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June 6, 2018

The results are in from 8 states' primary elections. Here's what they mean for health care.

Daily Briefing

    Eight states held primary elections Tuesday and results in several states suggest that health care will be a key issue in this year's midterm elections, Axios' "Vitals" reports.

    Before the midterms, learn how the Medicare ACO models stack up

    Spotlight on single-payer

    According to the New York Times, voters in Alabama, California, Iowa, Mississippi, Montana, New Jersey, New Mexico, and South Dakota cast their ballots Tuesday.

    Primary elections in California and Iowa provided a spotlight for candidates that support shifting the United States to a single-payer health system, raising questions about whether the Democratic Party will embrace such a push as part of its platform leading up to the midterms, "Vitals" reports.

    For instance, in California, Democratic gubernatorial candidate Gavin Newsom, who currently serves as the state's lieutenant governor, came out on top of the state's gubernatorial primary. Leading up to the election, Newsom's campaign had run ads touting his implementation of a near-universal coverage ordinance in San Francisco when he served as the city's mayor.

    Although primary races in some California districts remained too close to call as of this morning, candidates that support a single-payer system were leading in at least six of the seven California districts that "are key" to helping Democrats win control of the House, "Vitals" reports.

    But single-payer candidates were not as successful in Iowa. Cindy Axne—who supports implementing a public health insurance option over a government-run health insurance system—won the Democratic nomination for Congress in Iowa's 3rd District, beating candidate Pete D'Alessandro, who supports a single-payer system and was endorsed by Sen. Bernie Sanders (I-Vt.).

    Where other health care issues are likely to play a role in midterms

    Primary election results in other states suggest single-payer is not the only health care issue that could play a role in this year's midterm elections, "Vitals" reports.

    In Montana, Matt Rosendale, who currently serves as the state's insurance commissioner, won the Republican primary, setting him up to challenge incumbent Sen. John Tester (D-Mont.) in November. According to Axios, premiums for Affordable Care Act (ACA) exchange plans are set to be finalized this fall, and could end up being a source of criticism for both candidates—as Rosendale could face flack over how Montana has handled rising health insurance premiums, and Tester could be panned for supporting the ACA.

    In New Mexico, Rep. Michelle Lujan Grisham (D) won the Democratic gubernatorial primary despite recent criticism over how she profited financially from New Mexico's high-risk insurance pool. Lujan Grisham until last June had co-owned the company that ran the high-risk pool, according to Politico.

    In New Jersey, Bob Hugin, former CEO of the drugmaker Celgene, won the Republican primary, setting him up to challenge incumbent Sen. Bob Menendez (D-N.J.). According to "Vitals," the race "could be a wild one": Democrats have been focusing on high drug prices ahead of the midterms, but in a state where the pharmaceutical industry has a large presence, it is unclear if that strategy will help Democrats.

    Further, although Menendez won his primary race, nearly 40% of Democratic voters backed his challenger, raising questions about whether Democrats will vote for Menendez in the midterms, Politico reports. Menendez has been entangled in a federal corruption lawsuit that alleged he accepted gifts and campaign contributions from a Florida ophthalmologist in exchange for intervening in the provider's Medicare billing disputes. The Department of Justice ultimately dropped the suit, but Politico reports that the primary election outcome shows "many Democrats remain uneasy with" the senator (Baker, "Vitals," Axios, 6/6; Siders et al., Politico, 6/6; Diamond, "Pulse," Politico, 6/6; Petroski et al., Des Moines Register, 6/5; New York Times, 6/6).

    Before the midterms, learn how the Medicare ACO models stack up

    Hospitals, health systems, and physician groups across the country continue to evaluate the menu of Medicare ACO options. Whether applying for the first time, graduating to downside risk, or tracking CMS's evolving approach to ACOs, leaders need to understand the key details of each model.

    Download this new infographic to learn how the different Medicare ACO models stack up.

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