Viewpoints: Sebelius and Vilsack on rural health; Many thoughts on repeal vote; State budget cuts

The Kansas City Star: Rural Areas Can't Afford Health Care Bill's Repeal
As former governors from the Heartland, we've seen firsthand how Americans in rural areas struggle to get the health care they need. Whether it's a farmer losing his health insurance because he has no good choices or a mom putting off a treatment because there aren't enough doctors nearby, rural Americans often go without critical preventive care or key procedures. … The new law is giving rural Americans better health coverage choices, stronger protections from insurance abuses and more access to doctors and nurses. To repeal the law just as families across the country are starting to see the benefits would be a huge mistake (Kathleen Sebelius and Tom Vilsack, 1/18).

Politico: GOP Hiding True Costs Of Repeal
If the Republican repeal bill passes, small businesses that paid to insure their employees through 2010, counting on this tax credit, will have to pay a substantially larger tax bill in April. Many large employers, including state and local governments, will also lose the retiree reinsurance coverage they have relied on for the past year to cover 80 percent of expenses of their high-cost retirees. For employers, the loss of this assistance may mean the end of their retiree programs (Timothy Stoltzfus Jost, 1/19). 

Kaiser Health News: What Repeal Is Not About
First and foremost, the law itself is not at risk this week. … Despite this, defenders of the law have launched a massive disinformation initiative regarding the vote. So, in the interest of dispassionate evaluation, let us step back for one moment and review the situation. ... Real health care reform that delivers quality care at lower cost and controlling explosive federal spending and debt -- that is what the repeal vote is about (Douglas Holtz-Eakin, 1/18).

Kaiser Health News: Repeal And Replace - But Replace With What? 
It's not an easy question to answer. Republicans have yet to embrace a specific proposal and, rhetorically, they have made contradictory arguments about what they want. They have, for example, criticized the new law for reducing Medicare spending. But they've also applauded proposals, like the one offered by House Budget Chairman Paul Ryan, R- Wis., which would reduce spending far more dramatically  (Jonathan Cohn, 1/18). 

The Atlanta Journal-Constitution: On Health-Care Reform, GOP Has An Unmet Obligation To Get Beyond 'NO!'
As I've documented before, Republican leaders understand how popular and even necessary it is to find a way to cover those with pre-existing conditions. They have promised to retain that part of ObamaCare, but they have never explained how they intend to do so without relying on some form of individual mandate. The time has come for answers (Jay Bookman, 1/18).

Los Angeles Times: Healthcare For All, Somehow
As House Republicans prepared for a symbolic vote to repeal the comprehensive healthcare reform law enacted last year, the Obama administration sought to remind lawmakers about one of the thorny problems the law aims to solve. A report issued by the Department of Health and Human Services estimates that up to 50% of Americans below retirement age have preexisting health conditions that have led insurers to raise their rates or deny them coverage (1/19). 

The Washington Post: Health Care Debate: Tastes Great, Less Killing
It took an attempted assassination and the grave wounding of one of their colleagues, but it was a refreshingly sober Republican majority that handled itself - at least its early stages of the debate, which resumes Wednesday - in a far more responsible way than it did during the past two years. There were no chants of "Kill the bill!" No shouts of "Hell, no you can't!" No outbursts of "Baby killer!" or "You lie!" (Dana Milbank, 1/19).

The Washington Post: Americans Don't Want Health-Care Repeal 
House Republicans should be aware that while conservative activists may support the action they're about to take, surveys indicate that the general public clearly does not (Eugene Robinson, 1/18). 

The Wall Street Journal: Health Care Repeal Won't Add To The Deficit
The Congressional Budget Office says repealing the Affordable Care Act would increase the deficit by $230 billion over the coming decade and by a modest amount in the decade after that. The CBO estimate has become the central defense by ACA advocates fighting the upcoming repeal vote in the House. They might want to re-think their strategy (Douglas Holtz-Eakin, Joseph Antos and James Capretta, 1/19). 

San Francisco Chronicle: GOP Lie: Healthcare Law Not "Job-Killing"
Republicans say the health care law would kill 650,000 jobs. Back the old pre-New Civility days, House Speaker Boehner near-Tourettically repeated "job-killing" to describe its effects during a press conference. Boehner's peeps have since, post-Tucson, down-graded "job-killing" to "job-destroying." Whatever. They're both wrong (Joe Garofoli, 1/18). 

Fox News: Repeal Obamacare? Americans Deeply Divided About Who Should Handle Their Health Care
So the opportunity for Republicans, then, is to introduce the 21st-century health care equivalent of the airplane and the tank--that is, harness science and technology to their side of the Obamacare debate. It is technology that can break the stalemate. If Republicans offer cures, while Democrats offer only finance, it is Republicans who will win. And the insurance debate will take care of itself--because in the long run, science and medicine trump finance and insurance (James Pinkerton, 1/18). 

Milwaukee Journal Sentinel: Strengthen The Law
Trashing the new law is short-sighted. It brings coverage to millions more Americans and does away with the policy of excluding from coverage many people with pre-existing conditions. And, according to the Congressional Budget Office, repeal would cost the Treasury $230 billion. That doesn't mean the law cannot be improved (1/18). 

The Atlanta Journal-Constitution: Shape Health Law For Georgia
To make the most of the law, Georgia should move swiftly to establish a commission to proactively coordinate the pieces of the law our state is required to put into place, such as an expansion of Medicaid, design elements that we can tailor for our state's needs, such as the new health insurance exchanges, and maximize grants to strengthen our public health system and our health care workforce (Cindy Zeldin, 1/18).

The Seattle Times: Health-Care Delivery Must Be Reformed For Sustainable State Budget
A number of credible studies tell us that more than a third of all health-care expenditures don't add to health or increase life span. In our state that translates to at least $10 billion a year that could be saved for families, employers and government, without hurting anyone's health. In fact, health could be improved by focusing limited resources on public health and better delivering dental, primary and chronic care (Steve Hill, 1/18).

The Arizona Republic: Brewer Makes Tough, Correct Choice
The governor and Republican-led Legislature are not going to raise taxes. Voters decided that by electing us in November. ... Arizona now covers one out of every five people through AHCCCS (Arizona Health Care Cost Containment System). Because of this, the governor has proposed that we reduce the number of people that qualify to a level comparable to other states. We are down to two options: cut health care to a level comparable to other states or make huge cuts to education. I think the governor has made the right decision (Debbie Lesko, 1/19).

The Arizona Republic: Brewer's State Budget Should Boast A Plan B
The problem is that one provision of "Obamacare" requires states to maintain their Medicaid-eligibility standards. In fact, Obamacare calls for all states ultimately to cover up to 133 percent of the federal poverty level through their Medicaid programs. Brewer plans to ask for a waiver. There's justice in the request. Arizona is one of just seven states that cover childless adults up to 100 percent of the federal poverty level. Basically, under Obamacare, Arizona is stuck with a much more expensive program than other states. It is unfathomable, however, that the Obama administration would grant such a waiver. ... Prudence would suggest that Brewer and Republican lawmakers have a ready Plan B. There's no evidence they are developing one (Robert Robb, 1/19).

The Wall Street Journal: The Coming Doctor Shortage
As they celebrate their 65th birthdays at the rate of 10,000 a day, Baby Boomers are now approaching the stage of their lives when they will need more medical care. But they—along with everyone else—are going to have a hard time getting appointments (Dr. Herbert Pardes, 1/19). 

Politico: Who Gets To Have A Plug?
Administration officials buried a new rule in the recently released changes to Medicare that provides reimbursement for doctors who counsel patients annually on the use of advance directives, and advise those patients whether they are willing to follow these directives. Now let's be clear: This consultation, when truly voluntary, can be positive. A patient should know whether his doctor is willing to honor his desire to receive critical life-sustaining treatment in the event he is incapacitated. ... However, an advance planning consultation can look quite different when it is not truly voluntary. Elderly or disabled patients should never be pressured or coerced to make decisions or sign documents regarding end-of-life care (William Saunders, 1/19).