First Edition: June 11, 2014

Today's headlines include a range of stories about the upset of House Majority Leader Eric Cantor -- a Virginia primary election shocker -- as well as continuing coverage of health law implementation issues and congressional responses to the VA's health care troubles.

Kaiser Health News: Michigan To Reward Medicaid Enrollees Who Take 'Personal Responsibility'
Kaiser Health News staff writer Phil Galewitz, working in partnership with USA Today, reports: "Delayed by state lawmakers, Michigan did not expand Medicaid until the day after the federal online insurance exchange closed March 31 – a move advocates feared would undermine signups. Turns out, enrollment is exceeding expectations, which has pleased officials who seek to make the state among the first in the nation to add a heavy dose of "personal responsibility" to the federal-state entitlement program" (Galewitz, 6.11). Read the story.

Kaiser Health News: Mass. Inches Toward Health Insurance For All
Reporting for Kaiser Health News in partnership with NPR, WBUR's Martha Bebinger writes: "When Massachusetts passed its landmark health coverage law under Gov. Mitt Romney in 2006, no one claimed the state would get to zero, as in 0 percent of residents who are uninsured. But numbers out this week suggest Massachusetts is very close" (Bebinger, 6/10). Read the story.

Kaiser Health News: Capsules: Study: Health Law Boosts Hospital Psych Care For Young Adults
Now on Kaiser Health News' blog, Jay Hancock reports: "Expanded coverage for young adults under the Affordable Care Act substantially raised inpatient hospital visits related to mental health, finds a new study by researchers at Indiana and Purdue universities. That looks like good news: Better access to care for a population with higher-than-average levels of mental illness that too often endangers them and people nearby" (Hancock, 6/11). Check out what else is on the blog.

The New York Times: Virginia Governor May Try To Expand Medicaid On His Own
Gov. Terry McAuliffe has lost his battle with the legislature over Medicaid expansion, an enormous retreat from the high expectations he set for a liberal agenda. However, he is thought to be studying how to press the issue by executive action -; a legally and politically uncertain course (Gabriel, 6/10).

The Wall Street Journal's Washington Wire: GOP Says Tax Man Cometh For Health Law Enrollees
Republican lawmakers on Tuesday warned that Americans getting larger health-insurance subsidies than they should under the Affordable Care Act will face a tax hit come April. The Centers for Medicare and Medicaid Services, the agency overseeing the health law, has said that at the end of May there were around 1.2 million people whose insurance-exchange applications for coverage had income inconsistencies. That could include people who had misstated their income, had a change in family status, or who got a bonus or raise (Armour, 6/10).

The New York Times: A Health Insurer Calls, With Questions
Medical management options include, for example, programs for expectant mothers, to help make sure they get prenatal care. They are an outgrowth of disease management programs, which aim to improve care and lower costs by helping patients with chronic conditions adhere to treatment regimens. As of April 30, the company has identified about 38,000 new members who would qualify for medical management programs "and, by working closely with providers," has helped them more easily navigate the health care system to get proper care, she said. Members aren't terminated because of responses they may give on the calls, she said. Rather, "this outreach is only to help our members by providing assistance and tools to best manage their health" (Carrns, 6/10).

The Wall Street Journal: Some Small-Business Employees To Have Only One Health-Plan Choice
Small employers in 18 states will offer only one health plan to workers when the Affordable Care Act's small-business exchanges open this fall, federal officials said Tuesday. The 2010 law called for new online insurance marketplaces, which were supposed to open last year, for small businesses to pick group plans to cover workers. But those exchanges were delayed a year, and federal officials say they will lack some functions when they open in November (Radnofsky, 6/10).

The Washington Post: Obamacare's Employer Mandate Is Under Attack From Both Sides. Will It Survive? 
Critics of the health care law, including many business owners, have long bemoaned a provision that requires employers to provide health coverage to their workers. Now, some of the law's supporters are starting to call for the rule's elimination, too (Harrison, 6/10).

Los Angeles Times: A Primer On How The VA Crisis Broke The Usual Congressional Gridlock
The Veterans Affairs healthcare scandal has done something that few other issues have achieved in this hyper-partisan Congress: Unite members of opposing parties in support of swift action to reduce veterans' waits for care and hold VA officials accountable for misrepresenting waiting times. The bipartisanship was apparent Tuesday as the House overwhelmingly approved a bill that would allow veterans facing long waits for VA care to see private doctors, suspend VA bonuses and require an outside assessment of the VA healthcare system (Simon, 6/10).

Politico: House Passes VA Bill
The House approved legislation on Tuesday that gives veterans stuck on long wait lists for medical care the ability to seek treatment outside of the system established by the Department of Veterans Affairs.
Sponsored by Committee on Veterans' Affairs Chairman Jeff Miller (R-Fla.), the bill passed 421-0 with overwhelming support from both parties (French, 6/10).

The Washington Post: Eric Cantor Succumbs To Tea Party Challenger Tuesday
In Washington on Tuesday, the idea of Cantor's loss was so strange that there was no plan in place to deal with it. Other Republicans puzzled: Did Cantor have to resign his position as the House Republican leader immediately? … On Capitol Hill, Cantor's defeat will create enormous uncertainty in the House. Cantor, 51, had been considered the next generation's GOP leader, who would take over for House Speaker John A. Boehner (Ohio) when Boehner, 64, retired. In a caucus deeply divided between establishment Republicans and fire-breathing conservatives, these were the two who had shown some ability to keep order (Costa, Vozzella and Fahrenthold, 6/11).

Politico: The GOP Leadership Scramble
Cantor's loss could also dramatically alter the Republican legislative agenda for the next five months. Cantor had been scrambling to craft GOP health care bill to replace Obamacare -; trying to piece together plans from wide corners of the party that could win support from a majority of Republicans. GOP leadership aides were tentatively planning for a series of health care related votes following the July 4th recess. If a number of Republican Study Committee members hop into the race, it could raise the prominence of their health care alternative. Scalise launched a push just last month to pressure Cantor to schedule a vote on that bill (French and Bresnahan, 6/11).

The Wall Street Journal: Eric Cantor Loses To Tea Party's David Brat In Virginia Primary
Mr. Cantor, responsible for setting the House's legislative schedule, had taken the lead organizing House Republicans' efforts to draft an alternative to the Affordable Care Act, an effort now cast into doubt. Mr. Cantor's defeat also scrambles the outlook for the future of the House GOP leadership. He had been seen as the likely successor to Mr. Boehner, who some had thought might be considering retiring after the next term (Peterson and Hook, 6/10).

Politico: Planned Parenthood To Spend $3M In North Carolina
The political arm of Planned Parenthood is planning to spend $3 million on voter mobilization efforts in North Carolina to help bring women to the polls for Democratic Sen. Kay Hagan. Hagan faces a tough battle in November against GOP nominee Thom Tillis, the state House speaker (Parti, 6/10).

USA Today: Seniors' Use Of Potent Meds Via Medicare Staggering
he number of senior citizens getting narcotic painkillers and anti-anxiety medications under Medicare's prescription drug program is climbing sharply, and those older patients are being put on the drugs for longer periods of time, a USA TODAY examination of federal data shows. From 2007-2012, the number of patients 65 and older getting Medicare prescriptions for powerful opioid pain medications rose more than 30% to upward of 8.5 million beneficiaries, the data show (Eisler, 6/10).

NPR: Switching To Newer Insulin For Type 2 Diabetes Comes At A Cost
Many people with diabetes have switched to newer forms of insulin called analogs, because they can make the disease easier to manage. But that switch can be expensive, a study finds (Shute, 6/10).

Los Angeles Times: L.A.County Board Said Unaware Of U.S. Focus On Mentally Ill Inmates
Supervisor Mark Ridley-Thomas said board members and their staffs were not privy to communications sent by the U.S. Justice Department to Sheriff's Department and county mental health officials regarding ongoing problems until September. That's when county officials received a letter announcing a federal civil-rights investigation of the jail system (Sewell, 6/10).

Los Angeles Times: San Quentin Plans Psychiatric Hospital For Death Row Inmates
The court-appointed monitor of mental health care in California's prison system reported to judges Tuesday that about three dozen men on death row are so mentally ill that they require inpatient care, with 24-hour nursing. For now, they are being treated in their cells, but the state plans to have a hospital setting ready for them by November, according to documents filed Tuesday in federal court (St. John, 6/10).