STATE WATCH APRIL 27, 2015 California Healthline: ACLU Says California Vaccine Bill Could Violate State Constitution The American Civil Liberties Union has sent a letter to state Sens. Richard Pan (D-Sacramento) and Ben Allen (D-Redondo Beach) arguing that their bill (SB 277) to strengthen California's childhood vaccination requirements could be unconstitutional, the Los Angeles Times' "California Journal" reports (Abcarian, "California Journal," Los Angeles Times, 4/24). California Healthline: E-Cigarette Bill Hearing Today A bill restricting electronic cigarette use in California will be heard by the Senate Appropriations Committee on Monday, as industry and public health officials continue to face off over the health effects of e-cigarettes. SB 140, by Sen. Mark Leno (D-San Francisco), would include e-cigarettes in California's smoke-free laws. The bill would prohibit smoking e-cigarettes -- known as "vaping" -- in workplaces, schools, daycares, hospitals, restaurants and bars, on public transport and other public places. (Vesely, 4/27)

Kaiser Health News: California High Court To Consider Limits On Regulators’ Access To Prescription Database The case against Dr. Alwin Lewis started with a patient’s complaint about his unorthodox diet plan. But it landed at the California Supreme Court with a much broader issue at stake: Whether regulators should have unrestricted access to a state database detailing doctors’ prescribing practices. (Tillman, 4/27)

CAPITOL HILL WATCH

Politico: Conservatives Fear GOP Leaders Giving Up On Obamacare Repeal Many House conservatives backed the budget last month and spared GOP leaders another showdown with their right flank for one big reason: They were under the impression the spending blueprint would help them — finally — get an Obamacare repeal to the president’s desk. Now they’re concerned that Speaker John Boehner and company have other plans. (Bade, 4/27)

Reuters: Republicans Seen Scrapping Ryan Medicare Plan In U.S. Budget Push Aiming to acquire more budget powers and take a swipe at Obamacare, Republicans will likely scrap a proposal that stirred controversy and helped launch Wisconsin congressman Paul Ryan on the national stage: privatizing the Medicare health program. Ryan's bold Medicare "premium support" plan would be sacrificed to ensure passage of Congress' first full budget in six years and allow Republicans a rare opportunity to use a powerful procedural tool to ease passage of other legislation. (Lawder, 4/24)

ADMINISTRATION

NPR: Surgeon General Vivek Murthy On Gun Control, Vaccines And Science Surgeon General Vivek Murthy was officially sworn in this week. His confirmation was held up for more than a year because of comments he made about gun violence. Murthy talks with NPR's Scott Simon. (4/25)

The New York Times: Michael Botticelli Is A Drug Czar Who Knows Addiction Firsthand Six recovering substance abusers sat in an inner-city treatment center, sharing their stories. When Michael’s turn came around, he spoke of his former drug of choice, alcohol, and mentioned the night years ago when he drove drunk on the Massachusetts Turnpike, caused an accident and was arrested before passing out. ... “You are my people,” he said, wiping one eye. Catharsis is common in treatment centers, but Michael is not the typical former substance abuser: He is Michael Botticelli, the director of the White House Office of National Drug Control Policy, informally known as the drug czar. Mr. Botticelli is the first person in substance-abuse recovery to hold the position. (Schwartz, 4/25)

MARKETPLACE

The Wall Street Journal: Pharmaceutical Companies Buy Rivals’ Drugs, Then Jack Up The Prices On Feb. 10, Valeant Pharmaceuticals International Inc. bought the rights to a pair of life-saving heart drugs. The same day, their list prices rose by 525% and 212%. Neither of the drugs, Nitropress or Isuprel, was improved as a result of costly investment in lab work and human testing, Valeant said. Nor was manufacture of the medicines shifted to an expensive new plant. The big change: the drugs’ ownership. (Rockoff and Silverman, 4/26)

Modern Healthcare: Top-paid Healthcare CEOs See Pay Grow Faster Than Profits

Total compensation for some of the highest-paid CEOs in the healthcare industry increased faster than their companies' profits last year, a Modern Healthcare analysis of the first firms to report executive pay found. Corporations with the most richly rewarded CEOs by sector in 2014 included Community Health Systems, a Franklin, Tenn.-based hospital operator; Centene Corp., a St. Louis-based insurer; CVS Health Corp., a retail pharmacy and pharmacy benefit manager based in Woonsocket, R.I., and Regeneron Pharmaceuticals, a New York City-based biotechnology company. (Evans, 4/25)

Bloomberg: How Much Would You Pay For An Old Drug? If You Have MS, A Fortune Imagine Apple's first iPhone is still on sale today. Now imagine it costs many times its original price of $599, and that the price goes up every time a new, competing phone is released. That bizarro world is what the market for multiple sclerosis drugs looks like, as described in a new paper in the journal Neurology. And doctors are calling for it to change. (Tozzi, 4/24)

The Wall Street Journal's Pharmalot: Multiple Sclerosis Drug Prices Rose At An ‘Alarming’ Rate: Study There has been an “alarming rise” in the cost of multiple sclerosis treatments over the past dozen years and the cost of these drugs increased at rates well beyond the overall growth in prescription drug prices, according to a new study. (Silverman, 4/24)

HEALTH IT

Modern Healthcare: Insurers Face Tougher Oversight On Protecting Data New national guidelines indicate health insurers will face tougher regulatory scrutiny over how they protect customers from data breaches. But the guidance likely won't do much to prevent cyberattacks in the first place. The National Association of Insurance Commissioners on April 16 adopted a dozen principles for “effective cybersecurity insurance regulatory guidance.” The guidelines were issued in

response to the massive data breaches that burned health insurers this year, including at Anthem and Premera Blue Cross, involving data on more than 90 million people. (Herman, 4/25)

NPR: As Health Apps Hop On The Apple Watch, Privacy Will Be Key One day soon, you may be waiting in line for a coffee, eyeing a pastry, when your smart watch buzzes with a warning. Flashing on the tiny screen of your Apple Watch is a message from an app called Lark, suggesting that you lay off the carbs for today. Speak into the Apple Watch's built-in mic about your food, sleep and exercise and the app will send helpful tips back to you. (Farr, 4/25)

EDITORIALS AND OPINIONS

The Wall Street Journal's Washington Wire: Few Consumers Use Information On Health Provider Quality Or Price It’s widely assumed that Americans will become increasingly diligent and informed health-care consumers as higher deductibles and other forms of cost sharing push them to be more prudent purchasers and as they become aware of comparative provider quality and price information. That may well happen–but findings from the Kaiser Family Foundation’s April Health Tracking Poll show that the effort to bring provider quality and cost information to consumers is still in its infancy. (Drew Altman, 4/27)

The New York Times: Nobody Said That Imagine yourself as a regular commentator on public affairs — maybe a paid pundit, maybe [a] supposed expert in some area, maybe just an opinionated billionaire. You weigh in on a major policy initiative that’s about to happen, making strong predictions of disaster. The Obama stimulus, you declare, will cause soaring interest rates; the Fed’s bond purchases will “debase the dollar” and cause high inflation; the Affordable Care Act will collapse in a vicious circle of declining enrollment and surging costs. But nothing you predicted actually comes to pass. What do you do? You might admit that you were wrong, and try to figure out why. But almost nobody does that; we live in an age of unacknowledged error. (Paul Krugman, 4/27)

STATE WATCH APRIL 28, 2015 California Healthline: 'Right-to-Try' Bill Advances A bill (SB 149) that would give terminally ill Californians greater access to experimental medications advanced through a Senate committee on Monday.The "Right-to-Try Act," by Sen. Jeff Stone (R-Riverside County), would allow patients with terminal illnesses to use early-stage drugs that have not yet been approved by FDA. (Vesely, 4/28)

California Healthline: Analysis: California Could Be a Model for Latino Enrollment Efforts California could serve as a model for overcoming barriers to expanding health coverage to uninsured Latino populations, according to an analysis by the Commonwealth Fund, The Hill reports. (4/28)

California Healthline: Long-Term Care Reform Package Making Its Way Through Legislature California legislators are considering a package of 24 bills this session collectively aimed at improving the state's support network for aging services and long-term care. The bills -- 12 in the Assembly and 12 in the Senate -- deal with a variety of issues involving some of the 112 separate programs for aging and long-term care overseen by 20 different agencies and departments in the state and county governments. (4/27)

CAPITOL HILL WATCH

Los Angeles Times: Democrats, Several Of Them Californians, Were 'Party Of No' In House Budget Fight Republicans are usually cast as the "Party of No" in today's Congress. But it was Democrats like [Rep. Ami] Bera in competitive electoral environments who formed the largest bloc of "no" voters during last month's budget debate, the first opportunity lawmakers had this year to weigh in on the crucial taxing and spending battles ahead. A Republican proposal — cutting social safety-net programs, lowering tax rates and raising spending on defense — eventually passed along mostly party lines, 228 to 199, setting the stage for negotiations with the Senate. (Bierman, 4/27)

Politico: GOP Budget Dodges Fights Over Entitlements, Defense Forget about Paul Ryan’s Medicare privatization plan. The same with other entitlement reforms. And never mind offsetting defense spending increases. In almost every instance, sources describe a GOP budget deal in which political practicality beats out ideology as Republican leaders tack toward the party’s center now that they’re in control of both chambers. The final agreement was expected to be unveiled Monday evening until Sen. Bob Corker (R-Tenn.) announced he would not sign the deal without explanation. (Bade, 4/27)

MEDICAID

Kaiser Health News: Medicaid’s Tension: Getting Corporate Giants To Do Right By The Needy Lynda Douglas thought she had a deal with Tennessee. She would adopt and love a tiny, unwanted, profoundly disabled girl named Charla. The private insurance companies that run Tennessee’s Medicaid program would cover Charla’s health care. Douglas doesn’t think the state and its contractors have held up their end. In recent years she says she has fought battle after battle to secure essential care to control

Charla’s seizures, protect her from choking and tube-feed and medicate her multiple times a day. (Hancock, 4/28)

The Washington Post's Fact Checker: Christie’s Claim That Medicaid Spending Has Grown ‘Over 800 Percent’ In 25 Years Overhauling long-term entitlement programs has become a major talking point for [N.J. Gov. Chris] Christie, and it is expected to his centerpiece of his potential presidential campaign. Christie recently unveiled his plan to make sweeping changes to government spending and structure of entitlement programs, especially long-term programs such as Social Security, Medicare and Medicaid. Such programs have grown out of proportion and taken up too much of the federal budget and debt, according to Christie. ... While it is correct that Medicaid spending has grown disproportionately to the size of the economy, Christie’s numbers give a misleading impression of the magnitude. (Lee, 4/27)

HEALTH LAW ISSUES AND IMPLEMENTATION

Reuters: U.S. Top Court Throws Out Obamacare Contraception Ruling The U.S. Supreme Court on Monday revived religious objections by Catholic groups in Michigan and Tennessee to the Obamacare requirement for contraception coverage, throwing out a lower court decision favoring President Barack Obama's administration. The justices asked the Cincinnati-based 6th U.S. Circuit Court of Appeals to reconsider its decision that backed the Obama administration in light of the Supreme Court's June 2014 ruling that allowed certain privately owned corporations to seek exemptions from the provision. (Hurley, 4/27)

The Hill: Study: ObamaCare, Outreach Could Boost Hispanic Health Coverage A new analysis points to expanding Medicaid under ObamaCare and improving outreach efforts as ways to lower the stubbornly high uninsured rate among Hispanics. Hispanics have long had higher uninsured rates. The Commonwealth Fund, a health research group, finds that ObamaCare is making a dent but that the rate remains high. (Sullivan, 4/27)

EDITORIALS AND OPINIONS

Bloomberg: Obamacare, Assessed No single statistic can cover all of [the federal health law's] many aspects. But there are some data sources than can shed some light. It’s helpful to step back from the day-to-day partisan battle and recall the sweeping goals of the law: to give more people health insurance while reshaping a medical system that spends more and delivers less than that of any other wealthy country. (Alex Wayne, 4/27)

Modern Healthcare: Rating A Politician's Claim That Medicaid Kills One of Florida's most powerful Republicans reportedly is using the results of a narrow study focusing on surgical outcomes to insinuate that extending Medicaid to more Americans increases their chances of dying. Rep. Richard Corcoran is leading the battle in Florida to block a bill approved by the GOP-led state Senate to expand Medicaid to low-income adults. ... when his constituents email him about the expansion issue, PolitiFact Florida reported, Corcoran sends this reply: "The largest national study, conducted by the University of Virginia, found that Medicaid patients were 97% more likely to die than those with private insurance." PolitiFact Florida rated Corcoran's statement to his constituents as “mostly false.” “Mostly false” seems charitable. (Harris Meyer, 4/27)

STATE WATCH APRIL 29, 2015

NBC News: Four in 10 Americans Are Breathing Unhealthy, Polluted Air. Are you? Here’s something to consider before you go for a run on a smoggy day or buy a house near a busy highway. Air pollution remains a "pervasive public health threat" in the U.S., with almost half of Americans — about 44 percent — living in communities where the air can be dangerous to breathe, a new study by the American Lung Association has found. (Pawlowski, 4/29)

California Healthline: Drug Costs, Restrictions Get Hearing Specialty pharmaceuticals took the stage at the Assembly Committee on Health yesterday with discussion -- and approval -- of two bills addressing the rising costs of prescription drugs. Prices for specialty drugs for the treatment of serious or chronic conditions have soared in recent years. Specialty drugs represent 3% of brand name drugs dispensed over the past five years, but they have accounted for 73% of drug spending growth, according to a committee bill analysis. (Vesely, 4/29)

California Healthline: Third Senate Panel Advances California Vaccine Bill After Amendment On Tuesday, the California Senate Judiciary Committee advanced a bill (SB 277) that would end all Third Senate Panel Advances California Vaccine Bill After Amendmentpersonal belief exemptions to childhood vaccination requirements, the AP/San Francisco Chronicle reports (AP/San Francisco Chronicle 4/28).

CAPITOL HILL WATCH

Politico: Budget Still Blocked By Corker Over ‘Gimmick’ Sen. Bob Corker has slammed the brakes on a much-awaited budget deal that was supposed to sail to passage this week — taking on Republican leadership, budget negotiators and appropriators alike over what he calls a spending “gimmick” that produces billions in fantasy savings. The Tennessee Republican on Tuesday said he would not sign the final budget deal because the agreement would let appropriators take unspent money from mandatory programs — like a crime victims fund or children’s insurance account — and use it to pay for other congressional priorities. Because the money was never going to be spent anyway, lawmakers like Corker think it’s dubious to count it as “savings.” (Bade, 4/29)

HEALTH LAW ISSUES AND IMPLEMENTATION

Kaiser Health News: Florida House Goes Home Early Over Medicaid Impasse The Florida House – at odds with the state Senate over the expansion of Medicaid – abruptly ended its session three days early on Tuesday, leaving hundreds of bills unrelated to health care unfinished. Shortly after the adjournment, Gov. Rick Scott, a Republican, filed a lawsuit against the federal government over the same issue. (Hatter, 4/29)

Stateline: States Find Savings Through Medicaid Expansion Medicaid expansion has given a budget boost to participating states, mostly by allowing them to use federal money instead of state dollars to care for pregnant women, inmates, and people with mental illness, disabilities, HIV/AIDS, and breast and cervical cancer, according to two new reports. States that levy assessments and fees on health care providers, which have collected higher revenues as a result of expansion, have reaped extra benefits. (Ollove, 4/29)

Miami Herald: CMS To Florida: LIP Is Not Linked To Medicaid Expansion Hours after Gov. Rick Scott announced he's filed a lawsuit suing the federal government for linking the Low Income Pool to Medicaid expansion, CMS released a statement saying that LIP funding is "not dependent on whether it expands Medicaid." ... Here's the statement from Aaron Albright, spokesman for CMS: “The decision to expand Medicaid, or not, is a state decision. We will work with Florida and each state that has an uncompensated care pool regardless of its Medicaid expansion status, to support access to health care for low-income residents that works for individuals, hospitals and taxpayers, taking into account the state’s specific circumstances. CMS will review proposals regarding uncompensated care pools based on the same principles whether or not a state has expanded Medicaid.” (Klas, 4/28)

EDITORIALS AND OPINIONS

JAMA Forum: Why Section 1332 Could Solve The Obamacare Impasse Section 1332 of the ACA, known as “State Innovation Waivers,” allows states, starting in 2017, to apply to the federal government for 5-year renewable waivers from key provisions of the legislation. For instance, states could request changes to or exemptions from the individual and employers mandate, the market exchanges, the exchange subsidies, the Essential Health Benefits requirements, and other provisions. Moreover, states can combine waivers from ACA provisions with waivers from Medicaid provisions (so-called 1115 waivers), Medicare, the state Children’s Health Insurance Program, and waivers available through “any other Federal law relating to the provision of health care items or services.” The opportunity for states to transform the ACA within their borders is breathtaking. It’s little wonder that a former top aide to the late Senator Edward Kennedy describes Section 1332 as “state innovation on steroids.” (Stuart Butler, 4/28)

The Washington Post's Plum LIne: Republicans Flummoxed By Sudden Possibility Of Big Victory Over Obamacare Remember, Republicans have very good reasons for trying to offer a fix: With some of them openly worrying that the political fallout from millions losing insurance will land squarely on them, they are eying a temporary patch to the subsidies to punt that fallout until after 2016. And putting forth such a contingency plan could also be a way to maximize leverage over Democrats to get them to accept changes to the law Republicans want in exchange for keeping the subsidies going — and keeping insurance markets from imploding — such as junking the tyrannical individual mandate. (Greg Sargent, 4/28)

STATE WATCH APRIL 30, 2015 California Healthline: Nurses, Hospital Officials Clash Over Observation Units, Charity Care On the eve of a nurses' strike at Sutter Health and three Los Angeles area hospitals, California nurses clashed with hospital officials over two bills at a hearing of the Senate health committee. SB 483, by Sen. Jim Beall (D-San Jose), would provide more state oversight of hospital observation units and limit patient observation status at hospitals to 24 hours. The bill would also apply state nurse-to-patient ratios to observation units.( Vesely, 4/30)

Los Angeles Times: Almost 40% Of California Hospitals Graded C or Lower for Patient Safety

Nearly four in 10 California hospitals received a grade of C or lower for patient safety in a new national report card aimed at prodding medical centers to do more to prevent injuries and deaths. The Leapfrog Group, an employer-backed nonprofit group focused on healthcare quality, issued its latest scores Wednesday, it said, so consumers and employers can be aware of poorly performing hospitals before using them. (Terhune and Smith, 4/29)

Los Angeles Times: State, L.A. County Set to Overhaul Nursing Home Oversight Procedure Los Angeles County and state officials are preparing to realign nursing home inspection and oversight duties as part of a drive to better manage a chronic backlog of investigations into complaints of abuse and neglect. But some patient advocates say the proposed changes aren’t likely to significantly improve conditions, and could make matters worse. (Sewell, 4/29)

Los Angeles Times: California's Individual Health Insurance Market Grows 64% To 2.2 Million The number of Californians buying individual health insurance soared 64% to nearly 2.2 million as Obamacare took full effect last year, a new report shows. In California, 843,607 people joined the individual market both inside and outside the Covered California insurance exchange, as of Dec. 31, 2014. (Terhune, 429)

Los Angeles Times: Theft Of Private Data on 900 L.A. County-USC Patients Investigated Officials are investigating a security and privacy breach affecting 900 patients who were treated at the Los Angeles County-USC Medical Center’s mental health facility. The breach was discovered April 3 during a search of the home of a nurse who was employed at the Augustus F. Hawkins Mental Health Center, said Michael Wilson, a spokesman for the Los Angeles County Department of Health Services. The investigation was not related to county business, he said. (Rocha, 4/29)

CAPITOL HILL WATCH

The Wall Street Journal: U.S. House And Senate Republicans Agree on Combined Budget If it passes, the budget resolution will also unlock a procedural tool that Republicans say they will use to send the White House a repeal of Mr. Obama’s health-care law. That tool, known as “reconciliation,” allows legislation to pass Congress with a simple majority. Republicans control 54 of 100 seats in the Senate, where most bills require 60 votes to avoid procedural hurdles. (Timiraos and Peterson, 4/29)

HEALTH LAW ISSUES AND IMPLEMENTATION

Kaiser Health News: More Evidence That Health Plans Stint on Mandated Birth Control Coverage

Women’s health advocates were thrilled when the Affordable Care Act became law in 2010, because it required insurance companies to cover a broad array of women’s health services at no additional out-of-pocket cost beyond premiums. Five years later, however, that requirement is not being enforced, according to two new studies. Health insurance plans around the country are failing to provide many of those legally-mandated services including birth control and cancer screenings.(Rovner, 4/30)

Politico: GOP Warms To Obamacare — If Americans Work For It In nearly a dozen Republican-dominated states, either the governor or conservative legislators are seeking to add work requirements to Obamacare Medicaid expansion, much like an earlier generation pushed for welfare to work. The move presents a politically acceptable way for conservative states to accept the billions of federal dollars available under Obamacare, bringing health care coverage to millions of low-income people. But to the Obama administration, a work requirement is a non-starter, an unacceptable ideological shift in the 50-year-old Medicaid program and a break with the Affordable Care Act’s mission of expanding health care coverage to all Americans. The Health and Human Services Department has rejected all requests by states to tie Medicaid to work. (Wheaton, 4/30)

The Associated Press: Obama Administration Hasn't Changed Course on LIP, Medicaid The Obama administration said Wednesday it had not changed its position on Medicaid expansion and hospital funds, despite contrary interpretations from lawmakers. The confusion comes a day after Gov. Rick Scott filed a federal lawsuit accusing the Obama administration of coercing Florida into expanding Medicaid by withholding more than $1 billion in hospital funds. (Kennedy, 4/29)

MARKETPLACE

Modern Healthcare: Insurer Stocks Tumble after Humana Hints at Higher Hospital Claims Humana gave the first indication Wednesday that hospital spending could eventually eat into the earnings of health insurers. The announcement dented the stocks of all health insurers. Competitors Aetna, Anthem and UnitedHealth Group reported this month that their medical-loss ratios in the first quarter had decreased and none said there was an underlying surge in healthcare utilization. That so far has been in direct contrast to economic indicators and guidance from hospital chain HCA that show hospital spending and admissions were on the rise. (Herman, 4/29)

MEDICARE

Reuters: Special Report: Banned from Medicare, Still Billing Medicaid A doctor who took kickbacks from a Pennsylvania hospice involved in a multimillion-dollar fraud. An Ohio psychiatrist who billed for treating no-show patients. A Georgia optometrist who claimed he conducted 177 eye exams in one day. Their transgressions vary. What these doctors have in common is that each was paid by a state Medicaid health insurance program after being kicked out of another state's Medicaid system or the federal Medicare program. That's not supposed to happen. The Affordable Care Act, or

Obamacare as it is popularly known, explicitly requires that states suspend the billing privileges of most providers who have been "terminated" or "revoked" by another state or Medicare. (Pell and Cooke, 4/29)

Reuters: Figuring Out Who Can Bill Medicare and Medicaid, And Who Can't To determine how many healthcare providers were banned from Medicare or a state Medicaid program while still allowed to bill Medicaid in another state, Reuters compared states’ lists of approved providers against lists of providers terminated by other states or Medicare on a specific date in 2014. In response to open-records requests, all states and the District of Columbia supplied approved-provider lists. Only 23 states supplied terminated-provider lists, as did the Centers for Medicare and Medicaid Services, the federal agency that administers Medicare, and the U.S. Department of Health and Human Services Office

of the Inspector General. (Pell and Cooke, 4/29)

STATE WATCH MAY 1, 2015 California Healthline: Children's Eye Exam Bill Advances This week, a bill requiring eye exams for school-age children with the goal of identifying serious eye conditions that can affect learning sailed through the state Senate Health Committee with a unanimous 8-0 vote. SB 402, by state Sen. Holly Mitchell (D-Los Angeles), would require students entering elementary school in California to have a thorough eye exam by a physician, optometrist or ophthalmologist. Repeat vision testing would be required every second year. (Vesely, 5/1)

California Healthline: CMS Releases Medicare Part D Prescription Drug Spending Data On Thursday, CMS unveiled data covering about $103 billion in Medicare prescription drug spending in 2013, in the most-detailed breakdown of such spending ever provided, the New York Times reports. The largest amount of spending -- more than $2.5 billion -- was on Pfizer's heartburn treatment Nexium, which was prescribed to about 1.5 million beneficiaries in 2013 (Thomas/Pear, New York Times, 5/1)

CAPITOL HILL WATCH

The Associated Press: House Adopts Compromise GOP Budget Targeting 'Obamacare' The House Thursday adopted a compromise GOP budget that promises to speed repeal of the President Barack Obama's health care law while giving the Pentagon an additional $38 billion next year. (Taylor, 4/30)

The Hill: House Votes To Overturn DC's Reproductive Health Law The House voted late Thursday night to overturn the District of Columbia's law prohibiting workplace discrimination based on reproductive health choices. Passage of the resolution formally disapproving of Washington's local law fell mostly along party lines on a vote of 228-192. Thirteen Republicans joined the opposition, and three Democrats voted in favor. It marked the first time either chamber of Congress has passed legislation to stop a D.C. law since 1991, when the House voted to disapprove of the city council's action to amend a law that restricts the height of the District's buildings. (Marcos, 4/30)

CNN: Hillary Clinton Campaign Blasts GOP Abortion Bill Hillary Clinton is accusing congressional Republicans of planning to "overrule the Democratic process" in Washington with a Thursday night vote to block a D.C. law banning discrimination by employers against employees who have had abortions. (Jaffe, 4/30)

HEALTH LAW ISSUES AND IMPLEMENTATION

The Hill: GOP Prepares List Of Demands If Justices Rule Against ObamaCare

Republicans believe a Supreme Court ruling against ObamaCare this summer would give them leverage to force President Obama to scrap the healthcare law's central pillars. Sen. John Barrasso (R-Wyo.), who is leading the Senate GOP’s response to King v. Burwell, said Republicans will be willing to strike a deal with Obama to ensure that the 7.5 million people who stand to lose their subsidies are protected, at least

until the 2016 elections. But in return, they would demand that Obama to do something he has long

resisted: nix the employer and individual mandates for insurance coverage. (Ferris, 5/1)

NPR: Expanding Medicaid Trims Hospitals' Costs of Caring for Uninsured When patients show up in the hospital without health insurance, they often receive charity care — the hospital treats the person and then swallows some or all of the costs. ... Hospitals are able to recoup some of the costs of this care, but it can still put a financial strain on some systems. One of the goals of the Affordable Care Act was to reduce the burden of charity care, which totaled nearly $85 billion in 2013. A new study by the nonprofit Kaiser Family Foundation suggests that Medicaid — a government health insurance program that covers many people who don't make much money — might be doing just that. (Kelto, 4/30)

HEALTH POLICY RESEARCH

The Kaiser Family Foundation: Data Note: How Has The Individual Insurance Market Grown Under The Affordable Care Act? 6.7 million people were insured through marketplace plans as of October 15, 2014. However, it has been unclear precisely how many of these Marketplace enrollees were previously uninsured or how many would have purchased individual coverage directly from an insurer in the absence of the ACA. Kaiser Family Foundation analysis of recently-submitted 2014 filings by insurers to state insurance departments (using data compiled by Mark Farrah Associates) shows that 15.5 million people had major medical coverage in the individual insurance market – both inside and outside of the Marketplaces – as of December 31, 2014. Enrollment was up 4.8 million over the end of 2013, a 46% increase. (Levitt, Cox and Claxton, 4/29)

The Commonwealth Fund: Latinos Have Made Coverage Gains but Millions Are Still Uninsured Since the Affordable Care Act’s health insurance marketplaces opened and states began to expand Medicaid eligibility; uninsured rates among Latinos have begun to decline for the first time in decades. ... the Commonwealth Fund Biennial Health Insurance Survey finds Latinos continue to have the highest uninsured rates among major U.S. racial or ethnic groups. ... While about one-quarter of Latino adults who live in states that expanded their Medicaid programs were uninsured by the end of 2014, nearly half remain uninsured in states that, so far, have not expanded their Medicaid program. ... Texas and Florida, neither of which have expanded eligibility for their Medicaid programs, are home to the largest proportion of Latinos who are uninsured. (Doty et al., 4/27)

MEDICARE

Kaiser Health News: Medicare Itemizes Its $103 Billion Drug Bill The federal government popped the cap off drug spending on Thursday, detailing doctor-by-doctor and drug-by-drug how Medicare and its beneficiaries spent $103 billion on pharmaceuticals in 2013. (Rau, 4/30)

The New York Times: Medicare Releases Detailed Data On Prescription Drug Spending

The data was the most detailed breakdown ever provided by government officials about the prescription claims of Medicare beneficiaries. It included information about 36 million patients, one million prescribers and $103 billion in spending on drugs under the program’s Part D in the year 2013, the most recent year available. The data did not take into account rebates that the drug manufacturers pay to the insurers that operate the Medicare beneficiaries’ drug plans. (Thomas and Pear, 4/30)

EDITORIALS AND OPINIONS

Los Angeles Times: Going Undercover at Crisis Pregnancy Centers You've seen the billboards up and down the state: "Pregnant and scared?" Well, Dania Flores wasn't pregnant but she was a little bit scared the first time she visited a crisis pregnancy center. A recent high school graduate, she was working undercover, posing as a pregnant teen to gather intel on these operations, which have but one goal: to prevent abortion. ... Flores said she was never informed that abortion was a safe, legal alternative to childbirth. She was never told that California's Medi-Cal program covered the cost of reproductive services, including abortion. Nor that time was of the essence. Instead, she says, she was misled and shamed by anti-abortion activists masquerading as concerned healthcare providers. (Robin Abcarian, 5/1)

The New York Times' The Upshot: Speedy Drug Approvals Have Become The Rule, Not The Exception

Congress has over the past few decades passed a series of special approval pathways for important drugs that treat life-threatening or rare diseases. This week, a new bill introduced in the House could add two more. (Margot Sanger-Katz, 5/1)

The Washington Post's Plum Line: Morning Plum: A Crack In Red State Resistance To Obamacare? Maybe sort of. Politico reports this morning that there is a real shift underway among red state governors towards Obamacare: A number of them are newly open to accepting the Medicaid expansion — as long as they can couple it with some kind of work requirement. ... I’m going to suggest that this is, on balance, a good development — in the sense that more GOP governors appear open to finding terms upon which they are willing to take the money to cover their constituents. (Greg Sargent, 4/30)