First Edition: May 11, 2011

Today's headlines include news from the 4th Circuit Court of Appeals, where oral arguments were held yesterday regarding two legal challenges to the health law.

Kaiser Health News: Letter From California: Exchange Board Has Daunting Task
Reporting for Kaiser Health News, Hilary Abramson writes: "Now comes the hard part. California, which has had a long, sometimes-tortured history of trying to overhaul its health care markets, beat every other state last year when it passed a law creating a health insurance exchange - an online marketplace where millions of uninsured residents will be able to get insurance" (Abramson, 5/10).

Kaiser Health News: 4th Circuit Court Of Appeals Hears Arguments In Health Law Case
In this Kaiser Health News audio report, Ariane de Vogue, a reporter for ABC News, joins Jackie Judd to talk about two cases challenging the constitutionality of health care reform heard there by a three judge appeals panel. In both cases, the key issue is whether Americans can be required to obtain health insurance, as the 14-month old law mandates. A transcript of the interview also is available (5/10).

Kaiser Health News: Study Details How GOP Budget Plan Would Cut States' Medicaid Funding
Kaiser Health News staff writer Phil Galewitz reports: "Eight states - including Florida, Colorado and Georgia - would lose more than 40 percent of their federal funding for Medicaid over the next decade under the House Republicans' plan to repeal the 2010 federal health law and convert Medicaid into a block grant program, according to an analysis of the plan's effects on states released today" (Galewitz, 5/10).

Los Angeles Times: Healthcare Law Gets Friendly Hearing In Appeals Court
By their comments and questions Tuesday, the judges signaled they were likely to uphold provisions in the law that require virtually all Americans to have health insurance by 2014 or pay a penalty (Savage, 5/11).

The Washington Post: Judges In Va. Appear Skeptical About Health Overhaul Arguments
During a hearing that lasted more than two hours, the judges — all appointed by Democratic presidents — frequently interrupted lawyers on both sides to probe their legal positions. …  Though the U.S. Court of Appeals for the 4th Circuit tends to rule in about 45 days, the judges Tuesday offered no indication of how long they would take before deciding the cases, which resulted from appeals of contradictory lower court decisions (Helderman, 5/10).

The New York Times: Appellate Court Hears Defense Of Health Law
The Obama administration opened its appellate defense of the 2010 health care act on Tuesday before three randomly selected judges who each had been appointed by Democratic presidents, including two named by President Obama himself. … At Tuesday's hearing in Richmond, the three Fourth Circuit judges — Diana Gribbon Motz, who was appointed by President Bill Clinton, and the two Obama appointees, Andre M. Davis and James A. Wynn Jr. — challenged both sides with pointed questioning. The hearing lasted more than two hours (Sack, 5/10).

USA Today: Judges Hear Arguments On Obama Health Care Law
The challengers, the state of Virginia and Liberty University, have argued the decision to forgo insurance is not an economic activity that traditionally falls under Congress' power to regulate interstate commerce. U.S. Appeals Court Judge Diana Gribbon Motz, who presided over today's hearing, observed at one point that the decision about health insurance is not an "idle" one, but rather takes some active consideration. She noted that Congress has been heavily involved in the health care field, including through Medicaid and Medicare, over decades (Biskupic, 5/11).

NPR: Appeals Court Hears Challenges to Health Care Law
A three-judge panel in Richmond, Va., heard Tuesday oral arguments in two cases challenging the constitutionality of the nation's landmark health care law. It marked the first time any of the dozens of lawsuits filed against last year's law have reached the appellate level, and brings the measure a step closer to what most predict will be a legal showdown that will only end at the Supreme Court sometime in 2012 (Rovner, 5/11).

The Wall Street Journal: Judges Test Health Law's Foes
The hearing previewed how the Obama administration likely will argue before Supreme Court, which is expected ultimately to decide the case perhaps as soon as its 2011-12 term. It was the first oral argument before a federal appellate court, with the Fourth Circuit hearing two challenges side by side. Tuesday's arguments didn't involve the biggest challenge to the health law, brought by 26 states. Federal District Judge Roger Vinson of Pensacola, Fla., ruled in favor of those states in January and wrote that the entire health law must be voided (Adamy, 5/11).

The Associated Press: Obama Focusing On Debt In Meeting With Democrats
The president was to host Senate Democrats at the White House on Wednesday and Senate Republicans on Thursday. The meetings come as Vice President Joe Biden leads bipartisan efforts to identify some of the less politically explosive areas of the budget that could be reduced as a first installment in the effort to contain the debt. Obama has been calling for long-term deficit reduction that blends both tax increases and changes to massive government health programs such as Medicare for older adults and Medicaid for the poor. Some Democrats are anxious for Obama to detail his proposals, worried that he might cut too deeply into venerable Democratic initiatives. Meanwhile, Republicans have proposed restructuring Medicare and Medicaid but have rejected any tax increases (Kuhnhenn, 5/11).

The New York Times: Critics Fear GOP's Proposed Medicaid Changes Could Cut Coverage For The Aged
As Republicans inch away from their plan to reshape the nation's Medicare program, their equally transformative ideas for Medicaid, now largely in the shadows of the budget debate, are moving front and center. While the largest number of Medicaid recipients are low-income children and adults, who tend to be far less politically potent voices in battles over entitlement programs than older voters, the changes to Medicaid proposed by Representative Paul D. Ryan of Wisconsin, the House budget chairman, could actually have a more direct impact on older Americans than the Medicare part of his plan (Steinhauer, 5/10).

Los Angeles Times: Study: 44 Million Could Lose Medicaid Coverage Under GOP Plan
House Republican plans to repeal the new healthcare law and to convert the Medicaid insurance program into a block grant to states could force as many 44 million poor and disabled Americans out of the program over the next decade, according to a new analysis by the nonprofit Kaiser Family Foundation (Levey, 5/10).

The Washington Post: Romney To Confront His Critics In A Speech On Health Care
Former Massachusetts governor Mitt Romney, who is seen as a possible front-runner for the 2012 Republican presidential nomination, on Thursday will confront the issue that poses his greatest political risk: health care (Tumulty, 5/10).

The Wall Street Journal's Washington Wire: Romney To Delivery Health-Care Speech
Former Massachusetts Gov. Mitt Romney will seek to blunt a major criticism Republican primary voters harbor against him by delivering a health-care speech in Michigan on Thursday that lays out a plan to replace the new national health-care law with other, more targeted changes (O'Connor, 5/10).

The Associated Press: Romney To Address Health Care In Michigan
Mitt Romney will deliver a speech about health care this week, tackling one of his biggest vulnerabilities before formally entering the still-forming field of Republican presidential contenders. The former Massachusetts governor will outline a health overhaul that would give states the responsibility of taking care of the poor, uninsured and ill, aides said, and propose giving patients a tax deduction if they buy their own health insurance (Elliott, 5/10).

Politico: Mitt Romney To Give Big Health Care Speech In Michigan
Mitt Romney's major health care speech on Thursday has a single goal: ending the current fixation on "RomneyCare." Donors ask about the Massachusetts health care law in private fundraisers. The ladies of "The View" asked Romney to explain it when he went on to try and sell his book. His triumphant return to New Hampshire back in March resulted in a crush of stories about it. After a foreign policy speech in Las Vegas in April, an audience member asked about health care instead (Hunt, 5/10).

The Wall Street Journal's Washington Wire: Heritage Foundation Takes Ryan Plan A Step Further
If you thought House Budget Chairman Paul Ryan's plan to revamp the federal budget didn't go far enough, try this: The Heritage Foundation weighed in Tuesday with a plan the group's economists said would balance the budget and lower the jobless rate to 5.2% within a decade (Boles, 5/10).

Politico: GOPers: Outspend Dems On Medicare
Senate tea partiers are lining up behind a novel Medicare proposal: Outspend President Barack Obama. Pennsylvania Republican Sen. Pat Toomey on Tuesday rolled out a budget blueprint with Sen. Jim DeMint (R-S.C.), the chamber's de facto tea party ring leader, and freshmen GOP Sens. Marco Rubio of Florida, Mike Lee of Utah and Ron Johnson of Wisconsin.  …  The Toomey plan would spend more on Medicare by permanently reforming the "sustainable growth rate" — the formula that keeps requiring Congress to pass "doc fixes" to prevent big cuts in payments to physicians. Changing the formula would add $300 billion to Medicare's baseline over 10 years (Wong, 5/10).

Los Angeles Times: Court Orders Major Overhaul Of VA's Mental Health System
A federal appeals court Tuesday lambasted the Department of Veterans Affairs for failing to care for those suffering post-traumatic stress disorder and ordered a major overhaul of the behemoth agency. Treatment delays for PTSD and other combat-related mental illnesses are so "egregious" that they violate veterans' constitutional rights and contribute to the despair behind many of the 6,500 suicides among veterans each year, the U.S. 9th Circuit Court of Appeals said in its 2-1 ruling ( Williams, 5/11).

Los Angeles Times: Indiana Governor Signs Planned Parenthood Funding Ban
Indiana Gov. Mitch Daniels, a Republican considering a run for president, signed legislation Tuesday to bar Planned Parenthood from receiving federal funding in his state, a move widely seen as a bid to woo influential social conservatives. Planned Parenthood of Indiana and the American Civil Liberties Union went to court to try to block the measure from taking effect (Levey, 5/11).

Chicago Tribune: Abortion Restriction Effort Not Gaining Much Traction In Illinois
The conservative push in other states to restrict abortion rights hasn't gained much traction in Illinois, largely because Democrats continue to control the General Assembly and Gov. Pat Quinn opposes most restrictions (Wilson, 5/10).

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