Viewpoints: Rep. Ryan says entitlements hold the key to an agreement; health law's impact on smokers; WSJ on Medicaid expansion

The New York Times: First End The Crisis, Then Talk
Once those threats are removed, however, there is plenty to discuss: how to replace the sequester cuts, which are already devastating domestic programs and are about to get much worse for defense spending; how to use fiscal policy to stimulate the creation of jobs and fix the nation's infrastructure; how to repair a broken tax system, reduce long-term debt, and ensure that social welfare programs remain healthy (10/8).

The Wall Street Journal: Here's How We Can End This Stalemate
So the president has negotiated before, and he can do so now. In 2011, Oregon's Democratic Sen. Ron Wyden and I offered ideas to reform Medicare. We had different perspectives, but we also had mutual trust. ... Over the next 10 years, the Congressional Budget Office predicts discretionary spending-;that is, everything except entitlement programs and debt payments-;will grow by $202 billion, or roughly 17%. Meanwhile, mandatory spending-;which mostly consists of funding for Medicare, Medicaid and Social Security-;will grow by $1.6 trillion, or roughly 79% (Rep. Paul Ryan, R-Wis., 10/8).

The Washington Post: Divided Government Requires Bipartisan Negotiation
For three years, Congress and the White House have been building to this moment. Not the debt limit or Obamacare specifically, but this clarifying moment of Washington dysfunction. … President Obama has often chosen to unilaterally circumvent the law under the guise of executive authority. Most recently, that was demonstrated in July with his delay of Obamacare mandates for corporations, but it has been a hallmark of this presidency (Rep. Eric Cantor, R-Va., 10/8).

The Washington Post: What Wisconsin Can Teach Washington
Working with the state legislature, we took a $3.6 billion budget deficit and turned it into a budget surplus of more than half a billion dollars. ... We enacted long-term structural reforms that include allowing schools to bid out health insurance, local governments to stop overtime abuse and the state to collect reasonable contributions for health insurance and pensions -; all of which saved millions (Gov. Scott Walker, 10/8).

And on the issue of the health law --

The Wall Street Journal: Obamacaid 
Democrats do have one lament about implementation: Some states are opting out of the Medicaid expansion. Medicaid, the joint state-federal safety net intended for the poor, already covers more than one of five Americans and pays for two of five U.S. births. ... The feds are dangling the promise of paying for all the costs of the new beneficiaries, at least for the next three years. This subsidy honeypot can't last forever, and Governors are right to worry about taking on fiscal obligations ...The Beltway boys and their allies in the hospital industry that are ravenous for more federal revenue are stunned that their bribery failed (10/8).

Richmond Times-Dispatch: Medicaid Expansion Opportunity To Change Lives
The vast majority of Virginia adults who would gain health insurance under the Medicaid expansion are in low-paying jobs that don't come with health insurance. Their pay is too low to afford private insurance but too high to qualify for Medicaid under current rules. Others who would benefit include returning veterans, low-income workers and workers who are in between jobs. Medicaid also provides low-wage workers with financial security by reducing the risk of medical debt (Kathy May, 10/9).

The New York Times' Public Editor's Journal: 'Obamacare' – With or Without Quotation Marks
A Times reader, Tom Bird, of East Lansing, Mich., raised a timely issue, given all that's happening in Washington. He wrote that other news organizations, including The Associated Press, are putting the expression "Obamacare" in quotation marks, "signifying that it is not a neutral expression, but instead is political rhetoric that is being used in a partisan way." And he added, "When will The Times wake up?" (Margaret Sullivan, 10/8). 

The Washington Post: Questions And Answers About The Health-Care Law
Okay, so the rollout of the health insurance marketplaces created under the Affordable Care Act didn't go so smoothly. Technical glitches and heavy traffic occurred almost right away. Nonetheless, interest in the exchanges hasn't waned. As open enrollment continues, many people will have questions about the marketplaces (Michelle Singletary, 10/8).

The Washington Post's Right Turn: And Then There Is Obamacare
Although Republicans have done a bang-up job of blurring the issue and diverting the public's attention, Obamacare remains a problem for Democrats and a burden for their incumbents up for reelection in 2014. If the Republicans could get away from the unpopular shutdown fight and focus fully on Obamacare, they might benefit from three factors that threaten the president's signature legislation (Jennifer Rubin, 10/8).

Forbes: Three Key Questions For Obamacare's Rollout
President Obama's signature health law achieved a major milestone on Oct. 1, when its subsidized insurance exchanges went online. But Obamacare is already reshaping the health insurance landscape. If you want to track how well the law is working, keep an eye on three aspects of it (Avik Roy, 10/9).

The Seattle Times: Obamacare Is Here, GOP, Ready Or Not
The other day as GOP spokeswoman Cathy McMorris Rodgers of Spokane was on cable flailing away at Obamacare again -; "People are panicked," she said, "the wheels are falling off!" -; it turned out people really were a little panicked. To get in on it. ... More than 9,400 Washington state residents enrolled in the first days, most of whom were previously uninsured (Danny Westneat, 10/8).

Reuters: How Obamacare Burns Smokers
[I]nsurers participating in the exchanges can charge a premium of up to 50 percent for smokers. But the penalty doesn't stop there: The premium subsidies that Obamacare makes available for the poor and lower-middle class are based on a formula that subsidizes an individual or family so that they do not have to pay more than a certain percentage of their income -; out of their pockets– for their insurance. However, under the law, those subsidies cannot be applied at all to pay the 50 percent smokers' premium. The loss of that subsidy can be a big deal (Steven Brill, 10/8).

http://www.kaiserhealthnews.orgThis article was reprinted from with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.



The opinions expressed here are the views of the writer and do not necessarily reflect the views and opinions of News Medical.
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