| | | | |  | | By Ben Leonard and Chelsea Cirruzzo | | Presented by |  | | | | | | | 
Some Arizona voters support abortion rights while still backing Republican candidates who oppose them. | Frederic J. Brown/AFP via Getty Images | DEM ANXIETY RISES IN ARIZONA — PHOENIX — Battleground suburb voters in Phoenix and Tucson, Arizona, are increasingly telling canvassers and pollsters they plan to vote to overturn the state’s 15-week abortion ban but support former President Donald Trump and other Republicans, POLITICO’s Alice Miranda Ollstein reports. Those GOP candidates, including Senate hopeful Kari Lake, have a history of opposing abortion rights. It’s the latest warning sign for Democrats in the Grand Canyon State who hope the ballot measure could boost turnout and votes for their party. The state could be key in deciding control of Congress and the White House. “[Voters are] prioritizing other issues,” said Chris Love, a Planned Parenthood senior adviser and spokesperson for Arizona for Abortion Access. “I hear that a lot of times, even from Planned Parenthood donors, who tell me [they’re voting Republican] because they’re fiscally conservative.” Some conservatives fought to keep the measure off the ballot. Others now say they’re happy voters can support abortion rights while backing Republican candidates. “There’s going to be a tremendous amount of people who say, ‘OK, I think that my grocery prices are too high. I think the border is open. But I also like that proposition,’” said Caroline Wren, a senior adviser to Lake. The Harris campaign dismissed fears over “ticket splitting” and said their message to Arizona voters — that only the ballot measure and Democratic victories together can protect abortion access — is resonating. “We see the high support for pro-choice ballot initiatives as indicators that we have a lot of room to move people on this issue,” said a campaign official granted anonymity to discuss internal strategy. “We don’t expect the ballot initiatives to deliver these states for us, but in a close race, this is a motivating issue that could bring more people to Harris’ side.” Zooming out: Record-high support for abortion rights spurred by the fall of Roe v. Wade helped Democrats hold off an expected red wave in 2022 and flip key legislative and judicial seats. But it hasn’t always carried over into partisan races. As a slew of state abortion ballot measure campaigns try to court GOP voters and Republican candidates attempt to paint themselves as moderates, polling shows that many swing-state voters plan to vote for abortion-rights initiatives and for GOP candidates. WELCOME TO THURSDAY PULSE. The saga is over: DCA is adding five new flights. Send your tips, scoops and feedback to bleonard@politico.com and ccirruzzo@politico.com and follow along @_BenLeonard_ and @ChelseaCirruzzo.
| | | | A message from PhRMA: Drug price “negotiations?” Higher costs and less access to medicines are not what seniors were promised when the Inflation Reduction Act (IRA) was signed into law. Learn more about the IRA’s unintended consequences. | | | | | | | | 
A new Senate report reveals significant increases in care denials and prior authorization requirements by major Medicare Advantage insurers, including United Healthcare. | Patrick Sison/AP | MEDICARE DISADVANTAGE? Senate Democrats released a scathing report Thursday on Medicare Advantage care denials, finding that United Healthcare, the nation’s largest Medicare Advantage insurer, more than doubled the rate at which it denied care following hospital stays for its patients between 2020 and 2022, POLITICO’s Kelly Hooper reports. The report from Democratic staff on the Senate Homeland Security Committee’s investigative subcommittee found Humana’s denial rate for a similar type of care grew 54 percent during the same period. And at CVS Health, the number of care requests for similar services that the insurer required prior approval increased nearly 58 percent from 2019 to 2022. Spokespersons for CVS, United Healthcare and Humana pushed back on the claims, saying they're misleading. The bigger picture: The findings are the latest in growing scrutiny of Medicare’s private sector alternative and come amid bipartisan interest in changing the system. More than half of Medicare beneficiaries are now in Medicare Advantage. The report lands more than a year after the Permanent Subcommittee on Investigations launched a probe into the three largest Medicare Advantage insurers — Humana, United Healthcare and CVS Health’s Aetna — which revealed that the companies deny prior authorization requests for post-acute care at far higher rates than other types of care. Insurers argue they use prior authorization to ensure that all care is needed and to take on rising health care costs. A CMS spokesperson said the agency has “taken many steps to address the use of prior authorization by MA plans.” Chris Bond, a spokesperson for insurer lobby AHIP, said that tens of millions of people choose MA “because it provides them better care at a lower cost than fee for service.” Mary Beth Donahue, president of the insurer-funded Better Medicare Alliance, said the report paints a “misleading picture” of how the program operates” but also said it supports prior authorization reforms.
| | MAT ACT FOLLOW-UP — Reps. Paul Tonko (D-N.Y.), co-chair of the Addiction, Treatment and Recovery Caucus, and Mike Turner (R-Ohio), a caucus member, are gathering information from providers, insurers and other health care organizations in a bid to boost access to addiction treatment. Tonko and Turner wrote to dozens of major insurers, hospital groups, pharmacy chains and provider organizations in a bid to learn more about successes and barriers that remain since Congress passed the Mainstreaming Addiction Treatment Act in 2022, aimed at easing access to buprenorphine to treat opioid use disorder. The lawmakers hope it can inform future legislation. The history: In a bid to make the drug easier to prescribe, lawmakers eliminated the so-called X-waiver, which included a requirement that practitioners be trained to prescribe the treatment. But the eased requirements have yet to translate into more prescribing, DEA officials have said. Buprenorphine is itself an opioid intended to help patients wean off stronger opioids. Providers previously told POLITICO that a DEA system tracking suspicious orders, stigma, insurance coverage issues and state laws have all deterred more prescribing. “We must use every tool possible to realize the dream of the MAT Act,” Tonko said in a statement, pushing his legislation that would require the DEA to temporarily exempt buprenorphine from its suspicious order system.
| | LATEST VAX DATA — Preventable diseases are rising in the U.S. amid sliding vaccine coverage rates, which has led to an increase in measles outbreaks, whooping cough cases and pediatric flu deaths, setting a record last season. POLITICO’s Sophie Gardner reports that the latest data from the CDC shows another decline in vaccination coverage for kindergartners across all reported vaccines, disappointing health officials who had hoped for a rebound.
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| You can read more of Sophie’s reporting on the consequences here.
| | | | EPIC’S ANTITRUST DEFENSE — Epic, the electronic health records giant, is slamming an antitrust lawsuit filed by health IT company Particle Health ahead of Epic’s expected motion to dismiss the case. In a letter to Judge Naomi Reice Buchwald of the U.S. District Court for the Southern District of New York, Epic’s counsel called the lawsuit an “attempt to distract from the public reckoning” from a prominent data dispute involving the two companies. The letter is a preview of Epic’s anticipated arguments to get the judge to throw out the suit, which delves into the data dispute that has rattled the health tech industry and raised questions about data governance. “Instead of accepting responsibility, Particle launched this baseless lawsuit under the incredible notion that Epic violated the Sherman Act by … taking … steps to ensure that patient privacy was being protected,” attorney Lauren Moskowitz of law firm Cravath, Swaine & Moore. She argued Particle failed to show Epic engaged in anticompetitive conduct. A Particle spokesperson said the company is confident its case will survive a motion to dismiss. The background: Particle has claimed that Epic used its large market share to “coerce” Particle’s customers into leaving and launched a “smear campaign” against Particle. Epic has said Integritort, which provides analyses of medical records for legal cases, and other customers used Particle Health to improperly access its patient data through nonprofit data-sharing framework Carequality. Integritort has denied wrongdoing. The Carequality steering committee’s written resolution found that some Particle customers — were not or may not have been using the network for treatment purposes. Those customers’ names were redacted from the report. They will be barred from the network for a year under the resolution.
| | | | A message from PhRMA:   | | | | | JILL BIDEN TO TAKE STAGE — First Lady Jill Biden is taking the stage at a major health care conference in the final months of the Biden administration. She’s speaking next week at HLTH in Las Vegas, the conference announced Wednesday. She’ll focus on women’s health research, which has been a top priority for the first lady. Most recently, she announced last month that the Pentagon will invest $500 million in women’s health research. The speech before an audience of plugged-in health care industry insiders will be a chance for her to attempt to cement her legacy in health care.
| | Leslie Wheeler is joining Sloane & Company as managing director of its health care practice. She was previously at Spectrum Science. The Infectious Diseases Society of America has named Dr. Tina Tan as its new president starting Oct. 20. She’s a professor of pediatrics at Northwestern University’s medical school.
| | The Washington Post reports on “digital twinning” in surgery and other medical situations. The New York Times reports on Italy passing a law making it a crime to seek surrogacy abroad. Axios reports on private equity firms pulling back from investing in firms that could be hurt by the popularity of GLP-1 obesity drugs.
| | | | A message from PhRMA: Seniors are feeling the true cost of drug price “negotiations.”
Instead of saving money, some Medicare patients will pay more for medicines.
Others may not be able to get their medicines – 89% of insurers and PBMs say they plan to reduce access to medicines in Medicare Part D because of the Inflation Reduction Act.
Higher costs and less access. That’s not what seniors were promised.
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