Health program spending at crux of partisan budget debate

As details emerged regarding the Obama deficit plan, news outlets explored the very different approaches favored by the White House versus the GOP to control Medicare and Medicaid spending.

Politico: President Obama: I'll Fix Health Care My Way
President Barack Obama is outlining a deficit reduction plan Wednesday that calls for deep Medicare and Medicaid spending cuts, but through a stronger independent Medicare board and a new Medicaid funding formula rather than the structural changes Republicans want. Obama is setting a new goal of saving $340 billion in Medicare and Medicaid costs over 10 years, and $480 billion by 2023, with another $1 trillion in savings in the decade after that, according to a fact sheet released by the White House. But he would do it in part by beefing up the Independent Payment Advisory Board, one of the least popular parts of the health care law among most Republicans and some Democrats — as well as provider groups that fear the cuts it would recommend. The idea of expanding the board is unlikely to gain traction in Congress any time soon, especially since it assumes that Republicans would end their efforts to repeal or defund the law (Nather, 4/13).

The Hill: Obama Outlines Plan To Cut Medicare, Medicaid Costs
House Republicans last week proposed a budget that would largely privatize Medicare and turn Medicaid over to the states, but Obama rejected both approaches in a speech Wednesday afternoon. The House Republican proposal "lowers the government's health care bills by asking seniors and poor families to pay them instead," Obama said. "Our approach lowers the government's health care bills by reducing the cost of health care itself." ... Of the two proposals, the most controversial is likely to be Obama's push to strengthen the reform law's Independent Payment Advisory Board (IPAB). Lawmakers must adopt the board's proposed cuts to Medicare providers or propose their own. ... Far from eliminating IPAB, Obama proposes strengthening it beginning in 2018 by having it kick in if Medicare costs are growing at GDP per capita plus 0.5 percent, far sooner than the current rate of GDP plus 1 percent (Pecquet, 4/13).

Kaiser Health News: Obama's Deficit Plan: A 'Nuanced Approach' Or 'So Partisan'
Kaiser Health News staff writers Mary Agnes Carey and Shefali Kulkarni report: "As President Barack Obama presented his vision for deficit reduction Wednesday, he took an evolutionary rather than revolutionary approach, saying he wanted to work with Congress to preserve the current structure of Medicare and Medicaid but make the programs more efficient. The reaction to Obama's remarks fell predictably along partisan lines" (Carey and Kulkarni, 4/13).

The Washington Post: Obama Proposes Tighter Curbs On Health Care Spending
President Obama proposed Wednesday tighter curbs on Medicare spending and a new way of sharing Medicaid and children's health care costs with states as he laid out a path to rein in the entitlement programs that pose the single largest threat to the nation's fiscal future (Goldstein, 4/13).

The Wall Street Journal: Obama Seeks Medicare Savings, Rejects GOP Plan
President Barack Obama on Wednesday outlined a plan to cut $480 billion by 2023 from the U.S. government's health care programs for the elderly and poor, drawing a sharp line of disagreement with House Republican leaders over how to rein in the burgeoning costs of medical care (Adamy, 4/13).

USA Today: Medicare At Center Of Budget Debate
In the debate over deficits that is likely to dominate the capital for the next year, there are a few signs of common ground between President Obama and emboldened Republicans as each side tries to trim trillions of dollars from the federal budget. But not on Medicare (Page, 4/14).

Marketwatch: Obama Doubles Down On Health Care Reform
Everyone who's studied the budget knows that health care is where the money is, and health care is where the potential savings are.
Obama would allow Medicare to bargain directly with the drug companies to reduce drug costs, and would prohibit Big Pharma from blocking the use of generic drugs. But the best way to reduce spending is to make sure that we pay only for effective care. Obama says he can slow the growth of health care costs by empowering an independent review board to scientifically examine what works and what doesn't. Medicare would pay for care that works. It's the most powerful idea in the Affordable Care Act, and one that has chance of bringing U.S. health care spending down to the much-lower level spent in other advanced countries. It will require a massive change in how doctors, hospitals, drug companies and insurance companies operate (Nutting, 4/13).

Kaiser Health News: Health On The Hill - Obama Hits Back At GOP Deficit Plan On Medicare, Medicaid
KHN's Mary Agnes Carey and Marilyn Werber Serafini talk with Jackie Judd about President Obama's Wednesday speech outlining his details for reducing the deficit and hitting back at a Republican deficit plan (4/13). Read the transcript.

NPR Shots Blog: Obama Wants Medicare To Flex Muscle For Lower Drug Costs
Medicare, the health program for the elderly, is a big target for budget-cutters in both parties. The Republican vision, as articulated by Rep. Paul Ryan (R-WI), would privatize and subsidize coverage for Americans now younger than 55. Obama has different ideas. He rejected Ryan's approach and would keep Medicare fully part of the federal government. … Basically, Obama would take steps to reduce the costs of the Medicare rather than transform it. A prime target: drug spending (Hensley, 4/14).

Stateline: Governors Split on Obama's Medicaid Plan
President Obama's commitment to preserving the current Medicaid program was met with praise from Democratic governors and skepticism from Republicans. ... [Meanwhile] Maryland Governor Martin O'Malley signed a bill this week authorizing the creation of a state health insurance exchange, as required by the 2010 health law. California and West Virginia are the only other states with such laws so far (Vestal, 4/14).

Kaiser Health News: Video Excerpts Of President Barack Obama On Health Care And The Deficit
Kaiser Health News provides video excerpts of yesterday's major speech at George Washington University in which President Barack Obama laid out a framework for controlling the deficit (4/13). KHN also has details of the health care policies from the plan - based on a White House fact sheet; and highlights from the text of the speech.