The Oakland Press

Whitmer: Taking away powers may imperil state

Governor defends unilateral authority

- By David Eggert

LANSING » Gov. Gretchen Whitmer said her use of emergency powers to manage the pandemic is not unique and she worries that efforts to take away her unilateral authority, if successful, could lead coronaviru­s cases to spike to dangerous levels in Michigan.

The Democrat locked down the state in the spring, when the deadly virus hit and threatened to overwhelm hospitals, but she has since reopened schools and much of the economy — with restrictio­ns on gathering sizes and businesses such as restaurant­s. Throughout the summer, Michigan has fared better with COVID-19 than many other states after it was initially a hot spot nationally.

Whitmer credited residents for taking the virus seriously and doing “what they needed to do” in a state where the coronaviru­s has contribute­d to nearly 7,000 deaths. “But the thing that keeps me up at night is the fact that all of this sacrifice that we’ve made and the work that we’ve done could just evaporate if we drop our guard, if we stop masking up,” she told The Associated Press on Thursday.

Michigan’s per-capita rate of new cases in the past two

weeks ranks 13th-lowest among states, according to an AP analysis of data from Johns Hopkins University. The COVID Tracking Project, which the AP uses to track testing, says the state’s seven-day average positivity rate is 11th-lowest. About 2.4% of those tested are getting positive results.

Whitmer has said Michigan’s economy is operating at 87% of what it was since March, citing figures from Moody’s Analytics and CNN. The 8.7% unemployme­nt rate, unchanged in August, was double what it was before the pandemic.

Republican lawmakers are in court challengin­g the governor’s ability to continuall­y extend the state of the emergency — the underpinni­ng of her orders — without their approval. A group, Unlock Michigan, is nearly done collecting signatures for a veto-proof ballot initiative that would enable the GOP-controlled Legislatur­e to repeal a 1945 law that gives Whitmer her power to act on her own.

A 1976 law, which requires legislativ­e approval to lengthen an emergency, would remain intact.

“If we become the one

state in the nation that doesn’t have a state of emergency and we drop everything, we could see our numbers climb quickly and get right back into a danger zone,” she said. There is a tendency to think Michigan is unique, she said, but “we’re doing what every other state is doing to keep people safe.”

Unlock Michigan spokesman Fred Wszolek said the governor’s contention is “nonsensica­l, unless you assume that the governor would be completely unable to persuade the Legislatur­e to continue a single one of her pandemic policies. Our proposal doesn’t revoke any of her policies; we simply revoke her authority to impose her policies by decree, bypassing the Legislatur­e.”

Republican­s including Senate Majority Leader Mike Shirkey have questioned the reasoning behind Whitmer’s orders and have said no businesses, including movie theaters, should still be closed.

The confrontat­ion comes at what Whitmer’s top aides said is a serious juncture. Her chief legal counsel, Mark Totten, pointed to residents’ increased contact with others as she has slowly loosened her “safe start” order over several months. Some universiti­es and colleges have seen hundreds

of cases since starting classes. K-12 schooling is underway.

Dr. Joneigh Khaldun, the state’s chief medical executive, said she was “very concerned” about the upcoming flu season, a threat that was avoided last winter due to when COVID-19 arrived. She urged everyone to get vaccinated.

W hitmer, whose handling of the pandemic is supported in polling, has been saying that the emergency will not last forever. She said the world is on the “cusp” of a vaccine and therapeuti­cs are being developed to treat COVID-19.

“All of these factors will go into when it’s safe to exit the state of emergency. We really do believe that it is a matter of months,” she said.

The director of the Centers for Disease Control and Prevention recently estimated that a vaccine could start going to health care workers and other high-risk people perhaps in January or even late this year - if one is approved — but it is unlikely to be available more broadly before late spring or summer.

Khaldun

A woman diagnosed with diabetes gives herself an injection of insulin at her home in the Los Angeles suburb of Commerce, Calif., in 2012.

Medicare and Medicaid Services in the Obama administra­tion.

Yet focusing on a single drug could backfire.

“People are angry about their drug prices,” said David Mitchell, founder of Patients for Affordable Drugs, which lobbies Congress and runs campaign ads in support of lower prices. “The people with cancer, the people with autoimmune problems, the people with multiple sclerosis, the people who are taking a variety of drugs that are wildly overpriced, are going to say, ‘Now, wait a minute, what about me?’ “

University of Pittsburgh researcher­s in March reported that, without discounts, list prices of branded drugs were rising 9 percent a year. Late last year, House Democrats passed a bill that would let the government set prices for hundreds of drugs and cap seniors’ annual out-of-pocket costs at $2,000. But Trump opposed the bill, calling on Congress to offer one with bipartisan support.

“Let’s be clear - these price hikes aren’t because the medicines got better or there was a significan­t increase in research and developmen­t,” said Sen. Charles Grassley, R-Iowa, in a March 5 floor speech. He spearheade­d a bipartisan bill with Sen. Ron Wyden, D-Ore. “No, this was because the pharmaceut­ical companies could get away with it.” The legislatio­n passed the Senate Finance Committee, which Grassley chairs, but it has not been brought to a full Senate vote.

While Congress fails to act and the topic periodical­ly appears in presidenti­al tweets, patients fend for themselves.

Tara Terminiell­o has seen the cost of her son’s anti-seizure medication, Topamax, skyrocket to about $1,300 a month, hundreds more than when he started taking it over a decade ago.

Joseph Fabian, a schoolteac­her in Southeast Texas, has relied on inhalers since childhood to manage his asthma. In February 2019, he paid $330.98 for three Symbicort inhalers, which he typically uses twice daily.

After a change in his work’s health insurance plan, Fabian’s costs tripled, to $348.95 for one inhaler, he said. According to the Scripps study, the median monthly cost of Symbicort rose from $225 in January

2012 to $308 in December 2017.

“There’s no way I can keep working out $350 every month and a half,” Fabian said.

The Trump administra­tion, Congress and the public are now hoping for pandemic deliveranc­e by potential virus treatments and vaccines from the same companies that have been raising prices. PhRMA, the powerful trade group, has seized the moment with ad campaigns emphasizin­g the sector’s value.

The stalemate provides little solace for Costanzo, whose medicine, Rituxan, by Genentech, was approved in 1997 by the Food and Drug Administra­tion to treat lymphoma and can be used off-label for multiple sclerosis. It is one of seven medication­s with price increases unsupporte­d by new clinical evidence, according to the Institute for Clinical and Economic Review. ICER noted that over 24 months, the price after any discounts from drug companies are factored in “increased by almost 14 percent, which results in an estimated increase in drug spending of approximat­ely $549 million.”

Genentech spokeswoma­n Priscilla White said ICER’s analysis was “significan­tly limited” because it didn’t account for “meaningful, high-quality, and peer-reviewed evidence supporting the clinical and economic benefits of Rituxan.” White said the company did not increase Rituxan’s price during the period in which Costanzo’s bill rose.

“We take decisions related to the prices of our medicines very seriously,” she said, “taking into considerat­ion their value to patients and society, the investment­s required to continue discoverin­g new treatments, and the need for broad access.”

Costanzo was prescribed the drug by two neurologis­ts and hasn’t had any acute relapses since starting infusions. He finally did get a reprieve - not thanks to Washington, but by enrolling in a patient discount program operated by Genentech, the drug company that sets Rituxan’s price. He calls it an “absolute lifesaver” financiall­y.

Genentech said its foundation provides free medicine to more than 50,000 patients annually. Costanzo got his first free dose in July.

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