 Welcome to Friday’s Overnight Health Care. President-elect Joe Biden previewed his COVID-19 proposal and the Trump administration approved Tennessee’s Medicaid block grant waiver. Meanwhile, the FDA chief is urging states to allow vaccinations of lower-priority groups. Let’s start with vaccine news: Biden to quickly release nearly all vaccine doses in shift from Trump President-elect Joe Biden plans to release almost all vaccine doses immediately, a spokesman said Friday, a change from the Trump administration’s strategy of holding half of the supply in reserve for second doses. “The President-Elect believes we must accelerate distribution of the vaccine while continuing to ensure the Americans who need it most get it as soon as possible,” Biden spokesman TJ Ducklo said in a statement. “He supports releasing available doses immediately, and believes the government should stop holding back vaccine supply so we can get more shots in Americans' arms now.” The Trump administration has been holding back half of the available doses to ensure there is enough supply for everyone who is getting a first dose to later get a second dose as well. But the Biden transition said it is confident there will be enough manufacturing to ensure enough supply for second doses. A group of eight Democratic governors also wrote to the Trump administration on Friday asking them to immediately release the doses held in reserve. But the Trump administration on Friday pushed back on that idea and noted that not all of the doses already distributed have been actually administered. Read more here. FDA chief urges states to allow vaccination of lower-priority groups The leader of the Food and Drug Administration (FDA) on Friday urged states to allow lower-priority groups to get vaccinated against COVID-19 if their doses would otherwise go to waste. FDA Commissioner Stephen Hahn told reporters he thinks the federal guidelines for vaccination, which recommend starting with health workers and nursing home staff and employees, make sense. However, Hahn said he thinks "it's reasonable" to expand the groups, and not get too fixated on finishing one before moving on to others, such as essential workers, first responders or people over the age of 65. The ultimate goal is to vaccinate as many people as possible, Hahn said, and in cases where people may be hesitant to get a shot, it doesn't make sense to keep those doses on a shelf or let them go to waste. “I would strongly encourage that we move forward with giving states the opportunity to be more expansive in who they can give the vaccine to," Hahn said during an Alliance for Health Policy event. Read more here.
Under pressure, Cuomo to widen vaccine eligibility The most vivid example of what Hahn was talking about: New York. Facing mounting criticism, New York Gov. Andrew Cuomo (D) on Friday said the state will expand COVID-19 vaccination eligibility to a wider range of the public, including people over the age of 75 and first responders. Cuomo has been under fire for rigidly adhering to the state's system that prioritized health workers and nursing homes, despite numerous instances of vaccine doses sitting unused in freezers or even being thrown out. Even with a limited supply of vaccines from the federal government, New York's vaccination rollout has been slow. Cuomo blamed hospitals, threatening to fine them and remove doses if they didn't vaccinate health workers fast enough. Now beginning Monday, Cuomo said anyone in phase "1B" will be allowed to make an appointment to be vaccinated. While other governors expanded eligibility groups and praised hospitals and pharmacists for using extra doses, Cuomo stayed firm, insisting that providers were not allowed to deviate from the state's plan. They could be hit with a $1 million penalty, and have their medical licenses revoked for giving a dose to someone not deemed eligible. As recently as Thursday, Cuomo indicted the policy would not change, because there was not enough supply for lower priority groups. Cuomo also said that opening up eligibility to people in group 1B would essentially eliminate the priority for health workers and push them to the back of the line. Read more here. Trump administration approves controversial changes to Tennessee Medicaid program The Trump administration on Friday approved a request from Tennessee that would allow the state to receive Medicaid funding through a block grant, a change critics argue will lead to cuts to the health care program for low-income individuals. The change would give Tennessee more authority to make changes to its Medicaid program, which is jointly run by each state and the federal government. The approval marks the first time a state has been allowed to receive Medicaid funding through a block grant. It must be approved by Tennessee’s state legislature. “This is not based on the state spending less money in its Medicaid program,” said TennCare Director Stephen Smith in a call with reporters. “There are no cuts to eligibility, no reduction, benefits, no reduction to services, and no reductions to what we pay our providers.” Caveat: President-elect Joe Biden (D) opposes block grants and would have the authority to reverse the approval of Tennessee’s waiver once he takes office, though it would not be immediate. Read more here. Biden previews COVID-19 proposal 'in the trillions of dollars' President-elect Joe Biden on Friday previewed a COVID-19 relief bill that he said would be "in the trillions," setting the stage for the first major legislative battle of his presidency. "As I’ve said before, the bipartisan COVID relief package passed in December is an important step, but just a downpayment," Biden said in a speech announcing new Cabinet nominees. "Next week, I will be laying out the groundwork for the next COVID economic relief package that meets this critical moment for our economy and country," he added. Biden outlined several provisions of the bill, which appear to line up with some of his campaign promises on coronavirus relief. Among them was "billions of dollars" to improve the vaccine rollout, extending unemployment benefits set to expire in March and April, action on housing and sending out $2,000 stimulus checks. Read more here.
What we’re reading: As the vulnerable wait, some political leaders’ spouses get COVID vaccines (Kaiser Health News) Why 300 doses of vaccine sat unused in freezers for two weeks (New York Times) When Biden takes office, undoing Trump’s health care policies won’t be easy (Kaiser Health News) State by state Alabama health leaders say emergency departments are slammed with patients (WBRC) Behind West Virginia’s vaccine success story, chaos for local health departments (Mountain State Spotlight) ‘Triage officers’ would decide who gets care and who doesn’t if COVID-19 crushes L.A. hospitals (L.A. Times) | 
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