With Susannah Luthi, Adam Cancryn and Renuka Rayasam
PROGRAMMING NOTE: Morning Pulse will not be published on Monday Jan. 20. We’ll be back on our normal schedule on Tuesday Jan. 21.
Editor’s Note: This edition of Pulse is published weekdays at 10 a.m. POLITICO Pro Health Care subscribers hold exclusive early access to the newsletter each morning at 6 a.m. Learn more about POLITICO Pro’s comprehensive policy intelligence coverage, policy tools and services at www.politicopro.com.
— Long-term health care and drug manufacturing were among the health care issues discussed at last night’s Democratic debate.
— The White House is elevating a health specialist to a broader role on its influential domestic policy council.
— The Supreme Court gave New York a week to respond on the “public charge” rule as justices weigh a Trump administration request to let the controversial immigration policy proceed.
WELCOME TO WEDNESDAY PULSE — Where if you watched Jeopardy’s special prime-time, we hope you knew the Obamacare clue (and remembered to phrase your answer in the form of a question). Thanks to POLITICO’s Renuka Rayasam, among others, for the tip.
Make it a daily double: Send tips to Dan Goldberg (firstname.lastname@example.org), who’s pinch-hitting on the newsletter tonight, or Dan Diamond (email@example.com), who returns to his regularly scheduled PULSE spot tomorrow.
TWO MOMENTS ON HEALTH CARE FROM THE DEMOCRATIC DEBATE — Last night’s debate mostly skipped over health care in favor of an expected focus on foreign policy, climate and the suddenly frosty relations between Sens. Elizabeth Warren and Bernie Sanders. And when health care did make an appearance, Democrats resumed their now-familiar attack lines on the cost of Medicare for All, the competing pitch for a public insurance option and whether either plan would be popular or bold enough to win broad support or fix gaps in the industry.
But a few health care moments jumped out to PULSE, including these two.
AMY KLOBUCHAR SPEAKS UP ABOUT LONG-TERM CARE — The Minnesota senator redirected a conversation about Medicare for All and the public option, shifting the focus to “long-term care — the elephant that doesn’t even fit in this room.”
Klobuchar then launched into a riff on her own family’s struggles when caring for her father. “We have to make it easier for long-term care,” she said. “It’s not just for the seniors — it’s also for the sandwich generation, people trying to help their parents.”
Long-term care hasn’t gotten much airtime in the Democrats’ debates, but there’s considerable evidence that it’s a worsening problem as the baby boomers age into retirement. A 2016 HHS report projected that 52 percent of Americans turning 65 would develop a disability that required long-term services and supports.
ELIZABETH WARREN DEFENDS HER PLAN TO MANUFACTURE DRUGS — The Massachusetts senator was pressed on her proposal to publicly manufacture generic drugs “wherever drug companies have warped markets to drive up prices.”
“Why does it make sense for the government … to manufacture drugs, especially when public trust in government is near historic lows?” CNN’s Wolf Blitzer asked Warren.
“The government lets contracts for all kind of things,” Warren countered, pointing to the government’s funding of military weapons, housing and more.
— PULSE takes issue with CNN’s framing, noting that the government already plays a trusted, major role in health care. The feds provide health insurance to more than 100 million people through Medicare, Medicaid and other programs; the government also directly employs doctors and nurses at public hospitals and in the military.
Moreover, “Gov’t already does drug manufacturing at NIH’s Vaccine Center, and [the Biomedical Advanced Research and Development Authority] and DoD have funded creation of manufacturing facilities for drugs including to respond to a pandemic influenza,” tweeted former HHS official Chris Meekins.
And while CNN is correct that public trust in government is low, it’s even lower for pharma — which ranked at the bottom of Gallup’s annual rankings on industry trust.
DOMESTIC POLICY COUNCIL TO ELEVATE HEALTH SPECIALIST MARIA BONNER — Bonner will be deputy domestic policy adviser under White House domestic policy chief Joe Grogan, two individuals with knowledge of the move told POLITICO’s Adam Cancryn and Dan Diamond.
An FDA regulatory expert who previously worked in Vice President Mike Pence’s legal shop, Bonner first joined DPC as a special assistant to the president in April, amid efforts to build out the Trump administration’s health agenda and drug pricing initiatives. The White House didn’t respond to request for comment.
SUPREME COURT GIVES NEW YORK A WEEK TO COUNTER TRUMP ON “PUBLIC CHARGE” — The high court gave New York and its allies until next Wednesday to respond to the Trump administration’s request to green-light the controversial immigration policy, POLITICO’s Susannah Luthi reports.
The rule would allow immigration officials to deny green cards to legal immigrants if they’ve received safety-net programs like Medicaid or food stamps or are deemed likely to do so. While federal judges blocked the rule’s slated October 2019 implementation, only one nationwide injunction — secured by New York Attorney General Letitia James and a band of not-for-profit groups — is still standing. The Justice Department in a surprise filing Monday night asked the high court to override that injunction so the Department of Homeland Security can start implementing the rule while the various lower courts resolve all the legal challenges.
— James and her allies mocked the DOJ request in a statement, calling it a “desperate attempt to expedite implementation of their racist wealth test for immigrants even before the government’s appeals have been heard by the high courts,” in a statement.
HOUSE E&C GOP: WE WANT ANSWERS FROM OPIOID MANUFACTURERS — Ranking member Greg Walden (R-Ore.), Oversight and Investigations Subcommittee ranking member Brett Guthrie (R-K.Y.) and Rep. Morgan Griffith (R-Va.) on Tuesday renewed an investigation into the role of Insys, Purdue Pharma and Mallinckrodt in the ongoing opioid crisis.
“We write today to reactivate the investigation started on August 2, 2018,” the members write in their letters, pressing for more information on alleged kickback schemes, sales decisions and other reports centering on each company.
TEXAS: MORE WOMEN TRY TO CARRY OUT THEIR OWN ABORTIONS — About 7 percent of women who sought an abortion in Texas first tried to end their pregnancies on their own with medication or using a home remedy, according to surveys and interviews conducted by UT’s Texas Policy Evaluation Project between 2012 and 2015. That’s more than three times the national rate of 2.2 percent of women who sought to manage their own abortions, the UT researchers write in BMC Women’s Health.
The women said lack of funds and local clinics as well as the stigma associated with the procedure drove them to attempt to end their pregnancies on their own, POLITICO’s Renuka Rayasam reports.
NATIONAL ASSOCIATION of ACOs announces 2020 board. The organization appointed Thomas Kloos of Atlantic ACO and Optimus Healthcare Partners as board chair, and Rob Fields of Mount Sinai Health System as chair-elect. The full board.
MARTY MAKARY named editor-in-chief of MedPage Today. The Johns Hopkins surgeon and author will serve in a senior role at the publication focused on clinicians, MedPage Today announced. “I am very excited about this partnership,” said Rachel Warren, MedPage Today’s senior vice president of editorial. (Must credit PULSE with the scoop.)
Middle-aged people are increasingly dying from heart disease in cities across the country — including exercise-mad Colorado, the Wall Street Journal’s Betsy McKay and Paul Overberg report.
More than 100 billion pain pills saturated the nation over nine years, Steven Rich, Scott Higham and Sari Horwitz report for the Washington Post.
An FDA lawyer said the agency is facing “unprecedented” strain in trying to produce documents in the Theranos legal case, Ross Todd writes for Law.com. That strain is being driven by expansive requests from Elizabeth Holmes’ and co-defendent Sunny Balwani’s legal team, Law360’s Dorothy Atkins wrote in a tweet thread.