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White House officials said Mr. Obama is prepared to veto two bills GOP leaders plan to consider soon—one approving the Keystone XL pipeline and another changing the Affordable Care Act’s definition of a full-time worker from 30 to 40 hours a week—casting doubts over how much the president and GOP congressional leaders will be able to accomplish during the Democratic president’s final two years in office. (Peterson and Crittenden, 1/6)

The first congressional Republican attempt to weaken Obamacare with legislation boasting Democratic support appeared to be headed for troubled waters on both sides of the partisan aisle on Tuesday, only days before an expected vote. The bill, introduced in the U.S. House of Representatives, seeks to reduce the law's burden on companies by requiring them to offer private health coverage to full-time employees who work 40 hours a week rather than the 30 hours stipulated by President Barack Obama's Affordable Care Act. (Morgan, 1/6)

Business leaders are waging an all-out fight to change ObamaCare’s definition of full-time work, even as the White House threatens to veto legislation that would strike down the statute’s contentious 30-hour week. The issue, a K Street priority for years, has taken on fresh urgency with the dawn of a Republican-controlled Congress bent on chipping away at the president’s signature healthcare law. In the coming days, both the House and Senate will take action on bipartisan bills that would modify the full-time employee standard, a component of the law’s employer mandate. But corporate lobbyists now trying to build support among lawmakers will have to overcome objections from labor unions and President Obama. (Wilson, 1/7)

Under the 2010 Affordable Care Act, businesses with 50 or more employees are required to offer full-time workers insurance or face penalties. The proposed GOP bill would allow business to cover fewer of their workers by redefining full-time work to 40 hours a week. (Tau, 1/6)

The GOP bill, one of the first to get consideration in the new Congress, would redefine "full-time employee" under the ACA as someone who works at least 40 hours a week. It sounds commonsense enough — 40 hours is entrenched in American culture as the standard workweek. But studies indicate that what the GOP is trying to do will actually increase Americans' dependence on government-provided health insurance and raise the deficit. When the nonpartisan Congressional Budget Office scored an identical bill last year, it found that 1 million people would be dropped from their employer-sponsored insurance, causing between 500,000 and 1 million people to turn to public insurance options, such as Medicaid, the Children's Health Insurance Program and the ACA health insurance exchanges. (Millman, 1/6)

Now that Congress is back in Washington with a Republican majority, you can expect another symbolic Obamacare repeal vote that will be quickly quashed by the president’ veto pen. But there are a number of actual fixes to the health law and other health policies that Congress could realistically take up this year—maybe even in bipartisan fashion. (Ehley, 1/6)

On the new Congress' first day, the House unanimously approved Republican legislation Tuesday making it easier for smaller companies to avoid providing health care coverage to their workers by hiring veterans. That 2010 law is phasing in a requirement that companies with more than 50 full-time workers provide medical coverage for their workers. The House bill, sponsored by Rep. Rodney Davis, R-Ill., would exempt from that threshold veterans who already get health care from the Veterans Affairs Department or the military. Supporters say the measure would encourage employers to hire veterans. That's a goal backed by members of both parties, even as federal figures show unemployment among Iraq and Afghanistan veterans dropped from 9.9 percent in November 2013 to 5.7 percent last November. (Fram, 1/6)

The House passed legislation Tuesday to exempt veterans who have health insurance through the Defense or Veterans Affairs departments from ObamaCare's employer mandate. Members voted overwhelmingly in favor of the measure, the first House bill on the floor in the new Congress, by 412-0. The bill marks the first ObamaCare-related vote of the new Congress, after more than 50 in the last four years. ... Incoming House Ways and Means Committee Chairman Paul Ryan (R-Wis.) said the existing statute was redundant and possibly limited opportunities for veterans trying to find jobs after serving overseas. Businesses have an incentive to turn away veterans, not because they don't want to hire them but because it's too expensive to hire them. This is serving as a penalty to hiring our nation's veterans," Ryan said. (Marcos, 12/6)

Other changes were more partisan. One new rule allows the House to overturn recommendations of an independent panel created by the Affordable Care Act to trim Medicare costs. Another makes it more difficult to shift Social Security money between the program’s different trust funds, increasing the likelihood that deep cuts to disabled workers and their families will be made as the Disability Insurance Trust Fund nears depletion in 2016. That quickly drew condemnation from AARP, the powerful lobby for retired people. (Weisman, 1/6)

The original directors of ObamaCare's state-based exchanges have almost all resigned since the beginning of the law's first enrollment period, a new analysis found. Only five of the original 16 officials remain in their posts, according to Dan Diamond, manager of The Advisory Board's "Daily Briefing" newsletter. Most of the resignations took place during the exchanges' first sign-up window, when many online systems ran into technical flaws that put state officials in hot water. (Viebeck, 1/6)

The head of the Massachusetts Health Connector is stepping down. Jean Yang, the Connector’s executive director, will depart the agency next Friday, it announced. (1/6)

The state health insurance exchange reported Tuesday that 113,864 Coloradans signed up for a 2015 medical plan between Nov. 15 and year's end. That number includes 20,790 people new to the marketplace and 93,074 re-enrollments, according to Connect for Health Colorado. Also between Nov. 15 and Dec. 31, an additional 35,981 individuals enrolled for Medicaid coverage and 1,517 children were added to the rolls of the public insurance called Child Health Plan Plus. However, these forms of public insurance are year-round programs that do not limit the enrollment window for those who qualify. (Draper, 1/6)

Gov.-elect Asa Hutchinson on Tuesday still demurred from announcing his opinion on the expansion of the Medicaid private option in Arkansas.Hutchinson discussed the forthcoming legislative session, which starts Monday, at a forum hosted by the Arkansas Associated Press Managing Editors at the state Capitol. The governor-elect said he plans to make a "major speech" on health-care reform in the state sometime toward the end of the month. (Kloap, 1/6)

The Affordable Care Act had awarded primary care doctors treating Medicaid patients a two-year pay increase. It was funded entirely with federal money, and pushed their Medicaid pay to the level of Medicare reimbursement. But that additional Medicaid reimbursement, which went to family physicians, pediatricians and internists, ended Jan. 1. And doctors will be missing it. (Miller, 1/6)

As we shift into the new year, we're gearing up for an onslaught of new paperwork that is essential for filing your 2014 tax return. One brand-new piece of paper: Form 1095-A, the Health Insurance Marketplace Statement. If you obtained coverage under Obamacare last year, you need Form 1095-A to file your tax return for 2014. The form is to be sent by Jan. 31, but you're not going to be able to file your taxes without it. It may seem early to be talking about taxes, but this tax season could be a mess, thanks in part to some complicated tax rules involving the Affordable Care Act. (Tompor, 1/6)

The push to repeal the medical device tax already has bipartisan support, and it is expected to be one of the first issues taken up by Congress this year. The repeal of the 2.3 percent excise tax, imposed under the Affordable Care Act, is one of the priorities of the Republican-led Congress as lawmakers aim to chip away at parts of the health-care law. We don’t intend to single out Thune. He is among a chorus of lawmakers — Democrat and Republican — who want to repeal the tax, and among many who are using the job-loss claim as one of the reasons to get rid of it ... We don’t intend to single out Thune. He is among a chorus of lawmakers — Democrat and Republican — who want to repeal the tax, and among many who are using the job-loss claim as one of the reasons to get rid of it. (Ye Hee Lee, 1/7)

Kaiser Health News staff writer Phil Galewitz reports: "The Gold ‘N Silver Inn in Reno, Nev., has long offered health coverage to its employees — but many of the cooks, dishwashers and waiters who make close to minimum wage can’t afford the $100 monthly premium. Last January, when Nevada became one of more than two dozen states to expand Medicaid under the Affordable Care Act, 10 of the diner’s 55 employees qualified for the government insurance program for low-income Americans. None of them realized it, however, until the family-run restaurant hired BeneStream, a New York-based start-up funded partly by the Ford Foundation." (Galewitz, 1/7)

A company in the Grand Rapids area is not required to provide employee health insurance for birth control as a result of a U.S. Supreme Court decision. A federal judge says Autocam is covered by the court's decision last year in the Hobby Lobby case. Some private employers can avoid the contraceptive requirement in the Affordable Care Act. Autocam, based in Kentwood, makes auto parts and medical supplies. It is owned by the family of chief executive John Kennedy, a Roman Catholic who opposes contraception and abortion. (1/7)

Analysts expect another strong year from the for-profit operators because they've cut costs and adopted new initiatives to bring in more patients. ... The report contrasts with the negative outlook Fitch and other credit-rating agencies have placed on not-for-profit hospitals. Management teams at investor-owned chains kept a tight rein on expenses over the past year and were conservative with how they managed capital, said Megan Neuburger, an analyst at Fitch who covers the for-profit sector. (Kutscher, 1/6)

ProMedica has appealed to the U.S. Supreme Court in its battle to keep a hospital it acquired more than four years ago. A lower court ruled the acquisition violated antitrust laws. It's a case with potential implications nationwide as more hospitals seek to expand through consolidations and acquisitions in efforts to improve care and lower cost. They're faced with the challenge of doing so without violating antitrust laws. The Ohio health system filed a petition with the U.S. Supreme Court in late December, asking the court to hear the case. (Schencker, 1/6)

For investors, health-care stocks are a panacea in good and bad times. After helping to lead the market higher in 2014, shares of pharmaceutical and biotechnology companies have started off the new year avoiding much of the malaise afflicting other sectors. The broader market has stumbled in the early days of the New Year, with the S&P 500 down 2.7 percent. (Strumpf, 1/6)

The introduction in the U.S. of cheaper alternatives to complex biologic drugs faces a key test this week that could determine whether consumers and insurers will save billions of dollars on drugs to treat cancer and other ailments. A Food and Drug Administration advisory panel will decide Wednesday whether to recommend that the agency approve a drug known as EP2006 from Novartis AG ’s Sandoz unit. (Burton, 1/6)

U.S. Sen. Richard Blumenthal says he is resurrecting a measure to help prevent suicide among the armed forces and service veterans. The Democrat appeared in Hartford on Tuesday with the leaders of state veterans' organizations to tout legislation that would increase access to mental health care and outreach efforts targeting veterans. The Clay Hunt Suicide Prevention for American Veterans Act was introduced in November but failed to win passage in the Senate by one vote. That lone senator, Tom Coburn, has retired. (1/6)

The new director of the Veterans Affairs’ health care system in New Mexico is embarking on a tour of the state, with town halls planned from Alamogordo and Silver City to Gallup and Rio Rancho. Andrew Welch will be meeting with veterans and their families as part of an effort to restore trust after VA hospitals and clinics around the country were rocked by allegations of mismanagement, delays in care and secret waiting lists. (Bryan, 1/6)

Colorado Gov. John Hickenlooper came to the capital of government gridlock to offer a solution. Hickenlooper, chairman of the National Governors Association, said Tuesday that Congress and the White House should look to how states are governing themselves as a model for getting beyond the partisanship that has stymied action in Washington. ... Governors also would like Congress to reauthorize Head Start and the Children' Health Insurance Program, and find a better way to fund transportation projects. They also are calling for streamlining the way states institute alternative approaches, called waivers, to the Medicaid program that provides health care for the poor. (Theobald, 1/6)

On health care, the governors called on Congress to adopt more than 40 recommendations NGA shared with the Department of Health and Human Services last year. Those include streamlining approval of Medicaid expansion waivers and encouraging state innovation by helping to make successful state programs permanent and sharing savings that result from state-driven reforms. (Chokshi, 1/6)

Two Republican governors tried to convince President Barack Obama Tuesday to let them impose work requirements on new Medicaid recipients as a condition for expanding the program — but all they got was a listening session and a lively debate. North Carolina Gov. Pat McCrory and Utah Gov. Gary Herbert, who met with Obama at the White House Tuesday as members of the National Governors Association executive committee, sounded optimistic after the meeting and told reporters that Obama did not reject the idea out of hand. But they acknowledged that he didn’t make any promises either, and said their next step would be to talk to Health and Human Services Secretary Sylvia Mathews Burwell about getting waivers to try their approach. HHS has agreed to some state flexibility under Medicaid in the past but has not accepted work requirements when states sought to link them to Medicaid expansion under the Affordable Care Act. (Nather, 1/6)

At a White House meeting with President Barack Obama Tuesday, Gov. Pat McCrory raised the possibility of waiving federal rules on Medicaid expansion for North Carolina. ... McCrory said he asked the president about a waiver that could allow the state to require a job or job training as a condition of eligibility. He said the president “said he would be open to certain waivers that I’m looking at to potentially present to my legislature.” “We did not get assurances, but I thought we got a pretty good response about what the governor of Utah and I are thinking along the same lines,” McCrory said after his meeting. (Morrill and Kumar, 1/6)

Insurance Commissioner Dave Jones (D) used the occasion of his second-term inauguration to announce a regulation to limit narrow networks and push insurers to provide timely access to care. Gov. Jerry Brown (D), in contrast, had a relatively brief mention of health care in his inaugural speech. (Gorn, 1/6)

A judge has ordered a federal agency to stop using a disputed Medicaid reimbursement method that could have required Houston's Texas Children's Hospital to return tens of millions of dollars a year it uses to help care for the poor and uninsured. U.S. District Judge Emmet G. Sullivan in Washington, D.C., directed the U.S. Department of Health and Human Services' Centers for Medicare and Medicaid Services "to take no action to recoup" money the agency contends was overpaid in Texas and Washington. The injunction was sought by Texas Children's and Seattle Children's Hospital, both of which serve a disproportionate share of Medicaid patients. (Ackerman, 1/6)

When a 17-year-old Connecticut girl refused medical treatment for cancer and her mother agreed with her decision, state officials took custody of her and forced her to undergo what they called life-saving chemotherapy. The Connecticut Supreme Court will review that series of events under an emergency appeal filed by lawyers for the girl and her mother, taking up an issue decided by several other states — whether some minors are mature enough to make decisions about their own bodies. (Collins, 1/6)

Connecticut hospitals reported record numbers of patients killed or seriously injured by hospital errors in 2013, with large increases in the numbers of falls, medication mistakes and perforations during surgical procedures, a new state report shows. (Lisa Chedekel, 1/6)

This week, many people have a New Year's resolution they're trying to work into their lives. So, too, is Providence Health & Services, which will no longer sell or stock sugary drinks in Oregon hospitals and business offices as part of what's called a healthy dining initiative. On Monday, the organization removed the drinks at its Northeast Portland business office. During the next two months, the drinks will phased out at all eight of Providence's Oregon hospitals, clinics and businesses offices, said Sandy Miller, the organization's director of Health and Nutrition. (Hallman, 1/6)

Centra has completed its acquisition of health insurer Piedmont Community Health Plan. Centra bought Integrated Healthcare Incorporated’s 50 percent share in Piedmont for $7.5 million. The deal closed in late December. (1/6)

Denver-based DaVita HealthCare Partners, which has a dialysis center in Marion, has settled with Ohio and four other states over allegations that the company paid illegal kickbacks to induce the referral of patients to its dialysis clinics, according to a news release. DaVita has agreed to pay $22,356,143 to resolve the allegations regarding the Medicaid program, which is a program shared between the federal and state governments, the release issued by Ohio Attorney General Mike DeWine’s office states. Ohio’s share of the settlement is $597,227. (1/6)

Pennsylvania prison inmates with serious mental illness who misbehave will be diverted to special treatment units instead of being put in isolated cells, according to a settlement released Tuesday. The settlement between the Corrections Department and the Disability Rights Network of Pennsylvania, which sued the state in federal court in March 2013, potentially affects about 4,000 prisoners who are considered seriously mentally ill, the department said. (Jackson, 1/6)

One person was shot and killed in an El Paso Army medical facility Tuesday afternoon, and the alleged shooter is dead, army officials said Tuesday night. The incident at the El Paso Veteran Affairs Clinic was reported around 3:10 p.m. local time, Maj. Gen. Stephen Twitty, commanding general of Fort Bliss, said at a news conference. (Izadi, 1/6)

VA officials also wouldn’t discuss specifics or a possible motive for the shooting, but released a statement expressing grief about what had happened. “The Department of Veterans Affairs is deeply saddened by the tragic situation that has occurred in El Paso,” spokeswoman Victoria Dillon said. “We are actively working with our partners at Fort Bliss to investigate this matter.” (Frosch, 1/7)

Obamacare health exchanges that were a laughingstock a year ago are working more smoothly this enrollment period. Millions of people who could never get coverage, or faced bankrupting medical costs if they lost their jobs, now have real protection for the first time. So, after years of controversy, is the Affordable Care Act out of the woods? Hardly. Consider this the calm before the storm. Despite the recent progress, the 5-year-old law continues to face mortal danger from Congress, public opinion and the courts. (1/6)

You can't fix a fundamentally broken law; you've got to replace it. That's why Congress can't save Obamacare with a few tweaks, despite what its defenders say. No quick fix can correct the main flaw: The law takes power away from patients and hands it to bureaucrats. (Rep. Paul Ryan, R-Wis., 1/6)

The conservative approach to keeping Americans from taking advantage of the Affordable Care Act always has featured a large element of fear-mongering. Remember the "death panels"? Sticker shock? That these things haven't come true hasn't kept congressional Republicans from conjuring up a new threat: that if the Supreme Court rules against Obamacare tax subsidies in the King vs. Halbig case, millions of Americans will face huge retroactive tax bills. (Michael Hiltzik, 1/6)

As one of its first orders of business upon convening Tuesday, the Republican House of Representatives approved a rule that will seriously undermine efforts to keep all of Social Security solvent. The rule hampers an otherwise routine reallocation of Social Security payroll tax income from the old-age program to the disability program. Such a reallocation, in either direction, has taken place 11 times since 1968, according to Kathy Ruffing of the Center on Budget and Policy Priorities. But it's especially urgent now, because the disability program's trust fund is expected to run dry as early as next year. At that point, disability benefits for 11 million beneficiaries would have to be cut 20%. (Michael Hiltzik, 1/6)

Every piece of legislation has economic consequences. Most are small, but some are significant. When the CBO ignores them, it disregards the detrimental effects on economic growth of bad legislation as well as the positive effects on growth of good legislation. For example, when the CBO initially estimated the impact of the Affordable Care Act in 2010, it ignored any effects the law might have on gross domestic product, including job losses due to the law’s employer mandate. But these effects, detailed by Casey Mulligan in these pages in a September op-ed, “The Myth of ObamaCare’s Affordability,” are a direct cost to the economy that should have been recognized at the time the estimates were made. In February 2014, the CBO released an appendix to its original estimate acknowledging that there would be some adverse consequences for employment. (Edward P. Lazear, 1/6)

The decision by the Arizona Supreme Court that dissident legislators had standing to challenge the constitutionality of Medicaid expansion shouldn't have been a surprise. ... Nevertheless, the decision was a surprise to many and widely condemned. That illuminates a big political problem: a lack of understanding of, or appreciation for, the proper role of the judiciary in our system of government. The condemnation had the following tenor: Medicaid expansion was a good thing. Judges should not be aiding and abetting sore-loser legislators who want to overturn it. (Robert Robb, 1/6)

In his first act of 2015, California Insurance Commissioner Dave Jones issued an emergency order requiring insurance companies to increase the number of primary-care doctors in their networks. That’s easier said than done. Three of the state’s nine geographic regions already lack enough primary care physicians to ensure a healthy population, according to the California Healthcare Foundation. Reforming graduate medical education — the system used to train new physicians — would help address this doctor shortage in California and across the country. The current system, established in 1965, is outdated and inefficient. Voters must urge Congress to redirect funding toward new training models that fix the shortfall and meet patients’ needs. (Barbara Ross-Lee, 1/6)

People lost their minds last fall when four people in the United States were diagnosed with Ebola. Four! Only one of the four succumbed to the devastating disease. The others were cured. Folks were calling for travel bans. They were demanding quarantines. All to protect us from a disease that could only be transmitted if one came into direct contact with an infected person’s bodily fluids, such as vomit, blood or diarrhea. ... I’m hammering at this point because we are in the middle of a far more serious health crisis, but awareness of it is scarce. (Jonathan Capehart, 1/6)