First Edition: April 26, 2013

Today's headlines include reports that some Democratic senators have concerns about the health law's roll out as well as other news about the measure's implementation.

Kaiser Health News: With Time Running Out, Florida Medicaid Expansion Is In Doubt
Kaiser Health News staff writer Phil Galewitz, working in collaboration with USA Today, reports: "When the U.S. Supreme Court upheld the health law last year … the justices made the expansion of Medicaid voluntary. Of the 27 million people projected to gain coverage under the law, about 13 million are expected to do so through Medicaid.  … Fourteen states, many in the Republican-controlled South, have already rejected the Medicaid expansion, while 20 have agreed to comply with the law, according to consulting firm Avalere Health. Florida, with nearly four million uninsured residents, is one of more than a dozen still weighing the issue. And just as it has an outsized impact on presidential elections, it is likely to play a significant role in the success of the 2010 health law" (Galewitz, 4/26). Read the story.

Kaiser Health News: Capsules: Survey Finds Rate For Young Adult Coverage Improves While Others Decline
Now on Kaiser Health News' blog, Alvin Tran reports: "While the number of medically uninsured young adults dropped over the past two years, coverage of the overall working age population failed to improve, according to the findings of the Commonwealth Fund's 2012 biennial health insurance survey released Friday" (4/25). Check out what else is on the blog.

The New York Times: Democratic Senators Tell White House of Concerns About Health Care Law Rollout
Democrats in both houses of Congress said some members of their party were getting nervous that they could pay a political price if the rollout of the law was messy or if premiums went up significantly (Pear, 4/26).

Politico: Obamacare Exemption Talk Lights Up Capitol Hill
The Obamacare war is on in Congress. A top aide to House Minority Leader Nancy Pelosi sent an email to Democratic offices Thursday afternoon, warning that "Republican trackers" are on Independence Avenue asking lawmakers about the effort to rework which health care insurance members of Congress must use (Sherman, 4/25).

The Washington Post: Aide: Congressional Leaders Consulting On Health Law's Effects On Legislators, Hill Staffers
Congressional leaders are discussing how to mitigate the potential effects of a section of the 2010 health-care law that could cost lawmakers and their employees subsidies for health insurance, an aide said. The Affordable Care Act included a provision requiring members of Congress and their staffs to obtain insurance from online marketplaces set to open in 2014. The exchanges will sell insurance to Americans who don't have health-care coverage from their employers (Wayne and Hunter, 4/25).

The Wall Street Journal's Washington Wire: Obamacare Gives Hill Big Headaches
President Barack Obama's health-care law could cause big headaches for members of Congress and their staff, but efforts to address the potential problem are drawing complaints that congressional leaders are trying to protect their own. At issue is a provision that requires lawmakers and their staff to participate in the health-insurance exchanges that are being set up to help individuals who do not have group coverage to get affordable policies (Hook, 4/25).

The Washington Post's Wonk Blog: 'The Outlook For Medicaid Expansion Looks Bleak'
Twenty states and the District of Columbia have agreed to expand their Medicaid programs, to cover everyone under 133 percent of the federal poverty line. That leaves 30 states that haven't, although Avalere categorizes four states as leaning in that direction (Tennessee, Kentucky, Florida and New York). Some of these states have especially large uninsured populations. Texas, for example,  has an estimated 1.8 million people who would be expected to enroll in Medicaid under the expansion (Kliff, 4/25).

The Washington Post: Maryland Announces Connector Program To Help Enroll Residents Under Federal Health Overhaul
Maryland launched an initiative on Thursday to help residents get health insurance under the federal health care law. Lt. Gov. Anthony Brown and the Maryland Health Benefit Exchange announced the start of the Connector Program, which will be funded with about $24 million in anticipated state and federal grants. The money will be used to fund six organizations that will provide consumer assistance and enrollment resources throughout the state (4/25).

The Wall Street Journal's Risk & Compliance Journal: South Carolina Upgrades Medicaid System To Prepare for ACA
South Carolina is rolling out a new Medicaid platform to meet rules mandated under the Affordable Care Act that require states significantly upgrade their technology and accept more enrollees. The state is turning to an International Business Machines Corp. platform to meet the new requirements. But upgrades to social service platforms aren't without risk, as illustrated by another IBM deal to modernize a state welfare system (Schectman, 4/24).

The Washington Post: White House Chief Of Staff Meets With Senate Republicans On Budget Deal
Earlier this week, the White House considered trying to assemble a group of interested Republicans for further talks, according to Democratic congressional aides. But the administration rejected that approach, and is encouraging Republicans to choose their own negotiating party. Still, several Republicans involved in the process say there is little interest in setting up another "gang" or "supercommittee" to hold private talks with the White House outside the normal committee structure. Instead, senators are talking to the White House about setting a broad framework for moving forward, and then handing the job of drafting a deal off to the Senate Finance Committee, which has jurisdiction over Medicare as well as tax policy (Montgomery, 4/25).

USA Today: Startup Helps Health Insurance Cards Go Digital
In an era of e-tickets, bitcoins and app-based banking, it seems pretty antiquated that we still have to fumble through our wallets for an insurance card each time we go to the doctor's office. But a Philadelphia-based startup has a plan for making those flimsy pieces of cardboard digital -; and the upside isn't just the potential for going paper-free. With the rise of high-deductible plans, patients are increasingly on the hook for more of their medical expenses than they've ever been before. For patients, that means a bigger need for tools that provide more transparency about health care costs. And for doctors, particularly independent physicians, said Medlio co-founder and CEO David Brooks, that means a growing problem with collecting payment (Heussner, 4/25).

The New York Times: Doctors Denounce Cancer Drug Prices Of $100,000 A Year
With the cost of some lifesaving cancer drugs exceeding $100,000 a year, more than 100 influential cancer specialists from around the world have taken the unusual step of banding together in hopes of persuading some leading pharmaceutical companies to bring prices down (Pollack, 4/25).

The Washington Post: Women's Health Groups Want Peace Corps Volunteers To Have Insurance Coverage For Abortions
If a Peace Corps volunteer is raped and becomes pregnant as a result, she has to pay for an abortion herself, because the federal government refuses to cover the cost. Yet women on the paid Peace Corps staff, along with other federal employees, federal prisoners, women on Medicaid and Native Americans, have long received insurance coverage for abortions in cases of rape or incest or if their health is in danger. In January, women in the military got the same access (Rein, 4/25).

Los Angeles Times: HIV Vaccine Trial Shut Down
In another major setback for efforts to develop an HIV vaccine, federal researchers have shut down a key clinical trial after an independent panel of safety experts determined that volunteers who got an experimental vaccine appeared to be slightly more likely to contract the human immunodeficiency virus than those who got a placebo. … The announcement came Thursday from the National Institute of Allergy and Infectious Diseases, known as NIAID, which developed the HVTN 505 vaccine and launched the advanced clinical trial in 2009. The vaccine was designed to prime the immune system to mount a robust defense against all three subtypes of the HIV virus (Healy, 4/25).

The Associated Press/Washington Post: Md. Hospital Association Asks State Panel To Spare Hospitals From A Medicare Cut
The Maryland Hospital Association urged a state commission on Thursday to spare hospitals from a 2 percent Medicare cut that is part of federal budget reductions. In response to the recommendation by staff members of the Health Service Cost Review Commission to have hospitals absorb the cuts for the rest of the fiscal year, the group issued a report warning the panel about deteriorating financial health of hospitals in the state (4/25).

The New York Times: State Suspends Enrollment In Adult Care Plan Amid Fraud Concerns
State officials have suspended enrollment in New York's largest managed long-term care plan for frail elderly and disabled people, and investigators have begun examining the relationships between such plans, which are financed by Medicaid, and the social adult day care centers that send them new customers (Bernstein, 4/25).

Los Angeles Times: Medical Board Of California Could Lose Investigative Powers
The Medical Board of California would be stripped of its power to investigate physician misconduct under a sweeping reform plan by legislators who say the agency has struggled to hold problem doctors accountable. The medical board has come under fire for failing to discipline doctors accused of harming patients, particularly those suspected of recklessly prescribing drugs (Glover and Girion, 4/25).

Los Angeles Times: Labor Groups Renew Push For Paid Sick Leave
Following recent legislative victories in New York and Portland, Ore. -; and one of the worst flu seasons in years -; advocates for paid sick leave are hoping to ride that momentum to win victories locally. Previous failures to get the Legislature to mandate paid sick leave have taught labor groups a few lessons. Among them: Focusing on passing legislation on a city-by-city basis appears to be more fruitful (Lopez, 4/26).

The Washington Post: Plan Coming For Unpaid Chartered Health Claims, Gray Says
Not quite a week after it was announced that D.C. Chartered Health Plan could owe tens of millions more than previously anticipated to city health-care providers, Mayor Vincent C. Gray said Thursday his administration is "developing a plan to provide relief." Chartered Health Plan is currently the city's largest Medicaid contractor, handling the care of more than 104,000 District residents (DeBonis, 4/25). 

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