With votes counted, the 'fiscal cliff' looms large

News outlets report that with the election in the rear-view mirror, President Barack Obama and congressional lawmakers must pivot to high-stakes negotiations over expiring income tax rates, massive scheduled cuts to Pentagon spending and entitlement reform. Also on the to-do list: the Medicare doc-fix.

The Washington Post: Fresh From Reelection, President Finds Himself On Edge Of 'Fiscal Cliff'
The president, who won reelection late Tuesday, must now confront the "fiscal cliff," nearly $500 billion in automatic tax hikes and spending cuts set to take effect in January that could throw the nation back into recession. … Obama has threatened to veto legislation to avert the cliff that extends the Bush tax rates for the wealthy. After a campaign focused heavily on that pledge, Democrats say the president is prepared to draw a firm line in the sand, even if it means letting one of the largest tax hikes in U.S. history take effect on Jan. 1 (Montgomery and Goldfarb, 11/6).

Politico: Up Next: The Fiscal Cliff
Obama's convincing reelection, the Republicans' sustained majority in the House and Democrats' hold on the Senate only further complicate the prospects of cutting any kind of deal on expiring income tax rates, massive pending cuts to Pentagon spending and entitlement reform. A clarifying election this was not. Instead, it's the beginning of a stare-down that will almost certainly last months (Sherman and Raju, 11/7).

Kaiser Health News: Federal Deficit Talks Could Impact Obama's Moves On Health Law
President Barack Obama's victory preserves the federal health overhaul that he championed. The law, which withstood a challenge at the Supreme Court last summer and was bitterly assailed by Republicans during the campaign, is slated to move forward with Democratic control of the White House and Senate.
But some analysts predict the mounting pressures to reduce federal spending will complicate efforts to implement the law, known as the Affordable Care Act (Carey, 11/7).

National Journal: It's B-a-a-ck!
Elections can change everything on Capitol Hill. In the next few weeks, the process of members and their staffs packing up and moving out, or moving into better (or worse) offices, begins. But for all the adjustments ahead, there's one health policy issue that will neither change nor go away easily: the so-called doc fix, a multibillion-dollar Medicare headache that has been around for the past six election cycles. …Thankfully, when it comes to the doc fix, Democrats and Republicans actually agree on something: Congress should get rid of this flawed payment system. If only it were that easy. The challenge? How to pay for it. The 1997 formula was originally intended to constrain health care costs: If spending for a given year exceeded the ceiling, doctors' reimbursements under Medicare were automatically cut. But Congress regularly overrides the pay reduction. And as doctors get further and further away from the goal each year, it gets more and more expensive to delay the cut (McCarthy, 11/7).