Viewpoints: Brewer's Stance On Medicaid Expansion May Signal Important Shift In GOP; A Shrinking Government--Except For Health Care

National Journal: Why The GOP's Resistance To Medicaid Expansion Is Eroding
Jan Brewer, Arizona's feisty Republican governor, is better known for wagging her finger at President Obama than for linking arms with him. That's why Brewer's recent announcement that her state intends to join the expansion of Medicaid central to Obama's health care law may represent an important shift. If even Brewer, who has battled repeatedly with Obama, finds the case for expansion compelling, other Republican governors now resisting may also reconsider (Ronald Brownstein, 2/7).

Health Policy Solutions (a Colo. news service): Medicaid Expansion Will Save Lives And Money
As Colorado lawmakers prepare to consider expansion of Medicaid – the publicly-funded health insurance program for low-income individuals – it is important they use an evidence-based approach that considers costs and savings in terms of the health impact on the lives of Coloradans, as well as our state budget. A July 2012 study, published in the New England Medical Journal, reported a demonstrated reduction in mortality associated with Medicaid expansion in a handful of other states. The study found that for every 100,000 citizens in the population between the ages of 20 and 64, Medicaid expansion saves 19.6 lives every year. Applying this result to our population, we can expect Medicaid expansion to save the lives of at least 629 Coloradans every year (Dr. Ned Calonge, 2/7).

The Wall Street Journal: Hidden Secrets Of Spending
While the debate rages over the size of government, a funny thing has been happening: Quietly, government has been shrinking. ... This reality has been masked by the fact that government spending isn't declining, although the rate of increase has moderated. But the part of government that is really increasing right now is the part that churns out checks for people receiving Medicare, Medicaid and Social Security. Meantime the ranks of government workers at the federal, state and local levels—the bureaucrats everybody loves to hate, as well as more beloved figures such as firefighters—are declining (Gerald F. Seib, 2/7).

Bloomberg: Why Health Care Challenges Conservatives
While I don't find Ramesh Ponnuru's overall case for a conservative middle-class agenda convincing, he does highlight one middle-class problem that both parties have given short shrift. He has correctly argued that health-care inflation is not just a source of fiscal woes, but also has deprived middle-class families of real wage increases as more of their compensation has gotten eaten up by health benefits. The big challenge for conservatives is to take Ponnuru's point and come up with an agenda that does better than liberals at controlling health-care costs, so families can spend more money on other things (Josh Barrow, 2/7).

The Fiscal Times: Christie's Big Chance To Help Cut Obesity Costs
Chris Christie, the N.J. governor, can dish all he wants about his weight – but he doesn't like it when others do, even physicians who once took care of U.S. presidents. ... you'd have to have lived in a cave for the past 30 years to not understand that there are serious health risks – and costs – that result from obesity. As an elected public official often mentioned as a potential Republican presidential candidate, the governor is being disingenuous if he can’t acknowledge that his weight is an issue worthy of political, economic and even fiscal discussion (Maureen Mackey, 2/7).

Bloomberg: What The Catholic Bishops Owe President Barack Obama
U.S. Catholic bishops have a lot to worry about: the gunning down of children; 11 million undocumented immigrants, many of them Catholic; a warming planet; a chilly economy. Instead they've spent the last year obsessed with contraception. The bishops are furious over the Affordable Care Act, which generally requires employers to cover contraception. It isn't a novel concept (Margaret Carlson, 2/5).

The New York Times: The Family And Medical Leave Act, 20 Years Later
Twenty years ago, just a few weeks after his inauguration, President Clinton fulfilled a campaign pledge and signed his first bill – the Family and Medical Leave Act. The law sent a strong signal of his commitment to provide more opportunities for American workers in return for more personal responsibility. ... Since its passage, the law has been used more than 100 million times to improve the lives of American workers. Meanwhile, dire predictions by critics that it would destroy jobs and harm business have proven wrong. Employers covered by the law report little or no difficulty complying with its provisions. Indeed, many businesses credit the law with reducing turnover and increasing worker morale (Laura D'Andrea Tyson, 2/8).

Journal of the American Medical Association: Mental Illness And New Gun Law Reforms
The December 2012 tragedy in Newtown, Connecticut, transfixed the nation in a moment of shared grief for 20 small children and 6 adults who died in a merciless hail of bullets. The weeks since have brought numerous federal and state policy proposals to curb gun violence. Whether these crisis-driven reforms can help inch society toward the goal of reducing firearm-related deaths, the new laws' broader social consequences could long outlast the memory of what happened at Sandy Hook Elementary School. Policy makers would do well to pause and think them through (Jeffrey Swanson, 2/7).

Journal of the American Medical Association: A Systematic Plan For Firearms Law Reform
The United States has nearly as many firearms as inhabitants; while mortality rates from most major causes of injury have significantly declined, the number of annual firearms fatalities (32,163 in 2011) has not decreased. Even the political discussion in the wake of Newtown resulted in a spike in firearm sales. ... The right to bear arms has never been more robust than at the turn of the century, with the expiration of a federal assault weapons ban, the Supreme Court reading the Second Amendment's "militia" to refer to civilians for the first time in history, and states relaxing concealed weapon laws. Although the president's plan is well within the confines of the Constitution, the limits imposed by the Court, combined with a fragmented mental health system, mean that no constitutionally permissible plan will be fully effective. Still, the president's plan could reduce the devastating toll of firearm injuries and deaths through a public health strategy (Katherine L. Record and Lawrence O. Goslin, 2/7).

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