Medicare, other entitlement programs key to 'fiscal cliff' deal

Politico reports that "inside the talks," a framework for addressing the "fiscal cliff" is taking shape that includes both tax increases and entitlement cuts. Other news outlets note that publicly, President Barack Obama is playing down spending cuts, while GOP leaders demand entitlement reductions but offer few specifics.

Politico: Inside The Talks: Fiscal Framework Emerges
Cut through the fog, and here's what to expect: Taxes will go up just shy of $1.2 trillion -; the middle ground of what President Barack Obama wants and what Republicans say they could stomach. Entitlement programs, mainly Medicare, will be cut by no less than $400 billion - and perhaps a lot more, to get Republicans to swallow those tax hikes. There will be at least $1.2 trillion in spending cuts and "war savings." And any final deal will come not by a group effort but in a private deal between two men: Obama and House Speaker John Boehner (Vandehei and Allen, 11/29).

The New York Times: Obama Tilts Tax Debate Away From Spending Cuts
Mr. Obama has embraced specific cuts to the federal budget in the past and has committed to an agreement with Congress that will include deep reductions in spending. But it would be easy for those who listen to his public pronouncements lately to miss it. In public statements since his re-election, he has barely discussed how he would pare back federal spending, focusing instead on the aspect of his plan that plays to his liberal base and involves all gain and no pain for 98 percent of taxpayers. … Republican leaders were more scathing, saying the president was more interested in campaigning than sitting down to resolve difficult issues. They said they were willing to raise tax revenue by closing loopholes and limiting deductions, but Mr. Obama has not reciprocated with more restraint of entitlement programs (Baker, 11/28).

Los Angeles Times: Obama Takes 'Fiscal Cliff' Battle To Social Media
Democrats welcomed Obama's effort to mobilize public opinion as the divided Congress struggles to strike a budget deal before Jan. 1, when a series of automatic tax hikes and sharp spending cuts are scheduled to kick in. … Obama urged Americans to tweet members of Congress using hashtag #My2k, a reference to the $2,200 he said an average family would pay in additional taxes if Congress failed to act. He mentioned the Twitter hashtag four times, and it later appeared on a screen behind Jay Carney, the White House press secretary, at his televised afternoon briefing. House Speaker John A. Boehner (R-Ohio) indicated that he had little patience for the continued focus on taxes, and that he wanted the administration to put spending cuts to Medicare, Medicaid and other government programs on the table (Parsons and Mascaro, 11/28).

The Associated Press/Washington Post: White House, Congress To Talk As Fears Increase That Government Heading Toward 'Fiscal Cliff'
Amid increasing anxiety that the White House and top Republicans are wasting time as the government slides toward an economy-rattling "fiscal cliff," administration officials are heading to Capitol Hill for talks with congressional leaders. Treasury Secretary Tim Geithner and senior White House aide Rob Nabors were to visit separately Thursday with the four leaders of the House and Senate to discuss how to avert a series of tax increases and spending cuts due to begin in January. Republicans complain that the White House is slow-walking the talks and has yet to provide specifics on how President Barack Obama would curb the rapid growth of benefit programs like Medicare and Medicaid (11/29).

The Washington Post: 'Fiscal Cliff' Talks Bogged Down By Dispute Over Cost Of Retirement Programs
Negotiations to avert the year-end "fiscal cliff" advanced at a glacial pace Wednesday, with a dispute over how to tackle the soaring cost of federal retirement programs emerging as the latest roadblock to progress. … Republicans, meanwhile, insisted that it is up to President Obama to offer a plan to restrain the cost of Medicare, Medicaid and Social Security -; the government's biggest and fastest-growing programs -; in exchange for GOP concessions on taxes (Montgomery and Helderman, 11/28).

Roll Call: Liberals Start To See Entitlement Trim As Inevitable
When the Center for American Progress recently pointed to some potential savings from entitlement programs, the political implications were more important than the numbers. The left-of-center group's entry into the battle over entitlement spending provided some political cover that could allow more Democratic lawmakers to support a deficit reduction compromise including savings from programs they have long defended with their political lives -; Medicare, Medicaid and perhaps Social Security. The report said Congress could reduce the cost of health care for seniors by $385 billion over 10 years by picking up some proposals that were either discussed during the 2011 debt limit standoff or included in President Barack Obama's fiscal 2013 budget proposal -; things such as higher premiums for upper-income Medicare beneficiaries and cuts in Medicare payments to hospitals and nursing facilities (Krawzak, 11/28).

National Journal: Dems To GOP: Stop Stalling And Name Your Entitlement Cuts
Senate Democrats are blaming Republicans for the slow pace of the fiscal cliff negotiations, arguing that Republicans have failed to lay out the entitlement spending cuts they want to see as part of a deal. Instead, Republicans are trying to force Democrats into negotiating with themselves and in the process take on the political burden of proposing both tax increases on the wealthy and spending cuts that could hit the middle class, a Senate Democratic leadership aide said. ... Even Democratic Sen. Tom Harkin, who has publicly opposed including Medicare or Medicaid cuts in a deal, refrained from saying that Democrats would reject an Obama-Boehner crafted deal that includes spending cuts. Instead, he urged the president to keep Senate Democrats in the loop so they can work something out (Frates, 11/28).

Reports also explore what Medicare proposals could be in play -

NPR: The Hidden Costs Of Raising The Medicare Age
Whenever the discussion turns to saving money in Medicare, the idea of raising the eligibility age often comes up. … It's hardly surprising that the idea keeps finding its way into the conversation. That same increase is already being phased in for Social Security. Even President Obama reportedly had the idea on the table during his informal negotiations with House Speaker John Boehner during the summer of 2011 (Rovner, 11/29).

NPR: A Huge Pay Cut For Doctors Is Hiding In The Fiscal Cliff
On Jan. 1, Medicare is set to cut payments to doctors by nearly 30 percent. Both Republicans and Democrats in Congress want to prevent this from happening. But a very different Congress 15 years ago decided the cut was necessary to contain health-care costs (Joffe-Walt, 11/29).

The Medicare NewsGroup: AMA's New Leader Embraces Medicare Policy
For Dr. Ardis Hoven and other veteran policymakers within the American Medical Association (AMA), the nation's largest medical organization's move to support transitioning Medicare away from a defined-benefit to a defined-contribution system has been a long time coming. Hoven, an internist and infectious disease specialist based in Lexington, KY, served countless hours over the last two decades on the AMA's Council on Medical Service, debating how the physicians' organization could best advise Congress and the White House to preserve Medicare, the federal health insurance program for seniors and the disabled. Meanwhile, doctors became increasingly unsure what they would be paid by Medicare from one year to the next (Japsen, 11/27).