POLITICO's Pulse Check

The Trump administration has ushered in a new wave of conservative policies and personnel. But it’s also led to the rise of watchdog groups dedicated to investigating Trump and his agencies. And on this episode of PULSE CHECK, leaders of two new watchdogs discuss why they launched and what they’ve learned.

First, Mary Alice Carter of Equity Forward joined POLITICO’s Dan Diamond to discuss her organization’s focus on the HHS officials overseeing reproductive health, and why she thinks Trump’s health policy moves are especially dangerous. (Starts at the 1:50 mark.)

Then, Toly Rinberg and Rachel Bergman of the Sunlight Foundation’s Web Integrity Project discuss how their fledgling effort to track changes to federal webpages led them to Washington, D.C., and what they’ve uncovered at HHS and beyond. (Starts at the 17:10 mark.)

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Referenced on the podcast:

HHS’ move to remove lesbian and bisexual health content from its women’s health website, uncovered by the Web Integrity Project: https://www.politico.com/story/2018/03/21/hhs-strips-lesbian-bisexual-health-content-from-womens-health-website-430123

Equity Forward's focus on Scott Lloyd, the director of the HHS Office of Refugee Resettlement: https://www.equityfwd.org/research/personnel-policy-meet-anti-abortion-crusader-scott-lloyd/

Dan’s podcast with Seattle public health director Patty Hayes, who’s suing HHS over its move to cancel the teen pregnancy prevention program: https://simplecast.com/s/46ec2019

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Hurricane Maria made landfall in Puerto Rico nearly 200 days ago. For many residents — still dealing with power outages and no access to clean water — the disaster never ended.

And while the national spotlight has largely moved on, Puerto Rico remains one of the worst public health crises unfolding in the United States. This week’s episode of PULSE CHECK tries to unpack the structural problems with the nation's disaster response and what it means for residents’ health.

First, POLITICO’s Danny Vinik sits down with Dan Diamond to discuss his reporting on how the Trump administration favored Texas over Puerto Rico after devastating hurricanes struck. (Starts at the 1:15 mark.)

Then Dr. Oxiris Barbot, First Deputy Commissioner of New York City’s health department, joins PULSE CHECK to explain why she’s so concerned about Puerto Rico’s ongoing health challenges and what she’s learned on her trips to the island. (Starts at the 13:40 mark.)

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Referenced on the podcast:

Danny’s story on how Trump favored Texas over Puerto Rico in hurricane response: https://www.politico.com/story/2018/03/27/donald-trump-fema-hurricane-maria-response-480557

Reuters looked at Puerto Rico’s Medicaid shortfall: https://www.reuters.com/article/us-usa-puertorico-medicaid/puerto-rico-seeks-help-as-medicaid-crisis-deepens-after-maria-idUSKBN1D158Y

Quartz reports on the spike in suicide rates on the island: https://qz.com/1239417/after-hurricane-maria-suicide-rates-rose-by-almost-a-third-in-puerto-rico/

As mentioned on the show, PULSE CHECK listener AZ-CPA praised this recent episode on religious freedom in health care: https://simplecast.com/s/4ed0877f

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Paul Winfree spent a year as one of the Trump administration’s key policy leaders, with a bunch of big titles — he was Deputy Assistant to the President for Domestic Policy, the Deputy Director of the Domestic Policy Council, and the Director of Budget Policy.

Now Paul’s back at the Heritage Foundation, and he caught up with POLITICO’s Dan Diamond to share his view into Washington’s policy battles and what he learned from working in the White House.

On the podcast, Paul explains why he took the job amid all the scrutiny of Trump (starts at the 1:26 mark), what it was like inside the administration during the ACA repeal-and-replace debate (5:30), what the White House should’ve done differently on health care (14:10), how Paul thinks about the ACA now (22:00), his thoughts on entitlement reforms (27:20) and what he learned from his time in the administration (30:40).

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As Wisconsin governor, Tommy Thompson instituted welfare reform that became a national model. As HHS secretary, he created Medicare's Part D program. And as a boss, he played a pivotal role in the career of Alex Azar — who recently took over as the latest HHS secretary.

Thompson sat down with POLITICO's Dan Diamond to discuss lessons from his four years running HHS under the George W. Bush administration (starts at the 1:45 mark), how he views the current HHS and what he's told Secretary Alex Azar (12:45), why he supports FDA reform and Medicaid work requirements (15:20), his post-government career in the private sector (18:10) and how he sees the current political environment (20:45).

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HHS Secretary Alex Azar laid out an ambitious plan to promote value-based care this week, pledging that there's "no turning back" when it comes to reforming how hospitals and doctors get paid.

What does it all mean? Karen Murphy's in position to know: She's the Chief Innovation Officer at Geisinger Health System, but she also previously worked in the Obama administration, helping to oversee value-based care efforts, and served as Pennsylvania's Secretary of Health too.

Karen discussed how value-based care is playing out at the provider level, what she makes of Azar's comments on value-based care and medical marijuana, what Geisinger is doing on the biggest public health challenges and why she thinks every health care worker needs to do a stint in government. (Starts at the 18:20 mark.)

But first: POLITICO's Sarah Karlin-Smith and Rachana Pradhan joined Dan Diamond to discuss the latest Trump administration changes to Medicaid, the most recent developments related to the opioid crisis and HHS' evolving communication strategy (Starts at the 1:50 mark).

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Referenced on the podcast:

Sarah's story on Donald Trump's suggestion of using the death penalty to stop the opioid epidemic: https://www.politico.com/story/2018/03/01/donald-trump-death-penalty-suggestion-opioid-crisis-376176

HHS Secretary Alex Azar's remarks on value-based care: https://www.hhs.gov/about/leadership/secretary/speeches/2018-speeches/remarks-on-value-based-transformation-to-the-federation-of-american-hospitals.html

Penn professors Lawton Burns and Mark Pauly's article on value-based care: https://www.milbank.org/quarterly/articles/transformation-health-care-industry-curb-enthusiasm/

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HHS last summer made a move that shocked public health leaders: The Trump administration abruptly canceled $200 million-plus in funding for dozens of teen pregnancy prevention projects around the country. HHS said the projects weren't working, but public health advocates argue that HHS' decision was politically motivated - just the latest round in Republicans' war on Planned Parenthood.

One leader who's thrown herself into the fight: Patty Hayes, who oversees public health for 2 million people in Seattle and the surrounding King County - and sued HHS to try to get the money back.

Patty joined POLITICO's Dan Diamond to discuss how moves in Washington, D.C., have affected her work in Washington State (starts at the 1:30 mark), how she views the Trump administration and why she's suing HHS (11:00), her local perspective on the opioid fight (19:55), the public health challenges that get overshadowed (26:00), and her own career as nurse-turned-public health leader and why she joined Twitter as @PurpleHayesRN (33:00).

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Stories and audio referenced on the podcast:

DD's story on the conservative leaders on the rise at HHS: https://www.politico.com/story/2018/01/22/trump-religious-activists-hhs-351735

Last week's Pulse Check with Rachel Lazer of Americans United for Separation of Church and State: https://simplecast.com/s/4ed0877f

Last summer's Pulse Check with NYC health commissioner Mary Bassett and Chicago health commissioner Julie Morita: https://simplecast.com/s/ab9b9df6

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As a candidate, Donald Trump promised religious conservatives that their voices would be heard - and as president, he's repeatedly delivered through executive orders and agency moves that have been hailed by Christian conservatives.

Rachel Laser, the new head of Americans United for Separation of Church and State, joins the podcast to review how Christian conservatives came to support Trump (starts at the 31:30 mark), how the Trump administration and specifically HHS have pushed policies for religious liberty (36:30), the appropriate role of religion in the public space (44:20), and the role of religious conservatives among HHS leadership (51:25).

But first: POLITICO's Jennifer Haberkorn and Adam Cancryn join Dan to review Congress' latest changes to Obamacare (starts at the 1:45 mark), how new HHS Secretary Alex Azar is leading the agency (10:45), Mayo Clinic CEO John Noseworthy's retirement and hospitals' role in Washington (22:45), and which state is arguably most "important" in the current policy debate (27:25).

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Stories referenced on the podcast:

Jen's story on Congress removing the ACA's cost checks: https://www.politico.com/story/2018/02/19/obamacare-cost-checks-spending-deal-352346

Jen and Paul Demko's story on the IRS issuing millions of dollars in ACA employer mandate fines: https://www.politico.com/story/2018/02/20/trump-irs-obamacare-fines-tax-penalties-353614

Adam's story on Azar's priorities at HHS: https://www.politico.com/story/2018/01/24/alex-azar-secretary-health-confirmed-trump-nominee-365471

DD's story on HHS dismantling LGBT-friendly protections: https://www.politico.com/story/2018/02/19/trump-lgbt-rights-discrimination-353774

Jen's story on HHS working with a conservative group on an anti-Planned Parenthood policy: https://www.politico.com/story/2018/02/12/trump-hhs-planned-parenthood-policy-338084

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Sam Quinones is the author of "Dreamland" — an award-winning book about the rise of the opioid crisis, which shows no signs of slowing. There were more than 64,000 deaths last year from drug overdoses, including opioids.

Sam last month sat down with POLITICO's Dan Diamond to discuss how the opioid crisis got started, how he discovered the story and what he thinks health leaders and politicians should do next.

Note: The audio quality on Sam's end is a little rough, but we wanted to bring you this conversation given the. And since Sam sat down for an interview, there have been a few developments — chiefly, the Trump administration this week proposed adding $13 billion in new funding to the opioid fight.

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As CDC director, Brenda Fitzgerald should've been one of the nation's loudest voices on opioids and public health issues. Instead, she'd been remarkably quiet - recusing herself repeatedly from congressional hearings and other initiatives because of financial conflicts - and on Wednesday, she resigned after seven months in the job and one day after POLITICO revealed that she had bought tobacco stocks while running the CDC.

Three of the POLITICO reporters who broke the Fitzgerald news - Brianna Ehley, Jennifer Haberkorn and Sarah Karlin-Smith - join PULSE CHECK to reveal details of their reporting (starts at the 1:45 mark), why Fitzgerald had lost confidence of lawmakers (7:30), what the Fitzgerald and Tom Price scandals say about the administration (10:30), and what this says about what's next for HHS under Alex Azar and the CDC (15:15).

Then after the break, the Advisory Board Company's Rob Lazerow (starts at the 18:20 mark) sits down with POLITICO's Dan Diamond to discuss a much hyped story this week: Amazon, JP Morgan and Berkshire Hathaway's announcement that they're moving into health care.

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Stories referenced on the podcast:

Brianna and Sarah's story on Fitzgerald's resignation: https://www.politico.com/story/2018/01/31/cdc-director-resigns-over-financial-conflicts-380206

Sarah and Brianna's story on Fitzgerald's tobacco stock holdings: https://www.politico.com/story/2018/01/30/cdc-director-tobacco-stocks-after-appointment-316245

Jen and Brianna's original story on Fitzgerald's conflicts: https://www.politico.com/story/2018/01/18/cdc-director-avoids-congressional-testimony-297284

Paul Demko's story on Amazon, J.P. Morgan and Berkshire Hathaway's health care venture: https://www.politico.com/story/2018/01/30/amazon-health-care-business-316314

Rob's Advisory Board analysis of the Amazon et al deal: https://www.advisory.com/daily-briefing/2018/01/30/3-companies#ABCtake

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Alex Azar was confirmed as the 24th Secretary of the Health and Human Services on Wednesday, about four months after Tom Price's abrupt departure.

In a news roundup, POLITICO's Adam Cancryn, Paul Demko and Dan Diamond discuss Azar's confirmation, what his priorities are and what's next for the agency (starts at 2:20).

Then after the break, listen to Dan's interview with Rod Hochman, CEO of Providence St. Joseph Health, one of the nation's largest hospital systems, where they discuss care delivery, health care venture capital and the hospital business model (starts at 21:45). The conversation was recorded at the J.P. Morgan Healthcare Conference earlier this month.

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Stories referenced on the podcast:

Adam's story on Alex Azar's confirmation: https://www.politico.com/story/2018/01/24/alex-azar-secretary-health-confirmed-trump-nominee-365471

Dan's story on the religious activists on the rise at HHS: https://www.politico.com/story/2018/01/22/trump-religious-activists-hhs-351735

Paul's Pro story on the latest ACA enrollment figures: https://www.politicopro.com/health-care/article/2018/01/stagnant-enrollment-in-state-exchanges-masks-shake-up-in-marketplace-behavior-292657

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