First Edition: July 26, 2011

Today's headlines highlight Washington's debt-celing showdown, and a report that the federal government will conduct health insurance rate reviews in 10 states.

Kaiser Health News: Insuring Your Health: New Emergency Care Programs Focus On Quality-Of-Life Issues
In her latest Kaiser Health News consumer column, Michelle Andrews writes: "In the controlled chaos of an hospital emergency department, ensuring that patients are pain-free and can make informed choices about their care often takes a back seat to assessing and stabilizing them and moving them through the system as fast as possible. But now some experts say that providing palliative care - which focuses on patients' quality-of-life issues - can and should be a priority in emergency departments, and they're putting together a program to help hospitals better address those issues" (Andrews, 7/25).

Capsules: Some Small Businesses Say Health Insurers Are Dropping Their Coverage
Currently on KHN's Capsules blog, Bara Vaida writes: "One in eight small businesses told the National Federation of Independent Business that since the health law passed in 2010, their health insurer had either terminated their plan or notified them it is going to be eliminated. The NFIB said it couldn't say for certain that small businesses were losing their insurance because of the health law, but the organization is 'pretty sure' that costs related to the health law were the cause." Also on the blog,  a report about the Patient-Centered Outcomes Research Institute and Louisiana Medicaid's move to managed care.

The Washington Post: President Obama, House Speaker Boehner Present Dueling Debt-Limit Plans To Nation
As Boehner tried to rally support for his two-step plan to cut $3 trillion in spending, Senate Majority Leader Harry M. Reid (D-Nev.) offered a strikingly similar proposal for increasing the debt limit before the Aug. 2 deadline. The two leaders, however, remained bitterly divided over Boehner's demand to hold another vote next year to further expand the government's borrowing authority (Kane and Montgomery, 7/25).

The Associated Press: Rival Plans Ensnarl Congress Over Debt Ceiling
The Senate plan, unveiled Monday by Senate Majority Leader Harry Reid, D-Nev., and the proposal announced the same day by Boehner overlap in significant ways. Both identify about $1.2 trillion in spending cuts to the day-to-day operating budgets of government agencies, though Reid's proposal also counts an extra $1 trillion in savings from winding down wars in Iraq and Afghanistan. Both proposals would create a bipartisan congressional commission to identify further deficit reductions, especially in major health care programs such as Medicare and Medicaid. The primary difference between the two is timing. Reid's proposal would raise the debt ceiling enough so that it wouldn't have to be reconsidered until 2013, beyond the 2012 elections, as demanded by Obama. The GOP plan would only extend the debt ceiling for about six months (Kuhnhenn, 7/26).

The New York Times: Parties Head To Showdown As Obama Warns Of A 'Crisis'
The Democratic-led Senate and Republican-led House on Monday barreled toward a showdown on competing plans to cut spending and raise the debt limit as a resolution to the intensifying crisis remained farther from sight just one week before a possible federal default (Hulse and Calmes, 7/25).

Los Angeles Times: Prodding Congress To Act, Obama Warns Of 'Collateral Damage' To Nation In Debt Fight
President Obama on Monday issued a grave warning against prolonging the current political stalemate and specifically called on the freshmen in the House Republican caucus to bring it to an end. …  Republican House Speaker John A. Boehner (R-Ohio) immediately challenged Obama's account of the debt standoff, saying in his own nationally televised speech that there is no stalemate in Congress. … But the dueling speeches illustrate the depth of the conflict, just seven days from the Aug. 2 deadline when Treasury officials estimate the government will run out of cash to pay its bills. If the Congress hasn't voted by then to raise the debt limit, currently $14.3 trillion, the government will no longer be able to borrow funds to cover its deficit and will have to choose which bills to pay. That could mean that millions of government beneficiaries expecting Social Security checks, disability payments or salaries will go without or get much less than expected (Parsons and Mascaro, 7/25).

The Wall Street Journal: Obama Warns Of Default Risk
On Monday, each side sought to frame the debate to its advantage. Mr. Boehner said the first step of a debt-ceiling increase would carry the government through February or March, while imposing spending cuts of $1.2 trillion through a series of budget caps. In addition, Congress would vote by year's end on a balanced-budget amendment. A committee of 12 lawmakers would then recommend ways to cut the deficit by at least $1.8 trillion more, probably through an overhaul of the tax system and changes to entitlement programs like Social Security and Medicare. If Congress enacts the recommendations, Mr. Obama could propose a second debt-limit increase of up to $1.5 trillion, which could only be rejected by a two-thirds vote of both chambers of Congress (Bendavid and Lee, 7/26).

The Washington Post: As State Of Play In Debt Talks Changes By The Moment, Even Lobbyists Struggle To Keep Up
Advocacy groups that have spent months anticipating exactly the stalemate Washington has now reached are working to apply pressure to nudge political leaders engaged in talks on raising the nation's debt ceiling. But with the state of play changing by the moment, advocates are able to offer only the broadest of thoughts about how to proceed (Helderman, 7/25).

Kaiser Health News also tracked yesterday's coverage, including late stories about the speeches delivered by President Obama and House Speaker Boehner (7/25).

The New York Times: Federal Auditors Will Soon Review Health Insurance Rates In 10 States
The Obama administration will soon take over the review of health insurance rates in 10 states where it says state officials do not adequately regulate premiums for insurance sold to individuals or small businesses. At least one state, Iowa, has protested the federal decision and asked administration officials to reconsider (Pear, 7/25).

The New York Times: Lawsuit Says Drugs Were Wasted To Buoy Profit
One of the nation's largest providers of kidney dialysis deliberately wasted medicine in order to reap hundreds of millions of dollars in extra payments from Medicare, a former clinic nurse and a doctor are charging in a whistle-blower lawsuit (Pollack, 7/25).

Politico: Cash Sought To Prevent Diabetes
Left unchecked, diabetes is a ticking time bomb of a disease in an individual's life. It's also a $3.4 trillion-a-decade threat to the nation's fiscal health and a huge driver of Medicare costs. The health reform law authorized the National Diabetes Prevention Program — but didn't actually provide any funds for it. Another piece of the massive law, the Prevention and Public Health Fund, provides mandated dollars that could be a funding source for the diabetes program, but that fund is likely to be slashed in half in the debt ceiling negotiations (Webber, 7/25).

The Washington Post: Neb. Doctor Who Performs Late-In-Pregnancy Abortions In Md. Talks About Future Of Clinic, Security Concerns
As one of the few doctors in the nation who openly acknowledge performing abortions late in a pregnancy, and because he wants to expand his services, Carhart is the top focus of antiabortion groups. He took on that role after Kansas doctor George Tiller, his friend and mentor, was fatally shot by an abortion opponent in 2009. Tiller was attending church at the time — the only predictable event in his schedule (Sun, 7/24).

Politico: Poll: Voters Split On Abortion Changes
Americans overwhelmingly favor restrictions on late-term abortions and they don't want Planned Parenthood defunded, but are more closely divided on other controversial changes to abortion laws, according to a new poll on Monday. The Gallup survey found voters narrowly split on two measures being pushed in some states: requiring pregnant women to view ultrasound images of their fetus and allowing doctors to opt out of providing abortions (Groll, 7/25).