First Edition: November 15, 2012

Today's headlines include the latest details on states' decisions about pursuing health exchanges as well as other political and policy developments.

Kaiser Health News: States Count Down To Decisions On Health Exchanges
Kaiser Health News staff writers Phil Galewitz and Alvin Tran report: "With a federal deadline looming Friday, 10 states remain undecided about whether to build state-based online insurance markets designed to help millions of people buy health coverage starting next October" (Galewitz and Tran, 11/14). Read the story.

Kaiser Health News: Computer Issues May Hamper Online Markets
Kaiser Health News staff writer Julie Appleby reports: "New online insurance markets set to begin selling health coverage to consumers next October may be hampered by delays in launching a key computer program, according to state consultants and insurance regulators. State regulators learned late last week that an electronic system most insurers will use to submit their policies for state and federal approvals won't be ready for testing next month, as originally planned. The lag is being blamed on the wait for several regulations from the Obama administration, which are needed to update the software" (Appleby, 11/14). Read the story.

Kaiser Health News: Capsules: Hospitals, Home Health Care Services Lobby Against Cuts; Progressive Group Recommends $385 Billion In Health Cuts; Employer Health Costs Rise 4 Percent, Lowest Boost Since 1997
Now on Kaiser Health News' blog, Mary Agnes Carey reports on health industry lobbying related to the deficit deal: "As lawmakers and President Barack Obama discuss possible changes to federal entitlement programs as part of a larger deal to avoid the fiscal cliff, expect provider groups to make their case loud and clear: Don't cut us" (Carey, 11/15).

In addition, Phil Galewitz reports on a budget deficit cutting plan advanced by the Center for American Progress: "Hospitals, drug companies, nursing homes and health plans would lose billions in Medicare funding over the next decade under a budget deficit cutting plan recommended by the Center for American Progress, a left-leaning think tank which has close ties to President Barack Obama and former President Bill Clinton" (Galewitz, 11/14).

Also on Capsules, Jay Hancock reports on employer health costs: "Furnishing new evidence of slower growth in health costs, consulting firm Mercer said Wednesday that employers spent 4.1 percent more on health benefits this year than in 2011. It was the smallest increase in 15 years" (Hancock, 11/14). Check out what else is on the blog. 

The Wall Street Journal: At President's Meeting With Executives, Some Push, Pull And Give
President Barack Obama's meeting with top chief executives Wednesday included a frank exchange about the White House's chilly relationship with business executives and firm support for tackling the country's fiscal problems, several people familiar with the gathering said. … He also communicated to the chief executives, in a tone several described as persuasive, that he was committed to substantive changes in Medicare and other entitlement programs, which make up a large portion of federal spending and are projected to grow quickly in the next few decades as more Americans retire (Paletta and Linebaugh, 11/14).

Politico: Senate Liberals To Obama: 'Don't Buckle' On Cliff
Liberal Democrats in the Senate are warning President Barack Obama not to cave on taxes and entitlements in deficit talks set to begin this week, a move that could complicate efforts by the White House to win the backing of GOP leaders. West Virginia's Jay Rockefeller and Tom Harkin of Iowa are circulating a letter among their Democratic colleagues that calls on the president to stand firm on revenue, entitlement programs and spending cuts. They're hoping to get as many as 30 Senate Democrats to sign on, Rockefeller said (Sloan and Raju, 11/14).

The New York Times: Health Law Has States Feeling Tense Over Deadline
The days since President Obama won re-election have been marked by tension and angst in Republican-led states like Iowa, where Gov. Terry Branstad has waited until the last minute to decide whether to create a crucial tool for people to get medical coverage under Mr. Obama's health care law (Goodnough and Cooper, 11/14).

Los Angeles Times: Republican Governors Want More Time To Implement Healthcare Law
In a letter to the president Wednesday, Virginia Gov. Bob McDonnell and Louisiana Gov. Bobby Jindal, the current and incoming chairmen of the Republican Governors Assn., said governors do not have enough information to assess whether they should operate their own insurance exchanges in 2014 or leave the job to the federal government (Levey, 11/14).

The Washington Post: Medicaid Personal-Care Programs Are Targets For Fraud, Investigators Say
Lax requirements for both caregivers and patients, along with poor state and federal oversight, have made the rapidly growing Medicaid personal-care programs an increasingly lucrative target for fraud, according to a federal report scheduled for release Thursday (Eaton, 11/14).

The New York Times' The Caucus: Romney Blames Loss On Obama's 'Gifts' To Minorities And Young Voters
Saying that he and his team still felt "troubled" by his loss to President Obama, Mitt Romney on Wednesday attributed his defeat in part to what he called big policy "gifts" that the president had bestowed on loyal Democratic constituencies, including young voters, African-Americans and Hispanics. … The president's health care plan, he said, was also a useful tool in mobilizing black and Hispanic voters. Though Mr. Romney won the white vote with 59 percent, according to exit polls, minorities coalesced around the president in overwhelming numbers: 93 percent of blacks and 71 percent of Hispanics (Parker, 11/14).

Los Angeles Times: Romney Attributes Loss To 'Gifts' Obama Gave Minorities
Romney's frank analysis echoed his secretly taped comments at a May fundraiser, where he told a small group of donors that 47% of the electorate was unlikely to vote for him because they paid no income taxes and were dependent on government. It followed his running mate Paul D. Ryan's assertion that Obama's win stemmed from turnout among "urban" voters. … Young voters, Romney said, were motivated by the administration's plan for partial forgiveness of college loan interest, the extension of health coverage for students up to age 26 on their parents' insurance plans and free contraception coverage under Obama's healthcare plan, which he credited with ushering greater numbers of college-age women into Obama's coalition (Reston, 11/14).

The Washington Post: Romney: Obama's Gift Giving Led To Loss
Mitt Romney is blaming his loss in the presidential election on "Obamacare" and other "gifts" he says President Obama handed out to African Americans, Hispanics and other core supporters, according to news reports Wednesday. The defeated Republican candidate told donors in a conference call that Obama targeted those demographics, along with young voters and women, through programs such as health-care reform and "amnesty" for children of illegal immigrants, according to articles posted online by the New York Times and Los Angeles Times (Markon and Tumulty, 11/14).

Los Angeles Times: More Employers Embrace High-Deductible Health Plans To Pare Costs
With open enrollment for benefits in full swing, U.S. workers are seeing more high-deductible health plans from cost-conscious employers. A new report finds that 36% of large employers offered consumer-directed, high-deductible health plans in 2012, up from 14% five years ago. Enrollment in those plans has risen to 16% of all covered employees, compared with 5% in 2007, according to benefits consultant Mercer (Terhune, 11/14).

The Wall Street Journal: After Divorce, Many Women Lose Health Insurance
Shedding light on the issues of divorce and health care, a new University of Michigan study estimates that 65,000 American women become uninsured each year as a result of marital dissolution. Indeed, among married women who had health insurance and then divorced, 17 percent were uninsured six months later. There was also a big shift among divorced women from private insurance to public insurance, such as Medicaid. After divorce an estimated 115,000 women each year lose private coverage, the study reported, but many are bailed out by government programs (Akst, 11/14).

The Associated Press/Washington Post: Census: Fuller Poverty Picture Finds 49.7M Are Poor, Factoring In Medical And Work Expenses
The ranks of America's poor edged up last year to a high of 49.7 million, based on a new census measure that takes into account medical costs and work-related expenses (11/14).

Los Angeles Times: Pelosi Decides To Remain House Democratic Leader
In 2007, she became speaker -; and the first Californian to head the House -; overseeing passage of the most far-reaching healthcare overhaul since the creation of Medicare, an economic stimulus program, and the revamping of financial regulations, often with little or no Republican support.  But while she -; and her Democratic majority -; ruled the House, she became a favorite Republican campaign target as evidence of what's wrong with Washington (Simon, 11/14).

The Wall Street Journal: House GOP Elevates Woman To Key Post
House Republicans turned aside an effort by a group of conservative lawmakers to elevate their favored candidate to a top leadership position, choosing instead a female lawmaker who some in the party thought could help close the gap with women voters. The selection of Rep. Cathy McMorris Rodgers of Washington state comes after last week's presidential and Senate elections showed the party faces a challenge in reaching women (Bendavid and O'Connor, 11/14).

Los Angeles Times: Sebelius Subpoenaed Over Efforts To Promote Healthcare Reform
Despite last week's election, House Republicans kept up their attack on the Obama administration's 2010 healthcare law Wednesday, as the House Ways and Means Committee subpoenaed Secretary of Health and Human Services Kathleen Sebelius for information about the administration's efforts to promote the Affordable Care Act (Levey, 11/14).

Politico: Ways And Means Issues Subpoena For Kathleen Sebelius
The House Ways and Means Committee has subpoenaed Health and Human Services Secretary Kathleen Sebelius, demanding that she reveal details of how the agency is promoting the health reform law, according to the committee. The election may have iced efforts to repeal the law on the whole, but House Republicans are indicating they're full speed ahead on intense oversight of how the Obama administration is enacting the legislation (Haberkorn, 11/14).

NPR: Lawmakers Clash With FDA Over Meningitis Outbreak
Members of a House subcommittee clashed repeatedly Wednesday with U.S. Food and Drug Commissioner Margaret Hamburg over the outbreak of meningitis caused by contaminated steroid injections (Stein, 11/14).

The New York Times: FDA Chief Seeks Expanded Authority To Improve Safety Of Drug Compounders
The commissioner of the Food and Drug Administration on Wednesday called on Congress to empower the agency to better police compounding pharmacies like the one at the center of a national meningitis outbreak. But Republican lawmakers pushed back, arguing that the agency has enough authority, leaving it unclear whether the House would support efforts to increase oversight (Tavernise, 11/14).

Politico: Lawmakers Lambaste FDA Chief Over Fatal Outbreak
Appearing under subpoena before a House panel, the co-owner of the compounding pharmacy linked to the meningitis outbreak that has killed more than 30 people took the Fifth Amendment and refused to answer questions Wednesday (Norman, 11/15).

Los Angeles Times: 11% Of Children In California Are Uninsured, Study Says
Children in California are more likely to be uninsured than children nationwide, with 1.1 million lacking health coverage in 2011, according to a new study by the Keck School of Medicine of USC. About 11% of children lacked insurance last year -- and they were less likely to seek medical care than those with coverage, the authors reported. The study, released Wednesday by the California HealthCare Foundation, detailed children's insurance trends over a 10-year period (Gorman, 11/14).