Politico's Pulse Check

The Trump administration is sending mixed signals to health insurers, pushing controversial changes to the ACA markets while giving big pay bumps in Medicare Advantage. Meanwhile, companies like UnitedHealth, Walmart and even Amazon are circling deals that could shake up the industry. To make sense of this moment, this week’s PULSE CHECK features John Gorman, the head of the Gorman Health Group — one of Washington’s most thoughtful experts on the health care industry and government health programs. John sits down with POLITICO’s Dan Diamond to discuss why he left government to open his own consulting firm (starts at the 1:25 mark), the growth of Medicare Advantage (5:30), the state of private insurers and the rise of UnitedHealth (8:30), the CVS-Aetna deal (15:45), Walmart-Humana’s possible deal and Amazon’s looming presence (20:00), the Trump administration’s impact on insurers (22:20), and a quiet change to Medicare Advantage that could let health plans tackle social determinants of health (28:15). We'd

The Trump administration has discarded or reworked a number of Obama-era programs. But this week's Health Datapalooza — an annual conference launched by Obama officials and hosted by Academy Health — has received the current administration's full support, a reminder that the desire to improve data can trump partisan politics. On the podcast, Academy Health CEO Lisa Simpson joined POLITICO’s Dan Diamond to discuss the Datapalooza conference (starts at the 1:25 mark), why the Trump administration continues to supports the event and how the White House has shaped the current climate for researchers (3:20), why Academy Health focuses on "health services research" and how Lisa would like academic research to change (8:15) and the state of data, particularly as Silicon Valley firms eye health care (13:30). After the break, POLITICO’s Mohana Ravindranath discusses her reporting on the Trump administration's data-access initiatives. (Starts at the 18:45 mark.) Dan also remembers POLITICO’s Brett Norman, who died l

In six weeks, Matt Eyles will become the CEO of America’s Health Insurance Plans, taking over for Marilyn Tavenner — one of the most prominent seats in health policy. But before that, Eyles sat down with POLITICO to preview his agenda, critique the Trump administration’s changes to the insurance markets and rebuff concerns that AHIP has lost influence in Washington. On the podcast, Eyles discussed what it’s like to be a lobbyist in the Trump era and how he arrived at AHIP (starts at the 1:30 mark); how his leadership will differ from Tavenner’s (6:05); his thoughts on UnitedHealthcare and other top insurers choosing to leave AHIP, and whether his organization has lost juice on Capitol Hill (9:00); his views on Medicaid and why AHIP is touting the public program's benefits (16:40); the Trump administration’s changes to Obamacare and the insurance markets (19:40); the employer insurance market (26:30); and insurers seeking mergers with players like CVS Health (27:30). After the break, POLITICO insurance repo

When the Affordable Care Act was first signed into law, the state of Virginia led the fight against it. Eight years later, Virginia — with state Democrats on the upswing — is on the verge of expanding Medicaid, and more than 300,000 state residents could get covered as a result. First, POLITICO reviews the windy road that led to 32 states saying yes to Medicaid expansion. Then Del. Alfonso Lopez, the whip for Virginia House Democrats, explains what's ahead as he and his colleagues work to finalize a Medicaid expansion deal. (Starts at the 8:20 mark.) We'd appreciate your help: Please share PULSE CHECK and rate us on your favorite podcast app! Have questions, suggestions or feedback — especially on an episode like this one, where we tried something a little different? Email ddiamond@politico.com. Referenced on the podcast: Virginia Republicans said the backlash to Medicaid expansion has been milder than expected: https://www.washingtonpost.com/local/virginia-politics/republican-medicaid-expanders-in-va-sa

The Trump administration has ushered in a new wave of conservative policies and personnel. But it’s also led to the rise of watchdog groups dedicated to investigating Trump and his agencies. And on this episode of PULSE CHECK, leaders of two new watchdogs discuss why they launched and what they’ve learned. First, Mary Alice Carter of Equity Forward joined POLITICO’s Dan Diamond to discuss her organization’s focus on the HHS officials overseeing reproductive health, and why she thinks Trump’s health policy moves are especially dangerous. (Starts at the 1:50 mark.) Then, Toly Rinberg and Rachel Bergman of the Sunlight Foundation’s Web Integrity Project discuss how their fledgling effort to track changes to federal webpages led them to Washington, D.C., and what they’ve uncovered at HHS and beyond. (Starts at the 17:10 mark.) We'd appreciate your help: Please share PULSE CHECK and rate us on your favorite podcast app! Have questions, suggestions or feedback? Email ddiamond@politico.com. Referenced on the po

Hurricane Maria made landfall in Puerto Rico nearly 200 days ago. For many residents — still dealing with power outages and no access to clean water — the disaster never ended. And while the national spotlight has largely moved on, Puerto Rico remains one of the worst public health crises unfolding in the United States. This week’s episode of PULSE CHECK tries to unpack the structural problems with the nation's disaster response and what it means for residents’ health. First, POLITICO’s Danny Vinik sits down with Dan Diamond to discuss his reporting on how the Trump administration favored Texas over Puerto Rico after devastating hurricanes struck. (Starts at the 1:15 mark.) Then Dr. Oxiris Barbot, First Deputy Commissioner of New York City’s health department, joins PULSE CHECK to explain why she’s so concerned about Puerto Rico’s ongoing health challenges and what she’s learned on her trips to the island. (Starts at the 13:40 mark.) We'd appreciate your help: Please share PULSE CHECK and rate us on your

Paul Winfree spent a year as one of the Trump administration’s key policy leaders, with a bunch of big titles — he was Deputy Assistant to the President for Domestic Policy, the Deputy Director of the Domestic Policy Council, and the Director of Budget Policy. Now Paul’s back at the Heritage Foundation, and he caught up with POLITICO’s Dan Diamond to share his view into Washington’s policy battles and what he learned from working in the White House. On the podcast, Paul explains why he took the job amid all the scrutiny of Trump (starts at the 1:26 mark), what it was like inside the administration during the ACA repeal-and-replace debate (5:30), what the White House should’ve done differently on health care (14:10), how Paul thinks about the ACA now (22:00), his thoughts on entitlement reforms (27:20) and what he learned from his time in the administration (30:40). We'd appreciate your help: Please share PULSE CHECK and rate us on your favorite podcast app! Have questions, suggestions or feedback? Email d

As Wisconsin governor, Tommy Thompson instituted welfare reform that became a national model. As HHS secretary, he created Medicare's Part D program. And as a boss, he played a pivotal role in the career of Alex Azar — who recently took over as the latest HHS secretary. Thompson sat down with POLITICO's Dan Diamond to discuss lessons from his four years running HHS under the George W. Bush administration (starts at the 1:45 mark), how he views the current HHS and what he's told Secretary Alex Azar (12:45), why he supports FDA reform and Medicaid work requirements (15:20), his post-government career in the private sector (18:10) and how he sees the current political environment (20:45). We'd appreciate your help: Please share PULSE CHECK and rate us on your favorite podcast app! Have questions, suggestions or feedback? Email ddiamond@politico.com.

HHS Secretary Alex Azar laid out an ambitious plan to promote value-based care this week, pledging that there's "no turning back" when it comes to reforming how hospitals and doctors get paid. What does it all mean? Karen Murphy's in position to know: She's the Chief Innovation Officer at Geisinger Health System, but she also previously worked in the Obama administration, helping to oversee value-based care efforts, and served as Pennsylvania's Secretary of Health too. Karen discussed how value-based care is playing out at the provider level, what she makes of Azar's comments on value-based care and medical marijuana, what Geisinger is doing on the biggest public health challenges and why she thinks every health care worker needs to do a stint in government. (Starts at the 18:20 mark.) But first: POLITICO's Sarah Karlin-Smith and Rachana Pradhan joined Dan Diamond to discuss the latest Trump administration changes to Medicaid, the most recent developments related to the opioid crisis and HHS' evolving comm

HHS last summer made a move that shocked public health leaders: The Trump administration abruptly canceled $200 million-plus in funding for dozens of teen pregnancy prevention projects around the country. HHS said the projects weren't working, but public health advocates argue that HHS' decision was politically motivated - just the latest round in Republicans' war on Planned Parenthood. One leader who's thrown herself into the fight: Patty Hayes, who oversees public health for 2 million people in Seattle and the surrounding King County - and sued HHS to try to get the money back. Patty joined POLITICO's Dan Diamond to discuss how moves in Washington, D.C., have affected her work in Washington State (starts at the 1:30 mark), how she views the Trump administration and why she's suing HHS (11:00), her local perspective on the opioid fight (19:55), the public health challenges that get overshadowed (26:00), and her own career as nurse-turned-public health leader and why she joined Twitter as @PurpleHayesRN (33

As a candidate, Donald Trump promised religious conservatives that their voices would be heard - and as president, he's repeatedly delivered through executive orders and agency moves that have been hailed by Christian conservatives. Rachel Laser, the new head of Americans United for Separation of Church and State, joins the podcast to review how Christian conservatives came to support Trump (starts at the 31:30 mark), how the Trump administration and specifically HHS have pushed policies for religious liberty (36:30), the appropriate role of religion in the public space (44:20), and the role of religious conservatives among HHS leadership (51:25). But first: POLITICO's Jennifer Haberkorn and Adam Cancryn join Dan to review Congress' latest changes to Obamacare (starts at the 1:45 mark), how new HHS Secretary Alex Azar is leading the agency (10:45), Mayo Clinic CEO John Noseworthy's retirement and hospitals' role in Washington (22:45), and which state is arguably most "important" in the current policy debate

Sam Quinones is the author of "Dreamland" — an award-winning book about the rise of the opioid crisis, which shows no signs of slowing. There were more than 64,000 deaths last year from drug overdoses, including opioids. Sam last month sat down with POLITICO's Dan Diamond to discuss how the opioid crisis got started, how he discovered the story and what he thinks health leaders and politicians should do next. Note: The audio quality on Sam's end is a little rough, but we wanted to bring you this conversation given the. And since Sam sat down for an interview, there have been a few developments — chiefly, the Trump administration this week proposed adding $13 billion in new funding to the opioid fight.

As CDC director, Brenda Fitzgerald should've been one of the nation's loudest voices on opioids and public health issues. Instead, she'd been remarkably quiet - recusing herself repeatedly from congressional hearings and other initiatives because of financial conflicts - and on Wednesday, she resigned after seven months in the job and one day after POLITICO revealed that she had bought tobacco stocks while running the CDC. Three of the POLITICO reporters who broke the Fitzgerald news - Brianna Ehley, Jennifer Haberkorn and Sarah Karlin-Smith - join PULSE CHECK to reveal details of their reporting (starts at the 1:45 mark), why Fitzgerald had lost confidence of lawmakers (7:30), what the Fitzgerald and Tom Price scandals say about the administration (10:30), and what this says about what's next for HHS under Alex Azar and the CDC (15:15). Then after the break, the Advisory Board Company's Rob Lazerow (starts at the 18:20 mark) sits down with POLITICO's Dan Diamond to discuss a much hyped story this week: Ama

Alex Azar was confirmed as the 24th Secretary of the Health and Human Services on Wednesday, about four months after Tom Price's abrupt departure. In a news roundup, POLITICO's Adam Cancryn, Paul Demko and Dan Diamond discuss Azar's confirmation, what his priorities are and what's next for the agency (starts at 2:20). Then after the break, listen to Dan's interview with Rod Hochman, CEO of Providence St. Joseph Health, one of the nation's largest hospital systems, where they discuss care delivery, health care venture capital and the hospital business model (starts at 21:45). The conversation was recorded at the J.P. Morgan Healthcare Conference earlier this month. We'd appreciate your help: Please share PULSE CHECK and rate us on your favorite podcast app! Have questions, suggestions or feedback? Email ddiamond@politico.com. Stories referenced on the podcast: Adam's story on Alex Azar's confirmation: https://www.politico.com/story/2018/01/24/alex-azar-secretary-health-confirmed-trump-nominee-365471 Dan

Karen DeSalvo was a top HHS official in the Obama administration, where she spent months simultaneously running the Office of National Coordinator for Health IT and serving as the acting assistant secretary for health. She also will be a familiar voice for longtime PULSE CHECK listeners: Karen appeared on an early episode of PULSE CHECK, where she talked about her work and her life story. (You can find a link to that earlier episode in the show notes below.) Karen and POLITICO's Dan Diamond caught up at the J.P. Morgan Healthcare Conference to discuss what she's been up to in the year since leaving HHS (starts at the 1:35 mark), how her old departments are performing under the Trump administration (starts at 7:15), whether the focus on social determinants of health is overblown (starts at 14:00), and her latest gig at the new Dell Medical School (starts at 22:00). Then after the break, Dan runs through some of last week's big health care stories that got overshadowed by Congress' fight over a government shu

The health care business world gathered at the J.P. Morgan Healthcare Conference this week, with thousands of attendees haggling over deals and gossiping over drinks in San Francisco. One of the standouts at the conference: venture capitalist Bob Kocher, a doctor and Obama administration alumnus known for his provocative thinking and Silicon Valley influence. At Venrock, Bob focuses on health IT and services, with investments in companies like Aledade, Castlight, Stride Health and Zenefits. Speaking with POLITICO’s Dan Diamond, Bob discussed his approach to investing in health care (Starts at the 1:20 mark), how he got into venture capital (8:15), the difference between innovating in government and the private sector (13:45), the sector’s never-ending job growth (17:15), how the current administration is affecting the health care market (21:15) and his 2018 predictions (28:00). There’s also a quick lightning round at 30:15. Then after the break, Dan caught up with Victoria Colliver, POLITICO’s California c

FDA’s influence can be summed up in a simple statistic: About 20 cents of every dollar that Americans spend is on a product — whether food, drug or tobacco — that’s regulated by the agency. But that enormous responsibility has also exposed the FDA to a broad array of critics, including President Donald Trump, who last year bashed the agency’s reviews as “slow and burdensome.” Trump’s pick to reform the agency? Commissioner Scott Gottlieb, who’s steered FDA since last May to the praise of conservatives — and, surprisingly in this political moment, some progressives who think he’s successfully balanced political pressures with public health priorities. Gottlieb joined POLITICO’s Dan Diamond to reflect on the agency’s 2017 achievements and why he joined the Trump administration (Starts at the 1:30 mark), the FDA’s nutrition policy and its role in keeping food safe (9:30), whether FDA is approving too many drugs (13:15), his to-do list for 2018 and looming policy priorities (19:00), the ongoing crisis in Puerto

On today's PULSE CHECK, we’re bringing you a bonus conversation that captures this moment in politics and one of the key voices shaping the debate — a discussion with activist Ady Barkan. A Yale-trained lawyer, Ady worked with the Center for Popular Democracy to push progressive economic policies and reform the Federal Reserve, high-profile battles that led POLITICO to name Ady to our list of 50 leaders and influencers in 2016. But Ady's life radically changed after a diagnosis of ALS last year. Now he's fighting to stop Republicans' tax bill and avoid possible cuts to Medicare — an argument that Ady made in a viral video where he confronted Sen. Jeff Flake aboard an airplane over Flake's support for the tax bill On today's episode, Ady discusses his life, his advocacy work and what average Americans can do to shape the policy debate. We’d appreciate your help: Please share PULSE CHECK and rate us on your favorite podcast app! Have questions, suggestions or feedback? Email ddiamond@politico.com.

Too often, there's too much media focus on Obamacare. But with a surprise Senate upset throwing a wrench into Republican repeal plans, and with HealthCare.gov sign-ups poised to end on Friday, this was a week to go a little deeper on the ACA. First, POLITICO’s Paul Demko discusses his reporting on the ACA enrollment period and insurers’ profitability (starts at the 2:25 mark), as well as the health care ramifications of the shifts in the Senate (16:00), with Alabama's Doug Jones and Minnesota's Tina Smith poised to join the Democratic caucus. Then after the break, Sarah Gollust — a University of Minnesota professor who studies health care and the media and has closely tracked advertising around the Affordable Care Act — joins PULSE CHECK to discuss her latest findings (starts at the 24:20 mark). We’d appreciate your help: Please share PULSE CHECK and rate us on your favorite podcast app! Have questions, suggestions or feedback? Email ddiamond@politico.com. Stories referenced on the podcast: Paul's story

Congress continues to try and hammer out a year-end spending bill, while outside of Washington, health care organizations dramatically ramped up their deal-making this week. First, POLITICO’s Sarah Ferris and Adriel Bettelheim join PULSE CHECK to parse what’s happened with the spending negotiations and what’s next. (Starts at the 1:30 mark.) After the break, Craig Garthwaite, a health economist with Northwestern University’s Kellogg School of Management, discusses why there were so many eye-catching health care mergers this week and what he likes about CVS’s $69 billion deal to buy Aetna. (Starts at the 16:00 mark.) We’d appreciate your help: Please share PULSE CHECK and rate us on your favorite podcast app! Have questions, suggestions or feedback? Email ddiamond@politico.com.