Competition Key Ingredient To Success Of State Health Exchanges


Stateline reports that even some of the strongest health exchange
enthusiasts are concerned that some states will still only have limited
insurance choices for consumers. Meanwhile, in other news, the Arkansas
Medicaid expansion model gains momentum, Florida’s efforts face
continued complications, Arizona’s expansion standoff continues and the
Missouri Senate rejects the concept. Also, the shape of Ohio’s
compromise exchange is beginning to emerge.

Stateline: Lack Of Competition Might Hamper Health Exchange

The White House sums up the central idea behind the health care
exchanges in the new federal health law with a simple motto: “more
choices, greater competition.” But even some stalwart supporters of the
Affordable Care Act worry that in many states, people won’t have a lot
of health insurance choices when the exchanges launch in October. Health
economists predict that in states that already have robust competition
among insurance companies—states such as Colorado, Minnesota and
Oregon—the exchanges are likely to stimulate more. But according to
Linda Blumberg of the Urban Institute, “There are still going to be
states with virtual monopolies” (Vestal, 4/23).

Health News Florida: ‘Private Option‘ Plan, Florida Model, Passes In Ark.

Arkansas’ state legislature passed a model plan to expand Medicaid last
week, even though its Legislature is dominated by Republicans and the
measure had to pass by a three-quarters vote, the Associated Press
reports. The Arkansas plan is the model for Florida state Sen. Joe
Negron’s plan, which would accept an estimated $51 billion in federal
funds over 10 years to expand insurance to about 1 million of the
state’s low-income uninsured (Gentry, 4/22).

Miami Herald: Legislators Poised To Adjourn With No Medicaid Plan

As the clock winds down on the legislative session, Florida lawmakers
are sending signals that they are likely to adjourn without resolving
the issue of whether to accept federal Medicaid money to insure the
state’s poorest residents. “It’s not something you put together in a
week,”’ said Sen. John Thrasher, R-St. Augustine, chairman of the Senate
Rules Committee and a close adviser to Senate President Don Gaetz.
“It’s a very big, complicated issue and these issues take some time.” He
said he does not expect there would be political repercussions if the
Republican-led Legislature waits another year (Klash, 4/22).

Arizona Republic: Brewer, GOP In Medicaid Standoff

Three months after she stunned political observers and made her case for
expanding Medicaid coverage in Arizona, Gov. Jan Brewer is no closer to
reaching agreement with Republican legislative leaders on the issue,
which has driven a wedge through GOP ranks and is delaying work on the
state budget. By most accounts at the Capitol, Brewer has just enough
votes in the House and Senate to get expansion approved. Even some
lawmakers who oppose the plan predict it eventually will pass, owing in
large part to the power of the governor’s veto pen and her reputation
for tenacity, as well as pressure from top-flight lobbyists and
heart-tugging health-care crisis stories (Reinhart, 4/22).

The Associated Press: Mo. Senate Votes Down Federal Medicaid Expansion

Republican senators have made it clear that there will be no Medicaid
expansion in Missouri this session. The Republican-led Senate voted down
a Democratic attempt Monday night to insert $890 million of federal
funds into Missouri’s budget to expand Medicaid eligibility to an
estimated 260,000 lower-income adults (4/23).

Cleveland Plain Dealer: Ohio’s Medicaid Expansion Alternative Could Use Private Insurance

For the first time since Gov. John Kasich won national attention by
supporting Medicaid expansion, a clear picture is emerging on how the
Republican governor’s compromise with federal regulators could work.
Some uninsured Ohioans would be enrolled in the state’s traditional
Medicaid program, while others would sign up for private health
insurance using federal funding, said Greg Moody, director of Ohio’s
Office of Health Transformation. The proposal, which Kasich hopes to
sell to GOP lawmakers reluctant to support an outright Medicaid
expansion, has been dubbed “The Ohio Plan.” And it differs from the
standard federal expansion program on one crucial point: It puts some
enrollees in the private insurance market (Tribble, 4/22).

This is part of Kaiser Health News‘ Daily Report – a summary
of health policy coverage from more than 300 news organizations. The
full summary of the day’s news can be found here and you can sign up for e-mail subscriptions to the Daily Report here. In addition, our staff of reporters and correspondents file original stories each day, which you can find on our home page.

John Kasich

John Kasich (Photo credit: Wikipedia)

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Viewpoints: ‘Big Risks’ Of Buying Private Insurance With Medicaid Dollars; One Month Of Sequestration


US residents with employer-based private healt...

US residents with employer-based private health insurance, with self insurance, with Medicare or Medicaid or military health care and uninsured in Million; U.S. Census bureau: Income, Poverty, and Health Insurance Coverage in the United States: 2007 (Photo credit: Wikipedia)

Topics: Medicaid, Medicare, Health Reform, States, Health Costs, Women’s Health, Uninsured

Apr 01, 2013

The New York Times: Using Medicaid Dollars For Private Insurance
The Obama administration and Republican officials in several states are exploring ways to redirect federal money intended to expand Medicaid, the main public insurance program for the poor, and use it instead to buy private health insurance for Medicaid recipients. The approach could have important benefits for beneficiaries and for the future of health care reform. But the idea also carries big risks. Federal officials will need to enforce strict conditions before agreeing to any redirection of Medicaid dollars that were originally intended to enlarge the Medicaid rolls (3/31).

Forbes: The Arkansas-Obamacare Medicaid Deal: Far Less Than It First Appeared
When Arkansas Gov. Mike Beebe (D.) first announced that he had reached a deal with the Obama administration to use the Affordable Care Act‘s private insurance exchanges to expand coverage to poor Arkansans, it seemed like an important, and potentially transformative, development. … A Good Friday memo from the U.S. Department of Health and Human Services, however, splashes cold water on that aspiration. It’s now clear that the Beebe-HHS deal applies a kind of private-sector window dressing on the dysfunctional Medicaid program, and it’s not obvious that the Arkansas legislature should go along (Avik Roy, 4/1).

USA Today: ‘Sequester’ Still Looks Stupid, As Planned: Our View
Congress and the White House exempted some programs when they finalized the original deal, and the spending bill they agreed to last month to keep the government open to Sept. 30 spared some vital functions — food inspections, for example. But not enough. Nor does the sequester seriously address the major spending driver: health care costs. The best outcome would be for the sort of anger that forced Congress and the White House to re-open the government in 1996 to push Congress and the White House back to the table on a realistic budget deal this year. The outlines of that deal have been obvious for too long: Trim entitlement programs such as Medicare and Social Security, overhaul the hopelessly inefficient and corrupt tax code to bring in more money, and cut defense and domestic programs with a scalpel instead of an ax (3/31).

USA Today: ‘Sequester’ Needed To Rein In Spending: Another View
Let’s get real on the “sequester.” One month in, not much has changed. Nor is it likely to. Rather than devastating the federal government, the sequester is necessary to rein in the unbridled growth of federal spending. The sequester is certainly flawed. It’s a blunt instrument leaving the biggest spending drivers, entitlements, virtually untouched (Alison Fraser, 3/31).

The Wall Street Journal: The Liberal Medicare Advantage Revolt
A big political story this year is likely to be Democrats turning on their White House minders as the harmful and unpopular parts of the Affordable Care Act ramp up. On the heels of the recent 79-20 Senate uprising against the 2.3% medical device tax, now comes the surge of Democrats pleading on behalf of Medicare Advantage. Liberals have claimed for years to hate this program, but by now Advantage provides private insurance coverage to more than one of four seniors. And those seniors like it (3/29).

The Chicago Tribune: Scrubbing Medicaid
In January, Illinois launched an effort to scrub ineligible people from the state’s Medicaid rolls. … The initial results of this audit are … astonishing: Of the first 20,500 recipients screened by an outside contractor, the auditors recommend that 13,709 be removed from the rolls. Yes, that’s two-thirds of the first group screened, flagged as ineligible to receive their current Medicaid benefits. How so? In some cases, the recipients make too much money to qualify. In other cases, they don’t live in Illinois (3/31).

The New York Times: The Campaign to Outlaw Abortion
Anti-abortion groups have been trying to re-impose restrictions on abortion rights for 40 years, but the Legislature and governor of North Dakota have taken this attack on women’s reproductive health and freedom to a shocking new low … The clear message is the need for a stepped-up effort to hold state officials electorally accountable for policies that harm women in states where right-wing Republicans control the machinery of government (3/29).

The Seattle Times: State Senate Health Care Committee Should Vote On Abortion Measure
After the Senate Health Care Committee hearing on the Reproductive Parity Act Monday, members should vote for it before a key deadline Wednesday. State lawmakers do not need to complicate this issue. House Bill 1044 would maintain insurance coverage for women seeking abortions after federal health reforms take effect (3/31).

Los Angeles Times: The Starbucks Syndrome In Healthcare
Medicare statistics, for example, reveal that Los Angeles leads the nation in the amount of medical services provided during the last six months of a person’s life. Healthy seniors here are also big consumers of healthcare, getting about 65% more MRI studies and utilizing ambulances three times as often as seniors elsewhere. Commercial insurance data point to similar patterns in the healthcare of the younger population in Southern California. What explains such avid use of medical services. … Part of the problem is that Angelenos approach healthcare as they do other kinds of consumption. They expect their CT scans, when they want them, in much the same way they expect their decaf caramel extra hot low-fat macchiatos. (Daniel J. Stone, 3/31).

Los Angeles Times: Bump In The Road For Healthcare Law
One figure in a new report neatly summarizes the potential pitfalls for Obamacare: 30.1%. That’s how much premiums could rise next year, on average, for the roughly 1.3 million moderate- and upper-income Californians who buy individual health insurance policies. Most of that increase is attributable to the insurance reforms in the 2010 law, also known as the Affordable Care Act. The bill’s title is not ironic — its provisions will slow the growth of healthcare costs and lead over time to a more rational and efficient system. But the transition will have some rough patches, and we’re about to hit one (3/29).

Houston Chronicle: The Affordable Care Act Is A Poor Solution
Senator Orrin Hatch has speculated that the Affordable Care Act was designed to fail. A close look at the Act’s contents and history suggests he may be right. The Affordable Care Act is nothing more than a political stopgap, a waypoint on the road to something that might work. Republicans could stand around complaining or we could seize this opportunity to determine what comes next (Chris Ladd, 4/1).

Richmond Times-Dispatch: Moving Forward On Medicaid: More Important Than Ever
As a community physician for more than eight years, I’ve seen how medical care helps keep families strong and secure. When parents and their kids can access health care — and have a way to pay for it — they are much less likely to face unpaid bills or have to put off doctor visits. Instead of worrying about how their family is going to survive, they can focus on how their family is going to thrive. Unfortunately, too many Virginians — more than a million, in fact — find that getting health care is a real challenge because they don’t have insurance (Dr. Christopher Lillis, 4/1).

The Wall Street Journal: The Skinny On Anti-Obesity Soda Laws
New York Mayor Michael Bloomberg’s anti-obesity campaign to ban the sale of certain sugary drinks in large servings, especially sodas, was struck down last month in state court. A proposal for a penny-per-ounce excise tax on sweetened beverages also floundered in Vermont’s House of Representatives in February. … As an economist, I have two big gripes with such paternalistic public-health initiatives: The proposals aren’t grounded in data or compelling economic models, and soda taxes might catalyze a dismal chain reaction, with escalating government intrusions on personal freedom (Michael L. Marlow, 3/31).

Oregonian: Don’t Take Portland’s Sick-Leave Mistake Statewide: Agenda 2013
By voting to mandate paid sick leave last month, Amanda Fritz and her city council colleagues furthered Portland’s reputation as a place where businesses fear to tread. One way to protect city employers burdened by this mandate is to adopt a similar requirement statewide, erasing a competitive advantage a restaurant in, say, Beaverton might have over one in Portland. In other words, bail out Portland by making things tougher all over (3/31).

USA Today: ER Key To Curb Painkiller Abuse
Most opioids are prescribed in the doctor’s office, which has prompted some states to restrict primary care physicians like myself from prescribing them and to encourage referrals to pain specialists. New York City Mayor Michael Bloomberg has taken these curbs a step further by focusing on emergency departments. In January, he announced a voluntary initiative to limit prescription of opioid painkillers in the emergency rooms of the city’s 11 public hospitals. This approach should be expanded across the nation. From 2004 to 2009, the number of emergency visits in New York City hospitals related to opioid abuse or misuse more than doubled (Dr. Kevin Pho, 3/31).

This is part of Kaiser Health News’ Daily Report – a summary of health policy coverage from more than 300 news organizations. The full summary of the day’s news can be found here and you can sign up for e-mail subscriptions to the Daily Report here. In addition, our staff of reporters and correspondents file original stories each day, which you can find on our home page.

Overlap In Competing Budget Proposals Points Way To Deal


English: President George W. Bush and Presiden...

English: President George W. Bush and President-elect Barack Obama meet in the Oval Office of the White House Monday, November 10, 2008. (Photo credit: Wikipedia)

Topics: Health Costs, Medicare, Medicaid, Politics, States

Dec 05, 2012

The Associated Press reports the White House and House Republicans have identified areas of significant overlap that could form the basis for an agreement after posturing gives way to actual bargaining.

The Wall Street Journal: GOP Deficit Plan Irks Conservatives
The conservatives’ attitude could nonetheless complicate Mr. Boehner’s mission as he strives to negotiate with a re-elected Democratic president without losing so many Republican votes that his leadership would be in peril. GOP leaders said the criticism underscores how much Mr. Boehner’s proposal was an attempt at compromise, while Mr. Obama’s proposal, which would raise $1.6 trillion in new taxes, was not (Bendavid and Lee, 12/4).

The Associated Press/Washington Post: Hot Rhetoric Aside, There’s Overlap In Competing Fiscal Offers That Could Form Basis Of A Deal
Both sides now concede that tax revenue and reductions in entitlement spending are essential elements of any deal. If the talks succeed, it probably will be because House Speaker John Boehner yields on raising tax rates for top earners and the White House bends on how to reduce spending on Medicare and accepts some changes in Social Security (12/4).

Los Angeles Times: Republicans Drop Ryan Budget Plan In ‘Fiscal Cliff’ Negotiations
The austere federal budget plan drafted by Rep. Paul D. Ryan and embraced by Republicans as a sweeping reimagining of government has hit a roadblock on the way to the so-called fiscal cliff. Top Republicans, including Ryan, insisted this was not the end of the plan and pledged to “support and advance” its principles. But by sidestepping the plan, the House leadership sidelined the push for a transformative overhaul of federal entitlements — a move that quickly sparked dissent from the party’s conservative wing (Mason and Mascaro, 12/5).

The Washington Post: Governors Urge Obama, Lawmakers To Avoid ‘Fiscal Cliff’
Although some federal programs especially key for states — notably Medicaid — are exempt, many other federal grants to states would be cut. The Pew report said 18 percent of federal grant money would be subjected to the automatic hit. That includes Title I funding, which covers education programs for the poor and the disabled, medical research money, and health and human resource programs (Fletcher and Helderman, 12/4).

Stateline: In Fiscal Cliff Talks, Governors Get White House Seat
A bipartisan group of governors has called on Washington to find a solution — any solution — to the nation’s budget woes as the federal government nears its so-called ‘fiscal cliff.’ “It’s not acceptable to have failure when it comes to the fiscal cliff,” said Utah Republican Governor Gary Herbert, following a meeting Tuesday (December 4) with President Obama and five other governors. “We need the good people on both sides of the aisle to come together.” The governors — three Republicans and three Democrats — said they left the White House meeting feeling “encouraged” that Obama would strike a deal with Congressional Republicans before December 31, the date that would trigger a series of spending cuts and tax hikes to deal with the federal deficit but that economists say would plunge the nation back into recession (Clark and Malewitz, 12/5).

CQ HealthBeat: Governors Want To Be Heard In Fiscal Cliff Fight
Democratic and Republican governors who met Tuesday with the president and congressional leaders said they want a seat at the table when negotiations occur on spending cuts and major changes in health programs that could upend their state budgets. The bipartisan National Governors Association gave few specifics in a conference call with reporters after their meeting with President Barack Obama. The governors were equally vague when they spoke to reporters at the White House after their meeting with the president. But the state leaders said they want to be sure they’re not shut out from the deal-making among the White House and congressional Republicans and Democrats (Norman, 12/4).

This is part of Kaiser Health News‘ Daily Report – a summary of health policy coverage from more than 300 news organizations. The full summary of the day’s news can be found here and you can sign up for e-mail subscriptions to the Daily Report here. In addition, our staff of reporters and correspondents file original stories each day, which you can find on our home page.

Health Care Programs A Clear Target In Deficit Reduction Efforts


Topics: Health Costs, Medicare, Medicaid, Politics

Dec 05, 2012

As negotiators debate proposals to trim entitlement programs such as Medicare and Medicaid, stakeholders ranging from public hospitals to physician groups lobby to protect their interests.

Kaiser Health News: How The ‘Fiscal Cliff’ Affects Health Care: Six Questions
The impending “fiscal cliff” is a package of automatic spending cuts and tax hikes set to kick in next month unless President Barack Obama and Capitol Hill agree on a way to stop them. … The president and congressional Democrats have said they will reduce spending on entitlements, including Medicare, if Republicans will agree to increase tax rates on the highest earners. While Republicans have agreed to more revenue, they oppose increasing tax rates, preferring to focus on closing loopholes and eliminating some deductions. Here are a few questions and answers about what could happen in the weeks before the end-of-year deadline (Carey, 12/4).

Modern Healthcare: Likely Healthcare Deficit Targets Come Into View
As federal lawmakers remain stuck in negotiations to avert the fiscal cliff, healthcare experts say they’re hearing the Medicaid provider tax, evaluation and management services and graduate medical education are payment areas lawmakers could cut to achieve entitlement-program savings as part of a deficit-reduction deal. White House Communications Director Dan Pfeiffer said in a statement that a letter from House Republicans on Monday—intended as a counteroffer to an administration proposal last week—”includes nothing new and provides no details on which deductions they would eliminate, which loopholes they will close or which Medicare savings they would achieve” (Zigmond, 12/4).

CQ HealthBeat: Zandi Says Credible Cliff Deal Requires $600 Billion In Medicare, Medicaid Cuts
Economist Mark Zandi appeared to give the House Republican leadership’s proposal for entitlement changes a boost Tuesday by saying that a deficit reduction plan that would get the economy back on track would generate $600 billion to $700 billion in Medicare and Medicaid savings over 10 years. The framework House Speaker John A. Boehner, R-Ohio, proposed Monday includes $600 billion in Medicare and Medicaid savings. Last year Democrats first said they are willing to find $500 billion and then said they would agree to $400 billion in savings from the programs, according to people familiar with the negotiations. In his initial fiscal cliff proposal, President Barack Obama called for health care program savings closer to $400 billion (Reichard, 12/4).

The Hill: Safety-Net Hospitals: Don’t Cut Medicaid
A coalition of public hospitals has launched a new campaign against cuts to Medicaid that could come as part of a deficit-reduction deal. At ProtectMedicaid.org, the National Association of Public Hospitals and Health Systems (NAPH) argues the low-income health insurance program is essential for a healthy economy. “Medicaid ensures access to quality healthcare for more than 60 million people … all at a lower per-beneficiary cost than private insurance and Medicare,” NAPH writes (Viebeck, 12/4).

The Hill: Hoyer: Entitlement Benefit Cuts On The Table In Talks With GOP On ‘Fiscal Cliff’
Entitlement cuts should remain on the table as party leaders seek to hash out an end-of-the-year budget deal, Rep. Steny Hoyer (D-Md.) said Tuesday. A number of Democratic leaders — including Reps. Nancy Pelosi (Calif.), John Larson (Conn.) and Xavier Becerra (Calif.) — have said they would support some spending reductions in Medicare, but that cuts to direct benefits should not be a part of the negotiations. Along with Senate Majority Leader Harry Reid (D-Nev.), they also maintain that Social Security reform has no place at all in the “fiscal cliff” talks (Lillis, 12/4).

The Hill: Baucus: Don’t Shift Health Costs To Seniors In ‘Fiscal Cliff’ Deal
A deal to avoid going over the “fiscal cliff” should include controlling healthcare spending but shouldn’t shift costs to seniors, Sen. Max Baucus (D-Mont.) said Tuesday. Baucus acknowledged that rising healthcare costs are a burden on federal spending, and he said controlling those underlying costs is the way to tackle entitlements. “Shifting costs to seniors is not the solution,” Baucus said. “We cannot break the promise of Medicare and Social Security.” Baucus chairs the powerful Senate Finance Committee, which has jurisdiction over Medicare and other healthcare programs. He’s also up for reelection in 2014, and has been angling for a key position in negotiating a deal to avoid the fiscal cliff of automatic spending cuts and tax increases set to hit next month (Baker, 12/4).

Roll Call: Health Care Professionals Descend On Washington
From now through the end of the year, lawmakers can look forward to hearing from physicians, family practitioners, nurses, home health workers and anyone else who provides care to patients. On Nov. 29, four hospital executives held a briefing in the Rayburn House Office Building, while members of the American Academy of Orthopaedic Surgeons visited Capitol Hill. More such events by a variety of medical professionals are planned in the coming weeks. The visits are part of separate, but equally intense, efforts by health care groups to protect their members from potential Medicare payment cuts, especially in the ongoing deficit-reduction negotiations (Ethridge, 12/4).

Politico Pro: Another Patch For ‘Doc Fix’ – If Fiscal Cliff Doesn’t Interfere
The “doc fix” problem comes up almost every year, but this year the fiscal cliff talks could make a difference. The fiscal cliff negotiations could bog down even another temporary solution to the perennial Sustainable Growth Rate problem. But there’s also a long-shot chance that the cliff talks provide an opening to finally get full repeal of the outdated SGR formula. Still, the most likely outcome, according to several industry and K Street sources, is another patch: $25 billion for a yearlong fix. Physician groups, including the American Medical Association, are urging lawmakers to include the first steps toward SGR repeal in any grand bargain framework that would be filled in next year, according to Capitol Hill sources and health care lobbyists (Haberkorn, 12/4).

NPR: The Perilous Politics Of The Health Insurance Tax Break
There’s not much in health care that economists agree on. But one of the few things that bring them together is the idea that excluding the value of health insurance from federal taxes is nuts. “It just doesn’t make sense,” says Jonathan Gruber, an MIT health economist and author of Health Care Reform. “And it’s important to emphasize in this world where economists seem to agree about nothing, this is something where there’s just broad and universal agreement” (Rovner, 12/4).

Meanwhile, polls suggest the public supports protecting Medicare and other entitlement programs –

National Journal: Poll Shows Public Wants Entitlements Left Untouched
As Democrats and Republicans in Washington remain at odds over how to reshape the nation’s finances and prevent it from falling over the fiscal cliff, the public is supportive of cutting spending and at the same time more protective than ever of entitlement programs such as Medicare. Traditional cleavages of class and race, age and income, and even region are apparent in the latest edition of the United Technologies/National Journal Congressional Connection Poll, but they are far more muted than on issues such as President Obama’s reelection or the fate of his signature health care law. When it comes to the tax and spending issues that are at the heart of negotiations in Washington, primarily between the president and House Speaker John Boehner, the public is eager to defend the entitlement programs that both leaders have acknowledged need to be reined in if the nation’s $16 billion debt is to stop growing, let alone shrink (Cooper, 12/4).

This is part of Kaiser Health News’ Daily Report – a summary of health policy coverage from more than 300 news organizations. The full summary of the day’s news can be found here and you can sign up for e-mail subscriptions to the Daily Report here. In addition, our staff of reporters and correspondents file original stories each day, which you can find on our home page.

President Barack Obama talks with Democratic H...

President Barack Obama talks with Democratic House Majority Leader Steny Hoyer. (Photo credit: Wikipedia)

Fiscal Cliff: Lame Duck Budget Talks Begin


Topics: Politics, Medicaid, Medicare, Health Costs

Nov 21, 2012

News sources report on the beginnings of negotiations among White House and congressional staff.

Politico: Rough Start For Fiscal Cliff Talks
The opening round of negotiations this week between White House and senior GOP congressional staffers left both sides pessimistic about their ability to reach a quick deal on averting the fiscal cliff, according to sources familiar with the talks. Hill Democrats say Republicans aren’t serious about crafting a deal that President Barack Obama can accept. … For their part, Republicans remain unconvinced that Obama and Senate Majority Leader Harry Reid (D-Nev.) will make the kind of significant concessions on entitlement programs like Medicare and Medicaid that would make them agree to tax rate hikes (Sherman, Bresnahan and Budoff Brown, 11/20).

CNN Money: Deficit Reduction? Not Without Entitlement Reform
The nation is staring into the fiscal cliff, which involves $7 trillion worth of spending increases and tax cuts over a decade. If no other action is taken, it will start to take effect in January, kicking off with $491 billion in deficit reduction in fiscal 2013, a large chunk of which will come from the expiration of the Bush tax cuts. Another $54 million in spending cuts are set to take place as a result of last year’s debt-reduction deal. Empowered by his re-election victory, Obama is centering the conversation on increasing taxes on the wealthy. House Republicans, who lost seats on November 6, have said they are willing to talk about raising revenue if it is accompanied by spending cuts and entitlement reform. House Speaker John Boehner called on Democrats Monday to come forward with proposals (Luhby, 11/21).

Meanwhile, interest groups stake out their positions and brace for cuts.

Politico: Medicare Cuts Give Health Providers Jitters
The $716 billion in Medicare “cuts” that got so much attention in the presidential election have already begun sinking their teeth into health care providers. And there are widespread jitters that any further cuts as part of a year-end deal to stave off sequestration or strike a “grand bargain” for a long-term fiscal deal would deeply gouge some providers, if not put them out of business (Norman, 11/20).

The Hill: Nursing Homes Tout Quality Improvement, Blast Sequester
The lead advocacy group for nursing homes touted high customer satisfaction in its annual survey, released Tuesday, and cautioned that automatic federal spending cuts could hamper the industry. The American Health Care Association (AHCA) found that short-stay patients’ satisfaction reached 87 percent in 2012 as staff turnover decreased and individuals received more time with nurses. The group has been pushing Congress to stop the sequester’s looming cuts to Medicare, which AHCA President Mark Parkinson said could “undo this progress” (Viebeck, 11/20).

Los Angeles Times: Union Ads Take New Tack: Praising GOP Members
Labor unions seeking a fiscal solution that protects entitlement programs and raises taxes on the rich are trying the carrot approach before taking the stick to lawmakers. A new six-figure ad campaign backed by three major unions includes radio spots praising four Republican House members as “leaders willing to put people ahead of partisan politics.” … The commercials call on the lawmakers “to stand up for us by investing in job creation, extending the middle class tax cuts, and protecting Medicare, Medicaid and education from cuts.” (Gold, 11/20).

English: President Barack Obama signs the Tax ...

English: President Barack Obama signs the Tax Relief, Unemployment Insurance Reauthorization, and Job Creation Act of 2010 at the White House. (Photo credit: Wikipedia)

This is part of Kaiser Health News‘ Daily Report – a summary of health policy coverage from more than 300 news organizations. The full summary of the day’s news can be found here and you can sign up for e-mail subscriptions to the Daily Report here. In addition, our staff of reporters and correspondents file original stories each day, which you can find on our home page.

Fiscal Cliff Talks Moving Slowly; Boehner Wants Health Law On The Table


Official portrait of United States House Speak...

Official portrait of United States House Speaker (R-Ohio). (Photo credit: Wikipedia)

Topics: Health Costs, Medicare, Medicaid, Politics, Health Reform

Nov 23, 2012

The New York Times: Seeking Ways To Raise Taxes But Leave Tax Rate As Is
The Congressional leaders had said that aides would provide concrete ideas by Wednesday on deficit reduction targets through revenue increases and changes to social programs, especially Medicare. White House and Congressional staff members did meet early this week, but no such ideas were produced. Democrats want Republicans to first define what they mean by “structural changes” to Medicare and Medicaid. Republicans say Mr. Obama should make the first move, using what they say is the political capital gained by his re-election (Weisman, 11/22).

The New York Times: Boehner’s Rearguard Guerrilla Action
No one thought it would be easy for President Obama and Republicans in Congress to negotiate a package of tax increases and spending cuts over the next few weeks. But now Speaker John Boehner is trying to make the process even harder. In an op-ed article for the Cincinnati Enquirer today, Mr. Boehner said that “we need to repeal Obamacare” because it adds to the debt and is unaffordable. As a result, he wrote, “the law has to stay on the table as both parties discuss ways to solve our nation’s massive debt challenge” (Firestone, 11/21).

The Hill: Boehner: ‘ObamaCare‘ Must Be On The Table In ‘Fiscal Cliff’ Negotiations
President Obama’s signature healthcare law has to be on the table for cuts as Congress tried to negotiate a deal to avoid the “fiscal cliff,” House Speaker John Boehner (R-Ohio) wrote in an op-ed. “We can’t afford it, and we can’t afford to leave it intact,” Boehner wrote in the Cincinnati Enquirer. “That’s why I’ve been clear that the law has to stay on the table as both parties discuss ways to solve our nation’s massive debt challenge” (Baker, 11/21).

ABC News: Boehner Wants ‘Obamacare’ In Fiscal Cliff Negotiations
The Speaker argued that the President’s healthcare law is too expensive and that any serious deal to tackle the deficit should include talks of a full repeal. “If we’re serious about getting our economy moving again, solving our debt and restoring prosperity for American families, we need to repeal Obamacare and enact common-sense, step-by-step reforms that start with lowering the cost of health care,” said Boehner (Ono, 11/21).

The Washington Post: Polls Offer Little Guidance For Politicians Tackling ‘Fiscal Cliff’
On Tuesday, Fix the Debt, a new bipartisan campaign led by business leaders and former policymakers, released a poll taken just before the election in which 72 percent of likely voters said the deficit and federal debt would be extremely or very important in deciding their vote. More than 90 percent of likely voters agreed that a bipartisan agreement, with “everything on the table,” was needed to address the problem. But three major unions put out a survey that appeared to show exactly the opposite: People would prefer that politicians focus on job creation over cutting deficits, and they oppose cuts to Social Security, Medicare, education, and police and fire protection to address deficits (Helderman and Clement, 11/22).

The Washington Post: After Election Euphoria, Liberals Begin To Worry About The Political Fights To Come
The focus of their distress is none other than Obama, who many left-leaning Democrats fear will go too far in reaching an accord with Republicans on the “fiscal cliff.” Liberal groups are gearing up media campaigns aimed at pressuring Obama and congressional Democrats to hold the line on proposed GOP cuts to Medicare, Medicaid and other entitlement programs (Turque, 11/21).

Los Angeles Times: Obama For America Weighs In On ‘Fiscal Cliff,’ Hints At Future Role
Obama for America provided a hint Wednesday of what its post-campaign role may be, sending supporters an email promoting the president’s stance on the fiscal cliff and encouraging recipients to spread the White House’s message (Little, 11/21).

The Hill: Another Republican Lawmaker Ditches Norquist Tax Pledge
Republican Sen. Saxby Chambliss (Ga.) on Wednesday said that addressing the nation’s looming “fiscal cliff” took precedence over honoring the anti-tax pledge he signed for conservative activist Grover Norquist. “I care more about my country than I do about a 20-year-old pledge,” said Chambliss to local Georgia television station 13WMAZ. “If we do it his way then we’ll continue in debt, and I just have a disagreement with him about that” (Mali, 11/22).

This is part of Kaiser Health News’ Daily Report – a summary of health policy coverage from more than 300 news organizations. The full summary of the day’s news can be found here and you can sign up for e-mail subscriptions to the Daily Report here. In addition, our staff of reporters and correspondents file original stories each day, which you can find on our home page.

Obama, Boehner Gird For Talks To Avert ‘Fiscal Cliff’


English: Barack Obama delivers a speech at the...

English: Barack Obama delivers a speech at the University of Southern California (Video of the speech) (Photo credit: Wikipedia)

Topics: Medicare, Politics, Health Costs

Nov 09, 2012

The two men who failed to reach a “grand bargain” to tame the national debt last year face a year-end deadline to avert automatic budget cuts. Media outlets assess the likelihood of a deal that might curb Medicare spending in exchange for revenue increases.

The Washington Post: Obama, Boehner Again Prepare To Tackle National Debt
Tuesday’s election returned to power the same men who have battled for two years over the nation’s budget problems: President Obama and House Speaker John A. Boehner (Ohio). … the political winds have shifted in Obama’s favor. … In Boehner’s view, aides said, the starting point should be the deficit-reduction deal that he and Obama were close to sealing in secret talks during the summer of 2011. With Congress locked in a bitter battle over the federal debt limit, the two tentatively agreed to slice $2.4 trillion from future borrowing in part by trimming Medicare and Social Security benefits and generating $800 billion in new revenue by overhauling the tax code (Montgomery and Goldfarb, 11/8).

USA Today: Boehner Sees Short-Term Budget Fix
House Speaker John Boehner, R-Ohio, says he will resist any effort to make major tax or spending changes in the lame duck session of Congress beginning next week, seeking instead a short-term deal to delay the year-end “fiscal cliff.” “I’ve never seen a lame duck Congress do big things. And as speaker I feel pretty strongly that a lame duck Congress shouldn’t do big things,” he said in an interview with USA TODAY. … Boehner is proposing what he calls a short-term “bridge” that would extend all of the tax rates for one year and buy more time to overhaul the federal tax code (Davis, 11/8).

The New York Times: Congress Sees Rising Urgency On Fiscal Deal
The accelerated activity in Washington showed that members of Congress believed the election had amplified the imperative to strike a deal. Still, signs that the two sides are open to some compromise are no guarantee that they can reach an agreement after warring for two years. Many Republicans will continue to resist any proposal that can be read as increasing taxes, and many Democrats will balk at changes in entitlement programs and spending cuts (Weisman, 11/8).

The Wall Street Journal: Pressure Rises On Fiscal Crisis
The White House and Republican lawmakers faced pressure to reach a solution to the looming budget crisis after a nonpartisan agency detailed Thursday how inaction would push the U.S. economy back into recession next year, and skittish investors continued to drive stocks lower. … Offering a framework rather than a detailed proposal could be attractive to the White House because of concerns that Republicans might reject a plan with too many details. The White House also was trying to decide whether any offer should include deficit-cutting proposals that Democrats might find unappealing, such as changes to Medicare and Social Security (Paletta, Lee and Bendavid, 11/8).

Politico: Behind Boehner’s New Tone
After his secret debt negotiations last year with President Barack Obama sparked a sharp round of blowback from conservatives, his leadership and members of his House Republican Conference, Boehner has launched a carefully choreographed campaign on the high-stakes fiscal cliff talks. … Boehner said he was prepared to raise new revenue for the government — but not increase tax rates — as long as the White House would agree to entitlement reform (Sherman, Budoff Brown and Bresnahan, 11/8).

The Associated Press: Obama Approaches ‘Fiscal Cliff’ Days After Victory
Obama is not expected to offer specifics immediately. His long-held position—repeatedly rejected by Republicans—is that tax rates on family income over $250,000 should jump back up to Clinton-era levels. Republicans say they’re willing to consider new tax revenue but only through drafting a new tax code that lowers rates and eliminates some deductions and wasteful tax breaks. And they’re insisting on cuts to Medicare, Medicaid and food stamps, known as entitlement programs in Washington-speak (Taylor, 11/9).

Official portrait of United States House Speak...

Official portrait of United States House Speaker (R-Ohio). (Photo credit: Wikipedia)

This is part of Kaiser Health News’ Daily Report – a summary of health policy coverage from more than 300 news organizations. The full summary of the day’s news can be found here and you can sign up for e-mail subscriptions to the Daily Report here. In addition, our staff of reporters and correspondents file original stories each day, which you can find on our home page.