With help from Kyle Cheney, David Nather and Brett Norman
WHY THE REPUBLICAN GOVS AREN?T ON THE SAME PAGE ? So why is Florida Gov. Rick Scott sounding like he?s ready to start the peace talks on Obamacare, while Alabama Gov. Robert Bentley ? who had sounded open to building an exchange last year ? went in the other direction? And why is Mississippi sending these mixed signals ? yes on exchange, no on Medicaid? Scott may have his own reasons: the rap on the wrists voters delivered during the election ? going for Obama and reelecting Democratic Sen. Bill Nelson ? as well as a more moderate GOP Legislature and Scott?s own reelection hopes in 2014. But Pro?s Kyle Cheney reports that the Republican governors are also facing strong political cross-pressures on Obamacare, and that?s why they won?t all keep fighting the law just to please their conservative supporters. The POLITICO Pro story: http://politico.pro/RUIgmC
--FWIW, both the Cato Institute?s Michael Cannon and Dean Clancy of FreedomWorks said they?ve received multiple assurances that Scott hasn?t at all flipped on his Obamacare opposition.
Happy Thursday and welcome to PULSE, where we can?t believe it?s already just one week until turkey, gravy and stuffing ? and not worrying whether we?ve missed an exchange announcement.
?Couldn't quite seem to escape PULSE far enough, far enough, far from Florida?
TODAY ON POLITICO PRO:
--WHY DOC HASTINGS WANTS A NEW HEALTH CARE COMMITTEE ? Rep. Doc Hastings says a new, centralized committee dealing solely with health care matters would make it easier to work on Medicare, Medicaid and oversight of the ACA?s rollout, instead of leaving health care jurisdiction scattered among eight different committees and multiple subcommittees. http://politico.pro/RYEneU
ONE MENINGITIS HEARING DOWN, (AT LEAST) ONE TO GO ? House legislators called on FDA Commissioner Margaret Hamburg to account yesterday for why the FDA didn?t take action sooner against the company responsible for the fungal meningitis outbreak, despite a known history of violations. Her not-too-specific response: FDA needs more explicit authority from Congress to shine light on the ?gray area? of compounding pharmacy regulation, which currently rests in an ill-defined place between the states and the feds. http://politi.co/UraulH
?.THE UPDATE ? CDC reported yesterday that the death toll from the outbreak remained steady at 32, but the number of stricken people rose by 29 to 461 in 19 states.
GOP GOVS WANT MORE TIME ON EXCHANGES ? Republican governors say last week?s delay of some exchange deadlines just isn?t good enough. HHS last week said that states can have some more time to turn in their exchange plans, but they still have until Nov. 16 to say whether they want to run their own exchanges. In a letter to President Barack Obama yesterday afternoon, the governors say Friday?s decision deadline should be pushed back until HHS has answered all of their questions and finalized all the regulations. ?As has been stated many times, before making any final policy decisions, governors must carefully consider the short- and long-term implications of an expanded entitlement program and the consequences of significantly increasing the size of government to manage these programs,? wrote Govs. Bob McDonnell of Virginia and Bobby Jindal of Louisiana, who also asked Obama to meet with governors of both parties to discuss Medicaid reform. Their letter: http://politico.pro/RUvLHG
WALKER TORN ON EXCHANGE DECISION ? Wisconsin Gov. Scott Walker told reporters at the RGA conference in Las Vegas last night that he?ll announce his exchange decision on Friday, but he sounded kind of conflicted. ?Instinctively,? he said he wants to keep the state in charge, but he has ?significant concerns? about future costs and requirements. http://politico.pro/SXNYBV
MISSISSIPPI IN EXCHANGE WAR ? WITH ITSELF ? Mississippi Insurance Commissioner Mike Chaney, who?s been one of the most active Republican state officials on exchange planning, sent in his state?s plan to HHS yesterday. One person really not happy about it: Republican Gov. Phil Bryant, who thinks the state?s elected insurance commissioner made a huge mistake. ?I continue to believe that establishing a non-free-market health insurance exchange is a gateway to full implementation of Obamacare in Mississippi,? Bryant said in a statement. ?The federal government has never funded a program it did not eventually control and expand, and I regret the submission of a letter of intent by the Insurance Department stating that Mississippi will establish a health insurance exchange as demanded under Obamacare. This is one more step toward the largest entitlement program expansion in American history.?
--BRYANT NIXES MEDICAID EXPANSION ? Also yesterday, Bryant filed a budget that didn?t include funding for an expanded Medicaid program. ?[E]xpanding Medicaid will cost the state of Mississippi money that it does not have,? the Republican wrote in a letter accompanying his budget proposal. The letter declares that ?Mississippi does not have to suffer the blow of additional Medicaid spending.? His letter: http://bit.ly/UpZrJr
OTHERS WHO ANNOUNCED YESTERDAY ? The exchange decisions are starting to roll in. Here?s who else declared yesterday:
--Iowa Gov. Terry Branstad says there?s not enough information to do a state-based exchange right now. From the AP: http://bit.ly/TICfIr
--Indiana Gov.-elect Mike Pence decided against a state-based exchange, but he may later consider a partnership, the AP reports: http://bit.ly/SWzVwm
--Wyoming won?t do its own to start, but state lawmakers there are looking at their options down the road, the Wyoming News reports: http://bit.ly/TG76W7
--West Virginia Democratic Gov. Earl Ray Tomblin hasn?t announced yet, but state officials expect he?ll let the feds build an exchange there, according to the Charleston Gazette: http://bit.ly/T3L0in
W&M SUBPOENAS PR DOCS ? The election?s over, but ACA oversight efforts aren?t. The House Ways and Means Committee yesterday subpoenaed HHS Secretary Kathleen Sebelius, demanding details on how the department is promoting the health care law. Chairman Dave Camp (R-Mich.) and oversight subcommittee Chairman Charles Boustany (R-La.) want documents on how the law is being promoted through PR, advertising and message testing. It?s the department?s second subpoena in two months ? The House Oversight and Government Reform Committee also wants answers on a Medicare Advantage demonstration program. The POLITICO story: http://politi.co/TJTHfp
** A message from the National Community Pharmacists Association: When manufactured drugs aren?t an option, independent community pharmacists provide traditional pharmacy compounding to prepare customized medications for patients in accordance with a doctor?s prescription based on the patient?s individual needs. Learn more at www.ncpanet.org **
FLA. LAWMAKER LOOKING AT EXCHANGE OPTIONS ? Florida?s incoming Senate president said his colleagues are exploring their exchange options, and the Republican thinks the state could leverage ?exchange-like entities? already in the state. ?One of the options that presents itself is to use one of those existing or both of those existing exchange-like entities in what we would call a partnership exchange,? said state Sen. Don Gaetz in a phone interview. Still, he?s not ready to rush into anything, calling an exchange ?one of those issues where it?s best to be the second one or third one in the water, not the first one.?
PRICE MISSES OUT ON LEADERSHIP SPOT ? Rep. Cathy McMorris Rodgers (R-Wash.) beat out Rep. Tom Price (R-Ga.) for the House GOP?s fourth-highest leadership spot. Price, a physician, likely would have used the spot to keep more focus on the health care law. More from Pro: http://politico.pro/T24hQh
ROMNEY: OBAMACARE HELPED OBAMA WIN ? Mitt Romney blamed his loss on Obama?s ?gifts? to specific interest groups ? ?especially the African community, the Hispanic community and young people? ? and said the health care law?s young adult coverage and the contraceptive coverage helped Obama win with young voters. ?Free contraceptives were very big with young college-aged women. And then, finally, Obamacare also made a difference for them, because as you know, anybody now 26 years of age and younger was now going to be part of their parents? plan, and that was a big gift to young people,? Romney said in a conference call with his finance committee yesterday, according to The New York Times. ?They turned out in large numbers, a larger share in this election even than in 2008.? The NYT story: http://nyti.ms/RYkNiH
MASS. GETS THE BALL ROLLING ON COST CONTROL ? Stuart Altman, the recently named chairman of a board charged with overseeing Massachusetts efforts to control health care costs, finally has company. Gov. Deval Patrick, Attorney General Martha Coakley and State Auditor Suzanne Bump named 11 fellow board members who will take the reins of cost containment efforts that supporters hope blaze a trail for the country. The most notable name on the list: Harvard University economist David Cutler, a staunch defender of and adviser to President Obama and his health care policies. He has also previously advised President Bill Clinton and the campaigns of prominent Democrats. Other picks include local business officials, doctors and advocates. State health secretary JudyAnn Bigby is also an ex officio member of the board, which meets for the first time on Friday.
TAKEDA PHARMACEUTICAL TAPS NEW LOBBYING DIRECTOR ? Shelley Stewart, who worked for nearly five years as the American Enterprise Institute?s director of corporate relations, is joining Takeda Pharmaceutical as its federal government affairs director and lead lobbyist, the company tells our friends at POLITICO Influence. Stewart?s first day is Monday.?Takeda has a sizable D.C. lobbying presence, having spent more than $1.5 million on federal lobbying efforts during each of the past three years, and it?s on pace to do the same this year, congressional records show.
WHAT WE?RE READING, by Brett Norman
The Wall Street Journal has the story of a promising potential cure for Hepatitis C that was abandoned, not because it didn?t work, but because it didn?t make business sense. http://on.wsj.com/ZxFZAv
The New England Journal of Medicine has a Bellevue Hospital physician?s first-hand account of the night Hurricane Sandy struck and forced an emergency evacuation. http://bit.ly/TKls7o
The implementation of Obamacare, with its new taxes, individual mandate and the logistical challenges to setting up exchanges, may spell trouble for Democrats in 2014, Philip Klein argues in the Washington Examiner. http://bit.ly/UHG9jt
California Healthline?s Dan Diamond runs down all the ways the GOP can continue to fight Obamacare. http://bit.ly/UDdmlE
At Forbes, Grace-Marie Turner writes that with the reelection of Obama, the battle against Obamacare shifts to the states ? ?the new firewall.? http://onforb.es/UDK06H
Arkansas Gov. Mike Beebe said the Medicaid expansion may be the best way to avoid taking thousands of people out of nursing homes, The Associated Press reports. http://bit.ly/ZxzSfu
PBS?s NewsHour tells the story of the lethal meningitis outbreak through the eyes of a man with Lou Gehrig?s disease whose wife died after receiving a contaminated steroid injection. http://to.pbs.org/T2ywXb
An editorial in the Milwaukee Journal Sentinel dresses down nine Wisconsin Republicans who supported the ?nullification? of Obamacare, including the arrest of federal officials who attempt to implement the law. http://bit.ly/ZMw8WH
A New York Times review of FDA records turns up 13 deaths in the last four years possibly associated with 5-Hour Energy, a highly caffeinated energy shot. http://nyti.ms/XGM12t
** A message from the National Community Pharmacists Association: Traditional compounding pharmacy services help avoid allergic reactions to mass-produced drugs; get children the relief their pediatrician prescribed; and bridge the gap during drug shortages. These community pharmacists satisfy unique, individual health needs on a patient-by-patient basis. They should not be confused with rogue drug manufacturers, such as the company at the center of the tragic meningitis outbreak. Pharmacists are working constructively with Congress and others to preserve patient access to traditional compounding services, while thwarting any illegitimate manufacturers. Learn more at www.ncpanet.org. **
Source: http://feeds.politico.com/click.phdo?i=57e869a3b0784c7a862b96deca538c09
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