First Edition: March 7, 2013

Today's headlines include reports detailing what to expect next week when the congressional budget debate kicks off.

Kaiser Health News: In Conservative Arizona, Government-Run Health Care That Works
Kaiser Health News staff writer Sarah Varney reports: "In a low-slung building in the vast desert expanse east of Phoenix, a small school of tropical fish peer out, improbably, from a circular tank into the waiting lounge of the Apache Junction Health Center. The hallways of the nursing home are still. Only half of the rooms are filled, and the men and women who live here seem surely in life’s final season. 'These are folks that have chronic cognitive and physical disabilities that are not going to improve,' said George Jacobson, administrator of the nursing home" (Varney, 3/7). Read the story.

Kaiser Health News: Medicaid Expansion Divides Florida GOP
WFSU’s Lynn Hatter, working in partnership with Kaiser Health News and NPR, reports: "As the Florida legislature convened this week, House Speaker Will Weatherford helped rally fellow Republicans opposed to expanding the state's Medicaid coverage to more than a million low-income residents, but he also acknowledged that his own family benefitted from a program for low-income families without health insurance" (Hatter, 3/7). Read the story.

Kaiser Health News: Capsules: House Spending Bill Cuts Funding For Exchanges
Now on Kaiser Health News’ blog, Mary Agnes Carey reports: "You don't hear much these days about Republicans trying to repeal the 2010 health care law. The Supreme Court ruling last June upheld most of the measure. President Obama's re-election and Democrats’ continued control of the Senate have helped 'Obamacare' implementation to move ahead" (Carey, 3/7). Check out what else is on the blog.

The Washington Post: House Votes To Avert Shutdown As Obama Looks For Big Deal
With a government shutdown now unlikely, Obama is focusing on a new round of talks that the White House hopes could break the fiscal impasse. After more than two years of negotiations with GOP leaders that did not achieve a "grand bargain," the president is courting rank-and-file Republicans who may be interested in a deal that pairs cuts in entitlement programs with a tax overhaul that would include new revenue (Helderman and Rucker, 3/6).

USA Today: Congress To Kick Off Budget Debate Next Week
The debate that budget hawks have been waiting for kicks off in Washington next week when House Republicans and Senate Democrats unveil competing blueprints on the size and reach of the federal government. … Senate Budget Committee Chairwoman Patty Murray, D-Wash., has indicated Democrats will target tax loopholes to raise revenue, protect entitlement benefits and echo President Obama's fairness theme in paying down the debt. It is the first time since 2009 that Senate Democrats will produce and approve a budget resolution. … Ryan's budget is expected to again include a proposal to revamp Medicare from a guaranteed benefit to a premium support system in which seniors are given a federal subsidy to purchase health insurance on their own from the private market (Davis, 3/6).

The Washington Post: Paul Ryan, Patty Murray Hold The Keys To Any Budget Deal
Still, last year’s GOP budget hardly charted a path to bipartisan agreement. It proposed cutting deeply into domestic programs, and it would have converted many programs for the poor, such as food stamps and Medicaid, into state block grants with few federal controls. It eschewed higher taxes as a source of deficit reduction. And it proposed far-reaching changes to Medicare that would end the program’s open-ended guarantee for people 54 and younger. Senate Democrats haven't adopted a budget since 2009, Obama's first year in office. Murray has said her framework — which also will be unveiled next week — will propose replacing the automatic budget cuts known as the sequester in part with higher taxes. Democratic aides said that revenue would come from a far-reaching overhaul of the tax code under a fast-track process known as "reconciliation" (Montgomery, 3/6).

The Wall Street Journal’s Washington Wire: Paul Ryan Prepares 'No Surprises' Budget
House Budget Committee Chairman Paul Ryan (R., Wis.) said the budget he will unveil next week will make only "modest policy changes" in the conservative blueprint the House approved last year even though he is now  aiming for a much more ambitious goal: balancing the budget in 10 years. "I wouldn't expect any big surprises,’" Mr. Ryan told reporters Wednesday. Last year’s House budget called for major changes in Medicare and deep spending cuts in other programs, but did not eliminate the deficit for nearly 30 years. GOP leaders have promised this year to pass a budget that balances in 10 years. Mr. Ryan said that the task is not as hard as it looks because in the interim there have been changes that have helped close the budget gap: Congress has passed a big tax increase and health care costs have dropped, among other economic factors (Hook, 3/6).

The New York Times: House GOP Plans A Budget That Retains Tax Increases And Medicare Cuts
House Republicans will preserve Medicare cuts that their presidential nominee loudly denounced last year and accept tax increases they sternly opposed just months ago in a new tax-and-spending blueprint that would bring the federal budget into balance by 2023, senior Republicans said Wednesday (Weisman, 3/6).

Los Angeles Times: House GOP Debates Changing Medicare Sooner Than They’d Planned
As Rep. Paul D. Ryan readies the new GOP budget, House Republicans are debating whether to apply the party’s proposed Medicare changes a year earlier than planned, when Americans who are now 56  reach retirement age. No decision has been made, and Ryan declined to address the internal debate Wednesday. The party's earlier promise to keep Medicare unchanged for those 55 and older has bumped up against its vow to balance the budget in 10 years (Mascaro, 3/7).

Politico: For Republican Governors, Medicaid Expansion Is Hard Sell
Governors like Rick Scott of Florida and John Kasich of Ohio bucked their conservative base to accept billions in federal funds to provide basic health coverage to millions of uninsured constituents. But they need the support of their Republican-led legislatures to make it a reality. It's a tall task that's dividing statehouses around the country (Cheney and Millman, 3/7). 

Politico: Right Jabs GOP's Inaction On Obamacare
Once again, conservatives are unhappy with how congressional Republicans are handling a fiscal fight in Congress. This time, their ire is because Republicans aren’t trying hard enough to defund, or at least whittle away at, the Affordable Care Act by attaching language to the continuing resolution that passed the House on Wednesday (Gibson, 3/7).

Politico: Cruz Amendment Would Defund Obamacare
Sen. Ted Cruz (R-Texas) will offer an amendment to the continuing resolution – the bill to keep the government open after March 27 — that would defund the Affordable Care Act. "The very first priority of every elected official—Democrat and Republican—should be restoring economic growth, so we can ensure continued strength, prosperity, and opportunity for the next generations," Cruz said in a statement. "Obamacare does precisely the opposite. It is already hurting small businesses, reducing the hours Americans are allowed to work, forcing employers to drop coverage, and leading to substantial increases in healthcare premiums—especially for young people" (Gibson, 3/6).

USA Today: Diabetes Costs Nation $245 Billion Annually
The growing toll of diabetes cost the nation a record high $245 billion in 2012, a 41% increase from $174 billion in 2007, according to new research released today. The study Economic Costs of Diabetes in the U.S. in 2012, commissioned by the American Diabetes Association, estimated the health care and work-related costs of diagnosed diabetes. The full study will be published in the April issue of Diabetes Care (Payne, 3/6).

Politico: Lindsey Graham Gun Bill Targets Mentally Ill
Three senators potentially facing tough re-election challenges next year introduced NRA-endorsed legislation Wednesday that would bar more people from buying guns due to mental illness. The bill would add people who plead not guilty by reason of insanity to the electronic background check system that determines if someone can purchase a gun. It adds a list of additional disqualifiers, including being deemed a risk and having a court find the personally mentally disabled (Gibson, 3/6).

Los Angeles Times: Covered California’s Plan To Partner With Wal-Mart Is Criticized
California officials face mounting criticism from union leaders over plans to let retail giant Wal-Mart Stores Inc. enroll shoppers in President Obama's healthcare expansion. The state wants employees at Wal-Mart and other retailers to help consumers learn about their options and assist them in buying federally subsidized private insurance (Terhune, 3/7).

Los Angeles Times: Blue Shield And Aetna To Raise Healthcare Rates Over State Objections
Officials at the California Department of Managed Health Care said increases that average more than 11% for about 47,000 individual and small-business policyholders of Blue Shield and Aetna were unreasonable. But state officials don't have the authority to reject changes in premiums, and increasingly health insurers refuse state demands to lower rates (Terhune, 3/6).

Los Angeles Times: Protestors March To Urge Gov. Rick Perry To Expand Medicaid
Several hundred protesters marched in Austin on Tuesday to protest Texas Gov. Rick Perry's hard stance against expanding Medicaid coverage in the state. Perry has dismissed calls to follow two tenets of the federal Affordable Care Act: expand Medicaid, the government program providing health insurance for sick or low-income people, and set up a health insurance exchange where people can shop for coverage (Li, 3/6).

The New York Times: Arkansas Adopts A Ban On Abortions After 12 Weeks
The law, the sharpest challenge yet to Roe v. Wade, was passed by the newly Republican-controlled legislature over the veto of Gov. Mike Beebe, a Democrat, who called it "blatantly unconstitutional." The State Senate voted Tuesday to override his veto and the House followed suit on Wednesday, with several Democrats joining the Republican majority (Eckholm, 3/6).

The Wall Street Journal: Arkansas Abortion Law Is Now Nation's Strictest
The move will face stiff legal challenges. Mr. Beebe, who supports abortion rights but has backed some restrictions, said a series of Supreme Court decisions had established that states couldn't ban abortions carried out before a fetus becomes viable, or able to survive outside the womb. He said the proposed bill "would blatantly violate the United States Constitution" (Radnofsky, 3/6).

The Associated Press/Washington Post: Ark. Adopts US's Most Restrictive Abortion Law, A Near-Ban Starting In 12th Week Of Pregnancy
Lawmakers in the Republican-dominated Legislature defied Gov. Mike Beebe, overriding the Democrat's veto. The House voted 56-33 on Wednesday to override Beebe's veto, a day after the Senate voted to do the same. The votes come less than a week after the Legislature overrode a veto of a separate bill banning most abortions starting in the 20th week of pregnancy. That bill took effect immediately after the final override vote, whereas the 12-week ban won’t take effect until this summer (3/7).

Politico: Legal Fight Brewing Over Strict Arkansas Abortion Law
Abortion rights groups said they plan to challenge it in court within the next few weeks and predicted it would be easily overturned as the 12-week limit flies in the face Supreme Court precedent established in Roe v. Wade (Smith, 3/6).

The Associated Press/Washington Post: Federal Judge Strikes Down Idaho's 2011 Law Banning Abortions After 20 Weeks
A federal judge has struck down Idaho’s law banning abortions after 20 weeks of pregnancy based on beliefs held by physicians and others that the fetus is able to feel pain at that point (3/6).

The Wall Street Journal: Comptroller's Office Faults Adult Day Care
A [N.J.] state agency that serves as a watchdog over New Jersey government announced Wednesday that it has found improper billing of Medicaid by five adult day-care centers and is asking the centers to pay settlements totaling more than $10 million. The state comptroller's office found that centers were charging the state for caring for patients when they didn't receive care in some cases and for providing care that wasn't needed in others (3/6).

Check out all of Kaiser Health News' e-mail options including First Edition and Breaking News alerts on our Subscriptions page.