Maneuvering toward a 'fiscal cliff' deal

Despite progress toward an agreement with the White House, House Republicans appeared to veer off course Tuesday with a "Plan B" if budget talks fail. Some media outlets suggested that both President Barack Obama and Speaker John Boehner, R-Ohio, are attempting to quell backlash within their own parties -- Boehner for agreeing to tax increases, Obama for ceding some entitlement cuts.

The New York Times: Boehner Plan Addresses Taxes But Delays Fight Over Spending Cuts
House Republican leaders struggled on Tuesday night to rally their colleagues around a backup measure to ease the sting of a looming fiscal crisis by allowing tax rates to rise only on incomes over $1 million. The plan would leave in place across-the-board spending cuts to military and domestic programs that Republicans have been warning could have dire consequences, especially to national defense. ... Republicans would resume the fight for broad spending cuts, especially to entitlement programs like Medicare, in late January or February, when the government will face raising its borrowing limit and when, many Republicans believe, they will have much more leverage than they do now (Weisman, 12/18).

The Wall Street Journal: GOP Unveils A 'Plan B' If Budget Talks Fail
Despite progress toward agreement on a budget deal with the White House, House Republican leaders on Tuesday proposed a backup plan to prevent most Americans from facing an income-tax increase if negotiations collapse. ... Both leaders face perils as they enter what could be the final stages of high-stakes negotiations to avoid the "fiscal cliff" of higher taxes and spending cuts in early January. Mr. Obama will have to deal with liberals unhappy about entitlement cuts. Mr. Boehner faces a potential backlash from Republicans for contemplating tax-rate increases-;both in his talks with the White House and in Plan B (Hook, Lee and Boles, 12/19).

Kaiser Health News: Health On The Hill: Spending, Taxing Remain Sticking Points As 'Fiscal Cliff' Looms (Audio)
KHN's Mary Agnes Carey speaks with Jackie Judd about negotiations on Capitol Hill to avoid the "fiscal cliff" and just how close -- or far apart -- Democrats, Republicans and the White House seem to be on cutting spending and letting some tax cuts for the rich expire (12/18).

The Washington Post: Boehner's Backup Tax Plan Shakes Up 'Fiscal Cliff' Negotiations
House Speaker John A. Boehner (R-Ohio) veered off the bipartisan course he had been charting toward a broad tax-and-entitlement deal with President Obama and instead Tuesday pushed a GOP package to extend tax cuts for income up to $1 million. The move shook the Capitol after several days of significant progress between Obama and Boehner, who had moved closer to a pact raising taxes on the wealthy and curbing government spending, including on Social Security (Kane and Montgomery, 12/18).

Los Angeles Times: Boehner Changes Gears In 'Fiscal Cliff' Talks With Obama
The speaker made clear that he is not cutting off talks with Obama, but Democrats characterized Boehner as walking away just as compromise appeared within reach. This week, Obama made what White House aides saw as a substantial concession by telling Boehner that he would accept an agreement raising taxes on household income above $400,000, rather than the $250,000 threshold he had previously insisted on. He also proposed changes to reduce the long-term cost of government benefit programs, including Social Security (Mascaro, Parsons, and Memoli, 12/18).

CQ HealthBeat: What's In Obama's Offer Of $400 Billion In Health Care Cuts?
President Barack Obama's latest proposed fiscal cliff remedy includes $400 billion in health care cuts, according to sources familiar with the fiscal cliff negotiations. What are they? The White House hasn't offered specifics, but according to a House aide, "most of it can be found by looking at the Center for American Progress report and the president's budget." Those proposals would hit drug and medical devices hard, among other health sectors. The CAP report is better known as the "Senior Protection Plan." It cuts providers and product makers and charges affluent Americans more for Medicare Part B doctor care and the Medicare Part D prescription drug benefit, among other things (Reichard, 12/18).

The Associated Press: House GOP Focusing On Fiscal Cliff Backup Plan
Still short of a "fiscal cliff" deal with the White House, top House Republicans are laboring to rally their rank-and-file behind an alternative plan that would prevent looming tax increases for everyone but those earning over $1 million a year. House Speaker John Boehner's so-called Plan B, which is aimed at letting GOP lawmakers vote to prevent New Year's Day tax boosts on more than 99 percent of taxpayers, was getting a cool reception from conservatives reluctant to boost anyone's taxes, raising questions about whether it could pass the GOP-run House (Fram, 12/19).

Politico: Cliff Talks Turn Into Public Posturing
House Speaker John Boehner's decision to pursue a fiscal cliff backup plan looked like an attempt to go his own way. But it was really about bolstering his position in the one-on-one talks with President Barack Obama (Sherman, Bresnahan and Budoff Brown, 12/18).

Politico: Many Democrats Unhappy With CPI Offer
After weeks of gleefully watching Republicans struggle to find their footing in fiscal cliff talks, it's time for the Democrats to do some painful soul-searching of their own. President Barack Obama's latest offer to congressional Republicans crosses lines that Democrats have long portrayed as untouchable. The provision causing the most heartburn for Democrats on Capitol Hill is one that would change the way inflation is measured to ultimately reduce payments to Social Security beneficiaries (Sloan and Kim, 12/18).

The Wall Street Journal: Budget Hawk Is Now Quiet As A Mouse
What will Paul Ryan do? ... With talks at a crucial phase, Republicans are keeping close tabs on their recent vice-presidential nominee. His support for a compromise could stem conservative defections. His opposition could sink the deal entirely (O'Connor, 12/18).

The Washington Post: Eric Cantor Plays Loyal Lieutenant To Boehner
In the "fiscal cliff" drama, Cantor has been casting himself as a supportive bit player to Boehner, a contrast from the debt-ceiling showdown of 2011. At that time, Cantor had a starring role as a lead negotiator in high-level talks with Vice President Biden and as a chief antagonist to Obama, tangling with the president in one tense White House exchange. But that role did not go well for Cantor. It neither strengthened the GOP's hand in the fiscal crisis nor served the lawmaker's image. He emerged with a taint of disloyalty toward Boehner and a new reputation, carefully stoked by Democrats, as the leader of hard-liners unwilling to compromise (Helderman, 12/18).

The Hill: Advocates: Shield Medicaid From 'Fiscal Cliff' Cuts
A coalition of health and social justice groups is urging Congress not to allow Medicaid cuts in a deal to reduce the deficit and avoid the so-called "fiscal cliff." The 165 national groups sent a letter to lawmakers Tuesday asking them to shield Medicaid, which provides health insurance to low-income people, including millions of children. Liberal lawmakers have made the same case in recent weeks. Tuesday's letter also argued against proposals to block-grant the program, like House Budget Committee Chairman Paul Ryan's (R-Wis.) (Vibeck, 12/18).

Politico: The Toxic Medicare Payment Panel
Largely unspoken in the fiscal cliff Medicare fight is this fact: The Democrats' health law already includes a legally binding brake on Medicare spending. And the Republicans can't wait to get rid of it. Some Democrats aren't exactly crazy about it, either. So far, nobody on the Hill is talking about any kind of bipartisan revamp to make the Independent Payment Advisory Board work in a way both parties could tolerate. The talk of rationing, death panels and unelected bureaucrats has made IPAB far too toxic. But health care experts say there are fixes that could be considered if or when Congress finds itself so inclined. The Simpson-Bowles deficit-cutting commission wanted to give it more punch. Foundations and think tanks have published dozens of suggestions to make it stronger, weaker, faster, slower, broader or narrower. Right now, though, those ideas are going nowhere (Kenen, 12/18).

Also on Capitol Hill, doctors are appealing to members of Congress to stop funding cuts at NIH.

Medpage Today: Physicians Groups Work To Boost NIH Budget
Concerned that erosion of the National Institutes of Health's budget may be undercutting future health care advances, physician groups are aggressively lobbying Congress to restore the agency's funding. Even if negotiations between the White House and congressional Republicans succeed in averting the "fiscal cliff," these groups point out that NIH's budget has failed to keep pace with inflation over the past decade, putting an increasing squeeze on the biomedical research community. Moreover, they worry that longer-term efforts to reduce the federal deficit will take a further toll on NIH -- in essence, draining the well of knowledge from which new treatments and diagnostics must be drawn. One of the most aggressive medical societies in this regard has been the American Society of Hematology (ASH), which has been conducting a multifaceted campaign on behalf of NIH (Gever, 12/18).