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'Pharmacy deserts': Time to review the definition

Since the early days of American medicine, pharmacies have played an indispensable role in assuring the health of local communities. As trusted local advisors, pharmacists have served as a key access point to vital medications, tests, urgent care, and medical advice for those in their community. With the introduction of the COVID-19 vaccines and the provision of Paxlovid, this role has expanded to pandemic prevention and preparedness. As COVID vaccine administration efforts gathered steam, pharmacies became the single most important access point across the country, ultimately culminating in more than 258 million doses of COVID-19 vaccines having been administered by pharmacies in the U.S.

Despite their importance, we continue to see significant disparities in access to pharmacies in this country. As physicians, we try our best to work with patients to ensure they have access to their medications and often ask questions like “which pharmacy is closest to you” or “which pharmacy do you prefer.” However, despite our best efforts, studies show only 72 percent of new medications are picked up by patients. While there are many barriers to accessing medications — such as cost, navigating insurance, and healthcare literacy — in our recent work, we focused on the logistics of physically getting to a pharmacy.

Pharmacy deserts, a term initially borrowed from the FDA’s “food deserts,” are areas in which access to pharmacies is limited by geography, resulting in challenges accessing the vital medicine and medical care pharmacies provide. These sorts of areas are unfortunately rampant across the United States. As many as one in three neighborhoods in our largest cities are in a pharmacy desert, and they disproportionally impact racial/ethnic minorities.

While these important prior studies focused on the physical distance from a patient’s home to the closest pharmacy, in a recent paper, we utilized open-source tools to estimate the real-world travel time. For example, when thinking about which grocery store is most convenient or accessible, we generally think of the time it takes to get there rather than the distance. This preference is even more apparent in urban settings where distance and time can be very poorly correlated (i.e. short distances might take long times because of high density road networks, traffic patterns, and public transit routes).

In our study of over 4,500 neighborhoods in the four largest U.S. cities, we found that when taking travel time into consideration — by car and public transit — half a million people lived in pharmacy deserts. In all four cities, these deserts were much more likely to occur in predominantly Black and Latino neighborhoods. In cities with robust public transit (NYC, Chicago), public transit pharmacy deserts are less common than car pharmacy deserts. Our findings brought home the need to think carefully about the meaning of equity and access when evaluating access to medical care. Although important, thinking about distance from point A to B only provides a part of the story.

More broadly, the notion of an access “desert” — used by various governmental agencies — is ripe for revision.

While absolute distance to a location can be a helpful way of starting a conversation about access, we believe that these definitions are incomplete if they do not include real world measures like travel time as a criterium.

Armed with our findings, we have begun to work carefully with patients to ensure that when we prescribe, our patients can get their medications easily. Some of these barriers can be overcome with home delivery, while others require careful planning with patients to make sure their chosen pharmacy is one they can access. Additionally, since pharmacy closures are more likely to happen in Black and Latino neighborhoods, and because independent pharmacies play an outsized role in these neighborhoods, some have suggested incentivizing pharmacies to open locations in desert neighborhoods by raising Medicare and Medicaid reimbursement and including pharmacies in federal programs that increase payments to primary care providers. Ultimately, we suspect that a combination of these strategies would ensure durable and equitable access to pharmacies for all of our patients.

Dr. Peter Kahn is a fellow in the Section of Pulmonary, Critical Care and Sleep Medicine at Yale School of Medicine. He graduated from the Albert Einstein College of Medicine with honors and his M.P.H. from the Johns Hopkins Bloomberg School of Public Health in the department of Health Policy and Management. Dr. Kahn’s research has focused on health policy with a particular interest in the impact of climate change and utilities on health policy. Follow him on Twitter @PeterKahnMD

Dr. Xiaohan Ying is a resident in the department of internal medicine at New York Presbyterian Hospital/Weill Cornell. He graduated from Wharton with a focus in Healthcare Management and Policy and received his MD from Weill Cornell Medicine. Dr. Ying previously worked as a healthcare consultant, and his research focuses on health disparities and health policy.

Dr. Stan Mathis is the medical director of an ACT team and assistant professor in Yale’s Department of Psychiatry. A background in architecture and urbanism informs his clinical and research/teaching work. Taking care of patients in their homes or in the community, he sees firsthand the impact of the extra-clinical environment on their lives and wellbeing. He also co-developed a curriculum that combines data-driven and experiential learning to help psychiatry residents develop a deeper understanding of New Haven and the forces, historical and current, that impact its population.

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Vets stage sit-in at Capitol over burn pits vote

A group of veterans is staging a sit-in at the Capitol in response to Senate Republicans blocking a bill that would extend health care benefits to millions of veterans who were exposed to toxins during their service.

Twenty-five senators went from supporting the Sgt. 1st Class Heath Robinson Honoring Our PACT Act when it passed the Senate 84-14 last month to helping filibuster the bill when a technically updated version was blocked 55-42 on Wednesday.

“We got punched in the gut, right by those 25 senators that flipped their vote from yesterday,” Burn Pits 360 Executive Director and co-founder Rosie Torres told The Hill late Thursday.

Torres said the veterans rights group was spending the night on the steps of the U.S. Capitol “as a message to those senators, those 25 senators and asking them to right the wrong.”

“They shouldn’t be here, and to know that we’re in that America where they’ve turned their backs on veterans and their families are sick and dying. It’s disgusting. But if this is what we have to do to get the bill passed, and at all costs, all measures, we’re going to get it done,” she said.

The group later tweeted it would remain outside the Capitol until the next cloture vote on the bill, which is expected Monday.

The PACT Act was initially passed by the Senate before being tweaked by the House and sent back to the Senate for a second vote, where 24 Republicans and one Democrat voted against the bill.

Torres described the process of passing the act as “ping pong,” saying that “there was just one more procedural hurdle they had to get over, right, and then it was tanked because of political reasons, presumptively partisan politics.”

“This is what it’s come to. Veterans. The sick, the dying. Fed up. Pulling an all nighter to support their fellow vets. This is the hell their service has brought them,” comedian Jon Stewart, a longtime advocate for veterans’ and first-responders’ health care, tweeted in response to the announcement of a “Fire Watch” hosted by veterans on Thursday night.

Mychael Schnell contributed.

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Fed's inflation gauge jumped in June as gas prices soared

A June surge in gasoline prices fueled much higher inflation and a dip in household spending power, according to data released Friday by the Bureau of Economic Analysis (BEA).

The personal consumption expenditures (PCE) price index, a key gauge of inflation, rose 1 percent in June and 6.8 percent annually last month, according to the BEA. The monthly inflation rate rose from 0.6 percent in May and the annual inflation rate rose from 6.3 percent that month.

The PCE price index is the Federal Reserve’s preferred gauge of inflation and heavily influences the central bank’s plans to hike interest rates. The Fed aims for annual inflation of 2 percent each year and is raising interest rates rapidly to bring price growth back down to that level.

Economists expected the PCE price index to show another big jump in inflation in June, a month when the average cost of a gallon of gas in the U.S. rose above $5. The war in Ukraine and sanctions imposed on Russia have limited the global supply of oil and natural gas—along with food and other commodities—making prices higher and more volatile.

Energy prices rose 7.5 percent and food prices rose 1 percent June. High energy and food prices also can boost inflation throughout the economy as companies try to cover higher transportation, manufacturing and ingredient costs. 

Energy prices were up 43.5 percent and food prices were up 11.2 percent annually in June, according to the PCE price index.

Without food and energy prices, the PCE price index rose 0.6 percent on the month and 4.8 percent on the year in June, both up higher than their May levels of 0.3 percent and 4.7 percent respectively.

A recent decline in oil prices will likely push inflation down in July. But the June data also showed inflation picking up in areas beyond those directly affected by the war in Ukraine.

The monthly increase in the PCE price index without food and energy held at 0.3 percent in each month between February and May, but doubled to a 0.6 percent increase in June. Yearly PCE inflation without food or energy also rose for the first time since February.

The Fed and economists have paid closer attention to inflation without food and energy prices, also known as “core” inflation, since food and energy markets are more volatile and usually don’t reflect the broader forces pushing prices higher. Higher core inflation may be a sign that Fed rate hikes have not yet slowed the economy enough to make a dent in price growth.

Higher inflation also took a chunk out of household budgets in June. Disposable income rose 0.7 percent in June but fell 0.3 percent after adjusting for inflation. Consumer spending rose 1.1 percent, but just 0.1 percent after adjusting for inflation.

Rising inflation is one of the biggest challenges facing the U.S. economy, which has remained resilient and added 2.7 million jobs this year even as economists see the country edging closer to recession. U.S. gross domestic product (GDP) dropped for two consecutive quarters, long the rule-of-thumb guide for being in a recession, though economists believe the labor market remains too strong for the U.S. to be in one quite yet.

Even so, consumer confidence in the economy has fallen steadily over the course of the year and poses a massive threat to the Democratic Party’s efforts to retain majorities in the House and Senate in the November midterm elections.

President Biden and Democratic lawmakers have cited the strength of the job market and steadiness of consumer spending to reassure Americans the U.S. is not in a recession. Biden and Democrats are also rallying behind the Inflation Reduction Act, a bill meant to reduce prescription drug costs and speed up energy production while also raising taxes on corporations.

Republican lawmakers have argued the bill would only push the U.S. into higher inflation and have already declared the economy to be in recession, even if most economists have not said the same.

Source: TEST FEED1

Majority of Democratic, Republican voters support key antitrust bills: poll

A new poll found overwhelming support from voters in both parties for two key antitrust bills that are facing a dwindling deadline to pass this year. 

The survey of registered voters was conducted by Edison Research for the Tech Oversight Project, a group pushing for antitrust reform that is primarily funded by the Omidyar Network and the Economic Security Project. The poll asked voters about their support for two proposals that target the market power of dominant tech firms. 

Asked about the American Innovation and Choice Online Act, a bipartisan bill that would limit tech giants from preferencing their own products and services over rivals’, nearly 73 percent of respondents said they lean towards supporting the bill. 

The proposal, sponsored by Sens. Amy Klobuchar (D-Minn.) and Chuck Grassley (R-Iowa) advanced out of the Senate Judiciary Committee with bipartisan support earlier this year but has yet to be called for a floor vote. 

Asked about the Open App Markets Act, a bill that targets dominant app stores, more than 74 percent of respondents said they would lean toward supporting the legislation. 

The app store bill, led by Klobuchar and Sens. Richard Blumenthal (D-Conn.) and Marsha Blackburn (R-Tenn.), also advanced out of the committee with broad bipartisan support. But it has not been called for a floor vote either, despite ongoing pressure from supporters for leadership to call both bills to a vote 

The support for the bills in the poll was fairly split among Democratic and Republican voters. Nearly 76 percent of Democrats said they support the American Innovation and Choice Online Act, as did roughly 70 percent of surveyed Republicans, according to the poll 

Support for the Open App Markets Act had a similar breakdown, with nearly 78 percent of Democrats and 73 percent of Republicans saying they support the proposal, according to the poll. 

The poll surveyed 1,307 Americans online who reported that they will “definitely” or “probably” vote in the 2022 general election. The poll ran from July 12 to July 15 and the margin of error is 3 percent.

Versions of the bills advanced out of the House Judiciary Committee more than a year ago.

Lingering concerns among Democrats are threatening the chance of the bills moving forward this year before lawmakers leave for recess — and before the upcoming midterm elections may change the controlling party in one or both chambers.  

Senate Majority Leader Charles Schumer (D-N.Y.) reportedly told donors the American Choice and Innovation Online Act is a “high priority” but that the Senate does not have the 60 votes it needs to pass it, according to a Bloomberg report from earlier this week. 

But the sponsors of the bills remain steadfast in their position that the bills have the votes to pass. 

Klobuchar told Bloomberg in a statement, referring to Schumer and the American Innovation and Choice Online Act, “we were promised a vote on this bill and we take him at his word.” 

Last month four Senate Democrats asked Klobuchar to revise a portion of the bill they said could have unintended consequences that would limit companies’ ability to moderate violative content.

The bill has also faced criticism from the California delegation, in the House and Senate, the state home to most of the tech giants. 

Klobuchar and Grassley, along with the bill’s House sponsors Reps. David Cicilline (D-R.I.) and Ken Buck (R-Colo.), have fiercely defended the legislation against concerns, dismissing most criticism as being fueled by the tech industry.

Source: TEST FEED1

The judicial nominations queue can not afford an August recess

At the end of 2021, there was good reason to be ecstatic about the pace of judicial nominations. President Biden and Senate Democrats had worked together to nominate and confirm 40 district and circuit court nominees, a record tied with Ronald Reagan’s first year in office. These were nominees who brought important demographic and professional diversity to the bench and who are already ruling on important matters like voting rights and new anti-abortion laws.

Seven months later, however, the pace of judicial confirmations has significantly waned — and time may well be running out. Not only are there dozens of nominees still waiting in the confirmation queue, but new vacancies on the courts are opening at a faster rate than judges are being nominated and confirmed. If Republican senators win back control of the Senate in November, this year may be the last opportunity to confirm any of President Biden’s nominees. 

Currently, there are 15 circuit court nominees awaiting confirmation, and even their confirmations would only fill just over half of the 24 circuit court vacancies. Likewise, there are 33 district court nominations pending, which still won’t come close to filling the 90 vacancies on our district courts. Some of these nominations have been pending for as long as six months. 

Even confirming the nominees who have already been voted out of the Senate Judiciary Committee might be a challenge this year. Standard Senate rules require the body to spend up to 30 hours debating each individual circuit court nominees before it can vote, plus two hours for each district court nominee. That means it would hypothetically take longer than five weeks of 24/7 Senate processing just to finish off the judicial nominees who have already been named, let alone adding more to the list or completing any other Senate business. 

There are ways to accelerate the confirmation process. For example, shortcuts can be taken to ensure the floor time necessary for confirmations to ripen (as Senate Democrats have demonstrated before). Hearings can be expanded to include more nominees per panel. Recesses can be skipped to get more work done. Senate Democrats should commit to taking these and other unusual steps to meet the crucial goal of filling these vacancies while they still can. 

Hopefully, Democrats don’t need to be reminded that Republican obstruction will remain unrelenting. Despite nominees’ impressive credentials, Republican senators have blocked many of them en masse, resulting in ties in committee that require extra procedural floor votes called discharge petitions. Moreover, because some nominees won’t garner a single Republican senator’s vote on the floor either, they likewise require all 50 members of the Senate Democratic caucus and the vice president to be present. In other words, a single senator’s health issue or delayed flight can thwart the process. 

Such delays are only a preview of what we know to expect if Republicans take back power in the Senate. Republican senators have told us repeatedly that they’ll block Biden’s future nominees just as they blocked President Obama’s. In the wake of the Supreme Court’s Dobbs decision jettisoning a constitutional right to an abortion, Minority Leader Mitch McConnell (R-Ky.) has been bragging that blocking Merrick Garland’s nomination in 2016 was “the single-most consequential decision I’ve made in my public career.”  

Not only has McConnell made clear his willingness to block future nominees, but so have other Senate Republicans. In a tantrum during Justice Ketanji Brown Jackson’s hearings, Sen. Lindsey Graham (R-S.C.) openly stated his willingness to block future nominees. Sen. Chuck Grassley (R-Iowa), who would likely take over the Senate Judiciary Committee, has refused to promise if Biden’s nominees would get a fair hearing. Sen. Ted Cruz (R-Texas) already spent most of last year blocking Biden’s ambassadors and has promised to block Biden’s judges if given the opportunity. 

While the confirmation of Justice Jackson was a historic achievement, Democrats must make more progress on lower court judges. We need Senate Majority Leader Chuck Schumer (D-N.Y.) to expeditiously call these votes and ensure that the full Democratic Caucus is aligned to confirm these nominees. We can successfully secure our courts with champions of justice who will restore faith in the fairness of our judicial branch, but there’s no time to waste. 

Rakim H.D. Brooks is the president of Alliance for Justice. 

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HHS buys 66 million doses of updated Moderna vaccine for 'early fall' campaign

The Biden administration announced that it is buying 66 million doses of updated Moderna COVID-19 vaccine targeting the omicron variant ahead of a planned booster campaign starting in “early fall.” 

The updated vaccine will specifically target the BA.4 and BA.5 subvariants of omicron which are currently circulating and fueling a new increase in hospitalizations.  

The Moderna purchase comes on top of an order placed last month for 105 million doses of Pfizer’s updated vaccine.  

The first deliveries of the updated vaccines from both companies will begin in “early fall,” the Department of Health and Human Services said Friday, allowing the booster shot campaign to begin then, assuming the Food and Drug Administration formally signs off on the updated shots.  

“We look forward to receiving these new variant-specific vaccines and working with state and local healthcare partners to make the vaccines available for free in communities around the country this fall,” said HHS Assistant Secretary Dawn O’Connell.  

Experts stress the current vaccines still provide important protection against severe disease and hospitalization, and that it is key that people get their first booster shot now if they have not already, and their second booster if they are over age 50.  

But protection from the vaccines decreases over time, and the BA.5 variant currently circulating has shown an increased ability to evade protection, leading to calls for the updated vaccine campaign in the fall.  

The Biden administration is using money that it had to cut from other areas of the pandemic response to make the purchase of the updated vaccines, given that Congress has not provided new funding. The administration has warned that it has had to take from other important areas, like maintaining testing capacity and research on even better vaccines that can target all variants at once.  

Between Pfizer and Moderna, there are now orders for 171 million doses of updated vaccines. While that is not enough for every American, given the uptake rates for booster shots so far, it might be enough for everyone who will want the updated shots.  

About 107 million people have received their first booster, according to Centers for Disease Control and Prevention figures.  

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California man sentenced to 6 months home confinement for threatening Gaetz

A California man was sentenced to six months of home confinement on Thursday for threats he made against Rep. Matt Gaetz (R-Fla.).

Eugene Huelsman, 59, threatened to kill Gaetz in a voicemail left at the representative’s congressional district office in Pensacola, Florida, according to the Department of Justice (DOJ). He pleaded guilty to a count of transmission of a threat in interstate commerce.

“The free exercise of speech is central to our democracy,” U.S. Attorney Jason R. Coody said. “However, the communication of threats of physical violence, in this case by an individual who had previously made and been investigated for similar threats of violence, is clearly unlawful.”

Huelsman is also required to pay a $10,000 fine and will be placed on probation for five years after his home confinement.

The voicemail he left on Jan. 9, 2021, said he would “put a bullet in” Gaetz and his family he hoped the congressman would “die in a shallow grave,” according to the DOJ.

Gaetz’s office contacted U.S. Capitol Police after receiving the threatening voicemail, leading to an investigation of Huelsman.

Huelsman was previously investigated by the U.S. Secret Service for threats against a family member of a former president over social media.

“Words matter,” Special Agent in Charge of the FBI Jacksonville Division Sherri E. Onks said. “And this sentencing should serve as a warning. Everyone has the right to express their opinion, but when you harass, intimidate, and threaten violence against others, it’s a federal crime that will not be tolerated.”

Coody added: “Today’s sentence acknowledges the defendant’s repeated threats of violence and should serve as a significant deterrent to those who would threaten violence against others rather than engage in lawful debate.”

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Biden administration to convene outside lawyers on abortion rights

The White House and Justice Department on Friday will host their first meeting with outside lawyers to discuss how to protect those who seek abortions from legal repercussions after the Supreme Court struck down Roe v. Wade.  

Attorney General Merrick Garland, Associate Attorney General Vanita Gupta, White House counsel Stuart Delery and second gentleman Doug Emhoff, who is himself a lawyer, will all participate in Friday afternoon’s meeting with attorneys and members of the abortion rights community, the White House said. The outside participants were not immediately named.  

The group will discuss legal issues surrounding traveling out-of-state for abortions, denial of services, criminalization and reproductive health services, the White House said in announcing the meeting.  

President Biden signed an executive order three weeks ago that ordered his administration to convene meetings with pro bono attorneys, bar associations and public interest organizations to encourage legal representation of patients and abortion providers.

The came after the Supreme Court’s decision striking down the landmark abortion decision last month.  

The group was specifically tasked with discussing how to protect women who travel out of state to receive abortions because of restrictions where they live. Several states are moving to implement restrictions on abortions following the Supreme Court’s ruling. 

The White House has been under pressure to do more to provide access to abortion services.  

Biden’s executive order in early July order also triggered other actions to protect access to contraception, abortion pills and emergency medical care for pregnant women, and advocates regarded it as a positive step.  

Still, the administration has faced calls to declare abortion access a public health emergency and pleas for more information about access to medication abortion.  

Vice President Harris has traveled to several states to meet with local elected officials and stakeholders about abortion access, most recently visiting Indiana as state lawmakers considered an abortion ban proposed by Republicans. 

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How to stop Putin in Ukraine

Six months after invading Ukraine, not much has gone right for Russian strongman Vladimir Putin. But it’s dangerous for despots to admit defeat, so he’s doubling down on death and destruction in hopes of salvaging something he can call a win.

Having failed to topple Ukraine’s government or overwhelm its highly motivated defense forces on the ground, Putin is settling into a grinding war of attrition, featuring World War II-style leveling of cities and terror attacks on civilians.

His aim is to seize more land along Ukraine’s eastern and southern borders that adjoin territories already contested by pro-Russian separatists following Putin’s 2014 incursion. U.S. officials expect Moscow to declare its intent to “annex” the conquered terrain, just as it did with Crimea.   

In this way, Putin would have something to show Russians for the horrendous butcher’s bill he’s running up. CIA Director William Burns last week estimated that 15,000 Russian soldiers have been killed so far and as many as 45,000 have been wounded.

Since Ukraine is fiercely resisting its piecemeal dismemberment and occupation by Russia, the fighting could continue indefinitely. Putin shows no interest in negotiating an end to the war, either because he still believes he can break Ukraine or, more likely, because he thinks a military stalemate works in his favor.

This calculation rests on unflattering assessments of the West’s strategic stamina. As long as the NATO countries keep supplying Kyiv with weapons and financial support and enforcing suffocating sanctions on Russia’s economy, Ukraine probably can hold out against its bigger and heavily armed neighbor.

So Putin is betting that Western solidarity will wilt as the civilian death toll mounts, the strain of accommodating 5 million Ukrainian refugees intensifies and the threat of Russian gas cut-offs fuel public demand across Europe to mollify Moscow.

Putin also may be counting on a Republican takeover of Congress this fall. This could fray the strong bipartisan coalition President Biden has built behind robust U.S. military and economic aid to Ukraine. Although GOP congressional leaders have opposed Putin’s aggression, a Republican victory would surely embolden “America First” nationalists who share former President Trump’s admiration for Putin, disdain for NATO and indifference to Ukraine’s fate.  

So, what can the United States and its NATO allies do to disabuse Putin of the idea that time is on his side?

First, they should speed up deliveries of advanced weapons to Ukraine. Biden has led the way, sending Kyiv $8 billion worth of military aid, including the HIMARS mobile rocket system. Ukrainian forces are using it to devastating effect against Russia’s arms depots, supply lines and command posts, but they complain that the slow pace of deliveries is allowing Russian forces to gain ground.

Britain and Poland also are major arms suppliers to Ukraine. But two major NATO powers, Germany and France, have been laggards. France, former NATO secretary general Anders Fogh Rasmussen tartly observes, has delivered only $160 million in military assistance, about the same as Denmark. These two EU leaders need to step up.

Second, take swift advantage of Sweden and Finland’s decision to abandon neutrality and join NATO. Although he professes not to care, this is a huge strategic setback for Putin, as it means Russia will soon have a new, 800-mile northern border with NATO. Strengthening NATO’s Nordic flank will complicate Moscow’s efforts to intimidate the Baltic states. “He wanted less NATO,” Rasmussen says of Putin. “He got more NATO.”

Third, the Atlantic allies should publicly declare that they will never recognize the legitimacy of Putin’s land grabs in Ukraine (excepting Crimea, which Soviet leaders “gifted” to Ukraine). They should also raise their defense spending to the NATO benchmark of 2 percent of GDP, including resources to support prolonged Ukrainian resistance to Russian occupation.

Fourth, the allies should investigate and draw the world’s attention to Russian atrocities in Ukraine. Putin is employing the same barbarous tactics he used to crush the Chechen revolt in 1999 and pulverize anti-regime cities in Syria — indiscriminate shelling, airstrikes and cruise missile attacks intended to terrorize civilians. 

Ukrainian and European lawyers are collecting evidence to put before the International Criminal Court. House Speaker Nancy Pelosi (D-Calif.) and other lawmakers are pressing a reluctant U.S. State Department to designate Russia as a “terrorist” state. Whether or not we take that momentous step, U.S. intelligence agencies should assist international efforts to create a public record of Russian war crimes and identify officers and specific units responsible for committing them.

Fifth, Washington should ramp up liquified natural gas (LNG) exports to Europe. As EU leaders belatedly realize, their heavy reliance on Russian oil and gas has become a huge political vulnerability. Beset by sharp rises in fuel prices, rationing and strikes, Europe fears a cold, dark “winter of discontent” if Putin turns off the gas.

The United States lacks the export infrastructure to quickly replace Russian gas. But steadily boosting U.S. exports could help Europe diversify its supplier base over the next three to five years, blunting Moscow’s ability to weaponize its vast reserves of oil and gas. Substituting U.S. LNG for dirty (methane-intensive) Russian gas also would help Europe make progress toward its ambitious carbon-reduction goals under the Paris accords.

These steps would demonstrate U.S. and European resolve to win today’s test of wills with Putin. If he succeeds in biting off large chunks of Ukraine and destabilizing the democratic government of Volodymyr Zelensky, he wouldn’t stop there. Moldova, another former Soviet province also plagued by pro-Russia separatists, fears that it will be next.

Putin’s bellicose expansionism poses the greatest threat to European peace and security since the Cold War ended. It will require sacrifice and steady nerves, but the NATO allies have all the tools they need to stop him in Ukraine.

Will Marshall is president and founder of the Progressive Policy Institute (PPI).

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The Hill's Morning Report — US economy shrinks, recession fears grow

One day after the Federal Reserve reminded everyone that it’s trying to slow the economy to tame inflation, the government reported that gross domestic product had indeed slowed — to the point of contraction.

Slower growth helps pull high prices downward, but zero growth induces nervous hand-wringing about recession, which is what happened on Thursday when the government said GDP in the second quarter shrank at an annual rate of 0.9 percent (The Hill and The Washington Post). In sum, it was the second consecutive quarter in which economic output appeared to hit the brakes. The upshot from one analyst: “Business definitely pulled back.”

The debate continued about what conditions define a recession and who calls it, officially (The Hill).

President Biden on Thursday offered his reassurance that the economy is not currently in a recession, based primarily on strong job creation and wages in the first half of the year. He echoed the analysis of Fed Chairman Jerome Powell on Wednesday, who repeated his view that recession, while a risk the central bank is trying to avoid, is not the problem of the moment. The problem is record inflation.

Pointing to economic indicators that look brighter than the GDP report, the president said, “That doesn’t sound like recession to me.”

Treasury Secretary Janet Yellen, an economist, waved off recession fears. “We know there are challenges ahead of us. Growth is slowing globally. Inflation remains unacceptably high, and it’s this administration’s top priority to bring it down,” she told reporters Thursday. 

But she said the country is not seeing “broad-based weakening of our economy,” also known as recession, which she said would include layoffs, business closures, strains in household finances and a slowdown in private sector activity.

Jason Furman, an economist and former White House adviser under former Presidents Clinton and Obama, told the Washington Post, “This data is much more worrisome than it was in the first quarter. I don’t think you can easily dismiss these numbers. It isn’t just volatile factors anymore. Meaningful, important parts of the economy are slowing.”

The government this morning will report on consumer spending in June, which analysts believe continued to climb during a period of higher prices (The Wall Street Journal). The Fed has raised its benchmark interest rates four times since March to try to dampen consumer demand as a tool to bring down prices. There are some signs that consumers at the lower to middle tiers of the income ladder are shifting their shopping decisions in reaction to higher prices for gasoline, food, rent and retail goods.

Conversations this week about recession risks, slower growth and prices that outpace many households’ discretionary income are woven into the Republican Party’s narrative that spending by Democrats in Congress and by the president have been responsible for current economic woes. GOP candidates have sidestepped the worldwide price pressures, energy shortages and the effects of global sanctions after Russia’s invasion of Ukraine, plus the still-troublesome supply chain bottlenecks tied to the economic hangover from the pandemic.

The president on Thursday touted a new, proposed $670 billion Senate package, which if approved by Democrats, would invest in curbing climate change, lowering prescription drug prices and boosting health care subsidies under the Affordable Care Act while raising taxes on the wealthy and corporations. Democrats are selling the budget reconciliation blueprint to voters as a form of long-term inflation relief. Republicans oppose the measure, as The Hill reports, below.

The New York Times: Democrats’ plan to fight inflation may lower costs over time.

Biden on Thursday also spent two hours and 17 minutes talking with Chinese President Xi Jinping, their fifth call since Biden took office. The focus was on tensions between the two countries over Taiwan and Xi warned the United States not to “play with fire.” 

Shi Yinhong, a professor of international relations at Renmin University in Beijing, told The New York Times that the atmosphere between the two leaders was “remarkably worse” than in March, when Biden and Xi last spoke. Neither government reported any concrete progress on the status of Taiwan and independence, which China opposes, or any of the other issues that have flared between the two powers in recent months.

▪ Reuters: Following the Biden-Xi call, Taiwan to deepen its close security partnership with the U.S.

▪ Reuters: Russia supports the “one China” policy on Taiwan, its foreign minister said today. 

Related Articles

• CNBC: Deutsche Bank is not convinced a “slam dunk” recession is underway and wants more evidence.
• The Wall Street Journal: Recession worries put the Biden administration on the defensive.
• The Wall Street Journal: China’s Xi warns Biden over Taiwan.
• CNN: Biden, Xi agree to begin arrangements for a face-to-face summit, while areas of cooperation, including on climate change, were hashed out during a Thursday discussion.

   LEADING THE DAY

➤ CONGRESS  

It’s a waiting game on Capitol Hill as Senate Democrats look to sidestep potential minefields in their quest to pass the surprise reconciliation deal struck between Senate Majority Leader Charles Schumer (D-N.Y.) and Sen. Joe Manchin (D-W.Va.) on Wednesday.

Immediately, the GOP’s fury over the out-of-left-field deal took shape as House Republican leaders attempted to whip members against the $280 billion bill to boost domestic semiconductor production and competition with China. However, it didn’t stop the bill from passing, 243-187-1, including 24 Republicans who defied the last-minute party effort. All Democrats voted for it (The Hill). 

That maneuver followed the Senate GOP’s decision a day earlier to tank a bill aimed at helping millions of veterans who suffered exposure to burn pits while serving in the military.

However, there are other pressing questions facing the Democratic effort, including some that are unanswerable at this moment. Chief among them is whether Sen. Kyrsten Sinema (D-Ariz.) will follow the lead of her moderate colleague and back the $670 billion blueprint.

Upon leaving the Capitol, Sinema repeatedly declined to answer that question as a staffer told reporters simply that she is still reviewing the legislation and has no further comment (ABC News). Adding to the intrigue, Manchin said during a virtual press conference on Thursday that he has not talked to the Arizona Democrat.

“I would hope that she would be receptive,” Manchin said.

No Sinema decision is expected until the Senate parliamentarian gives the drug pricing portion of the bill the OK — a decision that is not expected for several days (Politico).

▪ Alexander Bolton, The Hill: Inside the secret Manchin-Schumer deal: Democrats shocked, GOP feels betrayed.

▪ The New York Times: After clash, Manchin and Schumer rushed to reset Climate and tax deal.

▪ The Wall Street Journal: Schumer lobbies Democrats to back Manchin climate, tax and health care deal.

▪ Emily Brooks, The Hill: Why two dozen House Republicans supported CHIPS despite last-minute whip.

Democrats are also facing another big unknown: COVID-19. In the last two weeks alone, Sens. Tina Smith (Minn.), Tom Carper (Del.), Manchin and Schumer have all missed time after testing positive for the virus.

That news became more problematic on Thursday as Sen. Dick Durbin (D-Ill.) tested positive, putting him out of work for at least five days and potentially longer (The Hill). Add on the continued absence of Sen. Patrick Leahy (D-Vt.), who is recovering from hip replacement surgery but available to vote if need be, and any additional positive test results could present real issues for the party to pass the bill by the end of next week. 

Assuming all Senate Republicans are in town, all 50 Senate Democrats will need to be available to vote, plus Vice President Harris to cast the tiebreaking vote. 

Politico: Splitsville: Senate Minority Leader Mitch McConnell (R-Ky.) and House Minority Leader Kevin McCarthy (R-Calif.) break on big votes.

Even following the CHIPS vote in the House and the Senate GOP’s burn pit bill takedown, the anger may not subside over Schumer’s Wednesday shocker. Sen. Susan Collins (R-Maine) indicated on Thursday that legislation to codify same-sex marriage is in more jeopardy now and that there is an increased lack of trust among Republicans. 

“After we just had worked together successfully on gun safety legislation, on the CHIPS bill, it was a very unfortunate move that destroys the many bipartisan efforts that are under way,” said Collins, who is the lead GOP co-sponsor of the same-sex marriage proposal (HuffPost).

Assuming everything goes right in the upper chamber, another question is what happens if the bill advances to the House by the end of next week or the week after, and whether Speaker Nancy Pelosi (D-Calif.) would haul lawmakers back to vote on the reconciliation package? Smart money says she almost certainly would. According to Bloomberg News, Pelosi is set to depart for her Asia trip on Friday that could include a stop in Taiwan.

Democrats want to get a health provisions through the Senate before the August recess because Affordable Care Act premium increases would otherwise take effect mid-month, increasing costs for many Americans during a period of inflation.

▪ The Hill: Manchin-Schumer deal could be historic win on climate change.

▪ The Hill: Manchin-Schumer deal stuns business lobby. 

▪ The Washington Post: Democrats to seek $21 billion to fight coronavirus and other outbreaks.

▪ The Hill: Veterans’ groups lash out after GOP blocks toxins bill: “I’m sick and tired of this bullshit.”

IN FOCUS/SHARP TAKES

➤ POLITICS

Former President Trump on Thursday defended his decision to host a tournament by Saudi-backed LIV Golf at one of his courses this weekend by saying that “nobody has gotten to the bottom of 9/11.”

LIV Golf and those associated with it have come under fire for being funded by the Saudi’s Public Investment Fund. That includes Trump, who has been criticized over the past week by 9/11 families for hosting the event at Trump National Golf Club.

“Nobody has gotten to the bottom of 9/11 unfortunately, and they should have,” Trump said, labeling those who carried out the terrorist attacks “maniacs that did that horrible thing to our city, to our country, to the world.”

Fifteen of the 19 attackers on 9/11 were Saudi nationals. Trump indicated that he was aware of this in 2016, having told “Fox & Friends” in an interview that it was the Saudis who “blew up the World Trade Center” 

“Take a look at Saudi Arabia, open the documents,” he said at the time. The FBI declassified information related to the attack last year showing that the attackers received assistance from Riyadh (Axios). 

▪ The Hill: House GOP brushes off Department of Justice probe of Trump.

▪ Amie Parnes, The Hill: Biden turns up the insults on Trump.

▪ NBC News: Biden’s soft power has not been enough to stop would-be rivals from grabbing the 2024 spotlight. 

▪ Niall Stanage: The Memo: No, really — What if Rep. Alexandria Ocasio-Cortez (D-N.Y.) runs for president?

📝 Introducing NotedDC, The Hill’s curated commentary on the beat of the Beltway. Click here to subscribe to our latest newsletter. 

OPINION

■ Recession or not, the recovery has ended, by Greg Ip, chief economics commentator, The Wall Street Journal. https://on.wsj.com/3vpSS5I 

■ How goes the war on inflation? by Paul Krugman, columnist, The New York Times. https://nyti.ms/3b9gQva 

WHERE AND WHEN

The House will meet at 9:30 a.m. and officially kick off the monthlong August recess at the conclusion of votes. Pelosi will hold her weekly press conference at 10:45 a.m.

The Senate convenes on Monday at 3 p.m. and will resume consideration of Elizabeth Hanes to be a district judge for the Eastern District of Virginia.

The president will receive the President’s Daily Brief at 10:15 a.m.

The vice president has no public events scheduled.

Secretary of State Antony Blinken at 9 a.m. will co-host with Commerce Secretary Gina Raimondo a ministerial meeting of the U.S.-Japan Economic Policy Consultative Committee with Japanese Foreign Minister Hayashi Yoshimasa and Japanese Minister of Economy, Trade, and Industry Haguida Koichi, followed by a press availability at noon at the State Department. Blinken and Yoshimasa will share a working lunch at 1 p.m. 

Economic indicator: The Commerce Department’s Bureau of Economic Analysis at 8:30 a.m. reports on U.S. consumer spending in June. 

The White House daily briefing is scheduled at 1:30 p.m.

⚾ At the Congressional Baseball Game for charity Thursday night at Nationals Park in Washington, GOP members of Congress triumphed over their colleagues across the aisle by a score of 10-0, making it a two-win streak for Republicans after winning 13-12 last year (Washington Examiner). Rep. Pete Aguilar (D-Calif.) was named MVP for the Democrats, while freshman Rep. August Pfluger (R-Texas) was the MVP for the Republicans, according to Fox News.

🖥  Hill.TV’s “Rising” program features news and interviews at http://thehill.com/hilltv, on YouTube and on Facebook at 10:30 a.m. ET. Also, check out the “Rising” podcast here.

ELSEWHERE  

➤ INTERNATIONAL

Russian forces launched their first missile attack on the greater Kyiv area in weeks on Thursday, a move Ukraine labeled as a revenge action as the war-torn nation’s government stands up to the Kremlin. Moscow fired six missiles from the Black Sea, striking a military unit just outside of the city. In response, Kyiv counterattacked in the Russian-occupied Kherson region that was taken over in the early stages of the war (The Associated Press).

Russian Foreign Minister Sergei Lavrov said today that Moscow will soon propose a time for a call with Secretary of State Antony Blinken to discuss a prisoner exchange. His response comes days after Blinken told reporters that the Biden administration has made a “substantial offer” to win the freedom of WNBA star Brittney Griner and former Marine Paul Whelan. Both are jailed in Russia (Reuters).

➤  PANDEMIC, POX & HEALTH

The administration plans to make available in September expected new booster COVID-19 vaccine shots manufactured by Pfizer and Moderna to tackle the latest mutation of the coronavirus in circulation, The New York Times reports. Anticipating that refined booster doses are on the horizon to better target the BA.5 subvariant of omicron, the government has decided not to expand eligibility for second boosters of the existing vaccines this summer. Currently, those 50 and older and those older than 12 with certain immune deficiencies can get booster shots. The goal: encourage people to get vaccinated and boosted with the most effective shots available ahead of a possible winter surge of the virus.

Los Angeles County’s COVID-19 infection rate improved enough to avert a potential return to a mandatory indoor mask mandate this week. A county health official on Thursday said a pending plan was dropped because infections and rates of hospitalizations stabilized (The Associated Press).

San Francisco declared a public health emergency on Thursday as monkeypox cases rise in the city. Mayor London Breed’s (D) office said the declaration goes into effect on Monday and will strengthen the city’s preparedness, responses,and expedite available resources to address the virus. The city has confirmed more than 260 cases of monkeypox, making up almost a third of the nearly 800 cases in California (The Hill).

Total U.S. coronavirus deaths reported as of this morning, according to Johns Hopkins University (trackers all vary slightly): 1,029,270. Current average U.S. COVID-19 daily deaths are 364, according to the Centers for Disease Control and Prevention.

If you thought vitamin D helped strengthen your bones against breakage, think again. In the first large randomized controlled study in the U.S., researchers report that vitamin D pills taken with or without calcium have no effect on bone fracture rates. The results of the government-funded research, published Thursday in The New England Journal of Medicine, hold for people with osteoporosis and even those whose blood tests deemed them vitamin D deficient. The newest advice? Stop taking the supplements, unless you have celiac disease or Crohn’s disease, or are deprived of sunshine and may not eat enough foods that are routinely supplemented with vitamin D, such as cereals and dairy products to help them absorb calcium (The New York Times). 

➤   STATE & CITY WATCH

Washington, D.C., Mayor Muriel Bowser (D), during a Thursday news conference, asked the Pentagon to deploy 150 National Guard members per day to help manage the influx of asylum seekers sent by bus to the nation’s capital by Texas and Arizona, calling the thousands of migrants arriving in search of assistance a “growing humanitarian crisis.”

The D.C. government is also seeking the Guard’s help to transport migrants “to a temporary processing center at the D.C. Armory or another suitable federal location in the National Capital Region such as Joint Base Bolling or Fort McNair for reception and eventual onward movement to their final destinations.”

In a letter, Bowser criticized Texas Gov. Greg Abbott and Arizona Gov. Doug Ducey, both Republicans, accusing them of “cruel political gamesmanship” for what she said were decisions “to use desperate people to score political points” (WTOP).

➤   PICTURE DAY

Their portraits have traveled the country, drawing large and enthusiastic crowds nationwide before returning to the Smithsonian’s National Portrait Gallery. After more than five years as private citizens, former President Obama and former first lady Michelle Obama will be on hand Sept. 7 to help unveil a different pair of official portraits, set to hang in the White House after an event to be affectionately hosted by Biden and first lady Jill Biden (NBC News). 

THE CLOSER

And finally … 👏👏👏 Congratulations to the victors of our weekly Morning Report Quiz! 

With July coming to an end this weekend, we thought it was a good idea to see how much everyone remembered about the month that was and inquire about some current events before the calendar hits August. 

Here’s everyone who went 4/4 and deserves a big Friday pat on the back: Stanley Wasser, Pam Manges, Amanda Fisher, Terry Pflaumer, Patrick Kavanagh, Lou Tisler, Randall S. Patrick, Robert Bradley, Jack Barshay, Stephen Delano, John Donato, Barbara Coen, Peter Sprofera and Shaun Donnelly. 

They knew that Biden did not travel to Spain during the course of July (he did appear there during the end of June).

At movie theaters, “Minions: The Rise of Gru” has taken the belt as the highest-grossing film in the U.S. since the start of the month. It raked in more than $300 million since its July 1 release. 

Among the past four British prime ministers delivered by the Tories, John Major logged the longest tenure at 6 years and 156 days (slightly more than the 6 years and 64 days of David Cameron).

Finally, former third baseman Scott Rolen was not part of the 2022 Baseball Hall of Fame class inducted on Sunday (but perhaps his day is not far off).

We want to hear from you! Email: Alexis Simendinger and Al Weaver. Follow us on Twitter (@alweaver22 & @asimendinger) and suggest this newsletter to friends!

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