Daily Health Policy Report

Wednesday, July 11, 2012

Last updated: Wed, Jul 11

KHN Original Reporting & Guest Opinion

Capitol Hill Watch

Health Reform

Campaign 2012

Administration News

Coverage & Access

Health Care Fraud & Abuse

State Watch

Editorials and Opinions

KHN Original Reporting & Guest Opinion

Administration Warns States Not To Roll Back Medicaid Eligibility

Kaiser Health News staff writer Phil Galewitz reports: "The nation's top health official signaled Tuesday that states should not try to use the Supreme Court's ruling on President Obama's health care law to make it more difficult for low-income people to qualify for Medicaid" (Galewitz, 7/11). Read the story.

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Health On The Hill: Court Ruling Triggers Tax Debate On Capitol Hill

Kaiser Health News staff writer Mary Agnes Carey talks to Jackie Judd about Tuesday's House Ways and Means Committee session on the individual mandate and congressional taxing authority. They also preview Wednesday’s House vote to repeal the health law. Listen to the audio or read the transcript.

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Capsules: Report: Nation Isn't Ready For Seniors' Mental Health Needs

Now on Kaiser Health News' blog, Christian Torres reports: "A continued lack of specialists and other trained providers including primary care physicians and nurses will likely make it difficult for aging patients to receive treatment for depression, dementia and other conditions" (Torres, 7/10). Check out what else is on the blog.

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Political Cartoon: 'Passing Grade'

Kaiser Health News provides a fresh take on health policy developments with "Passing Grade" by Chip Bok.

And here's today's health policy haiku:


Two Ricks, Perry and
Scott. Who can go lower on
FPL percent?

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.

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Capitol Hill Watch

GOP Spotlights Repealing - Rather Than Replacing - The Health Law

The House is scheduled to vote today to repeal the sweeping health law, although one Republican says they will not move a replacement measure until 2013 at the earliest. Meanwhile, the vote is being cast by GOP leaders as an effort to stop a new tax.    

Los Angeles Times: Republicans Focus On Repealing, Not Replacing, 'Obamacare'
Congressional Republicans, who once promised to "repeal and replace" President Obama's healthcare law, for now have all but given up pushing alternatives to the sweeping legislation the president signed in 2010.
... And as the House prepares to take its 33rd vote to repeal all or part of the Affordable Care Act, senior Republicans say they will not try to move a replacement plan until 2013 at the earliest. "There might be a chance for us to do this next year," House Rules Committee Chairman David Dreier (R-San Dimas) said Tuesday (Levey, 7/11).

The Associated Press: GOP Says Health Care Repeal Also Stops A Tax
House Republicans, stung by the Supreme Court decision upholding President Barack Obama's health care overhaul, are seizing on one wrinkle to bolster their election-year case for repeal — the court's judgment that the penalty for failing to get insurance is a tax. … Two weeks after the conservative-led court's ruling, the House GOP leadership pushed for another symbolic repeal vote on Wednesday with a fresh argument (Cassata, 7/11).

Reuters: New Name, Old Campaign As Republicans Wage War On "Obamacare"
Since Republicans took control of the House of Representatives, they have introduced by their own count 30 bills to get rid of or gut the law they call "Obamacare," bearing titles such as the "Reclaiming Individual Liberty Act," the "repeal the Job killing health care law" act and the "NObamacare Act of 2012." On Tuesday they began debate on the 31st, the "Repeal of the Obamacare Act," which is certain to win passage when the House votes on Wednesday and just as certain to go no further, since the Senate and White House are both in Democratic hands (Ferraro and Smith, 7/10).

The Wall Street Journal: House Set To Vote On Health-Law Repeal
The House is expected to vote Wednesday to repeal President Barack Obama's health-care law, as Republicans continue their furious response to the Supreme Court decision to uphold the law. … GOP leaders want to reaffirm their opposition to it in advance of November's elections. The arguments on the House floor Tuesday ahead of the vote weren't new, but the urgency was greater (Bendavid and Radnofsky, 7/11).

Bloomberg: Repealing, Not Replacing, Health Law Tops Republican Plan
U.S. House Republicans, united in opposition to President Barack Obama's health care overhaul, used to pledge to "repeal and replace" it.  Now, as they prepare to vote as soon as today to kill the law they call Obamacare -- their 33rd effort to undo all or parts of it -- Republican leaders have dropped the word "replace" from their promise. The omission is the result of an election-year calculation: They figure they stand to gain from public distaste for the 2010 measure’s central provision, the requirement that most Americans buy health insurance, and will lose if they start providing details about what they would do instead (Tiron and Rowley, 7/11).

The Hill: House Set For Second Vote To Repeal Obama Health Care Reform Law
The Republican-led House is set on Wednesday to vote again to repeal the entire 2010 healthcare law as lawmakers respond formally to the Supreme Court's decision to uphold President Obama's signature domestic achievement. While Democrats compared the move to the film "Groundhog Day," House Republicans said the vote was in keeping with the promise they made upon taking control of the chamber in 2010. They also argued repealing the healthcare law would help the economy (Berman and Viebeck, 7/11).

National Journal: The Health Care Debate Begins. Again.
For their part, Democrats started off blasting House Republicans for dwelling on the issue. "Never in the history of Congress has anybody voted this many times on a single issue. And why? We don't have anything else to do," said Rep. Louise Slaughter, D-N.Y. "We're here simply killing time... We're not making law here, we're making political points. Which is a shame because it's not that the country doesn't need our attention" (Izadi, 7/10).

Politico Pro: Why The House Gets To Rerun The Repeal Vote
The House will pass a bill today to repeal President Barack Obama's health care law — just like it did a year and a half ago. And it can just keep doing that, as many times as it wants. If House leaders want to pass the bill again in September, they can do that, too. It turns out there's really nothing to stop the House from going into reruns — not even the sarcasm the Democrats have tried to throw at the Republicans. If it seems like the House is just replaying the floor debate of January 2011, the last time it voted to repeal the health care law, that's OK — because under House rules, it can do pretty much anything it wants (Nather and Haberkorn, 7/11).

CBS/Associated Press (Video): House GOP Set For Health Care Law Repeal Vote, But Offering No Alternatives
House Republicans generally avoided talk of replacement measures on Tuesday as they mobilized for an election-season vote to repeal the health care law that stands as President Barack Obama's signature domestic accomplishment. ... "This is nothing short of economic malpractice," said Rep. Nan Hayworth of New York, citing tax increases, government mandates and other items in the law. "We can and we must do better." She did not elaborate, nor did any of the members of the leadership. ... Republican officials said the general reluctance to sketch any sort of alternative resulted from a desire to focus public attention on the health care law itself. It generally fares poorly in public polling, both nationally and in surveys of independent voters (7/11).

Fox (Video): House GOP Poised To Hold Vote On Repeal Of ObamaCare After Supreme Court Ruling
House Republican leaders are forging ahead with plans to hold a vote Wednesday on a full repeal of President Obama's health care law, after launching debate on the repeal measure Tuesday nearly two weeks after the Supreme Court upheld most of the law as constitutional. Wednesday will mark the chamber's second vote to repeal the Affordable Care Act in full, though this attempt is being given no greater chance of passing the Democratic-controlled Senate. Obama has vowed to veto any such measure, were it to reach his desk. House Republicans have held 29 other votes aiming to gut specific parts of the law since 2011 (Marcos, 7/11).

Also in the news, yesterday's Ways and Means Committee hearing on the individual mandate and Congress' taxing authority -

Kaiser Health News: Health On The Hill: Court Ruling Triggers Tax Debate On Capitol Hill
Kaiser Health News staff writer Mary Agnes Carey talks to Jackie Judd about Tuesday's House Ways and Means Committee session on the individual mandate and congressional taxing authority. They also preview Wednesday's House vote to repeal the health law.

CQ HealthBeat: GOP Lawmakers Predict 'Brave New World' Of Federal Tax Power After Health Care Law Decision
Witnesses and lawmakers clashed at a House Ways and Means Committee hearing Tuesday over whether the Supreme Court's health care law ruling is a dangerous expansion of congressional taxing power. In an assertion backed by three of the four legal analysts who testified, Chairman Dave Camp declared that the high court's ruling upheld "the first indirect tax on inactivity in American history." More onerous taxation of inactivity lies ahead, they warned (Reichard, 7/10).

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Republican Lawmaker Unveils Bill On Contraceptive Coverage Rule

The measure focuses on the potential tax implications of the Health and Human Services rule that contraceptives be counted -- without cost-sharing -- among the preventive health services that most employer-sponsored health plans offer. 

CQ HealthBeat: Sensenbrenner Unveils Bill On Contraceptive Coverage Rule
A Republican lawmaker is reopening the debate over health insurance coverage of contraceptive services, but this time the focus is on its potential tax implications. Rep. F. James Sensenbrenner Jr. of Wisconsin unveiled a draft bill Tuesday in response to a Health and Human Services (HHS) Department ruling in January that contraceptives be included among the preventive health services that most employers’ insurance plans will be required to cover without cost-sharing as part of the 2010 health care overhaul. The measure would prohibit the federal government from imposing taxes or penalties or taking other action against employers who do not comply with the requirement, which goes into effect in August, if they are opposed to the coverage based on a religious belief or moral conviction (Attias, 7/10).

The Hill: GOP Bill Seeks To Undercut Obama Contraception Mandate
A new Republican bill would remove the teeth from a contentious Obama administration health mandate by barring the federal government from penalizing employers that do not comply. The measure was written in response to the Affordable Care Act, which requires that most employers cover birth control without a co-pay for employees. Under the GOP bill, employers that object to birth control for religious reasons can refuse to cover it without facing financial penalties from the government. Rep. James Sensenbrenner Jr. (R-Wis.), an author of the new bill, argued that the mandate's current penalty for non-compliance would sink many religious groups (Viebeck, 7/10).

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Health Reform

Sebelius Urges States To Move Forward On Health Law, Warns Against Rolling Back Medicaid Eligibility

Health and Human Services Secretary Kathleen Sebelius urged states to participate in the expansion, but said the administration would waive penalties against poor residents for not carrying insurance in states that opt out. Experts, meanwhile, urge the administration to "be flexible" with states regarding the Medicaid expansion. And Wall Street continues to view Medicaid as a growth opportunity.

The Associated Press: Mandate Waiver For Some Low-Income People
The Obama administration says low-income residents in states that decide to opt out of a big Medicaid expansion in the new health care law will not risk federal penalties as an unintended consequence. … In a letter to governors Tuesday, Health and Human Services Secretary Kathleen Sebelius said low-income residents in those states who would have been eligible for the coverage will not face the individual insurance mandate (7/10).

Kaiser Health News: Administration Warns States Not To Roll Back Medicaid Eligibility
While the Supreme Court upheld most provisions of the health law in its landmark ruling last month, the justices ruled that the federal government could not penalize states that choose not to expand Medicaid by cutting off all funding for existing Medicaid programs. In a letter to the nation’s governors, Health and Human Services Secretary Kathleen Sebelius warned that "the court's decision did not affect other provisions of the law" governing the joint federal-state health insurance program for the poor and disabled. A White House official said that means states are still barred from reducing eligibility for Medicaid (Galewitz, 7/11).

The Hill: Sebelius Urges States To Implement Health Care Law, Including Medicaid Expansion
Sebelius also announced a new round of meetings for state and federal officials to discuss implementation of President Obama's healthcare law. Some conservative governors had been avoiding implementation until they knew how the Supreme Court would rule. "Now that the Supreme Court has issued a decision, we want to work with you to achieve our ultimate shared goal of ensuring that every American has access to affordable, quality health care," Sebelius wrote in a letter to governors Tuesday (Baker, 7/11).

Politico: Experts On Medicaid: Go Slow
Three former administrators of the Centers for Medicare & Medicaid Services who served Republican presidents have a bit of advice for Democrats trying to get conservative governors to go ahead with Medicaid expansion: Be flexible. Don't make it a political litmus test. And try not to pour fuel on what's already a hot-burning fire. The unexpected Medicaid ruling by the Supreme Court left the states with unexpected options and dozens of questions — and the three former CMS chiefs doubt they will be answered quickly, maybe not until after the elections (Norman, 7/10).

Politico: Medicaid Expansion Could Pay Off For Investors
For all the Republican governors saying they'll block President Barack Obama's plan to expand Medicaid in their states — now at least five — the market seems to think they're bluffing. There are clear signs that Wall Street is anticipating a spike in Medicaid spending that would come from the expansion (Reis, 7/10).

Bloomberg: WellPoint Deal Shows Medicaid Prospects Trump Court View
WellPoint Inc. (WLP)'s $4.9 billion deal for Amerigroup Corp. is a bet that health insurers can profit from Medicaid coverage for the poor even after the U.S. Supreme Court put the program's future growth up in the air….WellPoint Chief Executive Officer Angela Braly's sees "unprecedented growth" for Medicaid plans, even as Republican governors vow to resist an expansion pushed by President Barack Obama that would add as many as 17 million new members. If Obama's plan isn't implemented fully, the industry still may gain tens of billions of dollars in business as cash-strapped states turn to insurers to manage their programs, company executives said (Nussbaum and Wayne, 7/10).

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The Dust Up Continues As Some GOP Governors Reject The Medicaid Expansion

Virginia Gov. Bob McDonnell, however, says he is considering opting out but would like more answers -- both in terms of policy questions and the political outcome of the election -- before he makes a decision. Meanwhile, Stateline explores how the Medicaid expansion will present a tough fiscal call for many of state executives.

Politico: Southern Governors Secede From Medicaid
House Republicans are lining up to repeal the Affordable Care Act on Wednesday, but GOP governors in the South have a real plan to gut the law. Govs. Rick Perry in Texas and Rick Scott in Florida have both said they won't expand Medicaid to more of the working poor in their states — rejecting a central part of the law designed to cover 15 million more Americans (Allen and Smith, 7/10).

The Associated Press/Washington Post: GOP Governors Doubt Feds Can Deliver Health Care To Uninsured On Schedule
In a letter Tuesday to Obama, Virginia Gov. Bob McDonnell said GOP governors think it's unlikely the federal government will meet deadlines for new health insurance markets in each state by 2014. If that's the case, the governors said Obama should acknowledge it now (7/10).

CQ HealthBeat: Republican Governors Press White House For Answers About Health Care Law
One day before the Republican-controlled House planned to vote to overturn the 2010 health care overhaul, Republican governors slammed the law as an insufficient and unaffordable proposal that probably will not be ready by its Jan. 1, 2014, start date. In a letter to President Obama, Virginia Gov. Bob McDonnell, chairman of the Republican Governors Association, argued on behalf of his GOP colleagues that the Medicaid provisions in the health care law would put a financial burden on states and that federal health insurance exchanges will probably not be functional by the fall of 2013 (Adams, 7/10).

Politico Pro: RGA Has Lots Of Questions After SCOTUS Ruling
Republican governors are raising questions — lots of them — about how implementation of the federal health care law is going to work now that the Supreme Court has rendered its verdict. Virginia Gov. Bob McDonnell sent a seven-page letter Tuesday to President Barack Obama asking for "prompt answers" to 30 questions states need resolved before they can decide how to proceed with state health care exchanges and the Medicaid expansion (Norman, 7/10).

The Washington Post: McDonnell Considers Opting Out Of Medicaid Expansion
Gov. Bob McDonnell sent a letter to legislators Tuesday saying that he is considering whether Virginia should opt out of the federal health law's Medicaid expansion, but needs more information (Kumar, 7/10).

Richmond Times-Dispatch: McDonnell Wants More Answers On Health Care Law
McDonnell outlined his concerns in a three-page letter on Tuesday to members of the General Assembly, in which he repeated his objection to calling a special legislative session to carry out parts of the Patient Protection and Affordable Care Act. "I remain convinced for now that a special session would not be a good use of taxpayer dollars," he told lawmakers (Martz, 7/11).

NPR: Will Medicaid Bring The Uninsured Out Of The Woodwork?
Ever since the Supreme Court decided last month that an expansion of Medicaid under the Affordable Care Act should be optional, quite a few Republican governors have been vowing to take a pass. ... Perry and his colleagues say they're rejecting the health law for mostly ideological reasons. That's because when it comes to Medicaid, the states don't appear to be on the hook for very much money (Rovner, 7/11).

Stateline:  For Some States, Medicaid Expansion May Be A Tough Fiscal Call
Skeptics say the Republican governors who have pledged not to take part in the health-care law's Medicaid expansion are just posturing, and that eventually they will succumb to the lure of federal dollars. They note that several GOP governors initially refused stimulus money on political principle, but eventually accepted it because their states were desperate for help…If history is a guide, it might be years before the recalcitrant states agree to participate—if they ever do (Vestal, 7/11).

The Associated Press/Houston Chronicle: LePage, Pingree Clash Over Medicaid Cuts
[Maine] Republican Gov. Paul LePage clashed Tuesday with Democratic U.S. Rep. Chellie Pingree over Medicaid cuts that the governor sought to balance the state budget and that the congresswoman says run afoul of President Barack Obama's health care overhaul. Pingree wrote to U.S. Department of Health and Human Services Secretary Kathleen Sebelius this week asking her to reaffirm federal prohibitions on cuts in Maine's Medicaid program. LePage said Tuesday that she was working against the state's interests (Sharp, 7/10).

Meanwhile -

CQ HealthBeat: AIDS Activists Warn Medicaid Opt-Out Could Harm Treatment In Hard-Hit South
Concerned over announcements by some governors that they won't support the health overhaul's Medicaid expansion, AIDS activists Tuesday said they plan to mobilize on the local level to press legislators to allow low-income adults to be covered by the federal-state health program for the poor (Norman, 7/10).

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Campaign 2012

Candidates Take Sides Ahead Of Latest Health Law Repeal Vote

Candidates in Massachusetts and Colorado disagree over the course to take on the health law ahead of a repeal vote in the House Wednesday.

Boston Globe: Senate Rivals' Ideas Differ On Cutting U.S. Deficit
Democrat Elizabeth Warren would impose higher taxes on top earners, end oil subsidies, and raise estate taxes to cut the federal deficit. Senator Scott Brown would repeal President Obama’s health law, freeze federal pay, and consolidate redundant federal agencies. Warren would not touch entitlements, while Brown would not touch taxes (Bierman, 7/11).

Denver Post: Obamacare: Tipton, Pace Trade Barbs In Advance Of U.S. House Repeal Vote
On the eve of the U.S. House vote to repeal President Obama's health care bill, Congressman Scott Tipton's campaign manager slammed Democratic opponent Sal Pace for failing to take a clear stand on the issue, while Pace called the repeal vote "nothing more than an attempt to score partisan political points." Tipton, R-Cortez, voted against the bill commonly known as "Obamacare" in 2010. He voted for repeal in January 2011 and plans to do so again tomorrow (Burnett, 7/10).

Fox (Video): Dems Push Hot-Button Social Issues In Campaign Attack Ads
This campaign season, it seems that Democrats are the ones pushing the social issues hot buttons. In addition to his proclamation in favor of same-sex marriage, the President's campaign is now also running attack ads on the subject of abortion. In the ads from both the Obama campaign and Planned Parenthood's Action Fund, Romney is accused of favoring a complete ban on abortion in all circumstances. He actually supports exceptions in the case of rape, incest and when the life of the mother is threatened. … Democratic strategist Lanny Davis, who believes many independent voters struggle with the abortion issue, warns that the ads could backfire. "If you are in the middle on the issue ... you have doubts about abortion," Davis says, adding, "That ad may end up actually offending the people who are in the middle, which is why it's a dangerous ad" (Bream, 7/10).

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Administration News

Obama To Make Federal Health Insurance Available To Seasonal Firefighters

The directive to make federal health insurance coverage available to these seasonal employees follows a two-month electronic petition drive. 

The Associated Press: Wildland Firefighters Win Federal Health Benefits
President Barack Obama will make federal health insurance available to about 8,000 temporary wildland firefighters, a White House official said Tuesday. Despite the grueling and dangerous work they do, the 8,000 firefighters aren't covered by federal health insurance because they are temporary seasonal employees. Under federal personnel rules, such employees can't buy into federal health insurance plans (Elliott, 7/11).

Reuters: Obama Orders Health Insurance For Government's Seasonal Firefighters
President Barack Obama has ordered his administration to offer health insurance to seasonal firefighters employed by the U.S. government, after an outcry over the lack of affordable coverage available to thousands of such workers. Obama's directive, confirmed by the White House on Tuesday, capped a 2-month-old electronic petition drive started by a member of a U.S. Forest Service "hot-shot" crew based in South Dakota that has drawn more than 125,000 signatures (7/11).

Denver Post: Obama Directive Offers Wildland Firefighters Health Insurance
President Barack Obama has directed federal officials to offer seasonal firefighters the option of purchasing federal health insurance coverage, White House officials told The Denver Post Tuesday. On a recent trip to Colorado Springs, the president was apparently moved by the men and women firefighters he met, senior administration officials said in an interview (Sherry, 7/10).

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Coverage & Access

IOM Report: Nation Lacks Health Workers Trained To Meet Seniors' Mental Health Needs

The Institute of Medicine report, released Tuesday, found the continued lack of trained health care providers will make it difficult to meet the growing demand for mental health services from the nation's growing senior population.   

The Associated Press: Report: Too Little Mental Health Care For Boomers
Getting older doesn't just mean a risk for physical ailments like heart disease and bum knees: A new report finds as many as 1 in 5 seniors has a mental health or substance abuse problem. And as the population rapidly ages over the next two decades, millions of baby boomers may have a hard time finding care and services for mental health problems such as depression -- because the nation is woefully lacking in doctors, nurses and other health workers trained for their special needs, the Institute of Medicine said Tuesday (Neergaard, 7/10).

Kaiser Health News: Capsules: Report: Nation Isn't Ready For Seniors' Mental Health Needs
A continued lack of specialists and other trained providers including primary care physicians and nurses will likely make it difficult for aging patients to receive treatment for depression, dementia and other conditions" (Torres, 7/10).

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Health Care Fraud & Abuse

HHS Inspector General: Many Medicare Anti-Fraud Contractors Have Ties To Companies They Investigate

The Associated Press reports that as many as two-thirds of these contractors had financial connections to claims processors. 

The Associated Press: Study: Medicare Contractors Vulnerable To Conflict
Firms that are paid tens of millions of dollars to root out Medicare fraud are bidding on contracts to investigate companies they are doing business with — sometimes their own parent companies, according to a government report released Tuesday. Two-thirds of the companies that bid on contracts during a nearly year-and-a-half time period beginning in October of 2010 had financial ties to claims processors — and in some cases also processed Medicare claims themselves, according to the study by the U.S. Department of Health and Human Services' inspector-general (Kennedy, 7/10).

In other related news -

The Hill: HHS Inspector General: Health Grants Could Have Illegally Funded Lobbying
Federal healthcare grants might have been illegally used for political lobbying, according to the Health and Human Services Department's inspector general. The inspector general said grants administered by the Centers for Disease Control and Prevention (CDC) might have been used for lobbying efforts — and that the CDC might have led recipients to believe lobbying was appropriate, despite a federal ban on using grant money for political activism. Inspector General Daniel Levinson outlined his office's findings in an "early alert" letter to CDC Director Thomas Frieden, a copy of which was obtained by The Hill (Baker, 7/10).

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State Watch

Minn. Governor's Letters Detail Plans To Implement Health Law, Exchange

Minnesota Gov. Mark Dayton sent letters to HHS Secretary Kathleen Sebelius and Republican leaders in his state Tuesday saying that he is moving forward with implementing the health law -- including the formation of a health insurance exchange -- even though GOP leaders there are in a holding pattern.

Minnesota Public Radio: Dayton: MN Is Moving Forward With Health Insurance Exchange
Gov. Dayton sent letters to U.S. Health and Human Services Secretary Kathleen Sebelius and GOP legislative leaders saying his administration is moving forward with creating a state-based health insurance exchange. "We will seize the historic opportunities to improve the quality and affordability of health care afforded us by new law, known as the Patient Protection and Affordable Care Act, whose constitutionality has now been affirmed by the U.S. Supreme Court," Dayton wrote to Sebelius (Scheck, 7/10).

Minneapolis Star Tribune: Dayton Makes Plans For State To Implement Health Care Law
While some states are opting out of President Obama's health care programs, Gov. Mark Dayton wanted it known Tuesday that he's all-in. "I write to reiterate the State of Minnesota's intention to continue the planning and development" of a state-based version of the federal health care act, Dayton wrote in a letter to the U.S. secretary of Health and Human Services. "We will seize the historic opportunities to improve the quality and affordability of health care afforded us by the new law, known as the Patient Protection and Affordable Care Act, whose constitutionality has now been upheld by the U.S. Supreme Court" (Brooks, 7/10).

(St. Paul) Pioneer Press: Dayton Reiterates Plans For Health Insurance Exchange
Democratic Gov. Mark Dayton sent a letter to Republican legislators Tuesday, July 10, asking them to participate in planning for a health insurance exchange -- a key provision of the federal health care law. But a key Senate leader on health care issues Tuesday night said he continues to think Republicans should not engage the planning effort until voters get the chance to weigh in on the health law during elections this November. Republicans are promising to repeal the law if they take control of Congress and the White House (Snowbeck, 7/10).

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Hearing Set For Wednesday On Miss. Abortion Law

A federal judge today will hear arguments on letting an abortion law in Mississippi go into effect. Opponents say the law could shutter the state's only abortion clinic.

The Associated Press: Miss. Anti-Abortion Law Back Before Federal Judge
A hearing Wednesday will help a federal judge decide whether to keep blocking a Mississippi abortion law or let it go into effect. The state's only abortion clinic, Jackson Women's Health Organization, says it could be forced to close if the state is allowed to start enforcing the measure, which would require anyone performing abortions at the clinic to be an OB-GYN with privileges to admit patients to a local hospital (Pettus, 7/11).

In the meantime, a bill that would affect abortion in the District of Columbia has a hearing in the House.

The Hill: NOW Blasts 'Radical Right-Wing Men' Behind DC Abortion Bill
The National Organization for Women (NOW) slammed Rep. Trent Franks (R-Ariz.) and other GOP lawmakers for supporting a new bill that would limit abortion rights in Washington, D.C. The House Judiciary Committee was scheduled to mark up Franks's bill, H.R. 3803, on Tuesday morning. The measure would criminalize abortions after 20 weeks in the District because, Republicans argue, some research suggests that fetuses can feel pain at that point. NOW President Terry O'Neill called the bill a "clear strike in the ongoing War on Women" (Viebeck, 7/10).

And Planned Parenthood in Iowa faces fraud allegations.

Des Moines Register: Planned Parenthood Of The Heartland Faces Medicaid Fraud Allegation
Planned Parenthood of the Heartland faces a lawsuit alleging nearly $28 million in fraudulent billing and health care practices, according to documents unsealed this week. Planned Parenthood of the Heartland President Jill June released a statement describing the suit as "a pattern of harassment against women’s health care and Planned Parenthood affiliates across the country." ... Susan Thayer, a former Planned Parenthood clinic director from Storm Lake, brought the lawsuit in March 2011 under state and federal whistle-blower laws that allow people with knowledge of fraud involving government contractors to bring allegations forward in the form of a lawsuit (Finney, 7/10).

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State Roundup: Iowa Union Files Complaint Over Gov. Order On Insurance

A selection of health policy stories from Michigan, Florida, Kansas, California and Arizona.

Des Moines Register: Union Files Complaint Against Branstad Over Health Insurance Order
Iowa’s largest public employees' union filed a complaint today with the state alleging Gov. Terry Branstad broke the law when he signed an executive order that allows state workers to voluntarily pay 20 percent of their health insurance premiums. The prohibitive practice complaint filed with the Iowa Public Employment Relations Board alleges state law bans Branstad from making unilateral changes to health insurance plans because they are collectively bargained, said Danny Homan, president Council 61 of the American Federation of State, County and Municipal Employees (Krogstad, 7/10).

Health News Florida: DOH Denies Cover-Up On TB
Today, state officials defended the Department of Health from accusations that it covered up a serious TB outbreak in Jacksonville in order to proceed with downsizing of the state's largest agency. DOH's press office released a statement from Dr. Steven Harris, deputy secretary, that called the accusations inaccurate and "outrageous." Harris said that as soon as health officials noted a spike in Duval County TB cases, they asked for help from the Centers for Disease Control (CDC) and organized a coalition to address the issue (Gentry, 7/10).

Detroit Free Press: Bernard Kilpatrick Among 51 Who Get Health Care For Life In Wayne County
In Wayne County, as little as three years on the job was long enough to qualify for lifetime health care benefits for some high-ranking appointees and politicians. Fifty-one former Wayne County government employees are eligible for the benefit, which began in 1994. The county says it can't quantify what the health care coverage will cost and points out that it ended the program last year for everyone hired or elected after Oct. 1, 2011. That move came amid a firestorm of criticism over generous benefits that were being paid to top officials (Wisley, 7/11).

Kansas Health Institute News: Managed Care Execs Meet With KanCare Advisory Group
Representatives of the three managed care companies picked to run Kansas' $2.8 billion Medicaid program said Monday that they would keep the new system's procedural hassles to a minimum. "It's not like each of us are going to come in with new forms and administrative procedures," said Holly Benson, senior vice president of health policy for Centene, speaking at a meeting of the KanCare Advisory Council. KanCare is Gov. Sam Brownback's plan to overhaul the state's Medicaid programs in ways administration officials say will improve quality and lower costs (Ranney, 7/10).

HealthyCal: Program Trains Docs To Treat Underserved Groups
The San Joaquin Valley Program in Medical Education (PRIME) might not be that well known by residents yet, but it could improve health care for those who live in the eight-county area for years to come. The program is training doctors, most of whom are from the San Joaquin Valley, who want to treat underserved populations in the area. Currently, the San Joaquin Valley has too few doctors, including both primary care physicians and specialists (Noonan, 7/11).

Arizona Republic: Same-Sex Health Benefits Appeal May Hurt Tourism
Gov. Jan Brewer's latest fight for states' rights may impact Arizona's tourism economy, some say, pitting state officials against gay and lesbian tourists who pour millions of dollars into state coffers. The push back came in the wake of Tuesday's resignation of a member of the Arizona Tourism Advisory Council. Edwin Leslie, a Brewer appointee, stepped down over Brewer's decision to ask the U.S. Supreme Court to eliminate health-care benefits for state employees' same-sex partners (Sanchez, 7/10).

California Healthline: Capitol Reacts To Budget, Reform Ruling
Health care issues took center stage in California for the past month -- first, when budget pushback focused on health-related programs, and more recently, when the Supreme Court took a stand on legality of the federal health care reform law. Here's a taste of what California had to say about it all, culled from interviews, releases and a variety of media outlets (Gorn, 7/11).

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Editorials and Opinions

Viewpoints: Trouble Keeping Health Costs Down; Ignagni Says Law Needs Some Revisions; Coverage Is Like Clean Water

Reuters: Now Is The Time To Focus On Healthcare Affordability
Now that the Supreme Court has provided legal certainty on the recent healthcare reform law, the nation must turn its attention to affordability. While the law expands coverage to millions of Americans, a goal health plans have long supported, major provisions of the law need to be changed to avoid significant cost increases for consumers and employers (Karen Ignagni, 7/10).

Los Angeles Times: Health Insurers' Suits Show They're Not Keeping A Lid On Costs
With federal healthcare reform still facing political head winds despite its validation by the Supreme Court, this probably isn't the best time for health insurers to admit their utter incompetence in handling their most important role under the reform, which is keeping a lid on healthcare costs (Michael Hiltzik, 7/11).

The Washington Post: GOP To The Uninsured: Drop Dead
The Republican message to uninsured Americans in the wake of the Supreme Court's recent ruling couldn’t be clearer: You're on your own (Matt Miller, 7/10).

Bloomberg: Big Subsidies Will Push States To Expand Medicaid
The bottom line is that given the steep federal subsidies being offered, it seems likely that states will eventually take up the additional coverage, even if they resist at first. ... The process, moreover, will probably be asymmetrical: Once a state takes up the highly subsidized additional coverage, it will be very likely to keep it. But even if it refuses the offer initially, it can easily change its mind later on (Peter Orszag, 7/10).

USA Today: Health Care Reform Needs A Do-Over
The Affordable Care Act narrowly escaped death at the hands of the Supreme Court, but its troubles are far from over. Stability in how Americans will get their health care in the future is now just as much threatened by the ACA's internal flaws as it is by Republican opposition and fresh lawsuits (Arnold Relman, 7/10).

Bloomberg: Health Care Will Become A Right, Just Like Water
The arc of history suggests that eventually Americans will accept the right to health care. It appears that the country is continuing its path of two steps forward, one step backward, in establishing a higher bar of essential services for its citizens. Time has shown that this progress is not only good for individuals, but will serve the needs of American business, as well (Alex Marshall, 7/10).

Roll Call: Health Care Decision Cements Law, Not Debate
A vote to uphold the health care law makes it very hard to argue that the court has become the purely partisan instrument of its five Republican-appointed justices. On the decision itself, (Chief Justice John) Roberts' logic was actually foreshadowed in the oral arguments, where he showed an uncommon interest in the taxing power issue. But the fact that he rejected the mandate on Commerce Clause grounds, accepting the argument that inactivity is not the same as activity and that the slippery slope could lead Congress to mandate that everyone eat broccoli, is itself dismaying (Norman Ornstein, 7/11).

The Hill: Romney’s Tax Flip-Flop
(GOP presidential candidate Mitt) Romney's predicament is obvious — how do you attack a healthcare law concocted by the conservative Heritage Foundation, which you pioneered as governor, after it was approved by the Supreme Court’s foremost corporatist (Markos Moulitsas, 7/10)?

Sacramento Bee: Money Flows In Battle Against Health Reform
Republicans took back the House two years ago in part by targeting Democrats who supported Obamacare. Now that the Supreme Court has upheld Obama's signature achievement, the assault is accelerating. California is a major part of that fight. To understand how that battle will be fought, take a look at American Action Network, a nonprofit corporation, and its related organization, a super PAC called Congressional Leadership Fund (Dan Morain, 7/11).

The Milwaukee Journal Sentinel: A Bad Rerun: GOP Again Tries to Repeal Health Law
Republicans should move on. If they have a better plan, they should advance it. But here's the thing: The party doesn't appear to have a coherent plan to address millions of people without insurance or the rising costs associated with a broken system (7/10).

Houston Chronicle: Perry's Medicaid Move Will Cost Us Plenty
Rick Perry is saying no to a fully funded Medicaid plan to help almost 2 million Texans for no other reason than politics. He doesn't care that there will be higher taxes, higher medical costs and more suffering. His primary interest is in advancing his political career. And he is clearly convinced his own political ambitions are worth our sacrifice. Our health. Our money (Glenn W. Smith, 7/10).

The Dallas Morning News: On Health Care, Perry Offers Potshots But No Plan
A specific alternate plan ought to be the price of admission for criticizing the current plan. Call it "socialized medicine" or a "Washington power grab" or any other politically loaded phrase you'd like, but the next sentence out of your mouth ought to be a concrete proposal for something better. Otherwise, we're just going to get more performances like we saw on Monday from (Texas Gov. Rick) Perry — lots of posturing in front of lots of cameras with nary a word to move us forward on health care (Steve Blow, 7/10).

Arizona Republic: Repealing Health-Care Act Would Imperil Ariz. Lives
As the U.S. House prepares to hold another vote on repealing the Affordable Care Act, it's easy to dismiss the effort as political theater. But, for millions of Americans who rely on the law's benefits and protections, the devastating effects of repeal would be all too real. Here's what repeal would mean in concrete terms for families in Arizona and across the country (HHS Secretary Kathleen Sebelius, 7/11).

Journal of the American Medical Association: The Moral Duty To Buy Health Insurance
Rather than appeal to the collective good, this Viewpoint argues for a duty to buy health insurance based on the moral duty individuals have to reduce certain burdens they pose on others. Because physicians and hospitals have a duty to rescue the uninsured by providing acute and emergency care, individuals have a corresponding duty to purchase insurance to cover the costs of this care. Requiring individuals to meet this obligation is consistent with respect for individual liberty and does not imply that they must buy gym memberships or eat broccoli (Tina Rulli, Dr. Ezekiel J. Emanuel and David Wendler, 7/11).

JAMA: Patient Satisfaction And Patient-Centered Care: Necessary But Not Equal
Although quality of service is correlated with satisfaction, the dynamics of this relationship are complex and not fully understood. Because consumers are not always equipped to evaluate technical competency, they tend to rely on peripheral elements of the encounter such as friendliness and the quality of personal interactions. In this regard, customer and patient satisfaction are similar because both value the process by which services are delivered. Patient satisfaction is important because it means the physician has provided comfort, emotional support, education, and considered the patient's perspective in the synthesis of the clinical decision-making process. However, patient satisfaction and patient-centered care differ in that physicians are not obligated to satisfy all demands by patients in a patient-centered practice (Dr. Joel M. Kupfer and Edward U. Bond, 7/11).

The Washington Post: Resistance To Antibiotics Is Becoming A Crisis
One of the great medical advances of the last century, the invention of antibiotics, is at risk of being lost. Increasingly, microbes are becoming untreatable. Margaret Chan, director general of the World Health Organization, warned in March of a dystopian future without these drugs. "A post-antibiotic era means, in effect, an end to modern medicine as we know it," she said. "Things as common as strep throat or a child's scratched knee could once again kill" (7/10).

MinnPost: It's Time To Stop Appeasing The Food Industry, Obesity Expert Says
If we’re going to take the world's growing obesity problem seriously and actually do something about it, governments and public-health officials need to regulate, not collaborate, with Big Food, argues a leading obesity expert in a blistering commentary this month in the journal PLoS Medicine (Susan Perry, 7/10).  

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The Kaiser Daily Health Policy Report is published by Kaiser Health News, an editorially independent program of the Kaiser Family Foundation. (c) 2014 Kaiser Health News. All rights reserved.