| | | | |  | | By Ben Leonard and Chelsea Cirruzzo | | | | | | | 
Abortion opponents in Arizona want to reach voters with an anti-abortion message before abortion-rights advocates do. | Alex Wong/Getty Images | INSIDE ARIZONA’S BALLOT BATTLE — After a series of state losses, the anti-abortion movement is trying to stop voters from putting abortion on Arizona's 2024 ballot, POLITICO’s Alice Miranda Ollstein reports from Phoenix. Abortion rights groups are pushing to get 400,000-plus signatures by July to put a measure safeguarding access to the procedure up for a November vote. Anti-abortion advocates are trying to learn lessons from previous defeats in other states over the past two years, particularly mistakes like waiting too long to get involved. The bid to shoot down Ohio’s abortion-rights measure last November didn’t ramp up until two months before. At that point, some advocates said it was too late. “Most people had made up their minds already,” said Jeremiah Wilkerson, a Tucson-based anti-abortion activist who drove to Phoenix to attend Friday’s March for Life and knock on doors. Arizona is just one of many states with campaigns: Arkansas, Florida, Nebraska and South Dakota all have bids from abortion opponents trying to convince voters that the issue shouldn’t go to a popular vote. What it’s like on the ground in Arizona: The campaign leans into a “decline-to-sign” strategy since they lack the policies and levers of power conservatives use in other states. There’s no Republican attorney general willing to challenge the ballot measure in court or legislative supermajority wanting to change the rules to make it harder to qualify for the ballot. Activists mobilize where signatures are being gathered, and some try to reach voters with an anti-abortion message before abortion rights advocates do. Others use more confrontational methods, including tracking the locations of signature gatherers on a private channel, filming them and interrupting their work. On the other side: Thousands of abortion-rights canvassers — paid and volunteer — began gathering signatures across Arizona last fall. After crossing the quarter-million threshold in January, well ahead of schedule, the campaigns’ leaders say the decline-to-sign efforts are failing and might even be backfiring. “In some cases, it attracts more attention to our petition gatherers,” said Chris Love, a senior adviser for Arizona for Abortion Access. The abortion-rights coalition is working to gather double the number of signatures required in case any of the conservatives’ challenges prove successful. WELCOME TO WEDNESDAY PULSE. Senate Budget Committee Chair Sheldon Whitehouse (D-R.I.) unveiled a discussion draft today on bolstering primary care under Medicare. Reach us and send us your tips, news and scoops at bleonard@politico.com or ccirruzzo@politico.com. Follow along @_BenLeonard_ and @ChelseaCirruzzo.
| | | | A message from the Coalition to Protect America's Health Care: Half of our nation’s hospitals and health systems are operating at a loss. Tell Congress: Patients need policies that support access to lifesaving care from coast to coast. Learn more. | | | | | DON’T MISS POLITICO’S HEALTH CARE SUMMIT: The stakes are high as America's health care community strives to meet the evolving needs of patients and practitioners, adopt new technologies and navigate skeptical public attitudes toward science. Join POLITICO’s annual Health Care Summit on March 13 where we will discuss the future of medicine, including the latest in health tech, new drugs and brain treatments, diagnostics, health equity, workforce strains and more. REGISTER HERE. | | | | | | 
Dr. Robert Califf, head of the FDA, suggests the agency lacks the capacity to effectively oversee AI's safety and efficacy in healthcare. | Win McNamee/Getty Images | CALIFF’S AI ANXIETY — Ensuring the effective and responsible use of artificial intelligence in health care is too tall a task for the FDA to handle alone, Commissioner Robert Califf said Tuesday. “This issue is simply too large to be contained within the FDA,” Califf said at a webinar hosted by the Coalition for Health AI, which works with federal agencies. The group counts Google, Microsoft and Stanford Medicine among its 1,300 member organizations. Califf raised several concerns about AI’s future in the sector despite its promise, particularly that health systems lack sufficient infrastructure to determine whether AI has an effect on health outcomes. Two conditions must be met to ensure that such infrastructure is in place, Califf said. The first is an ability to monitor and test how algorithms change over time. He pointed to CHAI’s announcement Monday that it aims to support a network of assurance labs by the third quarter of this year. Assurance labs would validate and monitor AI and likely be housed in major universities nationwide. “It’s unclear how the performance of the models will be monitored at the scale that will be needed,” Califf said. The second is the ability to ensure “complete” follow-ups with the people the technology is used on, Califf said. Without a national approach facilitating data-sharing to follow patients, health systems can’t monitor them sufficiently, he added. The bigger picture: CHAI’s work with the FDA, the White House, HHS and the VA comes as regulators try to develop a framework to oversee AI, which could transform the sector. Despite the FDA’s authority to regulate some AI and recent rules from HHS’ Office of the National Coordinator for Health IT, significant gaps remain in ensuring AI transparency in health care.
| | | | JOIN US ON 3/21 FOR A TALK ON FINANCIAL LITERACY: Americans from all communities should be able to save, build wealth, and escape generational poverty, but doing so requires financial literacy. How can government and industry ensure access to digital financial tools to help all Americans achieve this? Join POLITICO on March 21 as we explore how Congress, regulators, financial institutions and nonprofits are working to improve financial literacy education for all. REGISTER HERE. | | | | | | | | | DEMS LEAN INTO IVF, ABORTION — Congressional Democrats’ State of the Union guests tell a familiar story: The party will continue to focus on abortion and reproductive rights. Sen. Patty Murray’s (D-Wash.) guest for the address Thursday will be Kayla Smith, who couldn’t get an abortion in Idaho because the state’s laws don’t have exceptions for fatal fetal abnormalities. Democrats also look to tout their commitment to protecting in vitro fertilization after the Alabama Supreme Court ruled last month that frozen embryos should be considered people. Sen. Tim Kaine’s (D-Va.) guest will be Elizabeth Carr — the first American to be born through IVF. Rep. Gerry Connolly (D-Va.) will bring Barb Collura, president of RESOLVE: The National Infertility Association. Sen. Tammy Duckworth (D-Ill.) and Rep. Lori Trahan (D-Mass.) have invited Drs. Amanda Adeleye and Pietro Bortoletto, respectively, who are both reproductive endocrinologists specializing in fertility care, POLITICO’s Megan Messerly reports. The bigger picture: It’s another sign of Democrats’ emphasis on abortion and reproductive rights in an election year, an issue they feel they have an advantage on over the GOP.
| | STAFFING UNDER THE MICROSCOPE — The House Ways and Means Committee is set to mark up legislation today to block the Biden administration’s proposed controversial nursing home staffing mandate. The legislation from Reps. Michelle Fischbach (R-Minn.) and Greg Pence (R-Ind.) would prevent HHS from finalizing its proposal to mandate for the first time that nursing homes maintain minimum staffing levels. The administration has said that close to 75 percent of facilities would have to add staff to meet the requirements. The proposal has provoked a significant lobbying effort from home operators concerned about the potential cost amid workforce shortages and patient advocates who want more stringent rules. The proposed regulations are part of the Biden administration’s bid to subject the industry to more scrutiny after the pandemic upended it. The panel will also examine two other bills: — The Kidney PATIENT Act of 2023, a measure that would delay CMS from moving oral-only drugs for chronic kidney disease into a different payment system that backers argue would restrict access and increase costs. It’s led by Reps. Buddy Carter (R-Ga.) and Ann McLane Kuster (D-N.H.) and has seven Democratic and five Republican co-sponsors. — The Real-Time Benefit Tool Implementation Act, which would require prescription drug plan sponsors to implement at least one electronic real-time benefit tool — which allows providers to see drug costs before prescribing — meeting requirements by Jan. 1, 2027. It’s led by House Budget Committee Chair Jodey Arrington (R-Texas) and Rep. Jimmy Panetta (D-Calif.).
| | HHS EYES PRIVATE EQUITY REGS — Three federal agencies are probing private equity’s control over health care, issuing a request for information Tuesday to get public input that could inform future regulation, Chelsea writes. The request for information, jointly issued by HHS, the DOJ and the FTC, is open through May 6. According to the Private Equity Stakeholder Project, a nonprofit watchdog group, at least 460 hospitals — including more than a quarter serving rural populations — are owned by private equity firms. The RFI “seeks to understand how certain health care market transactions may increase consolidation and generate profits for firms while threatening patients’ health, workers’ safety, quality of care and affordable health care for patients and taxpayers,” according to a DOJ press release.
| | | | A message from the Coalition to Protect America's Health Care:   | | | | | Lisa Lee has been elected rising board president of the National Association of Medicaid Directors. She’s commissioner for Kentucky’s Department of Medicaid Services. Dr. Joseph Kanter will become the CEO of the Association of State and Territorial Health Officials next month. He previously was state health officer at the Louisiana Department of Health.
| | | | DON’T MISS POLITICO’S HEALTH CARE SUMMIT: The stakes are high as America's health care community strives to meet the evolving needs of patients and practitioners, adopt new technologies and navigate skeptical public attitudes toward science. Join POLITICO’s annual Health Care Summit on March 13 where we will discuss the future of medicine, including the latest in health tech, new drugs and brain treatments, diagnostics, health equity, workforce strains and more. REGISTER HERE. | | | | | | | | | KFF Health News reports on a whistleblower lawsuit alleging Aledade used “billing software ‘rigged to make patients appear sicker than they were.” Aledade denies the allegations. The Associated Press reports on the White House ending its Covid-19 testing rules for those around Biden. The Military Times reports on the VA’s U-turn on banning an “iconic” World War II kiss photo from health care facilities.
| | | | A message from the Coalition to Protect America's Health Care: Hospitals and health systems provide 24/7/365 care for all patients and serve as engines of innovation and progress that are constantly pioneering new treatments, improving clinical outcomes, and enhancing patient safety.
Half of our nation’s hospitals and health systems are operating at a loss. More than 140 rural hospitals have cut services or closed altogether. Hundreds more are at risk.
The status quo is not sustainable. Policymakers must ensure hospitals have the resources they need to provide the care that patients deserve — and fight back against special interests like some corporate insurers who are pocketing record profits while jeopardizing Americans’ access to 24/7/365 care.
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