Democrats say a new report showing that 59.1 million Americans went without health insurance for at least part of the first three months of 2010 — a 400,000 increase over last year's count from the Centers for Disease Control and Prevention (CDC) — proves that healthcare reform was necessary.

"While GOP leaders are fighting to protect insurance companies," the Senate Democratic Communications Center argues, "the Democrats will continue to fight to protect American families who deserve quality health care."

The new numbers, released Tuesday, are slightly higher than those of the Census Bureau, which reported in September that a record 50.7 million Americans were uninsured last year.

The CDC said that while more people went without insurance because of the tough economy, the rate of uninsured children under the age of 17 continues to drop thanks to reauthorization of the Children's Health Insurance Program.

Cigarette packs sold in the U.S. could soon bear the image of an addict injecting a cigarette into his arm or a dying cancer patient.

The images are among several dozen proposals that will be pared down to nine color images and textual warning statements to be featured prominently on cigarette packages and advertisements starting in 2012. The Department of Health and Human Services and the Food and Drug Administration on Wednesday unveiled the proposed warnings — the most significant changes to health warnings on cigarettes and advertisements in more than 25 years — along with its broader strategic plan for dealing with the public health epidemic.

"Today, FDA takes a crucial step toward reducing the tremendous toll of illness and death caused by tobacco use by proposing to dramatically change how cigarette packages and advertising look in this country. When the rule takes effect, the health consequences of smoking will be obvious every time someone picks up a pack of cigarettes," FDA Commissioner Margaret Hamburg said in a statement announcing the new strategy. "This is a concrete example of how FDA’s new responsibilities for tobacco product regulation can benefit the public’s health."

The public will have until Jan. 9, 2011, to comment on the proposals. HHS will make its choice by June 22, and by Oct. 22, 2012, manufacturers will no longer be allowed to distribute cigarettes for sale in the United States that do not display the new graphic health warnings. 

The strategy is required by the Family Smoking Prevention and Tobacco Control Act, enacted last year. The labeling requirement is part of a broader strategy aimed at reducing the 443,000 tobacco-related deaths each year in the U.S.

Other aspects include: 

• The healthcare reform law gives Americans in private and public health plans access to recommended preventive care, like tobacco-use cessation, at no additional cost;

• Last year's Recovery Act invested $225 million to support local, state and national efforts to promote comprehensive tobacco control and expand tobacco quitlines;

• The 2009 Prevent All Cigarette Trafficking Act aims to stop the illegal sale of tobacco products over the Internet and through mail order, including the illegal sale to youth; 

• The Family Smoking Prevention and Tobacco Control Act of 2009 gives FDA the authority to regulate the manufacture, marketing and distribution of tobacco products. It restricts the use of the terms "light" "low," and "mild;" bans characterizing fruit, candy and spice flavors from cigarettes; and puts in place restrictions on the sale and distribution of cigarettes and smokeless tobacco products to youth;

• The Children’s Health Insurance Program Reauthorization Act of 2009 raised the federal cigarette tax by 62 cents per pack.

Senate Minority Leader Mitch McConnell (R-Ky.) will file a brief in a Florida court in support of a lawsuit challenging the constitutionality of the new health-reform law.

The top Senate Republican will file an "amicus curiae" ("friend of the court") brief in the Florida case and has urged GOP colleagues in the Senate to sign onto the filing, too.

"While I strongly believe that we should repeal the law and replace it with the types of commonsense reforms Americans support, I also strongly support the efforts of over twenty States that have challenged this law in the courts," McConnell wrote in a dear colleague letter.

The effort is meant to build support by Senate Republicans for one of the highest-profile legal challenges to health reform, President Obama and congressional Democrats' signature legislative accomplishment in the past two years. It can be seen within the context of Republicans' vow to repeal the president's new health plan, a cornerstone of the case they made to voters in last week's election.

The suit challenges the constitutionality of a key part of the legislation, the so-called "individual mandate," or the requirement for all individuals to have health insurance. A judge ruled in October that the Florida suit, brought by 20 state attorneys general and the National Federation of Independent Business (NFIB), could proceed.

McConnell wrote that the healthcare law would "remove an important bulwark" against government intrusion.

"I hope you will join me in arguing to the court in the attached brief why that should not happen," the Republican leader wrote.

Senate leaders filing amicus briefs are not entirely without precedent. Senate Majority Leader Harry Reid (D-Nev.) filed one earlier this year in support of military families who were challenging a church's First Amendment right to protest soldiers' funerals.

HHS is scheduled to announce the government’s new tobacco prevention efforts this morning. 

From a Food and Drug Administration advisory: "Tobacco use is the leading cause of preventable death in the United States, responsible for more than 440,000 premature deaths each year. Over the past 40 years, our nation has dramatically reduced tobacco use, but recently it has experienced a stall in those declines. Currently, 20.6 percent of adults and 19.5 percent of high school students smoke cigarettes.

"Reducing the nation’s tobacco use rate - and preventing people from starting in the first place - is a top public health priority for the Administration. Comprehensive and sustained tobacco control efforts are necessary to effectively eliminate this epidemic. Please join HHS officials as they discuss the Administration’s actions to achieve this goal."

Shimkus pushes for top E&C spot: Rep. John Shimkus (R-Ill.) is highlighting the fundraising and mentoring help he has given colleagues and is touting his conservative credentials as he launches a campaign to chair the powerful Energy and Commerce Committee. 

A letter Monday from Shimkus to House Republicans shows he’s using a different strategy than Energy and Commerce ranking member Joe Barton (R-Texas), who is seeking another two years as top Republican on the panel. http://bit.ly/aYSw5C

Dialysis expose sparks response: The chief medical officer at the Centers for Medicare and Medicaid Services (CMS) responded Tuesday to a scathing article on dialysis care in the U.S. by acknowledging that his agency is failing to adequately oversee the taxpayer-funded procedure.

"We have been not able to perform the oversight functions as frequently or as thoroughly as we might like to," Barry Straube told NPR. 

"We are hindered by funding that comes from Congress in order to perform regulatory oversight visits for all of the 17 different provider sites that CMS is charged with regulating. And the funding that is provided to the agency is insufficient in order to be able to meet the statutory requirements in terms of frequency and thoroughness of those sites." http://bit.ly/cy5d80

Chinese heparin prompts call for tougher FDA import controls: The Food and Drug Administration allowed Chinese heparin to be imported into the United States from firms that refused to grant inspectors full access to records and labs, according to a Government Accountability Office report released Tuesday.

The GAO report, requested by House Energy and Commerce ranking member Joe Barton (R-Texas), also faulted FDA's reliance on outside experts with links to heparin companies. FDA boosted its inspections of Chinese heparin plants in 2008 after the deaths of more than 80 people were linked to contaminated heparin, an anticoagulant made of pigs' intestines.

"It’s now obvious that FDA has a fundamental weakness in how it deals with the surge of Chinese medical and food imports," Barton said in a statement. "The FDA allowed importation of heparin from Chinese processors who refused to permit full inspections of their labs and plants. This was a mistake." http://bit.ly/aX02w5

Doctors' lobby supports greenhouse-gas regulations: The American Medical Association voted Tuesday to adopt policy supporting the Environmental Protection Agency's authority to regulate greenhouse-gas emissions. The AMA is currently holding its semi-annual policymaking meeting in San Diego.

"Changes to our climate pose serious risks to public health," AMA Board Member Edward Langston said in a statement. "This new policy shows the AMA's support for the EPA's authority to protect the health of all Americans by regulating greenhouse-gas emissions." http://bit.ly/a6Ct66

Advocates prepare for lame-duck nutrition battle: Advocates on behalf of poverty and children's issues are gearing up for a lame-duck session that many see as their last chance to get a childhood nutrition bill passed.

Supporters expect that a Senate-passed bill could pass as a stand-alone or be incorporated into an omnibus package if it doesn't get the votes it needs, but they're split over how to pay for it. Poverty advocates favor the bill, but not if it's paid for by cutting the food-stamp program.

"We cannot trade off one excellent nutrition program for another," said Mariana Chilton of Witnesses to Hunger during a conference call announcing a new report from the Food Research and Action Center.

The report, released Tuesday, found that 17.7 percent of Americans reported having struggled to get food on the table between April and September. That's down from the last quarter of 2009 and much less than what advocates say would have happened in a faltering economy if last year's recovery act hadn't boosted food stamp spending. http://bit.ly/a3iRRh

Bennet: Dems likely to revisit health law: The Senate is likely to revisit the new healthcare measure that became law earlier this year, a member of the chamber's Health committee said Tuesday.

Sen. Michael Bennet (D-Colo.), a member of the Health, Education, Labor and Pensions Committee, said he thought the majority Democrats would look at making changes to the bill President Obama signed into law in March.

"I think we will," Bennet said in an interview on NPR. "I think we didn't do enough the first time around on cost containment — there's more to be done there, on the Medicare incentive structure." http://bit.ly/9ssbOj

Timeline of Medicare changes released: The Congressional Research Service has released a handy, 143-page summary and timeline of the myriad Medicare provisions in the healthcare reform law. CRS also has a report on Accountable Care Organizations out.

Lowest-premium Part D plan launches: Humana and Walmart will launch their new Medicare prescription drug plan next Monday. The typical Medicare Part D beneficiary will be able to save $450 in 2011 by enrolling in this plan, according to the companies, making it the lowest nationwide monthly premium Medicare Part D Plan in all 50 States and D.C. http://bit.ly/a9dJBN

Rep. John Shimkus (R-Ill.) is highlighting the fundraising and mentoring help he has given colleagues and touting his conservative credentials as he launches a campaign to chair the powerful Energy and Commerce Committee. 

A letter Monday from Shimkus to House Republicans shows he’s using a different strategy than Energy and Commerce ranking member Joe Barton (R-Texas), who is seeking another two years as top Republican on the panel. 

The Illinois Republican, like Barton, is selling himself as a reliable conservative voice in the caucus. But Shimkus sent his letter announcing the campaign to the whole caucus, while Barton's initial pitch was aimed at incoming freshmen.

The chief medical officer at the Centers for Medicare and Medicaid Services (CMS) responded Tuesday to a scathing article on dialysis care in the U.S. by acknowledging that his agency is failing to adequately oversee the taxpayer-funded procedure.

"We have been not able to perform the oversight functions as frequently or as thoroughly as we might like to," Barry Straube told NPR. 

"We are hindered by funding that comes from Congress in order to perform regulatory oversight visits for all of the 17 different provider sites that CMS is charged with regulating. And the funding that is provided to the agency is insufficient in order to be able to meet the statutory requirements in terms of frequency and thoroughness of those sites."

Straube's comments come as The Atlantic magazine and the investigative outfit ProPublica published a year-long investigation into kidney-failure care, which is covered by Medicare. The article found that the U.S. mortality rate is worse than in most other developed countries that spend far less per patient, in large part because of a dearth of state and federal regulations regarding staffing ratios and training.

Straube told NPR that part of the problem was that Congress hampered the agency's oversight powers when it told the agency several years ago to focus on annual visits to nursing homes at the expense of other facilities, including dialysis centers.

He also said the article fairly described conditions at some facilities but overstates the problem overall.

"My main quibble with the article is that it sounds like one would not want to have dialysis in the United States," he said. "This is a lifesaving treatment that the vast majority of people are being treated very well in very clean facilities that hopefully make very few mistakes."

But ProPublica's year-long review of more than 1,500 clinics in California, New York, North Carolina, Ohio, Pennsylvania and Texas from 2002 to 2009 found that surveyors came across filthy or unsafe conditions in almost half the units they checked. 

"Hundreds of clinics were cited for infection-control breaches that exposed patients to hepatitis, staph, tuberculosis and HIV," the article says. "Prescription errors were common: 60 clinics had at least five citations for them."

The Food and Drug Administration allowed Chinese heparin to be imported into the United States from firms that refused to grant inspectors full access to records and labs, according to a Government Accountability Office report released Tuesday.

The GAO report, requested by House Energy and Commerce ranking member Joe Barton (R-Texas), also faulted FDA's reliance on outside experts with links to heparin companies. FDA boosted its inspections of Chinese heparin plants in 2008 after the deaths of more than 80 people were linked to contaminated heparin, an anticoagulant made of pigs' intestines.

"It’s now obvious that FDA has a fundamental weakness in how it deals with the surge of Chinese medical and food imports," Barton said in a statement. "The FDA allowed importation of heparin from Chinese processors who refused to permit full inspections of their labs and plants. This was a mistake.

"FDA already has the leverage to do in-country inspections in China because Chinese companies want access to U.S. markets," Barton added, "and FDA should use its leverage to insist on full inspections. To protect public health, there must be traceable and accountable supply chains in China — not just FDA keeping its fingers crossed."

The American Medical Association voted Tuesday to adopt policy supporting the Environmental Protection Agency's authority to regulate greenhouse gas emissions. The AMA is currently holding its semi-annual policymaking meeting in San Diego.

"Changes to our climate pose serious risks to public health," AMA Board Member Edward Langston said in a statement. "This new policy shows the AMA's support for the EPA's authority to protect the health of all Americans by regulating greenhouse gas emissions."

During its meeting, the AMA also voted to support a requirement that student athletes who suffer concussions not be allowed to return to play or practice without a physician's written approval. It also voted to oppose taxes on medical school tuition proposed by several local governments facing budget deficits.

The United Steelworkers union on Tuesday demanded immediate screening for lung cancer in the wake of a massive study that found CT scans of heavy smokers resulted in 20 percent fewer deaths than standard chest X-ray screening.

"We are now presented with an enormous opportunity to save workers from dying from lung cancer," USW International President Leo Gerard said in a statement. "Millions of workers have been exposed to asbestos, silica, chromium, arsenic, beryllium, cadmium, nickel and combustion products — and all of these exposures are firmly established as causes of human lung cancer.

"Union health and safety leaders and others need to meet in the very near future in Washington DC to devise a strategy for assuring that high risk workers are among the first to obtain the benefits of this new screening method," Gerard added.

The eight-year trial by the National Cancer Institute involved more than 53,000 current and former heavy smokers. Groups such as the American Cancer Society and the United States Preventive Services Task Force have yet to release screening recommendations because the data have yet to be more fully analyzed.