POLITICO's Pulse Check

Insurers like Aetna are dropping out. Rate requests are on the rise. It’s been a messy few weeks for Obamacare — and it’s Kevin Counihan’s job to clean it up. After Obamacare's exchanges sputtered to launch in 2013, Counihan was hired as marketplace CEO to make sure that a management mistake like that never happened again. But with major players like Aetna and UnitedHealth mostly walking away, and the remaining insurers asking for 24% rate hikes on average, Counihan's facing the biggest challenges of his tenure. Counihan sketches out his job as Obamacare’s marketplace CEO (starts at the 3:00 mark), explains how he’s thinking about the turnover in the market and why Aetna’s exit from 11 states is business as usual (4:30), who’s poised to win on the exchanges (9:45), how HHS is working to plug gaps as Aetna and other insurers walk away from markets (12:45), whether it matters if large insurers participate at all (19:00), how he’s approaching customers who are loath to purchase coverage (25:00), and why he’s not sweating Donald Trump getting rid of Obamacare (29:30). We’d appreciate your help: Please share PULSE CHECK and rate us on your favorite podcast app! Have questions, suggestions or feedback? Email [email protected].

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At the start of 2015, Marilyn Tavenner held one of the most important jobs in health care: Implementing Obamacare, as the head of CMS. Six months later, she'd swapped it for a completely different major role: Lobbying to change Obamacare, as the head of America's Health Insurance Plans. It's an unusual career shift, and it's given Tavenner — a long-time government official turned top lobbyist — a rare perspective on the changes unfolding in the industry. Tavenner talks about her early career as a nurse (2:20), her experience working for Tim Kaine in Virginia (5:30), the bumpy launch of Healthcare.gov and what Steven Brill's book gets wrong (9:45), what she'd have done differently as head of CMS and what she thinks of her successor Andy Slavitt (14:25), how she's doing on her top priorities and the reasons behind her unusual move from CMS to AHIP (17:50), the state of the health insurance industry (26:30), and what she sees ahead for Obamacare, Donald Trump, and more in 2016 (33:15). Plus: POLITICO's Paul Demko joins Dan to discuss his reporting on the health insurance industry. (39:50) We’d appreciate your help: Please share PULSE CHECK and rate us on your favorite podcast app! Have questions, suggestions or feedback? Email [email protected].

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As a top adviser to the Rubio campaign, Lanhee Chen fought Donald Trump's stampede through the primaries. Now he's coming to terms with the movement reshaping the Republican party — but that doesn't mean he's happy about it. Chen joined POLITICO's Dan Diamond to discuss his growing career as a TV pundit (starts at the 1:50 mark), what he learned as the policy director of the 2012 Romney-Ryan campaign (6:15), what a Romney presidency would've looked like (15:00), why the Rubio campaign failed and Trump won the nomination (18:00), where the GOP really stands on health care (24:15), his thoughts on Obamacare (32:15), and perceptions of a wonk gap between conservatives and liberals (38:00). Plus: Don't miss the lightning round quiz at 44:00. We’d appreciate your help: Please share PULSE CHECK and rate us on your favorite podcast app! Have questions, suggestions or feedback? Email [email protected].

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The politics of health care are messy. Obamacare is haunted by myths. And that's why Harvard's Kate Baicker — a former White House economist and one of the nation's most acclaimed researchers — is so focused on using evidence, not anecdotes, to shape America's health policies. Baicker talks about building a career in research (starts at the 1:55 minute mark), her pioneering work with the Oregon Health Insurance Experiment (8:45), what she thinks of Obamacare’s cost controls and President Obama’s pitch for a public option (24:30), whether the ACA did enough to bend the cost curve (34:00), and what beltway pundits get wrong about health policy (41:30). Plus: Don't miss the lightning round quiz at 46:10. We’d appreciate your help: Please share PULSE CHECK and rate us on your favorite podcast app! Have questions, suggestions or feedback? Email [email protected].

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Lamar Alexander is one of the most consequential legislators in Washington. The Tennessee Republican leads the Senate HELP committee — arguably the most important congressional committee for health care right now — and he's working to pass major bills on mental health, opioids and biomedical innovation and more. Sen. Alexander joined POLITICO’s Dan Diamond to discuss how his education background informs his perspective on health care(starts at the 2:40 mark), where several major pieces of health care legislation stand (9:45), why we need more funding for NIH (12:30), his thoughts on Obamacare (22:30), and what he learned from running for president and how he thinks about this year's race (29:45). We’d appreciate your help: Please share PULSE CHECK and rate us on your favorite podcast app! Have questions, suggestions or feedback? Email [email protected].

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House Republicans say they finally have a plan to repeal and replace Obamacare — six years after the Affordable Care Act passed. And Douglas Holtz-Eakin, who wrote Sen. John McCain’s health plan in 2008 and now runs the American Action Forum, insists we need to take it seriously. Holtz-Eakin joined POLITICO’s Dan Diamond to make the case for the GOP’s white paper (starts at the 3:00 mark), what conservative policy wonks want to change about taxing health insurance (8:50), how he grades Republicans’ signature health care ideas (13:00), why he’s pessimistic about the Affordable Care Act (19:45), how he thinks a potential President Donald Trump would use the plan (27:20), and what he learned from writing the 2008 McCain campaign’s health plan (30:45). Plus: Don’t miss the lightning round at 39:30. We’d appreciate your help: Please share PULSE CHECK and rate us on your favorite podcast app! Have questions, suggestions or feedback? Email [email protected].

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Medicare's planned Part B pilot is either a necessary fix to a broken drug payment system — or the first step to President Donald Trump dismantling the Affordable Care Act. It all depends whom you ask. And this week, we asked Peter Bach and Ted Okon — a high-profile proponent and opponent of Medicare's pilot, respectively — to make their case. Bach joined Dan Diamond to discuss why drug spending has become such a huge problem (starts at the 2:00 mark), why Medicare's trying to change how it pays doctors for drugs (6:00), and how he defends the pilot against charges that it's an over-reach (14:15). Okon joined Dan to explain his criticism of Medicare's pilot (25:20), why he thinks the Part B demo is a dangerous over-reach (34:50), and why oncologists are especially vulnerable to payment changes (43:00). Plus: POLITICO's Sarah Karlin-Smith and Brett Norman join Dan to referee the Part B fight and predict what happens next. (49:17) We’d appreciate your help: Please share PULSE CHECK and rate us on your favorite podcast app! Have questions, suggestions or feedback? Email [email protected].

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Peter Hotez has fought hookworm in Africa, demystified Ebola fears in America, and worked to eradicate many other infectious diseases over his storied thirty-year career. Now the Houston-based public health leader is confronting Zika — and he's worried that the Gulf Coast is in line for a financial and human disaster on the scale of Hurricane Katrina. Dr. Hotez joined POLITICO's Dan Diamond to discuss how poverty is making the world sick (starts at the 1:45 mark), how the United States is partially to blame for creating the West's mosquito problem (6:15), why he's concerned about Zika and partisan politics hurting public health (10:20), how the cost of Zika will rival a natural disaster (16:10), and why he's getting worried about an explosion of disease in Europe. (26:45) In a bonus, POLITICO's Paul Demko — who covers the health insurance beat — explains the latest news about Obamacare rate hikes and how it's playing on the campaign trail (31:30). We’d appreciate your help: Please share PULSE CHECK and rate us on your favorite podcast app! Have questions, suggestions or feedback? Email [email protected].

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Growing up, Karen DeSalvo never planned to have one of the nation’s most important health care jobs. Now she has two of them. As National Coordinator for Health Information Technology, she’s the White House’s point person on digitizing health care — and as acting Assistant Secretary for Health, she also helps guide the nation's public health strategy. Dr. DeSalvo joined POLITICO's Dan Diamond to discuss how she’s shaped by her upbringing (starts at the 1:20 mark), her perspective as New Orleans health commissioner post-Katrina (4:20), how she balances her two big jobs (15:45), the nation’s progress on digital records (20:00), and why white life expectancy has declined (32:00). Plus: Don't miss the lightning round quiz at 42:00. We’d appreciate your help: Please share PULSE CHECK and rate us on your favorite podcast app! Have questions, suggestions or feedback? Email [email protected].

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The nation's top infectious disease doctor doesn't scare easy. But Tom Frieden — the head of the Centers for Disease Control and Prevention — is deeply worried about the rise of Zika virus, which is spreading across the Americas and causing birth defects in babies. And he's shocked that Congress, which has refused to fund the White House's emergency Zika request, doesn't share his concern.

Dr. Frieden joined POLITICO's Dan Diamond to explain how he thinks about global disease threats (starts at the 2:00 mark), why Zika is posing an unprecedented threat (4:30) and why CDC desperately needs funding to fight the ongoing outbreak (8:50), what's behind the nation's opioid epidemic (17:20), and whether Americans' public health is really getting better (21:30) Plus: Don't miss the lightning round quiz at 24:50.

In a bonus, POLITICO's Nancy Cook — who's been tracking health care issues on the 2016 campaign trail — explains why Republican candidates for Congress are starting to talk about the opioid epidemic, and what we know about Hillary Clinton and Donald Trump's health plans (28:40).

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