February 28, 2024

Good morning, Vitals crew. Today's newsletter is 1,016 words or a 4-minute read.

Situational awareness: President Biden is issuing an executive order aimed at preventing sensitive personal information, including genomic and biometric data, from going to countries of concern, including China.

1 big thing: Biden's options to protect IVF

Photo illustration: Shoshana Gordon/Axios. Photo: Chip Somodevilla/Getty Images

Fertility providers are talking with the Biden administration about possible steps it can take to ensure access to in vitro fertilization, while legal experts say the administration likely has some limited powers, Maya writes.

Why it matters: President Biden has seized on the Alabama Supreme Court decision that's resulted in disruptions to IVF treatments, tying it into his campaign's focus on protecting reproductive rights.

  • But his administration hasn't yet said if or how it will use executive power to safeguard the procedure in Alabama and other states with strict laws governing when life begins.

State of play: The American Society for Reproductive Medicine said it's been in discussions with officials in the White House and the health and justice departments about possible measures in the aftermath of Alabama's ruling that frozen embryos are children and those destroying them can be held liable for wrongful death.

  • "It's clear the Biden administration is committed to helping fix this," Sean Tipton, chief advocacy and policy officer, told Axios in an email.
  • A White House spokesperson said the administration will keep speaking out about the ruling but did not say what policies it's considering.
  • Senate Democrats today are expected to try to force a vote on federal protection of IVF and other fertility treatments.

Zoom in: Legal experts suggested a couple of strategies the Justice Department could pursue.

  • DOJ could issue guidance emphasizing that IVF is still legal and that the recent decision only affects patients in Alabama, said Georgetown University professor Michele Goodwin.
  • DOJ could also look to protect interstate transfer of frozen embryos, said University of Chicago professor Amy Dru Stanley. A major company has already halted embryo shipments in Alabama.
  • HHS could consider issuing guidance to health care providers to help shore up access to IVF services. It used a similar strategy in effort to ensure access to emergency abortion care.

The bottom line: It could take time for the administration to sort out uncharted legal questions around IVF access, Stanley said.

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2. Strong opposition to IVF ruling

Share who say they support or oppose frozen embryo personhood and liability for their destruction
Data: Ipsos poll; Chart: Axios Visuals

Two-thirds of Americans oppose considering frozen embryos as people, with the issue rapidly resonating with Democrats already charged up by election-year messaging on reproductive rights, a new Axios-Ipsos poll finds.

Why it matters: The findings suggest the Alabama Supreme Court decision goes well beyond where public sentiment is in the post-Roe world, Axios' Adriel Bettelheim writes.

Driving the news: 66% of the public oppose designating IVF embryos as children and holding those who destroy them legally responsible, while 31% support it.

  • Republicans are divided on the question, with 49% supporting and 49% opposing.
  • The majority of the country (54%) still isn't familiar with the ruling. But within a week of the decision, 65% of Democrats were, compared with 35% of Republicans.

It's telling how quickly the information about the Alabama ruling spread, particularly on the Democratic side, said Ipsos vice president Mallory Newall.

  • "Democrats are tuned in in a big way," Newall said.

Between the lines: The poll suggests reported efforts by former President Trump and other Republicans to coalesce around a 16-week nationwide abortion ban aren't catching on beyond the GOP base, with 57% of the public opposed and 40% in support.

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3. FTC points finger at PBMs

Illustration: Shoshana Gordon/Axios

Pharmacy benefit managers aren't fully complying with a federal probe into their business practices more than a year and a half after it began, according to a letter from Federal Trade Commission chair Lina Khan shared first with Maya earlier this week.

The big picture: The FTC expects PBMs and their related group purchasing organizations to finish sending the required information "very soon," but Khan's letter noted that the agency can take companies to court for failing to comply.

  • Khan recently told the American Medical Association that she hopes to share some information from the PBM probe "in the coming months."
  • Sen. Chuck Grassley (R-Iowa), who requested the update from the FTC, said the agency and PBMs need to be more forthcoming.

The PBM trade group Pharmaceutical Care Management Association, which isn't part of the probe, welcomes "any opportunity to further demonstrate how pharmacy benefit managers reduce drug costs," a spokesperson said.

If you need smart, quick intel on health care policy for your job, get Axios Pro.

4. The case for renaming a vaccine safety system

Illustration: Brendan Lynch/Axios

It's time to rebrand the federally managed system for flagging possible adverse vaccine reactions to more accurately reflect its purpose amid a growing misinformation epidemic, a new JAMA article argues.

Why it matters: The system, which was previously little known to the public, was exploited by vaccine skeptics during the pandemic to fuel misconceptions about the safety of immunizations.

How it works: The Vaccine Adverse Event Reporting System (VAERS) allows anyone to self-report a medical event that they believe was related to a vaccination, triggering a process for investigating serious reports.

  • However, VAERS reports are "increasingly" cited as confirmation of vaccine risk even though the CDC notes they may be incomplete or inaccurate, write University of Pennsylvania experts in epidemiology and science communications.
  • "The idea that a federally managed 'vaccine adverse event reporting system' might not be definitive is a challenging leap for many in the public," they write.

They suggest renaming the system "Vaccine Safety Sentinel," which they say would reinforce it's an early-warning system with unverified information and that it's focused on protecting people who have been vaccinated.

  • Ultimately, they write, any potential name change should be part of a process with experts and the public overseen by the CDC and FDA, who co-manage the system.
  • The agencies may also want to consider augmenting the detail the system provides to the public, they suggest.

5. Catch up quick

🏛️ The Justice Department has reportedly launched an antitrust investigation into UnitedHealth. (Axios)

ğŸ”Ž Tainted applesauce that poisoned kids last year sailed through a series of checkpoints in America's food-safety system. (New York Times)

💉 An experimental weight-loss drug in a mid-stage trial performed even better than currently available drugs. (Washington Post)

🔌 Outages at Change Healthcare continued for a seventh day, while the company said 90% of pharmacies have set up electronic workarounds. (CNBC)

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