First Edition: November 14, 2012

Today's headlines detail how lines are being drawn regarding the 'fiscal cliff' negotiations.  

Kaiser Health News: Avoiding The 'Fiscal Cliff' Likely Means Changes In Medicare
Kaiser Health News staff writer Mary Agnes Carey reports: "Expectations are high.  President Barack Obama and House Speaker John Boehner, R-Ohio, say they want to avert the fiscal cliff, that toxic mix of expiring tax breaks and automatic spending reductions set to begin in January.  If Republicans make concessions on taxes, Democrats and the president say, they'll move on entitlements, such as Medicare and Medicaid, as part of a larger deal to reduce the federal deficit" (Carey, 11/13). Read the story.

Kaiser Health News: Nevada Quietly Moves Ahead On Health Law
Capital Public Radio's Pauline Bartolone, working in partnership with Kaiser Health News and NPR, reports: "Nevada has one of the highest rates of uninsured people in the nation – more than one in five Nevadans lack coverage. The state voted to reelect President Barack Obama by a margin of almost 7 points, but the president’s health law has been as controversial in Nevada as it has been in most states led by a Republican governor. Nevada was one of the 27 states that challenged the constitutionality of the Affordable Care Act in court. But now Gov. Brian Sandoval is moving forward on a key part of the law" (Bartolone, 11/13). Read the story.

Kaiser Health News: Missouri, Kansas Reject State-Run Health Insurance Exchanges
KCUR's Elana Gordon, working in partnership with Kaiser Health News and NPR, reports: "Immediately after the presidential election, and more than a week ahead of the Nov. 16 deadline, Missouri Gov. Jay Nixon, a Democrat, announced he had made up his mind. The state would not be setting up its own health insurance exchange. Next door in Kansas, Gov. Sam Brownback, a Republican, made a similar announcement. These governors' moves open the door for increased federal involvement in health care in both states (Gordon, 11/13). Read the story.

Kaiser Health News: Capsules: Health Law Was A Wash In The Election, Poll Finds; U.S. Lowering Rate Of Premature Births, But Slowly
Now on Kaiser Health News' blog, Jordan Rau reports on a new poll: "Both President Barack Obama and Republican Mitt Romney ended up getting equal support among voters who said the law was a 'major factor' in their vote for president, according to the poll from the Kaiser Family Foundation conducted shortly after last Tuesday's election. (KHN is an editorially independent program of the foundation.) This shouldn't come as a surprise since the public remained consistently split about the law throughout the election season (Rau, 11/13).

Also on Capsules, Shefali S. Kulkarni reports on new premature birth rate figures from March of Dimes: "The United States is slowly reducing its rate of premature births, bringing the rate to 11.7 percent in 2011, but the figure is still higher than public health advocates believe it should be" (Kulkarni, 11/13). Check out what else is on the blog.

The New York Times: Obama Vows Firm Stance On Deficit-Reduction Plan
President Obama reassured leaders of labor and progressive groups on Tuesday that he will not yield to Congressional Republicans and extend Bush-era tax cuts for the wealthiest Americans as he negotiates for a deficit-reduction plan to avoid looming tax increases and spending cuts. … The $4 trillion, 10-year plan includes the commitment to $1.1 trillion in spending cuts that Mr. Obama and Congress have already agreed to, he added, as well as additional spending cuts that include $340 billion in savings from Medicare and Medicaid. And, Mr. Carney said, Mr. Obama "insists as the essence of balance that revenue be included — $1.6 trillion in revenue" (Calmes and Greenhouse, 11/14).

NPR: Facing Cliff, Obama Tries Again For 'Grand Bargain'
Compromise is suddenly the watchword in Washington, as negotiations over taxes, spending and entitlements begin in advance of another self-imposed deadline, popularly known as the "fiscal cliff." Automatic tax increases and deep spending cuts are slated for the first of the year, unless the president and Congress take action. Leaders on both sides say they are willing to meet in the middle, but that makes their constituents worry about what any compromise will cost them. … Republicans, while offering an olive branch to the president in the form of greater tax revenues, are still adamant that income tax rates should not go up, even on the richest Americans. Liberal groups are just as adamant that no changes be made to Social Security or Medicare — something the president has been open to in the past (Liasson, 11/13).

The Wall Street Journal: Obama Sets Steep Tax Target
President Barack Obama will begin budget negotiations with congressional leaders Friday by calling for $1.6 trillion in additional tax revenue over the next decade, far more than Republicans are likely to accept and double the $800 billion discussed in talks with GOP leaders during the summer of 2011. Mr. Obama, in a meeting Tuesday with union leaders and other liberal activists, also pledged to hang tough in seeking tax increases on wealthy Americans. In one sign of conciliation, he made no specific commitment to leave unscathed domestic programs such as Medicare, leaving the door open to spending cuts many fellow Democrats oppose (Hook and Lee, 11/14).

The Washington Post: Obama To Open Talks With $1.6 Trillion Plan To Raise Taxes On Corporations, Wealthy
President Obama is taking a hard line with congressional Republicans heading into negotiations over the year-end fiscal cliff, making no opening concessions and calling for far more in new taxes than Republicans have so far been willing to consider (Goldfarb and Montgomery, 11/13).

Los Angeles Times: Speaker John Boehner Still Faces A GOP House Divided
In both the House and Senate, key Republicans have shown a willingness to compromise on taxes as part of a broader deal to cut spending on entitlements, such as Medicare — especially after an election when high-profile tea party candidates lost their Senate races. That support could give Boehner a political safety net in negotiations (Mascaro, 11/13).

USA Today: Tea Party Senator Digs In Against Talk Of Compromise
The political action committee founded by Sen. Jim DeMint, a darling of the Tea Party movement, was three-for-nine in picking conservative Senate candidates this year — after spending more than $8.7 million. … Boehner, in post-election remarks on Capitol Hill and in a national television interview, said House Republicans would be open to a deficit-reduction plan that includes new revenue through tax reform. He also said that comprehensive immigration reform was overdue and that the 2010 health care reform law — abhorred by conservatives — is the "law of the land." The Tea Party wing of the Republican Party opposes tax increases and a path to citizenship for illegal immigrants already in the country, and favors repealing of "Obamacare" (Troyan, 11/13).

The Associated Press/Washington Post: Senate GOP Leader: Up To Obama To Present Deficit Plan That's Not A Campaign Slogan
The Kentucky Republican said that like House Speaker John Boehner, he is ready to support new revenue as part of a deal that reins in government benefit programs like Medicare and Medicaid. But like the speaker, McConnell also says it’s a non-starter to talk about raising tax rates as the president has proposed for the wealthiest taxpayers (11/13).

The Associated Press/Washington Post: Budget Negotiators Get Options For $385B In Health Care Savings, Mostly From Medicare
Hoping to head off wider health care cuts in upcoming budget talks, a think tank close to the White House is unveiling a plan for how to save $385 billion, mostly from Medicare. Medicaid and the new health care law are largely spared from cuts in the blueprint being released Wednesday by the liberal-leaning Center for American Progress. Instead, it targets Medicare service providers, from the pharmaceutical industry to hospitals and nursing homes. And higher-income Medicare recipients would face increased monthly premiums for outpatient and prescription coverage (11/14).

USA Today: The Fiscal Cliff: Will Obama, Congress Cut Budget Deal?
Promise or peril, some Americans are going to feel the pinch. Should Obama get his way, those with annual incomes above $250,000 will face higher tax bills. If Republicans come out on top, tax rates and defense spending will remain the same, but social programs will face budget cuts. A compromise portends discomfort, most likely in the form of reduced paychecks, jobless benefits and business tax breaks. And a stalemate means higher taxes and reduced federal spending across the board, including at the Pentagon (Wolf, Mullaney and Davis, 11/13).

The Wall Street Journal: Companies Warn About Cutbacks
Some big American companies are making plans to slow investments, lay off workers and pay less-generous dividends if Congress and the Obama administration don't find a way to avert the so-called fiscal cliff. A range of businesses, including defense contractors and hospitals, will be directly affected by the $600 billion in cuts to government spending and end of tax breaks if Washington doesn't otherwise lower the deficit. Other employers worry the reduced spending will hurt them indirectly by slowing economic growth (Linebaugh and Hughes, 11/13).

The Wall Street Journal: Business Leaders Spooked By 'Fiscal Cliff'
Democrats and Republicans said they want to enact a package of long-term measures to reduce the federal budget deficit, which has exceeded $1 trillion for four straight years, but they are divided over issues related to taxes and big entitlement programs like Medicare. Mr. Obama and House Speaker John Boehner (R., Ohio) have suggested they are open to compromise and don't want to replay the brinkmanship that occurred last year during a fight over raising the government's borrowing limit. But negotiations are almost certain to spill into mid-December, and perhaps even beyond (Paletta and Reddy, 11/13).

The Wall Street Journal’s Washington Wire: Companies Eye Cliff Layoffs, Aetna Chief Says
Aetna Inc. Chief Executive Mark Bertolini, who is among a dozen chief executives meeting with U.S. President Barack Obama later this week, on Monday warned that companies are preparing backup plans that include layoffs if the White House and congressional leaders are unable to reach a deal to avoid the combination of tax increases and spending cuts known as the "fiscal cliff" (Hughes, 11/13).

The Washington Post: Some Question Administration's Ability To Set Up State Insurance Exchanges
With a growing number of state leaders saying they will leave it to the federal government to handle a crucial element of President Obama's health-care law, even supporters of the statute are wondering if the administration is up to the job (Aizenman and Kliff, 11/13).

Los Angeles Times: California Works To Get Word Out On Health Insurance Exchange
Under the federal law, the state-run exchange aims to fundamentally reshape the health insurance market by negotiating with insurers for the best rates and assisting consumers in choosing a plan. The exchange must also help millions of Californians figure out whether they qualify for an expansion of Medicaid, the government insurance for the poor, or federally subsidized private coverage (Gorman and Terhune, 11/14).

Politico: Medicaid Expansion Decision Looms For Many States
Clues about governors’ intentions for Medicaid expansion are beginning to seep out of tight-lipped state capitals, and it may be the start of a deluge. Most have kept silent until now, waiting for the presidential election to determine whether the Affordable Care Act — and its optional Medicaid expansion — would survive. But President Barack Obama's reelection, combined with looming budget deadlines in all of the indecisive states, could force their hands (Cheney and Smith, 11/14).

The Associated Press/Washington Post: Cardinal Dolan: US Bishops Won't Comply With Obama Rule On Birth Control Coverage In Insurance
A top American bishop said Tuesday the Roman Catholic church will not comply with the Obama administration requirement that most employers provide health insurance covering birth control. New York Cardinal Timothy Dolan, president of the U.S. Conference of Catholic Bishops, said church leaders are open to working toward a resolution with federal officials, but will meanwhile press ahead with challenges to the mandate in legislatures and in court (11/13).

Los Angeles Times: Medicare Paid $1.5 Billion In Improper Therapy Claims In 2009
Medicare paid $1.5 billion in improper claims for skilled nursing care in 2009, federal investigators found. The inspector general of the Department of Health and Human Services said Tuesday that 25% of all Medicare claims submitted by skilled nursing facilities had errors and the majority of those bills were "upcoded" for ultra-high therapy that wasn't necessary (Terhune, 11/13).

The New York Times: Hospitals Ordered To Do More To Protect Kidney Donors
Addressing long-held concerns about whether organ donors have adequate protections, the country's transplant regulators acted late Monday to require that hospitals thoroughly inform living kidney donors of the risks they face, fully evaluate their medical and psychological suitability, and then track their health for two years after donation (Sack, 11/13).

The New York Times: Friends In Congress Have Helped Drug Compounders Avoid Tighter Rules
Despite two decades of dire health warnings and threats of federal intervention, the specialty drugmakers at the center of the nation's deadly meningitis outbreak have repeatedly staved off tougher federal oversight with the help of powerful allies in Congress (Lichtblau and Tavernise, 11/13).

USA Today: FDA Finds Contamination Issues At Ameridose
Federal drug inspectors found a range of problems, including ineffective drugs given to children and pregnant women, leaky ceilings, insects, non-sterile conditions and at least one bird flying around, at a sister company to the Massachusetts compounding pharmacy linked to a national outbreak of fungal meningitis (Weise, 11/13).

The Wall Street Journal: Fiscal Health Of States Shows Growing Divergence
Factors such as growing unfunded pension liabilities and burgeoning fixed costs related to programs like Medicaid are weighing down weaker states, while stronger states are benefiting from improved business conditions and strong employment growth, he said. A closer look at some specific metrics shows this fiscal disparity (Nolan, 11/13).

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This is part of Kaiser Health News' Daily Report - a summary of health policy coverage from more than 300 news organizations. The full summary of the day's news can be found here and you can sign up for e-mail subscriptions to the Daily Report here. In addition, our staff of reporters and correspondents file original stories each day, which you can find on our home page.