First Edition: February 14, 2012

Today's early morning highlights from the major news organizations include news on congressional package to payroll taxes and stop a Medicare payment cut and analysis of President Barack Obama's budget.

Kaiser Health News: Despite Doctors’ Concerns, Home Births Are Increasing
In her latest Kaiser Health News column, Michelle Andrews writes: "For the vast majority of parents-to-be, giving birth involves a stay at a hospital or birthing center. But a growing minority are choosing instead to have babies at home, where, they hope, they can have a more private, low-tech experience and allow the process to unfold naturally. It doesn't hurt that in these days of rising health-care costs, having a baby at home is a lot cheaper, too" (Andrews, 2/14). 

Kaiser Health News: Capsules: It's Budget Time!; Getting More KHN
Now on Kaiser Health News' blog, Mary Agnes Carey reports: "If it’s the middle of February, it’s time for the yearly Washington ritual: a president proposes Medicare and Medicaid cuts and then nursing homes and hospitals complain that those cuts will destroy the quality of care.  Today was no different: President Barack Obama released his fiscal 2013 budget plan" (Carey, 2/13).

Also, Karl Eisenhower writes: "Can’t get enough Kaiser Health News?  Now there’s a new way to take KHN with you everywhere you go. KHN is available on Google Currents, a mobile news app for smartphones and tablets" (Eisenhower, 2/13). See what else is on the blog.  

The New York Times: House Republicans Yield On Extending Payroll Tax Cut
Congressional Republicans backed down on Monday from a demand that a payroll tax rollback be paid for with reductions in other programs, clearing the way for an extension of the tax cut for 160 million Americans through 2012. After months of partisan confrontation that left the tax break hanging in the balance, Republicans suddenly offered to extend the two-percentage-point cut while continuing to haggle over added unemployment benefits and a measure to prevent a drop in fees paid to doctors by Medicare. The payroll tax holiday and jobless benefits expire at month’s end, and doctors would face a 27 percent reduction in Medicare reimbursements (Steinhauer, 2/13).

The Chicago Tribune: House Republican Leaders Agree To Extend Payroll Tax Cut
Democratic leaders, including (House Democratic leader Nancy) Pelosi, were cool to the overture, largely because it failed to resolve two other issues that have been part of the $160-billion package along with the payroll tax cut — measures to continue long-term unemployment benefits and block a pay cut for doctors who treat Medicare patients. At the White House, Press Secretary Jay Carney said, "We need to do all three" (Mascaro, 2/13).

The Washington Post: House Republican Leaders Agree To Payroll Tax Holiday Extension Without Offsets
House Republican leaders said Monday that they will support extending the federal payroll tax holiday through the end of the year without demanding spending cuts to pay for it, a concession aimed at averting another po­litically damaging showdown in Washington. ... Republicans want to continue negotiations over financing the rest of the original legislative package, including an extension of un­employment benefits and a key tweak to maintain Medicare reimbursement rates for doctors, while ensuring that taxes will not rise on workers (Kane, 2/13).

The Wall Street Journal: GOP Pivots On Payroll-Tax Cut
In addition to the payroll-tax reduction, the two parties are negotiating how to pay for enhanced unemployment benefits, an arrangement that expires at the end of the month, and an adjustment of the Medicare system so that doctors don't face a steep drop in fees. Republicans want to cover the $50 billion cost for those items by continuing a freeze of federal workers' salaries, while Democrats resist that approach (Bendavid, 2/13).

Politico: House GOP Reverses On Payroll Tax cut
The announcement shocked rank-and-file members, who were back in their House districts. Senate Republicans were likewise caught off guard — even one GOP leader who was trying to negotiate a compromise had no idea it was coming. And conservative ire rose throughout the day, threatening to derail Speaker John Boehner’s plan to take the thorny issue off the table. “We need to stop bowing to political pressure and do the right thing and make sure we don’t bankrupt Social Security even further,” Sen. Ron Johnson of Wisconsin told POLITICO. Added Missouri Sen. Roy Blunt, a former House GOP leader: “I think the whole policy is a bad policy” (Raju and Sherman, 2/13).

The Washington Post: Obama Budget: National Debt Will Be $1 Trillion Higher In A Decade Than Forecast
President Obama rolled out an election-year budget on Monday that would delay action to reduce the national debt in favor of fresh spending on Democratic priorities aimed at rebuilding the American middle class. ... The budget released Monday would trim spending on federal health-care programs by about $360 billion over the next decade, primarily by reducing payments to drug companies and other providers. Starting in 2017, Obama also proposes to raise Medicare premiums for new retirees and seniors with higher incomes, start charging co-payments for home health-care services, and penalize patients who buy Medigap policies to take care of Medicare co-payments and deductibles (Montgomery, 2/13).

The New York Times: Military Cuts And Tax Plan Are Central To Obama Budget
But the question this year is whether Mr. Obama after the election, win or lose, can use his veto and looming budget deadlines to force some compromises — even a “grand bargain” of spending cuts and revenue increases for deficit reduction could be possible, Mr. Obama has told people privately. “The president’s budget is a reasonable opening move for what will likely be major budget negotiations after the election and before the Bush tax cuts are due to expire at the end of the year,” said Jim Kessler, vice president for policy at Third Way, a centrist policy organization (Calmes, 2/13).

The Associated Press/Businessweek: Obama Sends FY2013 Budget Proposals To Congress
The Obama budget seeks $360 billion in savings in Medicare and Medicaid mainly through reduced payments to health care providers, avoiding tougher measures, advocated by House Republicans and the deficit commissions, which supporters said were critical to the cause of restraining health care costs. The projections in Obama's budget show that he is doing little to restrain the surge in these programs expected in coming years with the retirement of baby boomers. Obama's budget projects that Medicare spending will double over the coming decade from $478 billion this year to almost $1 trillion in 2022. Medicaid, the government health care program for the poor and disabled, would more than double from $255 billion this year to $589 billion by 2022. (Crutsinger, 2/13).

The Hill: Budget Includes Familiar Cuts To Medicare, Medicaid
President Obama’s budget proposal would require wealthy seniors to pay for a higher share of certain Medicare benefits. It would charge a co-pay for home healthcare services and put new limits on supplemental policies known as Medigap. ... On Medicaid, the White House again proposed a streamlined funding system that states do not support. The plan would combine various rates of federal funding into a single percentage. States and budget analysts say that approach would simply shift costs to the states, rather than actually controlling the cost of Medicaid. Washington Gov. Christine Gregoire, a Democrat, said last year that the consolidated payment rates could be a "huge problem" for states (Baker, 2/13).

The New York Times: Pentagon Wants To Raise Some Retirees’ Health Fees
Defense Secretary Leon E. Panetta has warned that runaway personnel costs at the Pentagon are “unsustainable,” and on Monday he tried to put a big brake on the spending: Over the next five years the Defense Department plans to nearly quadruple the health insurance fees paid by many working-age military retirees (Bumiller, 2/13).

USA Today: Obama's Budget Proposal Draws Fire, Praise In Congress
Republicans plan to put forward specific plans to rein in the debt and reform entitlement programs, but that path is riddled with political land mines. Last year, Ryan included in the House-passed budget a plan to phase Medicare in to a premium support system that Democrats are keen to use against Republicans in congressional races this November. Ryan signaled Monday that Republicans would not back away from offering specific policy positions on entitlements. "We're going to put out a budget like we did last year to fix this problem," Ryan said. "We're going to come up with a plan and show America two different futures" (2/14).

NPR: What Would The GOP Candidates Do With The Federal Budget? A Look At Their Plans
It goes without saying that the men who are vying for the Republican presidential nomination found serious flaws with the budget plan President Obama released Monday. But it got us thinking that this might also be a good time to dig into the budget plans offered by the GOP candidates. ... The (Center on Budget and Policy Priorities) says that cuts in non-defense programs under Romney's plan would be 54 percent, to be precise, according to a recent analysis it conducted. Veterans benefits, Medicare, food stamps, education funding — you name it — it would probably have to be cut, says Van de Water. "I don't see how non-defense cuts of this magnitude could possibly be achieved" (Keith, 2/14).

The Wall Street Journal: Obama Seeks New Taxes On Rich
(Mitt) Romney issued a statement Monday criticizing the president's budget for not taking "any meaningful steps toward solving our entitlement crisis." Congressional Republicans also criticized Mr. Obama for offering no new proposals to reform Medicare, Medicaid or Social Security, which are expanding rapidly as Americans age and health costs climb.

Los Angeles Times: Obama Health Chief Visits L.A. Clinic, Announces Plan To Help Students
Health and Human Services Secretary Kathleen Sebelius visited a health clinic in downtown Los Angeles on Monday and announced more than $9 million in funding to help medical students repay school loans if they agree to work in underserved areas. Sebelius said the program will encourage more students to pursue careers in family medicine and will help relieve a shortage of primary care doctors (Gorman, 2/14).

Politico: High-Risk Insurance Pools Short On Enrollees
When the health care law passed nearly two years ago, the conventional wisdom was that the temporary insurance pools meant to carry the high-risk uninsured until the coverage expansion kicked in would tear through their $5 billion budget in no time. That didn’t happen. The next conventional wisdom was that the pools were ridiculously undersubscribed. ... Now the conventional wisdom is — there is no conventional wisdom. Some states are tearing through their money, having attracted a small but very, very sick pool of people. And others are not. And the varying experiences of the states have taught officials some lessons about care-seeking patterns of the chronically uninsured that may help smooth things out when state exchanges open in 2014 (Millman, 2/13).

Chicago Tribune: The Increasingly Male Face Of Caregiving
In the last 15 years, the number of men caring for loved ones with Alzheimer's or dementia has more than doubled, from 19 to 40 percent, according to the Alzheimer's Association. The trend corresponds to the higher number of women over the age of 65 in the U.S. with the disease — 3.4 million, compared with 1.8 million men. Those demographics have changed the tone of local support group meetings by adding a chorus of male perspectives. It has also prompted an outpouring of new books, organizations and online resources for men learning how to be nurturers. Experts attribute the increase in male caregivers to several societal changes, including evolving gender expectations as well as new life-expectancy rates (Ortiz Healy, 2/14).

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