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Democrats debate tonight in Las Vegas as they jockey for position in Saturdays Nevada caucuses.

President Donald Trumps health IT plan could gift Silicon Valley with troves of sensitive medical data.

Voters' top priorities remain reducing health care costs and prescription drug costs, regardless of party, according to a new POLITICO-Harvard survey.

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WELCOME TO WEDNESDAY PULSE Where Joe Grogan may be in line for hazard pay after the White House domestic policy chief tweeted last night from the "occupied territory" of California. (The remark provoked frustration from watchdogs and even friendly fire from a certain Fox News host, but controversy sells: Grogan has gained nearly 10 percent more Twitter followers since yesterday.)

PULSE's tipline is open in every state: Find us at acancryn@politico.com or ddiamond@politico.com.

WHAT TO WATCH IN THE DEMOCRATIC DEBATE TONIGHT The 9 p.m. ET debate gives members of the dwindling Democratic field a primetime spotlight to make their case ahead of Saturdays election day.

Slated to be on stage: Sens. Bernie Sanders, Elizabeth Warren and Amy Klobuchar; former Vice President Joe Biden; and former Mayors Pete Buttigieg and Mike Bloomberg.

While Bloombergs surged into the race, buoyed by historic ad spending, tonight would be the first time that hes debated in an election since he ran for New York City mayor in 2009. The transition from well-heeled campaign rooms and soft-pitch TV commercials to a crowded debate stage could lead to a bumpy evening for the billionaire candidate, NYTs Matt Flegenheimer writes.

Expect BLOOMBERG to be pressed on his health care remarks. Sanders campaign has called attention to Bloombergs years-old statements about the need for entitlement reform, seemingly at odds with a Democratic primary thats focused on coverage expansion.

No program to reduce the deficit makes any sense whatsoever unless you address the issue of entitlements, Medicare, Medicaid, Social Security, interest payment on the debt, which you can't touch, and defense spending, Bloomberg said on Face the Nation in 2013. Everything else is tiny compared to that.

Both conservatives and progressives also have circulated a 2011 video clip that shows Bloomberg appearing to say that some elderly cancer patients should be turned away from care, given the cost.

SANDERS could be challenged on the prospects of "Medicare for All." Rep. Alexandria Ocasio-Cortez, one of the senators highest-profile surrogates, told HuffPost last week that a worst-case scenario with Sanders in the White House is a compromise on health care that ends up adding a public option. Some Sanders allies have acknowledged the long odds of getting his signature proposal through Congress, particularly given the likelihood that Republicans will retain control of the Senate in 2021.

But Sanders broke with Ocasio-Cortez on CNN last night, saying that his policy proposal is already a compromise and he doesnt plan to back off it.

SANDERS also reiterated: Hes not sharing any more medical records. I don't think we will, no, the 78-year-old candidate said on CNN last night. Sanders had promised to release comprehensive records after having a heart attack last year, and the apparent reversal could be a topic of conversation tonight.

Anti-Medicare expansion industry group tees up new ad buy. The Partnership for Americas Health Care Future will air a new ad during the debate criticizing Democratic candidates various universal coverage plans, the group told PULSE. The spot which will run on MSNBC and related digital properties groups Medicare for All with more incremental Medicare buy-in and public option plans, arguing that theyd all take choice and control away from patients and lead to higher taxes.

HOW TRUMP COULD HAND SILICON VALLEY YOUR HEALTH DATA A Trump administration bid to give patients more control over their health records could gift Silicon Valley with troves of sensitive medical data, POLITICOs Darius Tahir and Adam Cancryn report.

The long-germinating policy changes would let patients download health records onto their smartphones and direct it to apps of their choice. But they could also give rise to a new tech boom built on vacuuming up and reselling that personal data with few limits.

The issue has pitted GOOGLE and APPLE against EPIC, the health IT incumbent thats lobbied hard against the changes that could threaten its current market dominance. Yet lost in the clash of industry giants are privacy concerns that some consumer advocates argue the administration hasnt fully thought through. The health data is going to give them insights into many other aspects of your life, Jeff Chester, executive director of the Center for Digital Democracy, said of a tech industry already facing scrutiny over its use and protection of consumer data.

Silicon Valleys influential ally: JARED KUSHNER. The presidents son-in-law has played a crucial role in pushing the overhaul, alongside ONC Director Don Rucker and HHS Secretary Alex Azar, who see a chance to jump-start a slew of new health IT business models.

The chief financial officer at the now-shuttered Shelby Regional Medical Center admitted to a federal judge that he made false statements to CMS when he said in November 2012 the hospital was a meaningful user of EHRs that year. | M. Scott Mahaskey/POLITICO

TRUMP COMMUTES SENTENCE OF MEDICARE FRAUDSTER Judith Negron was convicted in 2011 over a $205 million fraud case that was, at the time, the biggest mental health billing scheme. Negron, who was the only defendant in the case to refuse a plea deal and go to trial, was subsequently sentenced to 35 years. See Negrons clemency petition. The Miami Herald has more.

Trump also pardoned MICHAEL MILKEN, the junk-bond king of the 1980s who was convicted of insider trading and later reinvented himself as a philanthropist and health care thought leader. The Los Angeles Times has more.

POLITICO-HARVARD POLL: ITS THE COSTS, STUPID Americans across the political spectrum primarily want one thing ahead of the 2020 election: Lower health care costs.

A new POLITICO-Harvard T.H. Chan survey finds reducing health care and prescription drug costs rank as voters top priorities regardless of party far outpacing the need for major overhauls like Medicare for All or addressing climate change. That suggests Americans are focused on immediate issues affecting their families, rather than the big policy debates that have consumed the Democratic presidential primary.

Eighty percent ranked lower health care costs as "extremely" or "very" important, and more than 7 in 10 similarly prioritized reducing drug prices. There was far less urgency for ideas like a Medicare buy-in or Medicare for All and the poll suggests even GOP voters are losing interest in the partys yearslong goal of repealing and replacing Obamacare. Just 37 percent of Republicans thought it crucial to take another run at gutting the health law.

MEANWHILE: UNIONS SPLIT OVER MEDICARE FOR ALL Organized labor is divided over the prospects for single-payer health care, with some unions worried that theyll lose health benefits that they spent years fighting to achieve, POLITICOs Ian Kullgren and Alice Miranda Ollstein report.

The feuding reached a fever pitch last week when the 60,000-member Culinary Workers Union declined to endorse any Democrat in Nevada, after slamming Sanders health proposal as a threat to the hard-won private health plans they negotiated at the bargaining table.

Its an extremely divisive issue within the labor movement, said Steve Rosenthal, a former political director for the AFL-CIO. Nobodys opinions will be changed during the presidential nominating fight, and unions may well be divided over Democratic candidates until the end.

FIRST IN PULSE: PROTECT OUR CARE TO HOLD 10 DAYS OF ACTION TIED TO OBAMACARE ANNIVERSARY The pro-ACA group is kicking off a bus tour and holding other events next month to celebrate 10 years since the health law was passed.

The bus tour begins March 15 in Minnesota and will stop in battleground states like Iowa, Michigan, North Carolina, Pennsylvania and Wisconsin. The bus will also stop in Washington, D.C., on March 23 the anniversary of the ACAs passage.

NEW SEVEN-FIGURE SURPRISE BILL AD BUY A coalition of largely insurer and employer groups is launching a new ad campaign slamming the policy fix doctors and hospitals support as one that raises costs for everyone.

The Coalition Against Surprise Medical Billing will run ads in the Washington area during prominent TV slots like the Democratic debates to oppose letting an independent mediator resolve payment disputes between providers and insurers.

The ads arent new for Beltway viewers, who often have seen the ads paired with a competing message from Doctor Patient Unity, funded largely by two private-equity backed physician staffing companies arguing for the policy insurers and employers hate.

But the new ad buy comes at a crucial time for surprise billing. Two House committees approved their own legislation last week, leaving four congressional panels to hammer out a fix before a May deadline to pass funding for key health care programs.

FIRST IN PULSE: SHARPTON RAILS AGAINST SURPRISE BILL PLAN The Rev. Al Sharpton is taking aim at major legislation to eliminate surprise medical bills in a letter to the Congressional Black Caucus, blasting a proposal backed by Senate HELP Chair Lamar Alexander and the House Energy and Commerce Committee as a bailout at the expense of Black patients.

Sharptons position puts him in line with hospitals and private equity-backed physician groups that have spent tens of millions of dollars opposing the plan, which would use a federal benchmark payment to settle most disputes between insurers and providers.

But Sharptons objections are misleading. The civil rights activist who says hes been very focused on surprise billing suggested the HELP and E&C bill would let insurers dodge paying for care and stick patients with big medical expenses.

Thats false: The legislation would establish a new system for determining how much insurers must pay providers for out-of-network costs patients couldn't have avoided, such as emergency care. And patients would enjoy new protections insulating them against huge out-of-network charges a feature of all the competing surprise bill proposals.

PAULSEN CHAIRING NEW GENE THERAPY LOBBY Former Minnesota Rep. Erik Paulsen is chairing a new lobbying group in town this one aimed at ensuring coverage for a slew of pricey new gene therapies.

The Institute for Gene Therapies isnt backing specific legislation or regulatory actions yet. But Paulsen, a Republican congressman for a decade before losing his seat in the 2018 Democratic wave, told POLITICOs Sarah Owermohle that the group is focused on steps the administration and Congress can take to accelerate insurer coverage of new treatments.

The Institute is funded by drug manufacturers. Its corporate advisory council includes multiple companies working on gene therapies including Spark Therapeutics, which sells an $850,000 treatment for a rare form of blindness. Johnson & Johnson, PTC Therapeutics and Sarepta Therapeutics are also among those on the council.

A message from Genentech:

Of the estimated 4,000 disease-related targets known to us today, only a quarter have a medicine that can reach and act on them. While some may find these elusive targets to be undruggable, our scientists are taking on this challenge along with our collaborators to pursue new treatment approaches, like T-cell therapy or individualized cancer vaccines. Learn about how were tackling challenges in drug discovery to drive scientific breakthroughs and bring new medicines to patients in our mission to drug the "undruggable."

If health economists ran the U.S. health system, there would be no Medicaid work requirements but people who engage in unhealthy behaviors could be charged more money, Austin Frakt writes in the New York Times, drawing on recent polling.

Missouri lawmakers confirmed that as many as 60,000 children were wrongfully removed from the state's Medicaid program, Joe Gamm writes for the Jefferson City News Tribune.

Meanwhile, a plan to expand Medicaid in Kansas which has the blessing of the state's GOP Senate leader is being held up by another GOP official who says she's worried about abortion spending, Leslie Aguilar reports for KCTV5.

One of the world's largest tobacco companies is struggling after failing to diversify into cannabis and vaping, WSJ's Alexander Gladstone reports.

Originally posted here:
What to watch in tonight's debate - Politico

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