Viewpoints: Budget Deal Averts Crisis But Doesn’t Advance GOP Goals; Fatal Flaws In Co-Ops

Los Angeles Times: John Boehner's Last Deal Leaves Congress Better Off
In a parting gift to the conservatives who hectored him out of office, House Speaker John A. Boehner (R-Ohio) negotiated a budget agreement with Senate leaders and the Obama administration that increases federal spending and raises the debt ceiling in exchange for — well, not much that Republicans covet. There are no big changes in entitlements, no defunding of Planned Parenthood. Yet this backroom deal delivers the goods that matter most: It will avert the risk of a shutdown until after the next president takes office, providing a welcome measure of stability at a time of increasing anxiety about the global economy. (10/28)

Los Angeles Times: Congress' Budget Deal Inspires More Debt-Ceiling Demagoguery
Granted, the budget deal negotiated with the Obama administration could have included major entitlement reforms, overhauled the tax code or taken some other steps toward solving Washington's fundamental fiscal problems -- had Congress actually laid the groundwork for any of those things. But it hasn't. For all the theorizing House Republicans have done on the subjects of Medicare and Medicaid costs, they've not tried to implement the overhauls they've suggested in their annual budget resolutions. Tax reform gathered some momentum last year, but that seems to have dissipated now. (Jon Healey, 10/28)

Huffington Post: Boehner Wins Repeal Of Obamacare Provision You Never Knew Existed
Monday night’s spending agreement between the White House and Congress would repeal part of the Affordable Care Act. But the provision is a narrow one that few people knew existed .... The clause ... calls for automatic enrollment by large employers. If the administration fully implemented the provision, all companies that have more than 200 full-time employees and offer job-based insurance would sign up their workers for coverage. ... But the provision was unpopular almost from the get-go. Conservatives and employer groups complained that it would be difficult to implement and create unnecessary hassle. Some of the loudest cries came from the restaurant and retail industries -- which, perhaps, were less than enthusiastic about having to cover more of their workers. Liberals had worries of their own. (Jonathan Cohn, 10/27)

The Washington Post: Grading The Budget Deal
Unfortunately, [the budget deal's] virtues come with some glaring vices that lower the deal’s overall grade. The largest is the absence of any serious public debate. What this country desperately needs -- and has avoided for decades -- is a genuine debate over the role of government. In the 1950s and 1960s, this seemed less important, because rapid economic growth promised steady increases in tax revenues to pay for new programs. But now, slower economic growth and an exploding elderly population, raising the costs of Social Security and Medicare, have created a yawning gap between what people expect from government and what they’re willing to pay in higher taxes. Hence, endless budget deficits. (Robert J. Samuels, 10/28)

The Washington Post: Good Luck, Speaker Ryan. You’re Going To Need It.
Mr. Ryan promised last week that his speakership would bring “real reform.” Every American should hope he succeeds in establishing a governing majority that acts on issues Congress has let fester for years. ... He may waste more of the people’s time attempting to repeal Obamacare. But he might also push to reform corporate taxes and federal anti-poverty programs. He has already devoted considerable energy to these matters, which could produce useful results. ... Yet a House in which the hard right still holds considerable sway could easily sit more or less idle instead. (10/28)

The New York Times' The Upshot: Obamacare Shopping Is More Important Than Ever
When some premiums increased last year, a lot of Obamacare customers were able to find good deals by switching to a new health plan. New calculations from the federal government suggest that many consumers will need to do the same to find the best price in 2016. That means, once again, that the marketplace will offer customers a tough choice: stick with the plan you have and pay more, or switch to a new one to pay a lower premium. The savings may be substantial. Instead of simply renewing, the average returning customer who chooses the best deal in the same category as an old plan could find one costing $610 a year less, say analysts for the Department of Health and Human Services. About eight in 10 returning customers on HealthCare.gov can find a cheaper premium by switching. (Margot Sanger-Katz, 10/28)

Forbes: Why Obamacare Co-Ops Are Failing At A Rate Of Nearly 50%
[I]f the goal was to increase competition by stimulating the creation of new health insurers, then the ACA’s co-op program was, like other parts of the legislation, badly designed. The program offered federal loans and grants to startup insurers, but required that they be non-profits, not have anyone affiliated with an existing health insurer on their boards, and not spend any of their federal funding on marketing. Co-ops are also subject to another provision of the ACA requiring all health insurers to pay out in claims at least 80% of premium revenues, or refund the difference to policyholders. By law, insurers can retain no more than 20%, out of which they must fund sales and administrative costs before booking any remainder as free cash. That significantly constrains a non-profit carrier’s ability to accumulate capital needed for growth. (Ed Haislmaier, 10/29)

The New York Times: Church, State, And The Supreme Court’s Moment Of Truth
In the Hobby Lobby case 16 months ago, the Supreme Court ruled that a company with owners who objected on religious grounds to birth control was entitled to opt out of the federal requirement to cover contraception in its employee health plan. An opt-out mechanism was already in place for religious nonprofit employers, the court observed. ... A new wrinkle quickly emerged. It turned out that the very mechanism the Hobby Lobby majority held up as a model for how to accommodate the competing concerns of church and state was not accommodating enough for the religious nonprofits themselves. By the dozens, religiously affiliated colleges, nursing homes and similar organizations sued the government on the ground that even having to request the opt-out made them complicit in the eventual enabling of their employees to obtain birth control. These organizations are refusing, in other words, to take yes for an answer. (Linda Greenhouse, 10/29)

The New York Times' The Upshot: Prices Are Higher When Hospitals Buy Doctors’ Practices. That’s Set To Change.
In the last few years, there has been something of an acquisition boom in doctors’ practices, as hospitals have been snapping them up. Congress may have just cut a deal to slow down all that deal making. As part of the big budget agreement between the White House and congressional leaders, lawmakers want to take away a big incentive driving those mergers: the higher prices that doctors’ offices could charge Medicare when they were owned by a hospital. (Margot Sanger-Katz, 10/28)

USA Today: Preserve Fetal Tissue Research: Our View
What began as an uproar over undercover videos of Planned Parenthood officials callously discussing how to collect fetal tissue is now threatening research vital to finding treatments for devastating conditions from Alzheimer's to blindness. At least a half dozen states are moving to restrict potentially lifesaving studies because they involve tissue collected from abortions. A measure in Wisconsin, approved by two legislative committees, would ban such research. Colorado State University, under pressure from a Republican congressman, suspended tissue collection from one source and pledged to seek alternatives. And several members of Congress are pursuing bans on federally funded research. (10/28)

USA Today: Fetal Tissue Is Not Essential: Opposing View
Controversy over the use of fetal tissue in research has led some to believe that it offers the only way to treat, for example, a devastating disease afflicting their child. In reality, fetal tissue has not been the essential element in developing many important treatments. So, it’s misleading to suggest, especially to women considering donating their aborted fetus to research, that important medical advances depend on fetal tissues. (Tara Sander Lee and Kathleen M. Schmainda, 10,28)

The Philadelphia Inquirer: There Are Ways To Prevent Medicare Fraud
This month marked the beginning of the open enrollment period for Medicare. Many plans make changes to cost, coverage, network providers, and pharmacies throughout the year, and this period gives beneficiaries the opportunity to change their plans accordingly. Currently, 54 million Americans depend on Medicare for health-care services. And, unfortunately, they are often subject to fraud - especially during open enrollment, when changes and confusion can leave beneficiaries vulnerable to misinformation. (Mariel Lorenz, 10/29)