An abortion-rights group gave 19 states failing grades for women’s reproductive rights policies in a new report card released Friday morning and warned that Republican gains in 2010 could hurt its agenda.

“It is clear that the results of the 2010 elections could pose serious threats to the progress we celebrated in previous years' reports,” wrote NARAL president Nancy Kennan. “Some of our key pro-choice champions in Congress and in the states are not returning to their positions.”

While the NARAL Pro-Choice America report card said Republican gains in 2010 could hurt the group's agenda, it criticized the healthcare reform law for including "alarming new restrictions on women's access to abortion care." The group also criticized the Obama administration for issuing regulations banning abortion coverage from temporary high-risk pools for people with pre-existing conditions. Further, the report said five states have passed laws prohibiting abortion coverage in state health-insurance exchanges that were created by the reform law.

The report comes as anti-abortion groups have been trying to show their clout with a new Republican majority in the House. The groups have been pushing hard for the Republican National Committee to elect a like-minded chairman today, and the GOP selected their favored pick, Rep. Joe Pitts (R-Pa.), to lead the Energy and Commerce Committee's Health subcommittee.

Welcome to The Hill's evening roundup of the day's health policy news and advance look at tomorrow's schedule.

Thursday’s health news:

Repeal vote next week: A vote on repealing the healthcare reform law will be held next week, a spokesman for Majority Leader Eric Cantor (R-Va.) confirmed Thursday afternoon. A detailed schedule will be released Friday. http://bit.ly/fYOlN7

A vote on the repeal bill, a priority of the House’s new Republican majority, had been scheduled for Wednesday of this week until leaders delayed its consideration following Saturday’s shooting tragedy in Arizona. When Congress returns to debate the repeal bill, it will be interesting to take the temperature of the rhetoric. Some lawmakers have called for toned-down language in light of the Arizona shooting, which left six people dead and their colleague, Rep. Gabrielle Giffords (D-Ariz.), critically wounded.

Appropriations cardinal ready to take on 1099: The new chairwoman of the House Appropriations Committee's Financial Services subcommittee told The Hill she is ready to use the appropriations process to eliminate the healthcare reform law’s 1099 provision requiring businesses to report payments over $600 to vendors for the purchase of goods. http://bit.ly/gDLipm

Meanwhile, fast action expected on 1099: House Republicans signaled that repealing the 1099 provision is one of their top priorities — after repeal of the entire healthcare reform law itself. Rep. Dan Lungren (R-Calif.) last week already introduced a 1099 repeal bill, which was numbered H.R. 144, but it was renumbered to H.R. 4 on Wednesday.

The White House and lawmakers agree the requirement should be removed, but not enough lawmakers have yet agreed on how to do it. H.R. 4 has 245 co-sponsors, including 12 Democrats. http://bit.ly/gU0W2r

Consumer advocates say new FDA guidelines not enough: The consumer advocacy group Public Citizen is criticizing federal regulators for not extending new limits on acetaminophen to over-the-counter (OTC) drugs. The Food and Drug Administration (FDA) announced Thursday it is restricting the amount of acetaminophen in combination prescription painkillers to 325 milligrams because of acetaminophen's link to liver damager. However, the FDA left OTC drugs, which make up 80 percent of the acetaminophen market, untouched. http://bit.ly/gtfe9k

For more on acetaminophen: http://bit.ly/DEgxP

More data needed on disparities: There is insufficient evidence regarding the effectiveness of certain interventions in reducing healthcare disparities based on income level, race/ethnicity, gender and other attributes, according to a new Centers for Disease Control and Prevention (CDC) report. The report also said more national healthcare data is needed on disability status and sexual orientation. http://bit.ly/fuq6mn

Insurers warn against exchange requirements: America's Health Insurance Plans (AHIP) urged federal advisers against recommending specific "essential" items or services that must be included in health plans offered on new exchanges starting up in 2014. The health insurance lobby said the requirements set by the reform law are already specific enough. http://bit.ly/gCVcEt

New surveys show interest in EHR incentives: About 80 percent of hospitals and 40 percent of physicians are planning to apply for Medicare and Medicaid incentives for using electronic health record (EHR) technology, according to new surveys announced by President Obama’s health information technology czar. About two-thirds (65 percent) of hospitals and 32 percent of office-based physicians plan to enroll in meaningful use programs by the end of 2012 in order to receive the maximum incentives available under the 2009 stimulus package. http://bit.ly/giQTJ7

Nutrition groups praise school meals proposal: Child nutrition advocates are hailing a proposed rule that would tighten school lunch nutrition standards as part of the Obama administration’s effort to reduce childhood obesity. The proposed rule would require that by the 2012-2013 school year, schools increase the availability of fruits, vegetables, whole grains and fat-free and low-fat milk in school meals while reducing their sodium and saturated-fat levels. The standards also set age-based calorie requirements. http://bit.ly/emL2GO

Miller applauds: Rep. George Miller (Calif.), the Education and Workforce Committee's ranking Democrat, said the proposed rule follows through on the child nutrition reauthorization signed by President Obama earlier this year.

"The proposed rule today follows the spirit of the law by overhauling and improving the foods served to our nation's children," Miller said. "These sweeping changes will make a huge difference in our schools, for our children and for the future of our country."

Pharma’s top 11 for ’11: Tompkins Associates lists the pharmaceutical, biotech and medical products industries’ top 11 priorities for the new year. http://bit.ly/hbihsa

Health insurers boost Medicaid changes: With a number of states considering Medicaid cuts to balance their budgets, AHIP is circulating three Medicaid reports: one on Medicaid managed care cost savings, one on adding value to states and beneficiaries and another on innovations in Medicaid managed care.

Tobacco penalties might pose risk: States’ tobacco taxes may encourage individuals to use more harmful tobacco products, according to a new report from the free-market National Center for Policy Analysis.

On the agenda for Friday:

RNC chairman vote: The Republican National Committee (RNC) is scheduled to vote on a chairman Friday. The Susan B. Anthony List, an anti-abortion group, has been campaigning hard for the committee to elect a chairman with likeminded views. Current RNC Chairman Michael Steele, who is facing an uphill battle for reelection, angered anti-abortion-rights advocates two years ago when he called abortion “an individual choice,” but he recently backtracked from those remarks.

Abortion-rights advocate's outlook: NARAL Pro-Choice America on Friday will release its 20th edition of a report grading states on women’s reproductive rights.

MedPAC meeting wraps: The Medicare Payment Advisory Commission (MedPAC) will finish up its two-day meeting with a focus on assessing payment adequacy for long-term care hospital services and hospice care, as well as an update on quality in the Medicare Advantage program. http://bit.ly/eqaIUM

Around the Web:

MedPAC recommended that Medicare beneficiaries make a copayment for home health visits, The Associated Press reports. http://wapo.st/euK1QB

A Massachusetts requirement for individuals to purchase health insurance was pivotal to the success of the state’s universal healthcare system, The Boston Globe reports. http://bit.ly/ga5CoO

Kaiser Health News provides a guide on accountable care organizations, which are encouraged by the reform law. http://bit.ly/gswTKy

New Jersey Gov. Chris Christie, a rumored 2012 Republican presidential candidate, said healthcare costs will “bankrupt” the state unless workers chip in more for medical coverage, Bloomberg reports. http://bit.ly/gtGUNi

Rhode Island Gov. Lincoln Chafee (I) formed a state healthcare commission to implement the federal reform law, The Associated Press reports. http://bit.ly/feMjHm

A Health Affairs blog recommends a more permanent fix to the Medicare physician payment formula. http://bit.ly/fMHKbe


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The health insurance lobby urged federal advisers against recommending specific "essential" items or services that must be included in health plans offered on new insurance exchanges starting up in 2014.

The 10 general categories of benefits outlined in the reform law already specify an "appropriate set" of items or services that should be included in the essential health benefits package, America's Health Insurance Plans said in Thursday written testimony to the Institute of Medicine (IOM).

"Other programs, such as the Federal Employee Health Benefits Program and the Massachusetts Exchange, generally use a consistent model in which the benefit package only specifies general categories of items or services and does not indicate number and frequency of services that should be covered," wrote Carmella Bocchino, executive vice president of clinical affairs and strategic planning for AHIP.

AHIP's comments were considered in the middle of a three-day IOM meeting as the body prepares recommendations to the Department of Health and Human Services on essential health benefits.

The health insurer advocate also said the essential benefits package should not have the effect of forcing individuals and small employers to purchase a richer scope of benefits than what is currently available today.

"Broadening the scope of the essential health benefit package could have the unintended consequence of making products unaffordable and thereby limit access and consumer choice," Bocchino wrote.

The group also strongly urged against requiring plans on the exchanges to comply with state mandates. AHIP said more than 2,000 state mandates currently exist.

"It would be impossible to include this large number of existing mandates in a national essential benefit package while at the same time providing affordable access to care for consumers," the group said.

The IOM should recommend an essential benefits system that allows for plans to vary levels of co-payments, deductibles and coinsurance within different benefit categories, AHIP further recommended.

A consumer advocacy group is criticizing federal regulators for not extending new limits on acetaminophen to over-the-counter (OTC) drugs.

The Food and Drug Administration (FDA) announced Thursday it is restricting limits of acetaminophen in combination prescription painkillers to 325 milligrams (mg) because of their link to liver damage. Acetaminophen, a pain reliever found in thousands of over-the-counter products, is also combined with other ingredients in many ingredients, usually opioids such as codeine, oxycodone (Percocet) and hydrocodone (Vicodin). Some prescription products can contain up to 750 mg — double of the new FDA ceiling.

The FDA said it sought the new limits because acetaminophen overdoses are associated with serious liver damage.

"There is no immediate danger to patients who take these combination pain medications and they should continue to take them as directed by their healthcare provider," said Sandra Kweder, deputy director of the Office of New Drugs in FDA's Center for Drug Evaluation and Research. "The risk of liver injury primarily occurs when patients take multiple products containing acetaminophen at one time and exceed the current maximum dose of 4,000 mg within a 24-hour period."

A consumer watchdog says the new guidelines ignore the dangers of OTC products, which make up about 80 percent of acetaminophen's market.

“It is inexcusably poor judgment on the part of the FDA to have failed to take action concerning this major source of acetaminophen consumption and, consequently, acetaminophen toxicity,” said Sidney Wolfe, director of Public Citizen’s Health Research Group.

However, the agency is still considering new limits on OTC products, an FDA spokeswoman said.

“There are more complexities in the OTCs and the process of rulemaking occurs over a longer timeframe,” the spokeswoman said.

Higher-dose prescription combination acetaminophen products will be phased out over three years, and the FDA said the new guidelines should not create a shortage of pain medication. The agency is also recommending that boxed warnings — the strongest possible caution for prescription drugs — be added to all acetaminophen prescription products.

The new Republican majority had scheduled a vote for Wednesday, but it was postponed after the Arizona shootings.

There has been "less than adequate progress" toward eliminating most healthcare disparities, according to a new federal report that calls for more data on the subject.

It has been known for a long time that income levels, race and ethnicity, gender and other attributes play in a role in determining how likely an individual is to be healthy, sick or die prematurely, but there is insufficient evidence regarding the effectiveness of certain interventions in reducing those disparities, according to a new Centers for Disease Control and Prevention (CDC) report.

Some of the findings, based on 2007 data, include:

• low-income residents report five to 11 fewer healthy days per month than do high-income residents;

• men are four times as likely to commit suicide;

• the adolescent birth rate for Hispanics and non-Hispanic blacks are three and 2.5 times, respectively, of those of whites; and

• people with higher incomes are more likely to binge drink.

The CDC cites major gaps in national data on healthcare disparities based on disability status and sexual orientation.

"Regularly published health reports that include information on health disparities typically do not include disability status as a dimension for comparison," the report said, calling gaps in sexual orientation data "even more severe."

"Standard reporting of sexual identity/orientation or sexual behavior on national health surveys is necessary if these health inequities are to be observed and attenuated among population groups," the report said.

The report calls on future national and state surveys to consistently and routinely measure sexual identity, orientation and behavior.

Childhood nutrition advocates are hailing a new proposed rule that would tighten school lunch nutrition standards as part of the Obama administration’s effort to reduce childhood obesity.

The proposed rule would require that by the 2012-2013 school year, schools increase the availability of fruits, vegetables, whole grains and fat-free and low-fat milk in school meals while reducing their sodium and saturated-fat levels. The standards also set age-based calorie requirements.

The School Nutrition Association (SNA), which partnered with first lady Michelle Obama on childhood obesity initiatives, praised the Agriculture Department's rule that was made available online Thursday morning.

“By raising the bar for school meals nationwide, these proposed standards will promote healthier lifestyles for America’s schoolchildren,” said SNA President Nancy Rice in a statement.

The United Fresh Produce Association also praised the proposal.

“The new proposed meal requirements will raise standards for the first time in 15 years and will help improve the health and nutrition of nearly 32 million kids that participate in school meal programs every school day,” said association vice president Lorelei DiSogra in a Thursday statement.

According to the rule, its implementation would initially raise the average cost of producing and serving school lunches by almost 7 cents and school breakfasts by 37 cents for schools participating in the National School Lunch Program and the School Breakfast Program. By 2015, when new requirements kick in, the costs would increase an additional 7 cents and 13 cents, respectively.

Last month, President Obama signed a $4.5 billion child nutrition bill that expands eligibility for school meals programs, establishes school nutrition standards for all foods sold in schools and provides a six-cent increase to help cafeterias sell healthier meals.

About four-fifths of the nation’s hospitals and 41 percent of physicians are aiming for federal stimulus dollars for using electronic health records (EHRs), according to new survey results released by President Obama’s health information technology czar.

Starting this year, hospitals and office-based physicians can receive Medicare and Medicaid incentives for the “meaningful use” of EHR technology in accordance with standards established by the Medicare agency. The stimulus package enacted in the first month of the Obama administration makes available up to $45,000 in Medicare and $63,000 in Medicaid incentives to office-based physicians, while hospitals stand to receive millions for the adoption and use of EHR technology. Registration for the Medicare and some Medicaid programs began earlier this month.

About two-thirds (65 percent) of hospitals and 32 percent of office-based physicians plan to enroll in meaningful use programs by the end of 2012 in order to receive the maximum incentives, according to survey results announced Thursday morning. Fewer federal dollars will be available to hospitals and doctors that wait to adopt EHR technology, and failure to meaningfully use EHRs starting in 2015 will result in Medicare penalties.

EHR technology is meant to improve healthcare quality by making it easier for care providers to share information, but the technology’s high cost has often been cited as a main reason for the healthcare community’s reluctance to adopt it. Dr. David Blumenthal, the national coordinator for Health Information Technology (ONC), said Wednesday morning that the stimulus incentives are encouraging providers purchase EHR systems.  

“For years we have known that electronic health records would improve care for patients and bring about greater cost effectiveness in our health sector, yet adoption rates by health care providers remained low,” he said in a statement. “In 2009, Congress and the President authorized major new federal support for EHR adoption and use, and in combination with medical professional and hospital leadership. I believe we are seeing the tide turn toward widespread and accelerating adoption and use of health IT."

The American Hospital Association conducted the survey on hospitals' EHR plans, while the National Center on Health Statistics reported the office-based physician data.

Republicans signaled Wednesday that repealing a controversial tax provision in the healthcare law is one of their most pressing priorities.