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Health Care Edge

Burwell At The Finish Line - Health Care Edge

June 5, 2014

Burwell At The Finish Line 

By Sophie Novack and Sam Baker

THAT WAS EASY: The Senate is scheduled to hold its final confirmation vote for Sylvia Mathews Burwell as Health and Human Services Secretary this afternoon, roughly two months after President Obama announced that he would nominate her. It's been a painless process for Burwell, even though Republicans initially seemed eager for a fresh Obamacare battle. In part that's because of Burwell's credentials and reputation. At the same time, though, beating up on Obamacare just ain't what it used to be. Even some conservatives say the GOP's anti-Obamacare campaign has lost some of its intensity, particularly since the law cleared 8 million sign-ups.

 

Top Health Care News

BURWELL: The Senate voted 67-28 Wednesday to end debate on Burwell's confirmation. (Sophie Novack, National Journal)

  • Fourteen Republicans joined Democrats to advance her nomination. (Sophie Novack, National Journal)

MORE THAN TWO MILLION WHO ENROLLED THROUGH ACA EXCHANGES HAVE DATA DISCREPANCIES: About one-quarter of those who signed up for coverage through the exchanges have at least one inconsistency on their application, mostly involving details on income, citizenship, and immigration status. The federal government is reaching out to them for more information, attempting to resolve the issues before they complicate payments or jeopardize coverage. (Ricardo Alonso-Zaldivar, Associated Press)

  • Why the latest glitch might not be such a big deal: "So far, Administration officials say, the vast majority of immigration discrepancies they are seeing turn out to be paperwork issues—an applicant submitted an expired document, for example, or one letter was incorrect in the spelling of somebody's name. For the most part, officials say, the money is going to the right people, and in the right amounts." (Jonathan Cohn, New Republic)

MEDICAID ENROLLMENT GROWS BY OVER 6 MILLION SINCE SEPT: The Obama administration announced Wednesday that Medicaid enrollment surged by one million in April, indicating that outreach is ongoing after the open enrollment period for private insurance ended in March, and that states are addressing their Medicaid application backlogs. (Phil Galewitz, Kaiser Health News)

Implementation

IS THE GOP LOSING ITS ANTI-OBAMACARE ZEAL?: The latest opening to keep fighting the health care law--the confirmation of Burwell as HHS Secretary--turned into a total snoozefest. (Sam Baker, National Journal)

FISCAL IMPACT OF ACA UNCLEAR: "In its latest report on the law, the Congressional Budget Office said it is no longer possible to assess the overall fiscal impact of the law. That conclusion came as a surprise to some fiscal experts in Washington and is drawing concern. And without a clear picture of the law's overall financing, it could make it politically easier to continue delaying pieces of it, including revenue raisers, because any resulting cost increases might be hidden." (Paul M. Krawzak, CQ Roll Call)

A CALL TO REPEAL AND REPLACE THE EMPLOYER MANDATE: An ACA expert and longtime supporter says repealing the health law's employer mandate may not be a bad idea, as long as it is replaced with a better alternative. (Timothy Jost, Health Affairs)

  • An Urban Institute study called for the elimination of the employer mandate last month. (Linda J. Blumberg, John Holahan, Matthew Buettgens, Urban Institute)

Insurance

STUDY: HEALTH INSURANCE IMPROVES EDUCATIONAL OUTCOMES: "A 10 percentage point increase in childhood Medicaid eligibility reduced the rate of high school dropouts by 5 percent and increased completion of a bachelor's degree by 3.3 to 3.7 percent, [according to a paper recently published by the National Bureau of Economic Research]...Two things could cause access to health insurance to influence educational achievement. The first is pretty straightforward — access to insurance could make kids healthier and healthier kids could do better in school. But there's also a potential indirect effect — giving families health insurance could increase the financial resources they have available for non-health expenses, and that could help kids do well in school." (Adrianna McIntyre, Vox Media)

Veterans Affairs

SENATE MOVES FORWARD ON VA HEALTH CARE BILL: Senate VA Committee Chairman Bernie Sanders and Senator John McCain were in talks Wednesday on a compromise bill to help veterans avoid long appointment wait times and make it easier to fire administrators who cover up delays. Senators had hoped to vote on a VA bill today, but negotiations are continuing, making a vote this week less likely. A House vote on VA legislation scheduled for today has been postponed. (Matthew Daly, Associated Press)

BOEHNER CALLS FOR MORE ACTION TO ADDRESS VA SCANDAL: "Are you willing to do whatever it takes, pending the results of the investigations that are underway, to ensure our veterans get the care we owe them, even if it means shaking up the current bureaucracy and rethinking the entire system?" Boehner wrote in a letter to Obama, signed by House leadership. (Michael D. Shear, New York Times)

ACTING VA SECRETARY TO VISIT PHOENIX FACILITY: Sloan Gibson--who took over after VA Secretary Eric Shinseki resigned last week--is scheduled to meet with staff at Carl T. Hayden VA Medical Center today. (Terry Tang, Associated Press)

TOP 10 CONCLUSIONS ABOUT THE VA SCANDAL: Number one: "There clearly is a scandal here, not a faux one like the IRS or Benghazi." (Norm Ornstein, National Journal)

OPINION: HOW TO RESTORE TRUST IN THE VA: "Inadequate numbers of primary care providers, aged facilities, overly complicated scheduling processes, and other difficult challenges have thwarted the VA's efforts to meet soaring demand for services. For years, it has been no secret that the VA's front lines of care delivery are understaffed for the needs. And though there can be no excuse for falsifying data, we believe that VA leadership created a toxic milieu when they imposed an unrealistic performance standard and placed high priority on meeting it in the face of these difficult challenges. They further compounded the situation by using a severely flawed wait-time–monitoring system and expressing a "no excuses" management attitude." (Kenneth W. Kizer, M.D., M.P.H., and Ashish K. Jha, M.D., M.P.H., New England Journal of Medicine)

MERS

STUDY: MERS TRANSFERRED FROM CAMELS TO HUMANS: A man who died from the virus last November was almost certainly infected through the mucus of camels he was tending for, according to a new study from Saudi researchers that makes the first direct link between camels and the mysterious and deadly virus. (Maggie Fox, NBC)

STUDY: SINGLE DOSE ANTIBIOTIC AS EFFECTIVE AGAINST MERS AS CURRENT 10 DAY REGIMEN: "Many patients do not finish the complicated treatment for these infections, which requires two infusions of antibiotics daily, often in a hospital. Such incomplete treatments may breed resistance to antibiotics in surviving bacteria. A single-dose therapy may make it easier to treat these dangerous infections, said the authors of the new study, published in The New England Journal of Medicine." (Roni Caryn Rabin, New York Times)

Medicare

REPORT: INSURERS BRINGING IN EXTRA PAYMENTS FROM MEDICARE ADVANTAGE 'RISK SCORING' PROGRAM: "A new investigation from the Center for Public Integrity finds that insurers have been taking in much more money than they should have from the $150 billion-a-year program. Between 2007 and 2011, insurers netted $70 billion in improper payments from a program design flaw, according to the center's review of enrollment data, government audits, research papers and other documents." (Jason Millman, Washington Post)

PRIVACY LAW FRUSTRATES PARENTS ON MENTALLY ILL ADULTS: "The 1996 privacy law HIPAA (The Health Insurance Portability and Accountability Act) was created in part to protect patients' information, but it also presents a dilemma for families of people with serious mental illnesses like schizophrenia. Family members wonder how they can protect their loved one if they won't share treatment details." (Jenny Gold, Kaiser Health News/NPR)

Abortion

OHIO CONSIDERS BILL TO MAKE ABORTION COVERAGE ILLEGAL: The Ohio legislature is considering a bill that would make it illegal for insurance to cover abortion, even in cases of rape, incest, or where the mother's life is in danger. The bill would also prohibit coverage for public employees and those on Medicaid for birth control that prevents implementation of a fertilized egg, such as IUDs. (Kristen Mitchell, Columbus Dispatch)

MISSOURI GOVERNOR RAISES CONCERNS ABOUT ANTIABORTION BILL: Democratic Governor Jay Nixon called a bill mandating a 72-hour wait period between doctor visit and the abortion an "extreme proposal," criticizing lawmakers for not including a rape and incest exemption. The legislation was passed by the Republican-led legislature and is awaiting Nixon's signature to become law, but abortion rights advocates are hoping for a veto from the governor. (Kansas City Star)

HOW FDA ATTITUDE TOWARD OFF-LABEL PRESCRIBING IS CENTRAL TO ARIZONA'S MEDICATION ABORTION CASE: "A central point of debate in the case is whether FDA permits the off-label prescribing of drugs, or simply tolerates it. The court found that the agency has actively permitted the practice since at least 1982, noting that the agency sees it as an essential part of the ecosystem of medical innovation." (Alexander Gaffney, Regulatory Focus)

Happening Today

HEALTH PRIVACY SUMMIT: Healthcare providers, IT innovators, national and international privacy experts from academia, industry, and government will convene for the second day of the conference at Georgetown Law Center.

SENATE VOTE ON BURWELL NOMINATION: Following a procedural vote to end debate yesterday, the Senate will hold the final vote to confirm Sylvia Mathews Burwell as the next HHS Secretary at 1:45 p.m.

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