The chain drug store lobby is cheering Sen. Jim Webb (D-Va.) this week for his vocal opposition to cuts in military healthcare spending. 

The National Association of Chain Drug Stores (NACDS) is concerned that cuts to Tricare, the military's health insurance program, will cause beneficiaries to skip some of their prescribed medications. 

Webb, the chairman of the Senate Armed Services Personnel subcommittee, told reporters Wednesday that that he supports Defense Department efforts to trim wasteful spending, but will fight proposals to scale back Tricare benefits.

For that position, he's found fans at the NACDS.

"We recognize that the Department of Defense (DoD) is struggling with healthcare costs, just like other payers," NACDS President Steven C. Anderson wrote to Webb on Friday. "However, we agree with the subcommittee that savings are more likely to be found through improving business practices and encouraging preventive care, rather than increasing premiums, co-payments and other beneficiary cost sharing."

The group says that pushing more costs on military personnel would cause some patients not to buy needed medications, leading to even higher costs down the line. 

"We know that the annual cost of medication non-adherence is staggering — the New England Healthcare Institute estimates it to be $290 billion a year — 13 percent of total healthcare expenditures," Anderson wrote.

The letter arrives as top Pentagon leaders eye cuts to healthcare as a way to rein in DoD spending. Earlier in the year, Defense Secretary Robert Gates warned that healthcare costs “are eating the Defense Department alive,” The Hill's Roxana Tiron reported this week. 

More recently, Gen. Norton Schwartz, the Air Force chief of staff, cautioned that skyrocketing health costs could force the agency to scale back vital defense programs, Tiron wrote.

“We have to recognize that if we are not careful, these unbounded costs can force out military content elsewhere in the Department of Defense portfolio,” Schwartz said earlier this month. 

The Obama administration on Friday launched a new grant program designed to help states establish the online insurance menus scheduled to go live in 2014.

The "early innovator" grants will be available to fives states — or coalitions of states — that come up with cutting-edge health information technology (HIT) systems to run their exchange programs. The size of the grants has yet to be established, officials said, adding that funding amounts will hinge primarily on the ambitions of the states.

“Consumer-friendly information technology is the backbone of that effort which is why we are creating an incentive for states that are willing and able to lead the way to do so,” Health and Human Services Secretary Kathleen Sebelius said in a statement.  

The state-based insurance exchanges — a central element of the new healthcare reform law — launch at the start of 2014. The idea behind the competitive grants is to entice states to make the insurance menus as user-friendly as possible — with the remaining states benefiting from the best models.

Joel Ario, director of health insurance exchanges at HHS, said states are telling the agency they don't want to reinvent the wheel 50 times over. 

"It's technology to be shared," he told reporters on a phone call Friday. 

Jay Angoff, director of HHS's Office of Consumer Information and Insurance Oversight, said the ultimate goal is to create state systems that are "simple, seamless and secure."

"A strong IT infrastructure will be critical to their success," he said.

Officials also downplayed questions about the reluctance of some consumers to use the Internet, particularly for making purchases. 

"That reluctance is certainly breaking down," Angoff said, "and it will break down even more by 2014."

Conservative group claims 1 million signatures on repeal petition: A conservative group critical of the Democrats' healthcare reform law has collected 1 million signatures calling for the law's repeal, the group announced Thursday. Revere America, a Washington-based conservative group named after the Revolution-era hero, has posted its petition online, calling for "the repeal and replacement of this law with responsible reforms."

George Pataki, former GOP governor of New York and chairman of the repeal group, told reporters over the summer that he supports a more market-based system, including reforms allowing insurers to sell plans across state lines and limiting malpractice claims.

"The American people have made their concern known over this law, and they will deliver a clear message on Nov. 2," Pataki said in a statement announcing the million-signature mark. "Americans feel like they have been handed an unworkable system they neither trust nor understand." http://bit.ly/dqEyJ1

At the same time, Pataki is having trouble getting candidates for office to sign on. Only 55 have done so to date. http://bit.ly/aVkLcu

Hospital group backs repeal of cost-cutting board: The American Hospital Association this week officially endorsed a Republican bill to repeal the Independent Payment Advisory Board created by the healthcare reform law. The IPAB is one of the few cost-cutting measures in the bill; it drew hackles during the debate when Senate Finance Committee Chairman Max Baucus (D-Mont.) exempted hospitals from its mandate until 2020. 

"America's hospitals support the repeal of IPAB because its existence permanently removes Congress from the decision-making process and threatens the long-time, open and important dialogue between hospitals and their elected officials about the needs of local hospitals and how to provide the highest quality care to their patients and communities," the AHA wrote in a letter to Sen. John Cornyn (R-Texas), who introduced the repeal bill. http://bit.ly/deIzYV

Sestak says Dems caved in on healthcare: Rep. Joe Sestak, the Pennsylvania Democratic Senate candidate, said this week that Democrats bent too far in order to pass the healthcare reform bill. Agreements cut with individual lawmakers and various health industry groups represented a compromise of principles that ultimately made voters suspicious of the bill, Sestak said Wednesday, without offering specifics. And launching the trouble, he said, was the party shift of Sen. Arlen Specter (D), who was defeated by Sestak in the Democratic primary earlier this year. http://bit.ly/brNkf7

Medical device makers blast Puerto Rico tax: The trade association for medical device makers criticized a new 4 percent tax on certain transactions in Puerto Rico. In a letter sent this week to Gov. Luis Fortuño, Stephen Ubl of the Advanced Medical Technology Association warns that "this tax sends a very bad message to our members and will significantly impact device manufacturers’ ability to maintain and grow their manufacturing facilities on the island." AdvaMed members are major employers in Puerto Rico, Ubl writes, providing more than 15,000 jobs, or roughly 13 percent of the island’s manufacturing jobs.

HHS highlights growing early retiree program: Almost 700 additional employers and unions will soon get help providing health coverage to early retirees and their families, the Department of Health and Human Services (HHS) said Thursday. In all, nearly 3,600 employers and unions have so far been approved to participate in the healthcare reform law's Early Retiree Reinsurance Program to date, and applications are still being accepted. http://bit.ly/cz35QC

Rep. Braley joins in criticism of competitive bidding: Rep. Bruce Braley (D-Iowa) has joined in the criticism of the competitive bidding program for durable medical equipment in Medicare. In a letter sent Thursday to HHS Secretary Kathleen Sebelius and Donald Berwick, administrator of the Centers for Medicare and Medicaid Services, Braley requests another delay to the program.

NPR gets flak for "psychiatrist" remark: The National Alliance on Mental Illness has warned National Public Radio that a remark made by NPR's CEO in the firing of senior correspondent Juan Williams may violate the letter or spirit of the Americans with Disabilities Act. NAMI called "outrageous" NPR President and CEO Vivian Schiller's remark that Williams should have kept his personal feelings about Muslims between himself and his "psychiatrist or publicist — take your pick." In a letter to Schiller, NAMI Executive Director Michael Fitzpatrick calls on NPR to adopt a plan no later than its board meeting scheduled in November to "educate and reassure" managers and employees about ADA protections in the workplace for people with mental-health concerns. http://bit.ly/aIaXt2

Titus campaign hits GOP opponent on cervical cancer vote: The Service Employees International Union (SEIU) is gunning for the woman vote in Nevada. After releasing a television ad last week attacking Republican Senate candidate Sharron Angle and aimed at female voters, SEIU is finishing up a direct-mail campaign in support of Rep. Dina Titus (D-Nev.). Some of the mail pieces criticize Titus's GOP opponent, Joe Heck, for his vote in the Nevada state senate against requiring insurance companies to cover a vaccine for the human papillomavirus, a precursor to cervical cancer. 

Pawlenty raises questions: Minnesota Gov. Tim Pawlenty (R) says he'll file Freedom of Information Act requests with federal agencies to obtain information about Democrats' work to promote healthcare reform. Pawlenty hit the Democratic National Committee with his own FOIA request after ABC News reported on Wednesday that the DNC had filed similar requests with the Pentagon for information on a series of potential Republican presidential candidates in 2012, including the Minnesota governor. http://bit.ly/9xrcHw

A conservative group critical of the Democrats' healthcare reform law has collected more than 1 million signatures calling for its repeal, the group announced Thursday.

Revere America, a Washington-based conservative group named after the Revolution-era hero, has posted its petition online, calling for "the repeal and replacement of this law with responsible reforms."

George Pataki, former GOP governor of New York and chairman of the repeal group, told reporters over the summer that he supports a more market-based system, including reforms allowing insurers to sell plans across state lines and limiting malpractice claims.

"The American people have made their concern known over this law, and they will deliver a clear message on Nov. 2,” Pataki said in a statement announcing the million-signature mark.  “Americans feel like they have been handed an unworkable system they neither trust nor understand."

Another Revere America repeal drive targeting Congress members and candidates hasn't been as successful. Despite House Minority Leader John Boehner's (R-Ohio) endorsement of a candidate-focused repeal petition, only two other GOP incumbents have signed on. (A total of 55 candidates from across the party spectrum have endorsed that measure.)

In the waning days of the campaign, Revere America plans to use direct mailing to 300,000 voters, focusing on the top 75 House races and the top five Senate contests, the group said. Democrats who opposed the healthcare bill will not be targeted. 

The full text of the group's petition appears after the jump.

"We did compromise principles," Pennsylvania Democratic Senate candidate Rep. Joe Sestak said.

Former GOP Gov. George Pataki's "Revere America" group sent the pledge to all incumbents and candidates; only 55 have signed.

State commissioners send MLR to HHS: The National Association of Insurance Commissioners sent its medical-loss-ratio definitions to the Department of Health and Human Services (HHS) for approval on Wednesday, but the debate is far from over. In a cover letter accompanying the submission, the NAIC warns that "we continue to have concerns about the potential for unintended consequences arising from the medical loss ratio."  

The recommendations were unanimously approved by state insurance regulators on Oct. 21. But the NAIC reiterates its concern that "consumers will not benefit from higher medical loss ratios if the outcome is destabilized insurance markets where consumer choice is limited and the solvency of insurers is undermined." 

The NAIC, which supports a phase-in period for the medical-loss ratio, urges HHS to "give deference to the analysis and recommendations of state regulators when determining how the new requirements will be implemented in a destabilized market." The cover letter also expresses concern about the ratio's impact on agents and brokers, and notes that the NAIC has created a working group to coordinate with HHS to "ensure that the vital role of agents and brokers is preserved, especially during years leading up to 2014" when state insurance exchanges go into effect. http://bit.ly/cyErrj

Hospital group wants anti-trust exemption: The Federation of American Hospitals wants federal regulators to create a "safe harbor" protecting hospitals from anti-trust rules as they set up Accountable Care Organizations called for in the healthcare reform law. The ACOs aim to provide more efficient delivery of care through closer coordination between physicians and hospitals.

"The FAH strongly believes that such a safe harbor is necessary," President and CEO Charles Kahn writes in a letter to letter to the heads of the Centers for Medicare and Medicaid Services, the Federal Trade Commission and the HHS inspector general. "The absence of such a safe harbor will retard the spread and potential benefits of ACOs, both in Medicare and the commercial market." http://bit.ly/bVReFZ

Prescription-drug campaign gets cash: The National Association of Chain Drug Stores Foundation on Wednesday announced a $1 million contribution to the National Consumers League's national campaign to raise consumer awareness of the public health benefits of taking medications as prescribed. The medication-adherence awareness campaign includes more than 100 stakeholders from public- and private-sector advocacy organizations, government agencies and corporations, and will officially launch next spring. http://bit.ly/9Ms7Ke

New study weighs risks and benefits of pharmaceutical outsourcing: Global pharmaceutical outsourcing has become increasingly prevalent, says a new study by PricewaterhouseCoopers, but is creating a complex and risky supply-chain environment that has pharmaceutical and life sciences executives on high alert. The study cautions that "the ability to control the safety, efficacy and effectiveness of products will continue to be a challenge until the industry implements systems that can provide real time, global visibility into the supply chain, including practices and information from suppliers, distributors, shippers, and contract manufacturers." http://bit.ly/cvIrXm

Fight over abortion gets extreme: Planned Parenthood Federation of America President Cecile Richards on Wednesday called on the federal government to "investigate … seriously" new "Wanted" posters targeting abortion doctors that have gone up in the Charlotte, N.C., area. 

"Americans should not forget that in the recent past, ‘Wanted’ posters targeted physicians who provided abortions, and then those physicians were assassinated," Richards said. "Now, anti-choice extremists have resurrected the same tactic to frighten and intimidate doctors who help women on a daily basis. There is simply no place in our society for such outrageous and dangerous conduct."

The posters were put up by Operation Save America, which says the posters aren't threats but rather a statement that the doctors are wanted by Jesus. But CBS News in a segment about the posters, which include doctors' addresses, reminds viewers that similar posters went up before a rash of murders in the 1990s: David Gunn of Florida and George Patterson of Alabama were shot and killed in 1993, and John Britton was murdered a year later in Florida. http://bit.ly/a49XeF

New poll shows stark partisan divide over healthcare reform: More than 7 in 10 respondents say that a candidate’s position on the healthcare law will play a role in their congressional vote, according to a new poll published in the New England Journal of Medicine — and there’s a large partisan division on this question: 67 percent of Democrats say they are more likely to vote for a congressional candidate who supported the new healthcare law, and 72 percent of Republicans say they are less likely to vote for such a candidate. Among independents, a larger proportion says they would be less likely (37 percent) to vote for a candidate who supported the new law. http://bit.ly/bpJNCP

A top Democrat warned Wednesday that repealing the healthcare reform law would recreate a system where women typically pay more than men for their health coverage.  

"Health reform limits the ability of insurers to charge women and older individuals higher premiums for the same policy," Rep. Pete Stark (D-Calif.), chairman of the Ways and Means health subpanel, said in a statement. "The Republican pledge to repeal would give insurers free range to discriminate against these individuals and charge them more for health insurance."

A central element of the Democrats' healthcare law is the provision prohibiting insurers from denying coverage or setting rates based on gender, health status, genetic information or evidence of domestic violence, among other things.

The law also requires all new health insurance plans to provide women's preventive care — things like mammograms — at no additional cost to the patient.

Those provisions were designed to make health coverage more affordable for women, who tend to pay more for insurance for the simple reason that they typically use more healthcare services than men of the same age. The National Women's Law Center reported in 2008 that insurance companies were known to charge women as much as 48 percent more than men for individual coverage. 

From the market's perspective, the discrepancy makes perfect sense. But healthcare advocates have been quick to point out that the higher costs also leave women at a distinct disadvantage. 

"Because insurance carriers consider women, particularly young women, a higher risk than men, women experience more difficulty obtaining coverage from the individual market and are charged much higher premiums for the same benefits than men of the same age," health experts at the Commonwealth Fund wrote in July. "Women’s higher health care costs mean that they are more likely than men to experience problems paying medical bills — their own and those of family members."

Republican leaders are vowing to repeal the law and replace it with more market-based alternatives, but the details of their plan remain spare. It is unclear, for instance, how they could repeal the individual insurance mandate — among the most controversial of the Democrats' reforms — while retaining popular consumer protections, including the ban on gender discrimination.

Stark's warning Wednesday was the latest in a string of statements the California Democrat has released this month in an effort to highlight the consumer benefits that would be lost if the healthcare law were repealed.