First Edition: May 3, 2013

Today's headlines include a variety of stories about the health law's implementation, including reports about the Medicaid expansion's red state prospects.  

Kaiser Health News: Advocates Head To Court To Overturn Medicare Rules For Observation Care
Reporting for Kaiser Health News, in partnership with USA Today, Susan Jaffe writes: "Advocates for seniors say the distinction is not fair to patients. They are taking their argument to federal court in Hartford, Conn., Friday for the first hearing on a lawsuit seeking to have Medicare eliminate the observation label. Government lawyers argue in court filings that Medicare considers observation care an outpatient service and if elderly patients think they should have been admitted to the hospital, they should file an appeal" (Jaffe, 5/3). Read the story.

Kaiser Health News: Medicare Seeks To Limit Number Of Seniors Placed In Hospital Observation Care
Reporting for Kaiser Health News, in collaboration with The Washington Post, Susan Jaffe writes: "Medicare officials have proposed changes in hospital admission rules that they say will curb the rising number of beneficiaries who are placed in observation care but are not admitted, making them ineligible for nursing home coverage. 'This trend concerns us because of the potential financial impact on Medicare beneficiaries,' officials wrote in an announcement April 26. Patients must spend three consecutive inpatient days in the hospital before Medicare will cover nursing home care ordered by a doctor" (Jaffe, 5/3). Read the story.

Kaiser Health News: Colorado Weighs Reopening A Psychiatric Hospital To Serve The Homeless
Colorado Public Radio's Eric Whitney, working in partnership with Kaiser Health News and NPR, reports: "Last summer's mass shooting at the movie theatre in Aurora, Colo., led Gov. John Hickenlooper to call for stricter gun control and big new investments in mental health care. Several significant gun bills passed, and a package of mental health reforms are moving forward, but there may not be enough support to win funding for 300 new in-patient psychiatric beds" (Whitney, 5/2). Read the story.

Kaiser Health News: Letters To The Editor: Better Wages For Home Health Aides; Nurse-Staffing Laws; Physician-Owned Hospitals; Actuaries And 'Rate Shock'
This periodic Kaiser Health News feature offers a variety of reader comments on recent stories (5/2). Read the letters.

The Washington Post: In Several States, Medicaid Expansion Remains In Limbo As Time Runs Short
In the closing days of their legislative sessions, lawmakers in more than a dozen states are struggling with whether to expand Medicaid under the federal health-care law, with many of them leaning against participating in a program that is key to President Obama's aim of extending coverage to 30 million uninsured Americans. Twenty states and the District of Columbia have signed on to the expansion, and 14 are planning to decline. But 16 remain in limbo as lawmakers clash in the final days and weeks of the legislative calendar, when many must come to a decision in time for the provision to kick in next year (Somashekhar, 5/2).

The Wall Street Journal: GOP Clashes Stymie Medicaid Expansion
Several Republican governors who defied their conservative bases to support Medicaid expansion under the federal health-care law are running into a brick wall: their states' GOP-led legislatures. The latest clash is unfolding in Florida, where Republican Gov. Rick Scott, an ardent opponent of the 2010 health-care law, shocked many observers by announcing his support for Medicaid expansion in February (Campo-Flores, 5/2).

Politico: Medicaid Expansion Stalls In Red States
Conservative state legislators have thwarted Republican governors who broke with their base in favor of Obamacare's massive expansion of Medicaid. Governors such as John Kasich in Ohio, Rick Scott in Florida and Jan Brewer in Arizona spent political capital but saw their Medicaid expansion plans stall, the latest glitch in implementing the sweeping 2010 health law (Cheney and Millman, 5/2).

NPR: Political Battle Over Health Law Starts Next Chapter
In the three years since the Affordable Care Act became law, public opinion has remained deeply divided, with as many Americans opposing the law as supporting it. When Americans begin signing up for health insurance under the act, opinion may finally begin to shake loose. Some people without access to insurance gain it and others encounter new bureaucracies (Liasson, 5/3).

The Wall Street Journal's Washington Wire: Obamacare Gets New Court Challenge
Opponents of the health-care overhaul have filed a new lawsuit Thursday against the federal government on behalf of four individuals and three employers in the U.S. District Court for the District of Columbia. The complaint focuses on the law's distribution of federal subsidies for Americans to purchase insurance, and whether people can get them if they live in one of the 33 states that have refused to set up their own insurance exchanges and have left that task up to the federal government (Radnofsky, 5/2).

NPR: Congress, Staffers Caught Up In Health Act's Sticky Political Situation
Members of Congress have found themselves in another awkward situation when it comes to the federal health law. They wrote the law to require that members and staffs participate in the new health exchanges starting in 2014. But a glitch could stick them with huge out-of-pocket costs. And, as NPR's Julie Rovner tells David Greene, attempts to fix it could be seen as providing special treatment (Greene and Rovner, 5/3).

Los Angeles Times: Part-Timers To Lose Pay Amid Health Act's New Math
Many part-timers are facing a double whammy from President Obama's Affordable Care Act. The law requires large employers offering health insurance to include part-time employees working 30 hours a week or more. But rather than provide healthcare to more workers, a growing number of employers are cutting back employee hours instead. The result: Not only will these workers earn less money, but they'll also miss out on health insurance at work (Terhune, 5/2).

The Washington Post's Post Politics: Harry Reid Concerned About Obamacare Implementation
Senate Majority Leader Harry Reid (D-Nev.) expressed fresh concerns Wednesday about the implementation of the federal health care reform law, while a second congressional Democrat also chimed in with some worry. Reid said he agrees with Sen. Max Baucus (D-Mont.), one of the law's chief architects, who has expressed concerns about potential problems with implementing some of the law's key components. Baucus recently said he sees a  "huge train wreck coming down" the road in the implementation process (Sullivan, 5/2).

The Associated Press/Washington Post: W. Va. Governor Decides To Expand Medicaid; Analysis Says Additional 92K Likely To Be Covered
West Virginia will expand Medicaid under the federal health care overhaul through a plan announced Thursday by Gov. Earl Ray Tomblin, which would extend coverage to an estimated 91,500 uninsured low-income residents (5/2).

Los Angeles Times: Obama 'Very Comfortable' With Age Restriction On 'Morning After' Pill
President Obama says he's "very comfortable" with a Food and Drug Administration ruling that maintains age restrictions on females who can buy the so-called morning after pill without a prescription. The rule announced this week prohibits girls younger than 15 from buying the drug, known as Plan B, over the counter. The decision was made by the FDA and Secretary of Health and Human Services Kathleen Sebelius, Obama said, pushing back against women's groups that have suggested the White House has interjected its political concern about a touchy subject into the rule process (Hennessey, 5/2).

Politico: President Obama Defends Plan B Appeal
President Barack Obama on Thursday defended his administration's decision to appeal a judge's ruling that the Plan B morning-after pill should be available to women and girls of all ages, saying he was "very comfortable" with the Food and Drug Administration's current rule. Obama said the agency was likely to conduct an additional review, but would go forward with the appeal nonetheless (Epstein, 5/3).

Los Angeles Times: Plan B One-Step Debate Continues
Confused by the wrangling in federal court over the Plan B One-Step emergency contraceptive? You're not the only one. As U.S. attorneys work hastily to halt a federal judge's order regarding the sale of the so-called morning-after pill, medical and reproductive rights groups weighed in on the hot-button controversy, which mixes issues of drug safety, social mores and politics (Morin, 5/2).

The Wall Street Journal: Probe Into Medicare Tips Grows
Sen. Charles Grassley is expanding his investigation into how investors got advance word of a market-moving Medicare policy decision, a development that could shine a spotlight on the office of one of the senator's own colleagues (Mullins and McGinty, 5/2).

The Washington Post: Intel For Investors: What's Going On Behind Closed Doors In Washington
The Washington-based firm Height Securities is a small player in a burgeoning financial field where companies seek to acquire valuable information about even the most minor of federal actions and provide it to investors. Yet a stock brokerage with only $7 million in reported annual revenue, a pittance by Wall Street standards, was apparently able to provoke a major surge in market trading. After Height Securities alerted clients to a pending government decision favoring health-care insurers, trading spiked in the shares of major health-care firms. With a federal investigation underway into these events, the activities have gained public attention (Markon and Yang, 5/2).

The Washington Post: Three New Md. Health Laws Offer More Patient Protection
Maryland Gov. Martin O'Malley signed three laws Thursday that will give more protection for patients. The measures provide more state oversight of cosmetic surgery centers, pharmacies that make sterile medications and staffing agencies that find temporary jobs for health-care professionals (Sun, 5/2).

The New York Times: Park Slope Food Co-op Takes Up New Cause: Saving A Hospital
In a letter written "on behalf of the 16,000 members" of the co-op, its general manager, Joseph Holtz, and a member, Dr. Saul Melman, call on Gov. Andrew M. Cuomo to "take a leadership role" in developing a plan to save the money-losing hospital, known as LICH, which serves a large swath of food co-op territory from its perch in Cobble Hill in northern Brooklyn (Hartocollis, 5/2).

The Associated Press/Washington Post: NJ Gov. Signs Good Samaritan Bill to Help Overdose Victims; Bon Jovi Says It Will Be Lifesaver
The New Jersey law seeks to assure timely medical treatment for overdose victims by encouraging people to seek help without fear of being arrested for drug possession (5/2).