Power Up: DOJ settled for billions to allay the opioid crisis. The challenge now: Getting the money.

?In coronavirus vaccine news: Vice President Mike Pence, Second Lady Karen Pence, and Surgeon General Jerome Adams are scheduled to be vaccinated on live television at 8 a.m. this morning. 

THE OTHER EPIDEMIC: President Trump campaigned in 2016 on ending the country’s opioid crisis. In the waning weeks of his presidency, opioid overdoses are on pace to kill a record number of Americans in 2020 — a crisis that has largely slipped from public consciousness in the shadow of the coronavirus pandemic that has killed 309,000 people this year. 

A rare public appearance by two members of the billionaire Sackler family, which owns Purdue Pharma, highlighted just how difficult it will be to ensure that money secured in a much-ballyhooed Justice Department settlement with the OxyContin-maker actually goes toward compensating victims of the opioid crisis and delivering new resources for addiction. 

Non-apology apology: The Sacklers, testifying publicly for the first time in decades, acknowledged that the addictive painkiller contributed to the national opioid crisis. But they declined to take personal responsibility for the crisis. “I have tried to figure out if there’s anything I could have done differently knowing what I knew then, not what I know now,” Kathe Sackler told the House Oversight Committee. “I have to say there is nothing I can find that I would have done differently.”

But lawmakers critical of the Sacklers and Purdue appeared incensed that the company’s declaration of bankruptcy could ultimately mean the settlement is largely symbolic — and will continue to shield the drugmaker as it faces other massive litigation. 

• “The federal government audit of the Sackler family is that your family, you, and your fellow members of the Sackler family have $12 billion in profits from your aggressive marketing and sales of OxyContin,” Rep. Peter Welch (D-Vt.) told Kathe Sackler, a former Purdue vice president. “Is there any reason that money, every single dollar should not be returned and recovered by taxpayers for distribution to families?”
• “I am just sick to see what it appears to me as a family and a company that’s going to use the bankruptcy process to get out of this and to continue to be one of the wealthiest families in America,” Rep. James Comer Jr. (R-Ky.) told David Sackler, a member of Purdue’s board from 2012 to 2018. 
• “I think it’s clear your family has tried to fraudulently shield money for your own personal benefit,” said Rep. Carolyn B. Maloney (D-N.Y.) said, who also secured a commitment from the Sackler family to provide the committee with a list of what she called “offshore shell companies.”
• David Sackler said the family only shifted a “very small amount” of money from the family-owned company to offshore accounts and foreign banks. “According to court documents, between 2008 through 2017, the family withdrew approximately $10 billion from Purdue Pharma,” per the New York Times’s Jan Hoffman. 

Plus: “The settlement requires the company to hand over just $225 million of the $8 billion total to the government as long as Purdue makes good on plans to settle thousands of lawsuits filed by state and local governments, a matter now in bankruptcy court,” per the Associated Press’s Geoff Mulvihill.  

There’s also concern about how states handle the money — if or when they receive it. Dr. Kimberly Sue, an addiction physician-anthropologist at Yale School of Medicine and medical director of the Harm Reduction Coalition, is concerned that states whose budgets have been devastated by coronavirus pandemic will redirect “the opioid litigation money to their general funds and infrastructure.”

• “All states are just really reeling from the pandemic,” Sue told Power Up. “But [victims] deserve to see the money come back to them in terms of programs and treatment for their recovery and their healing.”

The next debate: An idea endorsed by the federal government in the settlement — that Purdue convert to a public benefit company so its future profits could be used to combat the opioid crisis — is under fire by a coalition of states. Twenty-five state attorneys general argued the deal would improperly entangle officials with future sales of OxyContin — and shield members of the Sackler family from personal liability. (The DOJ settlement did not preclude the possibility that Sackler family members could be criminally prosecuted in the future, though both Sacklers at the hearing denied any knowledge of criminal activity at the company.) 

• “The public deserves assurance that no opioid business is given the special protection of being placed under a public umbrella,” they wrote to Attorney General William P. Barr in October. “Although it may take time to find a private sector buyer, the public should be confident that public officials are seeking to avoid having special ties to an opioid company, conflicts of interest, or mixed motives in an industry that caused a national crisis.”
• “DOJ should not require the States, who are attempting to rectify the harm Purdue has done to their communities, to lead Purdue’s public benefit ‘repurposing’ campaign and take part in an enterprise that has contributed to thousands of American deaths,” a group of Democratic lawmakers wrote to Barr this month.

There are some public experts, however, who endorse the idea. Leo Beletsky, a professor and faculty director of Health in Justice Action Lab at Northeastern University School of Law, argues that a PBC could address “structural issues in the pharmaceutical market” by addressing the high cost of addiction and overdose medications like Naloxone, the overdose antidote, and buprenorphine and methadone — both used to treat opioid addiction and reduce withdrawal symptoms. 

• “Expanding access, cutting red tape, and lowering costs to these products is an urgent public health priority,” Beletsky wrote us. “Having a corporate manufacturer whose mission is to advance public health rather than maximize profits would certainly save lives.” 

Big picture: The full extent of the opioid and overdose crisis may not even be fully accounted for during the pandemic, experts fear, with public health resources stretched so thin. “The story is that as we failed to flatten the curve of covid-19, and we’ve also failed to flatten the curve of the overdose crisis,” Beletsky told us. 

TRUMP ALMOST BLEW UP STIMULUS TALKS: “White House aides intervened to prevent Trump from issuing a statement calling for substantially larger stimulus payments for millions of Americans,” Jeff Stein scoops.

• “On a phone call Thursday afternoon, Trump told allies that he believes stimulus payments in the next relief package should be ‘at least’ $1,200 per person and possibly as big as $2,000 per person … Congressional leadership is preparing a stimulus package that would provide checks of $600 per person.”

But aides convinced Trump that saying this publicly would derail negotiations: “The White House divisions underscore the internal Republican tensions over the next relief package and likely the president’s last major economic piece of legislation.”

… STILL NO DEAL YET: “Negotiators were hoping to resolve all of their differences and pass matching bills in the House and Senate by [tonight] to marry the stimulus bill with a must-pass government funding package. But the prospect of that appeared to slip away late [last night],” Mike DeBonis, Jeff Stein and Seung Min Kim report.

• Lawmakers will now need to pass a stopgap bill today to prevent a government shutdown: “Then they can continue negotiating the stimulus bill through the weekend.”

The lack of state and local funding could pose big future problems: “The U.S. economy struggled to shake off the last recession, with historically slow growth and a sluggish job market, in part because cities and states continued to lay off workers years into the recovery, pushing up the unemployment rate. It took until 2019 for state and local jobs to return to 2008 levels of unemployment,” the New York Times’s Jim Tankersley and Emily Cochrane report.

• Conservative lawmakers have staunchly opposed such funding, one of the reasons it is not expected to be in the final bill: “With most states required to balance their budgets, governments have turned to cutting jobs and other services rather than raising taxes on struggling households and businesses. The state and local government jobs shed since March — primarily in education — are a far higher toll than during the Great Recession, when cities and states laid off 800,000 workers from 2008 to 2013.”

BEHIND THE SCENES: “Biden’s transition — which began months before the election results were known — is providing the first portrait, if one largely conducted behind the scenes, of his style as a manager and decision maker-in-chief,” Matt Viser reports this morning.

• What we’re seeing so far: “Biden has always been one who stews over difficult decisions, letting them linger and growing agitated with those who try to rush him … His advisers describe a decision-making and hiring approach that resembles the playing of an accordion, starting wide and then narrowing — and then, sometimes suddenly, expanding once more.”
• Key quote: “He’ll be the first to tell you, ‘I have better political instincts than all of you,’” said one adviser. “He wants the recommendations. He will hear varied perspectives, and he wants people to present their case. But at the end of the day he listens to his gut …” 

Vice President-elect Harris is closely involved: “She has interviewed each candidate separately and traded notes with Biden afterward in what people close to the transition say has been an important step in deepening their working relationship.” Both of them receive thick packets dissecting a nominee’s “strengths, weaknesses and possible areas of conflict.” Biden’s are delivered directly to his Wilmington, Del., home.

His team began planning months ago: “By Election Day, the transition had built a database of 9,000 potential administration hires. Some 2,500 had already been vetted — half of whom were people of color and more than half of whom were women. That database now has more than 45,000 entries.”

• A goal has been to try to exceed the “Rooney Rule,” “the NFL requirement that teams interview at least one minority candidate for every head coaching and high-level job — so that more would have an opportunity to be considered”
• What he’s looking for: “Biden has valued expertise — not necessarily in particular subject areas but in crisis management. In his view, his administration is inheriting a multipronged crisis, and a government workforce that has spent four years being disparaged and downplayed.”

A PAIR OF HISTORIC CABINET PICKS: “Biden chose Rep. Deb Haaland (D-N.M.)  to serve as the first Native American Cabinet secretary and head the Interior Department, a historic pick that marks a turning point for the U.S. government’s relationship with the nation’s Indigenous peoples,” Juliet Eilperin, Dino Grandoni and Brady Dennis report. 

• On Haaland’s history making moment: “Native people are crying happy tears — on their apartment floor, on social media, in their cars — over Haaland’s selection,” Indian Country Today reports.

Biden also has tapped North Carolina environmental regulator Michael S. Regan to become the first Black man to head the Environmental Protection Agency.”

What this signals: “They were chosen to personify Biden’s plans to address the long-standing burdens low-income and minority communities have shouldered when it comes to dirty air and water. All three nominees will play a central role in realizing his promises to combat climate change, embrace green energy and address environmental racism,” our colleagues write.

• The third nominee, Obama administration veteran Brenda Mallory, will serve as the first Black chair of the White House Council on Environmental Quality.

TOP BIDEN ADVISOR HAS COVID: “Rep. Cedric Richmond (D-La.), who is set to resign from Congress to join the incoming Biden administration as a senior adviser, tested positive two days after traveling to Atlanta to attend a campaign rally that Biden headlined for Democratic Senate candidates Jon Ossoff and the Rev. Raphael Warnock,” the Associated Press’s Aamer Madhani reports.

• Richmond was not a close contact of Biden or either of the candidates: “Transition spokeswoman Kate Bedingfield said that Biden underwent covid-19 testing on Thursday, and the virus was not detected.”

HHS Secretary Alex Azar’s wife has also tested positive: “Azar said that he and his children have tested negative and have no symptoms. The HHS secretary also said he will continue to work on the advice of his physician and public health experts like CDC Director Robert Redfield,” Politico’s Dan Diamond reports.

TOP LAWMAKERS TO GET VACCINATED: “The Capitol’s leading doctor will soon receive doses of the coronavirus vaccine to administer to the Supreme Court justices and senior members of Congress under a continuity-of-government plan crafted by intelligence experts,” Paul Kane reports.

• “Congress and the Supreme Court, along with executive branch agencies, will be provided with a specific number of covid-19 doses to meet long-standing requirements for continuity of government operations,” Brian P. Monahan, the attending physician of the U.S. Congress and the Supreme Court, wrote in a letter to Senate Majority Leader Mitch McConnell.

THE RUSSIA HACK IS WORSE THAN WE THOUGHT: “Federal investigators reported evidence of previously unknown tactics for penetrating government computer networks, a development that underscores the disastrous reach of Russia’s recent intrusions and the logistical nightmare facing federal officials trying to purge intruders from key systems,” Craig Timberg and Ellen Nakashima report.

• The full extent on the intrusion is still not clear: “Thousands of private companies worldwide also were potentially affected, many in sensitive industries, after they uploaded software patches that were infused with malware, reportedly by Russia’s foreign intelligence service, known as the SVR. Purging the intruders and restoring security to affected networks could take months, some experts say.”

An agency that handles the nuclear weapons stockpile was breached: “The Energy Department and National Nuclear Security Administration, which maintains the stockpile, have evidence that hackers accessed their networks as part of an extensive espionage operation that has affected at least half a dozen federal agencies, officials directly familiar with the matter said,” Politico’s Natasha Bertrand and Eric Wolff report.

Sen. Mitt Romney (R-Utah) called the White House’s silence “extraordinary”: Trump has yet to address the hack

STATES REPORT CONFUSION OVER VACCINES: “Officials in multiple states said they were alerted late Wednesday that their second shipments of Pfizer-BioNTech’s vaccine had been drastically cut for next week, sparking widespread confusion and conflicting statements from Pfizer and federal officials about who was at fault,” Isaac Stanley-Becker, Yasmeen Abutaleb, Lena H. Sun and Josh Dawsey report.

It’s not entirely clear what is happening, but governors are reporting delays: “Illinois Gov. J.B. Pritzker (D) said anticipated shipments to the state in the next two weeks had been cut roughly in half. The uncertainty was even more pronounced in Florida, where Gov. Ron DeSantis (R) said new shipments from Pfizer were ‘on hold.’” Florida later said the plans were back online but had been significantly reduced. 

• The clash comes as the two sides negotiate over more doses: “The pharmaceutical giant and the administration are nearing an agreement that would provide the United States with more than 50 million doses, but fewer than 100 million, probably spread over the second and third quarters of 2021.” Pfizer previously said the administration turned down its offer to lock down another 100 million doses as recently as October.