Daily Health Policy Report

Thursday, March 29, 2012

Last updated: Thu, Mar 29

KHN Original Reporting & Guest Opinion

Health Reform

Capitol Hill Watch

Campaign 2012

Quality

State Watch

Weekend Reading

Editorials and Opinions

KHN Original Reporting & Guest Opinion

Minus A Mandate, Health Law Would Still Affect Millions

Kaiser Health News staff writer Julie Appleby reports: "If the Supreme Court strikes down the requirement that most Americans carry health insurance – along with related provisions that insurers must sell to people with pre-existing conditions and not charge the sick more – what’s left in the law? Quite a bit, say policy experts – although the changes could make what’s left harder to do" (Appleby, 3/28). Read the story.  

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Effort To Pay Hospitals Based On Quality Didn’t Cut Death Rates, Study Finds

Kaiser Health News staff writer Jordan Rau reports: " Medicare's largest effort to pay hospitals based on how they perform — an inspiration for key parts of the health care law — did not lead to fewer deaths, a new study has found. The study casts doubt on a central premise of the health law's effort to rework the financial incentives for hospitals with the aim of saving money while improving patient care" (Rau, 3/28). Read the story.

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Vigorous Questions on Severability, Medicaid On Final Day (Video)

In this Kaiser Health News video, Legal analyst Stuart Taylor, Jr., talks with Jackie Judd about the last 2.5 hours of this historic week during which the justices heard from the opposing lawyers about issues as basic as 'what is liberty?' and whether it's better to 'fix' flaws in legislation or scrap it entirely (3/28). Watch the video.

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Transcript Highlights: The Supreme Court's Wednesday Arguments

Kaiser Health News collected highlights of Wednesday Supreme Court arguments.

During the morning session, the justices pondered questions of "severability," meaning whether the health law in its entirety should be struck down if the insurance mandate is declared unconstitutional (3/28). Read the excerpts.

In the afternoon, justices looked at the health law's expansion of Medicaid, the joint federal-state health program for low-income people. The Obama administration argued in court briefs that the federal government has expanded the program repeatedly and the provisions of the law will not "impose significantly onerous burdens on the states." But states disagree and said they fear they will be left with a costly program to fund (3/28). Read the highlights.

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Slideshow: Days 1-3: Citizens Gather As Supreme Court Begins Review Of Health Law

This Kaiser Health News collection of photos taken by Jessica Marcy offers images of what was going on this week outside the Supreme Court, where Americans gathered to express their support or opposition to the law -- or just to see history being made (3/28). Check out the photos.

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Capsules: House Debates Ryan Budget: Predictably Partisan; Inside The Courtroom On The Final, Historic Day

Now on Kaiser Health News' blog, Marilyn Werner Serafini reports on the latest developments regarding the Ryan budget plan: "The tone was immediately and undoubtedly partisan Wednesday when the House began considering the Republican-backed 2013 budget resolution that the House Budget Committee recently approved" (Werber Serafini, 3/28).

Also on the blog, Phil Galewitz reports on the last day of the Supreme Court health law arguments: "Chief Justice John Roberts, seated in the center in a high-backed leather chair, quickly brought down the gavel. And the last of four hearings into the 2010 health care overhaul was underway" (Galewitz, 3/28). Check out what else is on the blog

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Political Cartoon: 'Which Side Are You On?'

Kaiser Health News provide's a daily installment of health policy humor with "Which Side Are You On?" by Nick Anderson. 

Meanwhile, here's today's health policy haiku: 

ALL ARGUED OUT

Severable… huh?
Medicaid Expansion... what?
No more words remain.
-Anonymous

If you have a health policy haiku to share, please send it to us at http://www.kaiserhealthnews.org/ContactUs.aspx  and let us know if you want to include your name. Keep in mind that we give extra points if you link back to a KHN original story.

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Health Reform

The Supreme Court Arguments Are Over - What Happens Now?

News outlets sum up the oral arguments and preview when to expect a decision, what impact the legal review might have on politics and what other ripple effects could occur.

The Wall Street Journal: Three Days Of Hearings Yield Five Take-Aways
It is notoriously hard to predict how the Supreme Court will rule on a case based on justices' questioning of attorneys. But with this week's health-care arguments having wrapped up, here is what we know (Radnofsky, 3/28).

Kaiser Health News: Vigorous Questions on Severability, Medicaid On Final Day (Video)
Legal analyst Stuart Taylor, Jr., talks with Jackie Judd about the final day's arguments during which the justices considered issues as basic as 'what is liberty?' and whether it's better to 'fix' flaws in legislation or scrap it entirely (3/28).

The Associated Press/Washington Post: High Court Arguments Suggest Justices Could Produce Partisan Split Familiar In Health Debate
The court's decision, due in June, will affect the way virtually every American receives and pays for health care and surely will reverberate in this year’s campaigns for president and Congress. The political effects could be even larger if the court votes 5-4 with all its Republican-appointed justices prevailing over all the Democratic appointees to strike down the entire law, or several important parts of it. Not since 2000, when the court resolved the Bush v. Gore dispute over Florida election returns that sealed George W. Bush's election as president, has a Supreme Court case drawn so much attention (3/29).

The Associated Press: 3 Days Of Hearings Over, 2 Justices May Be Key
[T]he questions justices asked the lawyers are the only tea leaves to read, however unreliable. That has led to the belief the fate of the health care law could lie with two justices. Justice Anthony Kennedy's mixed queries left the most room for him to be seen as a possible swing vote to decide the issue. Chief Justice John Roberts also spoke up for both sides of the issue at times (Cass, 3/29).

Roll Call: Three Branches In Historic Clash Over Health Care
For three days this week, Washington, D.C., was riveted as the three branches of government faced off dramatically in a packed room on First Street Northeast, and when it was all over, President Barack Obama’s health care law was hanging by a thread. Dozens of members of Congress attended at least one of the three days of oral arguments before the Supreme Court, including the principal authors of the law and its chief opponents. Attorney General Eric Holder, Health and Human Services Secretary Kathleen Sebelius and top White House aide Valerie Jarrett were among those representing the White House(Dennis, 3/29).

The Washington Post: Supreme Court's Health-Care Ruling Could Deal Dramatic Blow To Obama Presidency
The Supreme Court's skeptical consideration of President Obama's landmark health-care legislation this week has forced his supporters to contemplate the unthinkable: that the justices could throw out the law and destroy the most far-reaching accomplishment of the Obama presidency. The fate of the Patient Protection and Affordable Care Act is uncertain. … White House officials are refusing publicly to consider that the law might be struck down or to discuss contingency plans, insisting that they do not address hypothetical questions (Gardner, 3/28).

USA Today: Analysis: Day 3 Of Arguments In Health Care Case
Two years and six days after President Obama signed the most sweeping overhaul of the nation's health care system since the creation of Medicare and Medicaid, the law itself is on life support. … By the time it was over Wednesday afternoon, virtually everyone following the three-year battle within the three branches of the federal government had a strong opinion on the Patient Protection and Affordable Care Act. Everyone, that is, except for a few justices who hold its fate in their hands (Wolf and Heath, 3/39).

McClatchy: Supreme Court Wraps Up Arguments Over Health Care Law
The future of health care hangs in the balance, as do some political fates, with the conclusion Wednesday of Supreme Court arguments that showed the justices divided but clearly willing to rule on the major questions at issue. Longer than any since the 1960s, the arguments that ended Wednesday afternoon both clarified and clouded the potential outcome, with justices on the last day assessing whether most of the 2010 health care law could survive even if its most controversial provision — the individual mandate — were struck down (Doyle and Lightman, 3/28).

NewsHour (Video): Supreme Court Wraps Up Health Reform Law Hearings: What’s Next?
In the final day of Supreme Court hearings on the Affordable Care Act, justices questioned the constitutionality of requiring states to expand Medicaid coverage to more individuals. Betty Ann Bowser reports, and Marcia Coyle and Susan Dentzer discuss with Gwen Ifill whether the law could survive without an insurance mandate (3/29).

Bloomberg: Secret Vote Opens Health Law Review Shaping Court Legacy
U.S. Chief Justice John Roberts will probably ask each of his eight Supreme Court colleagues gathered in an oak-paneled room tomorrow where they stand on the law that would expand health insurance to at least 30 million Americans and affect one-sixth of the economy. The secret, preliminary vote, following the court’s standard practice, will kick off three months of behind-the- scenes deliberations on the fate of the law. The outcome will shape Roberts’s own legacy, influence President Barack Obama's re-election prospects and potentially deepen the partisan gulf that is already dividing the country (Stohr and Stern, 3/29).

The Associated Press: No Change In US Health Care While Court Decides
Nothing much changes for Americans' medical care while the Supreme Court mulls the fate of President Barack Obama’s health care law. The wait might take three months. Decisions can come anytime, but complex cases argued in the spring often emerge near the end of the session, in late June (3/29).

Reuters/Chicago Tribune: White House: No Contingency Plan If Healthcare law Rejected
The White House said on Wednesday that it was not working on contingency plans for President Barack Obama's signature healthcare law, in the event that the Supreme Court struck down all or part of the sweeping reforms. After three days of landmark Supreme Court hearings that raised doubts about the law's fate, White House spokesman Josh Earnest said the administration remains confident that the 2010 reform measure would be upheld when justices issue their ruling toward the end of June (Morgan and Mason, 3/28).

Politico: Justices To Congress: It's In Your Court After Health-Care Ruling
If the Supreme Court undercuts President Barack Obama’s health care law, Congress is prepared to do the following: nothing. The justices seemed hot on the idea Wednesday that legislators can clean up whatever mess is left behind if the court strikes down the individual mandate or the whole law (Allen and Dobias, 3/28).

The Hill: Justices Grapple With Polarized Congress
On Wednesday, it was the Supreme Court’s turn to grapple with a reality that the rest of the country has come to know all too well: the political polarization of the modern Congress. In considering whether they could strike the individual insurance mandate without overturning the entirety of President Obama’s healthcare law, the nine justices had to consider the likelihood that a divided Congress could fix a law once its core component had been taken out. Lawyers for both the government and the opponents of the law argued that simply striking the mandate while leaving in place corresponding new insurance regulations could result in a spike in premiums that Congress did not intend (Berman, 3/28).

The New York Times: Few Minds Are Changed By Arguments In Court
Three days of sharp debate over the fate of the Obama administration's signature accomplishment seems to have reinforced what many Americans already believe about the health care overhaul, but with an extra dose of repulsion or delight. The arguments before the court that will ultimately decide whether the law is struck down will not have any practical impact until June, when the justices' decision is expected. But many people across the country who paid close attention had already made up their minds, as interviews with nearly three dozen people over the last few days made clear (Saulny, 3/28).

National Journal: After The Ruling
The three days of arguments are over, protesters are going home, and the nine Supreme Court justices are left to decide among themselves what to do with health care reform. They’re expected to rule in June, but no matter what they decide, health care costs are not going to go down any time soon. Whether the justices leave the Affordable Care Act of 2010 intact, take out the individual mandate, or throw the whole thing out, health care reform is a work in progress and will be for decades to come (Fox, 3/29).

Kaiser Health News: Slideshow: Days 1-3: Citizens Gather As Supreme Court Begins Review Of Health Law
This collection of photos offers images of what was going on this week outside the Supreme Court, where Americans gathered to express their support or opposition to the law -- or just to see history being made (3/28).

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High Court And Severability: What Parts Of The Law Could Fall?

On Wednesday, the nine justices pondered what parts -- if any -- of the health law could go forward if the individual mandate is overturned. The discussion involved fundamental consitutional questions.   

The New York Times: On Day 3, Justices Weigh What--Ifs Of Health Ruling
The justices seemed divided on both questions before them: What should happen to the rest of the law if the court strikes down its core provision? And was the law's expansion of the Medicaid program constitutional? The two arguments, over almost three hours, were by turns grave and giddy. They were also relentlessly pragmatic. The justices considered what sort of tasks it makes sense to assign to Congress, what kinds of interaction between federal and state officials are permissible and even the political character of the lawsuits challenging the law (Liptak, 3/28).

Politico: 5 Supreme Court Takeaways
After three days and six hours of arguments, a core provision in President Barack Obama's signature health law appears to be in serious danger. And Wednesday, it looked quite possible that the entire law could fall. But there's no ruling yet, and oral arguments can sometimes be deceptive. The real action will take place behind the scenes, when justices meet to discuss whether the law should survive (Gerstein and Haberkorn, 3/28).

NPR: Justices Ask: Can Health Law Stand If Mandate Fails?
The major arguments of the day were premised on a supposition. Suppose, asked the court, we do strike down the individual mandate — what other parts of the law, if any, should be allowed to stand? (Totenberg, 3/28).

Boston Globe: Court Appears Split On Future Of Health Law If Mandate Is Out
For Justice Elena Kagan, the question boiled down to "is half a loaf better than no loaf?" Paul Clement, a lawyer representing 26 states suing the federal government, argued that the entire law should go if the mandate falls. Congress, he said, should be granted a clean slate to fix the country's burgeoning health care problems, which include skyrocketing costs and tens of millions of uninsured. For Clement and those opposed to the law, there are instances in which half a loaf is worse (Jan, 3/28).

The Wall Street Journal: Justices Question Extent Of Federal Power
The Supreme Court ended three momentous days of argument Wednesday over the constitutionality of the Obama administration's signature health-care law, with opponents pushing their rhetoric into fundamental questions about the limits of Washington's power. Conservative justices suggested that if one part of the law is judged unconstitutional, the entire health overhaul with hundreds of provisions may have to fall with it. In the afternoon, the case took a twist that upended expectations, as the conservatives challenged the basis of the federal-state Medicaid program (Bravin, 3/28).

Bloomberg: Some Justices Suggest Preserving Part of Health-Care Law
Several U.S. Supreme Court justices suggested they may leave much of President Barack Obama's health-care law intact even if they strike down its core requirement that Americans buy insurance. "The bottom line is, why don't we let Congress fix it" instead of throwing out the entire law, said Justice Sonia Sotomayor during the third and final day of arguments on the health-care law. Chief Justice John Roberts and Justice Ruth Bader Ginsburg, ... said the law includes items, such as reauthorizing black-lung benefits and an Indian health-care measure, that aren't related to the individual health insurance mandate (Stohr and Asseo, 3/28).

Des Moines Register: Iowa Legal Experts On Health Care Arguments: Hard To Read Tea Leaves On Tossing Whole Law Vs. Parts
The Register invited three Iowa law school faculty members and an independent health law expert to listen to the oral arguments each day and offer perspectives. … Mark Kende, law professor, Drake University: "The arguments about severability and Medicaid are filled with irony and perhaps politics" (3/28).

Kaiser Health News has excerpted transcript highlights from Wednesday's oral arguments on the question of severability.

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Medicaid Questions Complete The Court's Health Law Review

At some points during the Supreme Court's consideration of the health law's Medicaid expansion, conservative justices not only questioned this provision of the law, but the program itself.  

NPR: Medicaid Expansion Caps Supreme Court Arguments
The key issue is whether the health law's expansion of the Medicaid program for the poor unfairly compels the participation of states. Many considered this to be the weakest part of the states' challenge to the health law, and during Wednesday afternoon's arguments, that seemed to be the case (Hensley, 3/28).

The Wall Street Journal's Washington Wire: A Medicaid Twist In Health-Law Arguments
In an interesting turn Wednesday, the Supreme Court's conservative justices repeatedly questioned not just the expansion of Medicaid but the basis for the entire program. That raised the possibility, however remote, of a ruling that would throw out a 47-year-old pillar of the nation’s health-care system along with the two-year-old Obama health law (Landers, 3/28).

The Washington Post: On Health-Care Hearing's Last Day, Supreme Court Weighs Medicaid Expansion
The court’s divisions were on vivid display Wednesday during a discussion of the law’s Medicaid expansion, which gives states more federal money if they agree to enroll more of the poor. States can refuse, but only if they pull out of the program altogether. The states challenging the legislation say that is not an option. The Medicaid program has grown so large that it is impossible to forgo federal funding and still provide medical care to the poor, they say (Barnes and Aizenman, 3/28).

Politico: States Get Tough SCOTUS Questions On Medicaid
The Supreme Court's liberal justices hammered the health care reform law's opponents with tough questions about their objections to the law's Medicaid expansion Wednesday — and even Chief Justice John Roberts sounded skeptical of the states' argument that the law makes unreasonable demands on their Medicaid programs. The conservative justices stayed mostly silent during the early part of Wednesday's arguments on the Medicaid expansion, letting the liberal justices dominate the discussion more than they did during the court’s past sessions (Haberkorn, 3/28).

Modern Healthcare: Medicaid Arguments Close Out Health-Reform Challenge
No U.S. HHS secretary has ever cut off Medicaid funding for a state that refused to abide by the conditions for federal matching money in the healthcare program for the poor and needy. But that doesn't mean no secretary has ever threatened to do so (Carlson, 3/28).

NewsHour: Medicaid Expansion: Good Or Bad For America?
If the health care reform law pushes forward as planned, 16 million more Americans will receive health care coverage through the federal Medicaid program by 2014. ... we broke down the basics with Marcia Coyle of the National Law Journal ... For two more perspectives on the expansion, we turn to Tom Miller, a resident fellow at the conservative American Enterprise Institute, and Ron Pollack, the founding executive director of the left-leaning Families USA. Our basic question: Is the Medicaid expansion good or bad for America? (Kane and Bowser, 3/28).

Kaiser Health News excerpted highlights from the Medicaid arguments.

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Voiding The Mandate, Or The Entire Law, Would Upend Plans By Insurers, Employers

Popular provisions that have already gone into effect, such as letting children stay on their parents' insurance plans until they turn 26, would fall if the law is thrown out. If only the mandate is declared unconstitutional, however, the law would still affect millions.

The Wall Street Journal: Health Case Ripples Outward
Among those set to implement the law, insurers would have to ditch changes to their businesses designed to bring in millions of new customers. Provisions that have already gone into effect, including letting children stay on their parents' insurance plans until they turn 26, would no longer be required. Companies facing the law's requirements would be reprieved, including health firms set to pay new taxes and businesses that would have been required to insure their employees or pay a fee. It is impossible to predict how the court will rule, but skepticism from key justices heightened the possibility the 2010 health overhaul could be overturned in June, when the court is set to announce its opinion (Adamy, Bravin and Mathews, 3/28).

Kaiser Health News: Minus A Mandate, Health Law Would Still Affect Millions
If the Supreme Court strikes down the requirement that most Americans carry health insurance – along with related provisions that insurers must sell to people with pre-existing conditions and not charge the sick more – what's left in the law? Quite a bit, say policy experts – although the changes could make what's left harder to do (Appleby, 3/28).

The Connecticut Mirror: Supreme Court Sharply Divided Over Individual Mandate
At the center of the health care bill, the individual mandate helped persuade health insurers, including Connecticut-based companies like Aetna and Cigna, to accept other reforms on the way they do business. ... "Eight states enacted various (reforms) in the 1990s without covering everyone, and these reforms resulted in a rise in insurance premiums, a reduction of individual insurance enrollment and no significant decrease in the number of uninsured," AHIP President Karen Ignagni said (Radelat and Levin Becker, 3/27). 

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Who Was Who During The Supreme Court Arguments?

News outlets take a look at key personalities on the bench, in front of the justices, in the gallery and in the creation of the health law itself -- including examinations of the closing arguments by both the plantiffs' attorney and the federal government's lawyer.   

The Wall Street Journal: Big Case Stirs Up This 'Hot Bench'
Lawyers call a lively group of judges a "hot bench." This one was scorching. Over three days and 6½ hours of arguments, the Supreme Court justices were unusually animated -- jumping in with questions, delivering passionate lectures about liberty and quoting everyone from James Madison to Jack Benny. The tension rose by the day and the hour (Kendall and Bravin, 3/28).

NPR: Supreme Court Cheat Sheet Day 3: Scalia Unplugged
Wednesday's morning arguments were as spirited -- and divided along ideological lines -- as they were during Tuesday's session on the individual mandate (Halloran, 3/28).

Politico: And On The Seventh Hour Paul Clement Rests
Paul Clement expressed confidence Wednesday that the Supreme Court could overturn the entire health law. The justices are "considering all these issues very seriously," the lawyer who represented the 26 states challenging the law said on the steps of the court after the arguments were over. "No justice of this court thinks lightly about striking down an entire act of Congress, but the question is really what's going to make more sense for Congress: Do you want to take out this statute and try to fix the statute or do you want to start with a clean slate and fix the underlying problem?" he said (Nocera, 3/28).

Reuters: Obama Lawyer Asks Supreme Court To Save Health Care Law
The Obama administration's top courtroom lawyer made an impassioned plea on Wednesday for the Supreme Court to save President Barack Obama's health care law, capping three days of historic arguments that left it unclear how the nine justices would rule. … After what critics called a poor performance on Tuesday, U.S. Solicitor General Donald Verrilli, arguing for the administration, closed his case with an emotional request that the justices uphold the law. Verrilli cited millions of people with chronic conditions such as heart disease, diabetes and breast cancer who would get health insurance under the law (Vicini and Biskupic, 3/28).

McClatchy: Who's The Woman Out Front Against Health Care Law? Florida AG Pam Bondi
Blessed with sound-bite sensibilities in an all-male scrum of long-winded gray suits, Florida Attorney General Pam Bondi stood out in Washington this week as the unofficial spokeswoman for the 26 states that challenged the health care law to the Supreme Court. Elected in 2010, the telegenic former state prosecutor and former Fox News legal commenter inherited the lawsuit from former Republican state Attorney General Bill McCollum. But Bondi campaigned on the issue herself, and she has seized it as her own since taking office at the beginning of last year (Bolstad, 3/28).

The New York Times: Mr. Health Care Mandate
After Massachusetts, California came calling. So did Connecticut, Delaware, Kansas, Minnesota, Oregon, Wisconsin and Wyoming. They all wanted Jonathan Gruber, a numbers wizard at M.I.T., to help them figure out how to fix their health care systems, just as he had helped Mitt Romney overhaul health insurance when he was the Massachusetts governor (Rampell, 3/28).

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Capitol Hill Watch

House Poised To Approve Ryan Budget Plan

Passage of the GOP budget advanced by Rep. Paul Ryan, R-Wis., will likely be along party lines. Meanwhile, a bipartisan alternative was rejected Wednesday.  

The Associated Press: House Ready To OK GOP Budget, Rejects Rival Plans
Republicans are ready to ram through the House an election-year, $3.5 trillion budget that showcases their deficit-cutting plan for revamping Medicare and slicing everything from food stamps to transportation while rejecting President Barack Obama's call to raise taxes on the rich. The blueprint by House Budget Committee Chairman Paul Ryan, R-Wis., was headed for all but certain House passage Thursday, mostly along party lines. It faces a demise that is just as sure in the Democratic-run Senate, which plans to ignore it, but the battle remains significant because of the clarity with which it contrasts the two parties' budgetary visions for voters (Fram, 3/29).

The Hill: Ryan Budget Plan Poised To Pass House, Giving GOP Needed Boost
The House on Thursday is poised to approve Rep. Paul Ryan's (R-Wis.) budget measure, which would give Republicans a much-needed lift after months of intra-party squabbling. Ryan's blueprint — which cuts $5.3 trillion in spending compared to President Obama's budget proposal — has been gaining traction among Republicans in recent days. Yet, conservative deficit hawks have called for deeper cuts, while some GOP appropriators have grumbled about the spending caps in the budget resolution (Kasperowicz, 3/29).

Kaiser Health News: Capsules: House Debates Ryan Budget: Predictably Partisan
The tone was immediately and undoubtedly partisan Wednesday when the House began considering the Republican-backed 2013 budget resolution that the House Budget Committee recently approved (Werber Serafini, 3/28).

The Wall Street Journal: House Votes Down Bipartisan Budget Proposal
The House overwhelmingly voted down a bipartisan budget proposal Wednesday that would have directed lawmakers to reduce the federal deficit by more than $4 trillion over 10 years through a combination of spending cuts and tax increases. … The White House and many Democrats have called for deficit reduction through a combination of targeted spending cuts and large tax increases. Many Republicans, particularly congressional leaders, have said they won't support a deficit-reduction plan that raises taxes, and they have said any deal would require a large restructuring of Medicare and Medicaid (Paletta, 3/28).

Politico: House Crushes Budget Compromise
Republicans pushed toward House passage on Thursday of their new budget plan after crushing a bipartisan alternative Wednesday night and smoothing out internal GOP differences over the handling for future funding for disasters (Rogers, 3/29).

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Campaign 2012

Supreme Court Arguments, Upcoming Ruling Poses Challenges For Political Parties, Presidential Hopefuls

All sides agree that, despite the uncertainly that surrounds what the court will decide, the decision will have political repercussions.

The New York Times: Parties Brace For Fallout In Court's Ruling On Health Care
For all of the fretting by liberals and the tea-leaf reading by legal analysts about the pointed questioning from the justices about the health law, there is but one certainty: There will be substantial political fallout no matter how the court rules (Zeleny, 3/28).

Boston Globe: Ruling May Pose Test For Candidates
If the high court in June rules the law invalid, Republicans will no longer have the luxury of addressing Obama's health care plan with a simple "I am against it"’ and move on to the next issue. Already, that possibility is giving rise to "what if"’ questions being posed everywhere from the couches of late-night comedians to the hallowed halls of Congress. ... While campaigning, Romney often criticizes Obama's plan, but he less frequently brings up his own prescriptions for fixing the vexing problems facing health care. If the law is ruled unconstitutional, political observers say, it would be more incumbent on Romney to explain his own ideas (Viser, 3/29).

Politico: Mitt Romney Or Not, GOP Is Coming For 'Obamacare'
With the general election now in sight, Republican strategists and party officials have begun crafting a strategy that puts health care front-and-center in the campaign against President Barack Obama, even if Mitt Romney is at the top of their ticket (Burns, 3/29).

MSNBC: Romney Keeps Low Public Profile Amid Health Care Hearings
Mitt Romney's performed a disappearing act of sorts during three days of hearings before the Supreme Court on President Obama’s health care law, arguably the most high-profile of issues during the 2012 election, and the motivating issue for conservative primary voters. Romney has held just one public event, a speech at a medical device company outside San Diego, over the course of three days of oral arguments before the high court (Haake and O’Brian, 3/28).

The New York Times: Taking Heed Of Criticism, Santorum Tones Down Attacks
He still reserves plenty of derision for Mr. Romney, mocking him repeatedly as the "Etch A Sketch" candidate whose conservative values are malleable and insincere. But in campaign speeches across Wisconsin the past few days he has directed more of that outrage at Mr. Obama, particularly over the issue of government-mandated health care (Peters, 3/28).

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Democrats Respond To Ryan Budget Plan With Billboard, Cries Of Foul

GOP presidential hopeful Mitt Romney offered his support for the plan advanced by Rep. Paul Rayn, R- Wis., causing Democrats to point out inconsistencies with his attacks on the health law.  Meanwhile, Democrats have posted a billboard in Ryan's hometown criticizing his proposals on Medicare.

NPR: Romney's Support For Ryan Budget Has Democrats Crying Foul
What they're trying to have, says [Rep. Chris Van Hollen, D-Md.], is $500 billion in projected Medicare savings. Those savings are part of the Affordable Care Act, President Obama's health care law. They're achieved through slower payments to hospitals and a reduction in the overpayment of premiums to Medicare Advantage providers. Those savings are something Romney hits President Obama on day after day on the campaign trail. … But here's the rub: The Ryan budget assumes that very same $500 billion cut. Well, "cut" isn't the right word; "savings" is more accurate. The reality is that in real dollars Medicare spending will keep rising — just not by as much (Keith, 3/29).

The Wall Street Journal's Washington Wire: Democrats Put Billboard In Rep. Ryan's Hometown
With the vote on the House Republican budget scheduled for Thursday, Democrats have posted a billboard in Janesville, Wis., the hometown of Rep. Paul Ryan, chairman of the House Budget Committee, attacking the budget's approach to Medicare (Bendavid, 3/28).

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Health Law Continues To Trigger Salvos In Mass. Senate Race

Sen. Scott Brown, R-Mass., and Democratic challenger Elizabeth Warren continue to spar over health policy issues. At the same time, Brown's election to the Senate could continue to impact the fate of the health law.

The Associated Press/WBUR:  U.S. Sen. Brown, Democrat Warren Spar On Health Care
Warren Campaign Manager Mindy Myers called Brown's opposition to the law a "reckless" move that threatens health care coverage. ... Brown Campaign Manager Jim Barnett said the new law will have a devastating effect on the state's medical device industry  (3/28).

Boston Globe: Brown's Election Reverberates In Court Fight
Senator Scott Brown was elected in 2010 with a promise to be the 41st vote against President Obama's health care overhaul. But Democrats in the Senate found a way to deny the Republican senator that opportunity, using parliamentary maneuvers to push the bill through without him. Now, as the law is under review in the Supreme Court, Brown's opposition could prove to have an indirect, but significant, effect on whether it is overturned in its entirety (Bierman, 3/29).

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Quality

Paying Doctors and Hospitals For Better Outcomes May Not Pay Off

Medicare's largest effort to pay bonuses to hospitals that hit key performance measures -- or dock them if they miss --  did not lead to fewer deaths for heart attacks and heart bypass surgery, a new study finds. The analysis could lead to a reexamination of the idea of paying providers based on quality metrics, rather than on volume, which is key to the health law.

Kaiser Health News: Effort To Pay Hospitals Based On Quality Didn't Cut Death Rates, Study Finds
Medicare's largest effort to pay hospitals based on how they perform — an inspiration for key parts of the health care law — did not lead to fewer deaths, a new study has found. The study casts doubt on a central premise of the health law's effort to rework the financial incentives for hospitals with the aim of saving money while improving patient care (Rau, 3/28).

Reuters: Hospital Pay Incentives Fail To Help Patients: Study
A program to pay hospitals bonuses for hitting key performance measures, or dock them if they miss, failed to improve the health outcomes of patients, according to a large, long-term study. The study could lead to a re-examination of financial incentives in healthcare, as policymakers seek ways to reward results rather than paying doctors and other providers for each service they provide, such as a diagnostic test. Such an incentive program for hospitals is a key provision of the U.S. healthcare overhaul law that is being challenged this week before the Supreme Court (Krauskopf, 3/28).

National Journal: Paying For Better Outcomes May Not Improve Care
One of the planks of the 2010 health care law, paying hospitals to improve the quality of care, doesn’t appear to help patients survive any better, researchers reported on Wednesday. They compared two hospital systems over six years – one that took part in the so-called pay for performance plan offered by the Centers for Medicare and Medicaid Services, and one that didn’t. More than 6 million patients went through the 3,600 hospitals from 2003 to 2009. Ashish Jha of the Harvard School of Public Health and colleagues looked at how many patients died within 30 days after being treated for heart attacks, congestive heart failure or pneumonia or who had heart bypass surgery (Fox, 3/28).

WBUR's CommonHealth blog: Pay-For-Performance May Not Pay Off, Study Finds
Lead author Ashish Jha says it may be that doctors weren’t paid enough to compel change or that the payments weren't based on meaningful measures. "A lot of us believe that paying for performance is a good thing but how we do it is still something we don’t understand,” he said (Bebinger, 3/29).

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State Watch

Medicaid News: Calif. Readies Changes For Dual-Eligibles, Adult Day Care Program

California is revamping its adult day health care program as well as its program for people who are eligible for both Medicare and Medicaid. In Florida, a judge orders the Medicaid program there to cover autism therapy, and Georgia prepares to restructure its program.

California Healthline: Ironing Out Details of Duals Conversion 
State officials met with stakeholders in Sacramento yesterday to answer questions and work out the final details of the duals demonstration project -- an ambitious plan to enroll an estimated 700,000 dual-eligible Californians in 10 counties into Medi-Cal managed care. Enrollment will be mandatory for beneficiaries eligible for both Medi-Cal and Medicare. Jane Ogle, deputy director of health care delivery systems at the Department of Health Care Services, was quick to point out that beneficiaries would keep their own physician, even if that physician is not in the Medi-Cal network, and that beneficiaries have the power to opt out of the demonstration project, if they want (Gorn, 3/29). 

KQED/The California Report: Changes To Adult Day Health Care Coming This Weekend
On April 1, adult day health care will be eliminated as a Medi-Cal benefit. A scaled-down version of the program called Community Based Adult Services will take its place. But days ahead of the transition, advocates for the disabled have filed a contempt motion against the state (Varney, 3/28). 

Health News Florida: Judge Orders Medicaid To Cover Autism Therapy 
In a case that could jolt Medicaid programs across the country, a federal judge in Miami has ordered Florida officials to cover behavioral therapy for autistic children. ... Her order applies to more than 8,000 low-income children in Florida who are enrolled in Medicaid (Gentry, 3/28). 

The Miami Herald: Florida Must Pay For Autism Therapy For Poor Kids, Judge Says
Florida healthcare regulators have left autistic children from impoverished families at risk of "irreversible" harm by refusing to pay for a critical therapy that can help them lead more normal lives, a Miami federal judge has ruled. U.S. District Judge Joan Lenard, in an order signed this week, required the state’s Medicaid insurance program for needy families to begin paying for a psychological program, called applied behavioral analysis, designed to improve the behavior, language and cognitive development of autistic children (Miller, 3/28).

Georgia Health News: Lawmakers Get Update On Medicaid Restructuring 
The current timeline for a decision on restructuring Georgia Medicaid may not be feasible, a state official indicated to lawmakers Wednesday. ... The hearing focused on a recent state-commissioned report on the future of the Medicaid and PeachCare programs. That report, by the consulting firm Navigant, calls for Georgia to consider adopting an enhanced managed care system that would cover aged, blind and disabled Medicaid beneficiaries (Miller, 3/28). 

The Connecticut Mirror: In Court's Shadow, Others Connect Health To Housing 
Because the law expands Medicaid eligibility to those earning at or below 133 percent of the poverty level, a lot more public housing residents will be eligible for health insurance. ... In addition, as its now written, the law pumps nearly $11 billion into community health centers over the next five years. These centers will be looking for new clients to serve, and now they’ll have a new base of clients with health insurance (Satija, 3/28). 

In Iowa, Medicaid officials are investigating a charity for alleged Medicaid fraud --

Des Moines Register: Medicaid Probe Targets Des Moines Charity
A Des Moines charity that counsels troubled youths and families at taxpayer expense is under investigation for potential Medicaid fraud. The charity, called A New Beginning, is being examined by the Iowa Medicaid Fraud Control Unit and the U.S. attorney's office. The investigation is the result of two separate, recent referrals from Magellan, a company that processes Medicaid payments to privately run — but publicly funded — agencies providing counseling, mentoring and other community-oriented services (Kauffman, 3/28).

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Split Ariz. Republicans Stall Birth Control Measure

A split in the Republican party between moderates and conservatives has stalled a birth control bill aimed at allowing employers to opt out of covering contraception in their health plans. 

The Arizona Republic: Arizona Democrats, Moderates Block State Birth-Control Bill
A fissure between moderates and conservatives within Arizona's Republican party has become more obvious at the state Legislature. On Wednesday, the political split led to the downfall of a controversial bill to allow employers and insurance companies to opt out of covering contraception for religious reasons. … But while the death of the contraception bill has Democratic lawmakers celebrating, experts say it's not likely a sign that one of the nation's most conservative legislatures has suddenly had a change of political heart -- lawmakers have still introduced bills promoting conservative causes (Beard Rau and Wingett Sanchez, 3/28).

The Associated Press: Arizona State Senate Defeats Bill On Contraception
Majority Republicans were split Wednesday as the Arizona Senate narrowly rejected a bill to allow more employers to drop health insurance coverage for birth control amid concerns that the proposal jeopardized women's care and privacy. Supporters had changed the bill ahead of the vote Wednesday in an attempt to provide assurances that a woman wouldn't have to explain to her employer why she wants contraceptives. The amended provisions were a response to criticism that the proposal could force women to divulge private health matters to employers, an interpretation that supporters of the bill disputed (Davenport, 3/28).

In Kansas, the legislature has advanced a bill to allow pharmacists to avoid having to give patients pills that might cause abortion.

The Kansas City Star: Kansas House Advances 'Conscience' Protection For Drugs That Might Cause Abortion
The Kansas House is moving into the birth control debate with a bill that would allow pharmacists to bow out of providing drugs they believe might cause an abortion. The chamber tentatively agreed Wednesday to advance the bill, which is primarily intended to broaden the legal protections for health care providers who don’t want to be involved in the abortion procedure (Cooper, 3/28).

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State Roundup: N.H., Kansas Move Towards Health Care 'Compacts'

A selection of health policy news from Massachusetts, Wisconsin, New Hampshire, Maryland, Minnesota, Pennsylvania and Kansas.

The Associated Press/New England Cable News: House Passes Health Care Compact Bill
The [N.H.] House has voted to form an interstate health care compact, rejecting an effort to instead study the cost implications for New Hampshire if the state assumed control for health care within its boundaries. Under the bill, the states would receive block grants from the federal government and would take over Medicare and Medicaid (3/28).

Kansas Health Institute News: Health Care Compact Bill Not Taken Up By Conference Committee
Rep. Brenda Landwehr, R-Wichita, asked senators if they would be interested in taking up House Bill 2520, which would authorize Kansas participation in the Interstate Health Care Compact. ... Similar bills have passed and been signed into law in six states: Georgia, Texas, Missouri, Oklahoma, Utah and Indiana. Governors in Arizona, Montana and North Dakota have vetoed compact bills (Cauthon, 3/28). 

Related, earlier KHN story: Some States Seeking Health Care Compact (Gugliotta, 9/18/11)

(St. Paul) Pioneer Press: Minnesota Senate OKs Bill Creating Accounts For Part-Time Workers To Pay For Health Insurance
After a debate that featured lots of talk about the federal overhaul of the health care system, the Minnesota Senate passed a bill that its author suggested would address a much more limited problem - the challenge of part-time workers' search for health insurance. The bill that passed Wednesday, March 28, would create what are called "personal health premium accounts," in which individuals could amass funds from part-time employers and other sources to pay health insurance premiums, said Sen. David Hann, R-Eden Prairie (Snowbeck, 3/28).

Milwaukee Journal Sentinel: Walker Signs Three Health Bills
Gov. Scott Walker signed three bills involving electronic prescriptions, physician assistants and licensing anesthesiologist assistants on Wednesday … Senate Bill 421 expands physician assistants' scope of practice (Boulton, 3/28).

WBUR's CommonHealth blog: Mass. Health Plans Report: Payment Reform Won't Fix Prices
The latest Massachusetts Association of Health Plans annual report is out, and it offers some very colorful visual reminders of a point many in the state have been making: To stem the growth in health care costs, payment reform is not enough; something must be done about the "market distortion" that allows some hospitals to charge far higher prices than others (Goldberg, 3/28).

WBUR's CommonHealth blog: Health Policy Insiders Propose What They Call 'Smart Tiering'
Some of our friends and neighbors in Massachusetts pay a lot more to go to Massachusetts General or Children’s Hospital Boston than they do for Metro West or Tufts Medical Center. They have insurance that assigns hospitals to a high, medium or low cost tier with co-pays to match. ... Some health care insiders are also wondering if it makes sense to label a hospital “high cost” for everything they do (Bebinger, 3/28).

The Baltimore Sun: Good Samaritan Hospital Settles Claims It Defrauded Health Programs
Good Samaritan Hospital agreed to pay $793,548 to settle allegations that it submitted false claims to federal health benefit programs for four years ending in December 2008, federal Department of Justice officials reported Wednesday. The hospital denied any wrongdoing, but federal officials say the MedStar Health System hospital listed some patients admitted to the hospital as suffering from malnutrition when they were not diagnosed or treated for that condition (Cohn, 3/28).

The Philadelphia Inquirer: Kitchen Opposes Roxborough Hospital Buyer
Pennsylvania State Sen. Shirley M. Kitchen (D., Philadelphia) lashed out at the new owner of Roxborough Memorial Hospital in a letter to the director of the Pennsylvania Department of Health, urging Eli Avila to help stop Prime Healthcare Services from taking over the 140-bed facility. Based in Ontario, Calif., Prime Healthcare is reportedly under investigation by federal authorities over aggressive Medicare reimbursement requests, though a company spokesman denies such reports (Sell, 3/29).

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Weekend Reading

Longer Looks At Supreme Court Battle: Justices' Interactions Key To Decision

Every week, reporter Jessica Marcy selects interesting reading from around the Web.

The Atlantic: How Much Of The Health-Care Law Will The Justices Leave Intact
Welcome to the world of the law, Supreme Court edition, where after Tuesday's remarkable hearing the five conservative justices appeared eager, or at least willing, to defend an unworkable status quo that rewards people who choose to blow off health insurance coverage knowing that they will be treated anyway if they show up ill at a hospital. … It's likely that only a small percentage of what they heard from the lawyers this week -- a concession here, a point there -- will factor into their decision. More relevant will be the interactions between the justices -- centering around Justice Kennedy, of course (Andrew Cohen, 3/28).

Mother Jones: Will The Supreme Court Create Zombie Obamacare?
The first question before the Supreme Court on Wednesday, the last of three days of oral argument about the constitutionality of President Barack Obama's health care law, was whether the individual mandate—the requirement that certain uncovered Americans purchase health insurance or pay a fine—was the "heart" of Obamacare. In other words, if that beating heart is ripped out by a majority of the nine black-robed justices, should the Affordable Care Act be allowed to stumble along or be put down with a double-barrel shot to the head? (Adam Serwer, 3/28).

The New Yorker: Justice Kennedy And The Search For A "Limiting Principle"
For fans of high principles and impassioned debates, this wasn't very satisfying. I, for one, would have enjoyed seeing Verrilli challenging some of the conservative Justices on their own grounds, and defending the individual mandate on the grounds of economic efficiency and cost-benefit analysis. Ever since the rise of the "law and economics" movement, conservatives like (Chief Justice John) Roberts have elevated efficiency concerns to a potentially decisive role. And it's patently clear that if you want to ... retain a private insurance market and make it work efficiently, providing affordable coverage to more people, you need some form of individual mandate (John Cassidy, 3/28).

Salon: The Obamacare-Abortion Myth 
Anti-choice activist Lila Rose, founder of Live Action and best known for her deceptive undercover videos intended to bring down Planned Parenthood, declared Obamacare "our generation's Roe v. Wade case." Even as liberals worry that the justices will strike down healthcare reform, conservatives like Rose are preparing to keep up the fight in case the Court upholds it. If Obamacare stands, she says activists will take to the streets, the courts, the voting booth and the halls of Congress much in the way they have fought legal abortion. Rose’s invocation of Roe as a parable for Obamacare is emblematic of conservative confusion and hypocrisy when it comes to the law (Sarah Posner, 3/28).

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Editorials and Opinions

Perspectives On The Court And The Health Law: Is This Judicial Activism?; Decision Could Define Roberts; Health Economics 101

The New York Times: Activism And The Roberts Court
The ideological nature of the health care case was obvious on the last day of oral argument. By the time the proceedings were over, much of what the conservative justices said in court seemed like part of a politically driven exercise — especially because the issues addressed on Wednesday were not largely constitutional in nature (3/28). 

The New York Times: Opinionator: Moral Arguments 
David: Oh my, my. We spend years arguing about Obamacare (now its official bipartisan name) and after all that muss and fuss it may be struck down. ... Gail: How can this law not be constitutional? The other alternatives are forcing taxpayers to cover the cost of the care in emergency rooms for people who don’t want to pay for their insurance (David Brooks and Gail Collins, 3/28).

Chicago Tribune: If The Law Falls… 
Remember how Obama gathered Republican and Democratic leaders for a televised health care summit in 2010, in what he billed as an attempt to share the best ideas for reform? In the end, the Republican ideas wound up on the cutting-room floor. ... That said, Obama's Republican challenger will need more than slogans to convince voters. ... Lawmakers, candidates: Don't wait to see if the court really does hit the reset button. Start the debate now (3/29).

Boston Globe: If The Court Says No 
But assuming that only the mandate, and not the whole thing, was struck down -- as is considered the likelier scenario -- the law would be weakened, but not necessarily destroyed. There are several options for replacing the mandate (Joshua Green, 3/29).

The Wall Street Journal: The ObamaCare Reckoning 
[T]he bravado of the legal establishment has turned to uncertainty and in some cases outright panic. Everyone who said the decision was an easy fait accompli has been proven wrong by a Court that has treated the constitutional questions that ObamaCare poses with the seriousness they deserve (3/28).

Politico: Moment Of Truth For Justice John Roberts
History shows that the court gets into trouble when it strikes down national legislation on the basis of constitutional principles that majorities of the country intensely dispute. And only about 30 percent of Americans now think the court should overturn the mandate that everyone has to buy health insurance (Jeffrey Rosen, 3/28). 

The Washington Post: Judicial Activists In The Supreme Court 
The irony is that if the court’s conservatives overthrow the mandate, they will hasten the arrival of a more government-heavy system. ... And a court that gave us Bush v. Gore and Citizens United will prove conclusively that it sees no limits on its power, no need to defer to those elected to make our laws (E.J. Dionne Jr., 3/28).

The Hill: Supreme Court Scandals
As judicial precedent was abandoned in the Bush v. Gore and Citizens United cases, which transformed the Supreme Court into a protagonist in partisan and ideological wars, it is time to consider the dangers to the republic of a court whose majority — which could be on the brink of another election-changing party-line vote — increasingly acts as a partisan faction rather than a disinterested adjudicator of the law (Brent Budowsky, 3/28).

The Baltimore Sun: The Case For Obamacare
[T]he inaptness of the comparisons they used to call the individual mandate into question reveal the uniqueness of the health insurance market and the propriety of Congress' decision to regulate it in the way it did. And even as the justices questioned whether Congress overstepped its powers, they risked doing the same (3/28).

The Sacramento Bee: Justices Need To Study Up On Health Insurance
It is clear that Roberts and Kennedy will be the swing votes determining the outcome of this case. While at times they have appeared as confused as the others by the health care market, they do at least understand the basic problem that Congress was attempting to remedy: The one in six Americans without insurance not only bear the stress and burden of lacking good health care, they impose costs on everyone else – taxpayers, hospitals and the insured (3/29).

The Sacramento Bee: Head to Head: Is The 'Individual Mandate' Of Health Care Reform Constitutional?
Ben Boychuk: No. Obamacare's individual mandate is unprecedented. Worse – as the plaintiffs seeking to overturn the mandate argued in their brief to the Supreme Court and again in their oral argument Tuesday – it is "unbounded." ...  Pia Lopez: Yes. Those who oppose the law actually argued before the justices Tuesday that Congress under its commerce power could require individuals to buy insurance at the point they ask a doctor or hospital for medical care – but not in advance. Isn't that still a mandate? In any case, no insurance system, which aims to pool risks, could possibly work that way (3/29).

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Perspectives On Court's Political Fallout: A Loss Could Boost Obama; Mandate Could Be Replaced With Large Tax Credits

The Wall Street Journal: ObamaCare And The 2012 Election
The heart of the Patient Protection and Affordable Care Act is the requirement that every American purchase health insurance or pay a penalty. Justice Anthony Kennedy—widely considered the "swing vote" on cases that divide the Supreme Court evenly along ideological lines—raised concerns on Tuesday that this individual mandate "changes the relationship of the federal government to the individual in the very fundamental way." This might mean the president's signature domestic achievement will be declared unconstitutional. If so, he would face a critical decision (Karl Rove, 3/28).

The Washington Post: Obamacare And The Character Question
Whatever the Supreme Court decides in June, the fight over Obamacare has already taught us tons about the character of the president and the men who seek to replace him. Call it the Good, the Bad and the Ugly. We’ll take them in turn (Matt Miller, 3/28).

The Hill: Appeal Helps Obama
Irony alert — President Obama gets a boost no matter what the Supreme Court decides on his politically toxic healthcare reform law. The high court either upholds Obama’s signature domestic accomplishment, imprinting it for history, or it overturns the law, thereby breaking a big stick with which the GOP planned to beat Obama this fall. Should front-runner Mitt Romney become the GOP nominee, what’s left of the stick would more likely resemble a Q-Tip (A.B. Stoddard, 3/28).

The Hill: Health Care Reform Is No Poison Pill
As the Supreme Court puts healthcare reform in the dock, I've seen at least a dozen commentators offer up some version of political apocalypse, calling the law "radioactive," "poisonous" and "deadly." After all, a recent paper by five political scientists argues that by making members in conservative districts seem ideologically out of touch, the healthcare reform vote cost Democrats 25 House seats last cycle. Listening to the commentariat, you'd think it was a 20-80 issue, or maybe 30-70; that voters strongly and overwhelmingly oppose the law. In fact, they don’t (Mark S. Mellman, 3/28).

Bloomberg: Individual Mandate Is Ryan Tax Credit By Other Name
Interestingly, (Rep. Paul) Ryan’s (GOP budget) plan imposes, if anything, a harsher penalty on those who don't purchase health insurance (than the health law does). Ryan’s tax credit is far larger than the individual mandate's penalty, and much easier to enforce.…If the mandate falls, future politicians, who will still need to fix the health-care system and address the free-rider problem, will be left with the option to move toward a single payer system or offer incredibly large, expensive tax credits in order to persuade people to do things they don't otherwise want to do. That is to say, in the name of liberty, Republicans and their allies on the Supreme Court will have guaranteed a future with much more government intrusion in the health-care marketplace (Ezra Klein, 3/28).

The Arizona Republic: How 'Obamacare' Could Be Reformed
The problem with Obamacare is that it tries to do much more than solve the two main issues in the American health-care system: access for the poor that's affordable to taxpayers and security against going broke because of getting sick for everyone else. The problem with Republican alternatives is that they come up short of adequately addressing those two issues. Obamacare could be fixed and become affordable, if either political party ever develops an interest in doing it (Robert Robb, 3/28).

The Detroit Free Press: Romney, Then Obama, Got It Right On Health Care
The truth is those without health insurance in this country live sicker, suffer more and die earlier. And when we finally do treat them, we do it in a way that's so expensive it drives up the costs to American businesses, hurting their competitiveness globally and harming our country's economy. America's likely 2012 presidential nominees both got it right. And while they don't want to talk about it in this poisonous political atmosphere, they both know they got it right. Hopefully the U.S. Supreme Court won't undo what truly is their historic accomplishment (Mike Duggan, 3/29). 

CNN Money/ Fortune: Angry At Health Care Arguments? Get Even.
The point is that every time I hear liberals wearily complaining that they see no difference between the major party candidates, I want to wring their necks. And when I hear it in the future, I'll ask them to listen to Tuesday's oral arguments on the constitutionality of the Affordable Care Act, a/k/a Obamacare. The federal judiciary matters, and the Supreme Court matters most of all. To affect the composition of the federal judiciary you need to win Presidential elections. Republicans have understood these simple truths since at least the Ronald Reagan administration. Democrats -- incomprehensibly -- have not (Roger Parloff, 3/28).

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Viewpoints: IPAB Should Be 'Embraced'; World Bank Nominee 'Exactly What The Doctor Ordered'

Bloomberg: Road To Affordable Care Runs Through Medicare Pay Panel
Controlling costs will require a devilish balancing act among practitioners who resist change, consumer demand and best practices, and IPAB should experiment before imposing radical changes systemwide. But given the devastating, and growing, effects of Medicare spending on the federal debt, the U.S. can’t afford not to have an IPAB. The board should be embraced, not feared (3/28).

The Fiscal Times: What Dr. Jim Yong Kim Can Do for Healthy Aging
Obama has tapped a health policy expert to head the World Bank – and Dr. Jim Yong Kim, president of Dartmouth University, is a revealing choice. ... As the World Bank lays out its plans to stimulate growth in the coming years, Dr. Kim may be exactly what the doctor ordered − a health-field expert who can prioritize healthy aging. Americans are living well past traditional retirement age, so health and economic policy can no longer be separate enterprises (Michael Hodin, 3/28).

San Francisco Chronicle: Bill To Improve Chances Of Breast Cancer Detection
The message that mammograms save lives has resulted in an increase in early detection of breast cancer. But for 40 percent of women who get mammograms, the technology might not detect early-stage cancer because their dense breast tissue masks the cancer cells…. That's why state Sen. Joe Simitian, D-Palo Alto, has reintroduced legislation to require physicians to inform their patients if they have highly dense breast tissue…. Simitian is right to bring back the bill for a second try (3/29).

Minneapolis Star Tribune: Family Caregivers Deserve Fair Pay
When a sibling, parent, child or grandchild of an adult who is physically or developmentally disabled is willing to become that vulnerable family member's personal care attendant (PCA) -- often in order to keep him or her at home -- the state of Minnesota ought to say thank you. The state should not tell the caregiver that he or she deserves a smaller paycheck than a nonrelative would get (3/28).

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EDITOR:
Stephanie Stapleton

ASSOCIATE EDITOR:
Andrew Villegas

WRITERS:
Lisa Gillespie
Shefali Luthra

The Kaiser Daily Health Policy Report is published by Kaiser Health News, an editorially independent program of the Kaiser Family Foundation. (c) 2014 Kaiser Health News. All rights reserved.