First Edition: May 22, 2014

Today's headlines include coverage of the Senate Finance Committee vote to recommend Sylvia Mathews Burwell to head the Department of Health and Human Services.

Kaiser Health News: The Politics Of Health In 2014 Aren't What You Think
Kaiser Health News staff writer Julie Rovner reports: "Last year, the GOP playbook for keeping the U.S. House in 2014 and winning the Senate consisted of a fairly simple strategy: Run against Obamacare. But now that the 2014 races are starting to take shape, that strategy is looking not so simple after all. For example, at least a few Democrats are fighting back – using Republican opposition to the health law's expansion of Medicaid as a part of their own campaigns. Indeed, Democratic senators in two states are trying to capitalize on Republican opposition to the health law's expansion of Medicaid" (Rovner, 5/22). Read the story.

Kaiser Health News: Health On The Hill: Should Medicare Pay The Same No Matter Where The Patient Gets Care?
That question was the focus of a House subcommittee hearing Wednesday, and it's an important issue in the context of the debate over ending the Medicare SGR. Kaiser Health News' Mary Agnes Carey and CQ HealthBeat's John Reichard discuss the topic (5/21). Read the transcript or listen to the audio.

Kaiser Health News: Some Colorado Doctors May Be Overcharging Medicare For Routine Visits
Reporting for Kaiser Health News, in partnership with NPR and Colorado Public Radio, Eric Whitney writes: "Hundreds of Colorado doctors are charging Medicare far more than is typical for routine patient visits, according to a new database. The numbers could reveal fraud. But experts caution that the raw data alone could also make physicians who are doing nothing wrong look bad. Findings are based on an analysis of a database assembled by ProPublica, an independent, nonprofit newsroom. The data show payments made according to the system of codes for routine office visits doctors use to bill Medicare and insurance companies" (Whitney, 5/22). Read the story.

Kaiser Health News: Capsules: Single-Payer Advocates Hit Capitol With New Sense Of Reality; Minnesota, Not Florida, Not Hawaii, Is Healthiest State For Seniors
Now on Kaiser Health News' blog, Julie Rovner reports on the single-payer message on Capitol Hill: "Advocates for a single-payer "Medicare for all" health system are fanning out across Capitol Hill this week, lobbying members of Congress. But years of mostly fruitless struggles – and watching the intense opposition to the much less sweeping Affordable Care Act – appears to have left them with a much more clear-eyed view of what it will take for them to accomplish their goal" (Rovner, 5/21). 

Also on the blog, MPR's Elizabeth Stawicki reports on seniors' good health in Minnesota: "America's Health Rankings Senior Report rated Minnesota the healthiest state in the nation for adults aged 65 and over -; beating out Hawaii. And that retiree and snowbird haven, Florida? It came in 28th" (Stawicki, 5/22). Check out what else is on the blog.

Los Angeles Times: Senate Panel Oks Sylvia Mathews Burwell As Health Secretary
A Senate panel Wednesday recommended approval of President Obama's pick to oversee implementation of the Affordable Care Act, all but assuring Sylvia Mathews Burwell's confirmation as the next secretary of Health and Human Services. Eight Republicans joined all 13 Democrats on the Senate Finance Committee in endorsing Burwell, who is expected to easily be confirmed when her nomination is considered by the full Senate, likely next month (Levey, 5/21).

The Associated Press: Burwell Gets Committee Approval For Health Post
Burwell, who has served as President Barack Obama's budget chief, would replace outgoing Health and Human Services Secretary Kathleen Sebelius, who announced her departure last month just as the health law was recovering from the disastrous rollout of HealthCare.gov website to post stronger-than-predicted enrollment numbers. Despite expectations that Burwell's confirmation hearings would become an election-year trial of "Obamacare," there were no fireworks as she won support from senators of both parties (5/21).

The Wall Street Journal: Senate Panel Votes To Confirm Burwell To Run HHS
Ms. Burwell, the current Office of Management and Budget director, was tapped by the Obama administration last month to succeed Kathleen Sebelius to lead HHS. The agency implements the Affordable Care Act and includes Medicare, Medicaid and the Food and Drug Administration, as well as other health programs. Ms. Burwell secured the backing of all Democrats on the committee and most of its Republicans, including ranking member Orrin Hatch of Utah. The three members who opposed her were Republican senators Pat Roberts of Kansas, John Thune of South Dakota and John Cornyn of Texas (Radnofsky, 5/21).

Politico: Sylvia Mathews Burwell Approved By Finance For HHS Post
The vote serves as the latest example of how easily Burwell's nomination is sailing through the Senate despite her chief responsibility: running Obamacare (Haberkorn, 5/21).

The New York Times: Prosecutors Investigating Grants For Health Site In Oregon
Unworkable technology pushed Oregon's health care exchange to the brink, making it the first state to abandon its self-administered system in favor of the federal exchange. But now prosecutors are following the money. Grand jury subpoenas, issued last week by the United States attorney's office in Portland and released on Tuesday by Gov. John Kitzhaber of Oregon, have demanded all records, including email correspondence and memos related to the application or receipt of federal funds that might have been used in developing, building or administering the state's website (Johnson, 5/21).

Los Angeles Times: U.S. Prosecutors Investigate Oregon's Failed Health Insurance Exchange
Federal prosecutors and FBI agents requested an expansive list of documents from the Oregon Health Authority, a state agency, and Oregon's state health insurance exchange, known as Cover Oregon. The investigation appears to be focused on the representations that Cover Oregon made about the status and functionality of its website to officials at the Centers for Medicare and Medicaid Services, or CMS, the federal agency that parceled out the money to states to build exchanges under President Obama's Affordable Care Act (Reston, 5/21).

The Washington Post: Md. Health Insurance Exchange Board Violated Open Meetings Law, Compliance Panel Says
The board that oversees Maryland's troubled health insurance marketplace repeatedly violated a state law that requires such groups to fully explain their reasons for meeting behind closed doors, the Maryland Open Meetings Compliance Board concluded this week. The Maryland Health Benefit Exchange Board of Trustees failed to fully disclose and document its reasons for confidentiality, the compliance board wrote in an opinion released Tuesday (Johnson, 5/21).

The Washington Post: Nevada Officials Will Dump Health-Care Vendor And Join The Federal Exchange
HHS will pay costs associated with transferring Nevada's health exchange to the federal exchange. But the move will still cost Nevada millions of dollars as it merges the state's Medicaid system with the federal government. The state estimates those costs could be as much as $20 million, though Nevada will only be responsible for 10 percent of total costs. The board also voted to issue a request for proposals for a more permanent replacement, one that could come from another state with better software (Wilson and Hicks, 5/21).

The Washington Post's Wonkblog: It's Crunch Time For Obamacare's Broken Exchanges
The states that tried and failed to run their own Obamacare health insurance marketplaces aren't quite ready to call it quits. With the health-care law's next open enrollment period just more than six months away, Nevada on Tuesday joined the ranks of Maryland, Oregon and Massachusetts as states that have ditched their faulty enrollment Web sites. Of the 14 states -; plus the District -; that chose to run their own Obamacare exchanges in 2014, these four have either decided to join HealthCare.gov or do enrollment through another system in 2015 (Millman, 5/21).

Los Angeles Times: Only 2 in 5 L.A. Health Clinics Are Ready For Obamacare Patients
A May brief from the UCLA Center for Health Policy Research examined approximately 40 clinics in the Los Angeles area to determine how prepared they were for an expected increase in new patients because of the Affordable Care Act, the national healthcare law that went into full effect this year. Historically used by low-income patients with few options, community health clinics have begun employing a variety of strategies to make themselves more attractive to patients with new insurance plans and choices (Karlamangla, 5/21).

The New York Times: Conservatives Draft Manifesto To Help Republicans Attract Middle-Class Voters
Hoping to push their agenda ahead of the presidential election, a group of prominent conservatives has devised a 121-page policy manifesto aimed at giving the Republican Party a message that will attract some of the middle-class voters the party lost in recent White House races. The document, to be unveiled Thursday, features eight essays with proposals on issues including health care, taxes and education. The authors hope the book will help Republicans address the economic anxieties of Americans and nudge the party from its most polarizing positions and constant confrontations with President Obama (Martin, 5/21).

The Associated Press: Ky. Democrat Mum On Question Of 'Obamacare' Vote
Democratic Senate candidate Alison Lundergan Grimes on Wednesday twice refused to say whether she would have voted for President Barack Obama's signature health care law. Asked two times whether she'd have voted for the 2010 overhaul, the Kentucky Democrat who is challenging Senate Republican leader Mitch McConnell told The Associated Press: "I, when we are in the United States Senate, will work to fix the Affordable Care Act" (5/21).

Los Angeles Times: Study Sees Modest Costs In Healthcare For Immigrants Here Illegally
The study by the UCLA Center for Health Policy Research estimates that the net increase in state spending would be equivalent to 2% of state Medi-Cal spending, or between $353 million and $369 million next year, while the net increase in spending would be up to $436 million in 2019 (McGreevy, 5/21).

The Associated Press: Study: Care Costs Continue Slower Growth In 2014
A typical American family of four will spend an average of $9,695 on health care this year, according to actuarial projections in the 2014 Milliman Medical Index, which was released Wednesday. That counts their contribution toward insurance premiums, payments at the doctor's office or pharmacy and even bottles of aspirin purchased at the drugstore. That compares with $4,443 spent in 2004 and is up 6 percent from last year. Milliman actuaries make their projections for a family with preferred provider organization, or PPO, coverage through a big employer. That's a common form of insurance that involves large networks of doctors and other care providers (5/21).

The New York Times: History And Context Of An Embattled Department Of Veterans Affairs
The uproar over medical care for military veterans involves one of the nation's biggest health care systems, a far-flung operation that treats 6.5 million people a year at 151 hospitals and 820 outpatient clinics, with more than 18,000 doctors and an annual budget of more than $57 billion (Pear, 5/21).

The Wall Street Journal: Obama Pushes Accountability At VA
President Barack Obama took ownership of the burgeoning crisis at the Department of Veterans Affairs, saying Wednesday that he is ultimately responsible for any misconduct, a move that raises the stakes for the White House as calls accelerate for new leadership at the agency. Mr. Obama addressed the allegations of wrongdoing at VA hospitals for the first time since remarks three weeks ago in Asia. He said he expects VA Secretary Eric Shinseki next week to provide him with preliminary results of an inquiry into claims by VA employees that patients face excessive wait times for care and that secret bookkeeping was used to cover up the delays (Lee and Kesling, 5/21).

Los Angeles Times: At Least For Now, Obama Stands By VA Secretary Eric Shinseki
As the investigation into complaints that VA facilities have concealed long waits for healthcare widened Wednesday, President Obama vowed he would not tolerate misconduct at the Department of Veterans Affairs and stood by the agency's chief -; for now (Hennessey and Simon, 5/21).

Politico: Anatomy Of A Veterans' Affairs Scandal
But the tsunami of problems with the veterans' health care that smashed into the White House had been building for years, growing larger and more menacing as it headed toward the Oval Office. The slow-burn story at the Phoenix VA went from a largely ignored congressional hearing and a local news report before it landed on CNN and then exploded in the national media and seized the White House -; the latest reminder that it isn't always the president who sets the agenda (Gold, 5/21).

Politico: President Obama Defends Eric Shinseki, Demands VA Answers
Speaking at the White House after an Oval Office meeting with Shinseki and deputy chief of staff Rob Nabors, Obama said if allegations that as many as 40 veterans have died as a result of records being doctored, along with other charges of mismanagement, prove to be true, "it is dishonorable, it is disgraceful," adding "I will not stand for it -; as a commander in chief, but also as an American." Asked repeatedly if the secretary has offered to resign -; or whether he should -; the president gave a roundabout statement of wavering confidence -; but only after catching himself praising Shinseki's work on veterans' homelessness and the Post-9/11 Bill (Dovere, 5/22).

The New York Times: With New Bill, Abortion Limits Spread In South
The Louisiana State Legislature on Wednesday passed a bill that could force three of the state's five abortion clinics to close, echoing rules passed in Alabama, Mississippi and Texas and raising the possibility of drastically reduced access to abortion across a broad stretch of the South (Alford and Eckholm 5/21).

Los Angeles Times: Counties Sue Narcotics Makers, Alleging 'Campaign Of Deception'
Two California counties sued five of the world's largest narcotics manufacturers on Wednesday, accusing the companies of causing the nation's prescription drug epidemic by waging a "campaign of deception" aimed at boosting sales of potent painkillers such as OxyContin.