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Republicans demand answers on alleged 'race-based rationing' of monoclonal antibody treatments

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Republican lawmakers are demanding answers from the Biden administration after a viral video purportedly showed a man being denied monoclonal antibody treatment for COVID-19 because of his race.

In a letter to Health Secretary Xavier Becerra, 14 House Republicans led by Rep. Chip Roy (R-Texas) asked the Department of Health and Human Services to clarify why the administration is rationing the supply of monoclonal antibody treatments.

The letter is a follow-up to a previous inquiry from Roy asking HHS whether or not there was a "current or expected shortage of any monoclonal antibody treatments in the U.S.," a question Republicans said the Biden administration never answered.

"Despite HHS saying it is 'dedicated to transparency throughout this effort' multiple attempts from Congress to better understand HHS's role in regulating the mAb supply chain and distribution have gone unanswered," the lawmakers wrote on Tuesday.

"Now, we have heard of instances of individuals being refused mAb treatments, with a recent case regarding a man in Texas being refused treatment based on the color of his skin. Current Emergency Use Authorization guidelines list criteria for high-risk individuals including 'for example, race or ethnicity' in considering who receives treatment,'" the letter states.

The Republicans are referring to a viral video posted to Twitter by Harrison Hill Smith, a Texas-based blogger and self-described "Constitutional Extremist and Libertarian Nationalist" who claims he was "denied medical service because of [his] race."

In the video, Hill reportedly interacts with a Texas Department of Health and Human Services worker who told him he does not meet the eligibility criteria for receiving mAb treatment. The worker told Hill he is under 65, healthy, has no underlying medical conditions that put him at high risk for COVID-19, and as such "research shows that you should be able to fight off COVID."

When Hill asked if he would qualify for the treatment were he "black or hispanic," the worker said, "that's right."

Monoclonal antibody (mAb) therapy is a treatment for COVID-19 that studies have shown is effective at reducing the risk of hospitalization and death for patients with mild to moderate illness who receive early treatment. The Food and Drug Administration has granted emergency use authorization for mAb therapies to treat mild to moderate COVID-19 in adults and children older than 12.

In September, when mAb treatments were in high demand among seven red states, the Biden administration announced it would take over the distribution of mAb treatments to "maintain equitable distribution, both geographically and temporally, across the country." CNN reported at the time that Florida, Texas, Mississippi, Tennessee, Alabama, Georgia, and Louisiana accounted for 70% of monoclonal antibodies orders.

The guidelines for the state-funded Regional Infusion Center that operates in Tarrant County, Texas, say patients must meat at least one of several criteria to be eligible to qualify for COVID-19 therapeutics. The criteria includes being older than 65, being overweight, pregnant, having one of several preexisting health conditions, or being in a "high risk ethnicity group (Latino or Black)."

According to Roy's office, those Texas guidelines are based on federal guidelines that state "race or ethnicity" are among medical conditions or factors that may place individual patients at high risk of developing severe COVID-19.

The Republican letter asks Becerra to explain if there is a shortage of mAb treatments that makes rationing necessary and whether race or ethnicity is a factor in determining who gets rationed care.

"If there is no supply issue, as your Department's silence would indicate, then why is HHS rationing the treatment? Additionally, under no circumstance should an individual be turned away from receiving medical care due to the color of his or her skin," the letter states.

"Refusing to care for an individual based on the color of his or her skin raises very serious questions about potential violation of the 14th Amendment to the U.S. Constitution and the Civil Rights Act of 1964. Any guidelines, regulations, directives, or policies of any kind causing any doctor to deny access to care based on skin color should be immediately prohibited by your Department."

The lawmakers gave HHS a Nov. 29 deadline to respond to their inquiry.

HHS did not immediately respond to a request for comment.

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