First Edition: April 8, 2011

Today's headlines include stories tracking the partisan negotiations surrounding a current-year spending bill. Currently at an impasse, the differences between the GOP and Democrats as well as the White House surrounds more than just the total dollar figure attached to spending cuts. It also involves controversial "policy riders." Meanwhile, without resolution, a government shutdown is just hours away.  

Kaiser Health News: Health Insurance From Both Sides: KHN Interview Of Aetna CEO Bertolini
Kaiser Health News staff writer Julie Appleby spoke with Aetna CEO Mark Bertolini, who has had his own first-hand experiences with the health system (Appleby, 4/7).

Kaiser Health News: Policy Riders And Spending Debate Fueling Govt. Shutdown Fears
KHN's Karl Eisenhower and Stephanie Stapleton detail examples of some of the policy riders that now may be in play by reviewing the riders that were included in H.R. 1, the 2011 budget bill passed by the House in February (4/7).

Los Angeles Times: Republican Policy Demands Threaten Budget Talks
The federal budget stalemate that stands to trigger a government shutdown shifted Thursday from a debate over spending cuts to a fight over the thorny policy issues of abortion and environmental regulation that have divided Democrats and Republicans for years (Mascaro and Parsons, 4/8).

The Washington Post: Both Parties Continue Talks Over Elusive 2011 Deal
Republicans and Democrats on Capitol Hill say they are about $5 billion apart in their haggling to reach a deal to fund the federal government for the rest of the year (Kane, 4/7).

Politico: Government Shutdown Won't Stop Health Law Implementation
Implementation of the health reform law will not stop if there is a government shutdown, an HHS official says. "If it's funded by mandatory spending in the Affordable Care Act, implementation can continue," the official said. However, regulation writing would likely be "significantly hindered" because those staff salaries are funded by discretionary dollars (Feder, 4/8).

Politico: GOP Faces Difficult Defunding Choice
House Republicans are facing a tough choice in the budget talks: Is it more important to them to defund Planned Parenthood, or is it more important to shut off funds to the health care law? They've put a lot of time and energy into both sets of riders, but they're not likely to get both of them. In fact, they may not get either one, given how strongly President Barack Obama and Senate Majority Leader Harry Reid are insisting that none of them should be in the final agreement (Nather, 4/7).

Politico: In Past, Democrats Embraced Policy Riders
Senate Majority Leader Harry Reid (D-Nev.) and President Barack Obama hate policy riders. They have no place in spending bills, the top Democrats have said during the latest budget debate. Unless, of course, they're Democratic policy riders (Allen, 4/7).

The Washington Post: Some Republican 'Riders' Could Be Deal-Breakers For Democrats
The impasse that threatens to lead to a government shutdown is not simply about the federal budget. Some of the sticking points relate to policy and have been attached to the budget as "riders." On Thursday, a few GOP policy proposals emerged as possible deal-breakers for Democrats, as leaders sought to reach an agreement that would keep Washington operating (Somashekhar, 4/7).

Los Angeles Times: Rep. Paul Ryan's Medicare Privatization Plan Increases Costs, Budget Office Says
When House Budget Committee Chairman Paul D. Ryan unveiled his blueprint this week for cutting federal spending by $5.8 trillion over the next decade, he argued that a revamping of the government's health safety net would rein in skyrocketing costs. But because commercial insurers cost more to run than government plans, the Wisconsin Republican's proposal to privatize Medicare starting in 2022 would actually spark a dramatic increase in how much the nation spends on healthcare for the elderly, according to an independent analysis by the nonpartisan Congressional Budget Office (Levey, 4/7).

The Wall Street Journal: Dividing The Medicare Pie Pits Doctor Against Doctor
One of the biggest disputes in the Relative Value Scale Update Committee came in 2005, when members clashed over primary-care groups' push for increases in the payments for doctor office visits, which are among the most commonly-billed Medicare services (Mathews, 4/7).

The Wall Street Journal: Senators Push To Open Database On Medicare
Two senators have introduced legislation to overturn a 1979 court injunction that bars the government from revealing what individual physicians earn from Medicare. That information is stored in the Medicare-claims database, widely considered one of the best tools for finding fraud and abuse in the $500 billion federal health-insurance program for the elderly and disabled (Schoofs and Tamman, 4/8).

Los Angeles Times: Cuts To Anthem's Rate Hikes Are Not For Everyone
Nearly 151,000 Anthem Blue Cross individual policyholders face rate hikes of as much as 26% on May 1, even though far more Anthem individual customers are getting a break this year (Helfand, 4/8).

The Associated Press: Govt. Announces Plan To Reduce Health Disparities
From cradle to grave, minority populations tend to suffer poorer health and get poorer health care than white Americans. In a first-of-its-kind report, the government is recommending steps to reduce those disparities. The plan being released Friday runs the gamut from improving dental care for poor children to tapping "promotoras," savvy community health workers who can help guide their Spanish-speaking neighbors in seeking treatment (Neergaard, 4/8).

The Texas Tribune/New York Times: Cuts To Family Planning May Add To State's Expenses
In a series of amendment forays, House conservatives raided the state's family planning programs and sent the money to other areas like autism programs, crisis pregnancy centers and mental health services for children. Most of the conversation was couched as a this-versus-that choice between family planning and another program, often one attractive to Democrats (Ramsey, 4/7).

The Wall Street Journal: The $2 Million Patients
New York's state-run institutions for the mentally disabled are billing the Medicaid program nearly $2 million per patient a year—a rate that goes far beyond the cost of caring for the patients and is attracting the scrutiny of federal regulators (Gershman, 4/7).

USA Today: Gabrielle Giffords' Office Puts Focus On Brain-Injury Care
In a letter signed by chief of staff Pia Carusone, Giffords' office urged Secretary of Health and Human Services Kathleen Sebelius to include brain-trauma rehabilitation services as essential benefits in its Patient Protection and Affordable Care Act, despite budget cuts looming in Congress (Sternberg, 4/7).