OVERNIGHT HEALTH: Repeal debate begins in earnest

Hoyer says Dems willing to work with GOP to 'improve healthcare': House Minority Whip Steny Hoyer (D-Md.) said Tuesday that Democrats are willing to work alongside Republicans to make some "improvements" to the healthcare law.

"We are open to better solutions," Hoyer told reporters Tuesday morning ahead of debate on repealing the law. Democrats are expected to broadly vote against repeal. http://bit.ly/idBsKv

Echoing comments made by other Democrats, Hoyer also said his party "didn't do a good enough job" selling the reform law to the public.

Hoyer also said Medicare adjustments could be on the table as the deficit debate heats up: "We can adjust Medicare provisions and adjust those in the future — and perhaps we can make some adjustments for present recipients — but we need to make sure though that the benefits available to recipients which they need are protected."

Medicare actuary gives Dems ammo: Repeal would shorten the life of the Medicare hospital insurance trust fund by 12 years, exhausting it by 2017 instead of 2029, Rick Foster wrote Tuesday. http://bit.ly/gEIU8J

Patient advocates launch Medicare class action lawsuit: A Medicare rights group filed a class action lawsuit against the federal government on Tuesday that could affect many thousands of Americans seniors. The suit seeks to require Medicare to cover care even when it likely won't lead to an "improvement" in patients' condition. http://bit.ly/eaSRTe

Six states ask to join Florida lawsuit challenging reform law: Florida is asking a federal judge in Florida to allow six more states — all with newly empowered Republican governors — to join a multi-state lawsuit challenging the healthcare reform law. 

If accepted, the request to add Ohio, Iowa, Kansas, Maine, Wisconsin and Wyoming would bring the number of states on the lawsuit to 26. http://bit.ly/ig09ri

Administration files appeal: The Obama Administration indicated Tuesday it will file an appeal to the Virginia decision that struck down the individual mandate. HHS Secretary Kathleen SebeliusKathleen SebeliusMr. President, let markets help save Medicare IRS Tax Day glitch exposes antiquated tech infrastructure Trump administration's reforms could make welfare work again MORE filed the notice of appeal with the Eastern District Court of Virginia, and the 4th U.S. Circuit Court of Appeals would hear the appeal.

Meanwhile, Virginia Attorney General Ken Cuccinelli (R) filed a cross-appeal that seeks to invalidate the entire law.

Gay visitation rights protections take effect: Federal regulations barring hospitals from placing restrictions on visitation based on sexual orientation took effect Tuesday. The new regulations apply to all hospitals receiving Medicaid and Medicare funds.

Freshmen get nod on health subpanel: Rep. Trey GowdyHarold (Trey) Watson GowdyMark Sanford’s troubles did not begin with Trump The Hill's Morning Report — Sponsored by PhRMA — Outcry raises pressure on GOP for immigration fix Gowdy: House will use 'full arsenal' of constitutional weapons to get DOJ, FBI compliance on subpoenas MORE (S.C.) has been selected to serve as the chairman on the Oversight Committee's health subpanel. Rep. Paul GosarPaul Anthony GosarOvernight Energy: Spending bill targets Pruitt | Ryan not paying 'close attention' to Pruitt controversies | Yellowstone park chief learned of dismissal through press release GOP offshore drilling proposal triggers debate Republican moves on Arizona coal plant show they don’t believe their own rhetoric MORE (R-Ariz.), a dentist, will be vice-chair.

U.S. losing lead in medical technology innovation: The United States continues to lead the world in medical technology innovation, says a new "scorecard" from PricewaterhouseCoopers, but emerging markets led by China, India and Brazil are catching up. http://bit.ly/eQutgf

Issa gets an earful: House oversight panel Chairman Darrell Issa (R-Calif.) continues to hear from industry groups after asking them to share their concerns with government regulations.

The National Association of Chain Drug Stores raised questions with electronic storage of patient information and durable medical equipment regulations. http://bit.ly/ey7But

And the American Hospital Association wants a loosening of antitrust laws, among other changes. http://bit.ly/hDX6gE

Another GOPer declines benefits: Freshmen Rep. Jeff Landry (R-La.) on Thursday joined a handful of Republicans who are rejecting congressional health benefits based on their opposition to the reform law.

"Conveniently, this law calls for taxpayers to fund the health care plans offered to members of Congress; this is wrong," Landry said in a statement. Voters made it clear in November that such 'business as usual' must end."

On the agenda for Wednesday:

No new tone required in repeal debate: As the House prepares to vote on repealing healthcare reform Wednesday, Republican and Democratic House leaders said members have not been given special instructions to keep the debate civil. 

In light of this month's shooting tragedy in Arizona that left six dead and Rep. Gabrielle Giffords (D-Ariz.) seriously wounded, many have been calling on lawmakers to keep the discourse on repeal civil, given that the original debate on the reform law sparked incidents of heated rhetoric. But Minority Whip Steny Hoyer (D-Md.) and House Majority Leader Eric CantorEric Ivan CantorThe Hill's Morning Report — Sponsored by CVS Health — Trump’s love-hate relationship with the Senate Race for Republican Speaker rare chance to unify party for election Scalise allies upset over Ryan blindside on McCarthy endorsement MORE (R-Va.) said their respective parties have not issued special instructions to that effect. http://bit.ly/hLbyRh

GOP leader plans for Plan B: House Majority Leader Eric Cantor (R-Va.) said his party will do everything to "delay and defund" the healthcare reform law if repeal fails in the Senate, but there is still no timeline for how quickly the GOP will work on a replacement effort. http://bit.ly/hGhGKd

Good news for seniors: Medicare beneficiaries who reach the drug coverage "doughnut hole" won't have to return the $250 rebate checks they got thanks to healthcare reform if the law's repealed, Cantor clarified Tuesday. http://bit.ly/emHt2m

Around the Web:

President Obama's new order to review regulations likely won't touch rules implementing the healthcare reform law, the Wall Street Journal reports. http://on.wsj.com/hGOTWb

The Supreme Court will decide whether to allow California to reduce its Medicaid payments to help close its massive budget gap, the Associated Press reports. http://yhoo.it/dRN2h3

Former Senate Majority Leader Bill Frist (R-Tenn.) said Tuesday that Republicans should accept the healthcare reform law because "it is the law of the land," the Huffington Post reports. http://huff.to/ibOnPR

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Julian Pecquet: jpecquet@thehill.com / 202-628-8527

Jason Millman: jmillman@thehill.com / 202-628-8351