First Edition: April 11, 2013

Today's headlines include details regarding how Medicare and Medicaid, as well as funding for the health law's implementation, fared in President Barack Obama's budget plan. 

Kaiser Health News: HHS Seeking $1.5B In Funding To Run Federal Health Insurance Exchanges
Kaiser Health News staff writer Mary Agnes Carey reports: "The Obama administration is trying once again to convince Congress to provide more funding for the health law's insurance exchanges, which are set to begin enrollment this fall. According to figures released in the fiscal 2014 budget request Wednesday, the administration estimates that the federal government will spend about $4 billion on those federal- and state-run marketplaces for individual and small businesses purchasing insurance coverage" (Carey, 4/10). Read the story.

Kaiser Health News: Insurers Battle Over Federal Employees' Health Coverage
Kaiser Health News staff writer Phil Galewitz reports: "The Obama administration, in its fiscal 2014 budget proposal released Wednesday, said it favors allowing more plans to compete to cover federal employees. The Blues are fighting the change, saying  there is already sufficient competition with 230 plans participating in the program" (Galewitz, 4/10). Read the story.

The New York Times: Health Care And Military Spending Bear The Brunt Of Proposed Cuts
President Obama's effort to control federal spending would require the largest cuts from the government's biggest programs -; health care and the military -; while preserving or increasing spending on favored initiatives like early education, manufacturing and research. … The budget would require $57 billion in higher payments by Medicare beneficiaries, cut $306 billion in projected Medicare payments to health care providers and squeeze $19 billion out of Medicaid, the program for low-income people (Pear and Shanker, 4/10).

The Washington Post: Obama Releases A Budget Plan With A Simple Goal: Ending The Debt Standoff
But barely five months after winning a decisive reelection victory, Obama proposes nothing on the scale of the $1.2 trillion initiative to extend health coverage to the uninsured that he pursued after taking office in 2009. Instead, with sharp automatic spending cuts threatening to slow the economic recovery and another showdown over the federal debt limit looming this year, the blueprint establishes a budget deal with Republicans as Obama's top fiscal priority. For the first time, he is formally proposing to trim scheduled Social Security benefits -; a GOP demand that is anathema to many Democrats. He is also offering to make meaningful reductions in Medicare benefits, including higher premiums for couples making more than $170,000 a year (Montgomery, 4/10).

The Wall Street Journal: Obama Reaches For Middle Ground With New Budget Plan
President Barack Obama took a political gamble Wednesday by proposing to curb the growth of Social Security and Medicare, hopeful that the concessions would draw rank-and-file Senate Republicans into a budget deal that has so far proven elusive. … Congressional Republican leaders mostly dismissed the package and described it as a nonstarter because of proposed tax increases. But other Republicans said it contained measures that could show promise (Paletta, 4/10).

The Wall Street Journal: Social Security, Medicare Face Hits
As President Barack Obama's new budget indicates, the two political parties actually have agreed in the last two years to some significant steps to reduce deficits down the road. One big question is whether the budget points a way toward restraining the largest long-term drivers of the deficit, which are government entitlement programs, particularly for health care. The White House says its budget blueprint represents a good start down that path by offering proposals to curb the growth of Social Security, Medicare and other federal benefits programs (McKinnon and Radnofsky, 4/10).

Los Angeles Times: Obama Says His Budget Has 'Manageable' Cuts To Entitlement Programs
President Obama argued for "manageable" changes to Medicare and other social safety net programs as he released his budget proposal, a plan aimed at staking out the middle ground in the stalled deficit reduction talks. "If we want to preserve the ironclad guarantee that Medicare represents, then we're going to have to make some changes. But they don't have to be drastic ones," Obama said in remarks in the Rose Garden on Wednesday morning. "… Obama's remarks intended to draw a contrast with House Republicans' budget proposal, fashioned by Rep. Paul Ryan of Wisconsin, which would balance the federal budget in 10 years in part by transforming Medicare into a voucher-style system and cutting government spending on Medicaid (Hennessey and Mascaro, 4/10).

The Associated Press/Washington Post: Obama's Budget Seeks Cooperation On Deficit Deal While Hoping To Keep Faith With Democrats
Obama's stated goal is otherwise, namely that his $3.8 trillion budget should lead to the completion of a slow-motion grand deficit-cutting bargain by offering to save billions from programs previously sheltered from cuts. Medicare, Social Security and even military retirement are among them. Perhaps to reassure Democrats unsettled by this approach, the president said his offer to trim future benefit increases for tens of millions of people is "less than optimal" and acceptable only if Republicans simultaneously agree to raise taxes on the wealthy and some businesses (4/11).

The New York Times: Obama Budget Opens Rift For Democrats On Social Benefits
President Obama's new budget has opened a debate over what it means to be a progressive Democrat in an age of austerity and defines him as a president willing to take on the two pillars of his party -; Medicare and Social Security -; created by Democratic presidents (Calmes, 4/10).

The New York Times: Budget Embodies Obama's Vision For Remaking Economy
To pay for a series of programs he deemed crucial to the future and reduce the long-term budget deficit, Mr. Obama also called for cuts to Social Security and Medicare, putting him at odds with many other Democrats. They instead see those programs, created by previous Democratic presidents, as sacrosanct (Lowry and Rich, 4/10).

The Washington Post's WonkBlog: The White House Wants To Reverse $500 Million In Medicaid Cuts
The White House wants to reverse $500 million in cuts to the Medicaid program meant to start in 2014, aiming to ensure that states have adequate funds to assist those that remain uninsured under the Affordable Care Act. A bit of history is helpful here. For decades now, Medicaid has sent states billions of dollars in something called Disproportionate Share, or DSH, payments. These funds, which totaled $11.3 billion in 2011, go to the hospitals that provide a higher level of uncompensated care and are meant to help offset the bills of the uninsured (Kliff, 4/10).

Politico: HHS Seeks Obamacare Funds – But Is Ready To Scramble
The landmark health law may have survived the Supreme Court, countless repeal efforts and a presidential election -; but none of that required Republicans to shower money on Obamacare. And with at least 33 states refusing to build the critical health insurance exchanges, the federal government is unexpectedly on the hook to set them up -; and short of money to do so. The White House requested $1.5 billion more for the health law implementation in its budget Wednesday, but health officials know they're not likely to get it (Millman and Norman, 4/10).

The Associated Press/Washington Post: What Health Care Overhaul? Tracking Costs Of Obama's Health Law In Budget Isn't Easy
It turns out that the costs of the Affordable Care Act -; Obamacare to its unyielding Republican foes-; are sprinkled here and there through hundreds of pages of budget books. It's partly due to the arcane ways of government budgeting. It may also be an effort to avoid giving foes more of a target. ...  Even some of the major spending in the new law isn't easy to find. Starting Jan. 1, people who don't have health insurance through their jobs will be able to get coverage in two main ways. Low-income people will be eligible for an expanded Medicaid program, provided their state government accepts. Uninsured middle-class people in every state will eligible for subsidized private plans through new state health insurance marketplaces that go live online this fall (4/11).

The Wall Street Journal's Washington Wire: HHS Budget Aims to Boost Mental-Health Programs
The Obama administration is proposing to increase spending for mental health programs and the children's Head Start program while cutting funding for low-income energy assistance and community service grants. The 2014 budget for the Department of Health and Human Services released Wednesday totals $80.1 billion, about $4 billion above the enacted budget for fiscal year 2012. It calls for $1.5 billion for the government to build an insurance exchange that will allow certain Americans to shop for health insurance, HHS Secretary Kathleen Sebelius said Wednesday. The federal exchange is targeted to begin operating Oct. 1. and sell insurance coverage that kicks in Jan. 1 (Dooren and Burton, 4/10).

The Associated Press/Washington Post: Obama Health Care: Cover Uninsured, Trim Medicare, Hike Tobacco Taxes
President Barack Obama's new budget offers Medicare cuts to entice Republicans into tax negotiations, while plowing ahead to cover the uninsured next year under the health care law the GOP has bitterly fought to repeal. But the biggest health consequences of any new proposal in Obama's plan could come from nearly doubling the federal tobacco tax. If enacted by Congress, it could make young people think twice about the cigarette habit (4/10).

The Wall Street Journal: Obama, GOP Senators Talk 'Grand Bargain' Over Dinner
One person familiar with the dinner conversation, speaking on condition of anonymity, said the group talked about reaching a bipartisan agreement on what the president calls a "grand bargain"-;a sweeping budget deal that would shore up Social Security and Medicare while reining in deficits. It was clear from the dinner that divisions persist, participants said (Nicholas, Hook and Peterson, 4/10).

The Wall Street Journal: Some Drug Makers Cut Payments, Meals Provided To Doctors
Two pharmaceutical companies that are among the biggest payers of fees to doctors reduced such spending last year by double-digit percentages, as greater transparency sheds light on the hundreds of millions of dollars the industry pays physicians for marketing and research efforts (Loftus, 4/10).

USA Today: Rate Of Employer-Based Health Insurance Keeps Dropping
The availability of employer-sponsored insurance has fallen by about 10% over the past decade, which has spurred an increase in the overall number of Americans without health insurance, according to a report released today (Kennedy, 4/11).

The Associated Press/Washington Post: Report: Fewer In Virginia Getting Health Insurance Through  Employers; Less Offer Coverage
A new report shows fewer Virginians are getting health insurance through their employer. The Robert Wood Johnson Foundation report released Thursday says 66 percent of Virginia residents got their insurance through a job in 2011. That's down from 75 percent in 2000 (4/11).

Los Angeles Times: Blue Shield May Lose Exclusive CalPERS HMO Contract
Blue Shield of California may be losing its longtime grip on one of the healthcare industry's most coveted insurance contracts. Officials at the California Public Employees' Retirement System are recommending breaking up Blue Shield's current statewide HMO contract and replacing it with as many as four health plans for more than 400,000 public workers and their families (Terhune, 4/11).

Los Angeles Times: L.A. Jury Sides With Doctor In Anthem Blue Cross Case
In a rare case, a Los Angeles jury awarded $3.8 million in compensatory damages to a Porter Ranch doctor who contended insurance giant Anthem Blue Cross retaliated against him for being a strong patient advocate. The jury ruled late Monday in favor of Jeffrey Nordella, 58, an urgent-care and family-practice doctor who alleged that Anthem barred him from its network in 2010, when he applied to be a preferred provider. The damages could climb higher Friday, when the 12-person panel reconvenes and considers punitive damages against Anthem, a unit of insurance giant WellPoint Inc (Terhune, 4/10).