First Edition: January 17, 2014 Today’s headlines include reports from Capitol Hill about passage of a $1.1 billion spending bill as well as testimony by an Obama administration official about healthcare.gov.Kaiser Health News: Health On The Hill: Explaining Healthcare.gov’s ProblemsKaiser Health News staff writer Mary Agnes Carey and CQ Roll Call’s Melissa Attias discuss Thursday events in which Gary Cohen, the head of the federal online marketplace, answered questions on Capitol Hill about the rocky rollout of healthcare.gov (1/16). Read the transcript or listen to the audio.Kaiser Health News: Signing Up The Homeless, One At A TimeKaiser Health News staff writer Anna Gorman, working in collaboration with USA Today, reports: “On a recent winter morning, health outreach worker Christopher Mack walked through the streets and alleys of the city’s Skid Row, passing a man pulling a rusty shopping cart and a woman asleep on a crumpled blue tarp. The smell of marijuana wafted through the cold air. ‘Do you have health insurance?’ Mack, a towering man with long dreadlocks, asked one woman. ‘Do you go to the doctor?’ he asked another. Homeless men and women who didn’t qualify for insurance in the past now have the chance to sign up, and Mack – who was once homeless himself — is there to help” (Gorman, 1/17). Read the story.Kaiser Health News: A Reader Asks: Do Couples Have To Buy The Same Level Health Plan? KHN’s consumer columnist Michelle Andrews reports family members can opt for separate plans and still qualify for premium subsidies, but they need to consider some other important details (1/17). Read her response.The Wall Street Journal: For The Mentally Ill, Finding Treatment Grows HarderLast year, according to the U.S. Department of Health and Human Services, almost 91 million adults lived in areas like here where shortages of mental-health professionals made obtaining treatment difficult. A departmental report to Congress earlier this year said 55% of the nation’s 3,100 counties have no practicing psychiatrists, psychologists or social workers, a combination of budget cuts and doctors leaving the profession. … Such shortages are expected to only grow now, as the federal health-care law goes into effect and allows more people to seek help. Indeed, according to the National Association of State Mental Health Program Directors, some 6.8 million uninsured people with a mental illness will gain coverage after federal and state health insurance exchanges implement the new law (Fields and Corbett Dooren, 1/16).The Washington Post: Medicaid Expansion Takes A Hit In ArkansasA Democratic state senator forced to step down last year over ethics violations will be replaced by a Republican after a special election Tuesday that dealt a serious blow to Arkansas Gov. Mike Beebe’s (D) push to expand Medicaid. Republican John Cooper defeated Democrat Steve Rockwell in a northeast Arkansas district based in Jonesboro in a race that had centered on whether to expand Medicaid to cover those making less than 138 percent of the federal poverty line (Wilson, 1/16).Politico: HHS Feared Contractor Would Derail ObamacareThe White House spent December talking up its revamped and repaired HealthCare.gov website after the disastrous rollout. But health officials worried that the underperforming contractor could still derail Obamacare and destabilize the insurance industry, according to a new federal document. The concerns grew so acute that they decided to seek a new contractor (Cheney, 1/17).The Wall Street Journal’s Washington Wire: Under Construction: Healthcare.gov’s Payment SystemAn Obama administration official told Congress Thursday that the “back-end” of HealthCare.gov is still being built and he didn’t forecast a completion date. An automated system to send payments to insurance companies isn’t finished, said Gary Cohen, the director of the Center for Consumer Information and Insurance Oversight, an office in the federal Medicare agency that oversees the troubled website for buying health insurance (Corbett Dooren, 1/16).The Washington Post’s The Fact Checker: Pelosi Vs. Barrasso: A Tale Of Two Obamacare Talking PointsWashington is often a big echo chamber. Or maybe a double echo chamber, in which the two parties talk past each other. But in checking a recent statement by Sen. John Barrasso (R-Wy.), The Fact Checker encountered an odd situation. Barrasso criticized House Democratic leader Nancy Pelosi for a comment she made in 2010—which, depending on how you read it, is a mixed-up factoid that is actually supported by the data he cited (Kessler, 1/17).The Washington Post: Senate Sends Obama A Bill To Fund The Government Until OctoberCongress gave final approval Thursday to a $1.1 trillion spending bill that eases sharp budget cuts known as the sequester and guarantees that the nation will not endure another government shutdown until at least Oct. 1. … The Senate voted 72 to 26 to approve the measure Thursday evening after Republicans persuaded Sen. Ted Cruz (R-Tex.) to drop a last-minute push to force another showdown over the Affordable Care Act, reprising the fight that closed the government for 16 days last fall. The House overwhelmingly passed the spending bill earlier this week. President Obama is expected to sign it by Saturday to prevent agency offices, museums and national parks from locking their gates when the current temporary funding measures expires (Montgomery, 1/16).The Wall Street Journal: Senate Passes $1.012 Trillion Spending Bill On A 72-26 VoteIt provides targeted increases for biomedical research, pre-school education and infrastructure programs that are top Democratic priorities. But overall it provided far less than President Barack Obama requested and kept spending lower than levels that prevailed in 2009, when he took office (Hook, 1/16).The Associated Press/USA Today: House Passes Bill Requiring Weekly Health Care NumbersThe House on Thursday backed a bill that would require the Obama administration to report weekly on how many Americans have signed up for health care coverage as Republicans maintain an election-year spotlight on the troubled law (1/16).Politico: House Passes Health Exchange Disclosure BillThe Republican-led House has approved legislation 259-154 requiring weekly, detailed reports on how the Obamacare insurance exchanges are working, a direct jab at the Obama administration over the massive failures that upended early enrollment on HealthCare.gov. The bill garnered 33 Democratic votes, fewer than the 67 Democrats who backed another health law-related measure last week focusing on the security of personal information on the federal- and state-run exchange websites. The two bills would add disclosure requirements to the Affordable Care Act rather than repeal any provision, making both more palatable to moderate Democrats facing tough reelection battles this year. Still, neither piece of legislation is expected to advance in the Senate (Cunningham, 1/16).Los Angeles Times: Oklahoma Sen. Tom Coburn Says He’ll Retire At End Of YearRepublican Sen. Tom Coburn said late Thursday that he will leave Congress at the end of this session, two years before his term expires (Mascaro and Memoli, 1/16).The Washington Post: Battle Lines Drawn In Va. Senate Race As Ed Gillespie Launches Bid Against Mark WarnerLongtime Republican operative Ed Gillespie made his campaign against Sen. Mark R. Warner official Thursday, launching a bid to unseat the popular Democrat by casting him as a fiscally reckless supporter of the Affordable Care Act (Pershing, 1/16).Politico: Ed Gillespie Formally Announces Senate RunHe also took some early hits at Warner, criticizing his vote for Obamacare and past support for tax increases. The health care law “kills jobs and costs families the insurance and doctors they like” and should be “replaced,” Gillespie said. “Sen. Warner cast the deciding vote” for Obamacare, he said. “If I were a Virginia senator, it would not be law today” (Schultheis, 1/16).The Wall Street Journal: UnitedHealth Profit Up On Stronger EnrollmentsUnitedHealth Group Inc.’s fourth-quarter income rose 15%, fueled by expanding enrollment and growth in its health-services business, but shares slipped on concerns about future government payments for privately managed Medicare plans. The Minnetonka, Minn., company, the biggest U.S. health insurer, reported a profit of $1.43 billion, or $1.41 a share, up from $1.24 billion, or $1.20 a share, a year earlier. Revenue improved 8.2% to $31.12 billion. The earnings slightly beat analysts’ consensus prediction of $1.40 a share (Mathews, 1/16).The Wall Street Journal: Cigarettes Tied To More Deaths, Types Of IllnessCigarettes are deadlier and linked to more diseases than previously thought, according to a new report from the U.S. surgeon general being released 50 years after the government first warned that smoking kills. In the report to be released Friday, the nation’s top doctor warned that smoking is linked to the deaths of about 480,000 Americans annually. That’s a substantial increase over the government’s previous estimate of 443,000 deaths, despite the fact that fewer Americans are lighting up and those who do smoke are lighting up less often (Esterl, 1/17).USA Today: Smoking Causes Diabetes, Colon Cancer, New Report SaysA new report from the surgeon general finds that smoking causes even more physical and financial damage than previously estimated, killing 480,000 Americans a year from diseases that include diabetes, colorectal cancer and liver cancer. The report, released today, represents the first time the surgeon general has concluded that smoking is “causally linked” to these diseases (Szabo, 1/17).The Texas Tribune/New York Times: Sheriff And Judge Battle Over Medical Care In JailNow the judge and Sheriff Ray Nutt of Henderson County are in a pitched battle — that could turn litigious — over accountability for medical care in the lockup. Judge Tarrance argues that other inmates have received similarly shoddy treatment and that judges should have the authority to order improved health care when lives could be in jeopardy. Lawyers for the county say the jail’s medical services are exemplary and that the judge overstepped his authority (Grissom, 1/16).Los Angeles Times: California Gets F In Speedy Treatments At ERs From Advocacy GroupAn updated national report on U.S. emergency medical care has again awarded California an F for lacking access to speedy treatment, noting that the state has the fewest hospital emergency rooms per capita — 6.7 per 1 million people — in the nation. The America’s Emergency Care Environment report card, which gauges how well states support emergency care, was released Thursday by the advocacy group American College of Emergency Physicians (Brown, 1/16).Los Angeles Times: California Hospitals Charge $3,000 To $37,000 For Childbirth, Study SaysAmid growing scrutiny of hospital billing, a new study finds that California hospitals charged mothers $3,296 to $37,227 for a routine delivery. For women having a cesarean section, the UC San Francisco study found patients were billed $8,312 to nearly $71,000. Few of the patients in the study released Thursday had serious health issues, and most were discharged within six days of admission (Terhune, 1/16).The Washington Post: In Wake Of Son’s Death, Creigh Deeds Makes Case For reforms But Meets With ResistanceIn a meeting Thursday of a mental-health subcommittee in the Virginia Senate, Deeds made a passionate case for his legislation without delving into the personal tragedy he suffered only two months ago. … Two of Deeds’ proposals have met with unanimous support. A review of the training and qualifications of community services board mental health evaluators has gone to the full Senate for a floor vote. A mandate for the state Department of Behavioral Health and Developmental Services to offer an electronic database of psychiatric bed availability was passed on to the full Senate Education and Health Committee (Weiner, 1/16). 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