OVERNIGHT HEALTH: State gets first MLR waiver

Witness cites flaws: John C. Goodman, who heads the libertarian National Center for Policy Analysis and testifies on Wednesday, told The Hill his testimony will focus on certain features of healthcare reform "so defective" that lawmakers, regardless of party affiliation, will have to deal with them. In his sights: the individual mandate and subsidies to purchase healthcare on new state-run insurance exchanges opening in 2014. 

"At a minimum, these subsidies will cause a huge, uneconomical restructuring of American industry," Goodman said in written testimony provided to The Hill.

Berwick says White House has his back: Embattled Medicare chief Don Berwick said Tuesday that the White House has supported him throughout a partisan battle over his future at the Centers for Medicare and Medicaid Services. Healthwatch's Jason Millman reports.

Berwick's future at the agency is in doubt now that the overwhelming majority of Republican senators have called on the administration to withdraw his nomination. Berwick's deputy, Marilyn Tavenner, could get bipartisan support on the Hill to replace him, The New York Times reports.

Blumenthal touts HIT record: David Blumenthal, the national coordinator for health information technology, said Tuesday that the U.S. healthcare system is now well on its way to becoming paperless — and is sparking a whole new innovative industry in the process.

Speaking at a Health Affairs briefing, Blumenthal said new federal regulations and investments have led to the offering of more than 450 certified electronic health record products offered by 280 companies, 64 percent of which have fewer than 50 employees.

"It creates a powerful new market," said Blumenthal, who has been the national coordinator since 2009 but is headed back to academia. "Here is a little microcosm of robust innovation in a market created by the new federal program." Read The Hill story.

Polling battles continue: Revere America, former Republican New York Gov. George Pataki's organization dedicated to repealing healthcare reform, has a new poll showing continued public dislike for the law: 52 percent vs. 41 percent who support it.

Race a factor? A review of healthcare reform polling by the nonprofit Greenlining Institute suggests race is a powerful indicator of respondents' opinion of the healthcare reform law. A national survey found that 38.4 percent of whites supported the healthcare law, compared to 78.6 percent of blacks, 52.6 percent of Latinos and 43.6 percent of people from other racial groups.

"Race seems to be the big, unmentioned elephant in the room in the healthcare debate," said research director Daniel Byrd.

States debate health compacts: Texas on Tuesday became the latest state to introduce legislation that would allow states to take over healthcare and ignore the federal reform law. Such legislation has been introduced in seven states and last week passed the House of Representatives in Montana, according to the Health Care Compact Alliance.

Critics say the compacts will go nowhere because they need to be approved by Congress and be signed by the president. But they could yet prove to be political headaches for vulnerable Democrats in 2012.

New Medicaid bill in Florida: The Florida House of Representatives is considering a Medicaid overhaul bill that's less ambitious than the privatization bill introduced in the state Senate last month.

Medical bankruptcies in Massachusetts? An individual mandate has done little to stem the rate of medical bankruptcies in Massachusetts, boding poorly for the federal healthcare reform law enacted almost a year ago, according to a new study by single-payer advocates.

The number of medical bankruptcies in Massachusetts increased from 7,504 in 2007 to 10,093 in 2009, while the state’s rate of medical bankruptcies experienced a "non-significant" decrease from 59.3 percent to 52.9 percent, said researchers Dr. David Himmelstein and Dr. Steffie Woolhandler in the American Journal of Medicine. Healthwatch's Jason Millman reports.

Planned Parenthood plays defense...: A new ad, launched Tuesday, features a cancer doctor touting the organization's preventive health role as House Republicans continue their push to defund the care provider for performing abortions.

... to Concerned Women of America's offense: The group has a new radio ad urging Congress to defund what they call a "corrupt and potentially criminal enterprise." 

Sen. Rockefeller tackles drug abuse: A prescription drug prevention bill offered by the West Virginia Democrat would provide $25 million for state drug monitoring programs and create a national database of drug-related deaths.

Amicus brief watch: America's Health Insurance Plans (AHIP) argued in Virginia federal court that the healthcare reform law's "guarantee issue and adjusted community rating requirements and the prohibition on pre-existing condition exclusions would not be economically and actuarially sound if the individual mandate were struck down."

Channeling George Washington: The first president would have supported the law, the Constitutional Accountability Center told the Fourth Circuit Court of Appeals. The argument is rather unusual, since originalists usually demand less federal government.

Next step in waiver process coming: With HHS awarding more than 1,000 one-year waivers to the reform law's annual limit requirements, the department is looking for the next step in waiver offerings, said a top HHS official on Tuesday. The waivers have been given for so-called "mini-med" plans who can't meet the annual limit coverage requirements. Mini-med plans are supposed to eliminated by 2014, when new state-run exchanges open, but that's still a long way off.

Steve Larsen, who heads the HHS Center for Consumer Information and Insurance Oversight, told an AHIP conference the department will review the next phase of waiver applications during the spring and summer, and it will have additional guidance on how HHS will bridge the mini-med gap to 2014.

MedPAC gets Hill date: The Medicare Payment Advisory Commission will make its annual report to Congress on March 15 before the House Ways and Means health subpanel.

Wednesday's agenda:

AHIP conference, Day 2: On the agenda for Wednesday: Accountable Care Organizations, how to build a sustainable healthcare system, antitrust policy and health reform, and cost containment. Former Tennessee Gov. Phil Bredesen (D) speaks at 9:15 a.m. Joel Ario, who heads health exchanges, will speak at 2 p.m. to a separate AHIP conference on the exchanges.

Attorneys general debate drug abuse: The National Association of Attorneys General will debate Medicaid and Prescription Drug Abuse during their spring meeting dedicated to "State-federal cooperation in a challenging economy." Washington Attorney General Rob McKenna (R) addresses the issue at 10:35 a.m. Here's the agenda.

Reading list:

Senate Majority Leader Harry Reid (D-Nev.) said he "prefers" the House's 1099 repeal offset, but he didn't indicate the Senate would vote on it, Bloomberg reports.

The Tennessee legislature approved a bill allowing the state to opt out of healthcare reform, the Associated Press reports.

Politifact writes that Rep. Michele Bachmann's (R-Minn.) claim that the administration hid $105 billion in healthcare reform implementation funds is "barely true."

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

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