First Edition: May 17, 2012

Today's headlines includes reports about the deadline set by the federal government regarding the creation of state-based health insurance exchanges.  

Kaiser Health News: Can I Pay Negotiated Rates When I Pay Out Of Pocket? (Video)
Kaiser Health News’ Insuring Your Health columnist Michelle Andrews responds to a readers question about how to get the negotiated rates insurers pay even when paying for a medical procedure directly (5/16). Watch the video.

Kaiser Health News: Capsules: Senate Panel Looks At Innovative Health Care Strategies; States Must Submit Plans For Insurance Marketplaces By Nov. 16; Targeting Diabetes Prevention Among Medicare Beneficiaries; D.C. Health Program For Illegal Immigrants Avoids Cuts
Now on Kaiser Health News' blog, Mary Agnes Carey reports on Wednesday's Senate Health, Education, Labor and Pensions hearing: "No matter how the Supreme Court rules next month on the challenges to the 2010 health care law, there will be a continued focus on making the health care system more efficient, and senators looked at some promising options Wednesday" (Carey, 5/17).

Julie Appleby reports: "States must provide details to the federal government by Nov. 16 – just 10 days after the presidential election – on how they will run online insurance marketplaces, according to guidance released Wednesday" (Appleby, 5/16). In addition, Shefali S. Kulkarni reports on diabetes prevention efforts: "Recent studies might suggest an increase of Type 2 diabetes among children and young adults, but the real low hanging fruit, according to diabetes and policy experts, may be among the Medicare population" (Kulkarni, 5/16).

Also on the blog, Sarah Barr reports on a D.C. health program for illegal immigrants: "A public health insurance program that primarily serves illegal immigrants in the District of Columbia avoided the chopping block Tuesday under a budget compromise approved by the D.C. Council" (Barr, 5/16). Check out what else is on the blog.

Los Angeles Times: Congress' Partisan Fight Persists Despite High-Level Overture
As President Obama welcomed congressional leaders for a White House chat over hoagies about setting aside differences to improve the economy, a far different scenario was unfolding at the other end of Pennsylvania Avenue. Republicans in the House and Senate were conducting a series of partisan maneuvers Wednesday on legislation that has no chance of reaching the president's desk. The votes in the Senate on budget measures, which would slash social programs and revamp Medicare, were designed to underscore the GOP's alternatives to Obama's policies in advance of the November election (Mascaro, 5/16).

The Washington Post: Senate Rejects Obama Budget, Republican Alternatives
Among the Republican plans advanced on the floor was the spending plan authored by House Budget Chairman Paul Ryan (R-Wis.). It would balance the budget over the next three decades, in part by cutting deeply into social safety network spending and revamping Medicare. Like Obama’s budget, it failed to garner adequate votes to continue to a full debate. Republicans forced the series of budget votes to highlight Democrats' failure to advance their own plan. The Senate rejected Obama’s budget on a 0 to 99 vote (Helderman, 5/16).

The New York Times' The Caucus: Senate Republicans Engineer Rebuke On Budget
Republicans charged that Democrats have been derelict in their statutory duty to bring forward a budget. No long-term solution to the nation's fiscal problems can be reached, they say, unless both parties are willing to agree on their visions for spending and taxes, then go to the table to negotiate. Democratic leaders have made it clear that they do not want to subject their members to the politically difficult votes Republicans would spring on them if they brought a budget to the floor (Weisman, 5/16).

The Associated Press/Washington Post: Senate Democrats Reject House GOP Budget Plan But Don't Offer Alternative
Each GOP measure, though, would sharply cut domestic programs and called for a dramatic transformation of Medicare that would turn it into a voucher-like program in which future beneficiaries, those presently under the age of 55, would have to buy health insurance on the open market rather than have the government pay hospital and doctor bills. Democrats called for a "balanced" solution blending tax increases on wealthier people with less severe spending cuts (5/16).

Reuters/Chicago Tribune: Taxes Lurk Behind Court Test Of Obama Health Law
While Supreme Court watchers focus on the controversial insurance requirement in President Barack Obama's healthcare law, lesser known is that the court's ruling next month will also decide the fate of billions of dollars in new taxes. The 2010 law includes a 3.8-percent boost in taxes on investment income and a 0.9-percent increase in the Medicare payroll tax, both hitting people who earn more than $200,000 a year (Dixon, 5/16).

The Wall Street Journal: Bid To Coax States On Health Exchanges
The Obama administration on Wednesday made a fresh bid to coax reluctant governors to work with the federal government to help enact the health-overhaul law. The move centers on new marketplaces that sell health insurance, a key plank of the law that states are supposed to open by 2014. Republican governors, who lead 29 of the 50 states, are divided over whether to set up the exchanges, which would allow consumers to shop for insurance plans if they don't receive affordable coverage through an employer (Radnofsky, 5/16).

Reuters/Chicago Tribune: U.S. Sets Deadline For Proposals On State Healthcare Exchanges
The Department for Health and Human Services released a detailed blueprint of the legal and operational requirements states must meet in their proposals if they expect to win federal approval to begin operating regulated insurance markets, in whole or in part, by January 1, 2014, when the 2010 law is scheduled to come into full force (5/16).

Politico: Health Care Reform: GOP Preps Plan For Ruling On Law
House Republican leaders are quietly hatching a plan of attack as they await a historic Supreme Court ruling on President Barack Obama's health care law. If the law is upheld, Republicans will take to the floor to tear out its most controversial pieces, such as the individual mandate and requirements that employers provide insurance or face fines (Sherman and Haberkorn, 5/16).

Los Angeles Times: Crossroads GPS Fires Back At Obama With $25-Million Ad Buy
The 2012 campaign air battle grew more intense Wednesday with the news that Crossroads GPS, the cash-flush conservative advocacy group, is pouring another $25 million into television ads castigating President Obama for "broken" promises. The massive ad buy matches the $25 million that Obama's reelection campaign announced last week it would be spending on a month of TV airtime. … The commercial charges Obama with, among other items, raising taxes through his health care reform plan and failing to meet his pledge to cut the deficit in half (Gold, 5/16).

The Associated Press/Washington Post: Ad By Outside Group Accuses Obama Of Broken Promises On Health Care, Taxes And Deficit
The ad is from Crossroads GPS, the sister group of American Crossroads, a super PAC that has promised to raise millions of dollars to defeat Obama. A 30-second abridged version of the ad is also airing. The two ads are the latest in the intensifying TV ad war focusing on 10 presidential battleground states about six months before the fall election. The $8 million dollar buy for the two spots is part of a monthlong $25 million ad campaign by Crossroads GPS (5/16).

The Washington Post's The Fact Checker: Obama: Broken Promises On Taxes And Health Care?
The Republican-aligned Crossroads GPS has scheduled a massive $25 million ad buy, starting with this hard-hitting ad that purports to list a bunch of "broken promises" by President Obama. We are not going to quibble with some of these claims. The president, for instance, certainly has not met his pledge to cut the budget deficit in half. But we were interested in exploring more carefully the two health care-related items (Kessler, 5/17).

The Associated Press/Washington Post: HHS Secretary Kathleen Sebelius To Address Georgetown Grads, Despite Church Criticism
A planned graduation speech by U.S. Health and Human Services Secretary Kathleen Sebelius at Georgetown University is going forward, despite criticism from the Archdiocese of Washington that Sebelius is an inappropriate choice for the Jesuit school (5/16).

The Wall Street Journal: Georgetown Defends Sebelius Invitation
Georgetown University is defending an invitation for Health and Human Services Secretary Kathleen Sebelius to address its graduate students Friday amid criticism from Catholics angry with the Obama administration's health policies. Ms. Sebelius is set to speak at an awards ceremony at the Georgetown Public Policy Institute immediately after its commencement event (Radnofsky, 5/17).

The New York Times: New Fight On A Speaker At A Catholic University
As a two-term governor of Kansas, Ms. Sebelius was told by her bishop that she should be denied communion at Mass because of her support for abortion rights. As health secretary, she has been vilified for upholding the mandate in the health care overhaul that requires even religiously affiliated institutions to provide birth control coverage to their employees (Goodstein, 5/16).

The Associated Press/Washington Post: Doctors Ditching The Prescription Pad As More Than A Third Of Prescriptions Now Are Electronic
Doctors increasingly are ditching the prescription pad: More than a third of the nation's prescriptions now are electronic, according to the latest count. The government has been pushing doctors to e-prescribe, in part because it can be safer for patients. This year, holdouts will start to see cuts in their Medicare payments (5/17).

The Associated Press/Washington Post: Protestors Seeking More Political Disclosure Disrupt Insurer WellPoint's Annual Meeting
WellPoint Inc. shareholders rejected a call for more disclosure about the health insurer's political contributions Wednesday during a shout-filled, contentious annual meeting. Union representatives and other protesters repeatedly interrupted Chairwoman and CEO Angela Braly after she opened the meeting and introduced proposals for shareholder voting (5/16).

The New York Times: Senate Passes Bill Creating Monitor For Disabled Care
The State Senate unanimously passed Gov. Andrew M. Cuomo's legislation to protect developmentally disabled and mentally ill New Yorkers on Wednesday, but some high-profile advocates have been unnerved by what they perceive as flaws in the bill. Assembly Democrats have said that they intend to pass the bill, but will negotiate some changes before the legislative session ends on June 21 (Hakim, 5/16).

The New York Times: U.S. Expected To Retry Ex-Senator On 4 Unresolved Charges
Federal prosecutors will try to recover nearly $500,000 that Pedro Espada Jr., a former Democratic state senator from the Bronx, was convicted this week of stealing from a nonprofit health care network, as they seek a retrial for Mr. Espada and his son, according to a person familiar with the case (Hu, 5/16).

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