| | | | |  | | By Ben Leonard and Chelsea Cirruzzo | | | | | 
Today's presidential debate is expected to draw attention to both candidates' positions on certain health care issues, including abortion. | Kevin Dietsch/Getty Images | DEBATE FOCUSED — There are several areas where health care is expected to surface during Thursday’s first presidential debate between President Joe Biden and former President Donald Trump, even if it isn’t expected to be its focus. Abortion and reproductive rights: Abortion is likely to be a topic at tonight’s presidential debate in Atlanta, one of a few health care issues we’ll be watching for. In the wake of the Dobbs decision, Biden and his campaign see his stance on abortion rights as a top issue to sell him to voters and draw a clear contrast with Trump. Polling shows Biden has a clear advantage on the issue. Even if Biden, a devout Catholic, has been hesitant to address the issue personally, his campaign and surrogates have hammered Trump for his position, portraying him as a broad threat to reproductive rights, including in vitro fertilization and contraception. Trump is undoubtedly expecting a grilling on the issue, as his stance has shifted over the years. He recently told House Republicans to message on abortion as an issue for the states to decide and cast Democrats as radical. Trump can also expect questions on his contraception view. He said last month he would “never” push for contraception restrictions — though his administration enacted some during his term — after he said he’s “looking at” them. Insurance: If the future of Medicare comes up, expect a war of words over protecting its future. Biden will likely cast Trump as a threat to Medicare after he floated cuts to entitlement programs, but Trump has said he would never put Medicare at risk. Anticipate that Trump would cast Biden as a threat to Medicare solvency. As he has recently, Trump could also attack Biden for his administration’s actions on Medicare Advantage payments as cuts, which CMS has cast as payment bumps. Trump has also floated finding a replacement for the Affordable Care Act, something Biden can be expected to seize on. Drug pricing: Expect Biden to pitch his administration’s work to lower drug prices, especially through the Inflation Reduction Act, and push to build on it by allowing Medicare to negotiate more drug prices. The law Biden signed allowed Medicare to negotiate drug prices for the first time. It also caps insulin co-pays for Medicare patients at $35 a month, something Trump has attempted to take credit for. His administration had a voluntary program, but Biden’s action is significantly broader. WELCOME TO THURSDAY PULSE. We’re enjoying the “Friends”-inspired video that Sen. Bill Cassidy’s (R-La.) interns made. Reach us and send us your tips, news and scoops at bleonard@politico.com or ccirruzzo@politico.com. Follow along @_BenLeonard_ and @ChelseaCirruzzo.
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The House Ways and Means Committee, led by Chair Jason Smith (left) and ranking member Richard Neal, is expected to mark up a bill that would expand Medicare coverage for weight-loss drugs. | Francis Chung/POLITICO | WHAT TO WATCH IN E&C, W&M — Although many eyes will be on today's presidential debate, several major health care bills are getting votes in two of the House’s most prominent committees. Weight-loss drugs: The House Ways and Means Committee is expected to mark up legislation that would lift Medicare’s decadeslong prohibition on covering drugs to treat obesity like Novo Nordisk’s Ozempic. It’s a slimmed-down version of the Treat and Reduce Obesity Act that would apply only to those who had gotten insurance coverage for the drugs on a health plan in the year before joining Medicare. The change could reduce its cost, which is a key issue. Telehealth: The House Energy and Commerce Committee is expected to mark up an extension of pandemic-era Medicare telehealth rules ahead of their expiration at the end of the year. An amended version of the bill obtained by POLITICO indicates it will be a two-year extension using changes to lab test payment and pharmacy benefit manager practices as pay-fors. Privacy: E&C is also set to mark up legislation that would establish a national data privacy standard with substantial implications for companies collecting data tied to customers’ health. That’s despite opposition from GOP leaders. CONFLICT OVER AI REGULATION — Rep. Ami Bera (D-Calif.), who serves on the House’s bipartisan AI task force, pushed back Wednesday on Republican leaders’ stance against new artificial intelligence regulation at an Amazon Web Services summit in Washington. In a recent meeting of GOP members of the task force, committee chairs and members expressed substantial concern about taking action “right now,” according to a person familiar with the meeting and granted anonymity to speak freely on the situation. House Republicans also won’t back legislation establishing new agencies or adding burden for technology developers, the person said. “That might not be the right thing,” said Bera, who is a doctor and recently asked for feedback from the health care sector on AI legislation. “The problem is the states are moving ahead. … it’s really dangerous if you have 50 different frameworks. That can really stifle innovation.” He said that given other countries’ efforts to regulate the technology, lawmakers should also think about how regulation will intersect internationally. He also said lawmakers must examine AI-related liability issues in health care and some potential “fixes” for the federal privacy law HIPAA. Bera backed the Biden administration’s transparency regulations for some AI. “If I’m a doctor and I’m using AI to help make a diagnosis, I should talk to my patients and explain to them how we’re using this tool to provide better patient care,” Bera said.
| | VA EHR WOES CONTINUE — Health providers and nonclinical workers continue to be deeply unhappy with Oracle Cerner’s overhaul of the VA’s electronic health record system, new survey data shows.
|  | | The VA and outside researchers presented a survey of more than 1,800 respondents, including providers and nonclinical workers Wednesday. In the survey, nearly two-thirds of respondents said they “strongly disagree” that they’re satisfied with the system. The dissatisfaction was generally similar across the VA facilities surveyed. More than half of them said the system doesn’t keep patients safe, well above levels of concern about other systems. The results also showed a significant majority of users think the system is making them less efficient than they could be. The reported inefficiency has fallen a bit in recent years, with 74 percent of users saying they “strongly disagree” or “disagree” that the system is making them as efficient as possible this year compared with 89 percent in 2022. Seema Verma, executive vice president at Oracle Health and Life Sciences, said in a statement to Pulse that the company has made “significant improvements to the system” in the past two years. VA spokesperson Terrence Hayes pointed to some of the improvements, and said the agency is aware that the EHR isn’t meeting expectations and it’s “holding Oracle Health and ourselves accountable to get this right.” “While our current progress in the program reset is reassuring, we still have important work ahead,” Hayes said. “We expect to see continued improvements at our current sites.” The bigger picture: The system rollout at new sites has been on pause for more than a year amid substantial budget overruns and patient safety issues. VA Secretary Denis McDonough said last month he hopes the agency can resume rollouts by the end of the fiscal year in September. The results echo previous clinician complaints that POLITICO has reported and suggest the agency and Oracle Cerner have a significant way to go in getting provider buy-in. Internal messages obtained showed frustration with outages and errors that prevent staff from filling prescriptions and referring patients to other providers, as well as patient safety issues.
| | | | SUBSCRIBE TO GLOBAL PLAYBOOK: Don’t miss out on POLITICO’s Global Playbook, our newsletter taking you inside pivotal discussions at the most influential gatherings in the world. Suzanne Lynch delivers the world's elite and influential moments directly to you. Stay in the global loop. SUBSCRIBE NOW. | | | | | | | | | WANTED: FEEDBACK ON AI PLAYBOOK — The Coalition for Health AI said Wednesday it’s soliciting feedback for 60 days on its standards guide aimed at informing the development and evaluation of artificial intelligence tools. The guide attempts to ensure that AI is useful, useable, transparent, safe and secure, among other things. The guide walks through six use cases for AI in the sector, including generative AI and prior authorization. CHAI says it will revise the guide based on comments. The public-private partnership is working on assurance labs that could validate and monitor AI in the sector. The guide, released Wednesday, includes checklists for use in those labs and elsewhere. “We want to hear from the stakeholder community: 'What did we miss? What did we get right that was helpful? What did we forget about? What was not accurate?” CHAI CEO Brian Anderson told Pulse.
| | | | The Wall Street Journal reports on mail-order drugs costing employers more than those picked up in person. POLITICO's Alice Miranda Ollstein and Josh Gerstein report on an opinion briefly posted showing the Supreme Court is poised to restore emergency abortion access in Idaho. POLITICO’s Sophie Gardner reports on the CDC updating its RSV vaccine recommendation for older adults. | | | | Follow us on Twitter | | | | Follow us | | | | |
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