GOP at war with itself on Obamacare funding - HHS watchdog pares back audits amid cuts - AP: HPV vaccine rates still low

By Kyle Cheney

With help from Jason Millman

GOP AT WAR WITH ITSELF ON OBAMACARE FUNDING ? That?s the takeaway from the mixed messages coming from Republican quarters Thursday, with some on the right threatening a government shutdown if Democrats insist on funding the health law and others decrying the threat as akin to ?blackmail.? Republican hardliners in the Senate delivered a letter to Majority Leader Harry Reid vowing to fight against any effort to fund the government that includes a continuation of funding for Obamacare. But in a sign of ambivalence in some corners of the party, three senators ? including Senate GOP Whip John Cornyn, pulled their names from the letter. Backers of the effort held firm: ?I would say if we?re not going to have a red line in the sand on Obamacare, what will we have a line in the sand on?? Sen. Marco Rubio told POLITICO Thursday. http://politi.co/14NWRYH

?You put me on a shelf and kept PULSE for yourself.?

Happy Friday and welcome to PULSE, where we?re surprised it took as long as it did (three days) for the Heritage Foundation to connect the birth of the royal baby in England to Obamacare. What?s not surprising is the conclusion. http://herit.ag/15iSfaC

COUNTDOWN TO OCT. 1: 67 days.

HHS WATCHDOG PARES BACK AUDITS AMID CUTS ? The inspector general?s office is scaling back oversight of Obamacare implementation as it copes with a 20 percent workforce cut, the Center of Public Integrity reported Thursday. Projects on the chopping block include an audit of security measures in health insurance exchanges, an investigation into nursing home use of antipsychotic drugs and a study of drugs marketed in Medicare Part D before FDA approval. http://bit.ly/166Wh75

CAP: SGR BILL DOESN?T DO REAL PAYMENT REFORM ? The Center for American Progress says it opposes the current draft of the bill overhauling the Medicare physician payment formula, arguing that the legislation doesn?t establish ?a clear transition to new payment models.? In a letter to House Energy and Commerce leaders today, the left-leaning think tank argues the current bill establishes two duplicative programs that only ?create the appearance of payment reform.? Instead, CAP suggests that Medicare require bundling arrangements or start reducing fee-for-service payments by 2017 or 2018 while allowing doctors to switch into alternative payment arrangements to avoid the financial hit. CAP says the latter approach is similar to a bill from Reps. Allyson Schwartz and Joe Heck.

DESPITE HARSH WORDS, WALKER NEEDS OBAMACARE EXCHANGE TO WORK ? Wisconsin Gov. Scott Walker penned a sharply worded Wall Street Journal op-ed with Louisiana Gov. Bobby Jindal on Thursday denouncing Obamacare and the White House?s implementation effort. But Walker?s own recently enacted health reform plan in Wisconsin also counts on Obamacare?s insurance exchanges to work as planned. That?s because instead of opting to expand Medicaid, Walker won passage of a plan that scales back his state?s generous Medicaid program and encourages people to join the exchange instead. The Pro story: http://politico.pro/1dYE64q; ICYMI, the op-ed: http://on.wsj.com/1dXyiYU

PERLIN SLATED TO LEAD AMERICAN HOSPITAL ASSOCIATION IN 2015 ? Jonathan Perlin, president of clinical and physician services at the Nashville-based Hospital Corporation of America, has been tapped as the future chairman of the American Hospital Association. The group named Perlin ?chair-elect designate,? meaning he?ll take over the chairmanship In 2015, at a time when many hospitals may be grappling with the impact of Affordable Care Act cuts and working through the first challenges of implementing the health law. Perlin has previously worked as undersecretary for health in the Department of Veterans Affairs.

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AP: HPV VACCINE RATES STILL LOW ? CDC Chief Thomas Frieden says the country is ?dropping the ball? on getting teenage girls vaccinated against HPV, which commonly leads to cervical cancer, the Associated Press reports. ?About 54 percent of teenage girls have received at least one of the three HPV shots. Only a third was fully immunized with all three doses,? according to the AP. The rate of vaccination is little changed from recent years, and health officials say it?s because doctors aren?t as aggressive about encouraging patients to get the vaccine as they are with others. http://yhoo.it/1dXJnZR

PENN. BROKER SHUTS EXCHANGE LOOKALIKE SITE ? A Pennsylvania insurance broker shut down his website this week after state authorities said it appeared to present itself as the state?s official insurance exchange, local outlet WHYY reported Thursday. The site, PAhealthexchange.com, billed itself as ?The Pennsylvania Health Exchange? and featured a graphic that looked like the state seal, according to the report. The broker, Alan Heffler, said he took the site down immediately after receiving a call from a state insurance official. http://bit.ly/1dYIb8K

NEW DATA SHOWS DRUG USE ROSE SHARPLY FOR WOMEN IN TREATMENT ? Women undergoing substance abuse treatment used alcohol at a declining rate from 2000 to 2010, according to new data released by the Obama administration, but their use of illegal drugs climbed sharply. According to a report from the Substance Abuse and Mental Health Services Administration, 34.8 percent of women in treatment used alcohol in 2010, down from 46.6 percent at the start of the decade. But those using drugs rose to 63.8 percent from 51.1 percent. The report: http://1.usa.gov/19krQO3

IT?S HERE! ? MORNING EDUCATION: Looking for coverage of federal and state education policy? Get schooled with POLITICO Pro?s latest morning newsletter ? Morning Education. The newsletter covers everything from student loans and K-12 federal policies to state-level education policy disputes, and much more. Check out today?s edition and subscribe here.

CBO: IMMIGRATION BILL LOWERS DEFICIT BECAUSE OF ENTITLEMENT SAVINGS ? If you exclude the off-budget Medicare and Social Security direct spending that the Senate?s immigration reform is expected to support, the rest of the bill actually increases the deficit by $102 billion over 10 years, CBO director Douglas Elmendorf wrote in a reply to questions from Senate Budget Committee Chairman Jeff Sessions. CBO has estimated that the bill, with entitlement trust fund savings, will reduce the deficit by $260 billion over 10 years. Sessions was wondering what the bill?s deficit impact would be if Social Security and Medicare trust fund savings were retained to pay for future benefits. The CBO letter: http://1.usa.gov/11hFIDP

-- AND THE SENATE COMPOUNDING BILL HAS NO BUDGET IMPACT ? Senate legislation intended to establish a national system of oversight for compounded drugs would have a negligible budgetary impact, CBO reported Thursday. The bill would have a net impact of less than $500,000 in increased revenues or spending, according to CBO. http://1.usa.gov/12OWOGz

PULSE LYRICS

Monday: Styx, ?Come Sail Away?

Tuesday: Metallica, ?Fuel?

Wednesday: Alicia Keys, ?Fallin??

Thursday: Eric Clapton, ?Layla?

Friday: Coldplay, ?Swallowed by the Sea?

WHAT WE?RE READING, by Abby McIntyre

HHS Secretary Kathleen Sebelius urged female bloggers at a conference in Chicago to spread information about the health care law, The AP reports: http://wapo.st/1bmG9Dt

In his column in today?s New York Times, Paul Krugman argues that Republicans are digging in their heels on Obamacare because they?re starting to realize the law is probably going to work: http://nyti.ms/13fQ9UW

The Washington Post Wonkblog?s Dylan Matthews takes a look back at a 2009 GOP health care plan, the Patient?s Choice Act, which has a lot more in common with Obamacare than you might expect ? and still has the backing of Rep. Paul Ryan: http://wapo.st/167uiUS

A DOJ investigation is shining light on the potentially problematic situation of physician-owned distributorships, The Wall Street Journal reports: http://on.wsj.com/14OAPVE

Kaiser Family Foundation has compiled an issue brief on what coverage options those with HIV have under the Affordable Care Act: http://bit.ly/1c7B8wq

A leading researcher on?Lou Gehrig?s disease has been arrested on homicide charges in the cyanide death of his neurologist wife. He?s accused of lacing with poison an energy supplement she was taking to help her conceive. AP has the full story: http://wapo.st/15iQURo

Taller women are at greater risk for developing cancer, a new study finds. The LA Times: http://lat.ms/15iIj14

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CORRECTION: A PULSE item on Jonathan Perlin?s selection as chair-elect designate of the American Hospital Association misidentified his current role at Hospital Corporation of America. He?s the president of clinical and physician services.

Source: http://www.politico.com/politicopulse/0713/politicopulse11261.html

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