First Edition: March 20, 2013

Today's headlines include reports about how the health law's insurance expansion could cause stress among health care providers and strain within the health system.  

Kaiser Health News: Health Law Covers Breast Pumps, But Not All Moms Get The Best
Oregon Public Broadcasting's Kristian Foden-Vencil, working in partnership with Kaiser Health News and NPR, reports: "Under the Affordable Care Act, insurance plans are required to give new mothers equipment and services to enable them to breast feed. What that means in practical terms for most moms is that insurers have to cover the cost of a breast pump – either a rental or a new one" (Foden-Vencil, 3/20). Read the story.

Kaiser Health News: Q&A: I Had To Return To The Hospital; Will They Be Penalized? (Video)
Kaiser Health News consumer columnist Michelle Andrews answers a reader question about the likelihood that their hospital will face a financial penalty from Medicare because they had to return for a different condition (3/20). Watch the video.

Kaiser Health News: Capsules: Some States Balk At Enforcing Health Law's Insurance Protections
Now on Kaiser Health News' blog, Phil Galewitz reports: "Florida regulators won't penalize insurance companies that violate new health law consumer protections that take effect in January but will report them to the federal government, according to an agreement between the state and federal officials. Citing lack of money and legal authority, Pennsylvania's top insurance regulator hasn't decided whether his agency can enforce the provisions, … such as requiring insurers to provide coverage to all applicants regardless of their health status, prohibiting insurers from charging more based on gender or health, and greatly limiting what insurers can charge for premiums based on age. At least three others-; Missouri, Oklahoma and Wyoming -; have informed the Obama administration that they can't or won't enforce the law. … While federal officials say they will step in if necessary, policy experts note they have little experience enforcing health insurance laws and few resources in states to do it (Galewitz, 3/19). Check out what else is on the blog.

The New York Times: Finance Bill, Nearing Senate Passage, Would Protect Some Favored Programs
With the expected Senate passage this week of broad legislation to finance the federal government through Sept. 30, a lucky few programs will be spared the brunt of the automatic spending cuts now coursing through the federal government. … The overall size of the cuts will remain the same, as will the short-term impact on the economy, because total spending outside of entitlement programs like Medicare and Social Security must remain beneath a hard cap of $984 billion (Weisman and Lowrey, 3/19).

The Associated Press/Washington Post: Squabble Over Spending Cuts Slows Progress On Bill To Avoid Government Shutdown
Across the Capitol, the Republican-controlled House began debate on a budget that promises to eliminate federal deficits in decade. The blueprint, authored by Rep. Paul Ryan, D-Wis., calls for $6.4 trillion in spending cuts and no tax increases, and is expected to clear by week's end. For their part, Senate Republicans kept their distance from the plan, deciding not to seek a symbolic vote on it when the Senate begins its own budget debate later in the week. Sensing an opportunity for political mischief, Senate Democrats vowed not to let Republicans off easy. They said they would require a vote on Ryan's budget -; even though they unanimously oppose it (3/19).

The New York Times: In Shift, Lobbyists Look For Bipartisan Support To Repeal A Tax
When executives from Cook Medical gathered last month to offer Representative Cheri Bustos a tour of their central Illinois medical equipment plant, they had good reason to expect a frosty reception from Ms. Bustos, a new Democratic congresswoman. Cook executives had backed Representative Bobby Schilling, her Republican opponent in last year's election for Illinois's 17th District seat, after he had joined with other House Republicans to push for the repeal of a new medical device tax imposed to pay for President Obama's health care law. The company said the tax would cut its profits this year by an estimated $15 million, perhaps limiting future expansions. But in a hint of a shift in corporate lobbying strategy now under way in Washington, the industry pitch is now focused on Democrats like Ms. Bustos (Lipton, 3/19).

The Washington Post's The Fact Checker: Are People Getting $3 In Medicare Benefits For Every $1 In Taxes
Back when the Fact Checker covered politics, "person in the street" interviews generally yielded a similar answer when people were asked about the government -; and whether they got much in benefits for the taxes they pay. The common response: It's a raw deal for me. So we were struck by Barrasso's comment. Are folks really getting $3 in benefits for every $1 in taxes they have paid? And is this really the right way to look at this statistic? (Kessler, 3/20).

Politico: Under New Health Law, Battles Over Who'll Do What
State legislatures are wrestling with all kinds of "scope-of-practice" issues -; turf battles over who can provide what kind of health care, under whose supervision and for what kind of payment. And with the health law coverage expansion going into effect in earnest in 2014, the battles are sharp and numerous, particularly regarding primary care. Everyone agrees there's a primary care shortage, at least in underserved areas. There's less agreement on the role of other practitioners -; notably physicians' assistants and nurse practitioners with advanced degrees -; in preventing the already-strained primary-care system from buckling (Smith and Cheney, 3/20).

Politico: Experts: Obamacare Insurance Gains Could Stress Primary Care System
The health system is girding for millions of new patients under Obamacare, and experts are worried that an already-strained primary care system could buckle unless other health care professionals are marshaled to perform primary care. "We need to get away from the old system of fragmented care and really work on team-based care," said Wanda Filer, director of the American Academy of Family Physicians, at a POLITICO Pro Breakfast Briefing on Tuesday morning (Cheney, 3/19).

Los Angeles Times: Richer Health Benefits Cost 47% More, Industry Report Warns
This latest report examined the cost of about 30,000 individual plans that included eight health benefits and were purchased across 32 states through eHealth Insurance. The federal law requires coverage for a similar group of 10 "essential health benefits," such as maternity care, mental health services and prescription drugs (Terhune, 3/19).

NPR: Cash Back On Broccoli: Health Insurers Nudge Shoppers To Be Well
In the U.S., Wal-Mart and a company called HumanaVitality are now testing a similar healthful food incentives pilot program. Members of HumanaVitality, a partnership between the Vitality Group (owned by Discovery) and health insurer Humana, save 5 percent when they buy foods with the Great For You label at Wal-Mart. But is a 5 percent rebate, or discount, enough to motivate people to change their shopping patterns? It's not clear. HumanaVitality will find out when they analyze the results in September (Aubrey, 3/19).

Los Angeles Times: Rebates Motivate Shoppers To Buy Produce, Whole Grains, Study Says
The Rand study said interest is growing in food discount programs as motivators to improve diet. Nutrient-rich foods have become more expensive, compared with calorie-dense, nutrient-poor foods, and some speculate that this contributes to obesity, the researchers noted. The U.S. Congress funded a demonstration discount project that took place last year in Massachusetts; results are being analyzed (MacVean, 3/19).

Los Angeles Times: Supreme Court Hears Suit Over Liability Of Generic Drug Makers
Nearly 80% of prescriptions that Americans now fill are for generic drugs, and the high court finds itself at a crossroads on how to resolve claims from patients who are badly injured by these copycat products. Should patients have a right to take their cases to a jury and seek damages? Or should the court block all such claims on the grounds that federal regulators already decided the drug was safe for sale? (Savage, 3/19).

The Washington Post: Government Quits Legal Battle Over Graphic Cigarette Warnings
The federal government, facing a court-imposed deadline and fierce opposition from the tobacco industry, has decided to abandon its legal fight to require cigarette makers to place large, graphic labels on their products warning of the dangers of smoking. The decision marks a setback for the Food and Drug Administration, which two years ago announced that it would require tobacco manufacturers to include ghastly images on all cigarette packages (Dennis, 3/19).

The Wall Street Journal: FDA Scraps Graphic Cigarette Warnings
The decision is at least a temporary victory for tobacco makers and leaves it up to the Food and Drug Administration to propose a new set of labels aimed at discouraging smoking. Any new labels aren't expected to appear on cigarette packages for years. The government opted against seeking Supreme Court review of a case that challenged warning labels bearing striking images, such as diseased lungs and a dead body. In August, the U.S. Court of Appeals for the District of Columbia Circuit, in a 2-1 decision, ruled that the proposed labels violated the tobacco industry's free-speech rights under the First Amendment (Dooren, 3/19).

The New York Times: The Doctor Is In (Well, Logged In)
Surfing the Web in his all-white Dumbo loft, Dr. Jay Parkinson, 37, looks like any other young tech visionary. He has a trim beard and thick-framed glasses. He wears slim-fitting black outfits and jaunty scarves. He speaks with a measured, "This American Life"-like cadence. And he's a firm believer in the utopian promise of the Internet. But Dr. Parkinson's start-up isn't a new app or social network. He is a founder of Sherpaa, a Web site that operates like a virtual doctor's office, examining patients by e-mail and text message (Stein, 3/19).

Los  Angeles Times: Deal Will Avoid Deep Cuts In Home Care For Elderly, Disabled
Gov. Jerry Brown will no longer seek steep cuts in home care for the elderly and the disabled, ending a prolonged court battle spawned by the state's persistent budget crisis. The Brown administration reached an agreement with unions and social service advocates to allow an 8% cut in service hours, less than half the 20% reduction the state tried to enact last year (Megerian, 3/19).

The New York Times: Bishops Challenge Cuomo On Stronger Abortion Rights
As Roman Catholics worldwide celebrated the inauguration of Pope Francis, New York bishops traveled to Albany on Tuesday to meet with Gov. Andrew M. Cuomo, whose looming effort to strengthen abortion rights in the state has met with strong protests from Catholic and evangelical clergy (McKinley, 3/19).