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House Democratic sponsorship of ‘Medicare for all’ has actually fallen. Twenty-six House Democrats who signed on to a previous version of the Medicare for All Act have dropped off from the latest bill released Wednesday, as leaders are steering members to focus on shoring up Obamacare instead. Democrats picked up 40 House seats in November, but the number of lawmakers backing the Medicare for All Act so far has fallen to 107. That is fewer than the 124 co-sponsors the Medicare for All Act finished with in the 115th Congress. Three who have fallen off are high-ranking: Rep. Jim Clyburn, D-S.C., the House Majority Whip; Rep. Anna Eshoo, D-Calif., chairwoman of the Energy and Commerce’s Health Subcommittee; and Rep. John Yarmuth, D-Ky., chairman of the House Budget Committee. The split shows an ideological tension in the Democratic Party between those seeking to set an ambitious agenda that lays the groundwork for a liberal candidate to topple President Trump in 2020, and another faction that wants to rack up pragmatic victories for constituents. It’s possible, as well, that individual lawmakers have backed off the idea of a fully government-financed healthcare system in favor of keeping private insurers in the game.

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Democratic leaders want to prop up Obamacare. The chairman of the Energy and Commerce Committee, Rep. Frank Pallone, D-N.J., who hasn’t backed either version of the Medicare for All Act, has said that he wants to work first on fixing Obamacare. That’s the approach the healthcare industry is pushing for, and another large portion of the caucus wants to do the same. Rep. Debbie Dingell, D-Mich., co-chairwoman of the Medicare for All Caucus, said she is working on getting more co-sponsors, but even she indicated fixing Obamacare was the priority. “What I want to do right now is get pre-existing conditions taken care of,” she said. “We have got to do something to lower drug prices right now. People are hurting. It’s not either or. You’ve gotta have a vision. I’ve got a vision and we have to fix stuff now. You do both.” Some Democrats indicated they might again become co-sponsors later, such as Rep. Doris Matsui, D-Calif. “I really want to shore up the Affordable Care Act first,” she said. “That’s my first priority.” But for Rep. Zoe Lofgren, D-Calif., who co-sponsored only the former version, it’s the timeline of the bill that’s the rub. “I’m for ‘Medicare for All,'” she said. “But I think that bill is not the best way to achieve the goal. I think the two-year time frame is unrealistic.”

Then they’ll look at what to do with Medicare. Democrats vowed that, after working to protect Obamacare, then they would consider other options that would boost insurance rates and reduce the cost of coverage. “We are not going to enact ‘Medicare for All,'” Yarmuth said, alluding to the political realities of facing a GOP-controlled Senate and White House. “We’ll have a pretty good extensive debate on the variables in doing an expanded Medicare solution, and we are going to start that process in the Budget Committee.” The Budget Committee is looking at other bills that would expand Medicare, including legislation letting people buy into Medicare at a younger age. “I though it would be best for me to either not co-sponsor any of them or co-sponsor all of them,” Yarmuth said of the Medicare options on the table. “We have at least four different approaches introduced by members of the Budget Committee.” Eshoo, similarly, said that she is seeking to remain neutral toward the proposals in her role as the Health Subcommittee chairwoman, which she said was commonplace. “I want everyone that comes before the committee, anyone that has introduced a bill … some manifestation of universal healthcare, that they get a fair shake,” she said.

Republicans don’t want to revisit Obamacare. Undercutting the argument that Obamacare can be tackled first, however, is that Republicans don’t view it as an area of bipartisanship. A plan outlined by the centrist New Democrat Coalition on Wednesday is similar to an Obamacare stabilization package that failed last year in the Senate after Democrats objected to its anti-abortion language. Democrats have been unable to say how they would work around that impasse in pursuing the policy again. Sen. Lamar Alexander, R-Tenn., chairman of the Health, Education, Labor, and Pensions Committee, said at an Atlantic event that he was moving on from Obamacare. Pallone, who heard the remarks, said he “hadn’t given up.”

‘They are being totally dishonest,’ Cassidy says of Democrats supporting government healthcare. Sen. Bill Cassidy, R-La., on Thursday presented several arguments Republicans will make against a government-financed healthcare system, including that more than 150 million will be kicked off private health insurance and that Medicare is set to be insolvent 2026. “We are going to talk about the trade-offs, that it is cost versus innovation,” Cassidy told reporters at a roundtable held in his office. Republicans also plan to hammer Democrats on the cost, as no plan introduced has proposed a way to pay for the healthcare system. “They are being totally dishonest,” Cassidy said. “They want a bumper sticker saying ‘Medicare for all’ but they are hiding the cost and they are hiding the sacrifice.”

Senators will introduce legislation this month to fight surprise medical bills. A bipartisan group of senators will roll out a plan a the end of this month to protect patients from getting massive bills after a hospital visit. Cassidy, who is leading the effort, said in a meeting with reporters Thursday that the senators are talking about having more states set up an outside arbiter that works on settling medical bills so patients don’t have to get involved, among other ideas. “Providers and insurers are bringing us some really good ideas,” he said.

Pelosi on government healthcare: ‘How do you pay for that?’ “It’s not about what the benefits are,” Pelosi said when asked about the Medicare for All Act in a  Rolling Stone interview. “That is, administratively, the simplest thing to do, but to convert to it? Thirty trillion dollars. Now, how do you pay for that?” Pelosi went on to describe the current benefits Medicare has, and not the expanded version that liberal Democrats are proposing. She also held up Obamacare as a better example of healthcare policy.  “It doesn’t have catastrophic [coverage] — you have to go buy it,” she said. “It doesn’t have dental. It’s not as good as the plans that you can buy under the Affordable Care Act.” The vitriol over the ACA, she said, stem from what Congress has allowed to slip by the wayside. That doesn’t mean she is not willing to break the discussion down: “So I say to them, come in with your ideas, but understand that we’re either gonna have to improve Medicare — for all, including seniors — or else people are not gonna get what they think they’re gonna get.”

Poll: Huge majorities favor government action to lower drug prices. The public strongly favors sweeping government action to lower drug prices. According to a new Kaiser Family Foundation poll released Friday, seventy-nine percent agree that drug prices are “unreasonable,” and The vast majority of Americans agree that drug companies should list prices in their advertisements. There is also strong support for price negotiations between the government and pharmaceutical companies. 82 percent of seniors, the demographic most directly affected by changes to Medicare, are strongly in favor. Democrats generally support that policy, and Republicans and the industry oppose it. President Trump has criticized drug companies for high drug prices and backed Medicare negotiating some drug prices. Support, though, drops when people are told that it could lead to less drug research.

Anti-abortion group seeks to make Democrats pay for vote on abortion survivors. A national anti-abortion group is planning on making infanticide a key issue in the 2020 election campaigns by running ads and canvassing in battleground states targeting Democratic lawmakers who voted against the Born-Alive Abortion Survivors Protection Act in the Senate. The legislation, which would have required abortion doctors to provide adequate medical care for and report on the survivors of botched abortions, came to national attention and received a Senate vote after controversial comments from Democratic Virginia Gov. Ralph Northam about abortion legislation he favored. In his State of the Union Address earlier this month, Trump took aim at Northam over his comments on infanticide, saying Northam “would execute a baby after birth.” He tweeted Monday after the Senate Born-Alive vote that “[t]his will be remembered as one of the most shocking votes in the history of Congress.”

CMS updates hospital quality and performance data. The Centers for Medicare and Medicaid Services updated hospital performance data on the Hospital Compare site, which gives people information about how to find a hospital that meets their medical needs. “These decision-making tools offer greater transparency on hospital performance for a wide variety of users – patients, caregivers, families, and the broader healthcare industry,” CMS Administrator Seema Verma said in a statement. The American Hospital Association put down the website, saying CMS didn’t ask for the organization’s input and that the data aren’t reliable. The AHA wrote in a statement that the update doesn’t remedy what it considers to be an already flawed star rating system. The website first launched in 2005 and provides quality measures of more than 4,000 hospitals.

The FDA cautions the use of robotics in surgical cancer treatments. The Food and Drug Administration on Thursday issued a warning to healthcare providers and patients about using robotically assisted surgical devices. The administration hasn’t approved for any robotically assisted surgical devices to be used in cancer-related procedures, including mastectomies. The FDA has also received some reports showing negative outcomes of surgeries using these devices. Robotically assisted surgical devices allow surgeons to control surgical instruments attached to mechanical arms through a few very small incisions while viewing the surgical site in three-dimensional high definition. The method can help reduce pain, infection, and blood loss. “Certain patients with cancer may require surgical procedures to treat or prevent the spread of cancer in their body,” Dr. Terri Cornelison, assistant director for the health of women in the FDA’s Center for Devices and Radiological Health, said in a statement. “We are aware of scientific literature reporting that surgeons have been using the device for uses not granted marketing authorization by the FDA. We want doctors and patients to be aware of the lack of evidence of safety and effectiveness for these uses.”

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