First Edition: July 5, 2012

Early morning highlights from the major news organizations, including articles on Republican presidential candidate Mitt Romney's statement that the health law individual mandate is a tax.

Kaiser Health News: States Could Cut Medicaid Rolls In 2014 As A Result Of Court Ruling
Kaiser Health News reporter Phil Galewitz writes: "Starting in 2014, things could get worse for people in Medicaid. Not only could some states opt out of increasing the number of adults in the government health insurance program for the poor as a result of the Supreme Court's ruling, but they also could cut people now enrolled (Galewitz, 7/3). Read the story.

Kaiser Health News: Webcast: Your Questions Answered About The Supreme Court Ruling
KHN's Mary Agnes Carey moderates a panel discussion with KHN's Marilyn Werber Serafini, Politico's Jennifer Haberkorn and the L.A. Times' Noam N. Levey. The reporters field  readers' questions and break down Thursday's landmark Supreme Court decision on the constitutionality of the health law. Watch the video or read the transcript.

Kaiser Health News: Capsules: Marketing Mavens Offer Advice On Handling Health Law Messaging; Tax Or Penalty? Individual Mandate Haunts Romney; Report: Spending On Children's Care Rose Because Of Higher Prices; Doc Payments Show Underbelly Of Pill Marketing
Now on Kaiser Health News' blog, marketing experts offer their thoughts about how the two presidential candidates might use the Supreme Court ruling on the health law in their campaigns (Barr, Fleming, Kulkarni, Torres and Schwartz). In addition, Martha Bebinger writes for KHN and WBUR: "The Massachusetts health care law, Mitt Romney's signature achievement as governor, is adding more pressure to the expected GOP presidential nominee's campaign. Romney's support for the requirement that all residents have health insurance, known as the individual mandate, is at the heart of his predicament" (Bebinger, 7/4).

Also on the blog, KHN's Christian Torres writes about a new report from the Health Cost Institute: "Health care spending is growing significantly faster for children than for adults, and a new report finds that that's largely because of price increases" (Torres, 7/3).  And KHN's Jay Hancock reports on the recent settlement with Glaxo: "How do pharmaceutical companies boost sales and drive up health costs? Pay celebrity doctors to talk about their pills. Take doctors on lavish junkets. Misrepresent research. Push pills for unapproved uses. ... Documents unsealed as part of GlaxoSmithKline's settlement with federal prosecutors, however, offer a rare look at the details (Hancock, 7/3).

Politico: Romney Shifts, Says Mandate's  A Tax
Directly contradicting his senior adviser, Eric Fehrnstrom, presumptive GOP presidential nominee Mitt Romney told CBS that the Affordable Care Act's individual mandate is "a tax." Earlier this week, Fehrnstrom said in a TV appearance that Romney has the same view as the White House on the individual mandate: that it's a penalty, rather than a tax. Romney instituted a state-level mandate to buy health insurance as governor of Massachusetts. But Romney shifted gears in a sit-down with Jan Crawford, declaring that President Barack Obama broke his pledge not to raise taxes by imposing the individual mandate (Burns, 7/4).

The Washington Post: Romney: Health-Care Mandate Is A Tax
Mitt Romney said Wednesday that a mandate in President Obama's signature health-care law is "a tax," contradicting a position his campaign staked out this week and belatedly getting in line with many other Republican leaders. ... By saying the mandate is a tax, Romney seemed to acknowledge that the provision in the Massachusetts law that, like Obama's federal law, fines people who don't buy health coverage also is a tax. But he argued that is not the case (Rucker, 7/4).

The Associated Press: Romney Calls Obama's Health Care Requirement A Tax
"The majority of the court said it's a tax and therefore it is a tax. They have spoken. There's no way around that," Romney said in an interview with CBS News. "You can try and say you wish they had decided a different way but they didn't. They concluded it was a tax" (Hunt, 7/4).

The New York Times: Romney Now Says Health Mandate by Obama Is a Tax
 Mitt Romney declared on Wednesday that President Obama's health care mandate was in fact a tax, shifting his campaign's characterization of the law and aligning himself with the conservative voices in his party. Mr. Romney's remarks, made in a hastily arranged interview with CBS News on a national holiday, prompted renewed criticisms that he was willing to adjust his views for political expediency (Peters, 7/4).

The Hill: Romney Contradicts Top Adviser, Says Health Law Mandate 'Is A Tax'
Romney's comments followed criticism from Republican leaders after his adviser Eric Fehrnstrom called the individual mandate a penalty during an interview Monday. Fehrnstrom's remark conflicted with the emerging GOP attempt to characterize the mandate, which was upheld along with much of President Obama's Affordable Care Act, by the Supreme Court last week, as part of a tax increase from the president (Mali, 7/4).

Los Angeles Times: Mitt Romney Says Healthcare Plan's Individual Mandate Is A Tax
In his remarks Wednesday, Romney drew a distinction between a similar provision that he put in place in Massachusetts and the Obama mandate. Both laws require people who don't have health insurance to buy it or face a penalty. States, he said, "have the power to put in place mandates. They don't need to require them to be called taxes in order for them to be constitutional" (Landsberg, 7/4).

The Wall Street Journal: Romney Adds To Health-Tax Fireworks
Mitt Romney said Wednesday that the U.S. health care law's penalty is a tax, breaking with one of his top aides and further muddling the lines between the Massachusetts health-care plan he championed and the federal version he opposes. ... The comments from the presumptive Republican nominee illustrate a conundrum for him. Mr. Romney repeatedly has said that the Massachusetts health-care plan he enacted as governor differed from the federal version in two major ways: It didn't raise taxes and was not unconstitutional. (Murray, 7/4).

The Washington Post: More State Leaders Considering Opting Out Of Medicaid Expansion
A growing number of Republican state leaders are revolting against the major Medicaid expansion called for under President Obama's health-care overhaul, threatening to undermine one of the law's most fundamental goals: insuring millions of poor Americans. ... The Republican governors of four states -; Florida, Iowa, Louisiana and South Carolina -; have declared that they want to opt out of the expansion. Leaders of half a dozen other states -; including Texas, home to one of the largest concentrations of uninsured people -; are considering following suit (Aizenman and Somashekhar, 7/3).

Politico: More Legal Challenges To ACA On Way
The Supreme Court lawsuit isn't the end of the legal challenges to the health care law -; and the next ones just might help Republicans keep pushing their favorite political hot buttons. The next wave of lawsuits likely wouldn't put the whole law at stake, as the challenge to the individual mandate could have. But they're going after pieces of the law that happen to be red meat for many conservative voters -; like the law's contraception mandate and a new Medicare panel that Republicans call a "rationing board." And one possible legal challenge, which would try to block the feds from offering subsidies in a federal health insurance exchange, is meant to exploit a loophole in the law (Haberkorn, 7/4).

The New York Times: Polls: Public Division Remains Over Health Care Law
A fresh wave of public opinion polls has been released in the last few days, measuring Americans' views of the Supreme Court and its decision to uphold most of the health care law. The surveys found Americans divided over the ruling, as they have been over the law since its enactment in 2010 (Kopicki, 7/3).

The Washington Post: The Amazing Number Of People Who Know Nothing About The Health-Care Ruling
The latest poll numbers from the Pew Research Center on the Supreme Court's decision on President Obama's health-care law are (yet another) affirmation of that fact. Forty-five percent -; yes 45 percent! -; of respondents in the Pew poll either didn't know what the court had done in regards the health care law (30 percent) or thought that the court had rejected most of the provisions of the law (15 percent) (Cillizza, 7/3).

The Washington Post: 4 Pinocchios For Romney's Claim On An Obama Health Care Pledge
The campaign of former Massachusetts governor Mitt Romney is trying to nail President Obama for making an iffy promise during the 2008 campaign -; that premiums will be $2,500 lower under his health care plan. Instead, the Romney campaign argues in an effort to create a viral Facebook post, the swing has gone $4,893 the other way.  The Romney graphic is false on several levels (Kessler, 7/3).

The New York Times: Wooing Swing Voters, Both Parties Wary Of Overemphasizing Health Care
Leaders in both parties acknowledge that the ruling has thrown a wrench into their campaigns for control of the House and the Senate. House Republicans have scheduled another vote next week to try to repeal the law, known as the Affordable Care Act. And they say they are ready to play offense on the reinvigorated health care debate. But even as they highlight that mobilization, leaders of both parties say overemphasizing the health care issue could turn off weary swing voters who, they fear, just want to put the issue aside (Weisman, 7/3).

NPR: Ohio Senator Vulnerable For Health Law Support
President Obama hits the campaign trail Thursday with a bus tour in Ohio. The state is a crucial battleground not only for the presidential election, but also because it could decide whether Democrats keep control of the Senate. Up for re-election there is Democrat Sherrod Brown, who is being challenged by the state's Republican treasurer, Josh Mandel. Mandel is highlighting Brown's staunch support of the new health care law -; with a big assist from outside groups (Welna, 7/5).

Chicago Tribune: With Health Care Law Upheld, Employers Weigh Shift To Defined Contribution Insurance Plan
Many Chicago-area employers have remained on the sidelines with their employee health plans, waiting for the U.S. Supreme Court to determine whether the 2010 health care overhaul passed constitutional muster. But with the court's decision last week to uphold most of the law, companies may pursue a historic change. Many employers are quietly considering a move away from traditional defined benefit plans and toward defined contribution plans, which set aside a fixed amount of money each year for employees to use toward health care costs (Frost, 7/3).

The Wall Street Journal: Aetna, Doctors Face Off Over Costs
California physician groups sued health insurer Aetna Inc. Tuesday for a slate of business practices the doctors say limit patients' choices, the latest salvo in a classic standoff between managed-care and medical practices. In February, Aetna sued some of the same doctors bringing Tuesday's allegations, saying the physicians schemed to inflate their bills to the insurer for a raft of services by nearly 800%, raising health-care costs for members (Weaver, 7/4).

The Los Angeles Times: California Physicians Sue Aetna Over Out-Of-Network Referrals
The California Medical Assn., the largest physician group in the state, and more than 60 individual doctors sued health insurance giant Aetna Inc. as part of a growing legal battle over what patients are charged when they go outside an insurer's network. ... The suit alleges that the insurer illegally threatens doctors and patients who want to use out-of-network medical providers and then cancels the contracts of some physicians who persist in those referrals (Terhune, 7/4).

The Los Angeles Times: Blue Shield Plan To Close Policies To New Customers Is Denied
California Insurance Commissioner Dave Jones denied Blue Shield of California's plan to close several of its health policies to new customers, saying it violated state rules designed to protect consumers from large rate increases (Terhune, 7/4).

The New York Times: Rapid H.I.V. Home Test Wins Federal Approval
After decades of controversy, the Food and Drug Administration approved a new H.I.V. test on Tuesday that for the first time makes it possible for Americans to learn in the privacy of their homes whether they are infected (McNeil, 7/3).

Los Angeles Times: FDA Approves New Home-Use HIV Test
The Food and Drug Administration approved the first over-the-counter HIV test Tuesday, allowing people to test themselves in private at home and get preliminary results in less than 30 minutes. ... The test, manufactured by OraSure, already had been approved for medical clinics. The new at-home test, called OraQuick, will be sold in supermarkets and pharmacies beginning in October (Duncan, 7/4).

The Wall Street Journal: FDA Approves OraSure's Home HIV Test
The Food and Drug Administration Tuesday approved a home HIV test that will be sold in retail stores so people wouldn't have to go to a health facility to learn if they have the virus. The test, made by OraSure Technologies Inc., has been available to health-care professionals. The test, called the OraQuick In-Home HIV test, uses a mouth swab to collect saliva. The swab is then inserted into a test tube where results are made available within a 20 to 40 minutes (Corbett Dooren, 7/3).

NPR: New Home Test For HIV May Cut Down New Infections
No infectious disease has ever been detectable by a test that consumers can buy over the counter and get quick results at home. But HIV isn't just any infection. It's a stubborn pandemic virus that's still making people sick and killing them 31 years after it first appeared – even though infection is easily prevented and effectively treated. The Food and Drug Administration's approval of the OraQuick In-Home HIV Test carries the hope that it can help identify some of the nearly quarter-million Americans infected by HIV who don't know it (Knox, 7/3).