Senate Republicans are arguing that the pending omnibus bill contains more than $1 billion in funding for healthcare reform — one more argument for their caucus to vote against the more than 2,000-page bill.

The GOP has vowed to starve the bill of the congressional appropriations it needs in the next Congress.

According to an analysis by the Republican Policy Committee, omnibus funding for programs initiated by the Democrats' reform law includes: 

• $750 million for the new Prevention and Public Health Fund, which includes community transformation grants to fund investments such as walking paths and farmers markets;

• A $175.9 million "adjustment" in the Centers for Medicare and Medicaid Services' Program Management account to implement the law's Medicaid expansion and cuts to Medicare Advantage;

• An $80.7 million increase for the Health and Human Services Department's departmental management account to enforce new mandates and regulations; and

• $3 million for a national health care workforce commission.

The trade groups representing pharmacists and chain drug stores announced Tuesday that they've reached agreement with federal authorities on a motion to dismiss their lawsuit over Medicaid reimbursements.

The National Association of Chain Drug Stores and the National Community Pharmacists Association sued the Centers for Medicare and Medicaid Services in 2007 over a proposal to lower Medicaid reimbursements to pharmacists for dispensing generic drugs. A court that same year blocked the rule from being implemented, but the lawsuit had been lingering until now.

"Now that all of the issues raised in our ... lawsuit have been resolved," the groups said in a joint statement, "there is nothing left to challenge at this time and we are pleased to have reached agreement with CMS on a motion to dismiss the lawsuit."

The Department of Justice announced Tuesday afternoon it will appeal a district court ruling that a key part of the new healthcare reform law is unconstitutional.

A federal judge in Virginia ruled Monday that Congress cannot force individuals to purchase healthcare insurance, as required by the reform law in 2014. U.S. District Court Judge Henry E. Hudson only struck down the individual mandate and allowed the rest of the law to stand.

The administration will appeal the district court ruling to the Fourth Circuit Court of Appeals, Justice Department spokeswoman Tracy Schmaler said in a statement. Some Republicans, including incoming House Majority Leader Eric Cantor (Va.) had called on President Obama and Attorney General Eric Holder to fast-track the appeal to the Supreme Court. 

"Virginia’s suit is based on a state statute that is not applicable nationwide, and the department believes this case should follow the ordinary course of allowing the courts of appeals to hear it first so the issues and arguments can be fully developed before the Supreme Court decides whether to consider it," Schmaler said. "As Judge Hudson noted in denying an injunction, the individual responsibility provision does not go into effect until 2014, so there is more than sufficient time for the courts to consider this case in their normal course of business.”

Federal regulators have adopted at least 18 new rules since passage of the healthcare reform law eight and a half months ago, according to the Congressional Research Service, most of the time without giving the public much chance to comment ahead of time.

The new rules include health insurance reforms, the creation of an early retiree reinsurance program and requirements for states to start high-risk pools for people with pre-existing conditions. 

The new report found that most of the rules were not specifically required by the reform bill, but added that "the agencies' use of rulemaking to accomplish the underlying statutory objectives does not appear to be either improper or unusual." Furthermore, the report explains, "if an agency attempts to bind the public through some mechanism other than a rule, the agency's actions could be subject to judicial review and possible reversal."

More controversial is the decision to allow public comment only after a preliminary regulation was already adopted in 12 of the 18 regulations. That process — known as an interim final rule — theoretically allows regulators time to review the comments before final rules are published. But in this case, all 12 comment periods ended either the day the rules were published or later.

The report says the administration almost always justified its decision to limit comments, oftentimes by arguing that the law required many of the regulations to be put in place quickly. However, in the case of the 10 percent tax on indoor tanning services, regulators merely stated that it had "been determined" that a broader comment period wasn't needed, without further explanation of who made the determination and why.

In addition, the tanning tax regulation was not accompanied by a cost-benefit analysis that's required for regulatory actions that are expected to have an annual economic impact of at least $100 million. The Congressional Budget Office has estimated that the tax would bring in $2.7 billion over a period of 10 years.

Even if regulators were justified in their decision to shorten the comment period, the report concludes, doing so will likely limit stakeholders' input.

"Even though the comment periods for these rules ended on or before the rules took effect, the agencies may still be persuaded to change them at some point in the future," the report explains. "Nevertheless, comments on final rules are generally believed to be less likely to result in changes to the rules than if comments were permitted prior to the final rules being published and made effective."

Major improvements in public health emergency preparedness over the past decade are threatened by severe budget cuts as a result of the recession, according to a report released Tuesday.

Public health agencies over the past 10 years have improved how they prevent, identify and contain disease outbreaks and bioterrorism threats, as well as their response to natural disasters, according to the Trust for America's Health and Robert Wood Johnson Foundation report.

However, 33 states and Washington, D.C., cut public health funding between fiscal 2009 and fiscal 2010, with 18 of those cutting funding for the second-straight year, the report said. In January, 53 percent of local health departments reported their main funding had been cut from the previous year, and 47 percent anticipate cuts in the coming year.

Meanwhile, federal money for public health preparedness has taken a 27 percent hit (when adjusted for inflation) since fiscal 2005. 

Local public health departments have lost 15 percent of their workforce since January 2008. The recession’s impact has just recently hit the public health workforce because funding to support the H1N1 pandemic flu response has almost been entirely used, the report said.

Despite progress made since 9/11, the anthrax scare and Hurricane Katrina, the report identified a number of gaps in emergency health preparedness. These include gaps in funding and infrastructure; how quickly states collect and report data; a shortage of public health workers; research and development of vaccines and medications; and the ability to handle a surge in those requiring care and to identify and service the most vulnerable Americans.

Incoming House Energy and Commerce Chairman Fred Upton (R-Mich.) announced Tuesday that Gary Andres, a former White House staff member under President George H.W. Bush, will serve as staff director for the committee in the next Congress.

Upton said in his new role, Andres will take a lead role on the Republicans' efforts to repeal the White House's healthcare bill. The GOP is also expected to fight any new climate change regulations, and the committee should serve as ground zero for those confrontations.

"For over two decades, Gary has been a leading voice in Republican policy, always seeking solutions to advance our principles to limit the size and scope of government," Upton said in a statement.

"Gary knows how to focus like a laser beam to get the job done. He is one of the most respected, most knowledgeable individuals in Republican policy who has advised Presidents and Republican Leaders through the years and has the demeanor and relationships to help advance our agenda."

Andres previous served as deputy assistant for legislative affairs to the first President Bush and was an adviser to President George W. Bush's transition team. He currently services as vice chairman of public policy and research at the lobbying firm Dutko World Wide. He has also served as a columnist for The Weekly Standard Online, Politico, National Review, and Roll Call.

Andres is also a research fellow at the American University Center for Congressional and Presidential Studies and holds a Ph.D. in public policy from the University of Illinois-Chicago. He previously served vice president for Washington research at Prudential Securities and executive director of federal relations at Southwestern Bell Corp.

The Congressional Budget Office estimates that repeal of the provision would bring in $202 billion from 2014 to 2019.

A trade association challenging the healthcare reform law’s individual mandate thinks reform opponents have some momentum heading into oral arguments Thursday after a federal judge in Virginia struck the provision down as unconstitutional.

“I think it’s a positive that we got this ruling yesterday prior to oral arguments,” said Karen Harned, executive director of the National Federation of Independent Business’s (NFIB) legal foundation. “Any time a judge feels that he isn’t out on his own if he’s to rule in our favor, the better.”

The NFIB is involved in a 20-state lawsuit that also challenges the constitutionality of requiring individuals to purchase health insurance. Oral arguments in the lawsuit, filed by Florida’s attorney general in federal court, are scheduled for Thursday.

The Department of Health and Human Services on Tuesday unveiled a new plan calling for increased collaboration between government agencies and the private sector to tackle the growing challenge of people with multiple chronic conditions.

More than a quarter of all Americans suffer from several chronic conditions, according to HHS, such as arthritis, asthma, chronic respiratory conditions, diabetes, heart disease, human immunodeficiency virus infection and hypertension. Treating those patients takes up 66 percent of the nation's healthcare budget, adds HHS.

But the nation's healthcare system is largely set up to deal with one disease or condition at a time, says HHS. That increases the risk of complications such as adverse drug reactions, unnecessary hospitalizations and overall confusion caused by conflicting medical advice.

"Given the number of Medicare and Medicaid beneficiaries with multiple chronic conditions," said Medicare and Medicaid administrator Donald Berwick, "focusing on the integration and coordination of care for this population is critical to achieve better care and health for beneficiaries, and lower costs through greater efficiency and quality."

The new Strategic Framework on Multiple Chronic Conditions seeks to resolve those issues by "fostering change within the system; providing more information and better tools to help health professionals ― as well as patients ― learn how to better coordinate and manage care; and by facilitating research to improve oversight and care."