Chance for Congress to fix public health gaps could close fast

Political will to change public health system may fade

Registered nurses demonstrate for better protective gear in Lafayette Park Tuesday by reading names of health care providers who died from COVID-19 contracted by treating infected patients.  (Tom Williams/CQ Roll Call)
Registered nurses demonstrate for better protective gear in Lafayette Park Tuesday by reading names of health care providers who died from COVID-19 contracted by treating infected patients. (Tom Williams/CQ Roll Call)
Posted April 27, 2020 at 5:00am, Updated at 5:00am

Some lawmakers are seeking to overhaul programs that hindered the nation’s response to the COVID-19 pandemic, but the window for Congress to revamp the country's approach to preparing for global health crises may be narrow.

Congress’ response to the novel coronavirus has so far focused on ways to blunt its economic and health effects, but lawmakers also want future legislation to ensure greater domestic control of the medical supply chain or provide additional public health funds.

Lawmakers also hope to prevent a possible second wave of the virus next fall or winter from devastating the nation’s economy.

Still, experts who have watched Congress respond to health crises over the years predict the political interest and will to significantly change the nation’s public health system will be short-lived.

“A pattern repeated over and over again is widespread support for public health and preparedness during an emergency and then immediately afterward. And then within a year, the political will to keep that going starts to dry up,” said Richard Besser, a former acting director of the Centers for Disease Control and Prevention.

Congressional leaders already appear to disagree on how quickly to begin crafting a fifth relief package after President Donald Trump signed a $483 billion package into law last week. Republicans and Democrats have different priorities for any upcoming measure and conservatives are beginning to raise concerns about adding too much to the national debt.

[CBO details coronavirus economic shock]

Still, some lawmakers anticipate that broader changes may be needed outside of the response packages Congress is considering.

Rep. Tom Cole, R-Okla., the top Republican on the House Appropriations subcommittee overseeing the Department of Health and Human Services, told CQ Roll Call he hopes the panel will boost funding for the public health departments for the next fiscal year.

“We know coronavirus is coming back. It’s established in the population, so once we get through this, we don’t know what the severity will be but we have every reason to expect it to return next year and we certainly need to be prepared for it,” he said. “We can’t put this country through another ordeal like it’s going through right now.”

Congress has bulked up research and public health spending over the past four years, regularly providing additional funding to the National Institutes of Health and the CDC. The Trump administration proposed cutting the budgets for public health agencies, but appropriators essentially said that would not happen. Cole called for the administration to release a revised HHS budget proposal and for the panel to win more funds for its spending bill.

“As much as we’ve done, as many good decisions as we’ve made, we’re going to have to do more and to do that you’re going to have to think about increasing the allocation" for the Labor-HHS-Education spending bill, he said.

Lawmakers also have focused on the medical supply chain, which now relies heavily on foreign countries for the development of supplies and pharmaceuticals, and suggested that the U.S. should exert greater control.

Sen. Christopher S. Murphy, D-Conn., said in an interview that the federal government should start by making sure its stockpiles are ready for any future health crises and determining which items it needs. Murphy offered legislation that would begin to identify the prescription drugs and supplies he says the United States should have the capacity to make and store in the country’s stockpiles.

Murphy called producing every type of needed medical supply and drug within the U.S. a "herculean task."

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"I just think we have to be realistic about our capacity to make every single medical good in the United States,” he said. “The broader strategy is one in which we have stockpiles that are actually adequate to meet the moment. And we just didn't have stockpiles that were adequate.” 

Administration officials say they will make sure the national strategic stockpile is prepped for a potential second wave of COVID-19 later this year. Deborah Birx, the White House coronavirus response coordinator, said the U.S. is maintaining orders for items like ventilators to ensure the stockpile is refilled if cases spike later this year.

Murphy said a bipartisan coalition is interested in addressing supply chain issues and could spur momentum in the current crisis. Still, he acknowledged it could get more difficult as time moves on.

“Nothing prompts Republicans and Democrats to work together like a potential cataclysmic economic and public health collapse. I think that as time goes on and the country recovers, the imperative to get over our political differences wanes a bit, and that’s unfortunate,” he said.