OVERNIGHT HEALTH: Decision day on exchanges

Friday is the deadline for states to decide whether they're interested in a partnership exchange between the state and the federal government. The Obama administration has pushed the partnership model aggressively, especially for states that weren't entirely opposed to a purely state-run exchange but simply didn't have the time to get one ready.

The partnership is an attractive model, at least on paper — it allows states to retain some control over their exchange, which will be the anchor for many states' individual and small-group markets. But it doesn't require Republican governors to fully buy into "ObamaCare," a law that remains deeply unpopular with their base.

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Several states haven't made their intentions clear on a partnership, so tomorrow's deadline could be interesting. Roughly 30 states have said they won't set up an exchange entirely on their own, so that's the pool the Obama administration can potentially pull from in looking for states that are willing to share the workload.

Rough day: Gary Cohen, Health and Human Services's top implementation official, caught some friendly fire from Senate Democrats on Thursday. Cohen was grilled about several perceived holes in the implementation effort, and about the White House's bargaining position during recent debt talks. Rep. Bill NelsonBill NelsonTop Dem welcomes industry TV box plan Congress must resolve net neutrality once and for all Senators seek state revenue sharing for offshore drilling MORE (R-Fla.) was upset that the White House offered up health insurance co-ops as a source for cuts in the year-end tax deal. And Sen. Maria CantwellMaria CantwellOvernight Finance: Obama signs Puerto Rico bill | Trump steps up attacks on trade | Dodd-Frank backers cheer 'too big to fail' decision | New pressure to fill Ex-Im board Senate Dems urge Shelby to take up Ex-Im nomination Menendez rails against Puerto Rico bill for 4 hours on floor MORE (D-Wash.) took up states' frustration with the slow progress implementing the law's Basic Health Plan. Healthwatch has a full report from Cohen's rough day before the Senate Finance Committee.

Liberals lobby Obama on Social Security: Rep. Jan Schakowsky (D-Ill.) said pressure from congressional Democrats caused the White House to drop its support for raising the Medicare eligibility age, and she's hoping to repeat that success with the "chained CPI" in Social Security. Obama is open to the Social Security cut, but Schakowsky said she's trying to make the case to White House officials that chained CPI will have a real impact on seniors — especially in tandem with Medicare cuts the administration also supports. Healthwatch has more.

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HIPAA and background checks: GOP leaders with the House Energy and Commerce Committee want to know how the Health Insurance Portability and Accountability Act (HIPAA) and related privacy rules impact the sharing of mental health records. Specifically, Energy and Commerce Chairman Fred Upton (R-Mich.) and Rep. Tim Murphy (R-Pa.), who leads the Oversight and Investigations subpanel, asked federal Health Secretary Kathleen SebeliusKathleen SebeliusFighting for assisted living facilities The chaotic fight for ObamaCare California exchange CEO: Insurers ‘throwing ObamaCare under the bus’ MORE how HIPAA might prevent state and local officials from sharing mental health records with the national criminal background check system. Murphy is leading the committee's inquiry into mass shootings and related mental health policy. Read the letter here.  

Sequester and the flu: Democratic leaders on the House Energy and Commerce Committee sent a "Dear Colleague" letter Thursday warning that budget sequestration would endanger vital public health work at the Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA). Rep. Henry Waxman (D-Calif.), the panel's ranking member, and subcommittee ranking members Frank Pallone Jr. (D-N.J.) and Diana DeGette (D-Colo.) highlighted federal work to track and inhibit the seasonal flu virus — the subject of a hearing this week. "Advances like these and other essential public health services will be threatened if we don’t act quickly to prevent sequestration," the lawmakers wrote.

Bill surge: Congress is flooded with new and returning health bills. Here are a few:

• From Rep. John Conyers (D-Mich.), a Medicare-for-all bill
• From Sens. Ben CardinBen CardinMcConnell tees up House Puerto Rico bill GOP senators: Brexit vote a wake-up call Dems take over floor to protest Senate inaction on gun control MORE (D-Md.) and Susan CollinsSusan CollinsThe Trail 2016: Meet and greet and grief Senators press Obama education chief on reforms GOP senator: Trump endorsement could depend on VP MORE (R-Maine), bills to permanently repeal caps on therapies from skilled nursing centers
• From Sen. Marco RubioMarco RubioPoll: Rubio holds massive lead in primary Rubio: Turkey attack 'directed' by ISIS Trump: Rivals who don't back me shouldn't be allowed to run for office MORE (R-Fla.) and Rep. Ileana Ros Lehtinen (R-Fla.), bills to prohibit the transportation of minors across state lines to procure abortions
• From Sen. Frank Lautenberg (D-N.J.) and Rep. Barbara Lee (D-Calif.), a bill to provide grants for comprehensive sex education programs
• From Rep. Carolyn Maloney (D-N.Y.) and Lautenberg, bills to fine pharmacists that refuse to fill prescriptions they disagree with
• From Sens. Patty MurrayPatty MurraySenate Dems: No August break without Zika deal Senators press Obama education chief on reforms Overnight Finance: Senate sends Puerto Rico bill to Obama | Treasury, lawmakers to meet on tax rules | Obama hits Trump on NAFTA | Fed approves most banks' capital plans MORE (D-Wash.) and Jon TesterJon TesterBernie Sanders’s awkward return to the Senate Senators roll out bipartisan gun proposal Congress should stop government hacking and protect the Fourth Amendment MORE (D-Mont.), bills to allow veterans' kids to stay on their parents' VA health insurance until they turn 26
• From Sen. Mike EnziMike EnziJudd Gregg: The silver lining Judd Gregg: A little change Lobbying World MORE (R-Wyo.) and Rep. Donald Payne Jr. (D-N.J.), resolutions designating March as National Colorectal Cancer Awareness Month

Healthwatch also covered bills to repeal the healthcare law's Independent Payment Advisory Board, and to allow studies of organ transplants between HIV patients.

Friday's agenda

Rep. Grace Napolitano (D-Calif.) will hold a press conference on her Mental Health in Schools Act, joined by Los Angeles Laker Metta World Peace and other lawmakers.


State by state

Scott Walker says Medicaid plan will benefit hospitals

Mo. House budget plan skips Medicaid expansion

Jindal says he won't reconsider expanding Medicaid


Reading list

Feds increase costs to high-risk pool members

US-wide salt reduction could prevent deaths, study finds

US approves first method to give the blind limited vision


What you might have missed on Healthwatch

Liberal groups push for lower Medicare drug prices

CDC finds rise in use of 'morning-after' pill

MedPAC chief warns of Medicare payment crisis

Insurance lobby huddles with White House on ‘reasonable rates’ requirement


Comments / complaints / suggestions?


Please let us know:

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

Elise Viebeck: eviebeck@thehill.com / 202-628-8523

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