OVERNIGHT HEALTH: CLASS repeal vote marks open season on health law

As we said — bleak. Here’s our rundown of this morning’s CBO projections.

Healthcare law’s costs: In addition to the growth in Medicare spending, some parts of President Obama’s healthcare law are looking more expensive as CBO’s projections move further out. For example, new state-based insurance exchanges are supposed to be up and running in 2014, and most people who buy coverage through an exchange will get a subsidy to help cover the cost.

CBO expects enrollment in the exchanges to grow over time. Subsidies and the costs of running exchanges will probably run about $17 billion in 2014, CBO said, but in 2022 those costs will top $100 billion. The total cost of the exchanges over the new 10-year window is $645 billion, according to CBO’s estimates.

Essential benefits bonanza: Tuesday was the deadline to submit public comments on Health and Human Services's proposal for essential health benefits. As a reminder, HHS punted the issue to the states and will let them choose a “benchmark” policy that all plans in the state will have to match. Here’s a quick sense of the feedback so far:

• AARP: "We recognize some state flexibility may be desirable given the variation in state insurance markets. ... However we are concerned the proposed approach could result in individuals getting substantially different benefits across the states — and potentially inadequate benefits."

• Consumers Union: "Traditional plans do not categorize their services within the same benefit categories or use the same terminology as the (Affordable Care Act) uses. In the absence of further guidance from HHS, it is unclear how the essential health benefit package could be compared to potential benchmark plans. ... Any ambiguity with respect to what constitutes coverage of the 10 benefit categories may be exploited by insures, will lead to consumer confusion and tie up resources in an effort to establish where legal compliance begins and ends."

• Essential Benefits Coalition (business groups): "If cost is not taken into account, and the EHBs are defined too expansively with the inclusion of state mandated benefits not subject to rigorous evidence-based reviews or cost analyses, then it will remain difficult for small employers and individuals to purchase coverage leading to diminished access to health insurance coverage, despite the ACA."

Florida and Medicare: Mitt Romney is expected to win the Florida primary tonight, and Democrats were already raining on his parade before the polls had even closed. Democratic National Committee Chairwoman Debbie Wasserman Schultz (Fla.) held a conference call with reporters this afternoon to hammer Romney for comments he made Monday night on entitlement reforms. Romney said he wouldn’t "go after" Medicare, but the DNC said his plan for the program — similar to Wisconsin Rep. Paul RyanPaul RyanThe Hill Interview: Budget Chair Black sticks around for now Gun proposal picks up GOP support GOP lawmaker Tim Murphy to retire at end of term MORE’s — would be "a disaster" for seniors. Healthwatch's Sam Baker has the story

Abortion fallout: The country’s leading breast cancer charity, Susan G. Komen for the Cure, has broken off its partnership with Planned Parenthood over congressional investigations into the latter group. Planned Parenthood said it was “alarmed and saddened” by the dissolution, which will deprive the organization of grants that supported about 170,000 breast cancer screenings over the past five years. Healthwatch has more.

Bay State honor: Sen. John KerryJohn Forbes KerryFor the sake of national security, Trump must honor the Iran deal Bernie Sanders’s 1960s worldview makes bad foreign policy DiCaprio: History will ‘vilify’ Trump for not fighting climate change MORE (D-Mass.) and other Massachusetts Democrats vehemently denied that changes to Medicare hospital payment rates were sneaked into the health law to benefit their state. In a letter to President Obama, the lawmakers say recent allegations to the contrary by rural state hospital associations were "completely false" and represent "a thinly-disguised effort to discredit both your administration and the Affordable Care Act."

Read the state hospital association's initial complaint here.

Hospital cuts: Premier healthcare alliance, representing 2,500 nonprofit hospitals and health systems, urged the House-Senate conference committee tackling physician payments to reject any cuts to Medicare and Medicaid hospital rates. Read its letter to Conference Committee Chairman Dave Camp (R-Mich.) here

Drug labeling: The Food and Drug Administration needs to do a better job to ensure that antibiotic labels contain up-to-date information, the Government Accountability Office says in a new report.

Wednesday's agenda

The Energy and Commerce health subcommittee holds the first of three hearings on user fees that Congress is scheduled to reauthorize or create this year to fund the federal regulators who approve new medicines and medical devices. The first hearing will focus on fees on brand-name prescription drugs, which have already been worked out between the Food and Drug Administration and the drug industry. Here's the agenda.

HHS Secretary Kathleen SebeliusKathleen SebeliusPrice was a disaster for HHS — Time for an administrator, not an ideologue Trump says he's unhappy with Price Former Health Secretary: Price’s use of chartered flights is 'stunning' MORE and Medicare director Jonathan Blum announce the latest figures on savings Medicare beneficiaries enjoyed as a result of the healthcare reform law.

Horizon Blue Cross Blue Shield of New Jersey announces the launch of a nursing education program with two nursing schools. The partnership aims to train 200 nurses who will champion the kind of care coordination called for in President Obama's healthcare reform law.

And the House-Senate conference committee on the Medicare "doc fix" and other expiring provisions meets again, starting at 10 a.m. Wednesday's meeting is expected to concentrate on unemployment insurance. You can watch it here.

Bill tracker

Sen. Marco RubioMarco Antonio RubioOvernight Defense: Tillerson, Trump deny report of rift | Tillerson says he never considered resigning | Trump expresses 'total confidence' in secretary | Rubio asks Army to kick out West Point grad Rubio asks Army to kick out West Point grad with pro-communist posts GOP establishment doubts Bannon’s primary powers MORE (R-Fla.) introduced legislation that would overturn new health regulations requiring most religiously affiliated healthcare plans to pay for birth control. The Hill has more here

Reps. Larry BucshonLarry Dean BucshonDem says ObamaCare repeal effort moves US ‘toward single-payer’ The Hill's 12:30 Report Watch: House GOP veterans appear in Memorial Day video MORE (R-Ind.) and John Carney (D-Del.) introduced drug shortage legislation mandating expedited review of drugs that are vulnerable to shortage, requiring the FDA to a use more refined regulatory process that addresses manufacturing problems without instigating drug shortages. More information about the bill is available here.

State by state

South Carolina announced it has spent $305,000 on a health exchange study critics say was rigged from the get-go.

Businesses are calling on New Hampshire lawmakers to create a state health insurance exchange despite their misgivings about the federal law.

Massachusetts is working on prescription drug abuse legislation.

Revolving door

Mit Spears, a former general counsel of the Federal Trade Commission, is joining the drug industry lobby as executive vice president and general counsel. Spears will oversee the legal department at Pharmaceutical Research and Manufacturers of America and serve on PhRMA's management committee.  

Margaret Anderson, executive director of FasterCures, has been named president of the Alliance for a Stronger FDA for 2012. The alliance also announced other new members in leadership:

"Other members of the Alliance's leadership include Diane Dorman, National Organization for Rare Disorders (Vice President); Rich Buckley, AstraZeneca (Secretary); Caroline Smith DeWaal, Center for Science in the Public Interest (Treasurer); and executive committee members, Andrew Emmett, Biotechnology Industry Organization; Nancy Bradish Myers, Catalyst Healthcare Consulting Inc.; and Kasey Thompson, American Society of Health-System Pharmacists."

J.D. Kleinke, an expert on healthcare business strategy and entrepreneurship, joins the American Enterprise Institute's health policy team. 

Reading list

The nation's $50 billion military health system is planning for its future by slowing the growth rate of healthcare costs, strengthening partnerships and focusing on prevention, primary care and chronic disease management, the American Forces Press Service reports.

A new study in the Journal of the American Medical Association found that re-operation rates after a partial mastectomy vary widely from hospital to hospital and surgeon to surgeon.

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Comments / complaints / suggestions? Please let us know:

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

Sam Baker: sbaker@thehill.com / 202-628-8351

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