 Welcome to Thursday’s Overnight Health Care. Anthony Fauci and other public health experts decried the White House’s embrace of a herd immunity strategy. The Trump administration approved Georgia's request to get rid of its federal health exchange, and Mitch McConnell shot down the latest prospect for a stimulus deal. We'll start in Georgia: Georgia gets Trump approval for Medicaid work requirements, partial expansion The Trump administration has given Georgia the green light to partially expand Medicaid without federal support, and to impose work requirements on Medicaid beneficiaries. The plan announced by Gov. Brian Kemp (R) Thursday stops short of the full-scale Medicaid expansion supported by Democrats, which would cover thousands more low-income adults regardless of their employment status. Kemp’s plan, called "Pathways to Coverage," would cover adults who meet the work requirements and who earn no more than 100 percent of the federal poverty level — $12,760 a year for an individual. Kemp said his plan can help reduce the state’s high uninsured rate. In order to qualify, Medicaid beneficiaries must complete at least 80 hours a month of work, community service, or other qualifying activities. Most individuals who earn between 50 and 100 percent of the poverty level will also be required to pay monthly premiums. Context: Georgia is the first state to get approval for a partial expansion, but it's notable that Kemp is doing it without any additional federal money. Under ObamaCare, the federal government pays for 90 percent of the cost of states that wish to expand Medicaid. The pandemic: COVID-19 is still wreaking havoc across the country. The approval comes as the U.S. is mired in the middle of a global pandemic that shows little signs of abating. Infections are rising, and Americans are enduring record levels of unemployment. Read more here. McConnell shoots down $1.8 trillion coronavirus deal, breaking with Trump The White House wants a deal on coronavirus relief. Mitch McConnell doesn't want to spend the money. The Senate majority leader on Thursday shot down the prospect of a coronavirus deal totaling between $1.8 trillion and $2.2 trillion — the goalposts of the current talks between Democrats and the White House. McConnell's comments, made to reporters in his home state of Kentucky, underscore the divisions between President Trump and Senate Republicans on a fifth coronavirus package, with the GOP leader preparing to force a vote on a $500 billion bill next week. “I don’t think so. That’s where the administration is willing to go. My members think half a trillion dollars, highly targeted, is the best way to go," McConnell said, asked about the prospect of a deal between $1.8 trillion and $2.2 trillion. McConnell's comments come as Trump signaled on Thursday that he was willing to go higher than $1.8 trillion in negotiations with Democrats. “Absolutely, I would. I would pay more. I would go higher. Go big or go home, I said it yesterday. Go big or go home,” Trump said during a phone interview on Fox Business on Thursday morning. But McConnell is set to put a substantially smaller bill on the floor next week. Read more here.
Dozens of public health groups, experts blast 'herd immunity' strategy Dozens of scientists and public health organizations warned in open letters this week against a “herd immunity” strategy being endorsed by top officials at the White House, calling it dangerous and deadly. Key quotes: “If followed, the recommendations in the Great Barrington Declaration would haphazardly and unnecessarily sacrifices lives,” 14 public health groups, including the Trust for America’s Health and the American Public Health Association, wrote. “The declaration is not a strategy, it is a political statement. It ignores sound public health expertise. It preys on a frustrated populace. Instead of selling false hope that will predictably backfire, we must focus on how to manage this pandemic in a safe, responsible, and equitable way.” Herd immunity, typically achieved with a vaccine, is the point at which a disease, like measles, stops spreading widely throughout a population because enough people have been infected and are immune to it. It's not clear if prior COVID-19 infection confers long-term immunity to the disease. Background: A senior Trump administration official during a call with reporters Monday organized by the White House praised the so-called Great Barrington Declaration, a proposal by a small group of doctors that calls for quickly reaching herd immunity by letting COVID-19 spread uncontrolled among the young and healthy population while protecting the vulnerable. The three doctors behind the declaration met with Health and Human Services Secretary Alex Azar last week to discuss the declaration, as first reported by The Hill. Read more here. Fauci weighs in, too… Fauci rips herd immunity proposal embraced by White House as 'total nonsense' “If you just let things rip and let the infection go … that, quite frankly, George, is ridiculous,” Fauci said in an interview Thursday with ABC’s George Stephanopoulos. An impassioned Fauci noted that 30 percent of the population has underlying health conditions that makes them vulnerable. Additionally, older adults, even those who are otherwise healthy, are far more likely than young adults to become seriously ill if they get COVID-19. “What that will do is that there will be so many people in the community that you can't shelter, that you can't protect, who are gonna get sick and get serious consequences,” Fauci said. “So this idea that we have the power to protect the vulnerable is total nonsense because history has shown that that's not the case. And, and if you talk to anybody who has any experience in epidemiology and infectious diseases, they will tell you that that is risky, and you'll wind up with many more infections of vulnerable people, which will lead to hospitalizations and deaths. So I think that we just got to look that square in the eye and say it's nonsense," he said. Read more here.
Scrap Thanksgiving? Fauci urges Americans to evaluate 'risk-benefit' of holiday gatherings People traveling across the country for indoor Thanksgiving gatherings could be a recipe for spreading the coronavirus, Anthony Fauci warned Thursday. Fauci said American families should “evaluate the risk-benefit” of having a Thanksgiving gathering with regard to spreading coronavirus. “We really have to be careful this time, and each individual family evaluate the risk-benefit of doing that, particularly when you have people coming in from out of town who may have been on airplanes, in airports,” Fauci said in the ABC interview. The calculation depends in part on the risks for the people who would participate in the gathering, he said. “If you have vulnerable people, the elderly or people with underlying conditions, you better consider whether you want to do that now or maybe just forestall it and just wait and say, 'You know, this is an unfortunate and unusual situation, I may not want to take the risk.' But then it's up to the individuals and the choices they make,” he added. Read more here. What we’re reading Inside the fall of the CDC (ProPublica) The inside story of how Trump’s COVID-19 coordinator undermined the world’s top health agency (Science) President Trump’s Medicare drug discount cards face uncertain path (Washington Post) Did lockdowns lower premature births? A new study adds evidence (The New York Times) State by state First-of-its-kind examination shows how widely pharma showers campaign cash at the state level (Stat News) In Missouri, cost of Medicaid expansion remains a mystery (St. Louis Tribune) Washington health officer stepping down (The Seattle Times) Another wave? Ohio governor blames complacency for coronavirus increase (WKBN) | 
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