First Edition: July 18, 2011

Today's health policy headlines include the latest news on the debt-ceiling talks as well as reports on IPAB and health exchanges.

Kaiser Health News: FAQ: Seniors May See Changes In Medigap Policies
Kaiser Health News staff writer Julie Appleby writes: "As debt limit talks drag on, lawmakers are eying possible changes in Medicare supplemental plans - moves that could increase seniors' out-of-pocket costs. Traditional Medicare, the federal health program for the elderly and disabled, requires beneficiaries to pay hospital deductibles and a portion of the cost of tests and doctor visits. To protect themselves from those out-of-pocket costs, about 17 percent of beneficiaries buy Medigap plans. Another 34 percent get such coverage through a former employer" (Appleby, 7/15).

Kaiser Health News: Capsules: Drug Industry Rebates: The Sequel
On the blog, Kaiser Health News staff writer Mary Agnes Carey reports: "Note to drug makers: Just in case you thought you'd be spared as part of the debt ceiling talks, think again. At a Friday news conference President Barack Obama made it clear that drug industry rebates to Medicare are very much in the mix as negotiators try to find ways to reduce federal spending on entitlement programs." Also on the blog, check out KHN's roundup of summer health policy fact-checks and a report about food deserts. 

Kaiser Health News: It's Not Just The Money: Cost Control In Cancer Care (Guest Opinion)
In his latest Kaiser Health News column, Harold Pollack writes: "Health reform raises central ideological questions about the size and scope of government, about progressive taxation, about the individual mandate and more. It's easy to forget that cost control will be a huge challenge, no matter how these ideological matters are resolved, indeed under any health system. Finding the right combination of humanity and restraint will be particularly hard in addressing life-threatening or life-ending illness. Economic incentives, American culture, a changing doctor-patient relationship and fundamental uncertainties at the boundaries of clinical care conspire against our efforts to provide more humane, more financially prudent care" (7/17).

The Washington Post: Congress Tees Up Crucial Votes On Debt Limit
A bipartisan effort in the Senate to allow President Obama to raise the federal debt ceiling in exchange for about $1.5 trillion in spending cuts over 10 years gained momentum Sunday, as leaders agreed they would have to act in the next two weeks to avert a potential default by the U.S. government (Goldfarb, 7/17).

The Wall Street Journal: GOP Hopefuls Betting Voters Want Deep Cuts
The "cut, cap and balance" pledge has become a must-have on the resume of Republican presidential candidates—a written promise to cut federal spending immediately, cap it permanently and secure a balanced-budget amendment to the Constitution. … Meeting the strictures of the pledge would require a fundamental re-ordering of the federal government and an end to some of the basic compacts that it has developed with the states and citizens since World War II, budget analysts say. … That cap would track spending envisioned in the House-passed budget, drafted by Budget Committee Chairman Paul Ryan (R., Wis.). The nonpartisan Congressional Budget Office estimated that non-security discretionary spending would be cut by 33% by 2021 under the Ryan plan; Medicaid would be cut by $1.4 trillion over the coming decade and cut in half by 2030. Under the plan's transformation of Medicare to a subsidized, private health-insurance program, more costs would have to be paid by Medicare recipients (Weisman, 7/18).

The Associated Press: Tea Party Takes Its Turn In Debt Battle
Congressional leaders are giving tea party-backed Republican freshmen the run of the House this week with a plan to let the government borrow another $2.4 trillion -- but only after big and immediate spending cuts and adoption by Congress of a constitutional amendment requiring a balanced federal budget (Taylor, 7/18).

Los Angeles Times:  House Republicans Brace For Compromise On Debt
Republican leaders in the House have begun to prepare their troops for politically painful votes to raise the nation's debt limit, offering warnings and concessions to move the hard-line majority toward a compromise that would avert a federal default. … At a closed-door meeting Friday morning, GOP leaders turned to their most trusted budget expert, Rep. Paul D. Ryan of Wisconsin, to explain to rank-and-file members what many others have come to understand: A fiscal meltdown could occur if Congress fails to raise the debt ceiling (Mascaro and Hennessey, 7/16).

The Associated Press: Accusations Fly Over Obscure Medicare Board
So long death panels. Hello "rationing" board. An independent panel authorized by President Barack Obama's health care law to control excessive Medicare cost increases is drawing heavy fire from Republicans. Nearly every health industry lobbying group is pushing for its repeal, as are some consumer advocates. GOP lawmakers call it a rationing panel, and at least one has suggested seniors will die from its decisions (Alonso-Zaldivar, 7/18).

The Wall Street Journal: Romney Adviser Backs Obama Health Exchanges
Former Utah Gov. Mike Leavitt, a top supporter and adviser of Republican White House hopeful Mitt Romney, strenuously backed the core piece of President Barack Obama's health-care law and urged the states to move forward together in adopting health insurance exchanges (Weisman, 7/16).

The Wall Street Journal: Hospital Ads Raise Ire Of Democrats
An angry confrontation behind closed doors this week shows that the acrimonious debt talks in Washington are causing cracks in a normally rock-solid alliance: Democrats and health-care workers. Senior New York Democrats confronted leaders of the Greater New York Hospital Association and the health-care workers union, 1199 SEIU, at a meeting Wednesday, according to several people who were there. The lawmakers were upset that the two groups had taken out full-page newspaper ads that day suggesting Democrats might "kill health reform'' in ongoing budget talks (Barrett, 7/16).

The New York Times: States' Money Woes Show No Favorites
Arizona began cutting more than 100,000 people from its Medicaid rolls this month. Illinois, even after raising taxes, began the month with $3.8 billion worth of unpaid bills left over from last year. Connecticut sent layoff warnings last week to state troopers. The governors who gathered here over the weekend for the summer meeting of the National Governors Association have all been scathed by the unpopular things they have had to do to keep their budgets in balance. For the veterans, it was just the latest in a series of tough years. For the rookies — 29 new governors took office this year — it was their first taste of state budget battle (Cooper, 7/17).

NPR: AARP Finds Toll On Family Caregivers Is 'Huge'
A new study by the AARP estimates that for the more than 40 million Americans caring for an elderly or disabled loved one, the value of their work is $450 billion a year. That's a good deal for society. But for the family members doing the work, the study finds they need a lot more help (Ludden, 7/18).

Kaiser Health News tracked weekend health policy coverage, including reports about Medicaid funding and how the role of Medicare and Medicaid in the debt-ceiling debate could have election consequences.