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With Alice Miranda Ollstein
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.
Quick Fix
— The Trump administration will announce its Medicaid block grant guidance on Thursday, POLITICO scooped.
— House Speaker Nancy Pelosi appears open to new drug-price talks with President Donald Trump if the president’s impeachment trial ends with his acquittal, POLITICO scooped.
— An Iowa health clinic has become a destination for uninsured Pacific Islanders whose homeland was used as a nuclear-bomb testing site.
WELCOME BACK TO MONDAY PULSE — Where it’s eight days until the State of the Union address. Seven days to the Iowa caucuses. Six days to the Super Bowl. And five days to Washington’s “health prom.”
If you’re attending at least one, this is the newsletter for you. (If you’re attending all four, we advise you to pack a change of clothes.) Tips to ddiamond@politico.com.
Driving the Day
COMING THURSDAY: BLOCK GRANT ANNOUNCEMENT — The White House signed off on a long-developing plan to overhaul Medicaid by letting states shift some program funding to block grants, POLITICO’s Dan Diamond scooped on Saturday.
“The status quo is unacceptable,” said a senior administration official. “We have to give states some more flexibility.”
The controversial plan — which CMS Administrator Seema Verma has developed for more than a year — targets Obamacare’s Medicaid expansion, POLITICO scooped last week. HHS and CMS declined to comment on pending announcements.
— CMS is billing Thursday’s event as “Transforming Medicaid: A New Opportunity for Better Health.” POLITICO obtained a copy of the invitation sent to outside groups.
— The yet-to-be-announced plan is already being panned by advocates and researchers, worried about patients and providers seeing significant cuts. “A modest suggestion for a more accurate event title: Capped Federal Medicaid Funding: A Fiscal Straitjacket for States Leading to Fewer People Covered, Less Access to Needed Care & Poorer Health,” tweeted Georgetown’s Edwin Park.
The plan also has faced skepticism inside the administration, given that it could arm Trump’s critics with more ammunition that he’s attempting to cut health services in an election year. Meanwhile, officials acknowledge that it’s guaranteed to be enmeshed in litigation.
— But it’s also a win for Verma, who just six weeks ago was fighting with HHS Secretary Alex Azar in a feud that put both of their jobs at risk. Barring some last-minute reversal, she’ll oversee a significant step toward a long-held conservative goal: Capping Medicaid spending.
“Putting forth the plan like this in an election year is risky,” the Minnesota StarTribune writes in an editorial. “But there’s an admirable, if brutal honesty about Verma’s willingness to outline what entitlement reforms would look like.”
PELOSI COULD SEEK TO REOPEN DRUG-PRICE TALKS WITH TRUMP — Wendell Primus, the speaker’s top health aide, has floated the idea of reopening the discussions after Trump’s impeachment trial ends with his expected acquittal, POLITICO’s Adam Cancryn and Sarah Karlin-Smith scooped on Friday.
Primus, in conversations with lobbyists and Democratic advisers, has suggested negotiating broad bipartisan legislation that could be included in a May health care package. Both parties see drug-price reform — a top priority for voters — as a key issue heading into the 2020 election.
— But the fight over direct negotiations could derail any talks. Democratic leaders want to empower the government to directly negotiate drug prices; Trump health officials and Republican lawmakers are calling the idea a nonstarter in any deal.
And while Primus has privately expressed optimism about restarting talks with the White House, Pelosi’s office was adamant that Democrats wouldn’t agree to a proposal that fails to empower the government to negotiate, Adam and Sarah report.
— What Pelosi’s spox says: “Drug price negotiation is essential to meaningfully lowering prescription drug costs, and Democrats will hold Senate Republicans and President Trump accountable to his broken promise to ‘negotiate like crazy’ on prescription drug prices,” Henry Connelly said. “Our position is that if President Trump actually wants to lower drug prices, he should pick up the phone and tell Senator McConnell to send him the House-passed Lower Drug Costs Now Act which provides the negotiations he promised the American people.”
THE IOWA HEALTH CLINIC THAT’S DRAWING PATIENTS FROM 6,000 MILES AWAY — Dubuque’s Crescent Community Health Center offers free or subsidized care to residents from the Marshall Islands, whose homeland was irradiated by the U.S. military decades ago, Dan Diamond reported from Iowa.
About 800 Marshallese now live in the small Midwest city, with more islanders relocating to Dubuque for a chance to see the doctor.
— The U.S. dropped dozens of nuclear bombs on the Marshall Islands across the 1940s and 1950s, spreading radiation that was linked to a surge of cancers and, in some places, remains at a higher level than Chernobyl. The islanders also face a slew of other health problems, like widespread diabetes and heart problems, with the average man on the islands dying before he turns 63.
— The U.S. government eventually promised that the islanders would get Medicaid, but Congress later took it away in a 1996 welfare reform bill. That lack of a safety-net health program is one reason why so many Marshallese are uninsured — and why the promise of free care in Dubuque is so alluring.
— Meanwhile in Congress: A small group of Democrats, currently led by Hawaii Sen. Mazie Hirono, has fought for more than a decade to restore Medicaid coverage for the Marshallese and residents of two other nations, Palau and Micronesia. Meanwhile, Rep. Tony Cárdenas (D-Calif.) led a companion bill in the House last year that picked up Rep. Steve Womack (R-Ark.), and later won over progressive leader Rep. Pramila Jayapal (D-Wash.).
But the provision — estimated at $350 million over a decade — fell out of the budget package in December, after the lawmakers failed to win over more members of both parties. They’re trying again for the budget extenders deal that’s due in May.
Public Health
CDC: FIVE CONFIRMED U.S. CASES OF CORONAVIRUS, WITH MORE EXPECTED — CDC on Sunday announced the three new cases, adding that another 100 people in the U.S. are being monitored for possible infection, though many will be ruled out, POLITICO’s Sarah Owermohle reports.
A CDC official also called the situation in China “alarming” but applauded officials there for working to contain the virus. Eighty deaths have been reported and about 2,750 people are infected, Chinese officials warned Sunday, as the nation has put more than a dozen cities under quarantine and shut down other travel.
— It will get worse: The spread of the virus is “accelerating,” Chinese leader Xi Jingping warned over the weekend. The demand for medical supplies is outpacing China’s ability to produce them.
— Meanwhile: Chinese scientists race to develop a vaccine. The Chinese Centre for Disease Control and Prevention announced on Sunday that researchers had isolated viruses and were selecting a strain, the South China Morning Post reports.
Around the Nation
HOUSE CANDIDATE PETITIONS FEC TO SPEND CAMPAIGN FUNDS ON HEALTH CARE — A Democratic House candidate running this year for an open seat in the Atlanta suburbs is petitioning the Federal Election Commission for permission to use campaign funds to cover her health insurance premiums. Although federal law bars candidates from using funds they raise for “personal use,” the agency has never determined whether health coverage qualifies as such, POLITICO’s Alice Miranda Ollstein reports.
Thirty-year-old Nabilah Islam, who is hoping to flip Georgia’s 7th district from red to blue, says quitting her job to campaign full-time for the seat meant foregoing health insurance due to the high cost of a plan on the individual market in a state that has not expanded Medicaid. A ruling in her favor, she argues in her letter to the FEC, would help address some of the financial barriers to running for office and increase diversity in Congress.
— Other progressive candidates and past candidates have voiced support for the petition, Alice writes. Tiffany Caban, who narrowly lost her bid for Queens District Attorney , said giving up her health insurance while campaigning nearly deterred her from running.
“We need to make it more feasible for working folx to run,” she tweeted about Islam’s petition.
Names in the News
PETE STARK, 1931-2020 — The fiery California congressman helped write COBRA, the 1986 law that lets people stay on their old employer’s health plan after they leave work; EMTALA, a major provision of COBRA that guaranteed emergency patients the right to be seen, regardless of ability to pay; and so-called “Stark laws” that sought to limit physician self-referrals and discourage perverse incentives.
Stark later wrote parts of the Affordable Care Act and repeatedly pushed for universal health care. But he also memorably sparred with other lawmakers and officials, including controversially criticizing then-HHS Secretary Louis Sullivan in 1990. The Washington Post’s obituary | The San Francisco Chronicle’s obituary| The National Academy of Social Insurance’s obituary
JOANNE CHIEDI joins DLA Piper. Chiedi, who was acting HHS inspector general before stepping down this month, is now chief administrative officer at global law firm DLA Piper. Chiedi had been at HHS since 2005, serving as a top official in the inspector general’s office and holding other management roles, and was previously at the Justice Department.
What We’re Reading
A doctor who got famous for diagnosing NFL brain disease now trades on his fame as an expensive expert witness, Will Hobson writes for the Washington Post.
The health care industry launched a lobbying blitz ahead of Congress’ year-end spending deal, Rachel Cohrs writes for Modern Healthcare.
More than 60,000 people in Idaho have already signed up for the state’s new Medicaid expansion, the AP reports.
Washing your hands is more important to protect against the spread of a coronavirus than wearing a mask, Roni Caryn Rabin writes for the New York Times.
