| | | | |  | | By Chelsea Cirruzzo and Ben Leonard | Presented by the Healthcare Distribution Alliance | | | | | | 
Former President Donald Trump says Arizona went too far in its abortion ruling, and Republican candidates are falling in line with his view. | Joe Maiorana/AP | GOP, TRUMP VS. ANTI-ABORTION ACTIVISTS — Republican candidates are in step with former President Donald Trump’s call to leave abortion access up to the states — but not everyone is on board, POLITICO’s Alice Miranda Ollstein reports. Trump’s stance is in direct conflict with efforts by conservative lawmakers and activists to keep abortion-rights initiatives off state ballots. The gulf between Trump’s “let-that-be-to-the-states” view and the anti-abortion movement’s efforts underscores divisions that have dogged conservatives for two years since Roe v. Wade was overturned. Abortion-rights measures have won overwhelmingly when on the ballot, fueling calls on the right to take the matter out of voters’ hands and exacerbating existing tensions between Trump and the movement that helped carry him to the White House in 2016. Some abortion opponents argue it should be harder to change the state’s constitution, a process they see as too vulnerable to influence from out-of-state groups. Others insist that such referendums shouldn’t happen in the first place. Lila Rose, founder of the anti-abortion group Live Action, said Trump can’t credibly call himself pro-life anymore. And even anti-abortion groups that praised Trump’s abortion statement, including Students for Life, dispute his call to leave the issue up to states, arguing that the federal government is already deeply involved in abortion issues. Democrats and abortion-rights activists, meanwhile, are dismissing Trump’s “will of the people” call as empty rhetoric in light of the attempts to stymie state referendums on abortion access. Progressives note that the leave-it-to-states line obscures the fact that roughly half of states don’t allow citizens to collect signatures to put a constitutional amendment on the ballot, meaning millions of people in Texas, the Carolinas and other states with abortion bans have no direct democracy mechanism to overturn abortion rules. But for many conservatives, who believe elected legislators should set abortion policy, not a popular vote, this is a feature and not a bug. “People can engage their legislators — that is called the democratic process. That's why we have this whole checks and balances system,” said Susan Haugland, an activist with Arizona Right to Life. “But when you put something so radical and so extreme in the Constitution, to get that overturned is practically impossible.” WELCOME TO FRIDAY PULSE. Today’s newsletter is powered by this interesting segment from NPR’s Consider This about how the body positivity movement has been hijacked by brands to sell products, like processed snacks. Send your tips, scoops and feedback to ccirruzzo@politico.com and bleonard@politico.com and follow along @ChelseaCirruzzo and @_BenLeonard.
| | | | A message from the Healthcare Distribution Alliance: The healthcare distribution industry leverages its expertise and partnerships throughout the supply chain to solve some of the toughest healthcare challenges. Distributors deliver 10 million medicines across the country each day — from the biggest cities to the smallest towns – supporting providers and pharmacists and ensuring medicines are available to patients. Learn more. | | | | | | | 
Rep. Mike Bost took the VA to task at a hearing Thursday for the way the agency is implementing the Pact Act. | Manuel Balce Ceneta/AP | VA HIT ON PACT ACT — Rep. Mike Bost (R-Ill.), chair of the House Veterans’ Affairs Committee, is raising concerns that the VA isn’t following what Congress intended in terms of implementing the PACT Act, which expanded benefits for veterans exposed to toxins, Ben reports. Bost argued in a Thursday hearing on the VA’s budget request that the agency has used expanded payment authorities under the 2022 law “to spend themselves into a deficit,” meaning they’re struggling to afford employees. The VA wants a 10 percent bump in funding over 2023 levels, but Bost said the agency is putting money “in the wrong places” by moving expenses out of its base budget and into the Toxic Exposure Fund. “It is the opposite of what Congress intended when we provided those authorities,” Bost said. “I absolutely support the PACT Act, but VA’s implementation of parts of the law is getting very confusing.” The debt-ceiling deal prevented cuts to veterans’ health care, but Bost said the VA has been in a hiring freeze and had “budget problems.” VA’s side: Secretary Denis McDonough said that although it appears community care funding is down “at first blush,” the toxic exposure fund authority and other sources have allowed for more community care funding.” “One of the biggest changes in the last several years, partly because of your generosity over the course of many years during the pandemic, is additional funding streams,” McDonough told Bost. He said unspent money has been invested in medical care and added that the debt-ceiling deal forced “difficult choices.” “We are well-positioned to provide care,” McDonough said. THE E&C SHUFFLE — Rep. Troy Balderson (R-Ohio) will leave the House Energy and Commerce’s Communications and Technology Subcommittee to join the Health Subcommittee. House E&C Chair Cathy McMorris Rodgers (R-Wash.) said she’s shuffling some Republican members to new committees. Three Republican subcommittee members, Indiana’s Greg Pence and Larry Bucshon and Texas’ Michael Burgess, aren’t seeking reelection. McMorris Rodgers is also retiring.
| | | | YOUR GUIDE TO EMPIRE STATE POLITICS: From the newsroom that doesn’t sleep, POLITICO's New York Playbook is the ultimate guide for power players navigating the intricate landscape of Empire State politics. Stay ahead of the curve with the latest and most important stories from Albany, New York City and around the state, with in-depth, original reporting to stay ahead of policy trends and political developments. Subscribe now to keep up with the daily hustle and bustle of NY politics. | | | | | | | | MEDPAC SPEAKS ON TELEHEALTH — Research from Medicare Payment Advisory Commission analysts painted a largely positive picture of eased pandemic telehealth rules in a Thursday meeting of the panel, saying the measure didn’t impede in-person care, Ben reports. Telehealth usage fell substantially between 2020 and 2022 in traditional Medicare, federally qualified health centers and rural health clinics, the analysts found. But 90 percent of patients in a 2023 focus group of dozens were satisfied with virtual care, and 35 percent said they'd like telehealth to remain an option. The analysts also shot down common concerns about eased telehealth rules, including the proliferation of "telehealth-only providers." They found that just 1 percent of nonbehavioral health providers offered only telehealth in 2022. That share was 21 percent among behavioral health providers, though MedPAC analysts Brian O'Donnell and Ledia Tabor said telemedicine could expand access to behavioral health care. "It is unlikely that telehealth flexibilities are substantially impeding in-person care," the analysts said in a presentation. They said the return of in-person requirements used as guardrails could “disrupt established care patterns,” but policymakers could turn to scrutiny on "outlier physicians.” Still, they said some providers had concerns about conditions being missed during virtual visits, and patients and providers had “mixed” reactions about telehealth. Why it matters: As lawmakers weigh telehealth’s future with loosened Medicare rules expiring at the end of the year, some worry about cost, discouraging in-person care and fraud. They’ll likely consider MedPAC’s work.
| | | | A message from the Healthcare Distribution Alliance:   | | | | | AFTER THE UNWINDING — Nearly a quarter of people who lost coverage during Medicaid unwinding in early 2023 remain uninsured, according to a survey out today. KFF, a health research organization, surveyed more than 1,200 people enrolled in Medicaid in early 2023 before the end of the public health emergency, which ended continuous coverage and required states to again verify enrollment eligibility. Unwinding began across several states last April. One in 5 enrollees surveyed said they lost Medicaid coverage at some point last year. As of Thursday, more than 20 million people were disenrolled from Medicaid, according to KFF. Nearly 5 million children had lost coverage as of April 1, according to Georgetown University’s Center for Children and Families. Other findings: The survey also found that about half, or 47 percent, of people who were disenrolled said they had reenrolled in Medicaid, and 28 percent said they had another form of coverage. Many who tried to renew their coverage said they had difficulty because of long call-center wait times, incomplete documentation, or unreliable internet access. More than 50 percent of people who had problems renewing said they found the process difficult. In states that have yet to expand Medicaid, people surveyed were more likely to say they had to provide proof of residency to complete renewal.
| | | | A message from the Healthcare Distribution Alliance: Healthcare distributors work hard to ensure patients have the medicines they need. As the vital link in healthcare, distributors deliver medicines safely and reliably each day to nearly 330,000 frontline providers, pharmacies, hospitals and other sites of care across the country — from the biggest cities to the smallest towns.
When a supply chain disruption occurs, healthcare distributors are there to help lessen the impact. We're problem solvers: focused on collaborative solutions to reduce negative outcomes on patients and ensure a more resilient pharmaceutical supply chain. Learn more. | | | | | Clif Gaus, the longtime president, co-founder and CEO of the National Association of ACOs, will retire this fall.
| | POLITICO's Arek Sarkissian reports on how anti-abortion groups in Florida plan to block the implementation of a ballot measure that would protect the procedure if voters approve the initiative. The New York Times reports on a shortage of the global stockpile of cholera vaccines amid outbreaks. NBC News reports on a CDC report about a rise in measles cases this year that threatens U.S. elimination of the disease.
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