First Edition: July 11, 2011
In today's health policy headlines, more reports on the challenges President Barack Obama and congressional leaders are facing in the ongoing debt reduction negotiations.
Kaiser Health News: A Guide To Health Insurance Exchanges (updated)
It seems like a simple idea: create new marketplaces, called "exchanges," where consumers can comparison shop for health insurance, sort of like shopping online for a hotel room or airline ticket. But, like almost everything else connected with the health law, state-based insurance "exchanges" are embroiled in politics (Appleby, 7/10).
KHN's Capsules: Governors Wary Of 'Blending' Federal Contribution To Medicaid, CHIP
Kaiser Health News staff writer Mary Agnes Carey writes: "If a deal to reduce the deficit results in lower federal payments to states for Medicaid and the Children's Health Insurance Program, then the National Governors Association will say no thanks. As part of the ongoing negotiations between the White House and Capitol Hill, one proposal would combine the federal government's Medicaid and CHIP payments into a single blended rate for each state. A Center on Budget and Policy Priorities analysis says that change would mean less federal funding for already cash-strapped states, likely forcing state governments to reduce services and cut payments to health care providers" (7/8). Also on the blog: Phil Galewitz writes about one small businessman's health law skepticism (7/10).
Kaiser Health News (video): Q &A: Can I Get Medical Treatment And Hospice Care At The Same Time?
Kaiser Health News consumer columnist Michelle Andrews answers a question from a reader who wonders if there are states where they can get both curative care and hospice care at the same time. The health law may provide some solutions, Andrews says (7/11).
The Wall Street Journal: Deficit Negotiators Hit Reset
President Barack Obama and Republican leaders in Congress clashed Sunday over the scope of an effort to cut the federal deficit, one that could be shorn of its most ambitious elements, including revamping the tax code and significantly reducing growth in benefit programs (Lee, McKinnon and Bendavid, 7/11).
The New York Times: Obama Leans On GOP For A Deal On Debt Ceiling
White House officials said Mr. Obama was still determined to pursue the boldest package possible - one that would require new tax revenue as well as cuts in Medicare and other entitlement programs - but he faces steadfast opposition from Republicans and growing qualms among Democrats (Landler, 7/10).
Los Angeles Times: 'Big Deal' Eludes Obama In Latest Debt Talks
Negotiators agreed to meet again Monday, but otherwise their 75-minute session merely restated their positions. Republicans maintained that a deficit-cutting deal could not include any additional tax revenue, congressional officials said. Democrats argued that cuts in spending alone would not achieve a substantial reduction in federal deficits without also including new revenue. Using the full scope of the bully pulpit, Obama scheduled a news conference for 8 a.m. PDT on Monday to update the public on the negotiations (Nicholas and Mascaro, 7/10).
The Washington Post: Debt Reduction Talks In Limbo As Clock Ticks Toward Aug. 2 Deadline
Both sides appeared Sunday to dig further into their positions, leaving the talks deadlocked, a historic default looming and a fragile economy increasingly vulnerable to the consequences of Washington's entrenched partisanship and ideological divide over taxes and entitlements. House Speaker John A. Boehner (R-Ohio) jolted the negotiations Saturday when he announced that his party would not support the larger deficit-cutting plan Obama has proposed because it includes tax increases, complicating the meeting's agenda. According to a Democratic official familiar with the Sunday talks, Obama asked Republican leaders, "If not now, when?" (Wilson and Montgomery, 7/10).
USA Today: Obama, Leaders Take Last Stab At $4 Trillion Deal
President Obama refused to back down Sunday night from seeking a landmark compromise that would slash about $4 trillion over 10 years from budget deficits and raise the government's $14.3 trillion debt limit. In a rare weekend meeting at the White House, Obama sought to convince recalcitrant lawmakers that tax increases on upper-income Americans and major cuts in popular health care and retirement programs still were within reach - despite Republicans' pessimism. He will reiterate his case in a news conference this morning (Wolf, 7/11).
NPR: Bipartisan Debt Talks To Resume Monday
The weekend's biggest development was more of a breakdown than a breakthrough. Senior congressional Republicans said they would not support an ambitious plan to cut $4 trillion over a decade that could include major changes to the tax code and entitlement programs such as Social Security, Medicare and Medicaid (Shapiro, 7/11).
Los Angeles Times: Drug Makers Try To Sidetrack Demands For Discounts
As the president and congressional leaders look for savings as part of a major debt deal, the pharmaceutical industry has stepped up its behind-the-scenes lobbying to kill proposals that it contribute to any compromise. President Obama this spring said drug makers should offer discounts to low-income seniors who receive government subsidized health coverage through both the Medicare and Medicaid programs (Levey, 7/9).
The New York Times: For Boehner, Lofty Budget Goals Checked By Reality
So [House Speaker John Boehner, R-Ohio] and the president pursued an ambitious plan that would have reduced spending by as much as $4 trillion over 10 years. It was a transformative proposal, with the potential to improve the ugly deficit picture by shrinking the size of government, overhauling the tax code and instituting consensus changes to shore up Medicare and even Social Security. It was a once-in-a-decade opening. But the speaker's lofty ambitions quickly crashed into the political reality of a divided, highly partisan Congress (Hulse, 7/10).
Politico: Top Democrats Split On IPAB
For the past year, Democrats have been mostly united on health care issues, especially in the face of Republican efforts to repeal President Barack Obama's landmark law. But this week, House Republicans plan to fire their opening salvos against the Independent Payment Advisory Board - an issue on which Democrats are far from united (Haberkorn, 7/10).
The Washington Post: Huntsman, Pawlenty May Be Vulnerable When They Criticize Romney On Health Care
The universal health care that Mitt Romney passed as Massachusetts governor has proven to be a popular target for his critics. But it could be Romney's good luck that his two main establishment rivals for the GOP nomination are less than ideally positioned to capitalize on this liability. When they set out to reform health care in their states, both Jon Huntsman, former governor of Utah, and Tim Pawlenty, former governor of Minnesota, considered the same tools that Romney adopted, including a mandate that people obtain health insurance and a state "exchange" where they could buy it. Both men ended up settling for reforms far more limited than Romney's. But their records have left them open to charges of hypocrisy when they blast the Massachusetts and national health-care laws (MacGillis, 7/10).
The Wall Street Journal: Drug Makers Refill Parched Pipelines
The pharmaceutical industry, after years of research flops that led some to write its obituary, shows signs it is coming back to life. Credit a revamped research approach by the industry, which, after years of focusing on me-too drugs for ills that were already well treated, is pouring firepower into diseases that aren't (Rockoff and Winslow, 7/11).
The Wall Street Journal: Slow Recovery Curbs New Health-Care Jobs
Health-care employment, which defied the economy by adding jobs through the 2007-09 recession, is looking less robust. The sector is starting to come under pressure as the weak recovery coupled with state budget cuts and uncertainty about the financial effects of the health-care overhaul are pushing hospitals and health systems to cut costs (Dougherty, 7/9).
The Wall Street Journal: Medicaid Contract Bleeds New York
New York state's botched effort to modernize its Medicaid billing system is becoming an increasingly costly mistake. Over the past decade, the state has paid a Virginia-based IT company nearly $1 billion to set up and operate a Medicaid billing and processing system hobbled by delays, cost overruns and programming flaws (Gershman, 7/9).
The New York Times: New For Aspiring Doctors, The People Skills Test
Doctors save lives, but they can sometimes be insufferable know-it-alls who bully nurses and do not listen to patients. Medical schools have traditionally done little to screen out such flawed applicants or to train them to behave better, but that is changing (Harris, 7/10).
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