Presented by
With Sarah Owermohle, Renuka Rayasam and Rachel Roubein
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Quick Fix
— The feistiest Democratic debate yet centered on health care, with several candidates mounting vicious attacks over "Medicare for All" and Obamacare.
— Sen. Bernie Sanders signaled he would not release his medical records, reneging on earlier vows to be fully transparent about his health.
— Liberals are taking another shot at unseating Rep. Dan Lipinski, one of the few remaining anti-abortion Democrats in Congress.
THIS IS THURSDAY PULSE — Where our best wishes are with Minnesota Rep. Jim Hagedorn as he undergoes treatment for stage four kidney cancer. Hug your loved ones, call your parents, and only after you’ve done that, send tips to acancryn@politico.com and ddiamond@politico.com.
Driving the Day
KNIVES OUT: DEMOCRATIC DEBATE EDITION — Las Vegas hosted the wildest, sharpest, most entertaining Democratic debate to date — and across two hours of attacks and counterattacks, the conversation kept coming back to health care.
— Medicare for All was at the center of the bickering. Newcomer Michael Bloomberg took an early shot at Sen. Bernie Sanders (I-Vt.) over whether his Medicare for All plan has mass appeal, and the candidates were off — arguing repeatedly over the nuances of their proposals for achieving universal coverage.
— But there was a new edge to this debate. Former South Bend, Ind., Mayor Pete Buttiegieg and Sen. Amy Klobuchar (D-Minn.) attacked Sanders as forcefully as ever for refusing to detail how he’d pay for Medicare for All — prompting Sanders to hit right back. Joe Biden went after Bloomberg for calling Obamacare “a disgrace” in 2010, one of several moments that left the former New York City mayor flat-footed. And Sen. Elizabeth Warren (D-Mass.) targeted, well, everybody.
— WARREN’S strongest performance yet was fueled by detailed assaults on her rivals’ health plans. Buttigieg’s public option was “not a plan, it’s a PowerPoint.” Klobuchar’s vision was “like a Post-It note — insert plan here.” Sanders’ Medicare for All is “a good start,” but “instead of expanding and bringing in more people to help, instead his campaign relentlessly attacks everyone who asks a question.”
The upshot: What had been a rote topic of late feels fresh again, with Democratic contenders finding new ways to sharpen their health care differences and offer voters a window into their political visions.
THE NEW BLACK BOX: CANDIDATES’ HEALTH RECORDS — Sanders dodged a pointed question Wednesday night about earlier vows to be transparent about his health, in the latest signal he has no plans to release his medical records.
The moment is a reminder that voters know little about the health of those seeking the presidency, POLITICO’s Dan Diamond reports. None of the top dozen Democratic candidates have offered full health records, after Trump in 2016 released an infamous doctor’s note claiming he‘d be the “healthiest individual ever elected to the presidency.”
— Several candidates are set to turn 80 soon. Sanders and Bloomberg are both 78 and have had heart problems. Biden is 77 years old and Warren is 70.
Trump is 73, and has faced all manner of questions about his health — most recently in the wake of an unplanned trip to Walter Reed Medical Center in November.
— BUTTIGIEG pledged to undergo a physical if elected. “Transparency matters,” the 38-year-old said, linking Sanders' refusal to release more records to his unwillingness to detail how he'd pay for his sweeping plans. “I would look to the Obama standard of releasing not just a letter from a doctor, but actual results from a physical.“
2020 Watch
LIBERALS TAKE AIM AT ANTI-ABORTION DEMOCRAT — Progressives are mounting a fresh effort to oust Rep. Dan Lipinski, one of the few anti-abortion Democrats remaining in a House conference that’s moved notably left on the issue, POLITICO’s Shia Kapos reports.
The Illinois lawmaker has taken heat from liberals before and managed to keep his seat. But Lipinski’s race has taken on outsize importance this year, with Warren and Sanders joining a series of high-profile Democrats in endorsing his primary opponent, Marie Newman.
— The March 17 primary is a major test for the ascendant left, which is backing a series of challenges to Democratic incumbents. Justice Democrats — the group that helped get Rep. Alexandria Ocasio-Cortez elected — has endorsed seven candidates, including Newman, who are challenging incumbents.
Lipinski, meanwhile, has remained resolutely anti-abortion — and made the case that attempts to cut abortion critics out of the party “plays right into the hands“ of Trump.
Coronavirus
HOUSE DEMOCRATS' DEMANDS ON A CORONAVIRUS VACCINE — Nearly four dozen House Democrats will urge the Trump administration not to grant drug makers exclusive licenses for any coronavirus vaccines. Such monopoly rights could “result in expensive medicine that is inaccessible,” the lawmakers led by Rep. Jan Schakowsky (D-Ill.) wrote in a letter, which also calls for the administration to “use every tool” necessary to ensure any vaccine is affordable and intervene if a manufacturer sets prices too high.
— The request riled the drug industry. Pharmaceutical lobbyists tried to get some Democrats to take their names off the letter ahead of its finalization, a person with direct knowledge of the pre-emptive campaign told PULSE, by downplaying the taxpayer funds going toward coronavirus vaccine research and emphasizing the complexities of the drug development process.
NEJM: NEW EVIDENCE VIRUS COULD STEALTHILY SPREAD — Researchers in China suggest coronavirus-infected patients with minimal or no apparent symptoms could transmit the disease to others, according to new correspondence published by the New England Journal of Medicine.
The examination of 18 people found a similar “viral load” in both symptomatic and asymptomatic patients, they wrote. The findings could boost a theory that people can spread the coronavirus within days after being infected — unlike with the 2003 SARS outbreak, where transmission typically didn’t occur until days into the illness.
— Japan reports two new coronavirus deaths. The nation’s health ministry reportedly confirmed the deaths of two elderly Japanese citizens taken off the Diamond Princess cruise ship.
TEXAS RESEARCHERS MAP CORONAVIRUS — A team from the University of Texas and the National Institutes of Health created the first 3D atomic scale map of a part of the virus that infects human cells, a key step in creating a vaccine and antiviral drugs to combat the coronavirus. They published their results Wednesday in the journal Science, POLITICO's Renuka Rayasam writes.
The Texas team has already spent years studying other coronaviruses like SARS. Based on their previous research, they were able to create the 3D model of the coronavirus that originated in Wuhan within weeks of receiving a genome sequence of the virus from Chinese researchers.
Quotable
Vaping
TOBACCO HITS BACK AFTER BOOT FROM BLOOMBERG-BACKED EVENT — Philip Morris International has launched a mini ad campaign after one of its executives was barred from an e-cigarettes panel discussion Wednesday put on by Bloomberg Philanthropies-backed Vital Strategies, POLITICO’s Sarah Owermohle reports.
The tobacco giant took out ads on the New York Post’s site highlighting the issue, saying their “doors are open” to Vitals, the World Health Organization and other health experts who want to talk about cigarette alternatives like their heated tobacco device IQOS.
— Vitals isn’t backing down. The organization refuses to engage with Big Tobacco, mirroring the WHO’s approach to the industry — and has no plans to change even as more tobacco companies buy e-cig makers.
“The tobacco industry wants to be perceived as turning over a new leaf,” Vitals’ Sandra Mullin told Sarah. “The problem is that conventional cigarettes remain the bulk of the industry’s business.”
— Stopping Tobacco Organizations and Products, another Bloomberg Philanthropies-backed venture, separately published a report this morning alleging Philip Morris’ strategy of marketing IQOS at music festivals and fashion events targets youth.
Eye on FDA
FDA’S HAHN ADDS TWO ADVISERS — The new FDA commissioner is continuing to staff up, bringing on Jeet Guram and Tim Solberg as top advisers, POLITICO’s Sarah Karlin-Smith reports.
Guram, a senior adviser at CMS, will work on drug and tobacco issues for the agency. Solberg will focus on medical devices, and previously was a professor at the University of California, San Francisco.
Inside the Humphrey Building
IN SEARCH OF: FETAL TISSUE RESEARCH ADVISERS — HHS is seeking 15 advisers to help determine whether individual projects deserve federal funding, according to a notice scheduled to be published in the Federal Register today. Nominations are due in 30 days.
The panel was established after a controversial Trump administration review of fetal tissue research, which concluded last year that more oversight was needed — an outcome cheered by anti-abortion groups, which have argued that the research is unethical.
Scientists and abortion-rights advocates have panned the HHS review and upcoming panel, noting the department has created delays that have effectively stalled some research. “It’s critically important that research is done ethically, but what is unethical is undermining science at the behest of anti-abortion extremists,” said Mary Alice Carter of abortion rights watchdog Equity Forward.
Providers
PROVIDER GROUPS AIR CONCERNS OVER NEW CMMI MODEL — The National Association of Accountable Care Organizations and Premier, an alliance of health systems and providers, are asking CMS’ Innovation Center for more information on its new direct contracting model ahead of a key deadline.
Provider groups next week will have to apply to be part of the new Medicare payment model’s first wave. But in letters to CMMI Director Brad Smith, NAACOS and Premier wrote they’re lacking key information needed to weigh whether to sign up and asked for modifications to the model’s structure.
What We're Reading
An Indiana town could offer clues for combating the risk of drug-fueled HIV outbreaks, Kaiser Health News’ Laura Ungar writes.
Hundreds of New Jersey vape shop owners face the choice of rebranding or shutting down after the state outlawed nearly all nicotine vaping liquids, the New York Times’ Tracey Tully reports.
A biotech CEO who claimed his painkiller would replace opioids was sentenced to seven years in prison for defrauding investors.
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