,” said Rep. Carolyn Maloney, D-N.Y., who chairs the oversight panel.

County supervisors testify

Instead of hearing from Logan, legislators questioned two Republicans on the Maricopa County Board of Supervisors who opposed the “audit,” Chairman Jack Sellers and Vice Chairman Bill Gates.

Sellers and Gates defended the county’s lengthy planning efforts to ensure last year’s elections were safe and secure. They described the 2020 general election as the most-scrutinized election in the county’s history — followed by a drive by fellow Republicans to discredit those results, the county’s auditing process, and the level of cooperation by Maricopa officials.

Gates described how county officials went to court to get direction on whether they could in fact turn the ballots over to a third-party group like Cyber Ninjas — and even after they sought an expedited ruling, the state Senate was one vote away from holding them in contempt.

“That was wrong,” Gates said. “It was also wrong once they had the ballots, in my opinion, to conduct an audit with auditors who had no elections experience, and then also auditors who clearly had a preconceived notion.”

“I don’t have a problem with audits,” he added. “I had concerns with this particular audit.”

Also testifying was Ken Bennett, a former Arizona secretary of state who served as a liaison between the Arizona state Senate and the companies hired for the ballot review.

Bennett asserted that the aim of the “audit” was simply to verify that official election procedures were followed, and noted that the most “significant” finding was that the hand count very closely matched the official results in the presidential race.

Bennett also criticized what he described as a lack of cooperation by county officials in the ballot review.

“Not many people like to have their work checked, but audits are much better with the cooperation of the auditee,” he said.

Router questions

Several Republicans on the panel expanded on that line of attack.

Rep. Paul Gosar, R-Ariz., raised questions about county officials blocking access to routers. Gates responded that there were cybersecurity concerns with allowing access to those devices, and costs associated with having to eventually put the county’s network back together.

An agreement was eventually reached that will allow the county to keep its routers out of the hands of Cyber Ninjas, as the Arizona Mirror has reported. Instead, it will involve the appointment of a special master to answer any questions related to the routers and their data.

Other Republicans on the panel used their time to repeat misinformation about the 2020 election results.

Rep. Clay Higgins, R-La., said he believes the 2020 election “was indeed compromised,” and that a full investigation would “take time.”

“Yet as of January 20, 2021, Joe Biden was the inaugurated president,” Higgins said. “Listen good: On January 20, 2025, we’re gonna fix that. And Democrats will have an opportunity to deal with the re-elected and newly inaugurated President Donald J. Trump again, and I have no doubt that my Democratic colleagues across the aisle will object.”

Election experts have expressed alarm that the ongoing unsubstantiated claims of voting impropriety have undermined confidence in elections across the country.

Rep. Rashida Tlaib, D-Mich., asked Gates if he believes the audit was about restoring faith in elections, as supporters have claimed.

For some involved, they may have been focused on ensuring any lingering questions about the election were answered, Gates said.

“But unfortunately, I do believe that a lot of people who led this, that was not their major focus,” Gates said. “Instead, I think it was more on raising doubts, and I think we’re seeing that again today, quite frankly.”

Maricopa County ballots from the 2020 general election were examined and recounted by contractors hired by the Arizona Senate in an audit at the Veterans Memorial Coliseum in Phoenix on May 24, 2021. (Photo by David Wallace | Arizona Republic/pool photo).

WASHINGTON — When the U.S. House Oversight and Reform Committee holds a hearing Thursday to probe the so-called election “audit” in Arizona, the CEO of the company hired to conduct that controversial review will be absent.

Doug Logan, CEO of Cyber Ninjas, was asked to testify but told committee officials ahead of the hearing that he is refusing to participate, according to a press release from the panel Wednesday.

Logan’s unwillingness to testify comes after he and his company repeatedly refused to produce documents sought by the Oversight Committee, which is controlled by the Democratic majority in the House, as part of its investigation into the Arizona election review.

A spokeswoman for the House Oversight panel declined to comment on whether the committee will subpoena Logan, a step that is within the committee’s authority.

The result of the months-long review of ballots in Maricopa County was the same as the official outcome: President Joe Biden defeated former President Donald Trump in the county and in Arizona.

But election experts across the country have expressed alarm that the ongoing unsubstantiated claims of voting impropriety have undermined confidence in elections across the country.

“Consistent with Congress’s constitutional authorities, the committee is investigating the extent to which your company’s actions have undermined the integrity of federal elections and interfered with Americans’ constitutional right to cast their ballot freely and to have their votes counted without partisan interference,” wrote Democratic Reps. Carolyn Maloney of New York and Jamie Raskin of Maryland in a letter last month directing Logan to appear before their panel.

Thursday’s hearing will include testimony from two Republicans on the Maricopa County Board of Supervisors who opposed the “audit,” Chairman Jack Sellers and Vice Chairman Bill Gates.

Other witnesses will include a pair of election experts: David Becker, founder and executive director of the Center for Election Innovation and Research, and Gowri Ramachandran, senior counsel at The Brennan Center for Justice at New York University Law School.

A final witness, invited by the panel’s Republican members, will be Ken Bennett, a former Arizona secretary of state who served as a liaison between the Arizona state Senate and the companies hired for the ballot review

Bennett replaces an earlier invited GOP witness, Dr. Shiva Ayyadurai, an MIT-trained engineer and entrepreneur who has a history of promoting discredited and debunked conspiracy theories about the 2020 election, according to the Arizona Mirror.

Meanwhile, former Missouri Gov. Eric Greitens visited Arizona this week to signal his continued support of debunked conspiracies around the 2020 presidential election.

Greitens, who is running for U.S. Senate, posted videos on Twitter of him with an Arizona state legislator to tout the “first, quality audit of the 2020 election.”

“The mainstream media, and the left, are terrified,” Greitens said, “as are weak, woke RINOs.”

Sen. Roy Blunt speaks to reporters on March 10, 2020 in Washington, DC. (Photo by Samuel Corum/Getty Images).

WASHINGTON — Congress made a last-minute dash to avert a government shutdown on Thursday, with the U.S. Senate and House approving a short-term spending bill just hours ahead of a midnight deadline.

Every Democratic and independent senator and 15 Republicans supported the bill in the 65-35 vote. The GOP senators in the “aye” tally included Bill Cassidy and John Kennedy of Louisiana; Susan Collins of Maine; Roy Blunt of Missouri; and Richard Burr and Thom Tillis of North Carolina.

The House later passed the federal spending bill — which will keep government agencies funded at current levels through Dec. 3, and provide $28.6 billion in aid for regions struck by extreme weather — on a vote of 254-175.

Every House Democrat and 34 House Republicans voted to send the measure to President Joe Biden, who is expected to sign it.

“This vote says we are keeping the government open,” Senate Majority Leader Chuck Schumer, (D-N.Y.), said Thursday, calling it a “glimmer of hope” as Congress faces a slew of other legislative challenges.

Chief among those is increasing the federal borrowing limit, which must be done to prevent a default on the nation’s debt obligations. That default could occur as soon as mid-October, according to Treasury officials.

Democrats, who barely control the split 50-50 Senate, initially sought to advance legislation that would have increased the national debt limit, in addition to the provisions to avert a government shutdown and to approve disaster aid.

But GOP senators opposed raising the debt limit at a time when Democrats also are seeking to push through a massive social spending plan with no Republican support. They blocked an attempt Monday to begin debate on that broader bill.

Democrats expressed frustration that Republicans would risk a default. But ultimately they were forced to push off the extension of the debt limit, which will need to be done with only Democratic votes to avoid economic chaos.

The spending bill also includes $22 million to pay for the National Institute of Standards and Technology to investigate the Surfside building collapse in Florida, a provision praised by Rep. Debbie Wasserman Schultz, a Democrat whose district includes the site of that building site.

“We have years in front of us to determine just exactly how this building collapse occurred, and to adopt policies to make sure that it never happens anywhere in the country again,” she said.

Several GOP-drafted amendments to the spending bill failed during Thursday’s Senate floor votes, including one from Sen. Roger Marshall of Kansas.

Marshall’s amendment sought to prohibit the use of federal funds in enforcing COVID-19 vaccine mandates. He argued that receiving a vaccine should be a “personal choice” and not one that is mandated by the federal government.

The amendment failed on a 50-50 vote. Sen. Patrick Leahy, (D-Vt.), argued against Marshall’s amendment, saying it would “weaken one of our strongest tools to get people through this crisis.”

Meanwhile, other major pieces of the Democratic agenda remain stalled in Congress.

It remains unclear if Democratic leaders in the House will bring up President Joe Biden’s infrastructure legislation on Thursday.

Key surface transportation programs are set to expire after Thursday, but progressives have opposed voting for the road-and-bridge funding while the fate of a separate but linked proposal to expand a raft of social safety-net programs remains in flux.

Democratic Sens. Kyrsten Sinema of Arizona and Joe Manchin of West Virginia have opposed the $3.5 trillion price tag of the proposal drafted based on Biden’s “Build Back Better” policy plan. Democratic leaders have sought to pass that measure through the reconciliation process, which would allow it to be approved with 50 votes and without any support from Republicans.

St. Louis Department of Public Health registered nurse Barbara Forde gets her Pfizer COVID-19 vaccine from fellow RN Deidre Perry on Jan. 8, 2021 (Photo courtesy of Christopher Ave/St. Louis County Department of Public Health).

WASHINGTON — Eighteen months into the COVID-19 pandemic, state and local public health departments that were already struggling with too few workers and too little money have been pushed to the brink — and for some, beyond the brink.

“My staff is burnt out, overworked and underpaid,” Dr. Mysheika Roberts, health commissioner with the Columbus Public Health Department in Ohio, told U.S. House members on Wednesday. “Some are leaving the field entirely, unable to contribute any more to the work they once loved.”

“Simply put,” Roberts added, “their tank is empty.”

She and other public health officials from Kansas and Louisiana painted a bleak picture to the House Select Subcommittee on the Coronavirus Crisis during a hearing on the challenges facing public health departments.

While some of those problems have intensified during the pandemic, such as harassment and vitriol from those who refuse to believe the science behind vaccines, other issues, like a lack of resources, have been mounting for decades.

Roberts described how an emergency-preparedness unit that once had 20 staffers was down to five by the time the pandemic hit. Staffers from across the public health agency, some whose jobs have little to do with infectious disease response, have been called into the all-hands-on-deck fight.

The result? Staff fatigue and early retirement, while those who remain on the job have faced harassment and challenges to the authority of public health agencies.

Anger over mask mandates

Officials from across the country told similar stories.

Dr. Jennifer Bacani McKenney, a health officer in the Wilson County Health Department in Kansas, said a local sheriff volunteered to escort her to her car after a public meeting on mask mandates, because he was worried about the angry residents who spoke at the meeting.

McKenney, who is still employed by the rural health department, said she was later told that her job would be opened up for applications because she focused “too much on health and science, and not enough on business.”

“Many of my colleagues have experienced worse harassment than me, by the general public and elected officials, but some have not been able to speak up for fear of retaliation,” McKenney told the committee.

Since the pandemic began, more than 300 state and local public health leaders have left their jobs, according to Dr. Beth Resnick, assistant dean at Johns Hopkins University’s Bloomberg School of Public Health. That represents 1 in 5 Americans losing a public health official in their community.

McKinney attributed the decisions of many of those workers to the strain caused by the hostilities that her colleagues and others across the country have endured since the pandemic began.

“It’s because every day, they have to endure things like people lying to them about their close contacts or when their symptoms started,” she said. “It’s truly the personal effect of the way they’re putting their whole heart into everything that they’re doing to help people, only to get other people to, again, lie or yell or attack or shaming them in public for just trying to do their job.”

Resnick said she and her colleagues have identified at least 1,500 incidents in which public health workers have been attacked or harassed since the pandemic began. Half of local health departments they surveyed reported at least one incident of an attack or harassment, from protests to death threats to shots fired at their homes.

She urged members of Congress to establish a national reporting system for incidents of violence and harassment against public health workers, and for the federal Department of Justice to support state and local prosecutors in enforcing existing laws.

Consistent funding

Local health officials also called for more consistent, long-term funding for their agencies.

They expressed frustration with grants that may last only a year or two, and that are narrowly tailored to specific diseases or health challenges at that moment.

That system of funding makes it too difficult to retain talent within agencies that should be well-prepared to respond to a broad range of threats, they said.

“You can never build for the future if your funding is limited to the priorities of yesterday’s appropriations,” said Dr. Joseph Kanter, state health officer and medical director for Louisiana’s Department of Health.

Illustrating the scale of what health agencies are still grappling to contain, Kanter noted that Hurricane Ida resulted in 30 deaths in Louisiana. Since that storm made landfall, his state has tallied 1,541 deaths related to COVID-19.

The $1.5 trillion government funding section of the bill includes the first round of earmarks in more than a decade (Getty Images).

WASHINGTON — U.S. Senate Republicans blocked an attempt by Democrats on Monday evening to begin debate on a broad bill that would avert multiple looming fiscal crises for the federal government.

The measure to briefly keep the government operating past the end of the fiscal year on Thursday, as well as to increase the borrowing limit and approve billions in aid for regions struck by extreme weather, failed on a vote of 48-50.

All Democrats supported the measure and all Republicans opposed it, with Senate Majority Leader Chuck Schumer, D-N.Y., switching his vote to “no” so the measure could be brought up later for another vote.

It was not yet clear Monday evening how congressional Democrats would proceed with tackling the major, time-sensitive issues on their plate.

After the vote, Schumer said only that they will be taking “further action” this week.

The failed vote was expected, after Minority Leader Mitch McConnell, R-Ky., has said for weeks that GOP senators would oppose raising the debt limit at a time when Democrats also are seeking to push through a massive social spending plan with no Republican support.

The stalemate sets up a dangerous scenario: If the Democratic-controlled chambers of Congress can’t pass a short-term spending bill before midnight Thursday, the federal government would begin to shut down. That means suspending non-essential government services, and scaling back those that must continue.

And without congressional action to increase the amount of money that the federal government can borrow — a step necessary due to years of accumulating debt obligations — the country could risk defaulting on its debts.

After the failed vote, Schumer blamed GOP senators for the looming uncertainty, accusing them of “playing games with the full faith and credit of the United States.”

“The Republican Party has solidified itself as the party of default, and it will be the American people who pay the price,” Schumer said.

Republicans likewise pointed fingers at Democrats, who barely control the split 50-50 chamber, with Vice President Kamala Harris able to break tie votes.

McConnell argued for voting on an identical measure that would leave out the debt ceiling increase, saying his party will not help lift the debt ceiling while Democrats “write a reckless taxing-and-spending spree of historic proportions,” a reference to the $3.5 trillion social spending bill that’s a central part of President Joe Biden’s policy agenda.

Both of Louisiana’s senators, Republicans Bill Cassidy and John Kennedy, opposed moving ahead with the Democratic bill and spoke in support of removing the debt ceiling hike, highlighting the storms that have wreaked havoc on their state and the need to move forward on areas where there is agreement.

“It is moronic for us to be having this fight when it can be so easily solved,” Kennedy said, calling for the debt ceiling increase to be added to the budget resolution instead. “Nature abhors a moron.”

Syringes of COVID-19 vaccinations are filled during MU Health Care’s mass vaccination clinic at the Walsworth Family Columns Club at Faurot Field in Columbia on Feb. 4, 2021 (Photo courtesy of MU Health Care).

WASHINGTON — Booster shots soon will begin rolling out to some Americans who received the two-shot vaccine made by Pfizer—after a contentious and confusing federal approval process that isn’t over yet.

Determining who exactly should be rolling up their sleeves for an additional dose was tricky. The Biden administration had leapfrogged federal regulatory panels in announcing plans for a more sweeping booster campaign that it hoped would have begun last Monday.

Instead, only those who received the Pfizer shots will be eligible for boosters, and boosters will be limited to those 65 and older or individuals with underlying medical conditions, a Centers for Disease Control and Prevention panel recommended Thursday.

The initial eligible groups will also include health care workers, teachers and others at higher risk of exposure to the virus at their workplace — a category that the CDC panel declined to recommend, but the top CDC official added them back in the agency’s official guidance late Thursday night.

The federal booster effort ran into challenges in the month since President Joe Biden made his announcement, including the time it takes to gather data on booster shots.

Pfizer was the first to submit its data to federal regulators, and is the only one of the three vaccines so far to be formally considered for booster use.

Given a lack of data on the safety of mixing vaccines from different manufacturers, Americans who received the Moderna and Johnson & Johnson shots must wait to have their own boosters approved.

As federal health officials have scrambled to assess data on booster shots, the U.S. has been facing a fourth wave of cases, with an average of 130,000 infections and more than 2,000 deaths per day.

The overwhelming majority of current COVID-19 cases, hospitalizations and deaths are among people who have not received a vaccine against the disease. Some members of the CDC advisory panel expressed uncertainty over the potential for boosters to tamp down the spike in infections.

“We may move the needle a little bit” by recommending booster doses, “but that’s not really the answer to this pandemic,” said Dr. Helen Keipp Talbot, associate professor of medicine at Vanderbilt University, emphasizing the need to vaccinate those who still haven’t received their initial shots.

Here are some questions and answers about boosters:

Who can get a vaccine booster?

Pfizer booster shots will initially be recommended to those 65 and older, or in long-term care facilities, as well as those between 50 and 64 who have underlying medical conditions.

The CDC panel also voted to allow those between 18 and 49 years old with underlying medical conditions to obtain booster shots, based on an individual assessment of their risk from COVID-19.

The panel rejected a broader recommendation of a booster for anyone 18-64 who is in an occupational or institutional setting where risk of COVID-19 transmission is high, such as health care workers.  Several experts on the panel expressed concerns about the category being too broad and including some who may not receive much benefit from a booster shot.

But Dr. Rochelle Walensky, head of the CDC, included it in her guidance, as did the Food and Drug Administration when that agency granted its signoff on Wednesday.

Roughly 26 million Americans are at least six months past their second Pfizer dose, and about half of those individuals are 65 or older, according to the CDC.

What if I’m not in one of the approved categories?

You should wait to seek out a booster shot.

Data presented during the FDA and CDC hearings shows that while the vaccines’ effectiveness has waned when it comes to being vulnerable to infections, breakthrough infections still tend to be mild and the shots’ protection against severe illness and hospitalization remains strong.

“If you’re not in a group for whom boosters are universally recommended, it’s really because we think you’re well-protected,” said Dr. Matthew Daley, a senior investigator with Kaiser Permanente Colorado’s Institute for Health Research.

What if I received a shot made by Moderna or Johnson & Johnson?

For now, you’ll have to wait.

Moderna has submitted its federal application for a booster shot, and Johnson & Johnson said this week that it has provided data to the FDA on its booster study.

A number of health experts at Thursday’s CDC advisory panel meeting expressed frustration about the lack of safety data on whether the shots can be mixed across manufacturers. FDA officials said they are working with those drug companies and the National Institutes of Health to gather the information needed for a science-backed ruling.

What if I want to get one anyway?

The recommendations do not include any requirements that health care providers confirm that those seeking a booster vaccine are in the eligible categories (which also include people who are immunocompromised, who were approved last month for boosters).

But the federal regulations on using those boosters under emergency approval mean that providers are supposed to strictly follow requirements on how the vaccines can be used.

When and where can I get a booster dose?

For the eligible groups, booster shots are recommended at least six months after receiving the second dose of Pfizer’s vaccine.

Most individuals can head to their local pharmacy: More than 70% of COVID-19 vaccines currently are being administered through pharmacies, according to the CDC.

Will this change what it means to be fully vaccinated?

Not yet. Regulators said Thursday that the definition of being “fully vaccinated” — which is used by workplaces, entertainment venues and a range of other public and private settings — will still be the two doses of the Pfizer or Moderna vaccine (and one of the single-dose J&J shot).

Will the booster recommendation be expanded to more Americans?

These won’t be the last COVID-19 vaccination recommendations from federal health officials.

Throughout Thursday’s meeting, CDC doctors emphasized that the recommendations are on an interim basis, and will be re-evaluated and updated.

While children have been much less likely to be hospitalized or die from a COVID-19 infection thanks in part to differences in how their bodies respond to the virus, many still have become sick (Photo courtesy of CDC/ Amanda Mills).

WASHINGTON — The coronavirus pandemic has brought heartbreaking consequences for millions of U.S. children, even as most avoided serious illness themselves, pediatric experts told Congress on Wednesday.

Take, for instance, a young girl from Tennessee named Sophia, whose story was relayed by Dr. Margaret Rush, president of Monroe Carell Jr. Children’s Hospital at Vanderbilt University.

Within a few days after Sophia started kindergarten, she contracted a mild case of COVID-19, Rush said. She didn’t require hospitalization, but her parents, both unvaccinated, soon became critically ill.

Neither of Sophia’s parents survived, making her among 1.5 million children worldwide who have lost a main caregiver to COVID-19, Rush said.

“Sophia, now five, will carry this pain forever,” Rush said during the hearing held by the U.S. House Energy and Commerce’s Subcommittee on Oversight and Investigations. “There should be no question that this pandemic has negatively impacted the health and well-being of children, now and perhaps well into the future.”

While children have been much less likely to be hospitalized or die from a COVID-19 infection thanks in part to differences in how their bodies respond to the virus, many still have become sick.

As of Sept. 16, more than 5.5 million children have been infected by the virus since the start of the pandemic. That represents more than 15% of the total cases, according to Dr. Lee Beers, president of the American Academy of Pediatrics.

More than 21,000 children have been hospitalized, a rate that’s 2.5 to 3 times higher than flu-related hospitalizations, Beers testified.

At least 480 children have died as a result of COVID-19, making it one of the 10 leading causes of death for U.S. kids and one that has disproportionately affected Black and Latino children.

Delta variant, and the return to school

The more-transmissible delta variant, and the lack of a vaccine approved for children under 12, have been reflected in an exponential rise in infections among children.

There were more than a million new cases among children between Aug. 5 and Sept. 16, Beers said, and more than 225,000 cases added in the past week.

Rush said her hospital has seen a shift in the age distribution among children testing positive, though the percentage of children requiring hospitalization has remained about the same.

Still, children’s hospitals have seen an uptick in patients because more children nationally are being infected, she added.

Rep. Frank Pallone, D-N.J., who chairs the Energy and Commerce Committee, described the increases among children as “alarming,” and asked why it is that the children’s hospitals have been so hard-hit.

“Many of the public-health measures that were in place in 2020 that separated children, and they kept children more isolated, as we’ve all talked about this morning, also prevented the transmission of disease,” Rush said. “So children are now back together, they’re in school settings … and so they are sharing germs again.”

Tennessee’s low rate of vaccination has been a factor in the increases seen locally, she said, citing the state’s intermittent recent ranking as the state with the highest number of COVID cases for both adults and children.

Teenagers in Tennessee also have a vaccination rate that is below the national average for that age group, Rush added.

Mental health issues

But the pandemic’s effect on children goes beyond the direct consequences of an infection.

Whether they’ve become sick or not, American kids have had three school years disrupted due to COVID-19, and have faced growing challenges with mental health, obesity, and the loss of learning that should have occurred during those years.

Each of the witnesses during Wednesday’s hearing specifically mentioned the mental health issues for kids, who spent months away from school and friends. Rush described behavioral health as an epidemic among children before the COVID-19 pandemic, and said that hospitals have seen more children showing up in crisis.

Dr. Tracy Beth Høeg, a physician and researcher at the University of California at Davis, questioned whether some U.S. policies for children, including rules on mask use and school closures and quarantines, make sense.

She contrasted those policies against looser ones in some European countries, arguing that those countries have better acknowledged the non-COVID-19 health risks for children.

“It’s kind of ironic that in trying to keep these kids 100% safe, that they’re feeling abandoned,” Høeg said.

U.S. kids also have faced an uphill fight against vaccine misinformation.

One California teen launched her own site, VaxTeen, after hearing stories of fellow teenagers who were searching for accurate information on how to get vaccinated if their parents would not consent.

Kelly Danielpour, the site’s founder and a Stanford University student, said the pandemic has been a “tremendously difficult” time for everyone, particular for young people.

She asked legislators on the panel to think broadly about what it will mean for children to feel safe and healthy again, suggesting that it will take much more than just lower COVID-19 infection rates.

Danielpour described a Virginia teenager who had contacted her after successfully convincing her parents to let her be vaccinated. The teen was working in an ice-cream store, and told Danielpour how unsafe she felt, getting yelled at by customers who refused to wear masks.

“There’s so much to be said for the right to feel healthy and safe and protected that we cannot discount,” Danielpour said.

The U.S. Capitol on Dec. 18, 2019 in Washington, D.C. (Samuel Corum/Getty Images).

WASHINGTON — Congressional Democrats approved a short-term spending measure Tuesday over GOP opposition that would keep the federal government operating through Dec. 3 and provide $28.6 billion for costs related to recent natural disasters.

The bill faces a battle in the evenly divided Senate, where Republicans are opposed to a provision raising the debt ceiling. The spending bill would lift the limit on federal borrowing through the end of 2022, which would prevent a default on the federal debt that otherwise will occur in the coming weeks.

The short-term funding measure is needed because Congress is unlikely to finish its work passing full-year spending bills before the end of the current fiscal year on Sept. 30.

But the measure’s fate is complicated by the multiple urgent components packaged into one piece of legislation. Republicans have said they will not support raising the debt ceiling, even though not doing so risks significant fiscal consequences.

Democrats had sought to push past that opposition by including the money needed to avoid a government shutdown, as well as billions in disaster relief that would help a number of states with Republican legislators in Congress.

That disaster relief money included in the bill is slightly more than the $24 billion that the Biden administration asked Congress to approve for extreme weather events during the last 18 months, including hurricanes, floods and wildfires.

A summary of the new legislation specifies that it would include aid to states related to Hurricanes Ida, Delta, Zeta, and Laura, wildfires, severe droughts and winter storms and other natural and major disasters declared in 2021 and prior years.

“The relief is provided to virtually all corners of the nation, because all corners of the nation have been suffering,” House Appropriations Committee Chairwoman Rosa DeLauro, D-Conn., said during a Rules Committee meeting Tuesday morning.

“It helps to rebuild in the wake of these disasters, and provides a lifeline to families struggling to get back on their feet.”

The disaster relief money would be allocated through a broad range of agencies. It includes:

• $10 billion for crop losses due to devastating storms in 2020 and 2021;
• $2.6 billion to reimburse states for repairs to roads and bridges;
• $1.2 billion in low-interest loans to businesses, homes and renters; and
• $5 billion for Community Development Block Grants for restoration of housing and infrastructure, or economic revitalization.

It also includes funding for drought and disaster response related to Western wildfires, including fire remediation and a waiver on the annual pay cap for emergency wildland fire suppression workers at the Department of the Interior and U.S. Forest Service.

Other money in the bill is intended to reduce the effects of future extreme weather events, through research on forecasting hurricanes and detecting wildfires, and the construction of flood and storm damage-reduction projects.

The Biden administration issued a statement of support on Tuesday night, saying the measure “would keep the federal government open, provide disaster relief, and avoid a catastrophic default so that the government can continue serving the American people without interruption as we continue to confront a pandemic, recover from and respond to disasters, and power an economic recovery. “

After restrictions on abortion left Missouri with one in-state abortion clinic in St. Louis, residents turned to neighboring states for abortion services (Photo by Astrid Riecken/Getty Images).

WASHINGTON — The U.S. Supreme Court will hear oral arguments on Dec. 1 in a case that threatens to overturn decades of abortion protections established under the landmark 1973 ruling in Roe v. Wade.

The upcoming case, Dobbs v. Jackson Women’s Health Organization, stems from a Mississippi law that bans most abortions after 15 weeks. It has been blocked by a lower federal court.

The nation’s top court announced in May that it would take up the Mississippi case. Since that announcement, the justices also voted in a 5-4 decision against preventing a more-strict Texas law from taking effect.

That Texas law bans abortions once cardiac activity can be detected — typically around six weeks of pregnancy, and early enough that many women still do not know they are pregnant. It also allows private citizens to file lawsuits against abortion providers and anyone who aids an abortion.

Also on Monday, a coalition of attorneys general from 23 states and the District of Columbia filed an amicus brief asking the Supreme Court to deny Mississippi’s request that it declare broadly that there is no constitutionally protected right to an abortion.

That coalition includes attorneys general from Colorado, Maine, Maryland, Michigan, Minnesota, Nevada, New Jersey, New Mexico, North Carolina, Pennsylvania, Virginia, and Wisconsin.

They argue in the brief that the Roe v. Wade decision takes into consideration state interests, while also protecting the ability of individuals to “make one of the most consequential, intimate and properly private decisions” they will ever confront.

Congressional Democrats are taking up legislation as soon as this week to enshrine the legal protections from the Roe ruling in federal law. But even if that bill passes the U.S. House, where Democrats hold a slim majority, it’s unlikely to pass in the evenly divided U.S. Senate.

In Missouri, the Eighth U.S. Circuit Court of Appeals will hear arguments Tuesday morning in a lawsuit challenging a 2019 law criminalizing abortions after eight weeks of pregnancy with no exceptions for rape or incest.

The Missouri law before the court, which has blocked through an injunction,  also criminalizes abortions if they are being sought solely because of a prenatal diagnosis, test, or screening indicating Down Syndrome or the potential of Down Syndrome in an unborn child.

Missouri Attorney General Eric Schmitt speaks to a gathering of Missouri State Highway Patrol troopers in April 2021 (photo courtesy of the Attorney General's office).

WASHINGTON — More than 20 Republican state attorneys general — including Missouri’s Eric Schmitt — are threatening to sue the Biden administration over its mandate that large employers require their employees to either be vaccinated against the coronavirus or undergo weekly testing.

In a Thursday letter, the 24 attorneys general pushed the administration to remove the requirement that would affect nearly 80 million Americans and instead let employees make their own decisions on vaccinations.

“There are many less intrusive means to combat the spread of COVID-19 other than requiring vaccinations or COVID-19 testing,” they wrote. “The risks of COVID-19 spread also vary widely depending on the nature of the business in question, many of which can have their employees, for example, work remotely.”

On Sept. 9, President Joe Biden instructed the Department of Labor to issue a temporary emergency rule under the Occupational Safety and Health Act to mandate that employers either put in place a vaccine requirement, mandate weekly COVID-19 testing or fire employees who refuse to get vaccinated.

He later met with business leaders “who champion vaccine mandates that will. . .make sure that we keep businesses open and workers safe,” he said, underlining the mandate support from a traditionally Republican group.

The state attorneys general argue that Biden’s mandate is not legal.

“If your Administration does not alter its course, the undersigned state Attorneys General will seek every available legal option to hold you accountable and uphold the rule of law,” they wrote.

They argue that to justify OSHA’s emergency standard, the administration needs to prove that employees are exposed to grave danger.

“Moreover, many Americans who have recovered from COVID-19 have obtained a level of natural immunity, and the statistics are clear that young people without co-morbidities have a low risk of hospitalization from COVID-19,” they said. “You thus cannot plausibly meet the high burden of showing that employees in general are in grave danger.”

However, some studies have shown that COVID-19 infections are rapidly increasing in children. The American Academy of Pediatrics says that as of Sept. 9, nearly 5.3 million children have tested positive since the beginning of the pandemic and 243,000 cases were added in one week in September, the second-highest number in a week since the pandemic began.

The academy says that “at this time, it appears that severe illness due to COVID-19 is uncommon among children. However, there is an urgent need to collect more data on longer-term impacts of the pandemic on children, including ways the virus may harm the long-term physical health of infected children, as well as its emotional and mental health effects.”

Nearly 700,000 Americans have died of COVID-19 and there have been more than 44 million cases of the virus. Some of those who have recovered from the virus have suffered from long-haul COVID-19 symptoms, as reported by the Atlantic.    

The state AGs also argue that putting in place vaccine requirements is “likely to increase skepticism of vaccines.”

More than 180 million Americans, or at least half the U.S. population, are fully vaccinated, according to data from the Centers for Disease Control and Prevention.

The U.S. Capitol (photo by Drew Angerer/Getty Images).

WASHINGTON — New Medicare benefits for older Americans, like dental care.

An expansion of eligibility for Medicaid for low-income people in Republican-controlled states that have declined to take that step.

And potentially an historic effort to rein in prescription drug prices — if congressional Democrats can work through objections from moderates in their party.

The massive $3.5 trillion budget reconciliation package that House Democrats finished sketching out this week would make significant changes to how Americans obtain health care.

The proposals were drafted based on President Joe Biden’s “Build Back Better” policy plan. The House Democrats’ outline may be altered in the Senate, where some senators want to tweak those policies (including getting those upgraded Medicare benefits to seniors sooner).

Any plans also will need to pass procedural muster with the Senate’s parliamentarian, who could rule that certain sections of the bill can’t be enacted using the reconciliation process. That procedure allows bills to be passed with just a majority vote in the evenly divided Senate — meaning reconciliation could reach the president’s desk without any support from Republicans.

Here’s more on the health care provisions woven into that legislation, and how they would work:

Dental, hearing and vision coverage for seniors

One ambition of the proposal advancing in the House is to fill in holes in Medicare’s coverage. The federal health insurance program for seniors and people with disabilities currently doesn’t cover most dental, hearing or vision care — services that beneficiaries now must pay for out of pocket or through supplemental coverage.

The pending legislation would add those benefits, so that dentures, hearing aids, eye exams and glasses would be part of the traditional Medicare program.

However, the dental benefits would not go into effect until 2028, years after the hearing and vision coverage. Some Senate Democrats have opposed that lengthy timeline for incorporating dentists into the Medicare program, and have floated a voucher program to shorten the transition.

Not in House bill? Lowering Medicare eligibility age

One Medicare change sought unsuccessfully by some Democrats was to lower the age for Medicare enrollment, from the current 65 to 60.

That effort — backed by Sen. Bernie Sanders, a Vermont independent who caucuses with Democrats, as well as some centrist House Democrats — didn’t make it into the House legislation. It could be added in the Senate, but it’s likely to face tougher odds in that chamber.

More access to Medicaid

Another major shift would be the expansion of health insurance coverage to more low-income Americans. That would happen in part by broadening eligibility in 12 states that have declined to accept federal funding to extend their programs.

The 12 states that have refused to align with Medicaid eligibility requirements in the 2010 Affordable Care Act — which extended coverage to adults with incomes up to 138% of the poverty level —  include Wisconsin, Kansas, Tennessee, North Carolina, Georgia, and Florida, according to the Kaiser Family Foundation.

Starting in 2025, residents in states that have not expanded Medicaid would be able to join a federally managed Medicaid program.

Until that new fully federal option goes into effect, the proposal would expand the ACA’s premium tax credits to those whose incomes are below the poverty line, to make it easier for them to get health coverage through the insurance exchanges.

The proposal also would require states to begin Medicaid coverage for incarcerated individuals 30 days before they are released, so that people leaving prison have health coverage as they re-enter society.

And states also would be required to extend postpartum Medicaid and Children’s Health Insurance Program coverage for one year after the end of pregnancy, instead of just 60 days. The American Rescue Plan passed earlier this year gave states the option of making that change, while the reconciliation proposal would require it.

Dispute over drug price controls

A key challenge in extending these safety net programs is how to pay for the new costs, and part of the answer is intended to be in the savings from an overhaul to prescription drug pricing.

That proposal would allow the federal government to negotiate over the prices of hundreds of drugs, including insulin, and to penalize drugmakers that hike prices faster than inflation. Those changes, which are part of a separate bill, HR 3, have been projected to save $456 billion over a decade.

But the overhaul ran into opposition from a small group of moderate House Democrats who sought a narrower approach.

With three Democrats — Reps. Kurt Schrader, of Oregon; Scott Peters, of California; and Kathleen Rice, of New York — joining Republicans to vote against the drug pricing proposal in the Energy and Commerce Committee, the panel deadlocked.

The pricing plan did pass out of the Ways and Means Committee, which was crafting another portion of the reconciliation bill. But it also lost another Democratic vote there, with Rep. Stephanie Murphy, D-Fla., opposed.

“I strongly support numerous provisions in the House Ways and Means portion of the Build Back Better Act, especially the historic provisions to combat the existential threat of climate change,” she said in a statement. “But there are also spending and tax provisions that give me pause, and so I cannot vote for the bill at this early stage.

“As this process moves forward, I remain optimistic that the comprehensive reconciliation package will be appropriately targeted and fiscally responsible—paid for by tax provisions that promote fairness but do not hurt working families.”

The fight over reining in prescription drug prices is far from over. Trade groups representing pharmaceutical companies have been lobbying and advertising against the proposal for weeks. Some Senate Democrats also have been skeptical of the drug pricing plan.

Carrots are an excellent source of Vitamin A, which is necessary for healthy eyesight, skin, growth, and also aids our bodies in resisting infection. Carrots are also a good source of potassium. Carrots have a higher natural sugar content than all other vegetables with the exception of beets. This is why they make a wonderful snack when eaten raw, and make a tasty addition to a variety of cooked dishes (Mary Anne Fenley/CDC).

WASHINGTON — The number of states with high obesity among residents has nearly doubled since 2018, according to new data Wednesday from the U.S. Centers for Disease Control and Prevention.

There were 16 states that had obesity rates among adult residents of at least 35% last year, with Iowa, Ohio, Delaware and Texas on that list for the first time. That’s an increase from 12 states in 2019 and nine states in 2018.

Officials with the Association of State and Territorial Health Officials described the obesity rates as having hit all-time highs, and that they signal how the COVID-19 pandemic exacerbated the decades-long pattern of obesity in the United States.

“Our attention on COVID-19 diverted us from focusing on chronic disease prevention, which we need to get back to,” said Marcus Plescia, chief medical officer at the association. “We must get back on track to assure that we have the policies, systems and environments in place to support equitable access to physical activity opportunities and nutrition security for all.”

As recently as 2012, no state had an adult obesity rate above 35%, according to the Trust for America’s Health, a D.C.-based health policy organization.

Last year, more than 20% of adults in every state were obese, according to the CDC.

Mississippi had the highest rate nationally, at 39.7%. The rate in Missouri is 34%.

Others that ranked high were Alabama, Arkansas, Indiana, Kentucky, Louisiana, Michigan, Oklahoma, South Carolina, Tennessee, and West Virginia.

Colorado had the lowest obesity rate, at 24.2%.

Others in the lowest tier — between 20% and 25% — were Hawaii, Massachusetts, and the District of Columbia.

The obesity rates are based on self-reported height and weight data gathered through telephone surveys on health-related risk behaviors, chronic health conditions, and use of preventive services.

Analyzing obesity rates from 2018 to 2020, federal health researchers identified racial, educational and regional trends.

No state had an obesity prevalence at or above 35% among Asian residents, seven had high obesity rates among white residents, 22 had high rates among Hispanic residents, and 35 states had obesity rates at or above 35% among Black residents.

Among adults without a high school degree, obesity rates were 38.8%, while it was 25% among college graduates.

The Midwest and South had the highest levels of obesity among residents, at 34.1% in each region.

Western states had a rate of 29%, with 28% among residents in the Northeast.

(Photo by iStock / Getty Images Plus)

WASHINGTON — Make it simpler to apply for rental assistance money. Allow landlords to apply on behalf of unresponsive tenants. And consolidate two overlapping federal programs aimed at getting financial help to struggling renters.

Those were among the proposals that U.S. House members weighed during a hearing Friday on how to better help states and localities that have moved far too slowly in getting federal emergency rental assistance funds to tenants who need that aid.

Of the $46.5 billion approved by Congress to help renters who fell behind on payments amid the pandemic, only $5.1 billion had been distributed by the end of July, according to Treasury data.

Some states and localities have done better than others, according to housing advocates who testified Friday before the House Financial Services Committee.

New Jersey has distributed 61% of the state’s allocation from the first round of congressional rental assistance money.

Virginia, Texas and the District of Columbia all have distributed more than half of those dollars, according to Diane Yentel, president and CEO of the National Low Income Housing Coalition.

More than a dozen cities and counties have spent more than 80% of their initial allocations, Yentel said. Her written testimony noted that those higher-spending localities include Philadelphia; Leon County, Fla.; and Milwaukee County, Wis.

In Missouri, roughly $45.2 million of the $324 million the state has received so far to cover unpaid rent and utility bills incurred since April 2020 has been distributed. Applications from 8,968 households have been approved.

That is just a small fraction of the estimated 150,000 to 230,000 Missouri households at risk of eviction.

Struggles in Georgia, Tennessee 

But those success stories have been the outliers, she said, adding that 17 states and many localities have spent less than 10% of their allocation, including Georgia and Tennessee.

The reasons for that have varied. Some localities were hamstrung by the need for a state legislature or city council to sign off on a new program, while some received more money than they needed. Others struggled to get landlords or tenants to participate.

And even after federal officials increased flexibility on the required documentation, such as allowing renters to self-attest that they meet eligibility requirements, fewer than 17% of programs allow that easier process.

“Slow-spending [rental assistance] programs tend to do little outreach. They don’t have enough staff to process applications. They have long and complicated applications with overly burdensome documentation requirements,” Yentel said.

She added that if simplified application practices remain optional, “many programs will not adopt them.”

While there’s bipartisan agreement that the rental assistance programs have moved too slowly, Democrats and Republicans disagree over how to get the money moving faster.

Rep. Maxine Waters, the California Democrat who leads the Financial Services panel, has drafted legislation aimed at addressing several of the concerns cited by Yentel, other advocates, and property management firms that also say they want to see the distribution speeded up.

Her proposal would allow landlords to directly apply for back rent after providing notice to their tenants, and permit landlords to apply if a unit is vacant, so long as they did not evict the missing tenant.

It also would make it easier for tenants to show they meet requirements, and would protect localities from liability if applicants are not in fact eligible.

Meanwhile, Republicans have their own proposal, authored by Rep. Patrick McHenry, (R-N.C.). It would consolidate the initial $25 billion rental assistance program authorized last year with the $21.6 billion program approved in March. Those programs have similar but not identical rules and requirements.

While Waters’ bill would lengthen the period for receiving assistance, McHenry’s legislation would speed up the timeline for spending all of those dollars.

Advocates, landlords weigh in 

Margaret Salazar, executive director of the Oregon Housing and Community Services Department, testified Friday that her organization and others are anticipating that they will see even more demand in the months ahead, and that her group supports extending the time period for receiving benefits, as Waters has proposed.

Salazar and her group also support proposals to offer liability protection to agencies distributing the aid: “State and local officials are on the line for meeting this unprecedented emergency, and we’re acting in good faith when we work to balance urgency and accountability,” she told lawmakers.

Speaking on behalf of landlords and property managers in his role leading the National Multifamily Housing Council, David Schwartz said the two bills under consideration “address many of our concerns,” such as streamlining documentation requirements.

He did express opposition to a requirement in the Democratic bill that conditions the rental assistance funds on a commitment that the tenant can remain in their housing for at least the next 120 days. Schwartz said that will amount to another eviction moratorium, and one that could discourage landlords from participating in the program.

“There’s going to be a lot of reluctancy, and I think you’re going to kind of do the opposite of what the bill is intending to do,” he said.

It’s not yet clear if there will be enough support to approve any of the program overhauls when Congress returns later this month.

Congressional Democrats stumbled in an 11th-hour effort in July to extend federal eviction protections. After intense public pressure by some progressive Democrats, the Biden administration announced a ban on evicting renters in counties with high or substantial rates of community COVID-19 transmission.

But that extended ban was challenged by landlords and real estate companies, who argued that the Centers for Disease Control and Prevention moratorium was an overreach. Six members of the U.S. Supreme Court ultimately agreed, causing an abrupt end to that final moratorium extension — and increasing pressure to get as much rental aid out the door as quickly as possible.

President Joe Biden delivers remarks on COVID-19 on June 2, 2021, in the Eisenhower Executive Office Building at the White House (Official White House photo by Adam Schultz).

President Joe Biden (photo courtesy of the White House)

WASHINGTON — Federal employees will be required to be vaccinated against COVID-19 with no opt-out for testing under an executive order that President Joe Biden is expected to sign Thursday, according to several news outlets.

The new requirement will be rolled out as Biden gives a major address Thursday afternoon on new national strategies for combating the coronavirus pandemic and surging cases from the delta variant of that virus.

Those new tactics are expected to include expanded testing and steps to aid schools in keeping their doors open.

Early reports from the New York Times, CNN, and other news sources differed on whether the vaccine mandate would cover all or nearly all of the roughly 2 million federal employees. It’s also expected to include the millions of employees of private contractors that do business with the federal government.

The new vaccine requirement will affect thousands of employees in D.C. and neighboring states. At least 127,000 federal employees live in Virginia and another 115,000 reside in Maryland, according to data from the Office of Personnel and Management.

Those states also are home to many major government contractors, including some of the nation’s largest defense contractors.

But the vaccine mandate also will affect states farther from the nation’s capital. The city with the third-largest population of federal employees, according to OPM, is Atlanta — home to the Centers for Disease Control and Prevention, among other federal offices.

Biden has limited authority to require COVID-19 vaccines. But his administration already has enacted requirements on the military and workers at the Department of Veterans Affairs. He previously pushed federal workers to get vaccinated by announcing that those who refused would have to undergo regular coronavirus testing.

The president of the American Federation of Government Employees, the largest union representing federal employees, said in a statement ahead of Biden’s announcement that the union has strongly encouraged members to get vaccinated, but that any changes like what Biden was set to announce should be negotiated with bargaining units where appropriate.

“We expect to bargain over this change prior to implementation, and we urge everyone who is able to get vaccinated as soon as they can do so,” AFGE president Everett Kelley said in the statement.

The president also has directed nursing homes to ensure their staffers are vaccinated against COVID-19, or risk losing federal Medicare and Medicaid dollars,

Across the country, states have taken a range of approaches to vaccine mandates. Twenty-one states have some sort of mandate in place, covering state employees, nursing home workers, staffers in schools, or some combination of those employment settings, according to data from the Kaiser Family Foundation.

At least 11 states have passed laws prohibiting vaccine requirements by state or local governments.

Climate-induced weather disasters include record wildfires in the West, record-setting heat waves and droughts, and aggressive hurricanes. Here, smoke plumes and hurricane clouds are visible at once (photo courtesy of NASA Earth Observatory).

U.S. Secretary of Education Miguel Cardona talks about the necessity to get vaccinated during a tour Aug. 9, 2021, of Topeka High School’s vaccine clinic with second gentleman Douglass Emhoff (Pool photo by Evert Nelson/The Capital-Journal).

WASHINGTON — Federal education officials have launched civil rights investigations in five Republican-led states that have prohibited school districts from mandating mask-wearing, saying those policies could amount to illegal discrimination against students with disabilities.

The Biden administration notified the education chiefs in Iowa, Tennessee, South Carolina, Utah and Oklahoma of the investigations through formal letters Monday.

The new investigations will examine whether “students with disabilities, who are at heightened risk for severe illness from COVID-19, are prevented from safely returning to in-person education” as a result of the state policies preventing universal masking, according to the letters.

The investigations come after President Joe Biden and Education Secretary Miguel Cardona pledged earlier this month to use the administration’s full oversight and legal authority to stick up for local school officials imposing universal mask mandates in defiance of GOP politicians.

As of last week, eight states had prohibited school districts from setting mask requirements, according to a tally by Education Week, with lawsuits winding through the court system in several of those states. Fifteen states and the District of Columbia require masks be worn in schools.

In Iowa, Gov. Kim Reynolds signed a bill in May that forbids Iowa schools, counties and cities from requiring face coverings.

Tennessee Gov. Bill Lee issued an executive order that requires public schools and school districts to allow parents to opt their child out of a mask mandate, and his lieutenant governor has threatened to take “remedial options” against school systems that refuse to follow

Cardona had sent letters earlier this month to governors in Arizona, Florida, Iowa, Oklahoma, South Carolina, Tennessee, Texas and Utah, writing that restrictions on mask mandates in schools put children at risk.

The Biden administration has limited authority to regulate local school policies, though it does wield significant influence through the sizable sums of money flowing to school districts.

It also can launch civil rights investigations as it did Monday, citing authority to enforce federal laws that protect students with disabilities from discrimination based on their disability. Those laws include a right for students with disabilities to receive their education in the regular educational environment, alongside peers without disabilities, according to the Department of Education.

But federal education officials are arguing that preventing mask use could infringe on that right by “preventing schools from making individualized assessments about mask use so that students with disabilities can attend school and participate in school activities in person,” according to the letters.

“National data also show that children with some underlying medical conditions, including those with certain disabilities, are at higher risk than other children for experiencing severe illness from

COVID-19,” Acting Assistant Secretary for Civil Rights Suzanne Goldberg wrote. “At the same time, extensive evidence supports the universal use of masks over the nose and mouth to reduce the risk of COVID-19 transmission.”

The next steps in the state-federal skirmish may come quickly. Officials from the Education Department’s Office of Civil Rights will contact state education officials within a week to request data and other information necessary for the investigations.

The U.S. Supreme Court in Washington, D.C. (Laura Olson/States Newsroom).

Democrats and Republicans in Congress differ on how best to reduce the number of passengers bringing guns to airports (Russ Rohde/Getty Images).

WASHINGTON — Democrats in the U.S. House of Representatives on Tuesday muscled through a $3.5 trillion budget framework, overcoming a standoff with a handful of centrists who had demanded the House first approve the bipartisan $1.2 trillion infrastructure bill passed by the Senate.

That position by 10 House Democrats — including Reps. Josh Gottheimer of New Jersey, Carolyn Bourdeaux of Georgia, Jared Golden of Maine, and Stephanie Murphy of Florida — prompted a late-night negotiating session Monday between the centrists and top House Democrats.

The move risked upending the president’s domestic policy agenda, due to the razor-thin majority that Democrats have in the chamber.

Ultimately, all 10 voted to approve the budget framework in Tuesday’s party-line 220-212 vote, in which every House Republican voted in opposition.

The procedural vote included a commitment that the House will vote on the Senate-approved infrastructure bill by Sept. 27 — just days ahead of the Oct. 1 deadline that House Speaker Nancy Pelosi, D-Calif., had set for approving both the infrastructure bill and the budget package.

Pelosi said during her floor remarks Tuesday that she “salutes” the bipartisan nature of the infrastructure deal, but said that measure alone is “not inclusive of all of the values we need to build back at a time when we have a climate crisis.”

“Not only are we building the physical infrastructure of America, we are building the human infrastructure of America to enable many more people to participate in the success of our economy and the growth of our society,” Pelosi said.

Tuesday’s budget vote kicks off a fast-paced process that must be completed by Sept. 15 to draft the budget measure, which is expected to create and expand a broad range of domestic policy programs on child care, climate change, community college, immigration and health care.

Colorado Rep. Joe Neguse, who led the floor debate for Democrats, said domestic policy proposals that will be drafted in the budget reconciliation process would be “transformational” through a series of critical policy investments.

“This plan will create good paying jobs, put money in the pockets of American families, lower health care and childcare costs, and invest in our nation’s infrastructure, paid for by ensuring that the wealthiest Americans are paying their fair share in taxes,” Neguse said.

Republicans vehemently opposed the budget resolution, blasting it as recklessly increasing government spending at a time when inflation is increasing costs for American families. Rep. Steve Scalise, R-La., quipped that the bill should be dubbed the “Mountains of Debt for Our Children Act.”

“Democrats know their proposals are unpopular. They can’t even get their own conference to agree,” said Rep. Michelle Fischbach, R-Minn., referring to the objections from the handful of centrist Democrats.

That group of 10 centrist Democrats also included Filemon Vela, Henry Cuellar and Vicente Gonzalez of Texas; Ed Case of Hawaii; Jim Costa of California; and Kurt Schrader of Oregon.

Murphy, of Florida, was not among the initial nine pushing for an infrastructure vote before the budget debate. Instead, she added her name on Monday, writing in an op-ed published in the Orlando Sentinel that linking the two efforts would result in much-needed money for road and bridge projects sitting “stagnant” while Democrats attempt to untangle the most controversial parts of the domestic policy package.

“I’m bewildered by my party’s misguided strategy to make passage of the popular, already-written, bipartisan infrastructure bill contingent upon passage of the contentious, yet-to-be-written, partisan reconciliation bill,” Murphy wrote in the op-ed. “It’s bad policy and, yes, bad politics.”

Murphy’s office did not respond to a request for comment Tuesday.

In a statement after the vote, Gottheimer and eight Democrats who had threatened to withhold their support touted the approach that cleared the House as one that guarantees an infrastructure vote next month that is separate from the domestic budget reconciliation package.

“This is a big win for America and will help get people to work and shovels in the ground,” they said in the statement. “We have established a path forward that ensures we can pass this once-in-a-century infrastructure investment by September 27th, allowing us to create millions of jobs and bring our nation into the 21st century.”

While the centrists framed the outcome as a win, the strategy came with political risks, and some of those involved already have seen blowback from supporters of the domestic policy package that they endangered.

Bourdeaux, who narrowly flipped a congressional district in the northern Atlanta suburbs last year, has faced increased pressure back home since joining the moderate call for an infrastructure vote before the budget vote.

Progressive advocacy groups — as well as one of Bourdeaux’s former Democratic rivals — have publicly challenged the first-term congresswoman’s position and called on her to devote the same energy to the Democratic social spending plan.

“The families we represent literally cannot afford for you to block or pare back these critical priorities,” more than two dozen Georgia-based advocacy groups, such as 9to5 and Georgians for a Healthy Future, wrote in a letter to Bourdeaux.

The coalition said the funding in the Senate-passed bipartisan infrastructure bill only represented “a fraction of what our communities need” and argued the sweeping Democratic budget bill would be a “game changer.”

Democratic leaders in the House also will be watching those centrists closely.

Pelosi said in a statement after the vote that she thanks Gottheimer and the others “for their enthusiastic support for the infrastructure bill and know that they also share in the Build Back Better vision of President Biden.”

Georgia Recorder Deputy Editor Jill Nolin contributed to this report.

Mark Kirchhoff, left, a volunteer with Columbia Project Homeless Connect, speaks July 29, 2021 with Taylor Knoth, a public health nurse, at the registration table for a COVID-19 vaccination clinic. (Rudi Keller/Missouri Independent)

WASHINGTON — The U.S. has its first fully approved vaccine against COVID-19, with federal health officials announcing Monday the approval of Pfizer-BioNTech’s two-dose vaccine.

The green light from the U.S. Food and Drug Administration to move Pfizer’s vaccine from emergency use to full approval is a milestone in the national pandemic response, and one that comes as the country battles another surge in infections and hospitalizations due to the delta variant.

The Pfizer vaccine is the only one of the three shots being used under an emergency authorization so far to gain the FDA’s full approval. Moderna also has submitted an application for full approval, while Johnson & Johnson has said it will do so for its one-dose shot by the end of the year.

The approval represents a lightning-speed process at the FDA, which condensed a review process that typically would take roughly eight months in just three months.

As they sought to conduct that approval at a much faster pace due to the pandemic, public health officials also attempted not to undermine confidence among those who have said they were waiting to see the agency give a full sign-off before getting a jab.

“The moment you’ve been waiting for is here,” President Joe Biden urged Americans during a press conference Monday afternoon. “It’s time for you to go get your vaccination, and get it today.”

The vaccine’s full approval also may mean more Americans will be required to receive a vaccine in order to attend school, go to work, go out to eat, or attend concerts and other large-group events.

Members of the military are the latest to be subject to a vaccine mandate. Pentagon officials said Monday that a timeline for the new requirement is under discussion.

Pfizer shot to be marketed as Comirnaty

The Pfizer vaccine was the first of the three current COVID-19 shots to receive emergency approval in mid-December. Initially authorized for those 16 and older, that authorization was expanded in May to include shots for those 12 through 15 years of age.

Monday’s approval changes the status for the shot’s use in those 16 years and older. While the vaccine will now have a new brand name — Comirnaty — nothing about the vaccine formula itself has changed.

The process involved significant data reviews, examining hundreds of thousands of pages of information from the clinical trials and visits to sites where the vaccine was studied and produced. Peter Marks, director of FDA’s Center for Biologics Evaluation and Research, told reporters that more than half of the clinical trial participants have been tracked for any safety concerns for at least four months, and 12,000 have been followed for six months.

The full approval does not yet extend to vaccines for those between 12 and 15 years old, who can still receive Pfizer shots through the emergency-use authorization.

Pfizer also is expected to apply this fall for using the vaccine in those under age 12, who are not yet eligible for any of the COVID-19 vaccines.

Federal regulators also have approved a third booster dose of the Pfizer shot for those who are immunocompromised. Additional boosters are likely to be approved for the broader population, beginning eight months after a second dose, but regulators at the FDA and Centers for Disease Control and Prevention have not yet set dates for approving those boosters.

Approval effect on vaccination rate

Nationally, vaccination rates, which had lagged since a spring peak, have been rising again, with 62% of those over age 18 now fully vaccinated. Six million shots have been administered in the last seven days, marking the highest seven-day total in a month and a half, Biden said Monday.

Those rising numbers come as the delta variant has wreaked havoc across the country, filling hospital beds and causing a rise in pediatric admissions due to COVID-19. The vast majority of those hospital admissions are among Americans who have not yet been vaccinated.

Among those who have not received a COVID-19 vaccine, three in 10 said in a June tracking survey by Kaiser Family Foundation that they would be more likely to get vaccinated if one of the vaccines authorized for emergency use were to receive full approval from the FDA.

The National Governors Association praised the FDA’s approval in a statement Monday, calling it “another tool that will help combat hesitancy.”

“We have heard from many of our residents as we have traveled across our states and territories, held town halls, and met with residents, who are hesitant to get vaccinated because they are awaiting full approval of the vaccines,” said Govs. Asa Hutchinson of Arkansas and Phil Murphy of New Jersey, who lead the NGA, adding that the approval helps to address some objections and safety concerns.

More vax mandates to come?

As he urged unvaccinated Americans to get their shot, Biden on Monday also praised governors, mayors and companies that have required their employees and patrons to be vaccinated against COVID-19.

The full approval of Pfizer’s shot may spur an uptick in vaccine requirements in the public and private sector, which in turn may help drive up vaccination rates, said Dr. Mark McClellan, a Duke University health policy expert and former FDA commissioner.

“While we already had a number of businesses, schools, entertainment venues requiring vaccination or proof of a negative test or something like that, those numbers are going to go up significantly,” McClellan said. “That probably is going to drive the bigger impact of the full approval on vaccination rates in this country, probably even more than the remaining people who are having doubts and potentially willing to be convinced.”

U.S. Secretary of Education Miguel Cardona talks about the necessity to get vaccinated during a tour Aug. 9, 2021, of Topeka High School’s vaccine clinic with second gentleman Douglass Emhoff (Pool photo by Evert Nelson/The Capital-Journal).

An advocate representing the nursing home industry warned Missouri lawmakers healthcare staff might leave because of a coming COVID-19 vaccine mandate. (Credit: Katarzyna Bialasiewicz/Getty Images)

WASHINGTON — Nursing homes will be required to ensure their staffers are vaccinated against COVID-19, or risk losing federal Medicare and Medicaid dollars, the Biden administration announced Wednesday in a major move on vaccinations as the Delta variant sweeps many states.

Under the new nursing home policy, the U.S. Department of Health and Human Services will develop regulations to require vaccinations of nursing home staffers as a condition of participating in Medicare and Medicaid programs.

“I’m using the power of the federal government as a payer of health care costs to ensure we reduce those risks for our most vulnerable seniors,” President Joe Biden said during a news conference Wednesday detailing new federal actions.

“If you visit, live or work in a nursing home, you should not be at a high risk of contracting COVID from unvaccinated employees,” Biden added.

The new federal mandate is the latest vaccine requirement from the Biden administration. The Department of Veterans Affairs has required health care workers to get vaccinated, and all federal workers must either prove they have been vaccinated or face masking and testing requirements.

It also comes amid rising COVID cases in both Kansas and Missouri facilities, where vaccination rates among healthcare staff at CMS-licensed facilities remain low.

Missouri trails nearly every state in COVID-19 vaccinations for nursing home healthcare staff. Only 46.7% of the workforce is vaccinated, putting the state ahead of just Louisiana and Florida. Kansas is closer to the middle of the pack with 57% of its healthcare personnel vaccinated. 

Only 7.8% of Missouri nursing homes reported having vaccinated more than 75% off their health care staff as is the industry’s goal. In Kansas, just over 14% of homes reported meeting that mark. 

Biden acknowledged that while he has limited authority to require COVID-19 vaccines, he will be looking for additional ways to boost vaccination rates.

He praised governors and mayors in Maryland, California, New York and other states for enacting certain vaccine requirements, and said the federal government will be covering all costs related to National Guard missions related to the coronavirus pandemic.

The nursing home vaccination requirement that Biden announced Wednesday will apply to staffers in 15,000 facilities, which employ approximately 1.3 million workers and serve approximately 1.6 million residents, according to the White House.

Some states and some nursing homes already have required staffers at long-term care facilities — where they may be in close contact with patients at high risk of a serious infection — to get a COVID-19 shot.

Maryland Gov. Larry Hogan was the latest on Wednesday, announcing that nursing home staffers in his state will be required to show proof of vaccination, or adhere to ongoing COVID-19 screening and testing.

Nursing homes and other long-term care facilities accounted for a substantial share of the earliest COVID-19 infections and deaths.

Residents of those facilities were among the earliest to be eligible for COVID-19 vaccines, and the latest data from the Centers for Medicare & Medicaid Services shows 82% of residents are vaccinated.

But only 60% of the staffers in nursing homes are vaccinated, according to CMS data.

Since the beginning of the pandemic, more than 133,000 nursing home residents and nearly 2,000 nursing home staffers have died as a result of COVID-19 infections.

Kansas and Missouri

Neither Kansas nor Missouri has mandated COVID-19 vaccinations in nursing homes, but one chain with several locations in Kansas is requiring its employees to get vaccinated this fall or face dismissal.

Associations that represent Missouri and Kansas’ long-term care facilities said they support and encourage vaccinations among staff and residents, but expressed concern that a mandate may impact staffing levels amid a shortage exacerbated by the pandemic.

“One member said to me, specifically, when they heard of the mandate, ‘That we've now gone from crisis to catastrophe,’” said Nikki Strong, the executive director of the Missouri Health Care Association, which represents over 65% of Missouri's licensed skilled nursing care facilities.

The organization’s Kansas counterpart has yet to discuss the issue, its president and CEO, Linda MowBray, said in an email. 

“Staffing is already at a crisis level and singling out nursing homes will only compound the issue,” MowBray said.

Mark Parkinson, the president and CEO of The American Health Care Association and National Center for Assisted Living, said in a statement that the administration shouldn’t single out nursing homes because it will cause vaccine-hesitant workers to leave for other health care jobs.

“The net effect of this action will be the opposite of its intent and will affect the ability to provide quality care to our residents,” Parkinson said.

LeadingAge Missouri, a trade association that represents healthcare and housing providers that serve the elderly, is encouraging its members to mandate vaccination as a condition of employment for staff. Bill Bates, the group’s CEO, said staffing shortages will likely worsen, especially in rural areas, but that requiring vaccinations is the right call.

Bates estimated about half of LeadingAge Missouri’s members receive CMS funding, but because facilities can offer multiple forms of care — with some services not reimbursed through CMS — it may make implementation of the mandate less straightforward.

“So parts of a campus like that will have to mandate their employees. Other parts of a campus like that won't. And many employees go back and forth between levels of care,” Bates said. “So it's going to be confusing to implement. But it's the right thing to do.”

Masks in schools

The president also criticized Republican governors who have prohibited school boards from requiring students to wear masks.

He said he has directed Secretary of Education Miguel Cardona to use his oversight authority and legal action, if appropriate, to push back against governors who block or intimidate local educators from taking safety precautions in schools.

The New York Times reported that the administration will use the department’s civil rights office for enforcement, and send letters to staters including Arizona, Iowa and Tennessee “admonishing governors’ efforts to ban universal masking in schools.” Biden said he would be discussing schools again next week.

Cardona already has written Florida Gov. Ron DeSantis saying that if his administration withholds state funding from school districts that enact mask mandates, those schools can use federal coronavirus relief dollars to make up for the penalties.

This story has been updated since it was first published.

Syringes of COVID-19 vaccinations are filled during MU Health Care’s mass vaccination clinic at the Walsworth Family Columns Club at Faurot Field in Columbia on Feb. 4, 2021 (Photo courtesy of MU Health Care).

WASHINGTON — Top U.S. health officials announced a plan Wednesday to begin offering COVID-19 booster shots to Americans starting Sept. 20, with the scheduling of the additional shot to be based on when a person was fully vaccinated.

The new round of jabs will be extended to those who received the two-dose vaccine from either Pfizer or Moderna, and can be taken eight months after an individual’s second dose.

Dr. Vivek Murthy, the U.S. surgeon general, told reporters Wednesday that recent data makes clear that while the current COVID-19 vaccines have been highly effective against severe disease, hospitalization and death, the protection against mild and moderate disease has appeared to decrease over time.

“This is likely due to both waning immunity and the strength of the widespread delta variant,” Murthy said, adding that health officials are concerned that the decline in immunity could reduce protection against severe disease and death in the months ahead.

The more than 13 million Americans who received the one-dose shot from Johnson & Johnson may also need boosters, but will not yet be eligible.

Federal health officials said they are awaiting data from J&J in the next few weeks before urging additional doses. The J&J shot wasn’t approved until March, so those who received it will not hit eight months past inoculation until November.

The new booster rollout plan is subject to formal authorization from the Food and Drug Administration and the Centers for Disease Control and Prevention’s vaccine panel.

Those agencies will hold public meetings before the booster rollout can begin. But officials said they were detailing the booster plan ahead of those meetings in part to give state and local health officials time to prepare for another wave of vaccination logistics.

State and local health officials again under pressure

The plan for offering a third shot puts yet another layer of pressure on state and local health departments that have carried out the massive vaccination campaign.

Those officials are still seeking to boost vaccination rates that have lagged in certain regions amid skepticism and misinformation. Meanwhile, vaccine manufacturers are expected this fall to seek approval for administering shots to children under 12, who so far have not been eligible.

During Wednesday’s news briefing, Dr. Rochelle Walensky, the CDC director, cited several new studies that tracked vaccine effectiveness, including among New Yorkers across age groups and another following case counts from nursing homes.

Those studies have shown that protection against severe infection has held up but not against milder infections, she said, adding that other countries, such as Israel, also are starting to see “worsening outcomes.”

“In the context of all of these studies, different cohorts, different settings across the country, and our international colleagues, we’ve made the decision to plan for these booster doses,” Walensky said.

The booster shots will be available at roughly 80,000 sites nationally, including 40,000 local pharmacies. As with the other COVID-19 shots, the boosters will be free of charge.

The CDC had already approved a third COVID-19 shot for some immunocompromised individuals, who may not have received strong protection from the initial doses of the vaccine.

While the booster plan does not specifically mention other categories of individuals to receive a priority for boosters, the initial vaccine rollout did put certain groups first in line. So the first individuals to hit eight months after their second shot should be those in the earliest priority categories, such as health care workers and nursing home residents.

Missouri’s health department on Tuesday outlined who can get an additional shot.

People who received the two-shot Pfizer or Moderna vaccines – but not the single-shot Johnson & Johnson product – and who are moderately to severely immunocompromised people due to a medical condition or treatments are eligible, the department stated in a news release.

The conditions include, but are not limited to, people who have received transplants and are taking immunosuppressants, receiving treatment for some cancers, or have compromised immune systems.

No proof of the reason will be required to receive the third dose, the department stated.

The Independent’s Rudi Keller contributed to this story. 

Displaced Afghans reach out for aid from a local Muslim organization at a makeshift IDP camp on August 10, 2021 in Kabul, Afghanistan (Photo by Paula Bronstein /Getty Images).

WASHINGTON — The first U.S. stop for the nearly 2,000 Afghan interpreters and other refugees evacuated so far amid the collapse of the Afghan government has been central Virginia’s Fort Lee military base.

Tapped for its East Coast location and its ability to quickly ramp up to serve as a temporary host installation, the Army base just south of Richmond has been receiving Afghans eligible for Special Immigrant Visas since late last month.

Two other bases will soon be joining Fort Lee in processing the incoming Afghan evacuees. Department of Defense officials said Monday that they will also use Wisconsin’s Fort McCoy and Fort Bliss in Texas — which could allow for evacuating as many as 22,000 individuals to the U.S.

At Fort Lee and soon at other sites, officials have been attempting to speed up the final steps of an excruciatingly slow visa process for providing a legal path to safety for individuals who worked with U.S. forces and personnel during the 20 years of U.S. troops in Afghanistan.

More than 18,000 Afghans who have worked as interpreters, drivers, security guards and fixers for the United States during the war have been stuck in limbo as they await answers on their visa applications, and have faced threats to their lives and those of their families.

The initial arrivals had already completed their security vetting, but still needed to undergo a medical screening and other administrative requirements.

Social services agencies have been ramping up to assist with the influx of refugees. Many of those arriving are expected to be resettled in the Washington, D.C., area, according to the Lutheran Social Services of the National Capital Area, which has resettlement sites in Fairfax, Va., Dale City, Va., and Hyattsville, Md.

Maryland, which is among the top states for receiving refugees through the Special Immigrant Visa process, expects to receive at least 180 Afghan nationals, according to Gov. Larry Hogan.

“Many of these Afghan citizens — our allies — bravely risked their lives to provide invaluable support for many years to our efforts as interpreters and support staff, and we have a moral obligation to help them,” Hogan said in a statement, in which he also blasted the U.S. withdrawn from that country as “rushed and irresponsible.”

Iowa Gov. Kim Reynolds said in a statement that Iowa has resettled 94 Iraqi and Afghan Special Immigrant Visa recipients since fiscal year 2017 and the state is “exploring how we can continue to support Afghan SIV recipients who supported the U.S. government.”

Reynolds said the state is “currently waiting on additional details from the federal government to understand any new emergency processing and ensure proper vetting for any SIV or refugee resettlement.”

Amid a criticism of the Biden administration’s handling of the U.S. withdrawal, there has been a flood of bipartisan support for aiding the Afghan nationals who assisted the U.S.

Rep. Jason Crow, D-Colo., and a former Army Ranger who served in Iraq and Afghanistan, and Rep. Tom Malinowski, D-N.J.,  led a letter over the weekend with several dozen House members from both parties, urging the immediate evacuation of U.S. citizens and those eligible for special visas, as well as others at extreme risk.

“The safety of U.S. diplomats and military personnel must be our first priority. But we must also evacuate Afghans eligible for Special Immigrant Visas,” they wrote. “All public and private resources must now be mobilized to save not just those eligible for SIVs but as many other vulnerable Afghans as possible.”

Sen. Joni Ernst, R-Iowa, a combat veteran who was among lawmakers who visited Fort Lee earlier this month, said during a CNN interview Monday that she has been “extremely concerned” about the slow pace of visa approvals for Afghans.

“It is time that they expedite this,” Ernst said. “They need to get as many of our friends and allies out of Afghanistan as quickly as possible.”

Virginia officials from both parties also have shown support for the evacuation efforts.

U.S. Rep. Donald McEachin, a Democrat whose district includes Fort Lee, said in a statement Monday that his office has been “coordinating with the Biden administration, the State Department, and the Department of Defense to ensure these processes continue smoothly and our facilities remain ready for any additional needs.”

Virginia House Republican Leader Todd Gilbert called on Gov. Ralph Northam to “put the full weight of state government” behind an effort to support the interpreters and other refugees at Fort Lee.

Donald Trump participates in the final presidential debate against Joe Biden in 2020 (Justin Sullivan/Getty Images).

WASHINGTON — The months-long, Republican-led investigation in Arizona into the results of last year’s presidential election has cost millions of dollars and produced no evidence yet of major issues in tallying Maricopa County ballots.

Yet supporters of former President Donald Trump are still attempting to follow Arizona’s lead by pushing for so-called audits in several other states, including Pennsylvania, Georgia, and Wisconsin. The audits don’t comply with the legal process outlined in state laws for reviewing election results, and were launched months after vote tallies were certified.

But they’re the latest sign that Trump and his allies refuse to give up on the lie that he was the winner in 2020, not President Joe Biden—in the face of public doubt, discouragement from the U.S. Department of Justice and growing questions from Congress.

“This is all about a big grift, and it’s going to continue because there’s a whole ecosystem of individuals of scam artists whose livelihood now depends on … exploiting the sincere disappointment of millions of voters who wanted Trump to win, who are victims in a scam, and trying to scam money off of them,” said David Becker, executive director and founder of the nonprofit Center for Election Innovation & Research.

“And so I think these efforts will continue,” Becker added.

The separate audit drives share some financial ties, and some of the same attorneys have been linked to audits across states.

But even as the Arizona audit leaders disclose some key groups involved in paying for the effort, it remains unknown who contributed much of the money to those groups, according to the Arizona Mirror.

Election experts like Becker are troubled by the trend of these election investigations lingering across the country, questioning why the methodology has not reflected conventional auditing practices.

From state to state, those spearheading the investigations have claimed they want to reassure constituents that the election was secure. But they’ve had difficulty pointing to what exactly they believe did not work in the election process.

The most generous depictions from election security experts are that the reviews amount to little more than expensive fishing expeditions in states that Trump lost.

Others describe what’s going on as simply intended to raise money and degrade public faith in elections.

Defining a valid audit

So far, public opinion polling has shown more skepticism than support for the ongoing election investigations.

A Monmouth University poll in June found 57% of Americans see the audits of the 2020 election results as primarily a partisan attempt to undermine valid election results. One in three say these are legitimate efforts to identify possible voting irregularities.

Jennifer Morrell, an election procedures expert who served as an audit observer for Arizona’s Democratic secretary of state, says a valid election audit is straightforward.

“A valid audit is the audit that your state is required to conduct,” Morrell said, describing it as one that’s prescribed in state law, with transparent procedures that were outlined before the election results were known.

Typical audits would have a set sample size and period of time in which the audit must be completed, Morrell said, adding that auditors are required to follow a code of conduct.

In the cases of Arizona’s audit and those sought in Wisconsin and Pennsylvania, she said those questioning the election results have done little to demonstrate any election expertise (three retired police officers were hired to investigate in Wisconsin).

They also have been tight-lipped about practices they would abide by. The lead audit contractor in Arizona didn’t release documentation on its policies and procedures until after a court ruling.

In the audit attempt underway in Pennsylvania by state Sen. Doug Mastriano, a staunch Trump ally, Mastriano has said he is seeking to review physical ballots and “anything associated with the hard-copy ballots.”

He has not, however, outlined specific security procedures for those ballots.

Becker notes that Republicans control the legislatures in the key states where the audit efforts have flourished, and those GOP officials could have changed rules prior to balloting to beef up the process for verifying election results.

“They probably would have found allies amongst the Democrats,” he said.

The states in question also are ones that have taken extra verification steps, like a paper audit record, Morrell said. She notes that some states, such as Louisiana, don’t do any type of audit or require a paper trail — but that places like Arizona’s Maricopa County, which has more procedural safeguards in place, were the ones targeted.

Feds seek to discourage, investigate state ‘audits’ 

As the Arizona audit launched in March drags on and audit hopefuls elsewhere fight on, the federal Department of Justice and congressional Democrats have taken steps to discourage the so-called audits.

DOJ attorneys sent guidance last week to state election officials, warning that the vague investigations could violate federal laws regarding how election materials must be securely stored.

“Election audits are exceedingly rare. But the department is concerned that some jurisdictions

conducting them may be using, or proposing to use, procedures that risk violating the Civil Rights Act,” the DOJ guidance states. It added that allowing any election records to leave the control of local election officials creates “significant risk” that those records could be lost or compromised.

It was already clear that complying with the demands of those seeking audits could put local election officials in a legally questionable spot. Pennsylvania’s Fulton County already had its election equipment decertified after agreeing to allow its voting machines to be inspected as part of the private audit.

The Senate also is eying the election audits as it works on a voting rights measure. Sen. Amy Klobuchar, (D-Minn.), introduced legislation Thursday that would, among other changes, strengthen security requirements for ballots and other election records, according to the Washington Post.

The U.S. House Oversight and Reform Committee also has sought documents from the Cyber Ninjas firm that is spearheading the Arizona review, seeking information on the company’s ownership, funding, and auditing practices.

Top Democrats on that panel, including Rep. Jamie Raskin, (D-Md.), wrote in a letter seeking those documents that they are concerned the company’s actions “could undermine the integrity of federal elections and interfere with Americans’ constitutional right to cast their ballot freely and to have their votes counted without partisan interference.”

A spokeswoman for the House Oversight panel did not respond to questions this week about whether the company has responded, and the next steps in that investigation.

What’s next?

As for the lasting effects, 40% of respondents in the Monmouth poll said such audits will weaken American democracy, while 20% say it will strengthen it. Another 35% expect them to have no impact.

Becker said he believes the audit efforts have “lost a little bit of steam” as local election officials have pushed back on providing ballots and equipment.

In Pennsylvania, two counties — Philadelphia and Tioga — have rejected the bid to seek election materials and equipment, and a third, York County, has raised concerns about potential ramifications.

Mastriano — who did not respond to requests for comment — has told conservative outlet NewsMax that he intends to file subpoenas in the coming weeks.

Rep. Cori Bush, D-Mo., speaks outside the U.S. Capitol, surrounded by (from left) Rep. Mondaire Jones, Rep. Al Green, Reps. Jimmy Gomez and Rep. Alexandria Ocasio-Cortez (photo by Ariana Figueroa/States Newsroom).

WASHINGTON — Federal health officials on Tuesday announced a new, narrower moratorium on evictions through Oct. 3, which would protect struggling renters in areas of the U.S. that have been hit hardest by soaring COVID-19 infection rates.

The targeted eviction ban comes days after a federal moratorium in place since September expired on Saturday. The Biden administration previously said it could not legally extend that ban, and a last-minute legislative effort by congressional Democrats failed to extend those legal protections through mid-October.

Tuesday’s announcement from the CDC also followed intense public pressure by some progressive Democrats, including Missouri Rep. Cori Bush, who has camped out on the Capitol steps since Friday in protest of Congress not extending protections for vulnerable tenants.

“On Friday night, I came to the Capitol with my chair. I refused to accept that Congress could leave for vacation while 11 million people faced eviction,” Bush tweeted Tuesday. “For five days, we’ve been out here, demanding that our government acts to save lives. Today, our movement moved mountains.”

St. Louis Mayor Tishaura Jones praised the eviction moratorium extension Tuesday evening  — and Bush’s role in helping ensure it.

“The people of the St. Louis region elected Congresswoman Cori Bush to represent their best interests in Congress, and she has demonstrated the power of direct action by achieving what some considered politically impossible,” Jones said in a statement. “I am so proud to have her voice in Washington, D.C, as we fight together to build a better St. Louis for everyone.”

The new prohibition on evicting renters behind on their payments covers those living in counties with high or substantial rates of community COVID-19 transmission, or places with more than 50 COVID-19 cases per 100,000 residents.

That order is expected to cover the vast majority of Americans, with more than 80% of U.S. counties listed by the CDC in those categories.

If local case rates drop, the protections would expire after 14 days, according to the order. Localities that currently have lower case rates would see the eviction ban kick in if the community transmission rises.

The federal order also doesn’t supersede any state bans that offer renters stronger legal protections.

Lawsuits likely

The new eviction action is likely to face legal challenges. The Supreme Court indicated in a June ruling that congressional action would be needed to continue the previous eviction ban past July 31.

President Joe Biden, speaking ahead of the CDC’s announcement, said he had urged the CDC to consider any potential option to prevent evictions, and his administration had been speaking with constitutional scholars about which action could pass legal muster.

“At a minimum, by the time it gets litigated, we’ll probably give some additional time” for states to get more of the slow-moving rental assistance dollars approved by Congress out to landlords and renters, Biden said.

Housing policy experts have warned that millions of Americans are still struggling to pay their rent, and that the end of that legal protection was likely to lead to a surge in eviction filings across the country.

The CDC order said the previous federal moratorium led to a 50% decrease in eviction filings compared to historical averages, but that there still have been more than 450,000 eviction filings during the pandemic within just 31 cities and six states with readily available data.

Bush’s ‘passion’ praised

Outside the Capitol on Tuesday, Senate Majority Leader Chuck Schumer, D-N.Y., joined Bush as word spread of the CDC’s planned announcement, and in a written statement, he praised her as someone who “took her passion and turned it into amazingly effective action.”

In a white shirt that listed all the counties in Missouri’s 1st Congressional District, Bush held a press conference where she said even though lawmakers had not been able to review the new moratorium from the CDC, they were hopeful that it would help protect millions of Americans from losing their homes.

“We are hopeful that it is what will help 11 million people stay in their home, six million families to be secure in housing, where those children will be able to start school in the next few weeks, and not have to worry about where they’re going to sleep,” Bush said.

Bush herself has experienced homelessness with her two children; they had to live out of her car when they were evicted from their home. She said that experience spurred her to camp outside the Capitol, because she knew what it meant to face an eviction.

“Children won’t have to go through the trauma, the violence that happens to your mind when you are forced out onto the street,” she said.

Bush added that she is planning to head back to her district, where her office will continue to help constituents navigate paperwork and access rental relief.

“Our work isn’t done,” she said.

Last-minute scramble

The scramble to extend the eviction ban that expired Saturday did not begin until just days before that deadline, when the Biden administration — which had been focused on speeding up slow-moving rental assistance dollars — said it lacked the legal authority to renew those protections.

An 11th-hour push in the House of Representatives to extend it failed due to opposition from Republicans and some moderate Democrats, and the Democratic-led chamber adjourned for a recess set to last until Sept. 20.

On Monday, Biden called on state and local governments to put their own pause on evictions for at least two months, and urged them to use $46.5 billion provided by the coronavirus relief package for tenants and landlords.

Through the end of June, localities had distributed a little more than $3 billion of that rental aid — or only a fraction of the $46 billion approved by Congress.

That money has trickled out slowly as state and local governments scrambled to administer new programs or bolster ones that had been historically underfunded.

Getting those dollars distributed faster “would take care of the vast majority of what needs to be done” to keep people in their homes and prevent evictions, Biden said Tuesday.

The U.S. Capitol on Dec. 18, 2019 in Washington, D.C. (Samuel Corum/Getty Images).

The U.S. Capitol dome, photographed June 17, 2019 (Kathie Obradovich/Iowa Capital Dispatch).

WASHINGTON — A bipartisan group of U.S. senators say they have worked through the sticking points on a major infrastructure package, and the Senate agreed on a procedural vote on Wednesday night to advance to debate on the proposal.

That announcement came a week after Republicans blocked a test vote on the deal, with GOP senators opposed to beginning debate before that proposal was fully drafted. Democratic and Republican members of the Senate voted on Wednesday 67-32 to start work on the new version of the bill, easily surpassing the 60 votes needed. Seventeen Republicans joined all 50 Democrats on the vote.

A White House fact sheet on the sweeping $1.2 trillion deal said it contains $550 billion in new spending, including:

• $110 billion for roads, bridges and other major projects;
• $66 billion for rail improvements;
• $65 billion for broadband grants;
• $55 billion for wastewater and drinking water infrastructure;
• $46 billion to boost resiliency against floods, drought, and other extreme weather;
• $39 billion to modernize public transit systems; and
• $15 billion to build a national network of electric vehicle chargers, and pay for fleets of electric buses

The legislation would be paid for by repurposing money from the COVID-19 stimulus bills, including unemployment compensation dollars that states have not used. It also relies on money from corporate user fees and tougher tax enforcement on cryptocurrencies.

President Joe Biden said in a statement Wednesday afternoon that the deal “signals to the world that our democracy can function, deliver, and do big things.”

“As we did with the transcontinental railroad and the interstate highway, we will once again transform America and propel us into the future,” Biden said in the written statement.

The infrastructure deal’s announcement was swiftly lauded by the U.S. Chamber of Commerce, which urged speedy approval of a measure it said would “provide enormous benefits for the American people and the economy.”

Sen. Bill Cassidy, a Louisiana Republican who was involved in the infrastructure negotiations, also praised the proposal during a speech on the Senate floor, commending in particular the money intended to help mitigate flooding and other coastal issues in states like his.

“Some people have confused this bill with the $3.5 trillion Democrat tax-and-spend extravaganza,” Cassidy said, referring to a second bill that Biden also has sought to provide more money for child care, education, and a range of progressive policy goals.

“They are two different bills. This bill is for roads and bridges and broadband and resiliency, flood control and coastal restoration. The other is for who knows what.”

The linkage of those two proposals caused a brief speed bump last month for negotiators from the White House and U.S. Senate.

The group, led by Arizona’s Kyrsten Sinema, a Democrat, and Ohio’s Rob Portman, a Republican, had announced a deal on the general outline of an infrastructure proposal to spend $1.2 trillion over eight years.

But it was briefly jostled by Biden’s comments that he would only sign the bill paying for traditional infrastructure projects if Congress also sends him a second bill he’s sought to provide more money for what he calls “human infrastructure,” such as child care and education.

Biden later revised his comments, reasserting his support for the infrastructure deal.

The key senators involved in the infrastructure talks besides Sinema, Portman and Cassidy have included Republican Susan Collins of Maine; and Democrats Jeanne Shaheen of New Hampshire; Jon Tester of Montana; and Mark Warner of Virginia.

The Minute Man Geyser is one of the popular attractions at Yellowstone National Park. (Photo by National Park Service)

WASHINGTON — Watching the sunrise from Cadillac Mountain at Maine’s Acadia National Park is a gorgeous view — so breathtaking that on some days, as many as 500 cars could be found vying for the scenic overlook’s 150 parking spots.

That competition has become more manageable since Acadia officials began using a reservation system in May, according to the park’s superintendent, Kevin Schneider, who testified to federal lawmakers Wednesday about overcrowding in national parks.

“We want people to have a really high-quality experience, and not everybody can be out there at the same time in their cars,” Schneider told members of the Senate Committee on Energy & Natural Resources.

Some of the country’s most famous national parks are grappling with an increasingly unsustainable rise in visitors.

Marquee destinations like Montana’s Glacier National Park and neighboring Yellowstone have seen the number of annual visitors double since 1980, Sen. Steve Daines, R-Mont., said during Wednesday’s hearing. Yellowstone saw 4 million visitors in 2019, and Glacier tallied more than 3 million.

In 2019 alone, there were 327 million visits to U.S. national parks — or the equivalent of every American making a park visit, said Kristen Brengel, senior vice president of government affairs for the National Parks Conservation Association.

That demand has only been exacerbated recently, as Americans eager to resume travel have sought outdoor activities that are safer in the ongoing pandemic.

Senators at Wednesday’s hearing were flanked by poster-sized photos of traffic jams at Acadia and Glacier as frustrated visitors attempted to wiggle their way in to hike and see other attractions.

“We can accidentally love our parks to death,” said Sen. Angus King, I-Maine, chairman of the panel’s subcommittee on national parks. “Overcrowding can also significantly harm the visitor experience and strain the resources of gateway communities, souring what should be a once-in-a-lifetime vacation.”

Like Acadia, Glacier also has implemented a ticketed-entry system for summer-season visitors seeking to access Going-to-the-Sun Road between 6 a.m. and 5 p.m. daily.

The launch of that entry system has been bumpy, and came not long before the summer season kicked off.

Some visitors who booked trips long before the entry system was announced became frustrated when they couldn’t get entry tickets, said Kevin Gartland, executive director of the Whitefish Chamber of Commerce, a business group in the Montana resort town located 25 miles west of the park’s western gate.

“One businesswoman put it to me last Friday like this: She feels more like she’s a therapist than a marketing director this year,” Gartland said, urging decisions about next year’s entry requirements be made in the coming months.

Still, Gartland said the entry passes have helped manage the flow, preventing problems that occurred last year when the park gates were shuttered because it was at capacity. That meant traffic backed up for hours, blocking access to businesses near the park entrance.

Michael Reynolds, a regional director for the National Park Service who oversees parks in the states of Texas, Oklahoma, New Mexico, Colorado, Utah, Wyoming, Arizona, and portions of Montana, acknowledged that the rollout of Glacier’s entry system has had “fits and starts.”

Reynolds said that while the process has gotten smoother, he and other park officials intend to work more closely with the business community and local groups to improve that experience.

In addition to the entry reservations, senators and the park officials both said they’d like to see more efforts to encourage visitors to check out lesser-known parks as a potential way to alleviate some of the strain.

Reynolds touted the National Park Service’s new phone app as a resource, prompting King to ask whether it has the capability to show visitors which areas are more congested so they can divert to nearby attractions.

Reynolds promised to check into such an option, but cautioned that parks in some areas of the country may have challenges with that, due to limited internet bandwidth.

“We’re working on that in another bill,” King quipped, referencing the ongoing efforts on Capitol Hill to craft infrastructure legislation.

A sign advertising protective face masks is taped in the window of a coronavirus pop-up store in Washington, D.C., on March 6, 2020 (Photo by Samuel Corum/Getty Images).

WASHINGTON — Federal health officials on Tuesday urged Americans in areas of the country with the highest surges in COVID-19 infections to once again wear masks when they are in public, indoor settings — even if they are fully vaccinated against COVID-19.

The updated recommendations marked a sharp shift from the agency’s guidance in May that Americans fully vaccinated against COVID-19 do not need to wear a mask in most situations, indoors and outdoors.

The updates also included changes for schools, with federal health officials now urging everyone in K-12 schools to wear a mask indoors. That includes teachers, staff, students and visitors, regardless of vaccination status and the level of community transmission.

The update in CDC guidance was prompted by new data indicating that although breakthrough infections among the vaccinated are rare, those individuals still may be contagious and able to spread the disease to others, said Dr. Rochelle Walensky, director of the Centers for Disease Control and Prevention.

Wearing a mask indoors in areas with “substantial” or “high” transmission of the virus could help to reduce further outbreaks of the highly contagious delta variant, she said.

Some 39 states have infection rates that have reached “substantial” or “high” levels of transmission, according to a data tracker on the CDC website.

The agency also tracks infection rates on the county level, and 63% of U.S. counties are in those two categories of concern.

“This was not a decision that was taken lightly,” Walensky said. She added that other public health and medical experts agreed with the CDC that the new information on the potential for vaccinated people to have contagious infections required the agency to take action.

President Joe Biden described the agency’s revision on recommended mask use as “another step on our journey to defeating this virus.”

“I hope all Americans who live in the areas covered by the CDC guidance will follow it,” Biden said. “I certainly will when I travel to these areas.”

The mask-use changes may not be the only changes coming as the White House attempts to respond to the spiking infections. Biden also said Tuesday that a vaccination requirement for all federal employees is under consideration.

The U.S. Department of Veterans Affairs already has required its frontline health care workers to be vaccinated against COVID-19.

But the new recommendations on masks are expected to be met with resistance.

Areas of the country with the highest spikes in COVID-19 infections tend to be those with the lowest vaccination rates and places that were the fastest to end mask mandates for public settings.

Some have taken legal steps to prevent future mask mandates. At least nine states — Arkansas, Arizona, Georgia, Iowa, Oklahoma, South Carolina, Texas, Utah and Vermont — have enacted legislation that prohibits districts from requiring masks in schools, according to a CNN analysis.

Iowa Gov. Kim Reynolds, a Republican, blasted the updated guidance in a statement Tuesday, describing it as “not grounded in reality or common sense.” Iowa’s level of community transmission is rated as “substantial” in the latest CDC map. 

“I’m concerned that this guidance will be used as a vehicle to mandate masks in states and schools across the country, something I do not support,” Reynolds said, adding that the vaccine “remains our strongest tool to combat COVID-19” and that she will continue to urge vaccinations.

Walensky sidestepped a question during Tuesday’s news briefing about the level of compliance that the CDC expects with the new recommendations, saying only that the way to drive down rising community transmission rates is to wear masks and to increase vaccination rates.

The U.S. Capitol dome, photographed June 17, 2019 (Kathie Obradovich/Iowa Capital Dispatch).

The deaths data, which the department calls “probable” COVID-19 fatalities, is being added eight months after the department began reporting antigen-identified infections in its daily report (image courtesy of CDC).

(Getty Images )

WASHINGTON — State and local officials disbursed $1.5 billion in rental assistance during June to help households falling behind on rent and utilities, more than during the entire previous five months, according to U.S. Treasury data released Wednesday.

That progress in getting slow-moving federal dollars to struggling renters comes as the Biden administration and housing advocates have been scrambling to avoid an eviction crisis when the national moratorium expires at the end of this month.

In June, 290,000 U.S. households received help from rental assistance money provided in the federal COVID-19 relief laws, according to the Treasury data. That’s an increase from 157,000 households in May and 100,000 households in April.

But the money that has reached renters so far — a little more than $3 billion — is just a fraction of the $46 billion approved by Congress. Of that figure, $25 billion was approved in December, and another $21 billion in March.

Across states, an analysis of the data by States Newsroom found the progress on deploying those dollars has been spotty.

Missouri got $14.7 million into the hands of struggling residents between January 1 to June 30. As The  Independent reported this month, the state has seen a significant jump in assistance distribution since the middle of May, when only $3.6 million had been awarded to about 700 families. That number currently sits at $24 million awarded to the nearly 5,000 families, according to the state’s dashboard. 

However, it doesn’t match the pace of the need, where the state estimates 150,000 to 230,000 Missouri households are at risk of eviction.

Pennsylvania ranked fifth nationally in the rental aid paid out in June, pushing out more than $45 million, compared to roughly $19 million the prior month.

North Carolina paid out more than $30 million in June, after paying $8 million in rental aid in May.

At the same time, a handful of states — including Nevada and Maine — paid out less in rental aid in June than they did in May. (Local governments also are distributing rental aid in some states, and in Nevada, localities did pay out more in rental aid in June compared to May, based on the Treasury data).

Nationally, only 15 states distributed more than $10 million in June, according to the data.

Meanwhile, millions of Americans are still struggling to cover their housing costs: As of early July, 7.4 million renter households were behind on rent, according to U.S. Census Bureau data. Some 3.6 million said they were “somewhat likely” or “very likely” to face eviction in the next two months.

“The states and localities are getting this money out as fast as they can to the people that need it, but there’s still a long, long way to go,” said Will Fischer, senior director for housing policy and research at the left-leaning Center for Budget and Policy Priorities.

The attempt to get aid to tenants has underscored how in too many jurisdictions, rental assistance and eviction diversion programs have long been underfunded or non-existent.

Fischer said that lack of infrastructure increased the time it took for states and local governments to get the dollars to those most in need.

The Biden administration has sought to give those officials more time to get money flowing, announcing last month that it would extend the national ban on evictions through July 31. Administration officials also have sought to provide more clarity to states and local officials on how they can use the federal aid dollars.

During a U.S. House hearing on Tuesday, Republican lawmakers sought to blame the Biden administration over the pace of that financial assistance.

Rep. Patrick McHenry, R-N.C., sharply questioned Housing and Urban Development Secretary Marcia Fudge about the funding, which is distributed by the Treasury, not HUD.

Fudge, a former member of Congress from Ohio, told lawmakers that the money was held up due to state and local agencies that didn’t have enough capacity for the aid programs.

“I have been calling mayors and governors and others to say, ‘We’ve got to get the money through the system,’” Fudge said. “So what we’re seeing today is that the number of resources that are getting out is increasing exponentially every month.”

The Independent’s Rebecca Rivas contributed to this story. 

President Joe Biden (photo courtesy of the White House)

WASHINGTON — President Joe Biden met with a group of governors and mayors on Wednesday as he seeks to build support for a massive federal infrastructure package awaiting action from Congress.

The local officials joining Biden in the Oval Office included Mayors Nan Whaley of Dayton, Ohio; Kate Gallego of Phoenix, Ariz., and Michael Hancock, of Denver, Colo.

Earlier this week, a bipartisan group of 369 mayors sent a letter to Congress, urging lawmakers to swiftly vote on the infrastructure funding agreement reached last month.

The mayors touted that $1.2 trillion proposal as a long-term investment that would “help make our economy more sustainable, resilient, and just.”

Biden has called for a “dual-track” approach to infrastructure.

He’s urging votes on not only the framework for infusion of more money into road, bridge, transit and other traditional infrastructure projects but also a second measure that would include new money for “human infrastructure” programs like expanding access to child care and education.

Passing both proposals through Congress will be tricky. Democrats have only slim majorities in each chamber, leaving little room for losing any support within their own caucuses.

“We have a chance to solve these problems, a bipartisan chance to solve these problems. Create millions of jobs—literally,” Biden told the mayors and governors as Wednesday’s meeting began, according to a pool report.

“Time to stop talking about it and time to get you the resources,” Biden added.

Missouri voters legalized medical marijuana in 2018 (Uriel Sinai/Getty Images).

WASHINGTON — The top Democrat in the U.S. Senate says decriminalizing marijuana at the federal level is a change that’s “long overdue,” and that he’s prioritizing that effort amid a growing number of states legalizing cannabis.

To that end, Senate Majority Leader Chuck Schumer on Wednesday unveiled a draft proposal for removing cannabis from the federal Controlled Substances Act, freeing states that have been legalizing cannabis for medical and recreational use from repercussions over the clashing laws.

The discussion draft also calls for re-sentencing and expungement of non-violent marijuana convictions. Revenues from a new federal tax on cannabis would be used in part to assist those most affected by the current federal marijuana laws by paying for job training and reentry programs.

“As more and more states legalize marijuana, it’s time for our federal cannabis law to catch up,” Schumer, of New York, said at a news conference Wednesday, describing the proposal as intended to “right the wrongs of the failed war on drugs.”

Eighteen states and the District of Columbia have legalized small amounts of cannabis for recreational use among adults, and 36 states allow for medical use of marijuana, according to the National Conference on State Legislatures.

Legalizing marijuana is popular in public opinion polls as well: in a recent Pew Research Center survey, 60% of adults said marijuana should be legal for medical or recreational use, and 31% said it should be legal for medical use only. Just 8% said it should not be legal at all.

During Wednesday’s news conference, Schumer said marijuana opponents had predicted “doom and gloom” in states legalizing the drug, but said their forecasts of increased crime and other negative ramifications did not come to fruition.

Sen. Cory Booker, D-N.J., a long-time proponent of legalizing marijuana, decried the inequity of members of Congress and presidents having admitted that they have used cannabis, “but we have children in this country, people all over this nation, who are veterans, Black and brown people, low-income people now bearing the stain of having a criminal conviction.”

The measure released by the senators is a draft, which Schumer said will be revised with feedback from the public.

In a Senate chamber that’s evenly divided and requires 60 votes to advance legislation, supporters still have quite a bit of work to do.

Schumer acknowledged they do not have enough votes to pass such a proposal, or support from all Democrats.

Among Republicans, Sen. Chuck Grassley of Iowa, the ranking GOP lawmaker on the Senate Judiciary panel, released a statement blasting Schumer’s measure as putting “the cart before the horse.”

“It’s important that we have robust research and fully understand the good and the bad of marijuana use, especially in young people and over the long term,” Grassley said, highlighting his own proposal on marijuana research.

Sen. Ron Wyden, D-Ore., who chairs the Finance Committee and joined Schumer at the news conference, emphasized that it will be up to states to determine whether they want to legalize marijuana use.

“I don’t understand how Republicans who say they’re for states rights won’t support what my colleagues are talking about, because what this bill does is we decriminalize at the federal level, but we don’t require states to legalize,” Wyden said.

Beyond Capitol Hill, President Joe Biden, a Democrat, has been slow to embrace marijuana reform. He has previously supported decriminalization, but has not joined calls for legalization.

Asked Wednesday about Schumer’s proposal, White House Press Secretary Jen Psaki said she had no new endorsements of legislation to announce.

The letter that went out to parents around the country about the child tax credit.

WASHINGTON — The most ambitious part of the pandemic stimulus package signed by President Joe Biden earlier this year is about to hit the bank accounts of millions of U.S. parents.

Starting next week and ending in December, the vast majority of U.S. households with children will begin receiving monthly payments as a result of changes in that law expanding and reworking the federal child tax credit.

The tweaked tax credit drew less attention than stimulus checks and expanded unemployment benefits in that wide-ranging COVID-19 relief legislation.

But the effect may be longer-lasting, with Democrats already angling to prevent the temporarily broader tax credit from shrinking again next year.

The new law not only makes more families eligible for the child tax credit, it also changes when families receive its financial benefits.

For the first time, half of the tax credit will be distributed through monthly payments, instead of only when families file their taxes. That will send families up to $250 a month for every child between 6 and 17 years old, and up to $300 a month for kids under 6.

For roughly 39 million households — covering 88% of children in the United States — the monthly checks will be automatic, according to the Internal Revenue Service.

The rest of the tax credit — worth between $3,000 and $3,600 per child, depending on their age — will be paid out when a family files taxes next spring.

Researchers say it could have a significant effect on families, estimating that those dollars could cut child poverty in half.

Here’s more on how the program will work:

What exactly is the child tax credit?

Typically, the child tax credit is distributed annually, as a deduction for how much a family owes on their income taxes. Prior to this year’s changes, the deduction was up to $2,000 per dependent child under 17, and it phased out for those earning over $200,000, or $400,000 for couples filing jointly.

But low-income families who owed less in taxes than the amount of the deduction previously could only receive part of that deduction.

Under the revisions to the tax credit, children as old as 17 now count as qualifying dependents, and low-income families can now receive the full value of that tax credit, even if they have no earned income.

The amount per child also is higher for most families, increased to $3,000 for each child between 6 and 17 years old and to $3,600 for each child under age 6.

And the biggest change will be the monthly checks, which will provide essentially a guaranteed stipend to families.

Who is eligible?

Families can receive the full credit if their income is less than $75,000 for households with a single filer, $112,500 for head-of-household filers, and $150,000 for married couples filing jointly.

The increased credit phases out above those amounts, with those making more than $144,500 as a single filer and $182,000 as a married filer eligible for the previous $2,000 per child, according to the Congressional Research Service.

The structure puts single parents at a disadvantage, capping their credits compared to what married parents would receive. Rep. Katie Porter, (D-Calif.), a single mom, has pushed to make those filing as heads of household — as single parents typically do — eligible for the same amount as married couples.

Those eligible to receive the monthly payments may have received a letter from the Internal Revenue Service in the past few weeks detailing the tax credit and how much they will receive.

If not, there’s also an online tool for checking how much someone will receive.

How does it work?

Families who filed tax returns for 2019 or 2020, or who signed up to receive a stimulus check from the Internal Revenue Service, do not need to do anything to begin receiving the monthly payments.

Parents who didn’t file taxes should use an online IRS tool, called the “non-filer sign-up tool,” to get their money.

The payments will be made on the 15th of each month through December, except for August, when it is scheduled for the 13th because the 15th falls on a weekend.

Do families have to receive the monthly payments?

No, though it’s too late to opt out of the initial July 15 payment. Families that would prefer to receive their credit as a lump sum next year can opt out of payments starting in August using the online IRS portal, where they also can update bank account information.

Will the tax credit changes affect eligibility for other government benefits programs?

No. Receiving the expanded child tax credit will not impact eligibility for means-tested programs like Medicaid, the Supplemental Nutrition Assistance Program, known as SNAP, or Supplemental Security Income, known as SSI.

What will this money mean for families?

There are no restrictions on how families use the money. Spreading the payments throughout the year, as opposed to the lump sum approach, means that the aid will be better-timed to assist with recurring child-related costs.

Robyn Bles, a pastor in Des Moines, said during a recent Iowa event promoting the tax credit that she plans to use the money to enroll her 4-year-old daughter, Rosey, in swimming lessons and art classes. She also plans on making smaller changes, like buying more healthy foods.

Will the tax credit go away after next year?

The pandemic stimulus law only expanded the tax credit for one calendar year, 2021. It would take further action by Congress to extend the changes into future years.

But popular temporary tax changes have a way of getting renewed on Capitol Hill. Democrats already have been working to promote the broader tax credit and its effects, including vulnerable incumbents like Rep. Cindy Axne, who held a recent event with parents in her southwestern Iowa district highlighting the upcoming checks.

“I don’t think these are parents that are asking for too much for their children,” Axne said.

A Biden administration fact sheet detailing the tax credit notes that the president “strongly believes that we should extend the new Child Tax Credit for years and years to come,” and that he has proposed doing so in his American Families Plan.

Katie Akin of the Iowa Capital Dispatch contributed to this report.

Missouri Gov. Mike Parson during a press conference from the Capitol on Dec. 2, 2020 (Photo courtesy of the Missouri Governor's Office).

WASHINGTON — President Joe Biden’s key COVID-19 advisers on Thursday defended the administration’s strategies for boosting vaccinations in the states, after Missouri’s governor said federal door-to-door outreach efforts are not welcome there.

Top Biden adviser Jeff Zients said anyone mischaracterizing the administration’s attempts is “doing a disservice to the country.”

Gov. Mike Parson voiced his opposition to door-to-door vaccination outreach on Wednesday amid an influx of federal help that the state requested aimed at tamping down a surge in COVID-19 infections there.

The first member of a newly created federal surge response team arrived in Missouri this week, with others to join in person and remotely to help with data, research, vaccine uptake strategies and outreach.

Parson, a Republican, wrote on Facebook that he instructed state health department officials “to tell the federal government that sending government employees or agents door-to-door to compel vaccination would NOT be an effective OR welcome strategy in Missouri.”

Zients, the COVID-19 response coordinator for the White House, was asked about Parson’s comments at a press briefing on Thursday. Zients first emphasized that federal efforts to persuade unvaccinated individuals to get a shot rely in part on “trusted messengers,” such as local doctors and community leaders, who are typically the people consulted for such advice.

Those efforts have had an impact on vaccinations across communities, Zients added, before responding more directly to Parson’s social media post, without mentioning him by name.

“For those individuals, organizations, that are feeding misinformation and trying to mischaracterize this type of trusted messenger work, I believe you are doing a disservice to the country and to the doctors, the faith leaders, community leaders and others who are working to get people vaccinated, save lives and help end this pandemic,” Zients said.

White House Press Secretary Jen Psaki also responded to Parson’s remark during Thursday’s briefing, saying that engaging local leaders on vaccination outreach has been effective. That approach and other strategies have boosted vaccinations in states like Florida and Georgia, she said.

Missouri is currently seeing COVID cases and hospitalizations spike thanks to low vaccination rates and the prevalence of the Delta variant.

Hospitalizations hit 1,000 inpatients on Saturday for the first time since early March. On Wednesday, Steve Edwards, CEO of CoxHealth in southwest Missouri, tweeted that his hospitals have seen more than 100 COVID inpatients and 12 deaths in the past 8 days.

“Likely all recent deaths were avoidable with vaccination,” he said, “perhaps a few would have had cold like symptoms.”

At an event in Kansas City on Thursday, Parson doubled down, saying he would “object to the federal government coming in and going door-to-door to anybody’s house in Missouri if they don’t want that. I don’t know that there is any need for that.”

He said state officials “knew all along that there was going to be that hesitancy” about vaccines in Missouri. While his administration is now open to the idea of incentivizing vaccinations, something Parson initially opposed, he said: “I don’t think we need to be out there trying to scare people into taking a vaccine.”

Several federal “surge response” teams are working with Missouri and a handful of other states, including Nevada, as counties within those states combat rising infections. Those increasing case counts come after the national COVID-19 infection rate had been falling.

The federal teams will provide expert support from the Centers for Disease Control and Prevention on outbreak investigations; work with local health officials on getting more treatments for people with COVID-19; and help states increase vaccine competence and expand access to vaccinations and testing, according to the White House.

“In the days and weeks ahead, we will continue to make sure states have access to the specific federal resources and capabilities they need to fight the virus,” Zients said Thursday.

The areas where COVID-19 infections have been rising also tend to be the areas with the lowest vaccination rates, according to CDC officials.

Of the 173 counties with the highest case rates, the vast majority, 93%, have fewer than 40% of their residents vaccinated, said Dr. Rochelle Walensky, director of the CDC.

She emphasized that the existing vaccines have proven to perform well against the Delta variant of the virus that’s accounting for a fast-growing share of U.S. COVID-19 infections, and that areas with low vaccination rates will allow that variant to spread even more rapidly.

Preliminary data from several states during the last few months has indicated that more than 99% of deaths from COVID-19 were among people who were not vaccinated, Walensky added.

Asked specifically about the rising infections in southwestern Missouri, Walensky said that’s an area that federal officials are “following closely” due to low vaccination rates and the increasing case counts.

The Independent’s Rudi Keller contributed to this story.

Several Missouri legislators are working to prevent schools from issuing mask or vaccine mandates (File photo by Getty Images).

WASHINGTON — After last year’s abrupt shutdown of schools due to the coronavirus pandemic, increasing numbers of students returned to in-person learning.

But a new study shows that racial and geographic gaps persisted as K-12 students went back to their classrooms—with non-Hispanic white kids more often the ones attending a brick-and-mortar school full-time in most states.

From last September through April, students in the South also generally had greater access to full-time, in-person learning than those in other regions of the U.S., according to the study, featured in a Centers for Disease Control and Prevention Morbidity and Mortality Weekly Report.

The study’s lead author was Emily Oster, a Brown University economist who became a cultural icon for many U.S. parents during the COVID-19 pandemic for her data analysis of the health threats to children from the virus and advice on how to calculate risk.

At the same time, the conclusions from Oster that schools could reopen safely and that risks to children are generally low also drew pushback as federal public health officials grappled with crafting guidance for the nation’s schools.

The study found that access to in-person learning varied by state: 100% of students in Wyoming and Montana had access to in-person instruction, while Hawaii, Maryland and Washington had the lowest shares of students in their classrooms full-time.

The new data also found a racial disparity in most states on whether students were learning online or in person. In 43 states, access to full-time, in-person learning was higher for non-Hispanic white students compared to those of color.

The highest racial disparities were in Ohio and Pennsylvania, where on average, students of color were 21% and 23% less likely to have access to full-time, in-person learning.

The smallest disparities were in Montana and Wyoming — where all students had in-person access — as well as the District of Columbia, Delaware, and Hawaii.

More broadly, the report shows that the prevalence of virtual-only education did decline across racial groups starting in January, but with a larger share of white students returning to their classrooms than students of color.

The percentage of white students with access to in-person, full-time classes rose the most by April, from 38% to nearly 75%.

For Black students, 63% were able to access in-person instruction in April, up from 32%, while Hispanic students’ access to in-person classes went up to 60%, compared to 36% at the beginning of the year.

Oster, who’s also written popular books on pregnancy and parenting, and her co-authors noted several limitations on their analysis, including that it only covered 46% of public K-12 enrollment in the U.S.

It also looked at access to different types of instruction, not the number of students who actually received their instruction in person or virtually.

Their analysis was based on data collected from school district websites, Facebook pages, and other public data from 1,200 school districts across all 50 states and the District of Columbia.

The researchers logged whether the schools offered fully remote, hybrid, or fully in-person instruction, and which grades and demographic groups had access to each kind of instruction, tracking that data weekly from January to April.

They also identified differences in access by grade level.

In January 2021, 39% of students in grades K–5 had access to full-time, in-person learning, compared with 33% of students in grades 6–8, and 30% of students in grades 9–12.

That may reflect a challenge faced by local, state and federal officials as they tried to sort out how to safely reopen schools. Older students faced slightly different levels of risk from COVID-19 infections.

But it also was harder to keep those students in the same cohorts all day if they were in the school building, a practice that helped with tracing potential exposure if a student tested positive for infection.

The gap between which students were learning virtually and which were learning online last year could exacerbate some of the educational disparities that already existed, the report’s authors said, noting that reduced access to in-person learning is associated with poorer learning outcomes and adverse mental health and behavioral effects in children.

“Therefore, disparities in access to full-time in-person learning across demographic groups might translate into short-term increases in educational disparities,” they wrote.

The report said those disparities may be driven by a number of factors, such as urban districts with more students of color that may have been less likely to open due to higher COVID-19 community infection rates.

As school districts look to next year, many are preparing to reopen fully if they had not yet already.

But some are waiting on the CDC to offer updated guidance on whether students should continue wearing face coverings, though it’s not yet clear when or if federal public health officials will alter those recommendations.

Dred Scott, a Missouri slave who sued for his freedom. His petition was denied by the Missouri Supreme Court in 1852 and the U.S. Suprreme Court used his case to strip all Blacks of citizenship. (Library of Congress image)

WASHINGTON — The U.S. House voted Tuesday to remove from the Capitol a bust of the late Supreme Court Chief Justice Roger Taney, who in 1857 wrote the Dred Scott decision that stripped all Black Americans, free or slave, of their citizenship.

The legislation passed on a vote of 285-120 with only 67 Republicans joining with Democrats in support, also evicts statues and busts of men who fought for the Confederacy or served in its government.

It would replace the marble bust of Taney, which is displayed outside the old Supreme Court chamber on the first floor of the Capitol, with one of the late Thurgood Marshall, a fellow Marylander who was the first Black member of the Supreme Court.

Taney wrote the majority opinion in the Dred Scott case, which initiated in Missouri. The ruling, which provoked intense opposition in the North, said that people of African descent were not citizens and had no right to bring suit in federal court — effectively upholding slavery.

The House bill also would direct the Architect of the Capitol to remove other statues and busts of individuals connected with the Confederacy. The bill specifically mentions three men who promoted slavery and segregation — Charles B. Aycock of North Carolina; John C. Calhoun of South Carolina; and James P. Clarke of Arkansas.

At least eight other statues and busts would be poised for removal under the measure, based on a preliminary assessment from staffers for Majority Leader Steny Hoyer, D-Md., who introduced the bill.

Those statutes include Alexander Hamilton Stephens, a former governor and U.S. representative from Georgia; and Edmund Kirby Smith, a Confederate general from Florida who already is poised to be replaced this year with a statue of civil rights leader Mary McLeod Bethune.

North Carolina’s statues also include Zebulon Baird Vance, who organized the Confederate Army’s Rough and Ready Guards and served as governor during the Civil War.

A similar bill passed the Democratic-controlled House last year on a bipartisan vote of 305-113, with 72 Republicans joining Democrats in support. But it did not advance in the Republican-controlled Senate, where Democrats now hold a slim majority.

“It is never too late to do the right thing,” Hoyer said during Tuesday’s floor debate, quoting Martin Luther King Jr. “And this, today, is the right thing. It reflects our growth as a state as we have confronted the most difficult parts of our history.”

Each state contributes two statues of people of historical importance to be displayed in the Capitol. Those statues can be replaced by state officials, who select who will be depicted and raise money for the statue’s creation.

The Joint Committee on the Library of Congress can approve or deny state requests to replace their statues, and determines where those statues are displayed in the Capitol.

Under the bill now awaiting a Senate vote, the statues with Confederate ties would be sent back to their respective states.

Confederate monuments, statutes and other commemorative symbols have undergone reconsideration across the South in recent years, particularly following the 2015 mass shooting in Charleston, S.C., in which a white supremacist fatally shot nine Black worshipers at the Emanuel African Methodist Episcopal Church.

A report earlier this year from the Southern Poverty Law Center, a legal advocacy group that has tracked Confederate symbols in public spaces since that 2015 shooting, found 169 Confederate symbols were removed across the United States in 2020. But more than 2,100 Confederate symbols are still publicly present, according to SPLC’s tracking data.

During Tuesday’s debate over the statue-removal bill, most Republicans who spoke said they planned to support the measure, but criticized Democrats for not moving to replace the statues more quickly.

“It’s important the statues we have here reflect the values of this nation,” said Rep. Barry Loudermilk, (R-Ga.), adding that he too does not support the ideas espoused by Stephens, commemorated in one of Georgia’s statues and that “to say he was a racist was an understatement.”

However, Loudermilk said the joint congressional committee that signs off on replacing statues has met too infrequently, and has let requests from North Carolina and other states linger.

Back in his home state, Georgia state lawmakers have filed a resolution to replace Stephens’ statue with one commemorating the late civil rights icon, former U.S. Rep. John Lewis, the Georgia Recorder has reported.

The idea of including Taney at the U.S. Capitol was controversial well before sculptor Augustus Saint-Gaudens even started carving the piece, according to Maryland Matters.

Just a few months after Taney’s death in 1864, the U.S. Senate considered legislation to commission a marble bust of Taney as Congress had done for previous chief justices. But U.S. Sen. Charles Sumner, an ardent anti-slavery lawmaker from Massachusetts, opposed the proposal, saying his name “is to be hooted down the page of history.”

The rebuke was only temporary, though. Seven years later, when Taney’s successor as chief justice died, Congress ordered commissions for both of the late judges.

Hoyer noted that a statue of Taney has been removed from the grounds of the Maryland state House. Rep. Jamie Raskin, another Maryland Democrat, said the city of Frederick also took down a memorial to Taney several years ago.

Raskin praised the decision to honor Marshall, calling him “a great Marylander who has stood the test of time,” and deeply involved in the legal strategy to dismantle Jim Crow laws enforcing racial segregation.

The effort is the latest move by congressional Democrats to undo Confederate symbols on Capitol Hill and other federal property.

Last year, Speaker Nancy Pelosi ordered the removal of four portraits of previous House speakers who served in the Confederacy. A statue of Confederate General Robert E. Lee of Virginia also was removed from the U.S. Capitol last year, after having been moved to a less-visible spot within the Capitol during Pelosi’s first stint as speaker.

Congress also voted last year to remove the names of Confederate generals from military bases across the South. A commission is beginning the process of renaming those bases, with a final report due to Congress in October 2022.

The U.S. Supreme Court building (photo courtesy of Wikimedia Commons).

WASHINGTON — The U.S. Supreme Court said Monday that it will not hear a case of a transgender student in Virginia who was barred from using the boys’ bathroom, a decision that affirms lower-court rulings that said treating transgender students differently violates federal law.

Justices on the top court offered no comment in declining to take up the case of Gavin Grimm, who was required to use alternative bathroom facilities while a student at Virginia’s Gloucester High School in 2014.

With help from the American Civil Liberties Union, Grimm, who is now an adult, sued the school board. The Supreme Court was expected to review the case in 2017, but sent it back for reconsideration after the Trump administration rescinded Obama-era guidance protecting transgender students’ rights.

Since then, the U.S. District Court for the Eastern District of Virginia and the U.S. Court of Appeals for the 4th Circuit have both ruled in favor of Grimm, whose case has drawn national attention.

“I have nothing more to say but thank you, thank you, thank you,” Grimm said in a Twitter post, speaking to those who supported him and aided in the case. “Honored to have been part of this victory.”

The ruling comes at a time when a growing number of GOP-led states are passing legislation to restrict transgender athletes and otherwise limit legal protections for transgender individuals.

Two conservative justices, Clarence Thomas and Samuel Alito, said they would have heard the case.

Transgender rights advocates argue that bathroom policies that single out transgender youth violate federal and constitutional law and say such policies harm them, not cisgender students.

Grimm was using the boys’ restroom as a student at Gloucester High School until 2014, when the Gloucester County School Board adopted a policy requiring him to use alternative facilities after receiving complaints from some parents and residents, according to the Virginia Mercury.

In a statement released by the ACLU after Monday’s ruling, Grimm said being forced to use the nurse’s room, a private bathroom, and the girls’ room was “humiliating,” adding that having to use out-of-the-way bathrooms also “severely interfered with my education.”

“Trans youth deserve to use the bathroom in peace without being humiliated and stigmatized by their own school boards and elected officials,” he said.

His counsel, Josh Block, who serves as senior staff attorney with the American Civil Liberties Union LGBTQ & HIV Project, said that while the Supreme Court has allowed several appeals court decisions in support of transgender students to stand in recent years, “our work is not yet done.”

“The ACLU is continuing to fight against anti-trans laws targeting trans youth in states around the country,” Block said.

Amid the series of new state laws restricting transgender rights, the Biden administration has sought to expand legal protections for LGBTQ Americans.

The Department of Education recently expanded its interpretation of federal sex protections to include transgender and gay students, reversing a Trump-era policy. The Department of Health and Human Services also has prohibited discrimination based on sexual orientation or gender identity by health care providers that receive federal money.

U.S. Attorney General Merrick Garland speaks during an event at the Justice Department on June 15, 2021 in Washington, D.C. (Photo by Win McNamee/Getty Images).

WASHINGTON — U.S. Attorney General Merrick Garland announced Friday that the Department of Justice is suing the state of Georgia to overturn a sweeping elections law passed in March, with a legal challenge that alleges the new statute violates the federal Voting Rights Act.

The federal lawsuit is the latest in a series of challenges to Senate Bill 202, which would, among other changes, limit absentee voting, enact new voter ID requirements and make it illegal for volunteers to hand out food and water to those waiting in long lines to cast their ballots.

“Many of that law’s provisions make it harder for people to vote,” Garland said during a news conference Friday. “The complaint alleges that the state enacted those restrictions with the purpose of denying or abridging the right to vote on account of race or color.”

The legal action follows an announcement earlier this month that the DOJ was doubling its enforcement attorneys who work to protect voting rights, with Garland pledging that the agency would be “scrutinizing new laws that seek to curb voter access.”

The DOJ lawsuit joins seven other federal suits filed by civil and voting rights organizations that claim new absentee ID requirements, limitations on absentee drop boxes and other changes violate the federal voting laws.

Garland declined to reveal Friday if the department intends to file lawsuits over newly passed voting laws in other states, saying that the DOJ is analyzing other state laws and following other proposals under consideration by state legislatures.

“This lawsuit is the first of many steps we are taking to ensure that all eligible voters can cast a vote, that all lawful votes are counted, and that every voter has access to accurate information,” Garland said.

Georgia Gov. Brian Kemp responded to the lawsuit’s announcement with a Twitter post blasting the filing as “born out of the lies and misinformation” promoted by the Biden administration.

“Now, they are weaponizing the U.S. Department of Justice to carry out their far-left agenda that undermines election integrity and empowers federal government overreach in our democracy,” Kemp posted.

Republican supporters of Georgia’s election overhaul argue that the legislation improves the security of the absentee voting system, and that some Georgians would have more voting options due to the mandate for an extra weekend voting day and more public notice on polling location changes.

U.S. Sen. Josh Hawley, R-Mo., reacted to the lawsuit on Twitter.

“This is an outrageous abuse of power and politicization of the Justice Department — Joe Biden and Merrick Garland are now using the law enforcement power of the federal government to advance the Democrats’ false attacks on Georgia,” he tweeted. “This is wrong.”

But Democrats and voting-rights groups have blasted the law, saying it will significantly disenfranchise many Georgians, predominantly minority voters, people with disabilities and seniors.

Kristen Clarke, assistant attorney general for civil rights at the DOJ, outlined a number of provisions within the Georgia law that the DOJ complaint alleges were adopted with the intent of denying voting access to Black voters.

Those include changes that limit access to absentee voting — such as fewer drop boxes and a shortened timeline for requesting ballots — which Clarke said will push more Black voters to cast their ballots in person, “where they will be more likely than white voters to confront long lines.”

Other changes in the statute will reduce the likelihood that voters who show up at the wrong precinct will have their ballots counted, also disproportionately affecting Black voters, she said.

Clarke said the new lawsuit is a signal that the DOJ “stands ready to protect the constitutionally guaranteed voting rights of Americans in Georgia, and wherever else those rights may be threatened in our country.”

Georgia is far from the only state that has enacted more voting restrictions since the 2020 election.

Republican-controlled legislatures in 17 states have passed 28 new laws that advocates and Democrats say would make voting more difficult, particularly for people of color, according to the Brennan Center for Justice, a research institute. That includes Georgia and Florida.

Congressional Democrats also have held a host of hearings in the House and Senate on voting rights, and have listened to concerns about those Republican-led efforts to introduce and pass voting restrictions.

Garland repeated his call for Congress to restore a preclearance requirement that states with historical practices of racial discrimination get federal approval before making any changes to their voting laws.

That mandate was struck down in a 2013 Supreme Court decision. Garland added that if that section of the federal Voting Rights Act was still in place, “it is likely that SB 202 would never have taken effect.”

(Official White House photo by Adam Schultz)

WASHINGTON — The Biden administration on Thursday extended a national moratorium on evictions for another month, offering what federal officials say will be a final respite while they scramble to beef up other help for renters that could mitigate a wave of evictions once the legal protection does expire.

The added month of eviction relief comes after housing advocates have expressed concerns about the ramifications for renters if that moratorium by the Centers for Disease Control and Prevention expired on June 30.

More than 10 million adult renters were behind on rent payments as of early June, according to the Center on Budget and Policy Priorities, a left-leaning think tank.

The figure of those behind on rent payments encompasses 14% of adult renters in the U.S., and has barely changed since March, according to housing experts from the CBPP. Renters of color and those with children are most likely to be struggling with rent payments.

The federal protection against eviction now will remain in place through July 31. But the moratorium still faces a looming legal threat in the U.S. Supreme Court, where a group of Alabama real estate agents have asked the justices to declare that the CDC does not have the power to block evictions.

During what CDC officials say will be the final extension of the federal eviction moratorium, the Biden administration officials will be seeking to better connect struggling renters with access to assistance programs, which in some states like Pennsylvania have been slow to distribute emergency rental aid.

Among the new “all-hands-on-deck” efforts announced by the White House were proposals to:

• Raise awareness of emergency rental assistance money;
• Encourage state courts to adopt anti-eviction diversion practices;
• Provide clarity for states and localities that they can use federal housing relief money not only to help renters catch up on payments, but also to administer anti-eviction programs;
• Convene a summit with housing advocates and officials from 50 cities to develop strategies to better divert evictions.

Housing advocates praised the CDC’s extension on Thursday, saying that eviction filings are likely to be highest in areas with the lowest COVID-19 vaccination rates, raising both housing and public health risks.

But those advocates also cautioned that the moratorium is a short-term solution, and one that does little to mitigate challenges that renters faced in accessing affordable housing prior to the pandemic.

“For now, extending the eviction moratorium will protect the millions of people behind on rent,” Alicia Mazzara, a senior research analyst with the Center on Budget and Policy Priorities, told reporters. “But many of these renters faced a similar deadline only months ago, and they’ll face this deadline again at the end of next month. They need a long-term solution, not another Band-aid.”

Protections for renters and homeowners were enacted last year as businesses shuttered, and unemployment numbers began to spike. Eventually, 43 states and the federal government halted evictions on a temporary basis, though many of those state-level protections have since expired, according to the Pew Charitable Trusts.

Congress included a moratorium on evictions in the CARES pandemic relief bill passed in March 2020, which expired in late July. As that federal protection expired along with eviction moratoriums in a number of states, the CDC then issued its own moratorium in September.

That eviction pause ran through December and was extended through January, March, June, and now through July.

Former Missouri Secretary of State Robin Carnahan (photo submitted).

WASHINGTON — A Senate panel on Wednesday unanimously advanced the nomination of former Missouri Secretary of State Robin Carnahan to lead the federal Department of General Services.

The bipartisan voice vote by the Senate Homeland Security and Governmental Affairs Committee sends Carnahan’s nomination to await a vote by the full Senate.

If confirmed, Carnahan, 59, would lead a $20 billion, 12,000-employee agency tasked with managing work space for more than 1 million federal civilian workers, overseeing more than 480 historic buildings, and facilitating the technological, procurement and other needs of agencies across the federal government.

Carnahan has experience with GSA, where she founded and led the State and Local Government Practice at 18F, a digital services agency within the agency that collaborates across the federal government to help build and buy technology.

During last week’s nomination hearing, Carnahan told senators that one of her priorities as the agency’s chief would be working to shore up the “fragility” of the government’s digital infrastructure.

She also pledged to harness the agency’s resources to assist state governments, noting the challenges faced by state officials over the past year as aging unemployment compensation systems were overwhelmed by claims.

Carnahan comes from a long line of Missouri politicians: her father, Mel Carnahan, who served as governor, and her mother, Jean Carnahan, who became the first woman to serve as a U.S. senator for Missouri.

She served as Missouri’s secretary of state from 2005 to 2013, and ran unsuccessfully for one of the state’s U.S. Senate seats in 2010.

Syringes of COVID-19 vaccinations are filled during MU Health Care's vaccination clinic in the Walsworth Family Columns Club at Faurot Field in Columbia on Feb. 4, 2021 (Photo by Justin Kelley/MU Health Care).

WASHINGTON — Federal health regulators have instructed Maryland’s Emergent BioSolutions to scrap some batches of the Johnson & Johnson COVID-19 vaccine substance manufactured at the company’s troubled Baltimore plant, while clearing a small portion to be used in the U.S. or sent abroad.

Two batches of the J&J vaccine substance made in Baltimore were deemed “suitable for use” by U.S. Food and Drug Administration regulators, but “several other batches” were deemed not usable and other batches remain under review, according to an agency news release Friday.

Agency officials did not estimate how many doses are in those batches. The New York Times reported Friday that the equivalent of 10 million J&J vaccine doses was cleared for use, and roughly 60 million doses’ worth of ingredients would need to be discarded.

Previous estimates from company officials had projected that the drug substance that was quarantined for review could be used to produce more than 100 million doses.

“These actions followed an extensive review of records, including the production history of the facility and the testing performed to evaluate the quality of the product,” said Peter Marks, director of the FDA’s Center for Biologics Evaluation and Research, in a statement.

“This review has been taking place while Emergent BioSolutions prepares to resume manufacturing operations with corrective actions to ensure compliance with the FDA’s current good manufacturing practice requirements.”

The FDA statement added that the agency is not yet authorizing Emergent’s facility to produce new J&J doses, and that company officials are continuing to “work through issues.”

Emergent BioSolutions chief executive officer Robert Kramer acknowledged during a hearing of the House Select Subcommittee on the Coronavirus Crisis in May that his company had not yet produced one vaccine dose usable in the United States, despite a multi-million-dollar federal contract.

The company’s struggles came to public view in late March, when quality control checks revealed cross-contamination at the Baltimore facility, which was producing substances to be used in vaccine doses from both J&J and AstraZeneca.

In April, FDA investigators flagged a series of shortcomings at the plant, including failure to properly disinfect equipment and improper training of employees.

Company officials have said the cross-contamination occurred when substances transported from the part of the facility that produces the AstraZeneca materials “came in the general vicinity” of where the J&J materials are produced.

AstraZeneca material is no longer produced at the Baltimore facility, and J&J officials also are now providing 24-7 oversight as Emergent works with federal regulators to resume production.

The situation also has prompted an investigation by congressional Democrats, who released a memo last month detailing Emergent’s $27 million-a-month federal contract, and documents showing that a Trump administration adviser flagged risks at the Emergent plant in June 2020.

The two batches that now will be available were cleared for use after FDA regulators reviewed facility records and results of quality testing, according to the agency.

If those doses are sent overseas, FDA officials said the agency will share relevant information about those batches with regulators in the countries receiving any doses.

The Biden administration has pledged to share at least 80 million vaccine doses with other countries by the end of June.

Former Missouri Secretary of State Robin Carnahan (photo submitted).

WASHINGTON — President Joe Biden’s pick to lead the General Services Administration, former Missouri Secretary of State Robin Carnahan, told U.S. Senators Thursday that she was “horrified” by the slow pace of federal pandemic relief.

While Congress responded to the crisis with new programs and resources, in too many instances, that help was not fast enough in reaching families due to outdated technology systems, she said.

“We can’t implement government policy if we can’t make the damn websites work,” she told the Senate Homeland Security and Governmental Affairs Committee during her confirmation hearing.

If confirmed to run an agency tasked with supporting federal agencies, including their technology needs, Carnahan said one of her priorities would be working to shore up the “fragility” of the government’s digital infrastructure.

She would harness the resources of the $20 billion, 12,000-employee GSA to not only improve the operations of federal agencies, but also to seek ways to assist state governments, Carnahan said.

The state unemployment systems that were overwhelmed during the coronavirus pandemic have many similarities, Carnahan said, adding that she would look for ways to support shared services “that don’t have to be reinvented and rebuilt and paid for by taxpayers over and over again in every state.”

Carnahan, 59, comes from a long line of Missouri politicians.

Her father, Mel Carnahan, served as governor and her mother, Jean Carnahan, became the first woman to serve as a U.S. senator for Missouri. Her brother, Russ, was a member of Congress, as was her grandfather, Albert Sidney Johnson Carnahan.

She comes into the appointed role with significant familiarity with the GSA and with the challenges of modernizing government technology.

From 2016 to 2020, she founded and led the State and Local Government Practice at 18F, which is a digital services agency within GSA that collaborates with other agencies to help them build and buy technology.

Before that, she served as Missouri’s secretary of state from 2005 to 2013.

Carnahan told senators Thursday that on her first day in that role, she met more people manually opening mail and preparing checks to be deposited than there were working in the IT department.

That disparity “crystallized” for her the challenge ahead: using digital tools to streamline government, she said.

Introducing Carnahan at Thursday’s Senate hearing was a fellow Missourian, Republican Sen. Roy Blunt, who defeated her in the 2010 Senate race.

He praised Carnahan’s work as secretary of state — a role that Blunt and his son, Matt, also held — saying she utilized technology to save government money and improve service.

“Robin Carnahan understands the GSA and she understands the importance of the GSA to the country,” Blunt said.

Carnahan would take over the agency as it grapples with an aspect of post-pandemic life that’s also challenging private-sector businesses: the role of remote work, and how much physical offices are needed.

The GSA is responsible for managing federal office space, and Carnahan said it will be “a very big deal” for the federal agencies to rethink their long-term office needs.

Task forces are in the process of evaluating what that looks like, and the number of employees who need to be on-site day-to-day will vary across agencies, she added.

“I think this really is a long-term issue that we’re going to be dealing with in the government, and we need to get it right.”

The Senate panel is scheduled to vote next week on advancing Carnahan’s nomination to the Senate floor.

Taylor Powell of the Missouri Tigers throws a pass in the second half of a game against the Arkansas Razorbacks at War Memorial Stadium on November 29, 2019 in Little Rock, Arkansas. The Tigers defeated the Razorbacks 24-14. (Photo by Wesley Hitt/Getty Images)

WASHINGTON — There was little disagreement among senators Wednesday over whether a national law is needed to standardize what soon will be a patchwork of conflicting state statutes allowing some student athletes to earn money from their personal brands.

But the Senate Committee on Commerce, Science, and Transportation hearing shed little light on what a potential federal law would look like, when a law could come to a vote — and if that can be done quickly enough in light of the fast-moving changes at the state level.

There’s little time for Congress to act before July 1, when new laws go into effect in five states — Alabama, Florida, Georgia, Mississippi and New Mexico — guaranteeing the rights of student athletes to profit off their name, image and likeness.

A Missouri law would go into effect Aug. 28, if signed by Gov. Mike Parson.

More state laws will become effective in the months and years to follow, with 19 states so far approving legislation on these publicity rights.

“The cat is going to be out of the bag, so to speak,” said Matthew Mitten, a law professor and executive director of the National Sports Law Institute at Marquette University in Milwaukee.

“How do you put the cat back in the bag?” after those initial laws go into effect, asked Sen. Jerry Moran, (R-Kan.).

“I don’t think you can,” Mitten replied. “I think that is exactly the problem.”

University officials and coaches say allowing the branding contracts on a state-by-state basis will mean some athletes will suddenly have a potential income source, and others will not — resulting in a dramatic effect on recruiting and other aspects of college sports.

While the National Collegiate Athletic Association has begrudgingly said it will alter its rules in the wake of the upcoming state laws, it has not yet done so. A pending U.S. Supreme Court case on a separate but related question involving the NCAA’s limits on eligibility and compensation has further complicated action from that governing body.

“At this point, this is not an issue that the NCAA or individual states can fix,” said Mark Few, head coach of the men’s basketball team at Gonzaga University in Spokane, Wash. “Only action here by Congress can maintain some semblance of a level playing field.”

A handful of proposals have been introduced in Congress so far. Some are focused narrowly on the issue of name, image and likeness rights, and others seek to address a broader set of issues for college athletes, such as guaranteeing health care after their eligibility ends.

Sen. Richard Blumenthal, (D-Conn.), who has cosponsored a broader measure with Sen. Cory Booker, (D-N.J.), said Wednesday that he will oppose and seek to block any federal legislation that offers student athletes fewer protections than the bill approved in his home state.

Blumenthal blasted the NCAA as only willing to revise its own rules on publicity rights because they fear that patchwork of pending state laws.

Pressed by Sen. Brian Schatz, D-Hawaii, on whether the NCAA will file lawsuits against states, NCAA President Mark Emmert repeatedly demurred, saying it would be up to the organization’s board of governors. Eventually, he acknowledged the likelihood.

“I believe for universities themselves to file lawsuits against their own states is a very challenging thing to do,” Emmert said.

Those upcoming laws already have begun to affect recruiting conversations between coaches and prospective athletes.

Dr. Wayne A. I. Frederick, who serves as president of Howard University in Washington, D.C., and also as chair of the Mid-Eastern Athletic Conference Presidents and Chancellors, answered partly as a parent when asked how those differing laws are affecting competition among colleges.

Frederick said his son is actively being recruited by collegiate soccer programs, and coaches from states that have passed name and image rights legislation already are bringing up those possibilities in conversations about playing at their schools.

Speaking from his official role, Frederick said they desperately would like to see federal legislation on this issue. But he also expressed concerns about the financial effects on smaller schools like the Historically Black Colleges and Universities in his conference if that legislation includes broader requirements on medical expenses for athletes or requires hiring additional staffers to comply with new rules.

It’s not clear what the scope of a potential federal bill could be. Sen. Roger Wicker of Mississippi, the ranking Republican on the Commerce panel, argued that a bill narrowly tailored to image rights could be completed faster.

Booker called passionately for a wide-ranging bill addressing issues across a collegiate athletic industry that “too often is exploiting young men and women.” He cited a number of concerns across college sports, including a spate of heat-related deaths at practices, flimsy safety practices surrounding concussions, and the lower graduation rates for Black student athletes.

“Are our student athletes, are they truly [at] the center? If they were, we would do something about the forces that are creating such a dangerous environment for them,” Booker said.

There’s a myriad of other thorny issues to untangle even if Congress were to keep a bill limited to just name, image and likeness rights.

Those include who would oversee this program, whether that’s the NCAA, another organization, or some sort of combination. Mitten also urged that an entity other than the NCAA be charged with certifying agents, in an effort to offer protection and guidance for students seeking out representation with potential branding deals.

Any law also would need to address whether individual colleges can put limitations on the types of products an athlete can endorse, and whether they could prohibit deals with companies that sell alcohol or tobacco, for instance.

Several experts raised questions over how these rights will work for international students, and what it may mean for their visa status and taxes.

Frederick questioned whether loopholes could arise in the current web of state laws, such as if a student plays in a state that allows income from publicity rights, but their home university doesn’t.

The NCAA also has called for protections from lawsuits as they come into compliance with any new laws on publicity rights, a request that some senators expressed skepticism on Wednesday.

As the hearing concluded, Sen. Maria Cantwell, D-Wash., who chairs the panel, said that senators are “determined to get this done.” She offered no hints at the timing of next steps, beyond a promise to hold another hearing that included college athletes among those testifying.

(photo courtesy of Kansas City Area Transportation Authority)

WASHINGTON — U.S. House Democrats’ highway funding bill is poised to include roughly three out of five transportation projects submitted by members, as legislators vie for their share of federal dollars through the resurrected congressional earmarks process.

The 1,473 projects that made the cut were out of 2,383 that Democratic and Republican legislators requested for inclusion in a federal infrastructure bill, at a time when infrastructure is the subject of prolonged, high-profile negotiations between the White House and Republicans in Congress.

The earmarks list — detailed in an amendment to five-year, $547 billion surface transportation reauthorization bill that the House Transportation and Infrastructure Committee will take up on Wednesday — has a price tag of $5.7 billion. That’s about 40% of the nearly $14.9 billion that was requested for member-designated projects.

If the bill is passed, districts represented by Democrats would receive the largest share of those dollars. Nearly $4 billion is designated for projects requested by Democrats, and $1.7 billion is for Republican-backed projects.

Republicans requested money for far fewer projects than Democrats did, and some Republicans didn’t request any earmarked funding at all.

Montana’s sole House member, Republican Rep. Matt Rosendale, did not request any project spending, so the state would not receive any dollars from that portion of the bill.

Among Republicans, roughly 400 of the 600 projects they sought were included. Of the 1,778 projects that Democrats sought, the proposal includes 1,067.

In Missouri, there were 57 projects were included in the bill. Among the projects listed: $10 million for electric busses in Kansas City; $3 million for bridge repairs in Wentzville; $1.8 million to expand I-44 in Springfield; and $3 million for pavement improvements in Morgan County.

Some lawmakers saw each of their proposals included in the measure. The 11 Nevada requests for roadway repairs, bridge projects, and zero-emission buses all made the cut.

Others were granted part of what they submitted.

Rep. Garret Graves — the Louisiana Republican who had the most-expensive request with his submission for a new bridge for Baton Rouge — was successful in getting $8 million for pre-engineering design work and $1.6 million for an environmental evaluation included in the bill.

However, the $946 million that Graves sought for actually building that bridge was not included.

The return of earmarks

Congressional Democrats brought back the earmarks process this year, after Republicans banished it in 2011 following intense public criticism of corruption and a lack of fairness.

If the pending highway bill were to become law, it would be the first since 2005 to include earmarks, according to the Eno Center for Transportation.

New guidelines intended to make earmarks more fair and more visible require lawmakers to post documentation for each project on their websites, with a letter attesting that they have no financial stake in the project.

The text of the pending amendment doesn’t specify which lawmaker requested money for an individual project. But members can be identified by sorting through the list of project requests on the House Transportation panel’s website.

Across States Newsroom’s 22 states, lawmakers took varying approaches to the number of projects they submitted and the cost of those projects.

Some turned in targeted lists totaling close to the $20 million that House lawmakers were advised could flow back to each district if a new surface transportation bill is signed into law. Others asked for dozens of projects at costs that far exceeded that figure.

Wisconsin, Tennessee and Missouri, where lawmakers generally submitted project lists with a cost close to that figure, had among the highest percentages of their requests included.

Pennsylvania Rep. Susan Wild, a Democrat, submitted four projects tallying exactly $20 million. All four of those proposals for road work and bridge replacements were selected.

On the other end of the spectrum, Maryland’s eight House members sought funding for nearly 100 projects, at an average cost of more than $100 million per district. Just 20 of those Maryland projects were included in the bill.

“It certainly was not an easy nor quick task for our committee to vet thousands of submissions,” Rep. Peter DeFazio, D-Ore., chairman of the House Transportation and Infrastructure Committee, said in a statement. “But it was absolutely worth it to give elected representatives the chance to directly advocate on behalf of their districts in our surface transportation bill.”

Haggling over a price tag

As the House-drafted highway bill heads to the next step in the legislative process, there’s no guarantee that any of the projects ultimately will get funded and built.

President Joe Biden and congressional Republicans have been negotiating for weeks over the price tag of a bill to pay for building and repairing scores of aging and failing highways, bridges and transit systems.

It’s unclear if they’ll be able to reach a consensus, and if not, if Democrats will be able to push through a major transportation bill without GOP support.

In the meantime, congressional Democrats are attempting to continue moving forward on infrastructure. The Senate Environment and Public Works Committee advanced a surface transportation bill last month.

House Speaker Nancy Pelosi, D-Calif., has said she wants an infrastructure measure to come to the floor before July Fourth. Senate Majority Leader Chuck Schumer, D-N.Y., has said his chamber will also take up transportation legislation next month.

Taylor Powell of the Missouri Tigers throws a pass in the second half of a game against the Arkansas Razorbacks at War Memorial Stadium on November 29, 2019 in Little Rock, Arkansas. The Tigers defeated the Razorbacks 24-14. (Photo by Wesley Hitt/Getty Images)

WASHINGTON — A seismic shift will rock college sports next month, when a handful of new state laws go into effect allowing student athletes to make money off their personal images. 

It’s been against the rules governing collegiate sports for student athletes to make a profit off their name or image — a practice that’s commonplace in professional sports.

But a flurry of states has forged ahead with laws granting college athletes the rights to their own “name, image and likeness,” arguing that it’s a matter of fairness for student athletes. 

In Missouri, a bill approved last month sits on Gov. Mike Parson’s desk awaiting his signature or veto. If signed, it goes into effect Aug. 28.

Statutes in five other states will go into effect July 1. 

Congress could step in, but it has has been unable to come to agreement on a federal law that would resolve the coming patchwork of differing state laws. The Senate Commerce, Science, and Transportation Committee is scheduled to grapple with the issue again during a hearing Wednesday morning.

The state laws regulating name, image and likeness rights are part of a national wave of legislation. A tally by ESPN shows at least 10 other states — including Tennessee, Montana, Colorado, Michigan and Maryland — have statutes poised to go into effect in the coming months and years. 

Other bills also are working through legislatures across the country. So far, all but nine states have introduced some form of similar legislation, according to USA Today.

That state policy-making sets up a chaotic legal playing field for the National Collegiate Athletic Association, which governs college sports and has long resisted efforts to pay student athletes, even as its revenues and those of university athletic departments have soared. 

The NCAA has said it is “committed to modernizing” its name, image and likeness rules. But the sports governing body has held off any official changes because of yet one more complication — the U.S. Supreme Court is preparing to rule before the end of this month in a separate but related case involving the NCAA’s limits on eligibility and compensation.

SCOTUS decision looms

The result of that case, NCAA v. Alston, is likely to determine the NCAA’s ability to respond to the new NIL laws. The case centers around whether NCAA rules capping the amount of financial aid athletes receive from colleges violate federal antitrust laws. 

The NCAA has argued that current rules, which allow schools to offer athletes only a scholarship and an additional cost-of-attendance stipend, are in line with federal law. 

But a lower federal court struck down those limitations, saying the NCAA could restrict benefits unrelated to education, such as cash payments, but not potentially expensive education-related benefits, like free laptops or paid post-graduate internships.

It’s not clear how narrow or broad the Supreme Court’s ruling will be in the pending case, but depending on how that opinion is framed, it could make it “very difficult” for the NCAA to enact any policies on name, image and likeness rights, said Steve Ross, a professor of law at Pennsylvania State University and executive director of the school’s Center for the Study of Sports in Society.

If the top court rules against the NCAA in the Alston case, one option is that it could suggest that the matter be resolved by individual sports conferences, Ross said.

A favorable ruling for the NCAA could give assurance that it can legally attempt to set some guidelines around name, image and likeness rights, he added. Or the collegiate sports organization could launch a legal challenge to those state laws.

“I’m hopeful that after the Alston decision, Congress will actually look at this,” said Ross, who teamed up with other sports law professors to craft a proposal for regulating NIL rights.

Little uniformity among states

In the meantime, the bills passed by state legislatures so far offer little uniformity on how the issue will be managed state to state. 

There are some similarities. Most states would allow student athletes to hire professional representation to negotiate contracts with outside companies.

But there are differences as well. 

The new law in Georgia allows schools to require athletes to pool up to 75% of any name, image and likeness income they earn into an escrow account, which would then be shared with other athletes. A student’s share of those dollars could not be withdrawn until after they graduate or a year after they leave the school.

The Georgia law also requires college athletes to take courses on financial literacy to better prepare them for spending that money.

The measure approved in Maryland isn’t set to take effect until July 2023, allowing time for any policy changes that may come from the NCAA and the federal government. 

That Maryland law also creates new health and safety requirements in Maryland athletic programs to prevent and treat serious injuries, a provision prompted by the death of University of Maryland football player Jordan McNair, who died of complications related to heat stroke after a 2018 practice.

Even with distinctions across states, the new laws all bring the prospect of at least modest and potentially significant new income for players, particularly those in the most-watched, big-dollar sports like football and basketball.

A study by Pennsylvania-based Temple University School of Sport, Tourism and Hospitality Management also suggests that athletes across non-revenue generating sports may also be able to use their social-media platforms to “attract endorsement deals from sponsors with the opportunity to develop an audience and operate as influencers.”

That study noted that female student athletes tend to post more content than their male counterparts, and the median athletes of either gender have a comparable number of followers, suggesting a somewhat more level playing field for potential social-media endorsements based on their reach.

Multiple ideas in Congress

A federal law would help to standardize the nuances among those state laws, but members of Congress have been unable to reach agreement across at least eight proposals, including a bipartisan proposal from Rep. Anthony Gonzalez, an Ohio Republican and former Ohio State football player, and Rep. Emanuel Cleaver, a Missouri Democrat.

Those proposals range in scope. A wide-reaching measure from Democratic Sens. Cory Booker of New Jersey and Richard Blumenthal of Connecticut includes revenue sharing, a medical trust fund, and greater scholarship protections.

“I know firsthand that college sports can open doors of opportunity that most young people never knew existed—but the unfortunate reality is that the NCAA is also exploiting college athletes for financial gain, and disproportionately exploiting Black athletes who are over-represented in the revenue generating sports,” Booker has said.

“Under its current operation, the NCAA is preventing college athletes from earning any meaningful compensation and failing to keep the athletes under its charge healthy and safe, and that needs to change.”

A number of issues remain unresolved across those ideas from members of Congress, including whether a federal statute would entirely preempt state laws on the matter. 

“As states continue to pass laws determining how college athletes can be compensated for their name, image, and likeness, it is clear that a patchwork of 50 state laws would be devastating to college sports,” Sen. Marco Rubio, R-Fla., said last year when he introduced his Fairness in Collegiate Athletics Act.

The Senate hearing set for Wednesday could advance the debate. Staffers for Sen. Maria Cantwell, D-Wash., who chairs that panel and who has been a key player in talks over NIL legislation, did not return messages from States Newsroom for this report.

Sen. Jerry Moran, R-Kansas, who drafted one of the NIL rights proposals, told USA Today last month that it would be “difficult … if not impossible” to pass a federal law on the issue before July 1. 

But Moran also told the paper that the state laws have made NIL rights for college athletes “a much more important issue” than it had been even a few months earlier.

The Supreme Court is set to rule in the Alston case before it adjourns at the end of June. 

Depending on the timing and scope of that ruling, the next steps from the NCAA come on June 23, when one of the organization’s rule-making panels is set to meet. 

U.S. President Joe Biden addresses a joint session of congress as Vice President Kamala Harris (L) and Speaker of the House U.S. Rep. Nancy Pelosi (D-CA) (R) look on in the House chamber of the U.S. Capitol April 28, 2021 in Washington, DC. (Photo by Chip Somodevilla/Getty Images).

U.S. Capitol police officers point their guns at a door that was vandalized in the House Chamber during a joint session of Congress on January 6, 2021 in Washington, DC. (Photo by Drew Angerer/Getty Images)

WASHINGTON — Senate Republicans on Friday blocked consideration of a bill creating a bipartisan, independent commission to investigate what happened leading up to and during the Jan. 6 attack at the U.S. Capitol.

Legislation to form an investigatory panel into that attack passed the House of Representatives earlier this month, with 35 House Republicans joining Democrats in backing the measure.

Friday’s procedural vote in the Senate required support from at least 10 GOP lawmakers in order to advance to debate on the proposal and end a GOP filibuster.

Only six Republicans — including Sens. Susan Collins, of Maine; Bill Cassidy, of Louisiana; and Rob Portman, of Ohio  — joined with Democrats in the 54-35 vote, which needed 60 senators in agreement to move ahead. Eleven senators did not cast a vote.

Sen. Pat Toomey, R-Pa., was absent due to a family commitment, according to his spokesman, who said Toomey would have voted in favor of debating the legislation. He also was supportive of an amendment from Collins to address concerns about the commission’s staffing and duration.

Even with Toomey’s support, three additional GOP yes votes would have been needed to advance the bill.

In a statement after the vote, Cassidy — who also voted to convict former President Donald Trump on impeachment charges of inciting the Jan. 6 riot — said the legislation would ensure GOP lawmakers had equal involvement in an investigation that will occur even if they object.

“The investigations will happen with or without Republicans,” Cassidy said. “To ensure the investigations are fair, impartial, and focused on the facts, Republicans need to be involved.”

Other senators not voting on Friday included Marsha Blackburn of Tennessee, Roy Blunt of Missouri, Richard Burr of North Carolina, Jim Risch of Idaho, and Kyrsten Sinema of Arizona.

The Senate vote was expected to occur on Thursday, but it was delayed when Sen. Ron Johnson, R-Wis., and other conservatives raised objections to a separate bipartisan bill seeking to boost U.S. competitiveness against China. Final votes on that bill ultimately were postponed to next week so the Senate could vote on the Jan. 6 commission legislation.

Republicans opposed to setting up a 10-member commission — which would be appointed by lawmakers from both parties and styled on the panel that investigated the Sept. 11 terrorist attacks — criticized the commission’s makeup and said it was unnecessary given the other investigations underway.

“There’s no new fact about that day we need the Democrats’ extraneous commission to uncover,” Senate Minority Leader Mitch McConnell, R-Ky., said during a floor speech Thursday.

Democrats have argued that the panel is critical to establishing a comprehensive, independent analysis that pulls together all the events leading up to the crowd of rioters storming the Capitol hallways, destroying property, and assaulting law enforcement officers who were protecting lawmakers and staffers.

“I can’t imagine anyone voting against the establishment of the commission on the greatest assault since the Civil War on the Capitol,” President Joe Biden said ahead of the Senate vote.

Seeking to sway opponents, the mother and the longtime partner of fallen Capitol Police Officer Brian Sicknick spent Thursday meeting with GOP senators, urging them to back the commission. Sicknick was one of five people who died in the Jan. 6 assault and its aftermath.

“Usually I stay in the background, and I just couldn’t stay quiet anymore,” Sicknick’s mother, Gladys, told reporters after the two women and two officers who responded to the insurrection met with Sen. Mitt Romney, a Utah Republican. Romney ultimately voted in favor of advancing to debate on the commission.

Other GOP senators who met with the group lobbying for the commission’s creation included Toomey, Johnson, Collins and Roger Marshall, of Kansas.

Johnson has falsely described the Jan. 6 attack as largely a “peaceful protest.” After meeting with Sicknick and the officers, he said in a statement that “although we disagreed on the added value of the proposed commission, I did commit to doing everything I could to ensure all their questions will be answered.”

Marshall’s position also was unchanged by his meeting with Sicknick’s family. He said in a statement that he believes the ongoing investigations “will bring to light the needed answers and detail how security at the Capitol can be enhanced moving forward.”

Investigations already are underway by the Justice Department and multiple committees in the House and Senate. The Justice investigation, which is ongoing, has led to charges against more than 440 individuals so far, with those prosecutions likely to last for years.

Sen. Amy Klobuchar, D-Minn., who leads one of the committees involved in the Senate inquiry, said the congressional investigations are focused on immediate responses needed to remedy mistakes that occurred on Jan. 6.

“But it is no substitute for a 9/11-style commission,” Klobuchar added.

Collins, who supports an independent commission, had drafted an amendment to the commission legislation, seeking to ensure that staffers for the panel are jointly appointed by both Democrats and Republicans, and not just by the Democratic-appointed chairman.

She told reporters that there was “widespread support” among Republicans for her proposed changes, but also acknowledged that some GOP senators are “simply opposed to having a commission in any form.”

Majority Leader Chuck Schumer, D-N.Y., dismissed the reasons cited by Republicans against the commission as “silly,” and not reflective of their true motivation: that such a panel would upset former President Donald Trump, who was impeached but not convicted of inciting the rioters who stormed the Capitol that day.

“If our Republican friends vote against this, what are you afraid of? The truth?” Schumer asked in his floor speech ahead of Friday’s vote. “Are you afraid Donald Trump’s big lie will be dispelled? Are you afraid that all of the misinformation that has poured out will be rebutted by a bipartisan, down-the-middle commission?”

The failed vote is likely to further intensify the toxic atmosphere on Capitol Hill, which has worsened in the wake of the Jan. 6 attack.

Some Democrats have refused to work with Republicans who voted against certifying the 2020 presidential election on Jan. 6, a point of particular tension with some Republicans who are downplaying the violence that day.

Demonstrators hold signs during a protest at the Country Club Plaza on May 31, 2020 in Kansas City. Protests erupted around the country in response to the death of George Floyd in Minneapolis, Minnesota while in police custody (Photo by Jamie Squire/Getty Images).

U.S. President Joe Biden addresses a joint session of congress as Vice President Kamala Harris (L) and Speaker of the House U.S. Rep. Nancy Pelosi (D-CA) (R) look on in the House chamber of the U.S. Capitol April 28, 2021 in Washington, DC. (Photo by Chip Somodevilla/Getty Images).

(photo courtesy of Kansas City Area Transportation Authority)

Syringes of COVID-19 vaccinations are filled during MU Health Care’s vaccination clinic in the Walsworth Family Columns Club at Faurot Field in Columbia on Feb. 4, 2021. (Photo courtesy of MU Health Care)

WASHINGTON — Angry U.S. House Democrats on Wednesday had one key question as they grilled executives of a Maryland biotech manufacturer forced to dump 15 million doses of Johnson & Johnson’s COVID-19 vaccine: Has there been one usable vaccine dose produced as a result of the $271 million paid to date by the U.S. government?

The answer is no, Emergent BioSolutions chief executive officer Robert Kramer acknowledged when pressed during a hearing of the House Select Subcommittee on the Coronavirus Crisis.

“None of the vaccine that we’ve manufactured has been made available to the U.S.,” Kramer said. Quality control errors have plagued the rollout.

Kramer and Emergent’s founder and executive chairman, Fuad El-Hibri, faced an onslaught of questions from Democratic lawmakers during Wednesday’s hearing about the circumstances surrounding the company’s cross-contamination of the substance used to produce doses of J&J’s one-shot coronavirus vaccine at its Baltimore facility.

The nearly 10 million J&J shots administered in the United States to date have been imported from the company’s plant in the Netherlands.

The incorrect vaccine doses from Emergent were never distributed or administered after being discovered in late March, but the loss was particularly painful at a point when U.S. vaccine demand still outstripped supply.

Production at the plant has remained on hold pending approval from federal regulators.

Lawmakers on the panel also questioned how Emergent was granted an overall $650 million federal contract to boost domestic vaccine production capabilities, of which $271 million has been paid out to date on a monthly basis.

They also asked about the timing of bonuses to and stock sales by top company officials as the Baltimore plant struggled with production and discarded several batches of substance needed for the AstraZeneca COVID-19 vaccine last fall.

“As they’re destroying the vaccines, they’re cashing out, taking stock out of the company,” said Rep. Carolyn Maloney, (D-N.Y.), referencing news reports that Kramer sold $11 million in stock between January and February, prior to the stock price plummeting.

Ahead of the hearing, Democrats on the panel released a memo Wednesday morning detailing initial findings from the committee’s investigation into company operations.

Among the new findings were documents detailing the federal contract that paid Emergent $27 million a month to reserve manufacturing space, regardless of whether the company produced vaccines.

Other documents showed a Trump administration adviser flagged risks at the Emergent plant in June 2020, highlighting “inadequate” staffing plans and the need for “substantial remediation and expansion” of equipment before production could begin.

The memo also detailed at least $360,000 in consulting fees received by Dr. Robert Kadlec, a senior Trump administration official contracted by Emergent from 2012 to 2015, and the bonus received by its executive vice president responsible for manufacturing amid issues at the Baltimore plant.

Emergent’s executives defended their bonuses and stock sales, and denied any political impropriety by Kadlec in connection with the company’s work with J&J and AstraZeneca.

Kramer attributed the cross-contamination of the J&J doses to the rapid pace at which the company attempted to scale up production of not one, but two brand-new vaccines when it was not yet fully staffed.

The company has taken steps to prevent such contamination in the future, including no longer producing AstraZeneca material at the Baltimore facility, he said, adding that J&J officials also are now providing 24-7 oversight of its production.

“I apologize for the failure of our controls, and I give you my personal assurance that I’ll take every step that is needed to resume production safely,” Kramer told the panel.

The company’s struggles came to public view in late March, when quality control checks revealed cross-contamination at that facility, which was producing substances to be used in vaccine doses from both J&J and AstraZeneca.

In April, Food and Drug Administration investigators flagged a series of shortcomings at the plant, including failure to properly disinfect equipment and improperly training employees.

Kramer said the company’s internal review indicates that the cross-contamination occurred when substances transported from the part of the facility that produces the AstraZeneca materials “came in the general vicinity” of where the J&J materials are produced.

Republicans on the panel had few critical questions for the Emergent executives, largely focusing instead on criticizing the House’s mask mandate and President Joe Biden’s decision to waive intellectual property protections for COVID-19 vaccines in order to boost global access to those shots.

Rep. Steve Scalise, (R-La.), the ranking GOP member on the subcommittee, used his questions to underscore that quality control checks caught the contamination and that none of the material left the facility.

Scalise also criticized the FDA for not acting faster to approve use of an estimated 100 million doses’ worth of J&J vaccine substance in batches deemed free of contamination.

“If both Emergent’s and Johnson & Johnson’s internal reviews have said that those 100-plus million doses are OK, why hold them up?” he asked.

Scalise is one of three lawmakers on the panel who have received campaign contributions from Emergent executives, according to the New York Times. He and his campaign organizations received at least $150,000 since 2018.

Rep. Jim Jordan, an Ohio Republican, and Rep. Jamie Raskin, (D-Md.), each received $1,000 during the 2020 election cycle from the company’s political action committee. Raskin told the Times that he had returned the money after being contacted about the contribution.

During Wednesday’s hearing, Raskin pressed Emergent executives on the price tag and requirements of the contract, as well as the circumstances of the contamination, describing that as “a catastrophic failure.”

Syringes of COVID-19 vaccinations are filled during MU Health Care’s mass vaccination clinic at the Walsworth Family Columns Club at Faurot Field in Columbia on Feb. 4, 2021 (Photo courtesy of MU Health Care).

Syringes of COVID-19 vaccinations are filled during MU Health Care’s mass vaccination clinic at the Walsworth Family Columns Club at Faurot Field in Columbia on Feb. 4, 2021 (Photo courtesy of MU Health Care).

The state has $2.6 billion from the American Rescue Plan Act signed last March by President Joe Biden to cover revenue losses and invest in broadband and water infrastructure. There’s another $200 million for capital projects (Photo by Scalinger/iStock Getty Images)

U.S. Rep. Cori Bush, D-Missouri, testifies before the House Oversight and Reform Committee on Black maternal deaths and pregnancy complications (screenshot).

WASHINGTON — When U.S. Rep. Cori Bush of Missouri was pregnant with her first child, Zion, she saw a sign in her doctor’s office encouraging her to speak up about anything unusual she was feeling.

She did so, telling her physician that she was having severe pains, but her concerns were swiftly dismissed. The doctor told Bush, who is African American, that she was fine and sent her home — and one week later, Bush went into early labor.

“At 23 weeks, my son was born, one pound, three ounces,” Bush told a congressional hearing Thursday on Black maternal mortality. “His ears were still in his head. His eyes were still fused shut. His fingers were smaller than rice, and his skin was translucent, a Black baby, translucent.”

Bush recalled that the doctor who delivered her son apologized for not listening to her.

But when she was pregnant with her second child, she faced the same situation. She again went into early labor, and a different doctor refused to help her, telling Bush in a clear reference to her race: “You can get pregnant again, because that’s what you people do.”

Her story is far from unusual.

Mothers, spouses and loved ones of Black people who have died as a result of childbirth complications described their experiences to the House Oversight and Reform Committee in heartbreaking detail.

Black birthing people are three times more likely to experience pregnancy-related death when compared to their white counterparts, according to the Centers for Disease Control and Prevention. They also experience higher rates of pregnancy complications, infant loss, and miscarriage.

Affluent Black Americans also are disproportionately affected: a Black person with a college degree is twice as likely to experience a severe physical or mental complication from childbirth than a white woman without a high school degree, said Dr. Veronica Gillispie-Bell, medical director for the Louisiana Perinatal Quality Collaborative.

Gillispie-Bell and other medical experts said race and the country’s long history of racism are at the root of why childbirth has a greater likelihood of turning fatal for those who are Black.

False medical beliefs about Black people — including that they have thicker skin or a greater tolerance for pain — have contributed to health care providers being less likely to listen to and act upon health concerns raised by Black patients, studies have found.

One study found Black patients who undergo a cesarean section are less likely to receive the same anesthesia treatment as white patients who have the same surgery, said Dr. Joia Adele Crear-Perry, of the D.C.-based National Birth Equity Collaborative. She completed her medical degree at Louisiana State University and her residency and in obstetrics and gynecology at Tulane University’s School of Medicine.

After the doctor refused to help Bush, 44, now a freshman Democrat in Congress, stop her preterm labor in her second pregnancy, her infuriated sister threw a chair down the hallway.

The nurses who responded called Bush’s original doctor — the one from her first pregnancy who apologized for not listening — and the physician was able to place a surgical stitch to keep her cervix closed, allowing Bush to continue carrying her daughter to a healthy birth.

“Every day, Black women die because the system denies our humanity,” Bush said. She did not name the doctors or the health care facility where the incidents occurred.

When Charles Johnson went to the hospital with his wife, Kira, for the delivery of their second son, complications were far from his mind after a healthy pregnancy for both Kira and the baby.

But after her C-section, he grew alarmed when her catheter began to turn pink due to internal bleeding. For hours, he sought help, but a scan that was scheduled to be performed “stat” was delayed.

At one point in his pleading, a nurse told him flatly that his wife was “not a priority.”

When she finally was taken for surgery 10 hours later, three-and-a-half liters of blood had filled her abdomen, and Kira died.

Johnson, who founded an advocacy group on maternal mortality, said that even in her most vulnerable state, his wife urged him to stay calm. She feared that if he raised his voice as a Black man, he would have been seen as a threat and kicked out of the hospital.

“It haunts me. Should I have yelled?” Johnson asked. “But the reality of the situation, as a Black man, I did not have the same autonomy to raise my voice, scream, that a Caucasian father would.”

Johnson said he would like to see Congress take bipartisan steps to make childbirth safer. But he also expressed some resignation about the limits of federal powers. “You cannot legislate compassion,” he said, attributing his wife’s death to a lack of concern and humanity.

Democratic lawmakers have introduced a range of bills seeking to address disparities in the U.S. health care system that make childbirth more dangerous for Black Americans.

Cosponsored by Reps. Alma Adams (D-N.C.) and Lauren Underwood (D-Ill.), a package of legislation dubbed the Black Maternal Health “Momnibus” Act — using a pun based on the term for legislation covering wide-ranging issues — would seek to collect more data on the causes of the maternal health crisis; provide more money to community groups and telehealth services to support care during pregnancy; and aim to grow and diversify the country’s birth workers, including doulas and midwives.

“It doesn’t matter what side of the aisle you’re on: Either you have a mother, or you are a mother or you know women who are moms,” said Adams, co-chair of the Black Maternal Health Caucus.

House Oversight Chairwoman Carolyn B. Maloney, a New York Democrat, also said after the hearing that she has requested three new Government Accountability Office reports on the public health crisis.

One change that advocates urged lawmakers to support: making permanent a provision in the latest stimulus package that temporarily allows states to extend Medicaid coverage for pregnant people for a year after giving birth, instead of just 60 days.

Medicaid pays for nearly half of all births in the U.S., and the longer length of health care benefits is viewed as pivotal in ensuring those who are pregnant receive proper postpartum care for their physical and mental recovery.

Syringes of COVID-19 vaccinations are filled during MU Health Care's vaccination clinic in the Walsworth Family Columns Club at Faurot Field in Columbia on Feb. 4, 2021 (Photo by Justin Kelley/MU Health Care).

WASHINGTON — With demand for COVID-19 vaccines dropping in many states, the federal government is changing how those doses are allocated.

Under the new policy, any doses that a state doesn’t request from its weekly, population-based allotment will be held in a general pool, and states with higher demand can request additional shots from that surplus.

President Joe Biden’s COVID-19 advisers outlined the new policy to governors during a call Tuesday morning. Senior administration officials also described the policy to reporters during a separate conference call ahead of Biden’s remarks later in the day on the nation’s vaccination push.

Biden on Tuesday also is expected to announce multiple changes in the U.S. vaccine campaign that are aimed at increasing uptake, including a push to vaccinate adolescents if the Pfizer vaccine is approved for their use and more outreach to rural regions.

Under the new approach for states, they will continue to make weekly decisions on how many doses to request from the federal government. If a state orders fewer doses one week, that decision will not reduce its future allotments, administration officials said during the briefing call.

The change in how vaccines are distributed comes as vaccine appointments are readily available in most areas, and many Americans most eager to receive a shot have already done so. Many states are seeing a decrease in the number of shots they’re administering each week, according to tracking data from the CDC.

At least 56% of American adults have received at least one dose of one of the three authorized COVID-19 vaccines, according to the CDC. Nearly 105 million Americans are fully vaccinated, or about 41% of those over 18.

During his remarks Tuesday, Biden will set a new goal, calling for 70% of U.S. adults to receive at least one shot by July Fourth, and for 160 million Americans to get both shots by that date. Reaching that goal would require roughly 100 million additional shots during the next two months, according to his administration.

Getting those shots in arms will depend on finding those who are hesitant or skeptical of receiving a vaccine, making it even easier to get a vaccine and building confidence in the newly available shots.

States will see a new infusion of money for vaccine outreach efforts, with nearly $250 million for media campaigns and targeted messaging to specific communities.

The president is expected to direct pharmacies in the federal vaccine program to offer walk-in appointments, and encourage states to also offer vaccinations without an appointment. The federal government also will launch smaller, pop-up and mobile vaccine sites, as opposed to the mass-vax locations of the early rollout.

The administration also will increase focus on outreach in rural areas, with more money and shots going directly to rural clinics and hospitals. More than $100 million from the last COVID-19 stimulus package will go to outreach and education efforts across 4,600 rural health clinics.

Another $860 million from that legislation will pay for expanded COVID-19 testing and mitigation through rural hospitals and clinics.

A Kaiser Family Foundation study released last month found a larger share of rural residents reported they had received at least one dose of a COVID-19 vaccine than those in denser cities or suburban areas, where appointments have been harder to secure. But that report also found a greater share of rural residents are waiting to get the vaccine or do not intend to get one than those in urban or suburban communities.

Biden also will call on states to be prepared to expand access to younger Americans, with an application from Pfizer expected to be approved as soon as next week that would allow that shot to be given to adolescents between the ages of 12 and 15.

His administration will be seeking to send vaccines directly to pediatricians and family doctors to boost access and uptake in that age group.

U.S. President Joe Biden addresses a joint session of congress as Vice President Kamala Harris (L) and Speaker of the House U.S. Rep. Nancy Pelosi (D-CA) (R) look on in the House chamber of the U.S. Capitol April 28, 2021 in Washington, DC. (Photo by Chip Somodevilla/Getty Images).

A sign advertising protective face masks is taped in the window of a coronavirus pop-up store in Washington, D.C., on March 6, 2020 (Photo by Samuel Corum/Getty Images).

WASHINGTON — Fully vaccinated Americans do not need to wear a mask outdoors except in crowded settings, federal health officials said Tuesday as they updated recommendations for how vaccinated individuals can safely resume normal activities.

Those who are at least two weeks past receiving their final dose of a COVID-19 vaccine can safely be unmasked at small outdoor gatherings and while dining outdoors with friends from multiple households, according to the new guidance.

The color-coded chart on the Centers for Disease Control and Prevention website also says masks aren’t needed for those who are unvaccinated when walking or running outdoors alone or with members of their household.

The updated recommendations come after studies have shown that fewer than 10% of transmissions of the virus are occurring outdoors, where ventilation poses little problem.

Federal health officials still urged those who are vaccinated to wear a mask in crowded outdoor settings where it is harder to maintain a distance from others, such as concerts or stadiums, and also when indoors, where the virus can easily spread.

“When you are fully vaccinated, you can return to many activities safely, and most of them outdoors and unmasked, and begin to get back to normal,” Dr. Rochelle Walensky, the CDC’s director, told reporters Tuesday. “And the more people who are vaccinated, the more steps we can take toward spending time with people we love doing the things we love to enjoy.”

The recommendations are the latest update from federal health officials on how vaccinated individuals can safely resume normal activities.

They offered guidance in March on how vaccinated people can gather with those who are and are not vaccinated. Earlier this month, CDC officials said fully vaccinated individuals can travel at low risk to themselves, though in a murky messaging effort, they also urged Americans — vaccinated or not — to still refrain from any non-essential travel.

More changes in mask recommendations will require infections across the country to continue to fall, and vaccinations to continue to grow, Walensky said.

According to CDC tracking data, 54% of American adults have received at least one dose of one of the three authorized COVID-19 vaccines, and 37% have been fully vaccinated.

Infections from COVID-19 have been decreasing, after a smaller spike that crested in mid-April, Walensky said Tuesday, noting that hospitalizations and deaths related to the virus also have been declining.

“As I look at the curve now, it’s stabilizing, it’s coming down,” she said.

Photo by Ted Eytan | Wikimedia Commons/CC BY-SA 2.0

President Joe Biden participates in a Feb. 16 phone call with governors from the Oval Office of the White House. (Official White House photo by Lawrence Jackson)

WASHINGTON — Federal and state officials now face trying to reach Americans unable or unwilling to get the COVID-19 vaccine, after meeting President Joe Biden’s goal of administering 200 million doses within his first 100 days in office.

To aid in that push, Biden on Wednesday called on employers to give their workers time off with pay to get vaccinated or to recover from any side effects from the shot.

“No working American should lose a single dollar from their paycheck because they chose to fulfill their patriotic duty of getting vaccinated,” Biden said.

That process doesn’t have to affect a business’s bottom line, Biden argued, highlighting a tax credit included in the latest coronavirus relief law for businesses and nonprofits that offer paid leave to their employees.

That tax credit will be available to businesses employing nearly half of all private sector employees in the country, according to the White House. The Internal Revenue Service posted a fact sheet on Wednesday detailing what employers need to do to claim the paid sick leave credit on their quarterly tax filings.

Data from the Centers for Disease Control and Prevention shows that more than 40% of the overall U.S. population and more than 51% of those over age 18 have received at least one vaccine dose so far.

Biden noted the progress made in vaccinating early priority groups, including senior citizens, health care workers, and those with underlying health conditions that put them at high risk. But he acknowledged that “broad swaths” of adults remain unvaccinated, and some younger Americans remain skeptical of whether they need a vaccine.

He credited an Ohio hair salon owner, Patty Young of Springfield, whose receptionist has helped to sign up clients for vaccine appointments along with their haircut appointments.

“Now our objective is to reach everyone, everyone over the age of 16 in America,” Biden said, adding: “If you’ve been waiting your turn, wait no longer.”

The unvaccinated 

In a call with reporters Wednesday on state vaccination efforts, Dr. Nirav Shah, director of the Maine Center for Disease Control and Prevention, described three categories of those who are not yet vaccinated: people hampered by scheduling constraints or a lack of transportation; those who may not want it now, due to unanswered questions; and resisters who say they don’t ever want a vaccine.

Shah said state and local health officials aren’t writing off people in the final category, and must work to find messages and messengers that they will trust.

“As we approach these groups, we have to do so with an attitude and tone of respect,” Shah said. “Treating earnest questions with disdain has never changed anyone’s mind.”

Asked about the Biden administration’s call to employers to provide paid time off for vaccinations and recovery, Shah replied that it’s not enough for vaccines to be delivered to a state or a hospital — barriers to accessing those vaccines must be removed, “whether that’s time off, or child care or transportation.”

Another potential obstacle has been the large number of vaccine vials in each shipping package, which must all be used within a short time frame once the packages are opened.

Dr. Steven Stack, commissioner of the Kentucky Department for Public Health, said states have been asking the federal government to urge vaccine manufacturers to reduce the number of vials in each package, to ease distribution to settings that see fewer patients, such as primary care physicians.

Stack added that the federal government has been “well aware of our concerns,” and that states have been told Pfizer will be transitioning to a smaller package by June.

Pause on one-shot dose

The shift to reaching those hesitant or skeptical of the vaccine comes as federal health regulators have paused use of the one-shot vaccine from Johnson & Johnson while they investigate a handful of cases of a rare but serious blood-clotting disease among women who received it.

Pausing the J&J shot has left two other options available to Americans. Those vaccines from Pfizer and Moderna both require two doses scheduled several weeks apart.

That’s slightly more challenging for officials who had planned to use the J&J version to quickly inoculate college students, homeless individuals and others who may not easily be able to return for a second dose.

The federal pause, which regulators will review during a public hearing Friday, was the latest challenge for J&J’s vaccine rollout. The company had to discard 15 million doses that were incorrectly produced at a Baltimore manufacturing facility, which was awaiting approval from the Food and Drug Administration.

Agency investigators inspecting the Emergent BioSolutions plant released a report Wednesday identifying a series of shortcomings at the plant, including failure to properly disinfect equipment and improperly training employees. House Democrats also are investigating federal vaccine contracts won by the company during the Trump administration.

People gather together to ask the McDonald’s corporation to raise workers wages to a $15 minimum wage as well as demanding the right to a union on May 23, 2019 in Fort Lauderdale, Florida. The nation wide protest at McDonald’s was held on the day of the company’s shareholder meeting (Joe Raedle/Getty Images).

The iconic columns of the University of Missouri-Columbia campus (University of Missouri photo).

President Joe Biden, joined by Johnson & Johnson CEO Alex Gorsky and Merck CEO Ken Frazier, delivers remarks on COVID-19 vaccine production on March 10, 2021, in the South Court Auditorium in the Eisenhower Executive Office Building at the White House. (Adam Schultz/official White House photo)

WASHINGTON — Use of the Johnson & Johnson COVID-19 shot will remain paused for at least a week, after a federal vaccine advisory panel said Wednesday that it had too little data on a rare but serious blood-clotting condition reported in at least six women.

That means states and federally run vaccine sites will be relying on the other two authorized vaccines from Pfizer and Moderna until the panel meets again. The rare condition has not been reported following doses of those shots.

The Biden administration’s COVID-19 response team has said there are enough doses available of Pfizer and Moderna to continue the current pace of vaccinations nationally. 

All six blood-clotting cases—which were reported to federal health officials between March 19 and April 12—have involved women between the ages of 18 and 48. One woman has died, and another woman in Nebraska remains in critical condition.

Since the J&J shot was approved, 7.2 million doses have been administered, including 1.5 million to women between 18 and 50.

As they grappled with the next steps for the vaccine, the panel of independent health experts who advise the Centers for Disease Control and Prevention on vaccine policies expressed concerns about how an extended pause on vaccinations could affect vaccine confidence and access, given that the one-dose J&J vaccine is being targeted to certain populations who are more difficult to reach for vaccines.

“Any extension of the pause will invariably result in the most vulnerable individuals in the United States, who are prime candidates for the Johnson and Johnson vaccine, will remain vulnerable,” said Nirav Shah, director of Maine’s Center for Disease Control and Prevention.

“We’re in a situation where not making a decision is tantamount to making a decision,” said Shah, who represents the Association of State and Territorial Health Officials on the panel.

Ultimately, many of the panelists said they were uncomfortable taking action yet with so few details on the cases flagged in the federal system for tracking serious reactions to the shots. 

Public health officials testified Wednesday that so far, there are no clear identifiable risk factors explaining why the rare condition has occurred in more cases than would be expected for the doses given so far. 

“I continue to feel we’re in a race against time and the variants, but we need to do so in the safest possible way,” said panelist Grace Lee, a professor of pediatric infectious diseases at the Lucile Packard Children’s Hospital and Stanford University School of Medicine in Stanford, Calif.

The panel did not set a date for when it will reconvene in the next seven to 10 days, saying only that it would aim to schedule its meeting by Friday.

The public, live-streamed meeting, and the very public federal recommendation for suspending the vaccine’s use, were intended to bolster confidence in the U.S. system for tracking adverse reactions to the shot, which has only been in use since the beginning of March.

Officials with the Food and Drug Administration said pausing the vaccine’s use would in part give health care providers time to learn about the conditions they may see arise in their patients.

“Right now, we believe these events to be extremely rare, but we are also not yet certain we have heard about all possible cases, as this syndrome may not be easily recognized as one associated with the vaccine,” CDC director Rochelle Walensky said during a news conference earlier on Wednesday.

The clotting condition, known as cerebral venous sinus thrombosis, had combined with low levels of blood platelets in the six cases pending review by the FDA and CDC. The combination is unusual, and requires a different treatment than typical blood clots to avoid potentially dangerous consequences.

Of concern to the federal advisory panel are the 3.8 million shots that have been administered within the last two weeks. In the six cases of the blood-clotting condition, the symptoms occurred between seven and 14 days after vaccination, indicating that there could be more cases yet to be identified.

During Wednesday’s meeting, officials from Johnson & Johnson offered additional details on the medical conditions of the women in those cases, including one involving an 18-year-old from Nevada who fell ill 14 days after vaccination.

One additional case also occurred during J&J’s phase-three trial testing of the vaccine. That case involved a 25-year-old male, who experienced symptoms eight days after vaccination and has since recovered.

Public health officials have emphasized that anyone who has received a J&J vaccine within the last three weeks and develops severe headache, abdominal pain, leg pain, or shortness of breath should contact their health care provider.

One option when the panel reconvenes would be to recommend the J&J shot for use among only those over age 50, or just men, given who has been affected by the blood-clotting condition so far.

Regulators in Europe decided to limit the AstraZeneca vaccine to certain demographic groups after similar blood-clotting cases arose there. That company’s vaccine uses a similar technology to the J&J shot, which is different from the technology used in the Pfizer and Moderna vaccines.

President Joe Biden participates in a Feb. 16 phone call with governors from the Oval Office of the White House. (Official White House photo by Lawrence Jackson)

The U.S. Capitol dome, photographed June 17, 2019 (Kathie Obradovich/Iowa Capital Dispatch).

WASHINGTON — Congress had yet to even schedule a hearing on a measure granting statehood to the District of Columbia when a panel of state lawmakers in Arizona voted in February to take a stand against D.C’s plea to become the 51st state.

From their committee room some 2,300 miles from the nation’s capital, members of Arizona’s House Government & Elections Committee weighed in on the brewing statehood debate with a resolution declaring formal opposition.

That Arizona measure — which has cleared one GOP-controlled chamber so far — is an example of how far-reaching the national debate over D.C.’s latest push for statehood has become, as the U.S. House nears votes on the question. Democrats are framing it as a voting rights issue, in a year when states are battling over access to the ballot box.

At least 13 states have introduced resolutions this year signaling a position on whether D.C. should become the 51st state. Eleven have resolutions filed in support, two in opposition, and one state has measures both supporting and opposing statehood, according to a tally by Students for D.C. Statehood.

In Arizona, Republicans offered similar arguments against the idea to those unfolding in congressional committee rooms amid the latest D.C. statehood campaign: They blasted the idea as a way for Democrats to gain seats from a bright-blue city with fewer residents than all but two states.

“It could be annexed by not one but two different states, Maryland and Virginia,” said Rep. Kevin Payne, adding: “Why not let the states adopt them into their states, or let the people move? If they want representation, move. That’s what they made Mayflower for.”

A Democratic legislator, Rep. Athena Salman, pushed back, describing the prospect of voting congressional representation for D.C.’s residents as “long past overdue.” She implored her colleagues in the last of the contiguous states to join the union to remember Arizona’s own difficult path to statehood.

“I believe we should be sending a resolution not saying that we oppose this group of Americans who now are taking up the Arizona spirit for statehood, but I believe that we should be embracing it and celebrating it and cheering it on,” Salman said.

No longer on the fringe

Before this year’s flurry of resolutions, only 10 states had ever introduced legislation on the prospect of D.C. statehood, said Noah Wills, president of Students for D.C. Statehood. His group launched an initiative in 2020, seeking candidates to sign a pledge of support for D.C. becoming a state.

Starting in January, his group zeroed in on state legislatures. The first opposition measure popped up in Arizona not long after their grassroots efforts began, which Wills said offered a segue for pitching lawmakers on the concept.

He couldn’t find any previous state-level bills opposing D.C. statehood, so he said it signaled to him that the effort is “actually getting somewhere.”

“To have the people in our city adding their voices to the national conversation would help the entire country,” Wills said, adding: “We can’t do this without the people in the states.”

The latest push for D.C. statehood now enjoys mainstream support within the Democratic Party, a dramatic shift since a statehood bill first came up for a U.S. House vote in 1993. At that time, more than 100 Democrats opposed the idea.

Fast-forward to today, when President Joe Biden has expressed his backing, and a bill to pave the way to statehood is expected to pass the U.S. House for the second time later this month.

The movement has been tied in to a broader focus by national Democrats on voting rights, who argue that it’s fundamentally undemocratic for the 700,000 residents of D.C. to lack a voice in Congress. Not only do residents not have representation in the Senate, Congress can strike down D.C.’s local laws.

“The disenfranchisement of Washingtonians is one of the remaining, glaring civil-rights and voting-rights issues of our time,” D.C. Mayor Muriel Bowser said in her testimony to House lawmakers last month.

The measure under consideration in the House has been put forth each year by D.C.’s non-voting representative, Democrat Eleanor Holmes Norton. It would shrink the federal district to a small complex of federal buildings, such as the Capitol and the White House, which would remain as the nation’s capital.

The remainder of what’s now D.C. — the areas where its residents live — would be split off to become a state, with the same congressional representation as other states.

Bowser not only testified to Congress in support of that proposal — her office too has taken the fight to the states. Part of the District’s $240,000 budget for statehood initiatives has been spent on digital ads in states with senators seen as potential swing votes, according to the Washington Post.

Racing against legislative deadlines

The statehood bill poised for a U.S. House committee vote Wednesday and a vote by the full chamber the following week faces no urgent deadline in the two-year congressional session.

But faced with shorter legislative sessions, advocates for state-level action are under a time crunch. Georgia and Kentucky have already adjourned this year’s sessions, ending the chances for resolutions to pass there.

A measure sponsored by Democratic Rep. Ashley Bland Manlove of Kansas City has lingered in Missouri, where it has failed to get a committee hearing in the GOP-controlled House.

In Maryland, which shares a border with D.C., a supportive resolution did get a committee hearing but is unlikely to move far. (D.C.’s other neighbor, Virginia, has not introduced any resolutions weighing in on the statehood bid.)

And in Maine, voting rights groups have urged U.S. Sen. Angus King, an independent who usually votes with Democrats, to co-sponsor statehood legislation in the Senate.

Minnesota joined the list of states considering pro-statehood resolutions this week. The measure’s sponsor, Rep. Mike Freiberg, a Democrat, said he was spurred to do so by a constituent who contacted him, requesting that he introduce a pro-statehood bill.

“To a certain extent, it’s symbolic, but it sends a message to the residents of D.C. and to members of Congress,” Freiberg said in a phone interview, describing D.C.’s status as a “relic.”

He said getting such a specific request from a constituent in his state likely reflects increased national debate over the question of granting statehood to D.C., and that he’s already heard from some national statehood advocates since introducing the measure.

But the odds there may be long as well this year, due to Minnesota’s committee deadlines.

There likely will be another chance for state legislatures to weigh in. While the congressional bill is poised to pass the House, there are not yet 51 votes in the Senate for a 51st state. Forty-two senators have signed on as co-sponsors; all are Democrats except for Sen. Bernie Sanders of Vermont, an independent who votes with Democrats.

The U.S. Capitol on Dec. 18, 2019 in Washington, D.C. (Samuel Corum/Getty Images).

WASHINGTON — Members of Congress were among the first people in the U.S. to have access to the sought-after COVID-19 vaccine when the initial doses became available in December.

Three months later, a States Newsroom survey across 22 states — making up a large swath of Congress — found at least 155 members of the U.S. House and Senate have been vaccinated, based on a tally of responses from their offices and other public statements. Most, but not all, are Democrats, even as pollsters find greater hesitancy and even disinterest among Republicans in the broader U.S. adult population when it comes to the vaccine.

At least 14 legislators say they have not been vaccinated, either because they have been waiting to do so or because they don’t plan to at all. All but one are Republicans. Dozens of others among the 237 surveyed declined to share their vaccination status.

The race to inoculate the nation has become even more urgent in recent days as states loosen mask and social distancing requirements and infections in some places rise.

“Our work is far from over,” President Joe Biden warned on Monday. “The war against COVID-19 is far from won. This is deadly serious.”

There’s no definitive public tally of how many lawmakers have rolled up their sleeves for a shot: Members of Congress are not under an obligation to publicly disclose their vaccination status.

But the public aspects of their elected roles are one reason that they were among the first people allowed to receive the limited doses, in line ahead of other groups.

Many of the vaccinated legislators have posted on social media about receiving a shot, seeking to build confidence for the newly authorized vaccines by showing their willingness to have a needle in their own arms.

States Newsroom found at least 155 lawmakers out of 237 representing States Newsroom’s 22 states in the U.S. House and Senate have been vaccinated. That figure includes 100 Democrats, 54 Republicans and one independent.

Another 68 lawmakers — 64 Republicans and four Democrats — declined to share, or did not respond to questions about, their vaccination status.

In Missouri, Democratic Rep. Emanuel Cleaver, along with Republican Reps. Vicky Hartzler, Billy Long and Ann Wagner, said they had been vaccinated, with Long’s spokesman saying the congressman “strongly encourages others to get their vaccine if their doctor recommends it.”

Other members of Missouri’s delegation did not respond to inquiries with their office.

States Newsroom conducted the survey after House Minority Leader Kevin McCarthy (R-Calif.) claimed in a letter to House Speaker Nancy Pelosi (D-Calif.) earlier this month that “roughly 75 percent of House members have been fully vaccinated, or will be by the end of this week.” McCarthy did not specify how he obtained that estimate.

The 155 lawmakers who responded “yes” to States Newsroom account for 65% of the total lawmakers from the states surveyed. Breaking it down by chamber, 61% of the House lawmakers from those states responded that they have been vaccinated, and 84% of senators. Additional members may have been vaccinated already among those who declined to answer.

A House upended

McCarthy’s estimate that 75% of House lawmakers have been vaccinated was tucked in a letter calling for the legislative chamber to return to more normal operations.

As with other workplaces, the pandemic upended how business is conducted in Congress.

The 435 members of the House of Representatives and the 100 senators work in close quarters and travel across the country on a weekly basis, putting them at higher risk of becoming infected with COVID-19 and spreading the virus to constituents who may encounter them at home.

With the average age for House members at 58 and senators averaging 64, many lawmakers also were at increased risk of severe complications or even death if they contracted the virus. (One member of Congress, Rep. Ron Wright (R-Texas) died in February after being diagnosed with COVID-19, and Luke Letlow, who was elected to represent a Louisiana district in December, passed away from complications of the virus before he could be sworn in.)

More than 60 members of Congress have tested positive for COVID-19 since the pandemic began, according to a tally by NPR, and more have quarantined due to potential exposure.

The chamber has altered voting rules to allow members to cast a vote by proxy; they’ve extended the length of time for votes to limit how many people are in the chamber; and hearings have switched a virtual or hybrid format.

Reaching a critical mass of vaccinations among members of Congress and their staffers could allow for reversing some of those changes.

Some have been outspoken advocates for the vaccine. Rep. Mariannette Miller-Meeks (R-Iowa), who is a doctor, posted on Twitter about administering vaccines and is visiting all 24 counties in her congressional district to promote vaccinations.

Among those who haven’t received a vaccine, the reasons have varied. One common response is that the unvaccinated lawmakers previously tested positive for COVID-19.

A spokesman for Rep. Mike Kelly, R-Pa., who tested positive in March 2020, said the congressman “is consulting with his doctor about if and when it will be appropriate to get the vaccine, particularly because he wants to ensure he can continue donating plasma to help people currently suffering with the disease.”

Rep. Ted Budd, R-N.C., who also had COVID-19, does eventually plan to get vaccinated, according to his spokesman, Curtis Kalin. But Kalin added the congressman “felt that since he has the antibodies for a while, he was going to wait and let others get the vaccine first.”

Others, such as freshman Rep. Marjorie Taylor Greene, R-Ga., said they don’t see a need to get a vaccine.

“She is a perfectly healthy woman and doesn’t see a reason to do so,” Greene’s spokesman, Nick Dyer, said.

Public opinion leans toward vaccination

Beyond Congress, a growing number of Americans now say they have either gotten a vaccine, or intend to do so, according to a Pew Research Center report published this month.

Among U.S. adults, 19% say they have already received at least one vaccine dose, and another 50% say they definitely or probably plan to get vaccinated. Those categories account for 69% of the public — up from 60% who said in November that they planned to get vaccinated.

But as with Congress, those vaccination intentions show differences along partisan lines. Democrats are 27 percentage points more likely than Republicans to say they plan to get or have received a coronavirus vaccine, 83% to 56%.

There also have been racial differences in who is planning to seek a vaccine, though the Pew researchers found those to be shrinking. A majority of Black Americans, 61%, now say they plan to get a COVID-19 vaccine or have already received one, up from 42% in November.

Some reports have cautioned against characterizing Black Americans as hesitant to get the vaccine, arguing that access to vaccine doses is just as much of a problem.

Rep. Cori Bush, a Black freshman Democrat from Missouri who had COVID-19, shared her own hesitation about receiving a vaccine during a video conversation she taped in January for The Root with epidemiologist and anti-racism activist Dr. Camara Phyllis.

In promoting that video conversation, Bush posted that she would be taking the vaccine, but her office did not respond to questions about whether she has since done so. In the video, Bush describes what she called the “elephant in the room, which is the reluctance of many Black people like me to even get the COVID-19 vaccine.”

“I want to keep myself safe, my family, my loved ones, my staff, and everyone around me, and my community safe,” Bush says in the video. “My thought process was, I want to take the vaccination. I was apprehensive not having enough information, and I wanted to be able to show people the kind of conversation that you can have with your healthcare provider.”

Contributing to this report were Danielle J. Brown, Tyler Buchanan, Tim Carpenter, Laura Cassels, Ruth Conniff, Clark Corbin, Susan Demas, Jeremy Duda, Darrell Ehrlick, Jason Hancock, Josh Kurtz, Jerod MacDonald-Evoy, Kate Masters, Holly McCall, Lauren McCauley, John Micek, Graham Moomaw, Wesley Muller, Jill Nolin, Kathie Obradovich, Diane Rado, Rob Schofield, Gracie Stockton, Annmarie Timmins, Sarah Vogelsong, Quentin Young and Robert Zullo.

(Official White House photo by Adam Schultz)

Former Pennsylvania Department of Health Secretary Dr. Rachel Levine speaks during a press conference on Dec. 28, 2020 (Pennsylvania Capital-Star).

The state has $2.6 billion from the American Rescue Plan Act signed last March by President Joe Biden to cover revenue losses and invest in broadband and water infrastructure. There’s another $200 million for capital projects (Photo by Scalinger/iStock Getty Images)

WASHINGTON — Tucked in the Democrats’ massive coronavirus stimulus package was a long-awaited solution for a financial ticking time bomb: private pension funds on the brink of collapse, jeopardizing the retirement plans of millions of union members.

The $1.9 trillion pandemic relief measure included $86 billion that will be used for grants to help shore up the most troubled of those pension funds, covering the cost of retiree benefits for the next 30 years.

While union members in Michigan, Ohio and Midwestern states notably will benefit — the provision is named for an Ohio Teamsters leader — the grants will be available nationally.

Without government intervention, the largest of what are known as multiemployer pension funds — defined-benefit retirement plans covering unionized workers in a certain industry, rather than a single company — would have run dry within five years.

Those financial challenges also have threatened to upend the Pension Benefit Guaranty Corporation, the federal agency that insures pension funds.

Democratic lawmakers, business groups and union officials who support the new law’s pension relief provision have heralded it as a necessary move to ensure that workers will receive the retirement benefits promised to them.

GOP lawmakers critical of the provision describe it as a bailout that does too little to address the root causes of why these pension funds ran into fiscal crisis.

Not under dispute is the scale and immediacy of the crisis engulfing multi-employer pension plans.

‘Double whammy’ 

The Teamsters’ Central States plan, which represents 360,000 retirees and workers primarily in Ohio, Michigan and other Midwestern states, has been projected to go broke in 2026.

That plan is far from alone in its fiscal challenges. The federal government has designated 65 pension plans as in “critical and declining” status, and another 121 are listed as in “critical” status — categories that make up part of the criteria for receiving help under the new law.

The retirement plans have hit deep financial trouble as a result of “a double whammy,” says Joshua Gotbaum, a guest scholar at the Brookings Institution who previously directed the Pension Benefit Guaranty Corporation.

Industrial changes have meant that companies have gone bankrupt, leaving employees still in the plan without the company around to pay the bill. That leaves the other employers in the multiemployer plan sharing a larger financial burden.

In addition, actuaries “were too optimistic about investment returns and so, like many other traditional pensions, these plans are severely underfunded.”

Roughly some 130 plans have been projected to become insolvent within the next 20 years, putting at risk the retirement benefits of 1.4 million people, according to an actuarial analysis from The Segal Group. And that was before the pandemic, which analysts say has worsened the funding crisis.

Under the new law, the most troubled plans will be able to apply for aid through 2025. Retirees in plans that have suspended benefits will see those restored if their plan receives a grant.

The federal aid must be segregated from other plan assets, and must be invested in investment-grade bonds or other investments approved by the PBGC.

The International Brotherhood of Teamsters, the union with the largest number of members in the troubled pension funds, said in a statement that it was pleased that the fiscal fix finally reached the president’s desk, describing it as “the culmination of a more than two-decades-long effort.”

The U.S. Chamber of Commerce also supported the provision, writing in an advocacy letter to congressional leaders that “allowing the system to fail will create disastrous economic outcomes.”

Pension fix stalled for years

Ohio Sen. Sherrod Brown, a Democrat, has been pushing for a pension solution, championing a bill named for a former Teamsters organizer in southwestern Ohio.

The Butch Lewis Act was the basis for the pension reform added to the pandemic relief bill. The Democratic-controlled House approved that measure in 2019, with support from 29 Republicans, but it failed to advance in the GOP-controlled Senate.

A bipartisan, bicameral special committee also tried unsuccessfully to negotiate an agreement involving federal funds in 2018.

“People in this town don’t understand the collective bargaining process — people give up dollars today for the promise of a secure retirement, with good health care and a pension,” Brown said on the Senate floor. “And for years now, they have been living in fear of drastic cuts.”

But Republicans have been critical of the pension fix, adding it to the broader arguments that the pandemic stimulus bill amounted to a “blue-state bailout” that unfairly benefited Democratic-leaning areas.

“Americans know this bill will benefit states and unions that have been poorly mismanaged,” said Rep. Lauren Boebert, R-Colo., during the House floor debate.

Sen. Chuck Grassley, R-Iowa, who has put forward his own proposal for addressing the multiemployer pension crisis, unsuccessfully sought to remove the pension provision from the pandemic relief bill.

“It’s just a blank check, with no measures to hold mismanaged plans accountable,” Grassley said of the Butch Lewis provision.

Grassley has argued that his approach would go further toward resolving the underlying funding issues, through changes like increasing oversight of troubled plans and other steps.

Supporters like Rep. Haley Stevens, D-Mich., whose district includes thousands of members of the endangered Central States pension fund, dispute Grassley’s characterization.

Stevens pointed to the requirement that the federal aid be invested more securely, and said she expects there will be additional hearings going forward on ensuring pensions in less-critical status are secured.

“It’s not a bailout — it’s righting a wrong,” Stevens said.

(Getty Images)

The U.S. Capitol (photo by Drew Angerer/Getty Images).

A Department of Health and Human Services employee holds a COVID-19 vaccine record card Nov. 13, 2020, in Washington D.C. The cards will be sent out as part of vaccination kits from Operation Warp Speed, which is an effort by several U.S. government components and public partnerships to facilitate the development, manufacturing and distribution of COVID-19 vaccines, therapeutics and diagnostics. (DoD photo by EJ Hersom)

WASHINGTON — More than 70 million Americans have received at least one dose of a COVID-19 vaccine — and along with that shot, a small paper card with the CDC’s label detailing the timing and manufacturer of the dose.

Those paper cards at the moment are the only proof readily available to Americans of their vaccination against a virus that has upended businesses, schools and most other aspects of daily life.

That could soon change, with multiple companies and nonprofit groups working to create “vaccine passports” — smartphone-based apps would allow someone to certify that they’ve been vaccinated. The apps so far are aimed at travelers, who may be required to show proof of their vaccination status before boarding a plane or entering another country.

But concerns about broader vaccine requirements that could emerge have spurred Republicans in several states, including Missouri, to introduce legislation to ban discrimination based on vaccination status for employment or enrollment in schools.

The Missouri legislation would prohibit public employers from requiring employees receive a COVID-19 vaccination. It also prohibits local governments from adopting any ordinance, rule, or regulation that would require anyone get vaccinated.

Opponents have argued that the measures, some supported by anti-vaccination groups, could be harmful to public health.

So far, the federal government’s public focus primarily has been on boosting vaccine supplies and vaccinations. One of President Joe Biden’s initial executive orders hints at the prospect of vaccine passports, directing government agencies to “assess the feasibility” of adding COVID-19 vaccination records to international immunization cards, and have them digitized.

In order to function, the apps being developed would need a reliable data source detailing who has been vaccinated, or a way to verify any data uploaded by users. So far, it’s not clear how exactly that would work.

Asked Monday about any federal discussions around creating a vaccine passport, Andy Slavitt, a senior adviser on Biden’s COVID-19 task force, responded that the administration has “a couple of core beliefs” about the idea of creating vaccine passports, including that “it’s not the role of the government to hold that data and to do that.”

Slavitt noted the private-sector efforts underway, and added that the administration believes there is a “right way” for running such a system.

“It needs to be private; the data should be secure; the access to it should be free; it should be available both digitally and in paper, and in multiple languages; and it should be open source,” Slavitt said.

International vaccine certificates

The concept behind vaccine passports is not new: Some countries have long required certain vaccinations before travelers can enter, and the World Health Organization has an internationally recognized certificate of vaccination, known as a “yellow card,” which standardizes that process.

Some countries — and airlines — already have been working on a similar certification system for COVID-19 test results and vaccinations. The European Union is discussing a “digital green pass” for EU citizens, and Israel has launched its own passport system, allowing those who are inoculated to go to hotels, gyms and concert venues.

The International Air Transport Association is testing its own travel pass with airlines. And a coalition of tech and health care companies that include Microsoft and the Mayo Clinic have formed the Vaccination Credential Initiative as they seek to build a similar app.

Any requirements to show proof of vaccination will raise an array of legal, ethical and logistical challenges. U.S. laws require most employers to accommodate health or religious concerns that prevent an employee from getting the shot.

The idea that businesses could mandate vaccines for employment or simply to enter a facility also causes equity concerns, particularly at a time when the vaccines are still in scarce supply.

Dorit Reiss, a law professor at the University of California Hastings College of the Law who specializes in vaccine law policy, said while American are likely to encounter requirements to enter other countries, she doesn’t expect to see widespread mandates by U.S. businesses, noting the enforcement challenges.

“It’s tricky for Walmart to card everyone coming in,” Reiss said, adding that “not everyone would have access even to a free app.”

What if you don’t have a smartphone?

Relying on a digital passport causes additional concerns when it comes to equal access. While the apps being developed are expected to include a paper-based option, experts say a tech-driven approach could limit movements of those without smartphones.

“Let’s be clear: passports are paper. Nobody’s going anywhere without their paper passport,” said Michele Goodwin, a law professor who directs the Center for Biotechnology and Global Health Policy at the University of California, Irvine. “We’ve been able to utilize the mechanisms that are most accessible globally.”

And perhaps the biggest challenge is ensuring the security and accuracy of the data kept in those passport systems. States use different systems for collecting vaccination data, and so far, the federal government has not indicated that it will synthesize that data in a source that consumers across state lines could access.

Former Utah Gov. Michael Leavitt, who previously ran the U.S. Department of Health and Human Services, testified to Congress last month about the need for consumers to have an accessible, trusted way to receive their own vaccination data.

He compared the array of state systems for tracking vaccines to the early days of ATMs, when a bank customer had to find the machine networked to their own bank because the systems did not communicate with each other.

“I am a former Republican governor, from whom it is not typical to hear the words, ‘The government needs to require the states to…’” Leavitt said. “But the federal government is sending vast amounts of money and resources to make national systems work. And part of that should be a requirement, in my view, for them to make this data accessible to consumers through a standardized system.”