OVERNIGHT HEALTH: HHS extends exchange deadline

In a concession to Republican governors, the Obama administration extended the Friday deadline for states to decide whether they’ll implement their own insurance exchanges. In a letter to governors on the eve of the deadline, HHS gave states an extra month to file letters of intent on their exchanges.

By The Hill's count, eight states were undecided before the letter was released Thursday evening — Arizona, Idaho, New Jersey, Oklahoma, Pennsylvania, Tennessee, West Virginia and Wisconsin. The extra time could help coax some of those states into creating their own exchanges, rather than leaving the task up to the federal government.

Dec. 15 is the new deadline for states that want to run their own exchanges to make that intention known. States that don’t go that route will have until Feb. 14 to decide whether to work in partnership with the federal government or cede their exchange entirely to Washington.

Here’s our rundown of where things stood Thursday evening:

• Committed to a state-based exchange: 17 states and Washington, D.C.
• Planning for a partnership exchange: 5 states
• Have said “no” to a state-based exchange: 20 states
• Undecided: 8 states

Those 20 states that have rejected their own exchanges won’t be necessarily turn entirely to the federal government — a handful have already indicated they might be open to a partnership, and the Obama administration will certainly try to cajole more of them into at least some role in their exchanges.

Moving on meningitis: It was a big week for lawmakers probing the meningitis outbreak. The Senate followed the House with its own hearing Thursday — Food and Drug Administration (FDA) Commissioner Margaret Hamburg spoke before the Health Committee and faced questions on why her agency didn't come down harder on the New England Compounding Center (NECC), the pharmacy behind the deaths, over the last decade. In his remarks, committee chief Sen. Tom Harkin (D-Iowa) promised action to fight the possibility of future outbreaks linked to compounders.

"This committee has a demonstrated ability to work to find bipartisan solutions that will take into consideration the needs of all stakeholders," he said. "We will work together to identify and plug any gaps in our regulators’ authority." 

The Health, Education, Labor and Pensions Committee also released a bipartisan staff report on the outbreak that found multiple problems with NECC practices leading up to this year. The firm was "cited multiple times for improper use of prescription blanks to solicit orders" and faced questions over its sterility testing, the committee said. There were also two suspected cases of bacterial meningitis linked to NECC products in 2002, according to the report.

Back on the House side, the Energy and Commerce Committee slammed the FDA over requested documents the agency has not provided, maintaining the tough attitude members displayed toward Hamburg in Wednesday's hearing. (Read about that event at Healthwatch.) Rep. Edward Markey (D-Mass.) and five other Democrats also called on government investigators to probe drug shortages and whether they push hospitals to rely on compounding pharmacies such as the NECC. 

“Increased hospital reliance on compounded drugs should be a result of increased need not unfair pricing. The investigation we are requesting will shed light on any possible linkages between drug shortages and reliance on compounding pharmacies and help address gaps in our oversight of this industry," Markey said in a statement. 

Don't cut here: For-profit hospitals have joined the chorus of healthcare interests urging lawmakers to protect their payments in a final deficit deal. In a letter, the Federation of American Hospitals (FAH) warned that its members cannot absorb cuts from sequestration, the expiring Medicare doc fix or any major deficit-reduction deal.

"Hospitals need your help and we ask for your support during the coming days and week as Congress considers policies addressing the fiscal cliff," wrote FAH President Chip Kahn. Healthwatch has more on Kahn's letter and a similar appeal by AARP on Medicare.

Friday's agenda

The Alliance for Health Reform will hold a briefing on healthcare and the fiscal cliff.

State by state

Utah lawmaker pitches health privacy bill

Eleven percent of California children are uninsured, study says

Health advocates want to increase Maryland's cigarette tax

Ohio House committee approves bill to defund Planned Parenthood

Reading list

Big rise in Americans with diabetes, especially in South

Doctors, others demand clearer Irish abortion law

Co-owner of pharmacy blamed for outbreak stays silent at hearing

On Medicaid expansion, a high-stakes game of chicken

What you might have missed on Healthwatch

Study: US docs most negative on healthcare system

CDC: Smoking bans skyrocket in large US citie.

Democratic senators demand meeting with FDA on risks of energy drinks

Obama bioethics panel: Teach history of US-led STD experiments on Guatemalans

Rep. DesJarlais divorce records confirm affairs, his support of abortions

Harkin: Leave Medicare, Medicaid out of fiscal-cliff talks

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