Viewpoints: Sen. Cruz's strategy and a looming deadline; Michigan republicans face key test

The New York Times' Taking Note: Ted Cruz Plays Two Truths And A Lie
Mr. Cruz also acknowledged that he does "not have the votes right now" to force a shutdown. At least 41 Senators need to play along, and, so far, only 13 have signaled their commitment to the cause. But the senator would only go so far in accepting reality. He refused to concede that even if he could send a bill to President Obama's desk that cut off funding for health care -; the president would never sign it (Juliet Lapidos, 8/26). 

The Washington Post Plum Line: The Tea Party Tiger Has No Teeth
"It is going to take a [grass-roots] tsunami," he told host Candy Crowley. Then he made this astonishing admission: "Now is the single best time to stop Obamacare. If it doesn't happen now, it's never going to happen." He's absolutely right on that, of course, as once the law's exchanges go into place on Oct. 1, it will be procedurally and legally much more complicated to undo, not to mention that the political calculus flips once people start depending on Obamacare's benefits. If a "tsunami" doesn't materialize in the next month (don't hold your breath), then the defunders will demand heads (Alex Seitz-Wald, 8/26).

Los Angeles Times: Affordable Care Act: Is It Affordable?
A new report showing a relatively modest increase in premiums for employee health coverage is either a validation or an indictment of the 2010 healthcare law, depending on whose spin you believe. Supporters cite the slowing rise in healthcare spending, while opponents retort that premiums are still growing faster than the economy or consumer prices. There's a bit of truth to both sides, but more posturing. The biggest effects of the Patient Protection and Affordable Care Act won't be seen until next year at the earliest. And while there have been some promising signs, there are worrisome ones as well (8/26).

McClatchy: The Unsteady Rollout Of Obamacare
Any program as large and complex as Obamacare (not to mention one facing such entrenched opposition) is going to encounter some turbulence on its shakedown cruise. But the recent glitches are as important for what they tell us about reform, as for what they do (Caroline Poplin, 8/26).

Forbes: Report: If New Hampshire Expands Medicaid, State Hospitals Will Lose Hundreds Of Millions Of Dollars
In states that remain undecided about whether or not to expand Medicaid, as Obamacare prescribes, hospitals have lobbied furiously in expansion's favor. That's not surprising, on its face; hospital executives' eyes widen at the possibility of hundreds of billions in additional taxpayer subsidies under the law. But an analysis from the Lewin Group, a prominent health care consulting firm, finds that if New Hampshire expands Medicaid, Granite State hospitals will actually lose $228 million in revenue over the next seven years (Avik Roy, 8/27). 

Detroit Free Press: For State Senators, A Life-Or-Death Choice
More than four years ago, Congress adopted health care reform legislation that promised to extend Medicaid eligibility to millions of working poor Americans who can't afford private health insurance. Today, all that stands between that promise and 470,000 uninsured Michigan residents is the Republican caucus of the Michigan Senate (8/27).

Bloomberg: Doctors Should Bill For Life-Or-Death Decisions
As an intern admitting emergency-room patients to a Cincinnati hospital, I saw it happen again and again: Late-stage cancer patients in the midst of medical crises would roll into our ER in need of a ventilator as expected complications mounted. We would ask for their advance directives, who had their power of attorney, and whether they had considered "do not resuscitate" orders or hospice. Too often, these concepts were unfamiliar, even for patients who had been undergoing cancer treatments for months or years. ... For too long, American medicine has pushed off the big conversations with the sickest patients until too late (Ford Vox, 8/26).

Bloomberg: Are Hospitals Already Saving Money For Medicare?
Medicare continues to exhibit remarkably slow growth: a modest 3 percent over the past year. That's great news, but a debate is raging about whether this is caused by a weak economy (and therefore will reverse as the economy recovers) or other factors (and therefore may persist, drastically improving the budget outlook).  Two new studies tilt toward the optimistic possibility (Peter Orszag, 8/26).