First Edition: September 19, 2013

Today's headlines include reports about future health spending projections from Centers for Medicare and Medicaid Services' Actuaries as well as the latest on the upcoming House vote on a stopgap funding measure that would also defund the health law. 

Kaiser Health News: Health Spending Over The Coming Decade Expected To Exceed Economic Growth
Kaiser Health News staff writer Jordan Rau reports: "The nation's total health spending will bump up next year as the health law expands insurance coverage to more Americans, and then will grow by an average of 5.8 percent a year over the next decade, according to projections released Wednesday by government actuaries. That estimate is lower than typical annual increases before the recession hit. Still, the actuaries forecast that in a decade, the health care segment of the nation's economy will be larger than it is today, amounting to a fifth of the gross domestic product in 2022" (Rau, 9/18). Read the story.

Kaiser Health News: White House Pushes Back Against Fraud Fears By Obamacare Opponents
Kaiser Health News staff writer Phil Galewitz reports: "The White House on Wednesday unveiled several steps to protect consumers from fraud in the new online health insurance marketplaces, a move that comes after 17 states hostile to the law acted to limit the spread of information about the program, and congressional Republicans raised concerns about the privacy of medical and financial records. 'We are sending a clear message that we will not tolerate anyone seeking to defraud consumers in the health insurance marketplace,' said Health and Human Services Secretary Kathleen Sebelius" (Galewitz, 9/18). Read the story.

Kaiser Health News: Different Types Of Marketplace Plans Expected To Be Available (Video)
Kaiser Health News columnist Michelle Andrews helps you navigate the new insurance marketplaces that are scheduled to launch on Oct. 1. Today she answers a questions about the plan choices that will be available on the exchanges (9/19). Watch the video or watch others from the series.

Kaiser Health News: Many Cancer Patients Overtreated In Final Days
The Philadelphia Inquirer's Stacy Burling, working in partnership with Kaiser Health News, reports: "While most older people say they don't want aggressive care at the end of life, many get it anyway. Care in the last month of life for Medicare patients with advanced cancer typically is even more aggressive in the Philadelphia area than in the nation as a whole, concludes a report from the Dartmouth Atlas of Health Care, which studies regional differences in care. It released a report last week that showed the percentage of cancer patients who died in hospitals in 2010, or were hospitalized or in an intensive care unit in their last month" (Burling, 9/18). Read the story.

The New York Times: Obama Highlights Fiscal Risks In Addressing Business Group
Mr. Obama used an appearance before the group, the Business Roundtable, to call out House Republicans who have said they will not raise the nation's debt ceiling unless they succeeded in repealing Mr. Obama's signature health care law. In his remarks, Mr. Obama accused what he called "a faction" of Republicans in the House of trying to "extort" him by refusing to raise the nation's debt ceiling unless the president's health care plan is repealed (Shear, 9/18).

The Associated Press/Washington Post: House To Vote On Stopgap Funding Bill That Seeks To Derail President's Health Care Law
The GOP-controlled House is cruising toward a vote to gut President Barack Obama's health care plan as part of a temporary funding bill to prevent a partial government shutdown on Oct. 1. While raising the possibility of a government closure, the latest GOP plan is actually aimed at avoiding one. GOP leaders are looking to shift the fight over health care to even more important legislation required to prevent the government from defaulting on its financial obligations (9/19).

The Wall Street Journal: House GOP Ties Government Funding To Health Law
House Republicans said Wednesday that stripping funding from the health-care law championed by President Barack Obama would be their price for keeping federal agencies open after the end of this month, a move that sharply increases the risk of a partial government shutdown in two weeks. GOP leaders said the House would vote Friday on a bill to fund federal agencies for the first 2 1/2 months of the fiscal year, which starts Oct. 1, but strip all health-law funding (Hook and Peterson, 9/18).

Los Angeles Times: 'This Is The Land In The Sand,' House Republicans Say
House Republicans united Wednesday around a plan to use the threat of a government shutdown as leverage to repeal President Obama's healthcare law, confident the American people are on their side. House Speaker John A. Boehner (R-Ohio) yielded to his right flank by agreeing to attach the healthcare law repeal to a must-pass bill to keep the government funded past Sept. 30. A vote is expected Friday on a bill that would allow the government to stay open for the next few months (Mascaro, 9/18).

The New York Times' Congressional Memo: Pressed From His Right, Speaker Yields On A Budget Showdown
With much of the government set to run out of money at the end of the month -; and run out of borrowing authority by mid-October -; Mr. Boehner faced a choice: he could steer a middle ground and find a way out of his fiscal dead end with Republican and Democratic votes, or he could yield to a conservative movement to strip the Affordable Care Act of financing, unite his Republican majority around that war cry, and hope for the best (Weisman, 9/18).

The Associated Press/Washington Post: Avoid Government Shutdown, National Default, GOP House Leaders Say – But Also Defund Obamacare
House Republicans vowed Wednesday to pass legislation that would prevent a partial government shutdown and avoid a historic national default while simultaneously canceling out President Barack Obama's health care overhaul, inaugurating a new round of political brinkmanship as critical deadlines approach. Obama swiftly condemned the effort as attempted political extortion, and the Republican-friendly Chamber of Commerce pointedly called on lawmakers to pass urgent spending and borrowing legislation -; unencumbered by debate over "Obamacare" (9/18).

The Wall Street Journal's Washington Wire: House-Senate GOP War of Words On Obamacare Bill
House GOP leaders thought they'd found the ticket to party unity Wednesday when they announced  a bill to keep the government operating in the new fiscal year and strip funding from President Barack Obama's health-care law. They hoped to rally the party behind the cause of tea party allies, who had made "defunding Obamacare" their litmus test issue. But the move has provoked a remarkable war of words -; or at least of tweets -; between House and Senate Republicans (Hook, 9/18).

Politico: Shutdown Over Obamacare Won't Stop Obamacare
The fights over Obamacare could shut down the government next month. But shutting down the government wouldn't necessarily shut down Obamacare. The shutdown date -; Oct. 1 -; is also the first day people can start signing up in the new health insurance exchanges. Many Republicans, particularly in the House, are determined to do whatever they can to stop it (Cunningham, 9/18).

The Associated Press/Washington Post: House Conservatives Unveiling Alternative To 'Obamacare' With Bigger Tax Break For Consumers
A large group of House conservatives unveiled legislation Wednesday providing expanded tax breaks for consumers who purchase their own insurance and increasing the government funding for high-risk pools, the Republicans' first comprehensive alternative to President Barack Obama's health care overhaul. Under the proposal by the Republican Study Committee, individuals who purchase coverage approved for sale in their state could claim a deduction of $7,500 against their income and payroll taxes, regardless of the cost of the insurance. Families could deduct $20,000 (9/18).

The New York Times: U.S. Warns of Frauds Tied To Health Care Law
The White House warned consumers on Wednesday to beware of possible fraud by con artists taking advantage of the new insurance marketplaces being set up under President Obama's health care law (Pear, 9/18).

The Associated Press/Washington Post: To Thwart Scam Artists, Govt Urges Consumers To Watch For Fraud Sparked By New Health Care Law
Warning to seniors on Medicare: If someone asks for your personal information for a state insurance exchange under the new health care law, he's probably a crook. Those exchanges don't apply to seniors. No consumer, young or old, should give out medical information or pay up-front "enrollment" fees, the government says (9/18).

Politico: White House, GOP Battle Over Obamacare Fraud
With less than two weeks to go before millions can start enrolling in Obamacare, the White House and congressional opponents of the health law on Wednesday stepped up a battle over whether consumers can trust the new insurance marketplaces being built by the feds and the states. The White House convened a high-level meeting of Cabinet and state officials on the issue Wednesday and the administration announced a series of measures to assure the public that it's serious about fighting fraudsters who might try to capitalize on confusion over the new health care law (Millman, 9/18).

The Wall Street Journal: Big Insurers Skip Health Exchanges
Instead, the insurance companies that are likely to draw attention on the exchanges-;which are expected to enroll an estimated 7 million Americans in the first year-;are lesser-known, and in many cases will be offering comparatively lower rates. The biggest health insurers are eschewing many of the exchanges out of concern that many of the individuals who will purchase coverage need it because they have chronic illnesses or other medical conditions that are expensive to treat (Martin, 9/18).

The Wall Street Journal: Should Young Adults Stay On Their Parents' Health Plan?
When Rob Wyse's 22-year-old daughter received the offer letter for her first post-college job this summer, after the congratulations the family had a decision to make: Should they keep their daughter on the family health-insurance plan or tell her to get her own? (Wieczner, 9/18).

The Wall Street Journal: The Perils Of Out-Of-Pocket Health Costs
Small businesses offering health insurance tend to require their employees to cover significantly more out-of-pocket than do big companies-;and new limits imposed by the health-care law likely won't ease the pain. At businesses with fewer than 200 workers, for example, employees pay an average of $1,715 a year out-of-pocket to cover their deductibles-;the amount the insured pays before coverage kicks in. That is almost double the average outlay by workers with individual coverage offered by larger employers, according to the Kaiser Family Foundation (Needleman and Loten, 9/18).

NPR: Employers Trim Health Costs By Cutting Coverage For Spouses
When UPS told workers that it would no longer offer health coverage for spouses who had their own job-based insurance, it caused a big stir. But the shipping giant has plenty of company. So many employers are trying to cut back on health coverage for spouses that it has become a trend. The practice began well before the Affordable Care Act passed, and the connection to the law, in some cases, isn't that direct (Rovner, 9/19).

The Washington Post: A 'Narrow Window' To Imlement Long-Term Care Policy, Federal Commission Head Says
Over 12 million Americans today rely on long-term services and supports in their home or community or in an institution. That number is expected to swell as the baby boomer generation ages and the number of available caregivers dwindles. The Washington Post spoke with Bruce Chernof, president and CEO of The SCAN Foundation and chair of the bipartisan federal Commission on Long-Term Care, which today released a report with recommendations for a targeted long-term care approach as America ages. Some had hoped the commission would develop a new public or private insurance program to help finance long-term care, but Chernof said that was not part of its mandate. The recommendations include new models of public payment, better communication with family members, better monitoring and training of caregivers, and creating a Medicare benefit for long-term care (Bahrampour, 9/18).

Los Angeles Times: Health Spending To Rise Amid Coverage Expansion, Economic Growth
After five years of historically slow growth, the nation's healthcare tab is poised to grow again as the federal healthcare law expands coverage and the economy improves, according to a new government report. Total U.S. spending on healthcare is expected to surge over the next decade, hitting $5 trillion in 2022, independent economists at the federal Centers for Medicare and Medicaid Services estimate (Terhune, 9/18).

The Wall Street Journal: Lower Rise In Health Spending Predicted
Total U.S. health-care spending will jump by 6.1% next year when key provisions of the federal overhaul law take effect, a slower growth pace than previously had been expected, federal number-crunchers projected Wednesday. The Centers for Medicare and Medicaid Services said the rise would result from more Americans gaining insurance coverage and using more care. But it said the growth would be slower than the 7.4% pace anticipated a year ago, in part because of a June 2012 Supreme Court decision that allowed states to avoid expanding their Medicaid programs as envisioned under the health overhaul (Radnofsky, 9/18). 

The Washington Post's Wonk Blog: Is Health Spending Slowing For Good? Medicare's Number-Crunchers Aren't So Sure.
Health-care costs have, for four years now, grown at a historically slow rate. Instead of outpacing the rest of the economy, as the health sector has for decades now, medical costs have risen at the exact same rate, if not a little bit slower. Today, we got some bad news: The Center for Medicare Services' Office of the Actuary, in a new report, does not expect this ultra-slow growth to last forever (Kliff, 9/18).

The Associated Press/Washington Post: Government Says Obama's Health Overhaul Will Accelerate Spending Growth To 6.1 Percent in 2014
The government attributes much of the increase next year to the new health care program, which is expected to provide insurance coverage to millions of currently uninsured Americans beginning Jan. 1 (9/18).

NPR: Americans' Upside-Down View Of Medicare's Problems
Medicare is big. And as America gets grayer, the health insurance program for seniors and the disabled is going to get a lot bigger -; and more expensive. About 51 million Americans were covered by Medicare in 2012, at a cost of around $574 billion, or about 3.6 percent of the nation's gross domestic product. By 2023, about 70 million people will get health care paid for by Medicare, and their tab is expected to hit $1.1 trillion (Hensley, 9/18).

The New York Times: Mental Health Again an Issue In Gun Debate
Despite deep divisions that have kept Congress from passing new gun safety laws for almost two decades, there is one aspect of gun control on which many Democrats, Republicans and even the National Rifle Association agree: the need to give mental health providers better resources to treat dangerous people and prevent them from buying weapons (Peters and Luo, 9/18).

Los Angeles Times: Do Guns Make Us Safer?
The latest study, published Wednesday in the American Journal of Medicine, is ambitious: It aims to tease out the relationship among gun ownership, crime, violent death and mental illness by looking across 27 industrialized countries that keep reliable data on all of those measures. The second study, published last week in the American Journal of Public Health, focuses entirely on the United States--a patchwork of states with differing demographics, gun cultures, gun laws and crime patterns--and examines whether, over time, more guns have meant more or less gun-related homicides (Healy, 9/18).

The New York Times: Health Plan Penalty Ends At Penn State
After weeks of vociferous objections by faculty members, Pennsylvania State University said on Wednesday it was suspending part of a new employee wellness program that some professors had criticized as coercive and financially punitive (Singer, 9/18).