State issues

The Atlantic Wire synthesizes the coverage of Vermont's move toward a single-payer healthcare system.

The Associated Press has the details on Maryland's new health insurance exchange — one of the first in the nation.

Former White House budget diretor Peter Orszag said medical malpractice is the biggest hole in the healthcare law, the Huffington Post reports.

Fox Business Network rounds up the common preventive services that are now covered in their entirety under healthcare reform.

Oklahoma and Tennessee moved forward Wednesday on the healthcare “compact” that some states are pursuing as a challenge to the healthcare reform law.

Oklahoma Gov. Mary Fallin (R) signed the multi-state compact Wednesday, and it passed the state Senate in Tennessee. Georgia Gov. Nathan Deal (R) is the only other governor to sign the agreement. It has been introduced in 14 states and passed by at least one chamber in nine statehouses.

The idea is for multiple states to agree to the compact, essentially a contract among those states that “restores authority and responsibility” for healthcare to state governments.

But in order to take effect and supersede federal law, an interstate compact needs Congress’s stamp of approval. Congress would have to turn over all non-military federal healthcare programs to the states that sign the compact, along with the money it would have spent on those programs in those states.

Republican state legislatures are struggling with how to handle health insurance exchanges, reports Kaiser Health News.

An FDA panel considers new dosing recommendations for over-the-counter children's drugs with acetaminophen.

Maplight looks at the nursing lobby's campaign contributions after The New York Times reports that the industry is fighting to be exempted from the healthcare reform law's employer mandate.

The Center for American Progress suggests ways to cut back on Medicare and Medicaid fraud.

Technologies that allow remote care for critically ill patients lead to reduced mortality rates, hospital length of stay and preventable complications, according to a new study in the Journal of the American Medical Association.

A California state panel passed a bill Tuesday that would enable the state to block health plans from raising their rates — a policy that several states are considering because the federal government does not have that power. Consumer advocates say they’re optimistic about the bill’s chances despite past defeats, in part because of healthcare reform’s requirement that all Americans buy insurance.

The bill would require the state insurance commissioner to approve all rate increases before they take effect. It passed the state Assembly’s health committee Tuesday afternoon by a 12-5 vote. The next step, according to supporters, is a fiscal committee, followed by the Assembly floor.

Insurers in California must file their rates with the state insurance commissioner, but the office has no legal authority to approve or disapprove of any increases.

Sen. Dianne Feinstein (D-Calif.) and Rep. Jan Schakowsky (D-Ill.) pressed hard during the healthcare reform debate to give the federal government the power to reject insurers' premium increases, to no avail. They have since introduced stand-alone legislation.

The federal law does allow the Health and Human Services Department to demand that insurers justify certain rate hikes, but it does not give regulators the ability to stop those increases from taking effect. In the absence of that authority, rate review falls to the states — some of which have embraced it more warmly than others.

The Vermont Senate gave preliminary approval to a universal healthcare bill, writes the Burlington Free Press.

The Health and Human Services Department is barring drugmaker Forest Laboratories from doing business with the government until it ousts its CEO, reports The Wall Street Journal.

Kaiser Health News sheds light on healthcare sharing ministries.

The Colorado Senate gave preliminary approval to a state health exchange, reports The Associated Press.

The Oregon Senate also approved creating an exchange, reports the Statesman Journal.

AdvaMed's Stephen Ubl proposes ways to prevent Accountable Care Organizations from stinting on care on the Health Affairs blog.

Americans for Tax Reform opines that the healthcare reform law paves the way to taxing health benefits.

Vermont's proposed healthcare reform falls short of the single-payer overhaul it's being billed as, the advocacy group Physicians for a National Health Program said Thursday.

The doctors group said the bill passed by the Vermont House of Representatives late last month falls "far short" of single-payer reform. The bill would create a public program open to all Green Mountain state residents by 2017 but would retain a role for private insurers.

"This would negate many of the administrative savings that could be attained by a true single-payer program," PNHP said in a statement, "and opens the way for the continuation of multi-tiered care."

The group also criticized the bill for not addressing long-term care coverage and for not proposing a "concrete funding plan" for the public plan.

Vermont Gov. Peter Shumlin championed single-payer reform in his gubernatorial campaign last year. He defended the House-passed bill Thursday at an Atlantic event, saying it would be good for business because coverage would be paid for by public financing and no longer just those employers that provide it.

Republicans in the Oklahoma statehouse are split over what to do about the federal healthcare reform law, according to the Tulsa World.

State Senate President Pro Tempore Brian Bingman said Thursday the state's upper chamber won't pursue legislation creating a health insurance exchange because it would tie the state to the Democrats' law. The state's Republican governor, Mary Fallin, however supports a state exchange because the healthcare reform law calls for the federal government to run the show starting in 2014 in states that don't take the reins.

"If our state Senate does not take up a piece of legislation that outlines a plan for an Oklahoma exchange, the Senate puts the state of Oklahoma in jeopardy of having a federal health exchange forced down on us that is not developed by Oklahomans," Fallin said, according to the newspaper.

Fallin was a congresswoman prior to her election as Oklahoma's governor and voted against the healthcare reform law. She also supports state Attorney General Scott Pruitt's legal challenge against the law.

Complicating matters, Oklahoma requested and received a $54 million "early innovator" grant to kick start its exchange and serve as a model for the rest of the country. Some state lawmakers are now suggesting that Oklahoma return the money.

Officials from Oklahoma and the six other states that were awarded the competitive grants were in the nation's capital this week to meet with federal regulators about how to set up an exchange.

Republican governors ripped into Democrats' healthcare reform law on Tuesday, testifying before Congress that the law's massive Medicaid expansion and other federal mandates will hurt their states.

Mississippi Gov. Haley Barbour and Utah's Gary Herbert told the Energy and Commerce Committee that states were left out of the debate on Capitol Hill over the past couple of years. They also told the sympathetic Republican-led panel that they need much more flexibility to run their own healthcare programs.

"We shouldn't have to come here and kowtow and kiss the ring" of federal officials to get the needed flexibility to run Medicaid, said Barbour, a potential 2012 presidential candidate.

"Believe it or not," Barbour told lawmakers, "we love our constituents as much as you all do. And we want to do right for them. But we want to do what we can afford and can sustain."

Governors made that case repeatedly over the weekend, during their winter meeting of the National Governors Association. President Obama told them Monday that he'd heard their message and wants to work with them to reform Medicaid and find alternative ways to achieve near-universal healthcare coverage.

New York City Mayor Michael Bloomberg and two Democratic governors spoke out against House Republicans' family planning cuts Tuesday as the Senate prepares to take up the stop-gap funding bill for the rest of the year.

The continuing resolution passed by the House last week eliminated Title X family planning grants, a $327.4 million savings from the president's proposed budget for FY 2011. The House also adopted an amendment from Rep. Mike Pence (R-Ind.) that bars Planned Parenthood from receiving any federal funding for programs such as HIV screening, breast and cervical cancer screenings and infertility prevention.

Abortion opponents have made Planned Parenthood a focal point of their strategy this Congress. The organization is the country's largest provider of abortions, and Pence has argued that cutting funding for its health clinics will impact Planned Parenthood's ability to carry out abortions.

Bloomberg and the two governors, however, said cuts to family planning would only harm poor women and possibly increase the number of abortions.

"Many people don't realize that more than 90 percent of our health services are preventive in nature," said Planned Parenthood President Cecile Richards. "Every year, the doctors and nurses in our centers provide birth control to more 2.5 million women; we conduct more than 1 million cervical cancer screenings and nearly a million breast exams."

Taken together, the two House measures will have "very negative consequences," said Connecticut Gov. Dan Malloy (D), "including driving people in the direction of abortions from unplanned pregnancies."

"I can only imagine that this is a politically motivated vote having nothing to do with public health, having nothing to do with the welfare of children or of women," Malloy said during a conference call organized by the Planned Parenthood Federation of America. "It would be a gigantic blow to the state of Connecticut if these cuts were to take place."

Vermont Gov. Peter Shumlin (D) shared similar concerns.

"Cutting Title X money would be devastating for Vermont women," he said. "In a small, rural state like Vermont, often times this is the only healthcare that they get."

Texas Rep. Ted Poe accused another Republican of proposing legislation that would violate the Constitution.