First Edition: June 2, 2011

Today's health policy headlines cover a gamut of develoments, including reports about the latest Medicare dust up in the ongoing budget negotiations and about oral arguments in the latest round of appellate court action related to health law legal challenges.

Kaiser Health News: Medicaid Managed Care Expands In California As State Requires Seniors And Disabled To Join
Kaiser Health News staff writer Christopher Weaver reports: "More than one million of California's older and disabled population will receive a birthday gift this year that they may not have asked for: membership in a state-sponsored managed-care plan" (Weaver, 6/1).

Kaiser Health News: Report: Big Flaws In How Medicare Pays Hospitals, Doctors
Kaiser Health News staff writer Jordan Raud reports: "Medicare pays more to doctors and hospitals in expensive parts of the country. But a prestigious panel says Medicare's methods of evaluating regional costs are disturbingly imprecise and need to be overhauled" (Rau, 6/1).

Kaiser Health News: Medicaid To Stop Paying For Hospital Mistakes
Kaiser Health News staff writer Phil Galewitz reports: "Medicaid will stop paying for about two dozen 'never events' in hospitals, such as operations on the wrong body part and certain surgical-site infections, federal officials said today" (Galewitz, 6/1).

The New York Times: Second Appellate Panel Hears Arguments On Health Care Law
A panel of federal appellate judges seemed eager on Wednesday to rule on whether it is constitutional for the Obama health care law to require that uninsured Americans buy medical coverage. But the judges must first decide whether the plaintiffs still have legal standing to sue, after one disclosed that she recently bought health insurance from her employer (Sack, 6/1).

The Wall Street Journal: Judges Give Health Overhaul Mixed Reception
During 90 minutes of oral arguments, a three-judge panel of the Sixth U.S. Circuit Court of Appeals pressed lawyers for both the Obama administration and the challengers in the case, four individuals from Michigan and the Thomas More Law Center, a conservative legal organization (Kendall, 6/2).

The Associated Press: Obama Health Overhaul Argued In Ohio Federal Court
An attorney urged a federal appeals panel in arguments Wednesday to take a stand against expansion of federal power by rejecting President Barack Obama's health care overhaul (Sewell, 6/1).

The New York Times: Obama Urged To Act Quickly On Budget Agreement
The White House meeting on Wednesday was expected to focus on the debt limit fight, but instead got caught up in the dispute over Medicare.  Following the session, Representative Paul D. Ryan, the Wisconsin Republican who is chairman of the Budget Committee, said he asked Mr. Obama to not engage in demagogy about the Republicans' Medicare plan, which was under fierce attack from Democrats as essentially being a voucher program for older Americans (Hulse and Calmes, 6/2).

Los Angeles Times: President Obama, House Republicans Meet On Debt Ceiling
testy White House meeting between President Obama and House Republican leaders Wednesday failed to lower the partisan pitch in the capital, much less make progress toward a deal on the federal debt ceiling. Instead, the two sides traded complaints. …  Rep. Paul D. Ryan, architect of a Medicare overhaul aimed at slashing the cost of the popular entitlement program by reducing the government's open-ended commitment to seniors, accused Obama of "mis-describing" his plan and implored the president to ease up on the "demagoguery." In reply, Obama said he was no stranger to cartoonish depictions, reeling off a list of conservatives' favorite attack points: "I'm the death-panel-supporting, socialist, may-not-have-been-born-here president," Obama said, according to people familiar with his remarks (Nicholas and Mascaro, 6/1).

The Wall Street Journal: Budget Face-Off At White House
A highlight of Wednesday's meeting came in the exchange between Mr. Obama and Mr. Ryan, a Wisconsin Republican who heads the House budget committee and has become a chief GOP spokesman on fiscal issues. Mr. Ryan said he told the president that mischaracterizing each other's positions wasn't helpful. "If we demagogue each other at the leadership level, then we're never going to take on our debt," Mr. Ryan told the president, according to an account he later gave to reporters. Mr. Obama responded by telling Republicans that both parties were guilty of demagoguery, according to people at the meeting. White House press secretary Jay Carney later said Mr. Obama didn't believe he has misrepresented Mr. Ryan's Medicare plan (Hook and Lee, 6/2).

The Associated Press/The Washington Post:  Fact Check: Democrats Are Distorting The Fundamentals Of Republican Plan To Reshape Medicare
Democrats are distorting the fundamentals of a Republican plan to reshape Medicare, falsely accusing the GOP of pushing a proposal that tells the elderly "you're on your own" with health care and that lets insurers deny coverage to the sick (6/2).

The New York Times: Report Finds Inequities In Payments For Medicare
Medicare uses inaccurate, unreliable data to pay doctors and hospitals, the National Academy of Sciences said Wednesday. Although Medicare is a national program, it adjusts payments to health care providers to reflect regional differences in wages, rent and other costs (Pear, 6/1).

The Washington Post: Experiment To Lower Medicare Costs Did Not Save Much Money
A key government experiment that set out to lower costs and coordinate care for Medicare patients — now the blueprint for an innovation the Obama administration is trying to move to a national scale — has failed to save a substantial amount of money. The five-year test enlisted 10 leading health systems around the country and offered financial bonuses if they could save enough by treating older patients more efficiently while providing high-quality care (Goldstein, 6/1).

The New York Times: Improved Tax Collections Can't Keep Pace With States' Fiscal Needs, Survey Finds
Although state tax collections are picking up after several brutal years, a new survey by the National Governors Association and the National Association of State Budget Officers found that states still expect to collect less tax revenue and spend less money in the coming fiscal year than they did before the Great Recession began. At the same time the cost of Medicaid, the biggest single portion of state spending, has been rising, driven up by higher enrollment as many people have lost their jobs and their health insurance (Cooper, 6/2).

The Washington Post: House GOP Pushes Back Against Health Measures Affecting School Lunches, Tobacco
The Republicans have used an agriculture appropriations bill to send several messages: They don't want the government to require school meals that are more nutritional but also more expensive, they don't want the government to prod food companies to restrain marketing to children, and they don't want the Food and Drug Administration to regulate any substance based on anything but "hard science" (Layton, 6/1).

Los Angeles Times: Healthcare Law To Allow Generic Versions Of Biotech Drugs
Many patents on some top-selling biotech drugs will start to expire in the next few years. But when "biosimilars" or "biogenerics" will be available to U.S. consumers is unclear. The Food and Drug Administration is working on guidance on how the approval for this class of generic drugs will work (Japsen, 6/2).

The New York Times: US Says New Indiana Law Improperly Limits Medicaid
The Obama administration prohibited the State of Indiana on Wednesday from carrying out a new state law that cuts off money for Planned Parenthood clinics providing health care to low-income women on Medicaid. The state law penalized Planned Parenthood because some of its clinics also perform abortions (Pear, 6/1).

The Associated Press: HHS Rejects Indiana Medicaid Changes
The Health and Human Services Department rejected changes in Indiana's Medicaid plan Wednesday, saying it illegally bans funding for Planned Parenthood, and sought to make clear that a similar fate awaits other states that pass legislation barring any qualified health care provider (6/1).

NPR: Abortion Foes Push To Redefine Personhood
Last year's GOP takeover of the U.S. House and statehouses across the country has dramatically changed the shape of the nation's abortion debate. It has also given a boost to an even more far-reaching effort: the push to legally redefine when life itself begins. The question being raised in legal terms is: When does someone become a person? (Rovner, 6/1).

Los Angeles Times: Mitt Romney: Obama 'Has Failed America'
Since launching his exploratory phase in April, Romney has visited the early-voting states of Iowa and New Hampshire to reintroduce himself to voters. Seeking to head off his biggest liability before launching a full-fledged campaign, he delivered a speech on health reform, pledging to repeal Obama's national plan even as he defended the similar Massachusetts model he signed into law. On Thursday Romney will again pledge to repeal what he calls "Obamacare," which he paints as part of a massive expansion of government under Obama (Memoli, 6/2).

The Washington Post: The Fact Checker: Mitt Romney's Strange Counting Of Pages To Distinguish 'Romneycare' From 'Obamacare'
 Mitt Romney has a problem—the sweeping universal health care bill he signed into law five years ago. President Obama has cited "Romneycare" as a model for his own health care law, making it a political albatross for the former Massachusetts governor in the contest to win the GOP presidential nomination in 2012. So Romney has tried his best to emphasize that the law he signed was different and unique to Massachusetts and should not have been considered a template for the rest of the country. Nevertheless, our friends at PolitiFact.com have put together a clever quiz that demonstrates just how difficult it is to tell the difference between the two laws (Kessler, 6/2).

The Wall Street Journal: States See Uptick In Revenue, Costs
State budgets are improving but remain burdened by weak tax revenue and the growing cost of entitlement programs such as Medicaid, according to a report to be released Thursday by the National Governors Association and the National Association of State Budget Officers (Dougherty, 6/2).

Los Angeles Times: Mental Health Programs Suffering From Budget Cuts
States are slashing funding, and more cuts are expected. But in places like Reno, where police have teamed up with counselors to aid the mentally ill, the services don't seem expendable (Powers, 6/1).