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CMS head gets OK, but FDA chief pick remains elusive

The Senate yesterday confirmed Chiquita Brooks-LaSure to lead Medicare and Medicaid. But, four months in, President Biden still hasn't nominated anyone to lead the FDA.

Why it matters: The FDA has a slew of high-profile decisions coming up, as drug companies look to expand access to their COVID-19 vaccines and a controversial Alzheimer's drug awaits an approval decision.

The big picture: Federal health care agencies spend or regulate hundreds of billions of dollars per year. Getting those agencies staffed, especially in the midst of a pandemic, is extremely important for the Biden administration's domestic agenda.

  • The lack of a Senate-confirmed Medicare and Medicaid administrator had created some "drag" in the system as career staff held off on making certain decisions until political appointees are chosen, several lobbyists have told me.
  • And experts have said the same is likely happening at the FDA.

State of play: In March, a group of former FDA Commissioners urged the Biden administration to pick up the pace on picking a new FDA commissioner, the Washington Post reported.

  • Janet Woodcock, a longtime leader of the FDA office that reviews new drugs, has served as the interim commissioner since Biden took office in January. She's in running for the permanent job, but some Democrats fear she's too friendly with pharma.
  • Joshua Sharfstein, who served at the agency during the Obama administration and is seen as more wary of the drug industry, is also under consideration. The Wall Street Journal reported last month that the field of candidates had broadened to include at least three other people.
  • A senior Republican Senate aide told Axios' Caitlin Owens that between one and two dozen Republicans would likely vote to confirm Woodcock, but not Sharfstein.

Why the startup world needs to ditch "unicorns" for "dragons"

When Aileen Lee originally coined the term "unicorn" in late 2013, she was describing the 39 "U.S.-based software companies started since 2003 and valued at over $1 billion by public or private market investors."

Flashback: It got redefined in early 2015 by yours truly and Erin Griffith, in a cover story for Fortune, as any privately-held startup valued at $1 billion or more. At the time, we counted 80 of them.

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Scoop: Facebook's new moves to lower News Feed's political volume

Facebook plans to announce that it will de-emphasize political posts and current events content in the News Feed based on negative user feedback, Axios has learned. It also plans to expand tests to limit the amount of political content that people see in their News Feeds to more countries outside of the U.S.

Why it matters: The changes could reduce traffic to some news publishers, particularly companies that post a lot of political content.

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Scoop: Amazon quietly getting into live audio business

Amazon is investing heavily in a new live audio feature that's similar to other live audio offerings like Clubhouse, Twitter Spaces and Spotify's new live audio platform, sources tell Axios.

Why it matters: As with Amazon's efforts in podcasting and music subscriptions, the company sees live audio as a way to bolster the types of content it can offer through its voice assistant, Alexa, and its smart speaker products.

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Hurricane Ida exposes America's precarious energy infrastructure

The powerful hurricane that plunged New Orleans into darkness for what could be weeks is the latest sign that U.S. power systems are not ready for a warmer, more volatile world.

The big picture: “Our current infrastructure is not adequate when it comes to these kinds of weather extremes,” Joshua Rhodes, a University of Texas energy expert, tells Axios.

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"We must go further": 70% of adults in European Union are fully vaccinated

About 70% of adults in the European Union are fully vaccinated against COVID-19, Ursula von der Leyen, the president of the European Commission, said Tuesday.

Why it matters: The milestone makes the E.U. one of the world's leaders in inoculations, after an initially lagging vaccine campaign, the New York Times notes.

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What Elizabeth Holmes jurors will be asked ahead of fraud trial

Jury selection begins today in USA v. Elizabeth Holmes, with the actual jury trial to get underway on Sept. 8.

Why it matters: Theranos was the biggest fraud in Silicon Valley history, putting both hundreds of millions of dollars and thousands of patients' health at risk.

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