OVERNIGHT HEALTH: Health spending surges as O-Care plans begin

Total spending on medical care spiked in the first quarter of 2014 as ObamaCare's coverage expansion took effect, a widely anticipated shift that surprised observers nonetheless with its scale. Healthcare expenditures rose by 9.9 percent so far this year, according to the Bureau of Economic Analysis, a division of the Commerce Department. The figure came in a report showing that U.S. gross domestic product grew only 0.1 percent in the first quarter, a disappointing number that the administration blamed on persistently severe winter weather. 

The White House celebrated the healthcare spending trend as evidence that more people are getting medical care as a result of the Affordable Care Act. Officials also pointed to the distinction between spending growth and medical inflation: prices for healthcare services grew only 0.5 percent in Q1. Read more here. 

Wellpoint hedges: Wellpoint executives tiptoed around a previous prediction by one of their colleagues that rates on some ObamaCare exchanges would rise by double digits or more next year. On a call with analysts, leaders at the company, one of the nation’s largest insurers, delivered an upbeat assessment of enrollment under the healthcare law and their prospects for the future. The remarks coincided with Wellpoint raising its forecast again, which pushed shares closer to their all-time high. 

Asked specifically about the potential for double-digit rate increases, CEO Joe Swedish did not rule it out, but avoided making specific predictions. "I would say it's not an easy one to answer because it's going to vary by market and by product," Swedish said. Read more here. 

Right before deadline: The Centers for Medicare and Medicaid Services (CMS) issued a major proposed rule on hospital payments at 5:30 P.M. Wednesday. The agency is proposing to increase payments to general acute care hospitals by 1.3 percent in 2015 and to long-term care hospitals by 0.8 percent. The 1,700-page document also includes new price transparency requirements for hospitals and increases in penalties for 2015. Read or download the proposed rule here

Clinton slams O-Care media coverage: Former President Clinton blasted the press for deferring to convenient narratives about ObamaCare rather than covering all the facts about the law. "There is a craving that borders on addictive to have a storyline" among political reporters, he told an audience at Georgetown University. "And once people settle on the storyline, there is a craving that borders on blindness to shoehorn every development, everything that happens, into the storyline even if that is not the story." Read more here

Helpful recap: The Kaiser Family Foundation is out with a detailed guide to answering the question of how many people gained health coverage in ObamaCare's first enrollment period. Not only does the report describe various sources of data, but it also breaks down the results of the three private surveys that have sought to address the issue, all of which said the number of uninsured went down. Read it here

The Vitter amendment is back: Louisiana Republican Sen. David VitterDavid Bruce VitterSenate panel advances Trump nominee who wouldn't say if Brown v. Board of Education was decided correctly Planned Parenthood targets judicial nominee over abortion comments Trump nominates wife of ex-Louisiana senator to be federal judge MORE plans to re-introduce an amendment into an energy efficiency bill that would prevent members of Congress from exempting any of their staff from entering the ObamaCare health exchanges, require all executive branch appointees to participate in the healthcare exchanges and end subsidies for congressional staff to pay for insurance. The unrelated amendment has already derailed the energy bill once in the Senate. Read more here

States complain: Several state-run health insurance exchanges are pushing against the Obama administration’s proposal that they take on the responsibility for determining mandate exemptions under ObamaCare in the next enrollment period, the Washington Post reported. State officials argue they lack technical and funding capabilities to handle that task. While some are asking the administration to delay implementing the proposal others want to get rid of it altogether. Read more at the Post.

CMS on the hot seat: House lawmakers leaned into Shantanu Agrawal, newly appointed director of the Center for Program Integrity at CMS, for the agency’s inability to bring Medicare fraud under control. House Ways and Means Health subcommittee Chairman Kevin BradyKevin Patrick BradyLawmakers, businesses await guidance on tax law On The Money: Trump imposes B in tariffs on China | China blasts 'fickle' Trump, promises payback | Trump to name consumer bureau director next week Trump announces tariffs on billion in Chinese goods MORE (R-Texas) also took the agency to task for not implementing a measure to remove Social Security numbers from Medicare cards in a bid to quell identity theft. Read more here

Thursday's schedule:

The House Energy and Commerce Health Subcommittee will hold a hearing on emerging trends in teleheath. 

The Big Cities Health Coalition will hold a congressional briefing on e-cigarettes. 

The American Association of Orthopaedic Surgeons will continue its 2014 National Leadership Conference. 

State by state:

Missouri Medicaid bill wins symbolic committee vote

Georgia governor acts to bolster faltering rural hospitals

States enroll former foster youth in Medicaid

Lobbying registrations:

Capitol Integration / NXP Semiconductors

Reading list:

Reuters: Republican strategy memo focuses on Obamacare, not immigration

BloombergBNA: Value-based insurance design winning bipartisan support

MedPage Today: Medicare advisers say no to lung cancer screening

Modern Healthcare: CMS should not pay for regular CT screenings for heavy smokers, panel says

What you might have missed from The Hill's healthcare section:

Analysis: State O-Care exchanges spent more on outreach

BoehnerJohn Andrew BoehnerZeal, this time from the center Juan Williams: The GOP's deal with the devil Hillicon Valley: Trump hits China with massive tech tariffs | Facebook meets with GOP leaders over bias allegations | Judge sends Manafort to jail ahead of trial | AT&T completes Time Warner purchase MORE to have 'minor' back procedure

Report: Increased Medicaid access improves outcomes

House spending bill would prevent change to ObamaCare questions