The Washington Post (5/14, Hilzenrath) reports, "In comments submitted to the National Association of Insurance Commissioners (NAIC), which is helping the government translate the new requirement into detailed rules, members of the industry have asked for permission to count a wide range of expenses." For instance, "the BlueCross BlueShield Association...has told rule makers that its efforts to improve health quality include 'reducing inappropriate and sometimes potentially harmful care.'" But, "consumer advisers to the NAIC have countered that some expenses the association proposed including 'are core administrative functions of insurance companies.'" The Post notes, "As the debate playing out at the NAIC shows, the long, hard-fought battle over-health care legislation is quickly turning into a battle over health-care regulations. The ultimate impact of the law President Obama signed depends on fine print that has yet to be written."

 Lawmakers Target Insurers' Rate Increases, Profits. CQ HealthBeat (5/14, Norman,) reports, "Democrats' full-throttle assault on the health insurance industry continued unabated Thursday as part of an unfolding campaign to portray the new health care law as a necessary antidote for insurer abuses." Sen. Dianne Feinstein (D-CA) and Rep. Jan Schakowsky (D-IL) "renewed their call for action on Feinstein's legislation to cap rate hikes, though Feinstein acknowledged in a conference call with reporters that she likely can't gain 60 votes in the Senate for her measure (S 3078)" In addition, "two senior senators -- one a Republican -- shipped off a letter to health insurer WellPoint, Inc. demanding a detailed explanation of the assumptions that went into a proposed rate increase rejected by California regulators because of its miscalculations." Sen. Max Baucus (D-MT) wrote, "Shoddy calculations don't excuse 40 percent rate hikes."

Consumer Advocacy Group's Report Notes Increase In Health Insurer Profits. Modern Healthcare (5/14, Vesely, subscription required) reports that Aetna, Humana, WellPoint, UnitedHealthGroup, and Cigna Corp., "the five largest for-profit health insurers, reported combined net income of $3.2 billion in the first quarter of this year, up 31% over the same period in 2009, according to a new report by Health Care for America Now, a consumer advocacy group." In fact, the five companies "saw increased income in the first quarter of this year, while premiums grew faster than medical costs, according to the report." However, "America's Health Insurance Plans, representing the insurance industry, said insurers had slim profit margins of 4.7% in the first quarter of 2010 compared with drug maker profits of 22.7% in the same period."

Politico (5/14, Haberkorn) reports, "After weeks of letting Democrats try to take control of the health care message, Republicans have gotten back into the game in recent days, threatening to hold up a Medicare nominee and challenging White House claims that reform's start-up is going smoothly." House Minority leader John Boehner (R-OH) "said Health and Human Services Secretary Kathleen Sebelius must have been in an 'alternative universe' when she told Congress that implementation is on time or ahead of schedule." Boehner also "reiterated his promise to repeal the law, even though Republicans are in the minority in Congress."

        Bernie Becker also notes Boehner's comments in the New York Times (5/14) Prescriptions blog. Becker adds that Boehner "has written back to Ms. Sebelius taking issue with what he thinks are holes in the original letter" discussing the Administration's progress on health reform. "In his response, Mr. Boehner cited a study from the chief Medicare actuary that said the new law would not rein in the growth of health care spending, as cost control measures for Medicare and other programs would not offset the expansion of services to millions of people."

        Similarly, Roll Call (5/14, Drucker,) says, "Senate Republicans are poised to try to reignite the health care debate by launching a coordinated political messaging offensive to target Democrats and the White House for what they contend are the new law's onerous consequences." Notably, "a group of Republican Senators who played key roles in the yearlong fight over health care legislation met Thursday in Minority Leader Mitch McConnell's (KY) office to discuss the strategy. Under the slogan 'second opinion,' Republicans plan to communicate their message on multiple fronts, including on the Senate floor, in press conferences, via the Internet and through television and radio appearances." But, "Democrats rebuked the strategy as typical of what the Republicans offered throughout the contentious health care debate."

CBO Analyses May Help Democrats, GOP Further Their Arguments On Health Reform. CQ Today (5/14, Ethridge,) reports, "A new cost analysis of the health care overhaul law was issued this week. It was the third in as many weeks -- and it won't be the last." Notably, "two of the reports were requested by Republican lawmakers, part of a steady stream of inquiries to the Congressional Budget Office (CBO) and to the actuary for the Centers for Medicare and Medicaid Services (CMS) about the health care overhaul...and its cost to the government." CQ says, "The latest reports contain no new revelations. But health care financial projections are notoriously hard to make -- and even more so when laws are changing." In addition, "there are...many sides to every cost equation, and both supporters and opponents of the law can seize on parts that support their argument."

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