First Edition: August 1, 2011
In today's headlines, the early details regarding how the politics and policies involved of the debt-ceiling deal are taking shape.
Kaiser Health News: Medicare Prepares Rule to Penalize Hospitals With High Readmission Rates
Kaiser Health News staff writer Jordan Rau, working in collaboration with The Washington Post, reports: "When hospitals discharge patients, they typically see their job as done. But soon, they could be on the hook for what happens after Medicare patients leave the premises, and particularly if they are readmitted within a month. In an effort to save money and improve care, Medicare, the federal program for the elderly and disabled, is about to release a final rule aimed at getting hospitals to pay more attention to patients after discharge" (Rau, 7/30).
The New York Times: Obama And Leaders Reach Debt Deal
President Obama and Congressional leaders of both parties said late Sunday that they had agreed to a framework for a budget deal that would cut trillions of dollars in federal spending over the next decade and clear the way for an increase in the government's borrowing limit (Hulse and Cooper, 7/31).
The Washington Post: White House, Congressional Leaders Reach Debt-Limit Deal
Passage of the agreement, however, remained far from certain in the House, where skeptical Republicans were just beginning to digest the details. In the end, negotiators settled on a trigger that would force automatic across-the-board cuts of $1.2 trillion to agency budgets over the next decade, split half and half between domestic programs and defense. Programs for the poor, including Medicaid and Social Security, would be exempted. But Medicare payments to providers could be hit (Montgomery and Kane, 8/1).
Los Angeles Times: U.S. Leaders Strike Debt Deal To Avoid Default
In the second stage, a bipartisan congressional committee would be established to recommend by late November $1.5 trillion in further cuts. If the committee deadlocked and Congress failed to adopt its recommendations by December, as many lawmakers say is inevitable, as much as $1.2 trillion in additional cuts would automatically be triggered, starting at the beginning of 2013. That date would allow the Congress chosen in the next election to undo - or deepen - the cuts. The tentative deal would require automatic cuts of equal size, in dollars, in both defense and domestic accounts, officials said. Medicare, the popular health program for seniors, would face a cap on expenditures. White House officials said Democrats had succeeded in writing the provisions so the cuts would be limited to 2% and would not hit Medicare beneficiaries, but would instead reduce payments to doctors, hospitals and other providers of Medicare services(Mascaro and Hennessey, 8/1).
The New York Times: Congress Must Trim Deficit To Avoid Broader Cuts
The deal announced on Sunday by Congressional leaders and the White House would make across-the-board cuts in military spending, education, transportation and Medicare payments to health care providers if Congress does not enact further deficit-cutting legislation by the end of the year (Pear, 7/31).
The Wall Street Journal: Leaders Agree On Debt Deal
The deal would raise the debt ceiling by $2.4 trillion in two stages, and provide initially for $917 billion in spending cuts over 10 years. A special committee of lawmakers would be charged with finding another $1.5 trillion in deficit reduction, which could come through a tax overhaul and changes to safety-net programs. If the committee doesn't find at least $1.2 trillion in savings, or Congress doesn't adopt its proposals, a pre-set array of spending cuts would kick in, including cuts in military spending and Medicare payments to health-care providers (Bendavid and Lee, 8/1).
The Associated Press/Washington Post: Debt Ceiling Compromise Is Likely To Mean Further Fiscal Challenges For States
There also was concern among governors, state lawmakers and state agency heads that Congress would make deep reductions or changes in federal aid for health services for the needy, most notably through Medicaid. That could shift more of the costs onto states that already are having trouble balancing their budgets (7/31).
NPR: Is There A Debt-Ceiling Deal: Yes And No
Do we have a deal? It's still a yes and no situation. The deal the president has accepted appears likely to be acceptable to a Senate majority of 60 as well. The House is a bigger question. Nancy Pelosi and Speaker John Boehner may have agreed with the president; their respective parties have yet to do so. Democrats are unhappy about being taken for granted, and many want to vote no on this plan. There are no revenues in it, and all of the pain is on the spending side, with a clear sense that this round and the next round will be much the same in that regard and that every future increase in the debt ceiling will bring another major squeeze on beneficiaries of government programs (Elving, 7/31).
Politico: Does Deal Muddy Medicare Waters?
President Barack Obama's health care law has high negative ratings, and they're not getting any better. But House Budget Committee Chairman Paul Ryan's Medicare plan has high negatives, too - and they're not healing either. It's almost enough to suggest that the two plans will just cancel each other out as liabilities in 2012, with the Democrats and Republicans fighting to a draw as they try to scare voters to their side. The big health care question of the election would be: Whose albatross is bigger? (Nather, 7/31).
USA Today: Political Damage Even If A Debt Deal Is Done
In the debate over raising the government's debt ceiling, President Obama has seen his approval rating fall to a new low, his political adeptness questioned and his liberal base enraged over compromises he made on line-in-the-sand issues such as protecting Medicare from cuts. Cuts in Medicare and other entitlement programs are on the table. And, depending on how events unfold, both houses of Congress may be required to vote on a constitutional amendment requiring a balanced budget (Page and Schouten, 8/1).
Politico: Theory To Practice: Health Care Reform
Critics and supporters of the health reform law have one thing in common: Neither group knows what the most wide-reaching changes of the law look like in the real world. Those changes - to the insurance market, to patient care and to control of Medicare costs - simply don't exist yet. And if the law's critics succeed in their efforts to repeal or reshape it, many of these reforms won't ever exist (Haberkorn, Millman and Feder, 7/31).
The Washington Post: Health-Care Law Could Give Rise To Entrepreneurs
The Department of Health and Human Services this month released guidelines on how to set up exchanges, and more than half the states already are taking steps to build them. Once they're up and running, you'll be able to quit your job at Large Company X and start that plumbing or carpentry business, that mom-and-pop restaurant or barbershop, without putting your family's health or finances at risk. You can open that dance studio, play in that band, live off savings while you write or paint or launch the tech venture that could make you the next Bill Gates or Mark Zuckerberg (Lawrence, 7/29).
The New York Times: Opposing The Health Law, Florida Refuses Millions
When it comes to pursuing federal largess, most of the states that oppose the 2010 health care law have refused to let either principle or politics block their paths to the trough. If Washington is doling out dollars, Republican governors and legislators typically figure they might as well get their share (Sack, 7/31).
Los Angeles Times: State Shaves Funds For Health, Social Services
Faced with years of recession-driven budget shortfalls, state lawmakers have made deep cuts to health and social services. The reductions, including a round that took effect this month, translate into sizable state savings but are sharply scaling back the safety net for California's most vulnerable residents: the elderly, the disabled and the poor (Zavis, 7/30).
The Washington Post: Race Reemerges In Debate Over 'Personalized Medicine'
Federal examiners have rejected patents for genetic screening tests because the applicants did not explore their effectiveness for different races, adding to the debate about whether race has scientific validity in modern DNA-based medicine. Some geneticists, sociologists and bioethicists argue that "black," "white," "Asian" and "Hispanic" are antiquated categories that threaten to revive prejudices. Others, however, say that meaningful DNA variations can track racial lines and that ignoring them could deny many benefits of "personalized medicine," which aims to develop tests and treatments tailored to a person's genetic makeup (Stein, 7/31).
Kaiser Health News tracked weekend health policy developments, including the reaction from the nursing home industry regarding a change in Medicare payments, as well as news on Saturday and Sunday regarding the possible debt ceiling deal and default scenarios.
Also, KHN's earlier original coverage of the debt-ceiling debate and its possible impact on the health industry:
Kaiser Health News: Health Industry Could Feel Pinch, Then Pain From Default
Kaiser Health News staff writers reported on how the health sector might be impacted if Congess doesn't lift the debt ceiling: "Hospitals, nursing homes, doctors and state health programs could survive a brief pinch if the Washington debt ceiling deadlock leads the government to stop paying Medicare and Medicaid bills. But if an impasse were to drag on for more than a few weeks, health care providers could be unable to pay their staffs or even face insolvency, according to health care experts and former government officials" (Rau, Weaver and Marcy, 7/29).
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