OVERNIGHT HEALTH: O-Care expat bill passes House

The House approved legislation Tuesday to loosen ObamaCare's rules for expatriates and their insurance companies in a vote that drew support from 60 Democrats. Easy passage was expected for the bipartisan measure from Rep. John Carney (D-Del.), but conflict is still simmering underneath the apparent accord. Ahead of Tuesday's vote, senior Democrats continued to condemn the bill as an overly broad exemption for insurers and some workers from the healthcare law's rules.

"In trying to allow the American insurance companies to sell policies to expats, we could craft a bill that's narrow. But we are not getting cooperation to get to that point," said House Energy and Commerce Ranking Member Henry Waxman (D-Calif.).

The comments echoed a statement from the White House that, while stopping short of a veto threat, highlighted the administration's opposition to the legislation. The message from the Office of Management and Budget suggested that lawmakers had rejected "straightforward changes" that would have ensured the measure does not weaken ObamaCare's consumer protections. Supporters of the bill argue that the current system risks shipping jobs overseas.

What will happen next? The Senate has not indicated that it will take up the measure, which would put vulnerable Democrats in a tough spot. Leaders have not said a word, and action is not expected given the White House's opposition to the bill in its current form. Read more about the bill's passage in the House here and the White House's opposition here

First volley on Burwell: Five House Republicans from Louisiana are demanding that their senators place a hold on President Obama's nominee to lead the Department of Health and Human Services (HHS) until the administration withdraws the individual mandate. The call for Sens. Mary LandrieuMary Loretta LandrieuSenate GOP rejects Trump’s call to go big on gun legislation Project Veritas at risk of losing fundraising license in New York, AG warns You want to recall John McCain? Good luck, it will be impossible MORE (D-La.) and David VitterDavid Bruce VitterPlanned Parenthood targets judicial nominee over abortion comments Trump nominates wife of ex-Louisiana senator to be federal judge Where is due process in all the sexual harassment allegations? MORE (R-La.) to act comes as Landrieu faces a tough reelection battle with ObamaCare at the center of the debate. It is unlikely to bring any changes to the law, since Senate Democrats have the votes to confirm a new head of HHS. Read more on the letter here.

CMS finalizes payment system: The Centers for Medicare and Medicaid Services issued a final rule on Tuesday establishing a Medicare prospective payment system for federally qualified health centers. The new system, required by the healthcare law, could boost Medicare payments to the health centers by as much as 32 percent, federal health officials said. Under the rule, Medicare will often pay the health centers a single encounter rate per beneficiary per day for all services provided. The rates will be adjusted by region and several other factors. Read all 201 pages of the rule here.

Word from AHIP: A powerful healthcare lobbyist, Karen Ignagni, CEO of the trade group America’s Health Insurance Plans (AHIP), said a recent surge of ObamaCare enrollees has greatly increased the number of people covered by health insurance. (The Urban Institute also reported Tuesday that the number of uninsured adults has fallen by 5.4 million since September.) Ignagni said the late surge was primarily due to younger and healthier adults signing up, but the question now is whether they will balance out the sicker and costlier-to-cover early enrollees. Her comments were made at a breakfast event sponsored by Politico.

Warning against legalization: A National Institutes of Health director warned lawmakers that preliminary studies show marijuana could be a potential gateway drug to harder substances such as heroin. The testimony from Nora Volkow, with the National Institute on Drug Abuse, highlighted the split among federal agencies on drug policy and comes as the Obama administration takes a hands-off approach to state enforcement of marijuana laws. More details available here.

Cracking down on painkillers: West Virginia Sen. Joe ManchinJoseph (Joe) ManchinSchumer to oppose Pompeo as secretary of State Fox News poll: Blankenship trails Jenkins, Morrisey in West Virginia primary McConnell tees up Pompeo nomination after dramatic committee vote MORE (D) is asking the Drug Enforcement Agency to restrict who may prescribe a powerful painkiller he said is leading to thousands of deaths each year. Manchin has criticized the FDA for approving prescriptions of drugs that use hydrocodone as a painkiller, and is investigating whether the drug was approved under a pay-to-play deal. Manchin is, however, also asking for specific considerations for legitimate patients that need the drugs. Read more here

Wednesday's schedule

The Senate Veterans' Affairs Committee will look at the problem of overmedication among military veterans.

The House Ways and Means Health Subcommittee will hear about policies to address waste, fraud and abuse in Medicare.

The American Association of Orthopaedic Surgeons will begin their 2014 Leadership Conference.

The Pharmaceutical Care Management Association will hold its Pharmacy Benefit Managers Policy Forum. The gathering will hear remarks from Reps. Gus Bilirakis (R-Fla.) and Tammy Duckworth (D-Ill.) and former Medicare-Medicaid Administrator Tom Scully.

State by state

Rhode Island taxpayers face $52M tab for soaring Medicaid enrollment

How many people in each state are missing out on Medicaid coverage?

Looking for complaints, Rick Scott finds praise for O-Care

Lobbying registrations

King & Spalding / Gift of Life Donor Program

Reading list

Kaiser Health News: Some new enrollees emboldened to leave jobs, start businesses

Bloomberg Businessweek: ObamaCare co-ops undercut insurance giants — can they survive?

MedPage Today: FDA wants high-risk label for transvaginal mesh

Senior Housing News: CMS ramps up nursing home quality control program

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Poll: ObamaCare enrollment surge didn't raise public support