Kaiser Health News - Politics

Tensions, Threats Emerge In Ariz. Medicaid Expansion Debate

Fri, 24 May 2013 13:41:00 GMT

In addition, the legislative debate continues in Texas while in Florida there's speculation about what's to become of the state's uninsured population now that the legislature didn't take action.

Arizona Republic: Threat, Vetoes Fly As Tensions Rise Over Medicaid Expansion
Gov. Jan Brewer sent five bills to the scrap heap Thursday in a pointed gesture intended to prod lawmakers into a deal on the budget and her plan to expand Medicaid. The five vetoes, follow-through on Brewer’s promise to block legislation until her top priorities move forward, capped a tense day that saw some lawmakers receive threats over their support for the plan to provide health care for more of the state’s poor (Pitzl, 5/23).

The Associated Press/Washington Post: Republican Arizona State Representative Says She got Threatening Message Over Medicaid Support
A Republican member of the Arizona House who supports GOP Gov. Jan Brewer's push to expand Medicaid received an obscene and threatening voicemail at her office, a sign that the rancorous debate over embracing a signature component of President Barack Obama's health care overhaul in the state is far from over (5/23).

The Texas Tribune: Amendment On Medicaid Expansion Unlikely To Stick
An amendment that blocks Texas from expanding Medicaid without legislative approval doesn’t seem likely to stick. The House on Thursday knocked down a nonbinding motion to instruct conferees to keep the "anti-Medicaid expansion" amendment when they meet with Senate members to work out the final language of Senate Bill 7 (Aaronson, 5/23).

Health News Florida: Left Out: FL's Poorest Uninsured
At 7 a.m. on a Monday morning, poor people who don't qualify for government health programs such as Medicaid are lined up outside a health department building on a busy street in St. Petersburg…These are some of the people who will not gain health insurance when the federal health law kicks into high gear on Jan. 1. They'll be left out because they are in Florida, one of the states that turned down federal funds to cover adults below the poverty level – people with incomes under about $11,500 (Gentry, 5/23).

State Highlights: La. Grand Jury To Examine $200M Medicaid Contract

Fri, 24 May 2013 13:11:00 GMT

A selection of health policy stories from Louisiana, Oregon, Connecticut, Kansas, North Carolina, California, and New York.

Modern Healthcare: States Delaying, Dropping Controversial Dual-Eligible Pilot Program
More than half of the states that applied to participate in a controversial CMS pilot for dual-eligible beneficiaries have either dropped out or delayed implementation of their programs, according to health policy experts. Among the 26 states that applied to participate in the CMS Financial Alignment Initiative, which stems from the Patient Protection and Affordable Care Act, six have dropped out or opted for different "customized" plans and nine have delayed their start dates (Daly, 5/23).

The Associated Press/Washington Post: Grand Jury To Look Into $200M Medicaid Contract Awarded By Jindal Administration
The Louisiana attorney general's office said a special grand jury was selected Thursday to look into possible criminal activity involving a $200 million Medicaid contract awarded by Gov. Bobby Jindal's administration. Assistant Attorney General Butch Wilson told a judge that the grand jury was being empaneled in Baton Rouge as part of an ongoing investigation into the now-canceled contract for Client Network Services Inc., or CNSI (5/23).

Lund Report: Regence Posts Strongest Profits In Oregon's Top Insurers
Regence BlueCross BlueShield of Oregon bolstered its position as the largest health insurance company in the state during the first three months of 2013. At the same, it also time delivered the strongest profits among large Oregon insurers. Regence BCBS total membership climbed by 18,800 lives during the first quarter of the year, to 491,702, and the insurer posted a $16.09 million profit, according to financial reports made available in the past week by the National Association of Insurance Commissioners (Sherwood, 5/23).

Oregonian: Nonprofit Health Insurers Often Beat For-Profits, But Not In Portland: Study
Nonprofit health insurers often beat the premiums of their for-profit competitors and usually provide better protections on out-of-pocket spending, according to a recent survey of six cities around the country, including Portland. Interestingly, in Portland the distinction between nonprofits and for-profits blurs, however. The survey, conducted by the free consumer information website, HealthPocket.com, analyzed more than 2,000 quotes, focused on individual female nonsmokers. It adds numerical context to the debate among health care insiders over the transformation of some nonprofit insurers (Budnick, 5/23).

CT Mirror: Senate Adopts Measure To Coordinate Care For Mentally Ill Children
The state Senate unanimously adopted a measure Thursday aimed at improving coordination between a wide array of caregivers and support services for children with mental illness. The bill, crafted in response to last December's tragic shooting at Sandy Hook Elementary School in Newtown, lays the groundwork for a more comprehensive, coordinated response by mental health agencies, schools and emergency mobile psychiatric services (Phaneuf and Becker, 5/23).

Kansas Health Institute: Network Execs Squabble Over Issue Of Exchange Connectivity
Following a heated exchange between two network chief executives, the board regulating digital health record exchange in Kansas voted Wednesday to prohibit the networks from charging each other connectivity fees until at least 2015. In Kansas, the exchange of digital patient information began last summer via two private networks licensed by the quasi-governmental Kansas Health Information Exchange, Inc. (KHIE) (Cauthon, 5/23).

North Carolina Health News: Bill Addresses Doctors & The Death Penalty
It’s been almost seven years now since the state of North Carolina carried out an execution, as the procedure has been subject to political pressure by anti-death penalty groups and caught up in court cases. One of the barriers to carrying out executions has been legal wrangling over the role of doctors in the procedure (Hoban, 4/24).

California Healthline: Task Force To Examine Developmental Centers
Diana Dooley, secretary of the state's Health and Human Services agency, yesterday announced formation of a task force to take a hard look at the viability of closing four developmental centers in California. "I don't know if the four developmental centers we operate can all close," Dooley said. … Developmental centers in California have come under fire recently -- with allegations of chronic abuse of patients, investigations by multiple government agencies and loss of federal certification. The state has taken a number of steps, particularly at Sonoma Developmental Center, to investigate possible abuses and improve safety of the centers' clients (Gorn, 5/23).

The New York World: No Restraint At Drug-Dosing New York Nursing Homes
A year after a federal health agency vowed to sharply reduce the use of powerful antipsychotic drugs in nursing homes, prescriptions have declined only modestly -- and dozens of New York City facilities have actually increased their use of the medications. In May 2012, the Centers for Medicare and Medicaid Services announced an initiative to reduce antipsychotic use in nursing homes nationally 15 percent by the end of 2012 (Skinner, 5/23).

House Panel Considers Measure That Would Ban Abortions After 20 Weeks

Fri, 24 May 2013 13:10:56 GMT

The bill, which is national in scope, is a response to the conviction of abortion provider Kermit Gosnell as well as a range of new state laws.

NPR: Abortion Opponents Try To Spin Murder Case Into Legislation
As predicted, abortion opponents on Capitol Hill are wasting no time in their efforts to turn publicity over the recent murder conviction of abortion provider Kermit Gosnell to their legislative advantage (Rovner, 5/23).

Politico: House Panel Considers Abortion Bill
A bill banning most abortions after 20 weeks nationwide received consideration from a House panel on Thursday -- and the Kermit Gosnell case and recent court rulings provided a fresh backdrop. But the same familiar arguments in the fight over abortion dominated the discussion (Smith, 5/24).

Health Care Issues Become Hurdle For Immigration Reform Measure

Fri, 24 May 2013 13:10:00 GMT

The key question that seems to have stalled progress for House lawmakers is how to handle immigrants who do not have health insurance.

Los Angeles Times: Immigrant Health Care Bills Stump House Group
Differences over whether immigrants should be deported for failing to have health insurance or pay their health care bills have stalled a bipartisan group of House lawmakers, who blew past a self-imposed Thursday deadline as they pressed forward on a sweeping immigration overhaul (Mascaro, 5/23).

The Wall Street Journal: House Immigration Effort Hits Bump In The Road
Last week, a bipartisan group of House lawmakers thought they had a broad deal on how to overhaul the immigration system. This week, they don't. The eight House lawmakers were forced to backtrack from the "agreement in principle" reached last Thursday after House Democratic leaders objected to a provision dealing with health care coverage for illegal immigrants living in the U.S., according to aides from both parties. The group continued to meet this week, and its members remained hopeful they would be able to strike a deal that passes muster among all involved (Peterson, 5/23).

Modern Healthcare: Taxpayers Won't Pay Health Care Costs For Undocumented Immigrants
Two days after the Senate Judiciary Committee passed a comprehensive immigration reform bill, House Minority Leader Nancy Pelosi (D-Calif.) promised that U.S. taxpayers would not bear the cost of health care coverage for undocumented immigrants who are on the path to citizenship. Earlier reports had hinted that the coverage provisions under the Patient Protection and Affordable Care Act might be a sticking point as House members draft their own immigration-reform legislation (Zigmond, 5/23).

Health Law Politics Swirl Around Scandal Reports, Implementation Frustrations

Fri, 24 May 2013 13:10:00 GMT

Some of the political ebb and flow is exactly as expected, with news reports noting that Rep. Michele Bachmann, R-Minn., a staunch opponent of the overhaul, is focused on linking the Internal Revenue Scandal with the health law. However, in other coverage, The Associated Press reports that some labor unions, which were strong advocates, have become increasingly frustrated with some aspects of the law, and The Hill notes that some business groups are voicing concerns about the measure's wellness program.

The Associated Press/Washington Post: Health Care Overhaul Faces Backlash From Once Supportive Labor Unions
When President Barack Obama pushed his health care overhaul plan through Congress, he counted labor unions among his strongest supporters. But some union leaders have grown frustrated and angry about what they say are unexpected consequences of the new law — problems that they say could jeopardize the health benefits offered to millions of their members (Hananel, 5/24).

The Hill: Businesses Share ObamaCare Wellness Program Worries With White House
Business groups are weighing in on an ObamaCare proposal governing incentives for employees to stay healthy. The White House is currently reviewing a proposed rule for wellness programs that give workers incentives to take part in healthy habits such as joining a gym, signing up for a weight-loss plan or participating in a scheme to stop smoking (Hattem, 5/23).

The Washington Post's The Fact Checker: Bachmann's Absurd Claim Of A Vast IRS Health Database Of 'Sensitive, Intimate' Information
With the Internal Revenue Service in the news, Rep. Michele Bachmann (R-Minn.) has taken the opportunity to marry that scandal with her ongoing battle against the president’s health care law, a.k.a. "Obamacare." The picture she has sketched is pretty frightening — that the "most personal, sensitive, intimate, private health care information is in the hands of the IRS" via a vast database. Indeed, even though our colleagues at PolitiFact and FactCheck.Org have beaten us to the punch on this language, the issues she has raised have generated enough buzz on the blogosphere that we believe we should weigh in as well. What is Bachmann talking about? (Kessler, 5/24).

McClatchy: Scandal Draws Questions About IRS Role In Enforcing Obamacare
The blossoming IRS scandal over the targeting of conservative groups is provoking new scrutiny and terse questions about the agency’s role in shaping and implementing the controversial new national health care law, with the biggest changes set to begin next year. The Internal Revenue Service is an important cog in the implementation of the Patient Protection and Affordable Care Act of 2010, commonly shorthanded as Obamacare. The tax agency must act on 47 provisions of the new law, more than half of those already in effect, including the more controversial ones taking effect in 2014 such as the requirement that nearly all non-elderly adults have health care coverage (Hall and Lightman, 5/23).

First Edition: May 24, 2013

Fri, 24 May 2013 11:11:54 GMT

Today's headlines include details on California's new health insurance exchange rates, whether consumers will experience "rate shock" and what these numbers say about the health law's implementation.

Kaiser Health News: California Insurance Exchange Rates: Not Too High, Not Too Low
Kaiser Health News staff writer Sarah Varney reports: "In the first disclosure of individual health insurance premiums by the nation's largest state, California announced on Thursday a wide array of choices for the 5.3 million people expected to qualify to purchase coverage through its online marketplace established by the Affordable Care Act" (Varney, 5/24). Read the story.

The Associated Press/Washington Post: Health Care Overhaul Faces Backlash From Once Supportive Labor Unions
When President Barack Obama pushed his health care overhaul plan through Congress, he counted labor unions among his strongest supporters. But some unions leaders have grown frustrated and angry about what they say are unexpected consequences of the new law — problems that they say could jeopardize the health benefits offered to millions of their members (5/24).

Los Angeles Times: New California Health Insurance Rates Unveiled
Amid anxiety over rising costs from the federal healthcare law, California received better-than-expected insurance rates for a new state-run marketplace, but many consumers still won't be spared from sharply higher premiums (Terhune, 5/23).

The New York Times: California Puts Tentative Price On Health Policies Under New Law
State officials said that rate increases for individuals who already had insurance would not be as high as some had feared. Blue Shield of California, for example, estimated its current customers would see rate increases of about 13 percent. Some estimates had suggested rate increases could be 30 percent. The increases are largely the result of higher prices and the need to cover people who now have no insurance and are likely to have expensive medical problems (Abelson, 5/23).

The Washington Post: California's Likely Health Insurance Rates Under New Law Are Lower Than Expected
California health officials on Thursday unveiled the likely rates that insurers will charge under President Obama’s health-care law — and they are lower than expected, rebutting warnings by critics that many people will experience "rate shock" once the law is fully implemented. On average, a person who chooses a mid-level plan can expect to pay around $321 a month, about $100 less than the amount projected by the Congressional Budget Office when the law was being debated in Washington (Somashekhar, 5/23).

The Wall Street Journal: California Outlines Health Premiums
Early results around the U.S. indicate prices for exchange plans will vary widely—both from state to state and among consumers—as will the effect of the law on premiums. In states such as Vermont and Rhode Island, with regulations somewhat similar to the federal law's rules, the legislation is having little effect on premiums. In other places, like Maryland and Kentucky, there have been signs of sometimes-large rate increases. In California, "we're getting the best-case scenarios" on rates, with some "far lower" than projected in an actuarial report commissioned by the agency, said Peter V. Lee, executive director of Covered California. He said costs would go up for some consumers, and down for others (Mathews and Radnofsky, 5/23).

The Washington Post's The Fact Checker: Bachmann's Absurd Claim Of A Vast IRS Health Database Of 'Sensitive, Intimate' Information
With the Internal Revenue Service in the news, Rep. Michele Bachmann (R-Minn.) has taken the opportunity to marry that scandal with her ongoing battle against the president’s health-care law, a.k.a. "Obamacare." The picture she has sketched is pretty frightening — that the "most personal, sensitive, intimate, private health-care information is in the hands of the IRS" via a vast database. Indeed, even though our colleagues at PolitiFact and FactCheck.Org have beaten us to the punch on this language, the issues she has raised have generated enough buzz on the blogosphere that we believe we should weigh in as well. What is Bachmann talking about? (Kessler, 5/24).

The Associated Press/Washington Post: Hobby Lobby Appeal Tests Limits Of Federal Birth-Control Coverage Mandate
In the most prominent challenge of its kind, Hobby Lobby Stores Inc. asked a federal appeals court Thursday for an exemption from part of the federal health care law that requires it to offer employees health coverage that includes access to the morning-after pill. The Oklahoma City-based arts-and-crafts chain argued that businesses — not just the currently exempted religious groups — should be allowed to seek exception from that section of the health law if it violates their religious beliefs (5/23).

Los Angeles Times: Immigrant Healthcare Bills Stump House Group
Differences over whether immigrants should be deported for failing to have health insurance or pay their healthcare bills have stalled a bipartisan group of House lawmakers, who blew past a self-imposed Thursday deadline as they pressed forward on a sweeping immigration overhaul (Mascaro, 5/23).

The Wall Street Journal: House Immigration Effort Hits Bump In The Road
Last week, a bipartisan group of House lawmakers thought they had a broad deal on how to overhaul the immigration system. This week, they don't. The eight House lawmakers were forced to backtrack from the "agreement in principle" reached last Thursday after House Democratic leaders objected to a provision dealing with health-care coverage for illegal immigrants living in the U.S., according to aides from both parties. The group continued to meet this week, and its members remained hopeful they would be able to strike a deal that passes muster among all involved (Peterson, 5/23).

Politico: House Panel Considers Abortion Bill
A bill banning most abortions after 20 weeks nationwide received consideration from a House panel on Thursday — and the Kermit Gosnell case and recent court rulings provided a fresh backdrop. But the same familiar arguments in the fight over abortion dominated the discussion (Smith, 5/24).

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States Embroiled In Medicaid Expansion Battles Are Running Out Of Time

Thu, 23 May 2013 14:09:00 GMT

Politico reports that this health law implementation issue remains an open question for about a dozen states. Some are on the brink of giving up for the first year but looking ahead to the next set of state legislature sessions. Meanwhile, news outlets report on related developments in Michigan, Texas, Ohio, California and Iowa.

Politico: Clock Ticking On Full Medicaid Expansion Funds
States still mired in the fight over the Obamacare Medicaid expansion are starting to give up on their first year of full funding — and it's unclear whether they would be able to tap into the money before 2015. Expansion remains an open question in about a dozen states after months of legislative fights. As more states continue to wrap up their budgets, some are already looking to next year's legislative sessions as their next shot at the expansion, even amid calls for state legislatures to return for special sessions (Millman, 5/23).

The Associated Press: Snyder: Mich. Could Still Get Medicaid Expansion
Republican Gov. Rick Snyder said Wednesday he is hopeful he can still broker an agreement with the Republican-led legislature to expand government health insurance for low-income adults, despite the state's tentative budget deal that leaves out the Medicaid expansion. Snyder told The Associated Press during an interview in Washington that while the budget deal he reached with GOP leaders in the legislature on Tuesday does not include the expansion, they could come up with a solution after the final budget is passed (Durkin, 5/22).

The Associated Press: After Steady Heckling, Perry Meets With Protesters
Hecklers demanding that Texas expand the Medicaid program under the White House-backed health care law repeatedly interrupted a speech by Gov. Rick Perry on Wednesday, then descended on his office for a meeting to keep pressing their case…Texas has the highest rate of uninsured in the nation, with about 6.2 million of its residents lacking health care coverage. Advocates say extending Medicaid as directed by federal health care reform could provide up to 1 million Texans with some coverage. But because Medicaid is a jointly funded federal-state program, Perry says embracing expansion could bankrupt Texas (Weissert, 5/22).

The Texas Tribune: Health Care Hecklers Meet With Perry
Gov. Rick Perry met with three health care activists who helped organize a protest of his speech before Austin business leaders Wednesday. Perry invited the activists to his office after a dozen or more protesters infiltrated a ballroom at the downtown Hilton Austin Hotel, where Perry was speaking before a gathering of the “2013 Global Business Summit” being put on by his office (Aaronson and Root, 5/22).

Des Moines Register: Expansion Includes State-Paid Premiums
After arguing for months over how to provide health care to poor Iowa adults, the Iowa Senate approved a compromise plan late Wednesday and sent it to the House. The proposal was expected to be considered today by the House, whose Republican leaders have endorsed it. Gov. Terry Branstad also supports it. The new Iowa Health and Wellness Plan would cover the same Iowans who would have been covered by Medicaid under President Barack Obama’s Affordable Care Act. But the approximately 150,000 people would have their health care covered in different ways. Poor adults making less than the federal poverty level, or about $11,500 per year for a single person, would qualify for medical benefits similar to what state employees receive. People making between that amount and about $16,000 could buy private insurance on the state’s new health insurance exchange. The government would pay premiums for at least the first year (Leys and Petroski, 5/23).

Columbus Dispatch: Bill In Ohio House Revives Medicaid Expansion
Rep. Barbara Sears, R-Sylvania, introduced legislation yesterday to provide coverage to an estimated 275,000 people with incomes under 138 percent of the federal poverty level. The cost would be paid entirely by the federal government for three years under the new health-care law. Sears said she hopes to win passage of the legislation by the end of June to give state Medicaid officials the six months they say they need to implement an expansion by Jan. 1. That’s when the federal aid becomes available, and it’s also when most Americans must have health coverage or face penalties. House Speaker William Batchelder, R-Medina, said lawmakers will be studying the proposal over the next month, and it was “possible” it could be approved by June 30 (Candisky, 5/23).

California Healthline: How Obamacare Could Change Medi-Cal For The Better (And Worse)
As many as 1.5 million Californians are expected to gain Medi-Cal coverage over the next six years, thanks to provisions in the Affordable Care Act. That might be the easy part. What's tricky: Making sure that the already-strapped Medicaid program -- which is facing a controversial 10 percent provider rate cut -- has enough dollars to go around. "Expansion of Medicaid in California is a step in the right direction," Paul Phinney, president of the California Medical Association, said in a statement last week (Diamond, 5/22).

Idaho, New Mexico Ask Feds To Run Health Exchanges

Thu, 23 May 2013 14:08:00 GMT

In addition, media outlets report that the nation's largest for-profit insurers will not participate in California's online marketplace. Eleven insurers have applied to operate plans in Colorado.

The Wall Street Journal: Two States Seek Help With Health Exchanges
Two states that had planned to run their own health-insurance exchanges this fall are asking the federal government for help in the first year, a sign of the obstacles states face in carrying out a centerpiece of the health-care overhaul. Idaho and New Mexico had been among a few Republican-led states that had agreed to operate their own health exchanges, which will offer a variety of insurance plans for people who don't have coverage otherwise (Dooren, 5/22).

Kaiser Health News: Capsules: 11 Insurers Want To Play Ball In Colorado's Marketplace
Colorado became the latest state Wednesday to post proposed health insurance plans for its new online marketplace, which is slated to begin enrolling people in coverage Oct. 1. What stands out is the number of plans being proposed. A total of 11 insurers are seeking approval to market about 250 health plans to individuals and small groups in the state's online marketplace (Galewitz, 5/22).

Los Angeles Times: UnitedHealth, Aetna And Cigna Opt Out Of California Exchange
Some prominent health insurers, including industry giant UnitedHealth Group Inc., are not participating in California's new state-run health insurance market, possibly limiting the number of choices for millions of consumers. UnitedHealth, the nation's largest private insurer, Aetna Inc. and Cigna Corp. are sitting out the first year of Covered California, the state's insurance exchange and a key testing ground nationally for a massive coverage expansion under the federal healthcare law (Terhune, 5/22).

And, in Washington state -

The Associated Press: 2 Insurers Left Abortion Coverage Out Of Washington State Health Exchange Proposals
Two insurance companies who filed to compete in Washington state's health care exchange initially proposed not to provide abortion coverage, officials said Wednesday. All current Washington health plans provide abortion insurance. Stephanie Marquis, a spokeswoman with the Washington state Office of the Insurance Commissioner, said the plans without such coverage in the health exchange were recently filed by Kaiser Foundation Health Plan of The Northwest and BridgeSpan Health Company (5/22).

Political Cartoon: 'Pennsylvania Railroaded?'

Thu, 23 May 2013 13:40:38 GMT

Kaiser Health News provides a fresh take on health policy developments with "Pennsylvania Railroaded?" by John Cole.

Meanwhile, here is today's health policy haiku:

HHS CONTRA?

Is Sebelius
equal to Oliver North?
That's what Lamar wrote.
-Anonymous

And, as a bonus:

EVEN JACKIE CHAN COULDN'T SAVE THIS RUSH HOUR

The evening commute
for KHN staff gives me
a "sinking" feeling.
-Anonymous

If you have a health policy haiku to share, please send it to us at http://www.kaiserhealthnews.org/ContactUs.aspx and let us know if you want to include your name. Keep in mind that we give extra points if you link back to a KHN original story.

HHS Report Finds Uptick In Doctors' Use Of Electronic Health Records

Thu, 23 May 2013 13:32:50 GMT

Also in the news, the Pentagon is in search of a new system for veterans' health care while San Francisco is "leading the way" in new health data applications.

USA Today: Incentives Push Doctors To Electronic Medical Records
More than half of doctors' offices and 80 percent of hospitals that provide Medicare or Medicaid will have electronic health records by the end of the year, the Department of Health and Human Services announced Wednesday (Kennedy, 5/22).

CQ HealthBeat: HHS Report Shows Strong Growth In Use Of Electronic Health Records
More than half of all doctors now get Medicare or Medicaid incentive payments for using electronic health records, according to a report federal officials released on Wednesday. But Republicans say medical professionals should not just use the records in their own offices but also should exchange them with other providers (Adams, 5/22).

The Associated Press: Pentagon To Seek New Records System For Vets Health Care, Says It Won’t Solve Claims Backlog
The Pentagon has decided to buy a new computerized health records system to be able to better share and merge its data with the Department of Veterans Affairs, but officials cautioned that it was part of a “long-term modernization” effort and would not help ease the backlog in VA disability claims (5/22).

California Healthline: San Francisco Leading The Way In Health Data Applications
The city of San Francisco is leading the way in using health data in innovative ways and it's paying off in a big way, according to several city officials who spoke yesterday at the Healthy Communities Data Summit. The summit was held in San Francisco and that meant a number of success stories were local, but the conference cast a wide net in its approach to innovation prompted by public release of health data (Gorn, 5/22).

State Highlights: Conn. Democrats Eye Shifting $400M In Medicaid Money

Thu, 23 May 2013 04:00:00 GMT

A selection of health policy stories from California, Connecticut, American Samoa, Georgia, Oregon and West Virginia.

Los Angeles Times: Geography Has A Role In Elective Surgery Decisions, Study Finds
Geography plays a role in whether patients in California have elective operations such as joint replacement, weight loss surgery and gallbladder removal, according to a new study. The California HealthCare Foundation study showed wide variations in patient surgeries across the state (Gorman, 5/22).

CT Mirror: Democrats May Sidestep Spending Cap
Struggling to secure the super-majority necessary to exceed the current spending cap by half-a-billion dollars, legislative leaders are weighing a plan to green-light the extra spending with a simple majority. According to sources close to budget negotiations, the Democratic majority has discussed effectively shifting more than $400 million in Medicaid spending off the books next fiscal year. The process is common in other states, but rarely used here and never involving that much money (Phaneuf and Becker, 5/22).

Modern Healthcare: HHS Finds $2.2M In Billing Errors At Cedars-Sinai
Administrators at Los Angeles' largest community hospital, Cedars-Sinai Medical Center, were well aware of the flaws in their inpatient admissions process before an audit report Wednesday from HHS' inspector general's office publicly pointed them out. The 892-bed hospital posted a case manager in its emergency department last year to review all decisions to admit so-called "short-stay" inpatients, and that person now has access to standardized admissions criteria software from InterQual to evaluate make those decisions, hospital administrators wrote to the OIG (Carlson, 5/22).

Los Angeles Times: Most Unionized UC Hospital Workers Go To Jobs Despite Strike
As University of California patient care workers returned to the picket lines Wednesday, hospital administrators said they were gratified that so many others chose to come to work. More than three-quarters of union members who had been scheduled to work Tuesday did so, said Dianne Klein, spokeswoman for the UC office of the president. Hospital officials said they expected a similar turnout Wednesday (Gorman, 5/22).

The Associated Press/Washington Post: American Samoa To Keep Frequent Flier Miles Of Government Travelers; Use For Sick, Students
American Samoa plans to take away frequent flier miles from government workers who travel on behalf of the U.S. territory and use the loyalty points to help medical patients and students travel off the islands when necessary (5/22).

Georgia Health News: State Psychiatric Hospital In Thomasville To Close
A state agency Wednesday announced that its psychiatric hospital in Thomasville will close by the end of the year. The state Department of Behavioral Health and Developmental Disabilities told GHN that Southwestern State Hospital currently has a patient census of 116, divided between people with mental illness and development disabilities, and those housed in the facility’s forensic unit. The closing of the hospital continues the revamping of the state’s services for people with mental illness and developmental disabilities in the wake of Georgia’s landmark 2010 agreement with U.S. Department of Justice, which aims to move people from mental hospitals into community living situations (Miller, 5/22).

The Lund Report: Cultural Competency In Health Care Heads To Governor
Sen. Jackie Winters said 40 or 50 years ago, when some black Americans had diabetes, they had a colloquial term for it -- "the sugars" -- which their doctors may not understand. Winters, a black Republican senator from Salem, told The Lund Report that ethnic and racial minorities often face increased health disparities, often for purely cultural reasons, since physicians and nurse practitioners are more likely to come from an ethnic group different than their own. That's what's led her to find a legislative route that would compel health professionals to become educated in cultural competency (Gray, 5/22).

The Associated Press: W. Va. Gov Picks New Health Secretary
Former hospital executive and nurse Karen Bowling will become West Virginia's Health and Human Resources secretary on July 1, Gov. Earl Ray Tomblin said Wednesday, taking over a sprawling department recently scrutinized by an audit and assigned the daunting task of expanding the state's Medicaid program (5/22).

San Jose Mercury News: California Bill Would Prevent Genetic-Testing Firms From Using Surreptitiously Obtained DNA
If you want to keep your DNA to yourself, be sure not to leave any stray hairs, Q-tips or underwear lying around. There are genetic testing companies out there willing to reveal your most intimate biological secrets to anybody -- without your knowledge or permission. And under California law, such genetic snooping is perfectly legal. Now, legislators in Sacramento are considering a bill to change that. Senate Bill 222, which faces a key hearing Thursday, would require a donor's consent to collect, analyze or share genetic information (Shugart, 5/22).

Viewpoints: Sen. Alexander Sees Reflections Of Oliver North In Sebelius' Quest To Raise Funds; Vaccine Scare's Legacy

Thu, 23 May 2013 04:00:00 GMT

The Wall Street Journal: Kathleen Sebelius, Meet Oliver North
Major news outlets in recent days have reported that U.S. Department of Health and Human Services Secretary Kathleen Sebelius is raising money from the private sector -- including from health care executives -- for use by a private entity that is helping to implement ObamaCare. ... Is Ms. Sebelius raising funds for a private entity and then coordinating with that entity to do something Congress has refused to authorize, or for which it has refused to appropriate funds? And is she raising money from organizations she regulates, in violation of ethics laws? (Sen. Lamar Alexander, R-Tenn., 5/22).

The New York Times: Aftermath Of An Unfounded Vaccine Scare
Britain is experiencing serious outbreaks of measles that look to be a delayed consequence of a failure to vaccinate infants and young children more than a decade ago. A prime cause of that failure was ill-founded fears among parents that a widely used vaccine to combat measles, mumps and rubella might cause autism. Because they shunned the vaccine, their children, now in their teens, are suffering the consequences (5/22).

Milwaukee Journal-Sentinel: Mandatory Vaccinations Deserve Vigorous Debate
The debate over the mandatory influenza vaccinations of employees is worthy of a vigorous public airing. Controversy has been growing nationwide over the plight of employees, particularly health care workers, being dismissed from jobs due to their refusal to accept this unwanted intrusion into their personal health care decisions. I fully recognize this argument pits two groups advocating against each other over a position based on rights. Employers demand flu vaccinations of employees, with extremely limited exceptions, as a fundamental right of an employer. Those who object stand on individual liberties to make their own personal health care decisions without the threat of dismissal (Jeremy Thiesfeldt, 5/22).

The New York Times: Kill Bill
According to statistics United Republic assembled, the prescription drug industry spent $116 million lobbying for legislation to prevent Medicare from bargaining down drug prices — legislation that enabled drug companies to make an additional $90 billion annually. That amounts to an extraordinary 77,500 percent return on investment. Oil companies, in turn, had a return on investment of 5,900 percent, and multinational companies, 22,000 percent (Thomas B. Edsall, 5/22).

The New England Journal of Medicine: The Gross Domestic Product And Health Care Spending
An examination of data from the past 60 years for the economy as a whole and for health care expenditures indicates that there has been a robust relationship between the two. ... Some observers place great emphasis on the particularly slow growth of national health care expenditures in 2010 and 2011. How useful is the experience of growth over a period of 2 years in predicting the growth rate over the next 20 years? The answer seems to be not at all. ... [T]he rate of growth of national health care expenditures in the past appears to have been substantially related to the growth of the GDP. There has been some slowing of the growth of health care spending relative to the GDP, but it began not just a few years ago, but in the 1990s (Victor R. Fuchs, 5/22).

Columbus Dispatch: Obamacare May Lead To 'Skinny' Policies
Would you like to have a "skinny" health-insurance policy? Probably not. But if you're employed by a large company, you may get one, thanks to Obamacare. That’s the conclusion of Wall Street Journal reporters Christopher Weaver and Anna Wilde Mathews. They report that insurance brokers are pitching and selling "low-benefit" policies across the country. You might be wondering what a "skinny" or "low-benefit" insurance plan is. The terms may vary, but the basic idea is that policies would cover preventive care, a limited number of doctor visits and perhaps generic drugs. They wouldn't cover things such as surgery, hospital stays or prenatal care (Michael Barrone, 5/23).

JAMA: Public Health Regulation As A Public Process
Media coverage of new public health regulations often seems to follow a template: The [regulatory agency]'s plan to implement [public health regulation] is causing controversy among [businesses affected] and [individuals who object]. … But there's another way to think about how policy is developed to improve health: as a dynamic process open to a range of policy alternatives (Dr. Joshua M. Sharfstein, 5/22).

JAMA: Encouraging Smokers to Talk With Their Physicians About Quitting
Over the next few months, physicians may see an increase in patients asking for help in quitting smoking. Why? The Office on Smoking and Health at the Centers for Disease Control and Prevention recently launched the second stage of its national media campaign, Tips from Former Smokers (Tips). Some of the ads include a new call to action with the message, "You can quit. Talk with your doctor for help." This "talk with your doctor" initiative provides physicians with a golden opportunity to help more patients quit smoking (Dr. Tim McAfee, 5/22).

The Lund Report: Physician, First Do No Harm -- To Yourself
Studies confirm most doctors are overworked, exhausted, or depressed. The tragedy: few seek help. I ask the group, "How many physicians have lost a colleague to suicide?" All hands are raised. "How many have considered suicide?" Except for one woman, all hands remain up -- including mine. "Physicians have the highest suicide rate of any profession," I explain. "In the United States we lose over 400 physicians per year to suicide. That's the equivalent of an entire medical school. Even that's an underestimate because many physician suicides are incorrectly identified as accidents" (Dr. Pamela Wible, 5/21).

MinnPost: Failed Virginia Bill On Miscarriages Reveals Ignorance About Women's Health
As I've written here before, the medical ignorance of some politicians -- particularly in regard to women's reproductive health -- is a continual source of astonishment. ... While searching through the legislative history of Virginia state Sen. Mark Obenshain, now running on the Republican ticket for his state's attorney general position, reporters found that he had authored a bill in 2009 that would have required all women in Virginia to report miscarriages to police or risk legal penalties, including as much as a year in jail (Susan Perry, 5/22).

Bloomberg: Better Death Records Can Lead To Longer Life
Here's a morbid thought atop a morbid thought: Two in three deaths worldwide -- some 35 million a year -- go unregistered. And in many cases when deaths are recorded, reliable information on what caused them is lacking. Why does this matter? Without such records, public-health authorities can't tell enough about what's killing people to minimize the dangers they face (5/22).

Oregonian: Portland And Its Aversion To Fluoride Reflects Oregon's Unusual Politics
In 2011, the board of the Santa Clara Valley Water District voted to begin fluoridating water for about 850,000 customers in and around San Jose. Anti-fluoride activists grumbled but realized they didn't have the resources to take their fight to the public. That's sure not what happened in Portland, which once again showed that this far northwest corner of the country is willing to go where other parts of the country rarely tread (Jeff Mapes, 5/22).

The Hill: Insurers Feel Pressure To Support Enroll America

Thu, 23 May 2013 13:24:28 GMT

The Hill reports that unnamed insurance industry sources say they feel that Enroll America, the non-profit group raising funds to support outreach to the uninsured, is "just an arm of the administration." In a separate story, The Hill notes new research concluding the trend toward part-time work and reduced health benefits began before the overhaul.

The Hill: Insurers Feel Pressure From Health Group With Ties To White House
The links between a nonprofit promoting President Obama’s healthcare law and the White House have created an "air of expectation" that insurers will contribute to the group, according to an insurance industry official. Current and former administration officials have taken on leadership and fundraising roles for Enroll America, a nonprofit aiming to make sure people sign up for new coverage options (Baker, 5/23).

The Hill: Trend Toward Part-Time Work, Cuts In Health Coverage Predate ObamaCare
Employers have been cutting back employees' hours and access to health insurance since before President Obama's healthcare law passed, according to new research released Wednesday. The findings are potentially significant as the healthcare law is about to take full effect (Baker, 5/22).

Fox News: 56 Percent Want To Go Back To Pre-ObamaCare System
Majorities of American voters say their family will be worse off under the Affordable Care Act, and think it would be better to go back to the pre-ObamaCare health care system. A Fox News poll released Wednesday finds that while 26 percent of voters say their health care situation will be better under the new law, twice as many -- 53 percent -- say it will be worse. Another 13 percent say it won’t make a difference. … Young voters and seniors are pessimistic about ObamaCare. Majorities of those under age 35 and those 65+ think things will be worse under the 2010 health care law (Blanton, 5/22).

First Edition: May 23, 2013

Thu, 23 May 2013 11:14:00 GMT

Today's headlines include various status updates about state activity regarding the health law's online insurance marketplaces.

Kaiser Health News: Can My Insurer Deny Coverage For Care At An Out-Of-Network Hospital? (Video)
Kaiser Health News consumer columnist Michelle Andrews answers a reader question about emergency room and out-of-network hospital cost changes under the health law (5/23). Watch the video or read the transcript.

Kaiser Health News: Capsules: 11 Insurers Want To Play Ball In Colorado’s Marketplace
Now on Kaiser Health News' blog, Phil Galewitz reports: "Colorado became the latest state Wednesday to post proposed health insurance plans for its new online marketplace, which is slated begin enrolling people in coverage Oct. 1. What stands out is the number of plans being proposed. A total of 11 insurers are seeking approval to market about 250 health plans to individuals and small groups in the state's online marketplace under the federal health care overhaul" (Galewitz, 5/22). Check out what else is on the blog.

The Wall Street Journal: Contraception Violates Beliefs, Firms Tell Court
Two small-business owners challenging contraception-coverage mandates in the federal health-care law told a federal appellate court Wednesday the law would force them to violate their beliefs because they run their businesses in accordance with their religious faith. The Seventh U.S. Circuit Court of Appeals in Chicago is the first federal appellate court to hear arguments in cases challenging the mandate that took effect last August for most employers to cover contraception, including the morning-after pill, in workers' insurance plans without out-of-pocket costs (Kesling and Radnofsky, 5/22).

The Washington Post: Some Business Owners Resist Providing Employees With Contraceptive Coverage
Religiously devout business owners are waging a broad rebellion against providing their employees with contraceptive coverage, bringing dozens of lawsuits that seem certain to land the issue before the Supreme Court. The company owners say their religious beliefs take precedence over a new federal requirement, contained in President Obama’s Affordable Care Act, that they give employees insurance that covers contraceptives (Barnes, 5/22).

The Associated Press/Washington Post: Hobby Lobby Appeal Tests Limits Of Federal Birth-Control Coverage Mandate
In the most prominent challenge of its kind, Hobby Lobby Stores Inc. is asking a federal appeals court Thursday for an exemption from part of the federal health care law that requires it to offer employees health coverage that includes access to the morning-after pill. The Oklahoma City-based arts-and-crafts chain argues that businesses — not just the currently exempted religious groups — should be allowed to seek exception from that part of the health law if it violates their religious beliefs (5/23).

USA Today: Incentives Push Doctors To Electronic Medical Records
More than half of doctors' offices and 80% of hospitals that provide Medicare or Medicaid will have electronic health records by the end of the year, the Department of Health and Human Services announced Wednesday (Kennedy, 5/22).

The New York Times’ Bucks Blog: Family Medical Costs Still Rising
The good news is health care costs are going up more slowly. The bad news is that families continue to see larger medical bills. The typical cost to cover a family of four now exceeds $22,000, including the amount paid in insurance premiums and out-of-pocket costs, according to the latest Milliman Medical Index for 2013. Milliman, an actuarial and benefits consultant, puts the cost at slightly less than the amount a family might pay to send a child to an in-state public college for a year (Abelson, 5/22).

Check out all of Kaiser Health News' e-mail options including First Edition and Breaking News alerts on our Subscriptions page.

Medicaid Expansion Popular In Southern States, Despite Govs' Opposition

Wed, 22 May 2013 13:46:00 GMT

A poll by the Joint Center for Political and Economic Studies found popular support for this and other health law provisions in five southern states despite the conservative political climate. Meanwhile, expansion supporters are strategizing about their next moves in states where they have not been successful.

Stateline: Despite Governors' Opposition, Strong Southern Support For Medicaid Expansion
The Republican governors and legislatures in Alabama, Georgia, Mississippi, Louisiana and South Carolina have rejected the Medicaid expansion, which would extend health care coverage to more low-income people. But a poll conducted in March and April by the Joint Center for Political and Economic Studies found that 62 percent of the people in those states support the expansion, one of the key instruments in the Obama administration’s strategy to reduce the number of uninsured Americans (Ollove, 5/21).

Kaiser Health News: Survey: Even In Southern States, Medicaid Expansion Is Popular
Alabama, Georgia, Louisiana, Mississippi and South Carolina have a lot in common: The summers are hot and the political climates are conservative. These are states where Mitt Romney handily beat Barack Obama in the 2012 presidential election, so it's not surprising to learn that the president's signature health law is unpopular there. But despite the law's unpopularity, its expansion of Medicaid is supported by almost two-thirds of adults in these states, according to a survey by the Joint Center for Political and Economic Studies, a left-leaning think tank (Eisenhower, 5/21).

Georgia Health News: Medicaid Expansion Popular In South, Polls Shows
The political leadership in the five Deep South states is solidly against Medicaid expansion, and has been so for months. Republican governors in Georgia, South Carolina, Alabama, Mississippi and Louisiana, along with their GOP-controlled legislatures, have bucked proposals to open their states’ Medicaid programs to hundreds of thousands of uninsured people, as outlined under the 2010 Affordable Care Act. But a newly released survey of adults in those five Southern states shows a different sentiment among the public. Across the region, 62.3 percent of respondents view Medicaid expansion favorably, including 61 percent in Georgia, according to the survey results released Tuesday (Miller, 5/21).

Modern Healthcare: Proponents Of Medicaid Expansion Weigh Next Moves
As many state legislative sessions have finished or are nearing completion, advocates of expanding Medicaid eligibility are looking at their next steps. Expansion of Medicaid eligibility as called for by the 2010 healthcare overhaul will not happen in 19 states, and seven more states are leaning against expanding, according to the latest estimates by Avalere Health. But the failure of the expansion to pass in many recently or nearly concluded state legislative sessions is unlikely to spell the end for those measures (Daly, 5/21).

News outlets also offer updates on the latest developments in Virginia, Texas, Arizona and Florida -

The Associated Press/Washington Post: Major Savings Reform Va. Demanded To Expand Medicaid Gets Approval From Federal Officials
Federal officials approved a four-year Virginia cost-saving experiment intended to simplify and consolidate health care coverage for about 78,000 Virginians who are eligible for both Medicaid and Medicare, a major change Gov. Bob McDonnell set as a condition for expanding Medicaid (5/21).

CQ HealthBeat: Virginia Dually Eligible Demonstration Approved By Federal Officials
Virginia on Tuesday became the sixth state approved to participate in a national three-year demonstration to better coordinate care for people eligible for Medicare and Medicaid. The Centers for Medicare and Medicaid Services announced that about 78,600 Medicare-Medicaid beneficiaries in five regions of Virginia will be enrolled in managed-care plans when the demonstration begins in 2014 (Adams, 5/22).

Richmond Times-Dispatch: Va. OK’d For Dual Medicaid Pilot Project
Virginia has received federal permission to take the first and biggest step toward overhauling its Medicaid program, potentially setting the stage for expansion of coverage to hundreds of thousands of Virginians under the Affordable Care Act. More than 78,000 Virginians, including more than 24,000 in the Richmond region, will be able to use one ID card for Medicaid and Medicare services under an agreement reached between the state and federal government on Tuesday (Martz, 5/22).

The New York Times/Reuters: Texas: House Votes to Ban Medicaid Expansion
The Texas House passed a measure on Tuesday that would prevent the state from expanding its Medicaid program as outlined by President Obama's health care law (5/21).

Arizona Republic: House Turns To Medicaid Proposal
House Republicans on Tuesday began scrutinizing a Senate spending plan that includes Gov. Jan Brewer’s proposal to expand Medicaid, while their leader sought to build support for his plan to send the Medicaid question to voters. House Speaker Andy Tobin, R-Paulden, was still smarting over Senate President Andy Biggs’ decision last week to jump-start stalled Medicaid negotiations and push his budget through the upper chamber. Six Republicans joined Democrats to amend the package with the governor’s Medicaid-expansion plan and about $35 million in additional spending (Reinhart, 5/21).

Tampa Bay Times: Tampa Chamber: Businesses Concerned By Legislature's Inaction On Medicaid Expansion
For Tallahassee, refusing additional federal funds to expand Medicaid may turn out to have been the easy part. It will take longer, a half-dozen Hillsborough legislators acknowledged Tuesday, to come up with an alternative to provide health care coverage to an estimated 1 million uninsured Floridians. ... Some Tampa businesses, (Greater Tampa Chamber of Commerce Chairman Gregory Celestan told local legislators), are "very concerned about significant additional health insurance costs" because of the Legislature's "refusal to expand Medicaid." "We will be at a competitive disadvantage when recruiting new businesses or adding jobs," Celestan added. "How would you respond?" (Danielson, 5/21).

New Orleans Times-Picayune: Medicaid Expansion, Obamacare Rejection Bills Fail In Louisiana House
Two completely different bills dealing with the federal health care overhaul, one using federal funding to provide insurance to the working poor and the other trying to nullify parts of the Affordable Care Act, died on the House floor Tuesday (Kumar, 5/21).

Louisville Courier Journal: Doctor Shortages May Undercut Kentucky Medicaid Expansion
Dr. Ron Waldridge II sees up to 24 patients a day at a busy family practice in Shelbyville, and says he can’t take on any new ones unless they are family members of people he already treats. So he wonders how he and other Kentucky doctors will be able to handle the tens of thousands of Kentuckians expected to get Medicaid coverage through health reform (Ungar, 5/21).

And, on the topic of health exchanges -

The Associated Press: NM Changing Its Plans For Health Exchange
New Mexico is switching gears on its plan for a health insurance exchange and initially will partner with the federal government for computer services needed for an online insurance marketplace. The state intends to have a New Mexico-run insurance exchange ready for small businesses to shop for coverage for their employees this fall and will use a federally operated exchange to offer medical insurance plans to individuals for the next year, Dr. J.R. Damron, chairman of the exchange's governing board, said Monday (Massey, 5/20).

Market Pressures May Keep Premiums Low As Health Law Kicks In

Wed, 22 May 2013 13:45:00 GMT

USA Today reports this optimisitic view is offered by some industry analysts and health insurance officials. Meanwhile, Politico does a status check on the legal challenges to the health law's birth control mandate. News reports also track the latest regarding the Internal Revenue Service controversy and the overhaul.

USA Today: Market, Insurers Will Keep Premiums Low, Analysts Say
Market forces and an impetus to attract younger, healthier people into the insurance market will help keep health insurance premiums lower as the 2010 health care law takes effect on Jan. 1, industry analysts and insurance officials say. "If they price too high, young people won't buy insurance, and that's going to hurt the companies," said Jay Angoff, who led initial implementation of the law for HHS. "They need these people to come in. It's an industry problem" (Kennedy, 5/21).

Here's an on-the-ground look at premium filings --

Oregonian: Oregon's 2014 Health Premium Filings Spark Relief, Questions
Massive health insurance premium hikes predicted as the inevitable result of federal reforms haven't materialized in Oregon. The lower-than-expected preliminary rates come as much-needed good news for the Affordable Care Act. The law, passed in 2010, has been plagued by resistance in Congress and complaints of snafus as the Jan. 1 startup for expanded coverage draws closer (Budnick, 5/21).

Also, the latest on the birth control mandate --

Politico: Courts To Hear Birth Control Mandate Lawsuits
Obamacare’s birth control mandate will go before four different appeals courts over the next three weeks as private businesses that object to the policy on religious liberty grounds bring a barrage of lawsuits that opponents hope to get before the U.S. Supreme Court as soon as this fall. On Wednesday, two for-profit companies will ask the 7th Circuit Court of Appeals to strike the requirement that they provide employees with insurance coverage that includes birth control and other drugs that they say can cause abortion. Three other companies will present oral arguments in different appeals courts by early June (Smith and Haberkorn, 5/22).

Bloomberg: Contraception Mandate Challenge Faces Appeal Court Judges
The U.S. law requiring employers to provide health insurance coverage for birth control is set to come before an appeals court in cases brought by two businesses whose owners say they operate according to Catholic doctrine. The businesses, a construction firm from southwestern Illinois and an auto-parts maker in southeastern Indiana, are scheduled today to ask the U.S. Court of Appeals in Chicago for an order barring enforcement of the measure while they challenge its constitutionality in lawsuits (Harris, 5/22).

In addition, tea party groups see the Internal Revenue Service scandal as a potential means to gin up health law opposition -

The New York Times: For Tea Party Groups, Shades Of 2010
Leaders of the Tea Party movement hope outrage over the I.R.S. inquiry will rekindle grass-roots activism that in many places went dormant after big Republican electoral defeats of November 2012. They aim to link the current scandal to other government programs they consider overweening -- principally the rollout of the health care overhaul law -- and generate a Republican wave in the 2014 midterm elections reminiscent of 2010's (Gabriel, 5/21).

In other related news --

The Hill: GOP Sen. Thune Urges IRS To Stop ObamaCare Work
Republican Sen. John Thune (S.D.) is demanding that the Internal Revenue Service (IRS) refrain from implementing ObamaCare while investigators probe the agency's targeting of conservative groups.
Thune, who leads the Senate Republican Conference, wrote to the Obama administration Tuesday connecting the scandal to Sarah Hall Ingram, an IRS official who once had oversight of tax-exempt groups (Viebeck, 5/21).

Outreach Effort Moves Forward Despite Sebelius Controversy

Wed, 22 May 2013 13:23:20 GMT

Families USA Executive Director Ron Pollack tells CQ Healthbeat that the flap won't prevent a robust effort by the nonprofit group, Enroll America, to sign up the uninsured. Meanwhile, White House Press Secretary Jay Carney draws parallels to earlier allegations about President Barack Obama's birth certificate.

CQ HealthBeat: Enroll America 'Alive And Growing' Despite Sebelius Controversy, Pollack Says
The controversy over donations to Enroll America Health that Human Services Secretary Kathleen Sebelius solicited won’t prevent the nonprofit group from waging a vigorous campaign to sign up the uninsured, its founder said in an interview Tuesday. There is no question that fundraising will be "at least significantly into eight figures; it already is," said Families USA Executive Director Ron Pollack (Reichard, 5/22).

The Hill: Carney: Questions About Sebelius Fundraising Similar To Certificate Concerns
White House press secretary Jay Carney on Tuesday unfavorably compared questions about donations solicited by Health and Human Services Secretary Kathleen Sebelius to Republicans questioning the president's birth certificate. At a tense briefing where Carney took tough questions on a series of issues that could damage the White House politically, the press secretary aligned himself with White House Communications Director Dan Pfeiffer, who over the weekend accused Republicans of engaging in "partisan fishing expeditions" (Sink, 5/21).

Health Issues Play A Part In House Immigration Talks, Budget Cuts

Wed, 22 May 2013 13:15:00 GMT

Politico reports that issues related to the health benefits made available to undocumented immigrants as they seek citizenship could muddy House negotiations. In addition, House Republicans have pressed forward with budget cuts that would impact Indian health care and a number of other domestic programs.

Politico: House Immigration Talks Hang On Health Care
House immigration negotiators have given themselves until the end of the week to hash out language on what kind of health benefits should be available to undocumented immigrants seeking U.S. citizenship, a crucial issue for the talks. If they can’t resolve this issue, the four-year immigration negotiations could come to a crashing halt (Sherman and Bresnahan, 5/21).

The Associated Press/Washington Post: House GOP Panel Approves Agency Budget Cuts Far Deeper Than Those Approved In March
Republicans controlling the House pressed ahead Tuesday with slashing cuts to domestic programs far deeper than the cuts departments like Education, Interior and State are facing under an already painful round of automatic austerity. Veterans Affairs, Homeland Security and the Pentagon would be spared under the plan approved by the House Appropriations Committee on a party-line vote, but legislation responsible for federal firefighting efforts and Indian health care would absorb a cut of 18 percent below legislation adopted in March (5/21).

In addition -

Modern Healthcare: Bill Takes Aim At Reform Law's Rural-Floor Provision
New legislation from Rep. Kevin Brady (R-Texas) is welcome news to 20 state hospital associations working to eliminate a contentious hospital wage-index provision in the Patient Protection and Affordable Care Act. Brady's bill—the Medicare Hospital Wage Index Equity Act of 2013—relates to the rural floor component of Medicare's hospital wage index, which guarantees the wage index for rural hospitals is not more than the index for urban hospitals. Before the 2010 healthcare overhaul, federal law required that payments for hospital wage-index adjustments be budget-neutral within a state so that only hospitals in that state would be affected by the changes (Zigmond, 5/21).