Insurers look to build on mandate - GOP looks to stop rape comments - Just how bad is this flu season? - GOP considers default, shutdown in spending fight

By Jason Millman

With help from Kathryn Smith

GET READY TO HEAR ABOUT THE MANDATE AGAIN ? The fight to strike out the individual mandate is over ? now get ready for the fight over making the mandate stronger. The Obama administration backed the mandate when it determined that was the best way to enroll enough healthy people to pay for the sick ones who?ll be covered starting 2014. But there are real concerns that the mandate penalties aren?t strong enough, especially in the early years when the sickest patients can enroll right away. Insurers are telling the administration more incentives ? like a late enrollment fee ? are necessary to get healthy people to sign up sooner, and language in a recent HHS rule suggests the administration is willing to listen to some ideas. Regardless of what happens at the federal level, look for some states to come up with their own strategies for boosting enrollment in the early years. The POLITICO story: http://politi.co/13tHSjG

GOP LOOKS TO STOP THE RAPE COMMENTS ? Rep. Phil Gingrey?s recent attempts to explain Todd Akin?s rape remarks felt like a throwback to the 2012 campaign: Republican says something dumb about rape, then Democrats and their allies jump all over the remarks to paint the party as radical. Those kinds of comments may have hurt Republicans? chances of taking back the Senate, and party members are wondering how to make it all stop. For some, the answer is easy: Just shut up. ?This is actually pretty simple. If you?re about to talk about rape as anything other than a brutal and horrible crime, stop,? said Republican strategist Kevin Madden, who was a senior adviser in Mitt Romney?s campaign. The Susan B. Anthony List says such examples are extreme and a distraction from the abortion issue, and the group is developing a new training program to help candidates and lawmakers avoid future blunders. The POLITICO story: http://politi.co/UcrOhk

Good Monday morning and welcome to PULSE after a weekend that saw the Obama administration reject a $1 trillion coin and construction of the Death Star. And somehow, that felt like the biggest news from this weekend.

?Yeah, it's overwhelming, but what else can we do? Get jobs in offices and wake up for the morning PULSE.?

TODAY ON POLITICO PRO:

--EXCHANGE WEEK: BACK TO WORK ? Minnesota is looking to put its exchange into law ? it so far has been operating on an executive order ? and Florida?s new ACA study committee meets up for the first time this year. http://politico.pro/10tFgnr

IS IT JUST ANOTHER FLU SEASON? ? There?s been a steady flow of reports in the past week about influenza vaccine shortages and overcrowded emergency rooms, but officials can?t say yet whether this flu season is going to be worse than normal. There are signs it may have actually peaked already, but it?s too early to say for sure, CDC officials cautioned on Friday. Meanwhile, researchers are making efforts to develop more effective vaccines and do a better job of predicting when a bad flu season will hit. The POLITICO story: http://politi.co/100trnk

CAN OBAMA SPLIT THE GOP AGAIN? ? President Barack Obama earlier this month won tax increases on the highest earners by picking off House GOP votes in states that supported his reelection in 2012. What remains to be seen is whether that?s a winning strategy for future showdowns, like the debt ceiling and sequestration. As the focus turns to spending cuts, many in the party are confident the GOP will be on the same page going forward. ?When things are more focused around spending, there will be more unity,? said veteran GOP pollster David Winston. The POLITICO story: http://politi.co/11teUks

HOUSE GOP CONSIDERS DEFAULT, SHUTDOWN ? House Speaker John Boehner, who?s meeting with his leadership team today for a strategy session on the upcoming spending fight, will have to consider the growing support within the party for default or shutting down the government if Republicans don?t get the cuts they want. ?GOP officials said more than half of their members are prepared to allow default unless Obama agrees to dramatic cuts he has repeatedly said he opposes,? report POLITICO?s Jim VandeHei, Mike Allen and Jake Sherman. ?Many more members, including some party leaders, are prepared to shut down the government to make their point.? The POLITICO story: http://politico.pro/UhOlcB

** A message from PhRMA: Over the last century, 17 Presidents have been inaugurated. During the same period, America has celebrated major medical milestones that helped combat diseases such as HIV/AIDS and cancer. Join us for a webinar on Thursday focusing on future innovation milestones. **

TOP SENATE DEMS TO OBAMA: IF NECESSARY, SKIP CONGRESS TO RAISE DEBT CEILING ? ICYMI Friday afternoon, Senate Majority Leader Harry Reid and top Democrats told Obama he should raise the debt ceiling on his own if a bipartisan agreement can?t be reached. ?In the event that Republicans make good on their threat by failing to act, or by moving unilaterally to pass a debt limit extension only as part of an unbalanced or unreasonable legislation, we believe you must be willing to take any lawful steps to ensure that America does not break its promises and trigger a global economic crisis ? without congressional approval, if necessary,? Reid wrote in a Friday letter also signed by Sens. Dick Durbin, Chuck Schumer and Patty Murray. The POLITICO story: http://politi.co/VUu4ZU

PLANNED PARENTHOOD LOSES IN TEXAS FUNDING SUIT ? A Texas court Friday evening denied a preliminary injunction to Planned Parenthood in its challenge to being shut out from the state-run Women?s Health Program. Texas launched its own WHP Jan. 1 without federal funding. Bloomberg has more: http://bloom.bg/10n6ps2

PRELIMINARY INJUNCTION DENIED IN CONTRACEPTION LAWSUIT ? The conflicting rulings continue to pile up in cases against the administration?s contraception coverage rule. Conestoga Wood Specialties Corp., a Mennonite-owned wood cabinet company, was denied a preliminary injunction Friday against the rule. A judge from the District Court of Eastern Pennsylvania said the plaintiffs didn't prove that providing contraception coverage provided a substantial burden on the owners' religious exercise. The order: http://politico.pro/Y4jp4v

KAISER FOUNDATION SCALING BACK STAFF ? Layoffs came to the Kaiser Family Foundation last week, but the health policy and communication organization isn?t saying how much it?s scaling back. KFF is citing the 2008 financial crisis and a slow recovery as a reason for the staffing reduction. ?By focusing its resources on our core programs in policy analysis, polling and journalism, the foundation will continue to play the role it has always played as a leader in health policy analysis and communications,? KFF said in a statement provided to PULSE. ?We will have a somewhat smaller staff and reorganize some of our operations, but those who rely on us for information should see no change.? Best of luck, Kaiser folks, and please let PULSE know where you land.

DEMS TO GUN PANEL: DON?T FORGET ABOUT THAT 2008 MENTAL HEALTH LAW ? With Vice President Joe Biden?s gun task force supposed to issue recommendations by Tuesday, Democratic lawmakers are highlighting a focus on mental health ? particularly enforcement of a law already on the books. Sen. Al Franken and HELP Committee Chairman Tom Harkin called on the administration to fully implement the 2008 Mental Health Parity and Addiction Equity Act. Under the law, ?millions of Americans with health insurance are entitled to access to a full range of mental health and substance use disorder services,? they wrote in a Friday letter to Biden. ?However, while this historic law was passed four years ago, the administration has yet to issue a final rule, potentially leaving many Americans who need and have a right to these services without access to them.? Rep. Henry Waxman, in a separate letter, also urged final regs for the 2008 law, as well as new public health research and safety standards to prevent guns from accidentally firing. The Franken/Harkin letter: http://1.usa.gov/Uhek46. The Waxman letter: http://1.usa.gov/UXfW2Z

DePARLE STARTS AT BROOKINGS THIS MONTH ? Nancy-Ann DeParle, who led the White House Office of Health Reform during the ACA?s drafting, will start at the Brookings Institution on Jan. 28 as a guest scholar in economic studies, the think tank officially announced Friday evening. The announcement: http://bit.ly/W2nIXT

WHAT WE?RE READING

The Washington spending fight could reopen debate on a Medicare policy that provided hundreds of millions of dollars in bonuses to Massachusetts hospitals over the past two years at the expense of other states, The Boston Globe reports. http://b.globe.com/WCYQoT

Anticipating a greater demand for primary care, Morgan Stanley is planning to unveil a $100 million fund to build community centers near affordable housing, The Wall Street Journal reports. http://on.wsj.com/RQnlCe

The New York Times chronicles the difficulty city residents had locating flu vaccines this weekend. http://nyti.ms/WEvNkQ

A year after anti-abortion legislation sparked angry protests in Virginia, a pair of Republican lawmakers are again offering bills targeting abortion and the Obama administration?s contraception coverage rule, The Associated Press reports. http://bit.ly/13sSy1g

ACA implementation in Minnesota is partially on hold as state officials await federal guidance on the Basic Health Plan, the Minnesota Star Tribune reports. http://bit.ly/UfqCKb

California and Oregon regulators have quietly told health insurers to stop denying coverage to transgender patients based on their gender identity, according to the AP.? http://wapo.st/UWGKUK

Filmmaker Woody Allen, perhaps the nation?s foremost hypochondriac, takes to the NYT op-ed pages to reflect on what it?s like to constantly confront mortality after any sign of the slightest symptom. http://nyti.ms/UJ4giH

** A message from PhRMA: When Woodrow Wilson was sworn into office in 1913, U.S. life expectancy was just above 50 years. Now, as we approach the second swearing in for President Obama, that number has increased by more than two decades, to 78, thanks in part to medical advancements. Check out http://www.FromHopetoCures.org for a closer look at the past 100 years of medical innovation. And, join us for a webinar on Thursday where we?ll unveil a new report detailing potential new medicines in the pipeline that could take us from hope to cures. **

Source: http://feeds.politico.com/click.phdo?i=92ac7be4f240b7cd173e618d5ab373a2

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