Obama pledges 'substantive changes' to Medicare as part of budget deal

President Barack Obama told the nation's top CEOs Wednesday that he was committed to "substantive changes" to Medicare and other entitlement programs, but Senate Democrats are warning him not to cave on entitlements as negotiations with congressional leaders move forward. Also in the mix, health care providers lobby to counter possible Medicare cuts.

The Wall Street Journal: At President's Meeting With Executives, Some Push, Pull And Give
President Barack Obama's meeting with top chief executives Wednesday included a frank exchange about the White House's chilly relationship with business executives and firm support for tackling the country's fiscal problems, several people familiar with the gathering said. … He also communicated to the chief executives, in a tone several described as persuasive, that he was committed to substantive changes in Medicare and other entitlement programs, which make up a large portion of federal spending and are projected to grow quickly in the next few decades as more Americans retire (Paletta and Linebaugh, 11/14).

Politico: Senate Liberals To Obama: 'Don't Buckle' On Cliff
Liberal Democrats in the Senate are warning President Barack Obama not to cave on taxes and entitlements in deficit talks set to begin this week, a move that could complicate efforts by the White House to win the backing of GOP leaders. West Virginia's Jay Rockefeller and Tom Harkin of Iowa are circulating a letter among their Democratic colleagues that calls on the president to stand firm on revenue, entitlement programs and spending cuts. They're hoping to get as many as 30 Senate Democrats to sign on, Rockefeller said (Sloan and Raju, 11/14).

Kaiser Health News: Capsules: Hospitals, Home Health Care Services Lobby Against Cuts
As lawmakers and President Barack Obama discuss possible changes to federal entitlement programs as part of a larger deal to avoid the fiscal cliff, expect provider groups to make their case loud and clear: Don't cut us (Carey, 11/15).

In addition, the Medicare NewsGroups examines how Medicare fits into "fiscal cliff" negotations and in the spending cuts known as sequestration -

The Medicare NewsGroup: What Part Does Medicare Play In The Fiscal Cliff Discussions?
Policymakers have begun discussing a potential package of deficit-reduction measures to stop the nation from going over the "fiscal cliff," a series of mandatory budget cuts and tax increases scheduled to take effect starting in January 2013. These deficit-reduction measures could potentially include various cuts and/or alterations to Medicare, and there is growing speculation about how Congress will change the program to contain federal spending. Conversations are now underway as President Obama is set to meet with Congressional leaders on Friday (11/15).

The Medicare NewsGroup: What Does Sequestration Mean To Medicare?
Unless Congress passes an alternate deficit-reduction package, Medicare provider payments will be cut by 2 percent beginning in fiscal year 2013 as part of the spending reductions required by the Budget Control Act of 2011. The cuts will be applied to provider payments for services administered under Medicare Hospital Insurance (Part A) and Medicare Medical Insurance (Part B) and contractual payments to Medicare Advantage Plans (Part C) and Medicare Prescription Drug Plans (Part D), according to the Congressional Budget Office (CBO). … That means about 90 percent of Medicare spending is limited to 2 percent in cuts, and 8 percent is completely exempt from sequestration. The remaining 2 percent of Medicare spending would be subject to a 7.6 percent cut in 2013 because it falls under non-exempt nondefense mandatory programs (11/15).

Headlines also focus on a plan to trim health costs from a think tank close to the White House -

Kaiser Health News: Capsules: Progressive Group Recommends $385 Billion In Health Cuts
Hospitals, drug companies, nursing homes and health plans would lose billions in Medicare funding over the next decade under a budget deficit cutting plan recommended by the Center for American Progress, a left-leaning think tank which has close ties to President Barack Obama and former President Bill Clinton (Galewitz, 11/14).

The Boston Globe: New Plan Offered To Cut Cost Of Medicare
With Congress and President Obama poised to enter yet another budget battle, the Center for American Progress released a new plan Wednesday that the organization says will stem the rising cost of health care without hurting seniors. The plan would cut $385 billion from the federal budget over a decade through a series of proposals that target waste in the health care system and modernize Medicare (Jan, 11/15).

Some lawmakers do not view Medicaid as off limits -

CQ HealthBeat: Fiscal Cliff Negotiators Eye Tens Of Billions In Medicaid Savings, Medicaid Expert Says
Lawmakers eying possible Medicaid cuts in negotiations addressing the tax hikes and spending cuts known as the fiscal cliff have limited options to achieve the level of savings they are discussing, among them a delay in the start of the health care law, a leading Medicaid expert said Wednesday (Reichard, 11/14).

Politico Pro: CAP: States Won't Expand Medicaid If It's Cut In Fiscal Cliff Talks
Cutting Medicaid as part of the fiscal cliff discussions could discourage states from expanding the program under the health reform law, according to some of the law's strongest supporters. "With the Supreme Court decision on the Affordable Care Act, I think there are governors out there, even Democratic governors, who would take a very strong signal if all of a sudden the federal government was taking back money from Medicaid," Neera Tanden, president of the Center for American Progress and one of the law's crafters, said Wednesday at a briefing on health care savings with reporters. Governors are going to be deciding over the next several months whether to expand Medicaid under the ACA -; an option provided to them after the Supreme Court ruled that the expansion could not be mandatory, as it was written in the law (Haberkorn, 11/14).