First Edition: December 11, 2012

Today's headlines include coverage of yesterday's HHS announcement to states that the federal government will not fund partial Medicaid expansions.   

Kaiser Health News: HHS Tells States It Will Not Fund Partial Medicaid Expansion
Kaiser Health News staff writers Phil Galewitz and Mary Agnes Carey report: "The Obama administration answered a key question from governors on Monday with a clear 'no': States may not expand Medicaid only part of the way and still get the additional federal funding provided in the Affordable Care Act. The decision, announced by Health and Human Services Secretary Kathleen Sebelius in a letter sent to governors, is significant because after the Supreme Court ruling in June made the Medicaid expansion optional, several states have floated the idea of a less generous expansion than called for in the federal health law" (Galewitz and Carey, 12/10). Read the story.

Kaiser Health News: Aging Doctors Face Greater Scrutiny
Reporting for Kaiser Health News, in collaboration with The Washington Post, Sandra G. Boodman writes: "These real-life examples, provided by an expert who evaluates impaired physicians, exemplify an emotionally charged issue that is attracting the attention of patient safety experts and hospital administrators: how to ensure that older doctors are competent to treat patients" (Boodman, 12/10). Read the story.

Kaiser Health News: Insuring Your Health: When A Plan Overpays For A Service, Is A Patient Responsible For A Refund?
Kaiser Health News consumer columnist Michelle Andrews writes: "Experts say that overpayments can occur for a variety of reasons. An insurer may simply make a mistake and pay a provider more than the contracted amount for a service, for example. Or a provider may be paid for a service that's not covered under the patient's insurance plan. Whatever the reason, overpayments can create headaches for providers and patients alike" (Andrews, 12/10). Read the column.

The New York Times: Obama Approves Health Insurance Marketplace In 6 States
The Obama administration gave conditional approval on Monday to health insurance marketplaces being set up by six states led by Democratic governors eager to carry out President Obama's health care overhaul. … At the same time, the administration rejected pleas from other states that want to carry out a partial expansion of Medicaid, to cover fewer people than the president and Congress originally intended. Some states want to expand Medicaid to cover childless adults with incomes up to the poverty level, $19,090 for a family of three (Pear, 12/10).

Los Angeles Times: States Pressed To Guarantee Medicaid Expansion
The Obama administration stepped up pressure on states Monday to guarantee insurance for all their low-income residents in 2014 under the new healthcare law, warning governors that the federal government would not pick up the total cost of partially expanding coverage. … But Sebelius indicated that governors who do not open their Medicaid programs to all eligible low-income residents would forfeit some of the federal aid promised by the Affordable Care Act (Levey, 12/11).

The Washington Post: Partial Medicaid Expansions Won't Get Full Federal Funding, Administration Tells States
The Obama administration told states Monday that they couldn't do a partial expansion of Medicaid under the health-care law and still receive full federal funding, disappointing many Republican governors on one of the most important questions surrounding the health-care law. In recent weeks, these governors, along with other state officials, had shown increasing interest in the idea of a partial expansion of the state-federal program for the poor and disabled. In ruling that option out, the administration has raised the stakes for states debating whether to participate in a part of the law that is crucial to its success (Aizenman, 12/10).

NPR: Feds Say 'No' To Partial Medicaid Expansion
After several months of consideration, the Obama Administration delivered its decision Monday, as part of a series of questions and answers for states about Medicaid expansions and the set up health care exchanges (Rovner, 12/10).

The Associated Press/Washington Post: Feds Say States Must Follow Health Care Law To Get Full Medicaid Funding For Low-Income People
The ruling affects a federal-state program that covers nearly 60 million low-income and severely disabled people, caught in a tug-of-war between Republican governors and the Democratic administration. President Barack Obama's health care law expanded Medicaid to cover people up to 138 percent of the federal poverty line, or about $15,400 for an individual. The change mainly affects low-income adults without children at home, as well as low-income parents who can't get coverage under current Medicaid rules (12/10).

The Wall Street Journal: Feds Nix Partial Medicaid Expansion
Around half of the 30 million people expected to gain coverage from the law as it was passed were to gain it through the growth of Medicaid. … This summer, the Supreme Court's decision on the health overhaul's constitutionality effectively gave states the chance to choose whether to expand eligibility criteria for the program. Many Republican governors, and some Democratic ones, had indicated they were worried they wouldn't be able to meet their share of the costs of the full expansion. But several of those states had suggested they might be open to enrolling some residents whose incomes put them below the federal poverty level if they could exclude residents who had incomes just above the level. … On Monday, federal health officials ruled out that option and said they were confident governors would still decide to participate in the expansion as it was set out in the law (Radnofsky, 12/10).

The Associated Press/Washington Post: Maryland Gets Conditional Approval To Operate Health Insurance Exchange
Maryland has received conditional approval by the federal government to operate a state-based health insurance exchange in 2014, Lt. Gov. Anthony Brown announced Monday (12/10).

The Associated Press/Washington Post: Employers Grumble About 'Sleeper' Fee To Stabilize Insurance Market In Obama's Health Overhaul
Your medical plan is facing an unexpected expense, so you probably are, too. It's a new, $63-per-head fee to cushion the cost of covering people with pre-existing conditions under President Barack Obama's health care overhaul. The charge, buried in a recent regulation, works out to tens of millions of dollars for the largest companies, employers say. Most of that is likely to be passed on to workers (12/10).

The Wall Street Journal: Health Providers Watch Cliff Talks
Deficit-reduction negotiations have revived a long-standing question: How much can the government cut what it pays Medicare and Medicaid providers without directly affecting beneficiaries? (Radnofsky, 12/10).

Los Angeles Times: A Prayer As 'Fiscal Cliff' Talks Continue
Lawmakers returned to Washington as President Obama and House Speaker John A. Boehner continued negotiations to swerve around the so-called fiscal cliff of tax hikes and spending cuts in the new year. The president and congressional Republicans remain far apart, but the silence coming from the White House and the speaker's office after a meeting Sunday between the two principal negotiators was seen by many observers as a breakthrough of sorts. … Obama wants to extend existing tax rates for all but those at the top-2% income level, but Republicans are pushing to continue lower tax rates for all, including couples earning more than $250,000 a year, or singles bringing in $200,000 a year. Republicans also want spending reductions in popular safety-net programs, including Medicare, Medicaid and Social Security, in exchange for any new tax revenue (Mascaro, 12/10).

The Wall Street Journal: Obama-GOP Cliff Talks Take Positive Turn
Both sides still face sizable differences before any agreement might be reached by the end of the year, and talks could well falter again over such controversial issues as taxes and Medicare before any deal is reached. The people familiar with the matter say talks have taken a marked shift in recent days as staff and leaders have consulted, becoming more "serious" (Paletta and Lee, 12/11).

The Associated Press/Washington Post: Cliff Talks: No Progress Evident As Each Side Demands Specifics From The Other; Deadline Ahead
A year-end deadline approaching, quiet negotiations to avoid an economy-rattling "fiscal cliff" yielded no tangible signs of progress on Monday as Republicans pressed President Barack Obama to volunteer spending cuts he will support while the White House insisted the GOP endorse higher tax rates on upper incomes (12/10).

Los Angeles Times: Obama And Boehner Seem To Get A Long, Politics Is The Problem
After weeks of private phone calls and public posturing, the Ohio Republican quietly ducked into the White House on Sunday for his first one-on-one meeting with the president since mid-2011. The goal this time: forging a deal to avoid $500 billion in tax increases and spending cuts set to take effect in early January (Hennessey and Mason, 12/10).

The New York Times: In Talks, House Majority Weighs Loyalty To Voters
As their leaders inch toward agreeing to higher tax rates, dozens of House Republicans find themselves caught between the will of a larger American public that favors higher taxes on the rich and the wishes of constituents who re-elected them overwhelmingly to oppose the Obama agenda at every turn (Weisman, 12/10).

The Wall Street Journal's Washington Wire: Senate Democrats Seek Delay In Medical-Device Tax
A group of 17 Democratic U.S. senators and senators-elect have signed a letter urging for a delay in implementing a tax on the medical-device industry that is scheduled to go into effect Jan. 1, said two people familiar with the matter (Walker, 12/10).

Politico: GAO Hits Medicaid On Waste
The Medicaid program has government employees and contractors doing some of the exact same work, which is wasting government time and money, according to a new Government Accountability Office report released Monday. Medicare, meanwhile, could better use data programmed into claims processing systems to stop fraud, GAO said in a separate report (Haberkorn, 12/11).

USA Today: Health Rankings: USA Is Living Longer, But Sicker
Americans are living longer, with fewer deaths from heart disease and cancer, but more chronic illnesses, an annual snapshot of the USA's health shows. The 2012 America's Health Rankings highlight troubling levels of obesity, diabetes, high blood pressure and sedentary behavior. Medical advances are allowing more people to live with those conditions (Healy, 12/11).

The New York Times: Obesity In Young Is Seen As Falling In Several Cities
The trend has emerged in big cities like New York and Los Angeles, as well as smaller places like Anchorage, Alaska, and Kearney, Neb. The state of Mississippi has also registered a drop, but only among white students. … The drops are small, just 5 percent here in Philadelphia and 3 percent in Los Angeles. But experts say they are significant because they offer the first indication that the obesity epidemic, one of the nation's most intractable health problems, may actually be reversing course (Tavernise, 12/10).

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