Pence plugs enthusiasm gap for anti-abortion voters Presented by

Three ACOs have quit Medicare's latest high-profile program, and new data shows that physician compensation has continued to climb. But first: Mike Pence is officially Donald Trump's running mate, and his strong anti-abortion stance may boost Republicans on the campaign trail.

Pence plugs enthusiasm gap for anti-abortion voters. The Indiana governor’s long record of opposition to abortion has energized anti-abortion voters in a way that Trump has not, Pro's Jen Haberkorn writes.

Pence in the House wrote a bill to defund Planned Parenthood and other family planning clinics nearly a decade ago — long before it became a GOP policy staple — and as governor he has signed numerous restrictions into state law. Having him on the ticket gives anti-abortion voters more confidence that Trump will be a champion of causes that matter most to them. More for Pros.

What should moderate Republicans think of Mike Pence's health care positions? On "Fox News Sunday," host Chris Wallace pushed Paul Manafort, manager of the Trump campaign, about the Indiana governor's positions on health care.

"As governor, he signed a bill that would ban a woman from getting an abortion because her fetus has genetic abnormalities. A federal judge struck that down," Wallace said, also listing Pence's efforts to end federal funding for Planned Parenthood. "What should the moderate Republican woman … make of Mike Pence?"

"She should make of Pence, he's a man of principle," Manafort responded. "We think that the positions of Donald Trump … and Gov. Pence are in the mainstream of America."

WELCOME TO MONDAY PULSE — Where this weekend's fuss over the Trump-Pence campaign logo (since abandoned) may have been awkward, but nothing compares to the howling over the Arlington Pediatric Center's old logo. (We are not going to link it here; this is a family-friendly newsletter.) Tips and totally innocuous designs to [email protected] or @ddiamond on Twitter.

FROM THE WHITE HOUSE

Lower health care spending expected. The White House on Friday issued its mid-session budget review, saying that slow health care growth is one major reason why deficits have fallen faster than expected.

One key change: the administration now projects that the government will spend $308 billion less on the Affordable Care Act's premium tax credits and cost-sharing reductions over the next decade, given lower-than-expected ACA enrollment. The administration also projected $87 billion less in Medicare spending over the next decade.

Overall the review "slightly improves the outlook for the President's policies," the Committee for a Responsible Federal Budget says.

Biden wants to reframe the cancer 'moon shot.' The vice president, visiting Australia on Sunday morning, joked that he'd come to regret the label for the White House's cancer initiative.

“I almost wish we hadn’t called it the moon shot,” he said. “It really is more like the Manhattan Project, it really is about collaboration in a way that hasn’t happened before.”

… Of course, there are practical reasons for why the White House might not want to call its cancer-cure quest a "Manhattan Project," given that the effort to led to nuclear weapons. (Whereas the "moon shot" was about exploration.) And the U.S. government later acknowledged that the Manhattan Project and subsequent research into nuclear weapons resulted in higher cancer rates among workers.

… Meanwhile, the anniversary of the Apollo 11 moon landing — the original moon shot — is Wednesday, and Republicans have lined up several speakers likely to reference it. That's the day that former NASA astronaut Eileen Collins and space enthusiast Newt Gingrich are scheduled to speak at the GOP convention, along with Sen. Ted Cruz, who chairs the committee that oversees NASA. More from Mashable's Miriam Kramer: http://on.mash.to/29FkqMr

NEWS FROM THE HUMPHREY BUILDING

Is new ACO program just the 'next generation' of frustration? That's one potential takeaway, with three ACOs already quitting CMS's Next Generation ACO program, Modern Healthcare's Bob Herman reports.

The ACO program is voluntary, and CMS administrators have had trouble crafting a model that strikes the balance between encouraging payment reform while including penalties — especially after the earlier Pioneer ACO program was hit with massive defections. More: http://bit.ly/29N0hiz

A message from PhRMA: Today, there are several promising vaccine candidates in stage three clinical trials. These trials have tens of thousands of participants, from every walk of life. From development to robust clinical trials, and throughout manufacturing, these vaccine candidates follow the same rigorous process of other vaccines that have saved millions of lives. More.

EYE ON FDA

The agency publishes PDUFA agreement. The FDA on Friday outlined an agreement it reached with the pharmaceutical industry covering the agency's performance goals and industry user fees from 2018 to 2022.

The commitment letter follows months of negotiations and represents a major milestone toward the reauthorization of user fee legislation that Congress must pass before October of next year. More for Pros: http://politico.pro/29FkVWR

What's in it? A request for more than $110 million, 230 new staff. The agency is requesting more than $66.8 million in new prescription drug user fees between fiscal years 2018 and 2022 to support 230 new full-time staff members over the course of the next PDUFA with drug companies. The agency is also requesting an additional $8.73 million each fiscal year for other direct costs associated with new activities it will perform during this period. This will be adjusted for inflation each fiscal year.

More for Pros from Sarah Karlin-Smith: http://politico.pro/29Nm1RA

OPIOIDS

PDMP bill wins support from addiction-fighting groups. Anti-addiction groups are rallying to a bill that would tighten requirements that doctors and pharmacists consult prescription drug monitoring databases — an issue largely dropped from the Comprehensive Opioid Abuse Reduction Act, which is now before President Barack Obama.

The Prescription Drug Monitoring Act, introduced last week by Sens. Angus King, Amy Klobuchar and Joe Manchin, would restrict federal grants for fighting opioids to states that require prescribers to use a PDMP. More for Pros from Arthur Allen: http://politico.pro/2a0bkcr

MORE FROM THE TRAIL

Does the Republican platform imply that same-sex couples lead to less healthy children? On "Meet the Press," Chuck Todd pushed RNC chairman Reince Priebus about a provision in the draft Republican platform that says children raised in traditional two-parent households grow up to be healthier. "The facts lead to an inescapable conclusion that every child deserves a married mom and dad," the Republican platform reads.

"It's implying that somehow children of same-sex couples are more likely to be addicts, to engage in crime," Todd said.

"What we mean is that the best scenario for kids is a loving mom and dad," Priebus said, to defend the position. "It doesn't mean at all that single parents, that same-sex parents, that any parent in America can't love a child and can't raise a child … It just means what the facts say."

ICYMI: Pence thought threat of smoking was akin to drinking caffeine, driving sports-utility vehicles. "Despite the hysteria from the political class and the media, smoking doesn't kill," Pence wrote in a 2001 op-ed, blasting the government's deal with the tobacco industry. "A government big enough to go after smokers is big enough to go after you," he warned. Read the op-ed, which re-circulated this weekend: http://bit.ly/2alD3SK

INSIDE THE INDUSTRY

What doctors get paid. New compensation data compiled by Modern Healthcare reports that median annual compensation for physicians continues to outpace inflation. The specialties topping this year's list were:

· Orthopedic surgeons: $555,000

· Invasive cardiologists: $541,000

· Radiation oncologists: $500,000

· Radiologists: $475,000

Meanwhile, median compensation for family practice physicians and pediatricians was $229,000 and $224,000, respectively. More: http://bit.ly/2a2btha

AROUND THE NATION

Lessons from Indiana's Medicaid expansion model. Mike Pence's coverage expansion deal with the Obama administration suddenly got a lot more interesting. The state earlier this month sent to CMS its own interim evaluation on the first year of the expansion, known as Healthy Indiana Plan 2.0. Pro's Rachana Pradhan has takeaways on that and more from Missouri, Kentucky, California and Tennessee: http://politico.pro/29P1AAR

Drew Altman on Obamacare price hikes. The Kaiser Family Foundation CEO acknowledges that some double-digit rate requests in state exchanges are alarming and making news on the campaign trail — with Donald Trump citing one insurer's 60 percent proposed rate request as evidence of the ACA's flaws — but says that news reports are overblown.

"It would help counter public misperceptions if news reports explained that the proposed increases apply to only some of the 11 million people in the ACA marketplaces — and not everyone in the marketplaces or the 14 times as many people insured through their employer," Altman writes in the Wall Street Journal. "The more than 100 million people covered by Medicare and Medicaid are also unaffected in all this." More: http://on.wsj.com/29Tois8

AROUND TOWN

American Hospital Association names new chair-elect designate. Nancy Howell Agee, president and CEO of Carilion Clinic, will assume the chairmanship in 2018. Agee began her career as a nurse.

WHAT WE'RE READING

Former Senate Majority Leader Tom Daschle and former HHS Secretary Mike Leavitt argue that Congress should enact bipartisan, bicameral legislation to target Medicare's sickest patients. http://bit.ly/29NMfDr

Prime Healthcare figured out how make a profit in health care: through widespread fraud, the government alleges and Mike Hiltzik writes. http://lat.ms/29HfzXm

Herbalife will have to pay $200 million after settling with the FTC over charges that it deceived consumers. http://n.pr/29FNHGR

HHS Secretary Sylvia Mathews Burwell renewed her call for competition in the provider and insurer markets in an interview with Bloomberg's Zach Tracer on Friday. http://bloom.bg/2a9tfia

New York City hospitals are using the infamous eggplant and peach emojis on social media to reach young people about, well, you know. http://nyti.ms/2a1wOEy

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