First Edition: February 25, 2013

Today's headlines include reports about the looming sequester, how health programs fit into the debate and how the automatic budget cuts are being viewed by various stakeholders.  

Kaiser Health News: Plans To Expand Florida Medicaid Welcomed And Feared
Kaiser Health News staff writer Phil Galewitz, working in collaboration with The Washington Post, reports: "Almost overnight, Florida has gone from being an ardent opponent of the federal health care law to a laboratory for an ambitious experiment under the law" (Galewitz, 2/24). Read the story.

Kaiser Health News: Capsules: 2 Hill Panels Examining Changes To Medicare
Now on Kaiser Health News' blog, Mary Agnes Carey reports: "With $85 billion in automatic federal spending cuts set to take effect on Friday and predictions of economic disruption, much of official Washington is focused on the 'blame game.' Publicly, there has been no sign that Congress or administration officials has made any progress on averting these cuts or finding common ground on tackling the country's fiscal problems" (Carey, 2/25). Check out what else is on the blog. 

Kaiser Health News also tracked weekend health policy headlines, including reports about Virginia's work on the Medicaid expansion (2/24).

The New York Times: Budget Impasse Signals A Shift In GOP's Focus
But at the heart of the battle over sequestration — the nearly $1 trillion in budget cuts that are scheduled to begin on Friday and accelerate over the next decade — are fundamental misunderstandings between the two parties over their respective priorities. During the 2011 negotiations to raise the nation's statutory borrowing limit, Mr. Obama wanted an onerous "trigger" to force both sides to reach a compromise on deficit reduction. For Democrats, the bludgeon that would drive them to negotiate changes to entitlement programs like Medicare and Social Security would be cuts to domestic programs like child nutrition and national parks. For Republicans, the president wanted automatic tax increases to force a compromise on the broader tax code (Weisman and Parker, 2/24).

The New York Times’ Political Memo: A Complex Role For Medicare
In The Standoff In Washington But the politics of one core dispute between Democrats and Republicans — what to do about Medicare — are changing. And some of those changes complicate President Obama's agenda, even as he continues to flex his postelection muscle (Harwood, 2/24).

Los Angeles Times: Neither Side Blinks In Federal Budget Standoff
Now the cuts that both said would never happen are only days away. With some of the largest government programs, including Medicaid and Social Security, fully walled off from the cuts, and Medicare only partially exposed, the reductions in other federal accounts work out to about 13% for defense and 9% for domestic spending for the rest of this year, according to the government's Office of Management and Budget. At first, the public likely will not notice huge changes. Many furlough notices for federal workers take at least 30 days to kick in, for example, and the effect on other programs will vary in timing (Mascaro, 2/23).

The New York Times: As Governors Meet, White House Outlines Drop In Aid To States
In an effort to put pressure on Congressional Republicans, the White House warned on Sunday that automatic budget cuts scheduled to take effect this week would have a devastating impact on programs for people of all ages in every state (Pear, 2/24).

The Washington  Post: White House Releases State-By-State Breakdown Of Sequester's Effects
Republicans questioned whether the sequester would be as harmful as the White House predicted and worked on a proposal that could preserve the cuts while giving the administration more discretion to choose how to implement them. Democrats expressed worry that they might be forced to accept the cuts if the public outcry is not loud enough in coming weeks (Goldfarb and Kane, 2/24).

The Associated Press/Los Angeles Times: Governors From Both Parties Condemn Forced Federal Budget Cuts
At their weekend meetings, governors were focusing on ways to boost job development, expand their state economies, restrict gun violence and implement the new healthcare law approved during President Obama's first term. Some Republican governors have blocked the use of Medicaid to expand health insurance coverage for millions of uninsured; others have joined Democrats in a wholesale expansion as the law allows. The Medicaid expansion aims to cover about half of the 30 million uninsured people expected to eventually gain coverage under the healthcare overhaul. Yet for many governors, the budget fight remains front and center and fuels a pervasive sense of frustration with Washington (2/23).

The New York Times: In Impasse, New York Would Face Steep Cuts
The three states would also face nearly $1 million in curtailments to programs providing vaccinations to children against diseases like mumps, rubella, tetanus, measles, whooping cough, hepatitis B and influenza. If enacted, the cutbacks would mean that 12,670 fewer children would be receiving vaccinations in all three states, according to the White House estimate. … Programs providing meals for older people would also be hit. New York, New Jersey and Connecticut would face about $2.1 million in cuts to such programs, the White House estimated (Hernandez, 2/24).

The Washington Post: Jindal: Delaying Medicaid Expansion, Health Care Exchanges Could Avert Sequester
Louisiana Gov. Bobby Jindal (R) suggested Sunday that delaying elements of President Obama's health care law could help avert the across-the-board spending cuts known as the sequester (Sullivan, 2/24).

Politico: Jindal Pitches Obamacare Delay
Louisiana Gov. Bobby Jindal has one idea to help avoid the looming sequester: Use Obamacare. The Republican governor said delaying the expansion of Medicaid and delaying the health care exchanges created under the Affordable Care Act would help find the funds to offset the coming automatic budget cuts (Kim, 2/24).

The New York Times: Panel On Health Care Work Force, Lacking A Budget, Is Left Waiting
One of the biggest threats to the success of President Obama’s health care law comes from shortages of doctors, nurses and other health care professionals. But a 15-member commission created to investigate the problem has never met in two and a half years because it has no money from Congress or the administration (Pear, 2/24).

The Washington Post: Big Health Insurance Rate Hikes Are Plummeting
The number of double-digit rate increases requested by health insurers has plummeted over the past four years, according to a Friday report from the Obama administration (Kliff, 2/23).

The Wall Street Journal's Washington Wire: White House Doesn't Budge On Health Premiums
The Obama administration isn't budging on restrictions in the federal health-care law over how much insurance companies can reduce premiums for younger consumers. Federal officials released final rules Friday confirming that insurers will not be allowed to charge older people more than three times the amount they charge younger people starting in 2014 (Radnofsky, 2/22).

Politico: Suits Hit Contraception Rule's 'Religious Burden'
The Obama administration is aggressively defending its contraception coverage policy in the courts, asking judges to require the companies bringing the lawsuits to provide contraceptives to their employees even before the legal fight over religious freedom is resolved (Haberkorn and Smith, 2/25).

The Washington Post: After Newtown, Support For Mental-Health Spending Grows
Mental-health advocates from coast to coast are seizing upon a rare and unexpected chance to stem the years-long tide of budget cuts and plug gaps in the nation's patchwork mental-health-care system. In the wake of the massacre in Newtown, Conn., lawmakers from both parties, along with notoriously tight-belted governors, are pushing to restore some of the estimated $4.3 billion in mental-health spending that was slashed from state budgets between 2009 and 2012. At the same time, they are weighing new initiatives, such as adding beds at psychiatric hospitals and improving treatment for inmates with behavioral disorders (Dennis and Sun, 2/23). 

The Texas Tribune/New York Times: Advocates Seek Mental Health Changes, Including Power To Detain
Hospitals do not have legal authority to detain people who voluntarily enter their facilities in search of mental health care but then decide to leave. It is one of many holes in the state’s nearly 30-year-old mental health code that advocates, police officers and judges say lawmakers need to fix. In a report last year, Texas Appleseed, a nonprofit advocacy organization, called on lawmakers to replace the existing code with one that reflects contemporary mental health needs (Grissom, 2/23).

The New York Times: 'Bloodless' Lung Transplants Offer Hint At Surgery's Future
The reason: Ms. Tomczak, who was baptized at age 12 as a Jehovah’s Witness, insisted for religious reasons that her transplant be performed without a blood transfusion. The Witnesses believe that Scripture prohibits the transfusion of blood, even one’s own, at the risk of forfeiting eternal life. Given the complexities of lung transplantation, in which transfusions are routine, some doctors felt the procedure posed unacceptable dangers. Others could not get past the ethics of it all. With more than 1,600 desperately ill people waiting for a donated lung, was it appropriate to give one to a woman who might needlessly sacrifice her life and the organ along with it? (Sack, 2/24).

Los Angeles Times: Jerry Brown Wants Wiggle Room From Feds On Healthcare
(Gov. Jerry) Brown hopes to coordinate with other state leaders about how to expand coverage to the poor under the federal Medicaid program. Speaking to reporters at the National Governors Assn. winter meetings in Washington on Saturday, Brown said he wants to "build support among the governors for an appropriate state rule in the Medicaid expansion." With billions of dollars at stake, he said it was "absolutely critical that states have the authority they need to manage this very complex and expensive program" (York, 2/23).

The Wall Street Journal: GOP Pledges Medicaid Probe
New York state Senate Republicans plan to investigate the state's Medicaid program after news reports and a congressional audit alleged it was fraught with waste and mismanagement (Nahmias, 2/22).

The Washington Post: White House Moves To Make Federally Funded Research Open To The Public
The White House moved Friday to make nearly all federally funded research freely available to the public, the latest advance in a long-running battle over access to research that exploded into view last month after the suicide of free-information activist Aaron Swartz. In a memo, White House science adviser John P. Holdren directed agency leaders to develop rules for releasing federally backed research within a year of publication in scientific or technical journals (Vastag and Brown, 2/22).

The Wall Street Journal: Drug Makers Recall Omontys Anemia Medication
The recall comes as a sharp blow to Affymax, a small biotechnology firm based in Palo Alto, Calif., that developed Omontys and has no other late-stage drugs in its pipeline. The move affects thousands of kidney-disease patients who have been receiving the drug, promoted as a cheaper and more convenient alternative to Amgen Inc.'s blockbuster Epogen, which holds a near-monopoly in treating anemia in that market (Walker, 2/24).

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