Viewpoints: GOP’s Balanced Budget Or Phony Efforts?; Kids Could Be Victims Of Court Decision

The Wall Street Journal: The GOP’s Budget Test
[House Budget Committee Chairman Tom] Price’s budget would slow the annual growth of federal spending to a manageable 3.3% on average from the current 5.1%. That’s no small achievement given the accumulating obligations for ObamaCare and baby boom retirees. Mr. Price does this with targeted policy changes to the real drivers of the federal debt—the open-ended entitlement state. Mr. Price retains Mr. Ryan’s “premium support” reform, which would gradually modernize Medicare by introducing more competition among insurers and more individual choice of health plans. The budget also calls for repealing ObamaCare, and it makes a valuable contribution on Medicaid, which as a share of GDP has increased 240% since 1980 and is due to rise another 75% over the next 10 years. (3/17)

The New York Times: The House Budget Disaster
The plan’s deep cuts land squarely on the people who most need help: the poor and the working class. The plan also would turn Medicare into a system of unspecified subsidies to buy private insurance by the time Americans who are now 56 years old become eligible. And it would strip 16.4 million people of health insurance by repealing the Affordable Care Act (the umpteenth attempt by Republicans to do so since the law was enacted in 2010). (3/18)

The New York Times' The Upshot: Where The Republican Budget Plan Meets Reality On Health Care
The budget proposal released by House Republicans on Tuesday promises it can repeal Obamacare and save the government a lot of money in the process. But the document relies on some vague accounting to justify this claim. It is easy, of course, to save the federal budget a lot of money by simply eliminating the spending provisions of the Affordable Care Act. Getting rid of the law’s Medicaid expansion to low-income people and its premium subsidies for middle-income insurance shoppers would save about $2 trillion over 10 years, according to the House budget estimates. That number is published clearly and prominently in the budget’s accompanying tables. Less explicitly accounted for is the fact that the health law ... was also designed to reduce the deficit. (Margot Sanger-Katz, 3/17)

Los Angeles Times: Bulletin: House Budget Proposes Repeal Of An Incredibly Effective Law
The Republican assertion that "Obamacare is not working" fits this definition perfectly. You'll find it, among other places, on Page 16 of the budget resolution released Tuesday by the GOP-controlled House Budget Committee. There the magic power of the incantation is designed to justify repealing the Affordable Care Act in its entirety, a central goal of the budget resolution. The Republicans should hope that the magic is strong, because the mantra will have to do battle with hard facts and figures that flatly contradict it. (Michael Hiltzik, 3/17)

The Washington Post: The GOP’s Fiscal Phonies
[T]he majority-Republican House has produced a budget blueprint that serves no particular purpose except to demonstrate the inadequacy of pure, no-tax-increases GOP policy doctrine. To be sure, the document calls for an essentially balanced budget by 2025, which would reduce debt held by the public to 55 percent of GDP. It achieves this, however, entirely by cutting scheduled spending by $5.5 trillion , the largest chunk of which would be a $2 trillion 10-year savings from repealing the Affordable Care Act — which is neither sensible nor politically feasible. (3/17)

The Washington Post: The House GOP Budget Is A Gimmick
It was altogether fitting that Republicans rolled out their budget during a festival of inebriation in honor of the man who magically (and apocryphally) banished snakes from Ireland. What Republicans have done with their budget is no less fantastic: They have employed lucky charms and mystical pots of gold to make them appear more sober about balancing the budget than they actually are. ... It proposes to repeal Obamacare but then counts revenues and savings from Obamacare as if the law remained in effect. ... It doesn’t account for the $200 billion plan now being negotiated to increase doctor payments under Medicare and to extend a children’s health-care program. (Dana Milbank, 3/17)

The Washington Post: The House Republican Budget Departs From Both Economic And Political Reality
Programs that provide affordable health coverage for the middle class (Obamacare, which they repeal) and the poor (Medicaid, which is “block granted”) face large spending cuts. Future elderly persons do not escape unscathed, either, as Medicare is “voucherized” beginning in 2024. The budget includes more than $1 trillion in unspecified cuts that would appear to fall on nutritional support for the poor and tax credits for low-income, working families. (Jared Bernstein, 3/17)

The Washington Post's Wonkblog: House GOP Budget: Republicans’ Medicaid Cuts Aren’t A Good Way To Woo The Middle Class
The plan, released Tuesday, leads with a broad principle that middle-class voters -- and all voters, really -- endorse: It reduces the deficit and, in 10 years' time, balances the budget. But the road to balance is paved with budget cuts that middle-income voters, polls show, don't much care for. As they have in past years, Republicans are proposing to cut spending on Medicaid, food stamps and, eventually, Medicare. They'd also repeal the Affordable Care Act and reduce taxes on investment income and corporations. Those cuts are likely to balance the budget more on the backs of the poor than of the middle class (though you can make a case, as the Congressional Budget Office did on Tuesday, that falling deficits will eventually lead to stronger economic growth for the entire nation). (Jim Tankersley and Scott Clement, 3/17)

The New York Times: Patching Up The Social Safety Net
Looking back, [Wilbur] Cohen’s prescription [that only universal programs that served all Americans could achieve the broad political support] looks spot on. Social Security and Medicare remain the most politically robust bits of the United States’ social insurance apparatus — survivors of repeated attempts at privatization. Almost everything else, including food stamps and child subsidies for the poor, is vulnerable. (Eduardo Porter, 3/17)

Bloomberg: Obama Can't Ignore Court On Obamacare
Could the Barack Obama administration really ignore an adverse Supreme Court judgment in the King v. Burwell health-care litigation, as a University of Chicago law professor has proposed? Of course not. Obeying the court only with respect to the plaintiffs in this case would be a flagrant violation of the rule of law. It would put the administration in the position of flouting the court’s authority. It would be substantially more outrageous even than the Alabama Supreme Court’s order to its probate judges to ignore a federal ruling striking down the state’s anti-gay-marriage law. For these reasons, it’s also completely unrealistic. (Noah Feldman, 3/17)

The Washington Post: What Would Happen To Children If The Supreme Court Dismembers Obamacare
We already know that a ruling against the Obama administration in King v. Burwell, this year’s Affordable Care Act Supreme Court case, would be a public health disaster: Millions of people would lose insurance coverage, and insurance markets across the country would stumble out of balance. But what would happen to children, a vulnerable group with specific health-care needs that any rational society would address? The nonpartisan Urban Institute released an analysis Tuesday that games out the possibilities. The bottom line: In a worst-case scenario, a whopping 3.3 million more kids could end up without health coverage. (Stephen Stromberg, 3/17)

The Baltimore Sun: Lung Cancer Screening: More Harm Than Good?
Recently, the Centers for Medicare and Medicaid Services declared that Medicare would now be paying for lung cancer prevention with spiral CT scans. The scans would be offered annually to people between the ages of 55 and 77 with at least a 30-pack year smoking history (calculated by multiplying packs per day by the number of years smoking) and who either still smoke or who quit less than 15 years ago. The controversial decision came four years after the National Lung Screening Trial (NLST) of 53,000 current or former heavy smokers demonstrated what was characterized as a 20 percent reduction in lung cancer death among those who had annual spiral CT scans of their lungs. Before meaningful shared decision making between doctor and patient can ensue, it is important for both to understand the actual risks and benefits of spiral CT screening in absolute terms. (Andrew Lazris and Erik Rifkin, 3/17)

JAMA: Reengineering Advance Care Planning To Create Scalable, Patient- And Family-Centered Interventions
The Institute of Medicine (IOM) report Dying in America concluded that patients near the end of life often receive undesired, burdensome treatments and called for improvements in advance care planning to ensure that patients’ values guide medical care. There is no clear path to accomplish this because there are major shortcomings to existing advance care planning. ... In this Viewpoint, we propose 2 interrelated strategies to create the next generation of advance care planning tools: (1) leveraging web-based technologies to create online interventions and (2) using the science of user-centered design to ensure that advance care planning meets the needs of patients, families, and clinicians. (Drs. Jared Chiarchiaro, Robert M. Arnold and Douglas B. White, 3/17)