Anthony Fauci talked Covid in Congress in a nine-hour, closed-door grilling — and that was just day one

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What’s the legacy of Xavier Becerra?

HHS Secretary Becerra came into office amid an unprecedented pandemic — when Biden had already installed trusted advisers around him — and a migrant children crisis that few wanted to spearhead. He was called ‘invisible’ in his first few years and there were even talks of replacing him as secretary.

That’s changing, according to my conversations with more than a dozen people about Becerra’s day to day, his management style, and his potential legacy. The looming question is whether, with just a year left in Biden’s first and potentially only term, he’ll have enough time to put his official stamp on what was once considered one of the most consequential Cabinet positions.

No time could be more important than now: The longtime litigator’s agency is due before the U.S. Supreme Court this summer to defend Americans’ access to mifepristone. There’s also the massive hurdle of convincing voters just how much the administration has tried to do on drug costs and health care coverage, even if some of those changes, like the Medicare-negotiated prices, won’t be seen for a few years. Read more from me.

Fauci’s return to the Hill

Longtime top infectious disease official Anthony Fauci has said it’s possible he’s testified before Congress more than anyone else — and now he’s back. Today marks day two of the retired expert’s closed-door questioning with the House Select Subcommittee on the Coronavirus Pandemic, after a nine-hour grilling Monday.

Republicans who lead the committee say they want answers on the virus’ origins, gain-of-function research, and public policies like mask requirements and shutdowns. Committee Democrats, meanwhile, have painted the two-day session as a politically-motivated probe that is stalling progress in infectious disease preparedness and vaccination efforts.

Despite that marathon hearing and the dueling sides, multiple lawmakers told reporters outside that the questioning had been “respectful.”

Rep. Debbie Dingell (D-Mich.) said that Fauci “made it very clear that he is open-minded about wherever this virus came from, from the market, or it came from the lab,” but also clarified the definition of the gain-of-function field, which involves making viruses more transmissible or potent to study their spread. This type of research was reauthorized in 2017 under the Trump administration.

However, Republican leaders were critical of the former official’s responses to those questions. “Dr. Fauci signed off on all domestic and foreign research grants without reviewing the proposals and admitted that he was unaware if NIAID conducted oversight of the foreign laboratories they fund,” Chairman Brad Wenstrup (R-Ohio) said in a statement.

Covid clawbacks? More like leftovers

One of the big new additions to the government funding deal that lawmakers announced this weekend was an agreement to rescind $6.1 billion in Covid-19 relief funds. House Speaker Mike Johnson described the news as “real savings to American taxpayers and real reductions in the federal bureaucracy” in a letter to colleagues.

Some of the money is health care-related — but it likely won’t cause any real pain, my colleague Rachel Cohrs reports. Some of the clawbacks will come from HHS in the Public Health and Social Services Emergency Fund, Johnson spokesperson Athina Lawson said. The fund was the source of the Provider Relief Fund and money for Covid-19 vaccines and tests, among other things. She described the clawbacks as rescinding “recoveries of prior obligations/funds recently returned by states that were unspent.”

Health care isn’t the whole pot, however. Lawson said other clawbacks will come from broadband grants and technology modernization efforts funded through Covid-19 relief bills.

Stay tuned for news on extenders for Medicare and Medicaid programs and community health center funding, which wasn’t announced with the bigger topline package this weekend. Lobbying will be intense — Cynthia Fisher’s group Power to the Patients is hosting a fly-in and a concert with Jelly Roll and Wyclef Jean this week to push for the House’s health bill to be tacked on.

Who will get credit for drug importation?

The Biden administration is going to let Florida import Canadian drugs at lower prices —a popular policy with voters in both parties.

President Biden, and GOP presidential candidates Florida Gov. Ron DeSantis and former President Trump all can claim responsibility for drug importation, my colleague John Wilkerson reports. Biden supports drug importation, and it’s his administration that approved it. Florida Gov. Ron DeSantis made it a top priority and even sued to ensure the Biden FDA didn’t ignore his proposal. And Trump made it all possible when his administration published a regulation in 2020 that allows states to propose import plans.

DeSantis is already claiming to be the sole champion of drug importation and portraying Biden and Trump as opposed to it.

“After 3 years of fighting the federal bureaucracy of 2 presidential administrations, Florida can finally buy prescription drugs from Canada at a lower price,” DeSantis said on X, formerly Twitter. Read more from John.

HHS names its competition czar

HHS has tapped Stacy Sanders to lead its prong of an administration-wide effort to crack down on corporate consolidation in health care. Stacy Sanders, a current agency counselor and longtime Medicare rights advocate who also counts a stint on the hill with Sen. Bob Casey (D-Penn.).

Sanders is tasked with looking at how the agency can promote competition in health care markets, STAT’s Brittany Trang writes. That type of work is usually led by FTC and DOJ,

which are also developing anti-consolidation initiatives. However HHS could still be poised to crack down, especially through CMS payments. More from Brittany.

What we’re reading

What to expect from hospitals and health insurers at this year’s JPM Healthcare Conference, STAT

Staff warned about the lack of psychiatric care at a VA clinic. They couldn’t prevent tragedy, ProPublica

FDA’s Peter Marks says some secondary cancer cases after CAR-T therapy may be ‘causal,’ but benefits still outweigh risks, Endpoints