First Edition: January 23, 2013

Today's headlines include analysis regarding the dynamics of how entitlement programs will fit into the upcoming Capitol Hill budget battles. 

Kaiser Health News: HMO-Like Plans May Be Poised to Make Comeback In Online Insurance Markets
Kaiser Health News staff writer Julie Appleby, working in collaboration with USA Today, reports: "It's back to the future for insurers, which plan to sharply limit the choice of doctors and hospitals in some policies marketed to consumers under the health law, starting next fall" (Appleby, 1/22). Read the story.

Kaiser Health News: Cracks Appearing In GOP Opposition To Health Law
Kaiser Health News staff writer Phil Galewitz, working in collaboration with USA Today, reports: "Gov. Phil Bryant and Insurance Commissioner Mike Chaney have known each other for 30 years and call themselves friends. Now, though, a wedge has come between the two elected Republicans -- President Barack Obama's health law" (Galewitz, 1/22). Read the story.

Kaiser Health News: Despite Incentives, Doctors' Offices Lag On Digital Records
Colorado Public Radio's Eric Whitney, working in partnership with Kaiser Health News and NPR, reports: "The good news: Colorado is working to help kids stay current with their immunizations and has a computerized registry where any provider who gives a child a vaccine can report that information. The bad news:  The state's computer system is not compatible with most of the computer systems doctors use, so many practices don't update the central database because it's just too much extra work, according to Dr. Allison Kempe, a researcher at the University of Colorado" (Whitney, 1/22). Read the story.

Kaiser Health News: Capsules: CMS Community Initiatives Could Reduce Health Costs
Now on KHN’s blog, Ankita Rao reports: "A pilot program introduced by the U.S. Centers for Medicare and Medicaid Services to boost quality of care for seniors by developing community-wide approaches to health problems could play a key role in bringing down costs, according to a new report in the Journal of the American Medical Association" (Rao, 1/22). Check out what else is on the blog.

The New York Times: Obama Speech Leaves GOP Stark Choices
Their decision shows that even among some staunch conservatives, Mr. Obama's inauguration could be ushering in a more pragmatic tone — if not necessarily a shift in beliefs. From the stimulus to the health care law to showdowns over taxes and spending, Republicans have often found that their uncompromising stands simply left them on the sidelines, unable to have an impact on legislation and unable to alter it much once it passed. Even in the budget impasses that forced spending cuts sought by conservatives, the Republicans' ultimate goals — changes to entitlement programs and the tax code — have been out of reach. Now, some in the party say, it is time to take a different tack (Weisman, 1/22).

Politico: Paul Ryan Slams Obama 'Straw Man' Speech
The Wisconsin Republican told "The Laura Ingraham Show" that Obama's second inaugural address demonstrated the president does not understand the Republican position on entitlements such as Medicare and Social Security. Ryan responded to Obama's line that these programs "do not make us a nation of takers; they free us to take the risks that make this country great," telling guest host Raymond Arroyo that the president's take on the issue entirely missed the mark (Weinger, 1/22).

The Washington Post: Obama 'Will Not Oppose' House GOP Plan To Suspend Debt Limit Until May
The measure — set for a vote Wednesday in the House — would not resolve the dispute over how to control the national debt. … Balancing the budget over the next decade, however, is likely to require extraordinarily deep cuts in spending that go even further than reductions in previous House budgets. In the past, Ryan has targeted spending on health care for the poor and other social safety net programs, such as food stamps and aid for college tuition. On Monday, Obama vowed in his Inauguration Day speech to defend those programs (Montgomery and Helderman, 1/22).

The Wall Street Journal: Obama Would Accept Stopgap Debt Extension
But a debt-limit extension would defuse only one of the fiscal land mines scattered over the next several months. Both parties say the government needs to do more to reduce the deficit, but they remain far apart on how to do that. Republican leaders suggested Tuesday they will author a deficit-reduction plan that would balance the budget within 10 years. Last year's House budget plan, by contrast, wouldn't have led to a balanced budget until about 2040, according the Congressional Budget Office. White House officials remain opposed to many of the structural changes to Medicare and Social Security that Republicans have proposed, and President Barack Obama wants tax increases to be part of any agreement (Paletta and Hook, 1/22).

Los Angeles Times: House GOP Lines Up Debt Ceiling Vote; White House Will Not Oppose
Boehner and his leadership team emerged with the new strategy after a private retreat last week with lawmakers. They believe their leverage in forcing budget cuts to Medicare, Medicaid and other domestic programs will be greater on the next battles, and want to push the politically and economically risky debt ceiling debate off to pursue these next pressure points (Mascaro, 1/22).

The Associated Press/Washington Post: House Republicans Seek To Defuse Debt Crisis With Vote On 3-Month Increase In Borrowing Limit
But Republicans and Obama now appear on a collision course over how to replace the across-the-board cuts. … "The sequester is arbitrary, but the fact is that when the sequester goes into effect ... it will have a pretty dramatic effect of people's attitudes here in Washington, and they may get serious about cuts to the mandatory side of the spending equation," Boehner said, referring to benefit programs like Medicare and food stamps, whose budgets essentially run on autopilot (1/22).

The New York Times: Many Medicaid Patients Could Face Higher Fees Under A Proposed Federal Policy
Millions of low-income people could be required to pay more for health care under a proposed federal policy that would give states more freedom to impose co-payments and other charges on Medicaid patients (Pear, 1/22).

The Wall Street Journal: Return Patients Vex Hospitals
Hospitals fearing new Medicare penalties are trying to reduce the number of patients who need to return soon after discharge, a problem that new research suggests is widespread and without an easy fix (Landro, 1/22).

Politico: Medicare Eyes Hospital Readmissions
Now a major multicity Medicare quality initiative, highlighted this week in The Journal of the American Medical Association, has reduced readmissions by nearly 6 percent compared with similar communities over two years. The authors estimate that in an average community with 50,000 Medicare patients, spending $1 million on relatively simple steps to curb hospitalizations would save $4 million per year on hospital bills alone. That would add up fast if these programs were to spread nationwide (Kenen, 1/23).

The Associated Press/Washington Post: Health Insurer Wellpoint's 4th Quarter Profit Jumps 38 Percent
WellPoint says its fourth-quarter earnings jumped 38 percent compared to the final quarter of 2011, when the nation's second largest health insurer incurred a big hit from its Medicare Advantage business. The Indianapolis company says it earned $464.2 million, or $1.51 per share, in the three months that ended Dec. 31 (1/22).

The Associated Press/Washington Post: Republican Legislatures Across The Country Aim For New Abortion Limits As Roe V. Wade Turns 40
It has been rare for states to expand access to abortions since the 1973 Roe v. Wade ruling, but there have been numerous efforts to limit them — including several proposals already introduced in statehouses this year. Here is a look at some of the abortion restrictions currently being considered in Republican-controlled states (1/22).

The Wall Street Journal's Law Blog: Abortion Foes Mark Gains By Targeting Clinics, Abortion Providers
Anti-abortion activists have made significant strides in recent years by targeting not abortions per se, but the clinics that provide them. In the last two years, several states, among them Kansas, Mississippi, Tennessee, Pennsylvania, Virginia and Michigan, have passed bills adding layers of regulations to clinics (Jones, 1/22).

Politico: Ex-Sen. Ben Nelson Leads Insurance Commissioners Group
Former Nebraska Sen. Ben Nelson, one of the key figures in passing the president's health care law, is being tapped to lead the National Association of Insurance Commissioners, the group announced Tuesday (Millman, 1/23).

Los Angeles Times: Marijuana Still A Drug With No Accepted Medical Use, Court Says
Marijuana will continue to be considered a highly dangerous drug under federal law with no accepted medical uses, after a U.S. appeals court Tuesday refused to order a change in the government's 40-year-old drug classification schedule (Savage, 1/22).

The Wall Street Journal: Bidding Battle Over Bronx Hospital
Two competing bids to take over New York Westchester Square Medical Center, a struggling hospital in the Bronx, are bringing to light deeper tensions about health care in the borough (Kusisto, 1/22).

The Associated Press/Washington Post: Md. Officials Plan To Submit Changes To Unique Medicare Waiver In Coming Weeks
Maryland officials will submit a plan to the federal government aimed at allowing them to hang onto about $1 billion in Medicare reimbursements received under a unique agreement with Washington, the chairman of a panel that sets hospital billing rates told lawmakers Tuesday (1/22).

The New York Times: Cuomo Builds Budget With Cuts, Gambling And Fees
Over all, the proposed $142.6 billion budget represents a 5.3 percent increase over the current one, but much of the increase will be covered by federal money provided for the recovery from Hurricane Sandy and the enactment of the health care law championed by President Obama (Hakim and Kaplan, 1/22).

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