First Edition: February 6, 2013

Today's headlines include reports about the political and policy-oriented repercussions of yesterday's Congressional Budget Office fiscal forecast.   

Kaiser Health News: Kansas' Great Hope: Managed Care Will Tame Medicaid Costs
In partnership with Kaiser Health News, Bryan Thompson of KPR and Jim McLean of KHI News report: "And the costs have been escalating for the $2.9 billion Medicaid program. So Kansas is in the midst of huge changes. On Jan. 1, the state began enrolling nearly all of its Medicaid population -- including its most expensive patients – into a managed care program called KanCare. This effort is unrelated to the federal health law's Medicaid coverage expansion, on which Republican Gov. Sam Brownback has yet to take a position. Meanwhile, as the transition proceeds, many policy analysts are watching to see if the state has done enough to meet the goal of controlling costs while ensuring that these vulnerable patients receive quality health care" (Thompson and McLean, 2/6). Read the story

Kaiser Health News: Capsules: Aggressive Care Still The Norm For Dying Seniors; Long-Term Care Protection May Be Toothless
Now on Kaiser Health News' blog, Alvin Tran writes about a new study finding that many seniors get aggressive care at the end of their lives: "Although federal data show that fewer Medicare beneficiaries are dying in hospitals, new research suggests that doesn't mean they're getting less aggressive care in their final days" (Tran, 2/5).

Also on the blog, KHN's consumer columnist Michelle Andrews writes about long-term care protection: "There aren't many investments people make to protect themselves against something that may happen 20 or 30 years down the road. Yet that's exactly what long-term care insurance purchasers do.  But a provision in those policies that people rely on to help ensure their coverage will meet their needs decades hence may do nothing of the kind" (Andrews, 2/5). Check out what else is on the blog.

Los Angeles Times: Bright Fiscal Forecast For The Short Term
Revenue is increasing as the economy improves and as higher taxes on wealthier households take effect. The deficit is also shrinking because spending on unemployment insurance and other government assistance programs goes down as the economy improves. But the continued growth in healthcare costs and the increase in the nation's population of senior citizens eligible for Medicare will keep the budget on an unsustainable path. Even though health spending has slowed in recent years for reasons analysts do not fully understand, the sheer volume of new Medicare and Medicaid recipients means costs will rise (Mascaro and Parsons, 2/5).

The Washington Post: As Obama Calls For Short-Term Fix To Avert Sequester, CBO Reports Falling Deficits
Obama said that he is committed to a broad effort to restrain the national debt and that past White House proposals to rein in Medicare costs and increases in Social Security benefits "are still very much on the table" as part of that effort. But with the sequester due to hammer the fragile economic recovery in less than a month, the president said Congress should take quick action on a short-term measure to replace it, giving policymakers more time "to finish the job of deficit reduction" (Montgomery and Goldfarb, 2/5).

The Wall Street Journal: Debt Rise Colors Budget Talks
The projections will become a measuring stick for a rapid-fire series of budget decisions on Capitol Hill. Three key dates loom for policy makers: the across-the-board spending cuts are set to bite both military and domestic spending on March 1; that is followed by a March 27 deadline for funding government operations for the rest of the fiscal year as well as a new law that withholds lawmakers' pay unless they vote by April 15 on budget outlines. Even if Congress allows across-the-board spending cuts to kick in, sunsetting tax provisions to actually expire and Medicare doctor fees to be cut, the deficit is projected to begin increasing gradually from 2016 onward as more of the baby boom generation qualifies for Social Security and Medicare (Paletta, 2/5).

The Wall Street Journal's Washington Wire: Why CBO Figures More Employers Will Drop Health Coverage
The Congressional Budget Office says the year-end fiscal cliff deal that preserved lower tax rates for most households produced a little-noticed side-effect: Fewer people will get health insurance from their employer over the next decade. That nugget of economic thinking pops up in the nonpartisan office’s annual update of its budget and economic forecast (Radnofsky, 2/5).

The Associated Press/Washington Post: Analysis: Obama And GOP Want To Replace Across-The-Board Cuts, But With What?
As a result, they seem likely to spend the spring and perhaps a good part of the summer struggling to escape a bind of their own making. And this time, Medicare and the rest of the government's benefit programs are likely to face changes. Already, the two sides are laying down markers (2/6).

The Associated Press/Washington Post: Congressional Budget Office: Budget Deficit Estimated At $845 Billion For 2013
But as more and more baby boomers retire and claim Medicare and Social Security and as Obama's health care law takes effect, deficits would move higher and again reach near $1 trillion in the latter portion of the 10-year window — despite the recently enacted tax increase on family income exceeding $450,000 and automatic spending cuts of about $100 billion a year. The package of spending cuts and tax increases are punishment for Washington’s failure to strike a long-term budget pact (2/5).

USA Today: Obama Seeks Short-Term Budget Plan To Avoid Sequester
The president said he is still looking for a major debt reduction deal for the long term of more than $1 trillion over the next 10 years, saying that earlier ideas are "still on the table." Obama said he still supports proposed changes to the tax code and to the ever-rising entitlement programs like Social Security and Medicare, but he did not provide many specifics. White House spokesman Jay Carney said Obama would work with Congress on the composition of a short-term budget plan that would require tens of billions of dollars in debt reduction to avoid the scheduled budget cuts. Carney noted that Obama and congressional Republicans have struck previous deals that add up to some $2.5 trillion in debt reduction over the next decade (Jackson, 2/6).

The New York Times: Health Insurers Get In Shape For 2014
Since Patrick J. Geraghty arrived here a year and a half ago to lead the state’s largest health insurer, Florida Blue, he has expanded its operations in Medicare and Medicaid, entered arrangements with hospitals and doctors, bought a medical group, and dabbled with a new private sector marketplace that allows employees to choose plans from different insurance companies (Abelson, 2/5).

Politico: Some GOP Governors Accepting Parts Of ACA
A handful of Republican governors are bucking their party and going ahead with key pieces of President Barack Obama’s health care law — and so far, they’re not being cast out by the GOP as Obamacare traitors. Nationally, the heated politics surrounding the health law have hardly died down almost three years since its passage. But some Republican governors — including prominent ones like Ohio's John Kasich — are expanding Medicaid or building an insurance exchange without facing similar opposition at home (Haberkorn and Millman, 2/5).

The Wall Street Journal: FDA Warns Of New Batch Of Fake Cancer Drug
The Food and Drug Administration said Tuesday it has warned doctors that another counterfeit batch of the cancer drug Avastin has reached medical practices in the U.S. The warning follows a string of alerts last year, when the agency told doctors that versions of Avastin sold by at least two drug-distribution networks were fakes, containing cornstarch, acetone and other chemicals and none of the genuine drug's active ingredient (Weaver, 2/5).

USA Today: Hospice Care Used More, But Often Too Late
Twice as many elderly people died in hospice care as in a hospital or nursing home compared with a decade ago, but hospice is often treated as a last resort — and used too late to benefit patients and their families, says a study released Tuesday. The researchers examined Medicare records for 840,000 people 66 or older who died in 2000, 2005 and 2009 (Lloyd, 2/5).

Politico: Study: Boost In Hospice Visits By Way Of The ICU
At first blush it looks like great news: More Americans are choosing to die with hospice instead of spending their final days tethered to machines in a high-tech modern hospital. But a deeper look at the data finds a countervailing trend. Yes, more people are getting hospice care — but they are getting it for only a few days and often, only after highly aggressive care near the end of life, including multiple hospitalizations and stays in intensive care units (Kenen, 2/6).

Los Angeles Times: California Passes Up Millions For Prison Healthcare, Report Says
California's court-run prison healthcare program is missing out on tens of millions of dollars a year in federal funds because of disagreement with counties and software problems, a new legislative report states. The legislative analyst's office found increasing numbers of prison inmates who, because of their low income status, are eligible for the state's Medicaid program (St. John, 2/5).

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