Presented by

With Rachel Roubein

Editor’s Note: POLITICO Pulse is a free version of POLITICO Pro Health Care's morning newsletter, which is delivered to our subscribers each morning at 6 a.m. The POLITICO Pro platform combines the news you need with tools you can use to take action on the day’s biggest stories. Act on the news with POLITICO Pro.

— President-elect Joe Biden will nominate Andrea Palm as HHS deputy secretary, adding a veteran of the department to his emerging health team.

— The Biden administration will keep Covid-related travel restrictions in place, despite President Donald Trump’s attempt to lift them.

— Operation Warp Speed was the gem of the Trump administration‘s otherwise sloppy pandemic response, until it stumbled in its final stretch.

WELCOME TO TUESDAY PULSE — where our thoughts are with the family, friends and colleagues of the late, great Sharon Begley, memorialized in STAT this weekend as “science-writing royalty” and a newsroom mentor across her 43-year career.

It’s a big week for American democracy — send tips large and small to [email protected].

BIDEN’s HEALTH TEAM TAKES SHAPE — Biden’s selection of Andrea Palm for the No. 2 job at HHS is aimed at aiding an incoming administration with a lengthy agenda and a need to show results fast. Palm — a Wisconsin state health official who previously held several senior positions in the Obama HHS — already knows the department well, putting her in a prime position to manage its day-to-day operations.

And after spending the last two years navigating Wisconsin’s tricky political landscape, tangling with a GOP legislature that refused to confirm her and fought aspects of the state’s Covid-19 response — making her a target of anti-lockdown protests and lawsuits — she’s unlikely to be jarred by the deep divides in Washington.

THAT'S A CONTRAST to Biden’s pick for HHS secretary, Xavier Becerra, the attorney general of deep-blue California notable for leading Democratic states’ resistance to the Trump administration’s agenda.

The choice signals that while Becerra — a longtime politician — may be the one called upon to sell the Biden health agenda to the American public, much of the behind-the-scenes work of writing and implementing that agenda will hinge on Palm’s management of the policymaking process across the sprawling department.

BY THE TIME EITHER OF THEM IS CONFIRMED, Biden’s health policy changes will already be underway. In a memo circulated over the weekend, incoming chief of staff Ron Klain outlined plans for Biden to sign dozens of executive orders in his first days in office — including several aimed at tackling the pandemic and expanding access to health care.

Among them: a mask mandate for all federal properties and for interstate travel, in keeping with one of Biden’s first post-election promises. He also plans to sign initiatives to help schools reopen safely, expand testing and establish clearer public health standards — though it remains to be seen how much of that list will require congressional support.

STILL, SOME DEMOCRATS ARE WONDERING: Where are all the other high-level health appointments? On the eve of his inauguration, Biden has yet to nominate an FDA commissioner or CMS administrator, to name just two.

Instead, he rolled out additional members of his White House Covid squad and named his science team. That’s in keeping with Biden’s focus ending the pandemic and proving his administration will be guided by science. Yet it also means risking a slow start for the rest of his extensive health care to-do list.

TRAVEL BANNED — Biden press secretary Jen Psaki confirmed Monday that the incoming administration will not be easing coronavirus travel restrictions on Jan. 26, and added that Biden instead intends to strengthen health measures around travel.

The move will cancel a Monday executive order by Trump lifting limits for much of Europe, the U.K., Ireland and Brazil. In the order, Trump cited new CDC guidelines requiring that all air travelers into the U.S. get a negative Covid-19 test, and said HHS Secretary Alex Azar had advised him to remove the existing restrictions.

HOW WARP SPEED CRASH LANDED — The vaccine accelerator that Trump health officials believed would be their greatest achievement has faced growing criticism amid a troubled vaccine rollout, Dan Diamond reports in his final piece for POLITICO.

The initiative was conceived as a second Manhattan Project that would end the global pandemic. And while Operation Warp Speed found plenty of success en route to the record develpment of multiple Covid-19 vaccines, it has become linked just as closely to its failures — namely, its inability to vaccinate 20 million people in December as originally promised.

Some officials have blamed the CDC for its lack of operational expertise, while others have bristled at Warp Speed‘s secrecy. Those most dedicated to the project have been left lamenting its final stumbles.

“So much of the early Covid-19 response had gone wrong,” said one official. “This was a chance to get the vaccine right.”

CMS FINALIZES MORE STATES’ MEDICAID WAIVERS — The Trump administration on Friday, with just days left in Trump’s term, granted Texas and Florida 10-year approvals for their Medicaid waivers, POLITICO’s Rachel Roubein reports.

Both states’ Medicaid waivers include substantial funding for providers to cover the cost of caring for uninsured patients. Neither state has expanded Medicaid, and both have one of the highest uninsured rates in the country.

“My translation: Hospitals/providers we will pay you off so you don't push for Medicaid expansion until 2030,” Joan Alker, the executive director of Georgetown University’s Center for Children and Families, tweeted in response.

— SEEMA VERMA aims to preserve her Medicaid legacy. Trump’s CMS administrator has asked states to lock in a lengthy process if her agency, under Biden, decides to change or terminate a state’s Medicaid waiver. At least several red states have signed the agreement, which could make it more difficult for Biden to quickly unwind conservative changes to the safety net program.

Tennessee intends to sign the agreement after receiving the nation's first-ever Medicaid block grant earlier this month, a state Medicaid spokesperson confirmed. And at least two states with CMS-approved Medicaid work requirement waivers — Georgia and South Carolina — have signed on.

AZAR’S FINAL FAREWELL — Azar will deliver his final State of the Department speech this morning, after nearly three years in what he has repeatedly referred to as his “dream job.”

The address comes after Azar’s resignation letter, in which he complained that post-election “actions and rhetoric” that led to the Capitol assault threatened to tarnish the administration’s legacy, drew attention over the weekend.

HHS TESTING CONTRACT LATEST TO TARGET FDA — The health department has enlisted a private company to review the accuracy of some Covid-19 tests, marking its latest effort to bypass scientists at the FDA, POLITICO’s David Lim reports.

The last-minute contract would allow HHS to use the reviews to issue emergency authorizations for tests without the FDA’s input. The decision is largely symbolic, since the incoming Biden team could return that responsibility to the FDA.

But it’s yet another salvo in a fight over regulation of so-called lab-developed tests, after HHS stripped the FDA of its ability to require premarket review of the products. The agency has since halted reviews of all lab-developed tests to focus on other categories of tests.

— How HHS sees it: A spokesperson said the move was a response to labs refusing to offer Covid testing without the liability protections tied to emergency authorization.

JEET GURAM returns to McKinsey & Co. The FDA senior adviser left government after nearly four years to rejoin McKinsey, according to an internal email obtained by PULSE. Prior to joining the FDA in early 2020, he had served as senior adviser to Verma at CMS.

PATRICK VELLIKY joins Envision Healthcare. Velliky will be the physician staffing firm’s new vice president of government affairs. He was previously the vice president of legislation at the Federation of American Hospitals.

The former Baltimore mayor convicted on fraud charges tied to her “Healthy Holly” children’s book series is seeking clemency from Trump, The Baltimore Sun’s Justin Fenton reports.

A Trump administration effort to strip civil service protections from tens of thousands of career federal officials is unlikely to be finalized, The Washington Post’s Lisa Rein reports.

On a podcast hosted by Federation of American Hospitals CEO Chip Kahn, former Obama health aide Chris Jennings debates the health policy outlook for the incoming Biden administration with Galen Institute senior fellow Doug Badger.