With help from Joanne Kenen, Brett Norman and Jennifer Haberkorn
ROMNEY: TRADE ?OBAMACARE? FOR TROOPS ? Axing President Barack Obama?s health care law would help fund a military expansion that the Republican presidential nominee has called for on the trail. ?I?d get rid of that one at day one,? he said during Monday night?s foreign policy debate. And he didn?t stop there. Transforming Medicaid into a state-run block grant program would also help fund a larger military, he said. ?As governor, I thought, ?Please, give me this program, I can run this more efficiently than the federal government.?? Romney said. ?And states, by the way, are proving it. States like Arizona, Rhode Island have taken these ? these Medicaid dollars; have shown they can run these programs more cost-effectively.? http://politico.pro/X52dc1
--The truth of the matter is, Romney?s plan to repeal the health law would do little to pay for other spending, at least if the CBO is to be believed. That?s because the non-partisan scorekeeper determined earlier this year that repealing the law would actually add $109 billion to the deficit. Republicans have griped about the finding at times, but it?s put a crimp in their efforts to describe repeal as a national cost-saver. The Medicaid block grant idea, on the other hand, has some serious savings potential. Pro?s David Nather looks at the facts: http://politico.pro/PmRut5
--?TO THE EXTENT HUMANLY POSSIBLE? -- That was the way Romney qualified his desire to repeal the Affordable Care Act, a more tempered pledge than his previous, more aggressive promises to eliminate the law right away. A turn of phrase, or a nod to the potential legal and political hurdles to outright repeal?
Welcome to Tuesday PULSE, where we?re relieved that Tagg Romney didn?t take the post-debate opportunity to follow through on his recent joking desire to take a swing at the president. The two appeared to share pleasantries as the candidates? families poured onto the debate stage. But the Twittersphere was on high alert: http://bit.ly/RSfgIV. ICYMI, the origin of the Tagg affair: http://politi.co/OXNUEf
?Well, everybody knows that the PULSE is the word.?
TODAY ON POLITICO PRO:
--SHUFFLING THE DECK AT HHS -- Less than a month before states are due to submit plans for insurance exchanges, a key federal overseer has been moved off the case: http://politico.pro/SepRkj
ISSA TO SEBELIUS: BRING IT -- Rep. Darrell Issa made good Monday on a threat to subpoena the Obama administration?s files on Medicare Advantage, a task he hopes will unearth unflattering information about the handling of the program under the Affordable Care Act. In particular, the California Republican and chairman of the House Oversight and Government Reform Committee, wants to know why, and under what authority, HHS Secretary Kathleen Sebelius plowed billions of dollars in ?quality bonus payments? into the program. http://politi.co/RdxRSK
THE BOOK ON OBAMA?S SECOND TERM -- Literally, the book. Per an Obama campaign official: The president intends to release Tuesday, in book/magazine form, a ?detailed plan? for a second Obama term. ?We?re launching a full-scale, multiplatform organizational effort that will include direct mail, advertisements and distribution at field offices to ensure every voter knows what a second term of an Obama presidency would mean for middle class Americans,? according to the official. The effort includes printing 3.5 million copies. Surrogates around the country plan to feature the blueprint in the final two weeks of the campaign, and it will be posted online.
The booklet: Cover and ?Economy? http://bit.ly/RSQw3k ... ?Manufacturing? and ?Energy? http://bit.ly/XNPPfU ... ?Small Businesses? and ?Education? http://bit.ly/RetZ3C ... ?Tax Plan? and ?Health Care? http://bit.ly/TPBsDu ... ?Retirement? and ?Moving America Forward? http://bit.ly/XNQxd0 ... Back cover http://bit.ly/TPBQ4W
--Ads featuring the plan are slated to run in the nine most fiercely contested swing states. Obama himself may address the plan when he delivers remarks in Delray, Fla., at 10 a.m.
PULSE SCOOPLET: ANTI-ABORTION GROUPS LAUNCH GOTV EFFORT IN OHIO -- Susan B. Anthony List and American Majority Action have combined forces to drum up the conservative vote in this critical swing state. Over eight days, the groups have generated 100,000 phone calls, largely with the help of students from Franciscan University, which dropped health care coverage for its students earlier this year, citing the impact of the Affordable Care Act. The facility, located in Steubenville has been generated calls for 12 hours a day. Some of the calls are going to households in Colorado and Wisconsin, as well. The center, according to organizers, has made 100,000 calls in its first eight days, and it urges voters to vote "against President Obama and Sherrod Brown.?
NARAL: FOREIGN POLICY, ALSO A WOMEN?S ISSUE -- The pro-choice group wants voters to think about abortion when they evaluate the candidates? overseas agenda. ?Many people might not realize that the person in the White House has power over how funding is allocated to family-planning programs overseas,? the group wrote in a blog post Monday afternoon, ahead of- the debate. ?In his first week in office, pro-choice President Obama rescinded the global gag rule. This anti-choice policy cancels U.S. family-planning funds to many overseas health centers and denies the world's poorest women birth control ? Mitt Romney has threatened to reinstate the global gag rule. He also picked a running mate who has repeatedly voted against international family-planning programs.? At issue is the so-called ?Mexico City Policy,? first implemented by Ronald Reagan, rescinded by Bill Clinton, reinstated and expanded by George W. Bush, and re-rescinded by Obama. The rule prohibits taxpayer dollars from going to organizations that perform or advocate for legal abortions overseas. http://bit.ly/VwcXC8
CONTRACEPTIVE CASE GOES TO MEDIATION -- One of the private companies suing the Obama administration over its requirement that most employers provide contraceptives is going to court-ordered mediation today. Hercules Corp., a Colorado HVAC company, will meet with Justice Department officials to see if they can come to a settlement over the company?s request for an injunction to block the requirement. But don?t expect an immediate resolution in the high-profile case. Michael Norton, one of the Alliance Defending Freedom lawyers representing Hercules, told POLITICO that he?s not optimistic either side will retreat during mediation, which by definition requires one side to give something up. ?There?s not much to either give up or accept here,? he said. The 10th Circuit Court of Appeals required the mediation before it hears oral arguments on the injunction.
ANOTHER GOP INQUIRY ON MEDICARE -- This one from Sens. Orrin Hatch and Tom Coburn, members of the Senate Finance Committee. In a letter to the HHS inspector general, the pair asks for documents that support the Obama administration?s estimate on what their latest fraud prevention efforts will mean for Medicare?s bottom line. In particular, Hatch and Coburn are interested in a new system of ?predictive analytics? that CMS is using to detect Medicare fraud before sending money out the door. CMS was required to estimate savings from its use of predictive analytics and then certify that estimate with the inspector general. Now, the senators are asking the inspector general?s office for documents it used to evaluate CMS?s projection. ?The true test of the effectiveness of this tool can only be ascertained if there are valid, reliable results,? they wrote. ?We share your goal of protecting the Medicare program and want to ensure that taxpayer funds are being well utilized as CMS continues to enhance its program integrity efforts.? Oh, and they?re looking for a response by Nov. 2. The letter: http://politico.pro/RqK7No
--COBURN: DON?T EXPAND MEDICAID, OK? -- The Oklahoma Republican sent a letter to Gov. Mary Fallin raising a bevy of potential pitfalls if his state were to expand Medicaid. For example, he writes, Oklahomans would bear some of the cost, the federal government could pull the rug out from under states expecting a generous match rate for the expansion, private health insurers could pull out of the market, the federal government would have more say over Oklahomans? health care, and the Medicaid program itself is far from perfect. ?For these reasons and more, I believe Oklahoma should not expand its Medicaid program,? he writes. ?Focusing on managing the current program ? rather than expanding it ? is more responsible and compassionate than increasing spending and ceding more control to the federal government.? The letter: http://politico.pro/UtB1El
BUCKEYE NAILBITER SHOWS FAMILIAR THEMES ON HEALTH CARE ? Obama and Romney are neck and neck in Ohio, which is shaping up to be the decisive Election Day battleground. But on entitlements, the advantage still lies with Democrats, according to a new Suffolk University poll of likely voters. In fact, 49 percent of likely Ohio voters trust Democrats more with the reform of Social Security and Medicare, compared to 42 percent who trust Republicans more, outside the poll?s 4 percent margin of error. But by a similar margin, Ohioans think the Affordable Care Act is a bad deal for their state. Forty-nine percent say the law is ?generally bad? for Ohio, while 43 percent say it?s ?generally good." The marginals: http://bit.ly/QCd2Pa
FDA POSTS LIST OF NECC CUSTOMERS -- The agency published a list Monday of health care providers that have purchased drugs from the New England Compounding Center since May 21, when the first lot of steroid injections linked to the fungal meningitis outbreaks was produced. The customers are in more than 40 states, and a separate list of products sold by NECC runs 261 pages. FDA recommends providers follow up with any patients who received an injection of an NECC product that was shipped after May 21. The customers: http://1.usa.gov/Pm9P9t. The products sold: http://1.usa.gov/T7a9np. A list of all recalled products: http://1.usa.gov/SYGrki. The CDC Monday reported that infections from the outbreak had risen to 297. The number of confirmed deaths held steady at 23 from Sunday.
-- Late Monday, House Energy and Commerce Committee officials urged the NECC and one of its former owners ? Barry Cadden ? to turn over documents that might shed light on the outbreak. The request comes after Cadden informed the committee, through an attorney, that he wouldn?t brief them on the outbreak, according to the committee announcement. See the committee?s letter to Cadden: http://1.usa.gov/Tu20Qi. The letter to NECC: http://1.usa.gov/TbYEPN. A 2006 consent agreement between NECC and the Massachusetts Board of Pharmacy: http://1.usa.gov/OXBe07
TWEETING DOCS -- Doctors are using Twitter and other social media as a virtual doctors? lounge, where they throw ideas around with colleagues and sort out a huge mass of health information, American Medical News reports. ?The social media world is such an intense, immediately responsive place that you can have tremendous amounts of traffic pointing out the good and bad about an article itself technically, about the concepts that were put forward, and about potential flaws that were in a paper,? the article quoted one Texas cardiologist as saying. The AMN article: http://bit.ly/RmXka3.
BIRTH CONTROL, THE ULTIMATE BIPARTISAN ISSUE? ? Not if you?ve been following the presidential campaign. But new survey data issued by the National Campaign to Prevent Teen and Unplanned Pregnancy suggests that there?s broad consensus on access to birth control, limiting unplanned pregnancies and making sure women can afford contraception. A poll commissioned by the group found that 70 percent of adults believe insurers should cover the full cost of birth control for women, including 86 percent of Democrats, 67 percent of independents and 48 percent of Republicans. And 81 percent agreed that the government should help women unable to afford birth control, including two-thirds of Republicans. The telephone poll of 1,029 adults ? including 871 registered voters ? carries a 3.1 percent margin of error. The data: http://bit.ly/Tt6dDJ
THE DETERMINATORS: NOW ON YOUTUBE -- The Tea Party Patriots made waves last week when the group announced plans to distribute thousands of copies of an anti-?Obamacare? DVD to swing state voters. Now, the movie ? titled ?The Determinators? ? is available for general viewing on the TPP website, along with a fundraising solicitation to help send the DVD out to more voters:? http://bit.ly/R8vu1S. ICYMI, the initial story on the film: http://politico.pro/TtFh0R
JUST FOR FUN -- A new, satirical history of health care reform, as told through generations of political cartoons is due out in January. Here?s a preview: http://bit.ly/RqDPgI
PRO TRIVIA NIGHT RETURNS ? POLITICO?s Patrick Gavin and Pro?s Tony Romm will be teeing up questions on all things policy, politics and D.C. tonight at 6 p.m. Pros can RSVP with their teams of four to eholman@politico.com.
WHAT WE?RE READING
The New York Times reports on a proposed settlement agreed to by the Obama administration to permit people with chronic illness or disabilities to qualify for home health care or skilled nursing in Medicare: http://nyti.ms/SjuQOG
Health Affairs? Robert Master writes about the promise of coordinating care for those dually eligible for Medicare and Medicaid, among the most expensive patients to cover: http://bit.ly/Pm68Rh
A New Jersey doctor takes to the pages of The Wall Street Journal to warn about the potential pitfalls of electronic medical records: http://on.wsj.com/WF9H6U
The Boston Globe reports on the scope of the meningitis outbreak and provides details about the number of facilities that may have received tainted drugs: http://bo.st/RRpt8Y
Clinical trials show that a new flu vaccine meant to target four strains of the virus is just as effective as earlier versions, The New York Times reports: http://nyti.ms/Skcn4u
Source: http://feeds.politico.com/click.phdo?i=b57a6622eed0606c44eb929d9263e039
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