First Edition: February 2, 2015

Kaiser Health News: Why Florida Is No. 1 In Obamacare Enrollment Despite GOP Opposition
When Florida workers promoting President Barack Obama’s health law marketplace want instant feedback, they go to an online “heat map.” The map turns darker green where they’ve seen the most people and shows bright red dots for areas where enrollment is high. “The map shows us where the holes are” and what communities need to be targeted next, said Lynn Thorp, regional director of the Health Planning Council of Southwest Florida. She hands out information about the health law’s marketplace at rodeos, farmers markets, hockey games —almost any place where people gather. (Galewitz, 2/2)

Kaiser Health News: California Ranks Last In Spending On Diabetes Prevention, Audit Finds
Reporting for Kaiser Health News, Barbara Feder Ostrov writes: "California spends less per person than any state on diabetes prevention programs, even as one in 12 California adults is estimated to suffer from the chronic disease, according to a new report from the California State Auditor. Using only federal grants, California spent just 3 cents per person on diabetes prevention in the 2012-2013 fiscal year, compared to New York’s 42 cents per person in state and federal money that year, the report noted." (Ostrov, 2/2)

The New York Times: Obama’s Plans For Deficit And Taxes Are Detailed On Eve Of Budget Proposal
President Obama will propose a 10-year budget on Monday that stabilizes the federal deficit but does not seek balance, instead focusing on policies to address income inequality as he adds nearly $6 trillion to the debt. ... Republicans will put forward ideas for controlling the main drivers of the deficit — Social Security and health care programs that are expanding with an aging population — and will propose a budget that does balance. But, [Rep. Paul] Ryan indicated, they are not likely to force a showdown on entitlements. (Weisman, 2/1)

The Washington Post: Obama Budget Would Fund Public Works Program With Tax On Overseas Profits
The administration said it “achieves these goals by replacing mindless austerity with smart reforms, paying for all new investments” and seeking new savings. That isn’t likely to appease Republicans, however, who are expected to quickly dismiss Obama’s budget request and start drafting their own blueprint that would seek to eliminate deficits entirely over the next 10 years and tackle the biggest drivers of government spending: Social Security and federal health programs. (Mufson and O'Keefe, 2/2)

The Associated Press: Obama Sending $4 Trillion Spending Plan To Congress
Even before the massive budget books landed on lawmakers’ desks, Republicans were on the attack, accusing the president of seeking to revert to tax-and-spend policies that will harm the economy while failing to do anything about the budget’s biggest problem — soaring spending on government benefit programs. Obama’s fiscal blueprint, for the budget year that begins Oct. 1, proposes spending $4 trillion — $3.99 trillion before rounding — and projects revenues of $3.53 trillion. (Crutsinger, 2/2)

Los Angeles Times: Obama Budget Seeks To Boost Middle Class, Close Gap On Income Inequality
The Republican preference is for continued austerity and lower taxes, which will probably be reflected in their own budget plans expected next month. To boost Pentagon spending as defense hawks want, their budgets are expected to slash more deeply into food stamps, healthcare and other safety-net programs. Rep. Tom Price (R-Ga.), the House Budget Committee chairman, promised Sunday on Fox News that a Republican budget would re-imagine Medicare, Medicaid and Social Security, and “will do what the American people have to do with their homes and in their businesses every single day — and that’s not spend more money than what comes in.” (Mascaro and Hennessey, 2/2)

The New York Times: Piling On Work To Escape Gap In Health Law
Alma Ramos, a soft-spoken prep cook at a Tex-Mex restaurant, was eager to sign up for health insurance through the new healthcare.gov marketplace last year. But Ms. Ramos, a single mother of three, quickly hit a baffling hurdle. Because of a wrinkle in the Affordable Care Act, Ms. Ramos made too little money to receive federal aid for buying private insurance — and too much to qualify for Medicaid, the government health care program for the poor. But she found a solution. (Goodnough, 2/1)

The New York Times: White House Seeks To Limit Health Law’s Tax Troubles
Obama administration officials and other supporters of the Affordable Care Act say they worry that the tax-filing season will generate new anger as uninsured consumers learn that they must pay tax penalties and as many people struggle with complex forms needed to justify tax credits they received in 2014 to pay for health insurance. The White House has already granted some exemptions and is considering more to avoid a political firestorm. (Pear, 1/30)

The Wall Street Journal: GOP Lawmakers Weigh Contentious Tactic To Dismantle Health Law
Republican lawmakers and aides say there is broad enthusiasm for using the process known as reconciliation to try to repeal the 2010 health care law and potentially replace it with a GOP alternative. Another contender, looking less likely now, is using the process for a tax overhaul. (Peterson and Crittenden, 1/30)

The Associated Press: Drive To Repeal Medical Tax No Slam Dunk In Congress
It flew through the Republican-run House in 2012, and a year later 79 of the Democratic-led Senate's 100 members embraced it. With Republicans now controlling both chambers of Congress, the chances for repealing the 2.3 percent tax on medical devices are better than ever. Yet abolishing the tax won't be easy, even though Republicans rank it a top priority and are backed by Democrats from states that rely on the industry for jobs. (Fram, 1/31)

Politico: Lobbying Push Puts Obscure Tax At Top Of Obamacare Repeal Agenda
An obscure Obamacare tax on medical devices has emerged as the Republicans’ best chance of repealing part of the health care law this year. The tax may not be what ordinary Americans who oppose Obamacare focus on — or even know about. (Norman, 2/2)

The Washington Post: How Rand Paul Tried To Lead An Eye Doctors’ Rebellion
The saga began in the 1990s, when Paul — now a senator representing Kentucky and a GOP presidential contender — hatched a plan to put his family’s free-market ideals into practice. He wouldn’t submit to the establishment. He would out-compete it by offering doctors an alternative with lower fees and fairer rules. His do-it-yourself medical board lasted more than a decade, becoming one of the most complex organizations Paul ever led on his own. But it didn’t work. Indeed, in a life of successes, it became one of Paul’s biggest flops. (Fahrenthold, 2/1)

The Wall Street Journal: Medicare To Publish Physician-Payment Data Yearly
The U.S. government will begin releasing Medicare physician-payment records every year, cementing public access to how tens of billions of dollars are spent annually on everything from office visits to radiation therapy. Last April, a year’s worth of the data was released for the first time in more than three decades after Wall Street Journal parent Dow Jones & Co. challenged a 1979 injunction that prohibited Medicare from disclosing its payments to doctors. It was unclear at the time if any more records would be released. (Stewart and Carreyou, 2/1)

The Washington Post: The Biggest Challenge Facing The Government’s New Plan For Better Health Care
The Obama administration earlier this week announced a not-so radical idea: Medicare, the massive health-care program for seniors, should do a much better job of paying doctors and hospitals for quality, not quantity, when it comes to care. ... On its face, it sounds reasonable enough. Who doesn't want to cut waste in America's $2.9 trillion health-care system and improve the kind of care that patients get? But actually determining the quality of this care is tough business. (Millman, 1/30)

The Wall Street Journal: Debate Heightens Over Measuring Health-Care Quality
The Obama administration’s goal of tying more Medicare payments to the quality—not the quantity—of health care by 2018 has intensified the debate over how “quality” is defined and measured. (Beck, 1/30)

The New York Times: Medical Costs Rise As Retirees Winter In South
Like many retirees, one couple from upstate New York visit doctors in their winter getaway in Florida. But on a recent routine checkup of a pacemaker, a cardiologist there insisted on scheduling several expensive tests even though the 91-year-old husband had no symptoms. ... The couple’s experience reflects a trend that has prompted some doctors up north to warn their older patients before they depart for Florida and other winter getaways to check in before agreeing to undergo exams and procedures. And some patients have learned to be leery after being subjected to tests — and expenses — that long-trusted physicians at home never suggested. (Rosenthal, 1/31)

The New York Times: U.S. To Collect Genetic Data To Hone Care
Saying that “the possibilities are boundless,” President Obama on Friday announced a major biomedical research initiative, including plans to collect genetic data on one million Americans so scientists could develop drugs and treatments tailored to the characteristics of individual patients. (Pear, 1/30)

The Wall Street Journal: Obama Announces $215 Million Precision-Medicine Genetic Plan
President Barack Obama on Friday laid out an ambitious effort to amass genetic data on one million or more Americans, a plan aimed at discovering genetic causes of disease and finding new drugs that will target dangerous mutations. Speaking at the White House, Mr. Obama called the $215 million Precision Medicine Initiative “one of the biggest opportunities for breakthroughs in medicine that we have ever seen.” (Burton, Rockoff and Winslow, 1/30)

The Washington Post: Obama Touts ‘Lifesaving’ Potential Of Personalized Medicine
In recent years, targeted therapies have led to more effective treatments for various cancers and other diseases, such as cystic fibrosis. The Food and Drug Administration has approved a growing number of specialized drugs for patients with specific genetic mutations, and the biotech industry has many more drugs in development. The trend has benefited from sharp declines in the cost of genome sequencing. (Dennis, 1/29)

NPR: As Measles Outbreak Spreads, Some Babies Under Isolation
California is grappling with an outbreak of measles. In Alameda County, health officials have told parents whose babies have been exposed to the virus to keep their children at home for 21 days. (Neighmond, 2/2)

The New York Times: Vaccine Critics Turn Defensive Over Measles
Their children have been sent home from school. Their families are barred from birthday parties and neighborhood play dates. Online, people call them negligent and criminal. And as officials in 14 states grapple to contain a spreading measles outbreak that began near here at Disneyland, the parents at the heart of America’s anti-vaccine movement are being blamed for incubating an otherwise preventable public-health crisis. Measles anxiety rippled thousands of miles beyond its center on Friday as officials scrambled to try to contain a wider spread of the highly contagious disease — which America declared vanquished 15 years ago, before a statistically significant number of parents started refusing to vaccinate their children. (Healy and Paulson, 1/30)

Los Angeles Times: In The Fight Against Measles, Science And Detective Work Join Forces
The battle to halt the spread of the measles outbreak that began at Disneyland has required both infectious disease expertise and a good amount of old-fashioned detective work. Health officials in California and seven other states have painstakingly traced the steps of measles patients, tried to identify anyone who came in contact with them, and quarantined those at greatest risk of getting the highly contagious disease to keep the virus from spreading. (Xia, Lin II and Muskal, 1/30)

Los Angeles Times: Hospital Chain Prime Healthcare Faces A Fight To Grow
Buried in debt, Centinela hospital of Inglewood was on the verge of bankruptcy in 2007. It had lost $50 million in four years, and local officials worried that it might close — following the path of several other South Los Angeles hospitals. But where others saw risk, cardiologist Prem Reddy saw opportunity. Reddy's company, Prime Healthcare Services Inc., bought Centinela and quickly turned it around, cutting expenses and increasing revenue. Centinela lost $63 million in 2007. Six years later, it made $39 million. Today it's rated among the better-performing hospitals in the state. (Pfeifer, 2/1)

Los Angeles Times: California Stumbles At Shifting Care For Costly Patients
California's ambitious effort to save billions of dollars by changing how the state's costliest patients get treated is on the ropes. The Obamacare program was designed to reduce medical costs by putting more of the nation's 11 million most challenging and expensive patients into tightly managed care. But the rollout in California — one of the first states spearheading the effort — has been marred by widespread confusion, enrollment glitches and a revolving door of health officials. (Terhune, 1/31)

The Associated Press: California Health Care Contract Fight Resolved
Health insurance provider Blue Shield of California and the Sutter Health network of doctors and hospitals have reached agreement on a new contract, ending a dispute that threatened to force nearly 280,000 consumers in Northern and Central California to find new doctors. The companies announced the two-year contract on Friday. It means Blue Shield patients will be able to continue using Sutter doctors and hospitals without going out of their coverage network. (1/31)

The Washington Post: She Fought For Patients’ Rights, Then She Was Put In A Hospital Against Her Will
[Alison] Hymes was no ordinary patient. Before landing at Western, she spent years urging others with mental illness and their families not to let doctors, judges and social workers make decisions for them. She was part of a state task force charged with reforming civil commitment laws at the time of the 2007 Virginia Tech massacre, serving alongside doctors, academics, and law enforcement officials. The daughter of a prominent University of Virginia linguist, Hymes argued vehemently — and unsuccessfully — against loosening the state’s commitment criteria. Hymes, now 58, believed those changes made it easier for authorities to involuntarily commit her in 2011 and again in 2013. (Shin, 1/31)