BY DAN DIAMOND
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With help from Renuka Rayasam and Myah Ward
BREAKING — Scott Atlas, the physician who became President Donald Trump’s hand-picked coronavirus adviser, resigned from the White House today, an administration official confirmed to POLITICO.
BIDEN’S BAD BREAK — The president-elect is dealing with hairline fractures in his foot, a problem expected to plague him through December and require a walking boot.
It’s a minor injury but a symbolic one: Biden will limp into the new year rather than strut like many of his predecessors. At this point in 2008, the incoming Democratic president was dealing with headlines like “Gym Rat in Chief? Obama’s Fitness Regimen.” But even if Biden’s broken foot is forgotten by Inauguration Day, the episode may be remembered as the first of many in the Biden era, when political reporters are likely to find themselves scrutinizing a medical report, thanks to a simple reality: Aging Americans tend to need more health care.
— What will it mean to cover the oldest president? At 78, Biden would be older on his first day than Ronald Reagan (at 77 years and 349 days) was on his last. Biden’s age was a factor in his campaign’s aggressive strategy to keep him in a protective bubble and away from Covid-19, which harms the elderly at high rates, and will almost certainly keep Biden participating in smaller-scale and remote events until the pandemic is defeated. Biden’s team is already working to shield his health from view, which included moving a van to block reporters from watching the president-elect hobble into his doctor’s office on Sunday.
Just as the septuagenarian Trump spent four years under extra scrutiny for his physical and mental fitness, each of Biden’s medical visits will likely take on outsize importance, with the news media trying to decode the health of the elderly man holding the most powerful job in the world.
But it’s essential not to make assumptions about Biden’s health, doctors say, and just as Trump got access to cutting-edge care when he contracted Covid-19 last month, Biden’s situation will be atypical. While the CDC has found that men 75 and older go to the doctor more than twice as often as men between 45 and 64, there are a lot of reasons for that disparity — including access to health insurance and need for specialty care — that may not apply to the president. Biden will have doctors on demand, for instance.
“Age by itself doesn’t tell you that much about people’s health status,” Richard Baron, a geriatrician and head of the American Board of Internal Medicine, told Nightly today. “There’s no question that at 78 he’s more at risk for conditions that plague Americans of all ages … but it’s more about functional status and engagement.”
— Probing geriatric politicians’ functioning can raise uncomfortable questions , and some of the quizzing that awaits a future President Biden is predictable now. If he misspeaks at a key moment, is it the sign of a stutter or something more severe? Did he get a cognitive test at his annual check-up — and how did he do?
Biden’s team didn’t respond to POLITICO’s lighter questions, like whether the injured president-elect will now have to give up the Peloton and cycling that he’s said has helped him cope with the pandemic.
Baron, the geriatrician, singled out a Biden moment from three weeks ago that put some of his own concerns at ease.
“He comes jogging onto the stage” to memorably give his victory speech, Baron said. “There are a lot of people in their 50s and 60s who couldn’t do that,” he added — although acknowledged that a booted Biden is unlikely to be doing much jogging until 2021.
Of course, age is all relative; the 92-year-old Mahathir Mohamad won election as Malaysia’s prime minister in 2018, and while he was deposed this year, Mohamad is plotting a political comeback at age 95.
Welcome to POLITICO Nightly. Reach out at ddiamond@politico.com and rrayasam@politico.com , or on Twitter at @ddiamond and @renurayasam.
A message from AARP:
More than 94,000 residents and staff of nursing homes and long-term care facilities have died from COVID-19. With cases spiking across the country once again, desperate families demand that Congress take immediate action to save lives. aarp.org/nursinghomes
Cars are lined up at Dodger Stadium for Covid-19 testing today in Los Angeles. | Getty Images
| FIRST IN NIGHTLY |
HAIL MARY SEASON — Trump’s arsenal for overturning the election will soon be down to one final, desperate maneuver: pressing his Republican allies on Capitol Hill to step in and derail Biden’s presidency. Although the Electoral College casts the official vote for president on Dec. 14, it’s up to Congress to certify the results a few weeks later. And federal law gives individual members of the House and Senate power to challenge the results from the floor — a rarely used mechanism meant to be the last of all last resorts to safeguard an election.
But several House Republican lawmakers and aides now tell POLITICO they’re considering this option to assist Trump’s quest. “Nothing is off the table,” said Rep. Matt Gaetz (R-Fla.).
Vice President Mike Pence will be in the chair for any potential challenges — a potentially awkward scenario as his boss continues to deny the reality of the election he lost. Kyle Cheney and Melanie Zanona have more on how Trump’s defenders in Congress may take a final shot at subverting the election, who might carry Trump’s mantle, and why it’s almost certain to be more of a spectacle than a solution for Trump.
TRACK THE TRANSITION: President-elect Biden has started to form a Cabinet and announce his senior White House staff. The appointments and staffing decisions made in the coming days send clear-cut signals about Biden's priorities. Transition Playbook is the definitive guide to one of the most consequential transfers of power in American history. Written for political insiders, it tracks the appointments, people, and the emerging power centers of the new administration. Track the transition and the first 100 days of the incoming Biden administration. Subscribe today.
| FROM THE HEALTH DESK |
THE BIDEN HEALTH TEAM(S) — Choosing a secretary of Health and Human Services is hard enough without a pandemic. It’s a huge department so the secretary needs managerial skills, health policy chops and the political stomach for interminable Obamacare wars. During the pandemic, Biden is really setting up two teams: one to run HHS and one to head up the coronavirus operation, which will be based at the White House, health care editor at large Joanne Kenen emails Nightly.
In addition to choosing an HHS secretary, Biden needs to select the top people at the Center for Medicare and Medicaid Services, the Food and Drug Administration, and the Centers for Disease Control, the last of which is going to need a whole lot of rebuilding after bad calls on coronavirus testing and the damage done by attempted political interference from the Trump White House. Some of those posts could be filled later — but HHS secretary is a priority.
The Biden White House is likely to have a two-headed pandemic operation. Nothing is final, but a transition source tells Joanne that Jeff Zients, an experienced manager who led the effort to repair HealthCare.gov in the Obama administration, is likely to be the guy who will oversee the pandemic response but will partner with a top flight health expert. The person most often mentioned for that health role is Vivek Murthy, who served as surgeon general under Barack Obama and who has been a pivotal adviser during the campaign.
Joanne — and everyone else in town — is hearing a bunch of names for the various posts. The health positions are still in flux — and there are surprises in every administration. And, since we’re all relying on phone calls and Zoom instead of running into sources as we lead our normal lives, there’s a lot of echo chamber.
It could come sooner, but don’t be surprised if the health team leaks over the weekend. The transition pattern so far, for the national security and communications teams, has been a strategic leak on Sunday, followed by a press release on Monday and an event on Tuesday.
| TRANSITION 2020 |
SCOOP: ANOTHER COVID POSITIVE AT USAID — Max Primorac, a Trump administration appointee who acts as the No. 2 official at the U.S. Agency for International Development, recently tested positive for the coronavirus, two current and former USAID officials told Daniel Lippman. Acting USAID hed John Barsa, whose top deputy was ousted by the White House a few weeks ago so that he could keep his job, tested positive last week.
Primorac was promoted earlier this month from a top post at the agency’s Bureau for Humanitarian Assistance. USAID has played a key role in giving U.S. taxpayer assistance to helping less fortunate countries deal with Covid-19, and, along with the State Department, has allocated over $1.6 billion worldwide to help countries combat the pandemic. Primorac didn’t respond to a call or text message.
Pooja Jhunjhunwala, the acting USAID spokesperson, said in a statement that a “second positive case was identified in the Front Office” of USAID this week. “While the Privacy Act precludes us from revealing the identity of this positive case, or any others that might follow, the Agency’s Covid-19 Readiness Unit will continue to notify USAID staff that might have had contact with this individual and ensure all proper protocols are followed.”
| NIGHTLY INTERVIEW |
POST-SURGE, PRE-VACCINE — Harvard epidemiologist Michael Mina believes his $5 billion plan for universal, rapid, at-home testing is the answer to pulling the country out of the pandemic — even before the vaccines get here. Nightly’s Renuka Rayasam reached out to Mina today to talk about why no one is listening to him. This conversation has been edited.
How much would these tests have to cost for this plan to work?
Companies are making millions and millions and millions of dollars off of this pandemic by overcharging for PCR tests. We’re seeing something very similar happen with rapid antigen tests. The test itself costs somewhere around 50 cents to a dollar to make.
I would like to see the government actually build the tests with the companies, the same way that we do missiles and bombs and fighter jets. Then, ideally, the government would be giving away these tests for free. Nobody should have to go pay to get themselves tested. The test isn’t therapy. It’s about you knowing your status so that you don’t go and infect other people.
How do we educate people about what to do if they test positive or negative or about potentially false results?
What to do can be exceedingly simple, and that is to stay home.
One of the really nice things about knowing your status is that you can take your own mitigation steps. At this point, I think the epidemic has been going on long enough that the argument about people not knowing what to do if they’re positive really falls flat. I’d be surprised if 95 percent of America at this point hasn’t heard something about distancing and staying six feet away from somebody else.
Even with PCR tests people aren’t actually talking to their physicians. If they’re positive, they just get a call from someone who is not asking about their health status, but is asking about who their contacts are.
You use a lot of terminology from the public health response to HIV, including the term “know your status.” How much did the response to HIV inform your thinking about Covid?
It’s certainly formed a lot of the framework to show that the arguments against home-based testing and over-the-counter testing were wrong. There’s just such a long history of paternalism at the expense of allowing people to be empowered on their own.
For years, doctors and public health people said, There is no way women can know their pregnancy status on their own. How could they possibly deal with a result? If they’re negative, they’re going to go out and party and drink, but what if it’s a false negative? HIV is the same thing. How could they deal with the result if it’s positive? And if it’s negative, they’re going to go have sex with everyone and spread it even more.
Now we’re seeing the exact same age-old argument, assuming that people are stupid. This is just an ivory-tower mentality of public health people, that they’d rather see people die than assume that people can actually think for themselves. It’s so much more important for an individual to know their status than for the government or a doctor to know that person’s status.
Have you talked to anyone in Trump or Biden’s team about this idea?
I’ve talked to a lot of people in the task force. There’s some people on the task force who are extremely against testing as an approach.
Why hasn’t your proposal been adopted?
One of the biggest hurdles to testing is every single test needs a medical prescription. I’ve spoken to senators and governors and heads of federal agencies who all have the same really bizarre mentality, which is, just being very deferential to the FDA. I’ve been astounded at the people that I’ve spoken with who say to me, ‘Well, we’re not sure if this is gonna get authorization from the FDA.’
It’s extremely difficult to change a mindset to say, ‘Hey, you’re right. we evaluate our tests wrong.’ If they are for a public health use, we have to take speed of results into consideration. As a medical diagnostic test, speed of results isn’t even part of the FDA evaluation process. But speed is a huge part of a test’s ability to combat a virus at a population level. The FDA is willing to approve a great PCR test, even if it takes 10 days to get results back. It just shows how unwilling the FDA has been to budge on this.
With a vaccine, potentially, around the corner, why even bother at this point?
There’s definitely not a zero percent chance that it won’t mutate. It just takes one viral particle somewhere in the world to escape immunity, and then we’re kind of back to ground zero. It’s just always really, really important to have contingency plans like this. I’ve never seen a vaccine take the place of a test. They have different roles and they can work very well, synergistically together as we’re rolling at the vaccine. There’s no reason that we shouldn’t be really doing this.
| BIDENOLOGY |
Matt Wuerker
Welcome to Bidenology, Nightly’s look at the president-elect and what to expect in his administration. Tonight, senior tax reporter Brian Faler looks at a critical moment from Biden’s approach to tax policy:
Now that the transition has named its economic team, it’s worth remembering that Biden was a key dealmaker on taxes during his time as vice president. He was central to two of the biggest and knottiest tax agreements of the Obama administration.
Lawmakers had clashed for years over George W. Bush’s tax cuts, and were deadlocked over what to do with them as their expiration loomed in 2010. With both sides frustrated, Biden negotiated a deal with Senate Republican leader Mitch McConnell to keep the breaks for two more years in exchange for a temporary payroll tax holiday and expanded jobless benefits. Then, in 2012, Biden did it again, working out a last-minute agreement with McConnell to make most of the Bush tax cuts permanent.
In both instances, Biden’s handiwork produced sometimes bitter complaints by Democrats that he had given away too much to the Republican Party. Many were unhappy that Biden agreed to a lower estate tax as part of the 2010 tax agreement. They were even more upset with the 2012 deal. It came shortly after Obama had won his second term, and after Democrats had argued for years that the Bush tax cuts should lapse for people earning more than $250,000. Biden went along with Republicans’ proposals to lift that income cutoff to $450,000 — incensing many in his party.
That history looks especially relevant now. Unless Democrats pick up both Senate seats in Georgia’s runoff elections, Biden will once again face a divided Washington, much like he did during those tax negotiations (though, back then, Republicans controlled the House and Democrats held the Senate). McConnell continues to lead Senate Republicans and, once again, there will be a host of tax provisions that will automatically expire in the coming years unless lawmakers intervene.
Reprising his role as a bipartisan bridge builder will be tougher for Biden this time around.
For one thing, his party has moved to the left. Democrats are much more concerned with income inequality and hiking taxes on the rich than they were during his vice presidency. In an acknowledgment of that shift, Biden proposed trillions in tax increases during the campaign on corporations and the well-to-do. He called for rolling back the corporate tax rate to 28 percent from the current 21 percent, and offered a slew of tax hikes on the rich while promising not to raise taxes on people who make less than $400,000 a year. The early picks for his economic team — such as Heather Boushey and Jared Bernstein, economists Biden named to his Council of Economic Advisers — have long favored Robin Hood-style tax policies.
Tax increases remain a nonstarter for most Republicans and whoever wins control of the Senate will have a tiny majority, leaving little room for error. That will likely force Biden to scale back his tax ambitions, to focus on less controversial proposals — like boosting the popular child tax credit or expanding retirement-savings incentives or creating incentives for companies to move operations back to the U.S. from abroad — that can more easily win bipartisan support.
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| NIGHTLY NUMBER |
21 million The number of health care workers in the U.S. The Trump administration is passing hard decisions to the states about which Americans will get the limited early supplies of coronavirus vaccines. |
| PARTING WORDS |
DON’T DELETE YOUR TWITTER BOOKMARK YET — The Supreme Court today indicated serious reservations about the ambiguity and scope of the nation’s only major cybercrime law, hinting it may narrow the law’s applicability to avoid criminalizing such acts as checking social media at work, cybersecurity reporter Eric Geller writes.
During arguments in a case involving a Georgia police officer convicted of violating the 1986 Computer Fraud and Abuse Act by accessing a license plate database, the justices pushed a Justice Department lawyer to explain how a ruling in the government’s favor wouldn’t open the door to prosecutions of innocuous behavior. Those could include browsing Instagram on a work computer or performing public-spirited security research to test a system for vulnerabilities.
As the first CFAA challenge to reach the high court, the Van Buren case generated amicus briefs from a wide range of technology, privacy and cybersecurity experts, most of them on Van Buren’s side. A group of cybersecurity experts described the CFAA as a sword hanging over the head of researchers who probe computers for weaknesses with the goal of helping their owners fix the flaws.
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