First Edition: June 4, 2014

Today's headlines include a story about the costs some states will face in attempting to fix their online insurance marketplace.  

Kaiser Health News: A Hot Sauce Accident Leads To Health Insurance
Houston Public Media’s Carrie Feibel, working in partnership with Kaiser Health News and NPR, reports: “When we first met Tammy Boudreaux, a freelance social worker in Houston, last December, she was still weighing her health insurance options. She told us she was overwhelmed and confused by the choices she was finding on healthcare.gov; plus, the high deductibles of the Obamacare plans didn't seem like such a great deal. But when we checked back in with Boudreaux this month, we learned that complications from a chance encounter with a bottle of hot sauce ultimately changed her mind” (Feibel, 6/3). Read the story.

The Wall Street Journal: Five States' Health-Care Exchanges See Costly Fixes
Five states that launched health exchanges under the Affordable Care Act expect to spend as much as $240 million to fix their sites or switch to the federal marketplace, a Wall Street Journal analysis shows. Maryland, Massachusetts, Minnesota, Nevada and Oregon estimate the money will be needed to fix problems with troubled marketplaces or to join the federal exchange before the next enrollment period in November, according to an analysis of data provided by the state exchanges. Funds may come from the states, remaining federal grants and new federal requests (Armour, 6/3).

Politico: Democrats Embrace Medicaid Expansion On Trail
Democrats have found a big piece of Obamacare that nearly all factions of their party can back — and they say it’ll be a winning issue on the campaign trail this fall. Even some of the Democrats running for reelection in red states are embracing the Affordable Care Act’s optional Medicaid expansion and, along with their compatriots, pressuring Republican governors and legislatures to do the same (Haberkorn, 6/4).

The Washington Post: Poll: American Back Afghan Pullout, Deeply Concerned By VA Scandal
On a series of specific issues, Obama’s approval ratings are a net negative. Just 38 percent of Americans approve of his handling of immigration reform, 39 percent approve of how he has handled the implementation of the new health-care law, 41 percent approve of his overall handling of international issues and 43 percent approve of his handling of the economy. At least 50 percent disapprove of his handling of those four areas. President Obama has widespread support for his decision to withdraw U.S. forces from Afghanistan by the end of 2016, but a scandal at the Department of Veterans Affairs has united the country in its alarm about the problems, according to a new Washington Post-ABC News poll. … The VA scandal, in contrast, shows no partisan differences and reflects public outrage over reports of long delays for treatment and falsification of records at some veterans’ facilities. The new poll finds a near-unanimous verdict, with 97 percent of Americans describing the problems as serious and 82 percent calling them “very serious” (Balz and Clement, 6/3).

The Wall Street Journal: White House Considering Cleveland Clinic Head For VA Secretary Post
The White House is considering nominating the chief executive of the Cleveland Clinic to be the next secretary of the Department of Veterans Affairs, people familiar with the matter said. Delos "Toby" Cosgrove has led one of the nation's most prestigious hospital systems and is a decorated Vietnam veteran. Three people familiar with the matter said the White House has approached Dr. Cosgrove about the position, and two of them said Dr. Cosgrove is seriously considering pursuing the position (Paletta, Weaver and Adamy, 6/3).

Politico: Many Ideas, But Few Names For VA Pick
Veterans’ advocates and lawmakers won’t name their picks for the next Veterans Affairs secretary — but that’s about the only thing they won’t say about the department’s future. Veterans service organizations have long lists of ways they think the VA must reform and the kinds of skills needed to run it. Their positions are as different as the veterans they represent, but they all agree on one thing (Ewing and Herb, 6/3).

Los Angeles Times: VA Healthcare Crisis Sparks Competing Solutions In Congress
Whether to expand the massive — and troubled — VA healthcare system or simply give veterans greater ability to seek private care promises to ignite Congress’ customary partisan wrangling and complicate passage of reform legislation. Republican senators, led by John McCain of Arizona, on Tuesday rolled out the Veterans Choice Act , which would allow veterans facing weeks-long waits at VA facilities to seek care from private doctors, at the VA's expense. A more sweeping measure sponsored by Senate Veterans' Affairs Committee Chairman Bernie Sanders (I-Vt.) would give veterans who can’t get timely appointments with VA doctors the option of going to community health centers, military hospitals or private doctors at the VA's expense (Simon, 6/3).

Politico: VA Reform Could Face Senate Deadlock
The Senate’s fix to veterans health care problems might be headed down a familiar path: Right into the chamber’s procedural chokehold. There are already signs that Veterans Affairs Department reform could become the next victim of the Senate’s election-year legislative war over amendments votes. Those votes have killed popular tax break and energy efficiency bills in recent weeks and translated to a paucity of legislative votes since last summer (Everett and Herb, 6/4).

NPR: Can Civilian Health Care Help Fix The VA? Congress Weighs In
Veterans across the country are still waiting too long for medical care, a situation that drove the resignation of Veterans Affairs Secretary Eric Shinseki last week. Now Republicans and Democrats in Congress are competing to pass laws they think will fix the problem of medical wait times and other problems at the VA. The discussion over how to reform veterans' health care is starting to sound familiar. … Another private sector solution on the table is a sort of voucher system, which Sen. John McCain has been pushing since his presidential campaign in 2008 (Lawrence, 6/3).

The Wall Street Journal: Top Lawmakers Call For Disclosure Of VA Hospital Data
Two top lawmakers leading Congress's probe of the Department of Veterans Affairs called on Tuesday for the agency to disclose internal analyses that measure treatment outcomes at VA hospitals. … The finding was based on internal VA data called Strategic Analytics for Improvement and Learning, or SAIL. The data, which the VA doesn't make public, rank and score more than 100 VA hospitals according to a variety of metrics, including infection and mortality rates (Paletta and Burton, 6/3).

The Wall Street Journal: How Can You Rate Your VA Hospital?
The Wall Street Journal has published portions of previously undisclosed findings from an internal assessment the Department of Veterans Affairs uses to monitor a number of its hospitals, revealing a wide disparity in health care outcomes. The data are called Strategic Analytics for Improvement and Learning, or SAIL. SAIL data aren’t revealed to the public, but there are some other resources available that offer limited metrics to score VA hospitals as well as non-government hospitals (Paletta, 6/3).

Los Angeles Times: Insurance Commissioner Replay Set For November
Incumbent Democrat Dave Jones held a strong lead in Tuesday's primary election voting for state insurance commissioner, but he still faces a rematch in November against Republican challenger Ted Gaines (Lifsher, 6/3).

The Associated Press: Senate Advances Bill On Birth Control Insurance
A bill that would prevent employers from denying their workers reproductive health coverage under their insurance plans is slowly making its way through the Senate toward a vote. On Tuesday, the measure dubbed the "Boss Bill" was unanimously reported out of the Senate labor committee. … Manhattan Democrat Sen. Liz Krueger, the bill's sponsor, says it will close a loophole in the state's anti-discrimination law, regardless of the Supreme Court [Hobby Lobby case] decision (6/4).

The Wall Street Journal: Arizona's Limits On 'Abortion Pills' Struck Down By Court
A federal appeals court Tuesday struck down an Arizona regulation requiring that so-called abortion pills be administered under a protocol that abortion-rights activists say is outdated and overly restrictive. Ruling in favor of Planned Parenthood Federation of America and the Center for Reproductive Rights, the 9th U.S. Circuit Court of Appeals found that lawyers for the Arizona Department of Health Services "presented no evidence whatsoever that the law furthers any interest in women's health" (Phillips, 6/3).

The Associated Press: Arizona: Court Continues To Block Abortion Rules
Arizona’s rules on the use of abortion drugs are likely to be struck down and will continue to be blocked while a lawsuit against them plays out, a federal appeals court ruled Tuesday. A three-judge panel of the United States Court of Appeals for the Ninth Circuit unanimously ruled the regulations appeared to be an unconstitutional “undue burden on a woman’s right to abortion” and kept in place its injunction on them (6/3).

Los Angeles Times: Can Food Stamps Help Improve Diets, Fight Obesity And Save Money
In so doing, the $79.8-billion Supplemental Nutrition Assistance Program (SNAP) might also reap taxpayers untold future savings for the federally funded care of diabetes and other obesity-related ills among Medicaid recipients. The benefits of making such changes to the program -- more commonly known as food stamps -- would be small and might take a decade to see. But while food stamp recipients often respond to rule changes by paying for disallowed items from their own pockets, such directives can, on balance, nudge their purchasing and consumption habits in positive directions, says a group of medical and health economics researchers from Stanford University and UC San Francisco (Healy, 6/3).

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