First Edition: April 3, 2014

Today's headlines include reports on how Paul Ryan's budget is playing on Capitol Hill as well as news that the Obama administration is releasing a trove of data on physician services and payments.   

Kaiser Health News: Top Boston Hospital Begins To Tackle Readmissions Problem
Reporting for Kaiser Health News in collaboration with NPR and WBUR, Rachel Gotbaum writes: "Beth Israel Deaconess Medical Center is a highly regarded teaching hospital in Boston, but in 2012, the hospital found out it had one of the highest rates of readmissions among Medicare patients in the country. That meant federal fines of more than $1 million-;and a lot of soul searching for the staff, says Dr. Julius Yang, the head of quality for the hospital. 'Patients coming to our hospital, getting what we believed was high quality care, were coming back at an alarmingly high rate,' says Yang" (Gotbaum, 4/3). Read the story.

Kaiser Health News: Capsules: Why Some Don't Pay Their Obamacare Premium: It's Not What You Think
Now on Kaiser Health News' blog, KQED's Lisa Aliferis reports: "A new analysis finds that many people who signed up for a Covered California health insurance exchange plan are likely to drop the coverage for a good reason: They found insurance elsewhere. Researchers at the U.C. Berkeley Labor Center released estimates Wednesday showing that about 20 percent of Covered California enrollees are expected to leave the program because they found a job that offers health insurance. Another 20 percent will see their incomes fall and become eligible for Medi-Cal, the state's insurance program for people who are low income" (Aliferis, 4/2). Check out what else is on the blog.

The New York Times: What's Next For Health Care
The first open enrollment period for health insurance under the Affordable Care Act has just ended, and consumers, insurers and federal officials now face many immediate chores and challenges that will help determine if the law works as intended. Many questions about the law's potential impact on the health care system remain, and here are some preliminary answers (Pear, 4/2).

The Associated Press: Nonprofit Insurers Struggle In New Marketplaces
A smorgasbord of options and lower prices for consumers were two of the chief selling points for President Barack Obama as he promoted his overhaul of the nation's health insurance industry, predicting Americans would see "competition in ways we haven't seen before." Companies were even started as a way to encourage innovation and competition, namely 23 consumer-run, co-op insurers created with the help of $2 billion in federal loans. But rather than promote competition, the co-ops and smaller nonprofits in some states have languished behind major insurers, attracting in some cases minuscule shares of the market (4/2).

The Wall Street Journal: Health Enrollment Extension To End April 15
People who started signing up for private health coverage before the March 31 enrollment deadline will have until April 15 to finish their applications, the Obama administration said Wednesday, putting an end point on an extension that had prompted questions. The cutoff point is being set for hundreds of thousands of Americans who tried to apply for coverage at the last minute and ran into long waits at enrollment centers, on a telephone hotline or on the website HealthCare.gov because of limits on the system's capacity and a string of late technical problems (Radnofsky, 4/2).

Los Angeles Times: Many More Californians May Qualify For Obamacare After Deadline
Even with 1.2 million people enrolled by Monday's deadline, California's health exchange isn't done adding to the Obamacare rolls -; and it won't be for quite some time. In the months to come, it's estimated that several hundred thousand more Californians could qualify for a special enrollment period as college students graduate, families move and workers change jobs (Terhune, 4/2).

The Associated Press: Md. Panel To Get Update On Health Exchange
A legislative oversight panel on Maryland's troubled health exchanged is holding a meeting to get an update from state officials. The Joint Oversight Committee of the Maryland Health Benefit Exchange is scheduled to meet in Annapolis on Thursday afternoon to hear details about an audit by state analysts (4/3).

The Washington Post: 7 Questions You Should Ask About Maryland's Effort To Replace Its Troubled Health Exchange
Maryland Gov. Martin O'Malley (D) announced Tuesday that the state will replace nearly all of its troubled online health insurance exchange with technology borrowed from Connecticut, which has had one of the most successful exchanges in the country. The new system will be completed by November, officials say, in time for residents to enroll in private plans for 2015. Here are questions, and answers, about Maryland's decision and the impact it will have on citizens seeking to benefit from the 2010 Affordable Care Act (Johnson, 4/2).

The Washington Post's Wonkblog: Michigan And Wisconsin Highlight Divide On Medicaid Expansion
While the health care world was fixated yesterday on the end of Obamacare open enrollment, Tuesday also marked the beginning of a new Medicaid era for two neighboring states that took very different approaches to the law's expansion of coverage for low-income individuals (Millman, 4/2).

The New York Times: Health Enrollment Numbers Lift Democratic Hopes
After months of pummeling by Republicans and with a grim election season approaching, Democrats on Tuesday had a rare bright day. President Obama's announcement that the new health care plan had enrolled 7.1 million Americans coincided with the release by Representative Paul D. Ryan of a new Republican budget that proposes changes in Medicare and deep cuts in spending (Weisman, 4/2).

Politico: Barack Obama On GOP Health Care And Economic Plans: 'Stinkburger' Or 'Meanwhich'
President Barack Obama headed out on the road Wednesday still glowing from the latest Obamacare numbers and set his sights on congressional Republicans still working to obstruct his agenda. The House GOP's new budget proposal and efforts to repeal the Affordable Care Act "should be familiar because it was their economic plan in the 2012 campaign, it was their economic plan in 2010," he said at the University of Michigan in Ann Arbor. "It's like that movie 'Groundhog Day.' Except it's not funny" (Epstein, 4/2).

Los Angeles Times: Obama, Lampooning GOP, Calls For Hike In Minimum Wage
The edgy message opened a new phase for Obama. With the rollout of his 2010 health law nearly complete, the president is now focusing on the congressional elections and on keeping the Senate in Democratic hands, a task his advisors think depends in part on his ability to draw a sharp contrast with the GOP's economic proposals (Parsons and Memoli, 4/2).

The Washington Post: Bobby Jindal, With An Eye On 2016, Unveils Plan To Replace Obama Health-Care Law
In his 26-page plan, Jindal lays out a long critique of the health-care law and reiterates his belief that it needs to be done away with. He sets forth a bevy of ideas to replace it that have run through conservative thought for years, in some cases renaming them and in other cases suggesting new variations on old themes (Costa and Goldstein, 4/2).

The Associated Press: Jindal: GOP Needs 'Obamacare' Alternative
Louisiana Gov. Bobby Jindal, a potential 2016 presidential candidate, on Wednesday offered a Republican alternative to President Barack Obama's health care overhaul, saying states should play a greater role in containing health care costs while giving consumers more flexibility in choosing insurance plans. Jindal said Obama's health care law should be "repealed in its entirety" but said Republicans need to offer a better way to reform the health care system, wading into one of the most contentious policy issues in the upcoming midterm elections (4/2).

The Wall Street Journal: Louisiana Gov. Bobby Jindal Proposes Alternative To Affordable Care Act
Republican Gov. Bobby Jindal of Louisiana, trying to distinguish himself from other potential presidential candidates, outlined a replacement for the Affordable Care Act that he said would expand health coverage to more Americans by making insurance more affordable (Reinhard, 4/2).

Politico: Bobby Jindal Dismisses Obamacare Numbers, Unveils Own Reform Plan
Jindal's health package is predicated on a full repeal of the health care law, however. He said the longer Obamacare enrolls people, the less interested he is in accepting its massive expansion of Medicaid – an optional program that offers states billions of dollars to cover their poorest residents. Asked what he'd tell Republican colleagues who support Medicaid expansion, Jindal said his proposal wouldn't stand in the way of states that want to expand Medicaid on their own. He pointed out that Obamacare is offering states more money to cover able-bodied adults through the expansion than to cover disabled children, who were typically eligible for the traditional Medicaid program (Cheney, 4/2).

The Wall Street Journal: Medicare To Publish Trove Of Data On Doctors
Federal officials said they planned to release reimbursement information on April 9 or soon after that would show billing data for 880,000 health-care providers treating patients in the government-run insurance program for elderly and disabled people. It will include how many times the providers carried out a particular service or procedure, whether they carried it out in a medical facility or an office setting, the average amount they charged Medicare for it, the average amount they were paid for it, and the total number of people they treated (Radnofsky, 4/2).

The Associated Press: Medicare To Release Billing Data For 880K Doctors
Patients may soon get an unprecedented look at how their doctor compares to other physicians, after Medicare announced Wednesday it plans to publicly post billing data for more than 880,000 practitioners. Considered the mother lode of information on doctors, the Medicare claims database has been off-limits to the public for decades, blocked in the courts by physician groups. The American Medical Association has argued that its release would amount to an invasion of doctors' privacy. Consumer groups, insurers, employers and the news media have sought the information to help them evaluate clinicians (4/2).

The Washington Post: Physician Data On Health Services, Payment To Be Released By Obama Administration
The Obama administration announced Wednesday it would for the first time release data about health-care services provided by doctors who participate in Medicare, in what officials hailed as a major step toward making the health-care system more transparent and accountable. As early as next week, the administration plans to release information about the number and type of health-care services delivered by more than 880,000 physicians in 2012, as well as how much Medicare paid them for the services. Together, those physicians collected $77 billion in payments through Medicare (Somashekhar, 4/2).

The New York Times: Medicare To Share Information On Pay For Physicians
Medicare said on Wednesday that it planned to make available to consumers and others detailed information on what it pays individual physicians as soon as next week, despite the long-term resistance by the American Medical Association and other group (Abelson, 4/2).

The Associated Press: GOP Budget Slashes Spending, Aid To Poor
A budget plan stuffed with familiar proposals to cut across a wide swath of the federal budget breezed through the House Budget Committee on Wednesday, but its sharp cuts to health care coverage for the middle class and the poor, food stamps and popular domestic programs are a nonstarter with President Barack Obama (4/2).

The Washington Post: Ryan Budget Plan In Democrats' Crosshairs
Congressional Democrats said Wednesday that the new House Republican budget plan will play a central role in Democratic midterm election strategy. … The Ryan plan released this week closely resembles the House GOP budget requests proposed and passed in recent years. The plan would cut federal spending by $5 trillion over the next decade by effectively repealing the Affordable Care Act, making deep cuts to Medicare and cutting taxes significantly for the nation's wealthiest earners (O'Keefe, 4/2).

The Wall Street Journal's Washington Wire: Why Democrats Like Ryan's Budget
The DCCC Wednesday launched a new campaign called "Battleground: Middle Class" featuring ads and other efforts to attack the GOP budget proposals to revamp Medicare, replace Medicaid with state block grants, and cut spending in domestic programs throughout the budget (Hook, 4/2).

Politico: Paul Ryan Budget Faces Bumps Amid GOP Dissent
And the simmering dispute is significant as it carries political consequences. Even the smallest group of members voting "no" can potentially put a vote in jeopardy and give a black eye to Ryan -; a potential 2016 presidential contender -; and Republican leadership.This is the most serious fallout from the leadership's effort last week to pass a "doc fix" bill. In the blink of an eye last Thursday, Republican leadership used a voice vote to pass a patch of reimbursement rates for physicians who serve Medicare patients. No one had the chance to vote for or against the bill, which faced opposition from both parties (Sherman and French, 4/2).

Politico: Reality Hits Ron Wyden's Idealism
The awkward episode came as Wyden was engaged in a quixotic effort to thwart a bill personally crafted by Reid and House Speaker John Boehner. The deal achieved exactly what Wyden didn't want: a temporary patch in Medicare reimbursement rates that punted a long-term decision to another year. The measure passed the Senate over Wyden's objection and President Barack Obama signed it into law on Tuesday (Raju and Haberkorn, 4/2).

The Associated Press: Insurers Aetna, WellPoint Bulk Up Executive Pay
Health insurers enjoyed a boom year in 2013, with soaring earnings and stock prices, and some of the biggest companies shelled out millions of dollars to either keep or attract their leaders. Aetna Inc. Chairman and CEO Mark T. Bertolini saw his total compensation more than double to top $30 million last year, largely due to restricted stock and options valued at $17.6 million that the nation's third-largest insurer gave him last August. Meanwhile, WellPoint CEO Joseph R. Swedish received $1.5 million in restricted stock for joining the second-largest insurer last year and about $3.8 million to make up for pay he forfeited leaving his old job running a multistate Catholic hospital system (4/2).

The New York Times: Mental Health Groups Split On Bill To Overhaul Care
Lawmakers, patient advocates and the millions of Americans living with a psychiatric diagnosis agree that the nation's mental health care system is broken, and on Thursday, Congress will hear testimony on the most ambitious overhaul plan in decades, a bill that has already stirred longstanding divisions in mental health circles (Carey, 4/2).

The New York Times: Abortion Providers In Texas Sue Over A Restrictive Rule That Could Close Clinics
Health clinics offering abortions in Texas filed a federal lawsuit on Wednesday to block a new state rule that could shut down more than half of the state's remaining providers this fall, forcing women seeking an abortion in southern and western Texas to drive several hundred miles each way or go out of state (Eckholm, 4/2).

The New York Times: A Union Aims At Pittsburgh's Biggest Employer
For decades, United States Steel was this city's dominant employer, but now the biggest employer is the University of Pittsburgh Medical Center, with its 22 hospitals and 62,000 workers. … And just as labor unions famously clashed with Andrew Carnegie, UPMC faces its own labor showdown. The Service Employees International Union is seeking to organize more than 10,000 of UPMC's service workers, and demanding that the hospital system be a leader, much like U.S. Steel once was, in raising wages (Greenhouse, 4/2).

The Wall Street Journal: Lyme Disease Dispute Draws In State Legislatures
Some patients with lasting symptoms attributed to Lyme disease believe long-term antibiotics can help. But advocates claim doctors who back the approach are hesitant to prescribe for fear of professional sanctions, given a long-roiling dispute over whether such treatment even works. Now, lawmakers in a growing number of states in the Northeast, where the tick-borne illness is particularly prevalent, are taking up the cause. Bills in Vermont and New York would protect doctors from punishment just for prescribing long-term antibiotics for patients who have lasting symptoms that they blame on a Lyme infection (Kamp, 4/2).

The New York Times: At Trial, Queens Doctor Is Accused Of Recklessly Prescribing Drugs
Among Dr. Li's patients, prosecutors say, were drug addicts and street dealers who knew they could get a prescription, with few questions asked, for the right price. One patient was David S. Laffer, an addict who in June 2011 massacrd four people while stealing narcotics from a drugstore in Medford, N.Y., on Long Island. He is now serving life without parole. Dr. Li, through his lawyer, has previously denied selling drugs to Mr. Laffer (McKinley, 4/2).

Los Angeles Times: County Urges Meningitis Vaccinations For Men Who Have Sex With Men
Citing a recently identified uptick in potentially deadly meningococcal disease, the Los Angeles County Department of Public Health recommended Wednesday that men who have sex with men get a meningitis vaccination (Brown, 4/2).