First Edition: February 20, 2013

Today's headlines include reports about the impending March 1 automatic spending cuts, how they will impact health programs and the latest political posturing surrounding them.  

Kaiser Health News: Pressure Rising To Avoid Federal Spending Cuts That Will Impact Health Programs
Kaiser Health News staff writer Mary Agnes Carey reports: "Pressure is mounting for Washington to find a way to avoid the automatic spending reductions set to begin March 1, with President Barack Obama Tuesday urging Congress to stop the 'meat-cleaver approach' that he says will undermine U.S. military strength and 'eviscerate job creating investments in education and energy and medical research'" (Carey, 2/20). Read the story.

Kaiser Health News: Nurse Practitioners Push To Help Care For Health Law's Newly Insured
Kaiser Health News staff writer Alvin Tran sat down recently with David Hebert, a veteran health care lobbyist and former CEO of the American College of Nurse Practitioners, who now is the first CEO of the American Association of Nurse Practitioners (AANP). Hebert discussed the changing role nurse practitioners may soon have, as well as some physicians' efforts to stop them (Tran, 2/20). Read the interview.

Kaiser Health News: Capsules: Hospitals Hook Up With Drugstore Giants To Lower Readmissions; Big Firms Win Multimillion Dollar Contracts To Build Insurance Marketplaces; Today Few Public Family Planning Centers Accept Insurance
Now on Kaiser Health News' blog, Colorado Public Radio's Eric Whitney, working in partnership with KHN and NPR, reports on how Walgreens is working with hospitals to reduce admissions: "Dr. Jeffery Kang is a vice president at Walgreens, and describes the new role as 'our grandfather's Walgreens on steroids.'  Walgreens is now contracting with hospitals to eliminate conflicting prescriptions on discharge, and then the pharmacy will follow up with patients to make sure they understand all their medications and take them properly when they get home" (Whitney, 2/20).

In addition, Phil Galewitz reports on companies' that are winning contracts to build health exchanges: "President Barack Obama's health law has been criticized as a 'government takeover' of health care. But private companies are building the underpinnings of the online health insurance marketplaces that are a key element of the law – and winning contracts worth hundreds of millions to do so” (Galewitz, 2/19).

Also on the blog, Kaiser Health News consumer columnist Michelle Andrews writes about insurance and family planning centers: "Many of the state and local health departments, community health centers, Planned Parenthood clinics and other family planning centers that serve these women don't accept insurance, not even publicly funded insurance such as Medicaid. Not yet, anyway" (Andrews, 2/19). Check out what else is on the blog.

The New York Times: With Cutbacks Days Away, Obama Tries To Pressure GOP
Mr. Obama once again finds himself in a budget showdown with the opposing party, and numerous polls show his position to be more popular than Republican calls for spending cuts only, including cuts in Medicare. Mr. Obama and senior aides hardly disguised their sense of political advantage. Still, the president’s leverage might in fact be limited, since by all appearances he seems to want a deal far more than Republicans do. As the leader of the nation, Mr. Obama is eager to see an end to the repeated evidence of Washington dysfunction, or what he referred to again on Tuesday as the cycle of "manufactured crisis." And with his legacy ultimately at stake, he needs to lift the fiscal uncertainty that since 2011 has held down economic growth (Calmes, 2/19).

The Wall Street Journal: Rhetoric Turns Harsh As Budget Cuts Loom
The verbal jabs came after deficit hawks Alan Simpson and Erskine Bowles on Tuesday proposed a detailed plan for rewriting the tax code and implementing deep spending cuts, hoping it would be a road map to compromise. The two men served as co-chairmen of the White House's 2010 deficit-reduction panel, which put together a package of tax and spending changes that fell flat after the White House and congressional leaders took a look (Hook and Nelson, 2/20).

NPR: How The Sequester Could Affect Health Care
According to a letter to the Senate Appropriations Committee from Department of Health and Human Services Secretary Kathleen Sebelius, the required cuts "would result in about 3,000 fewer inpatient admissions and 804,000 fewer outpatient visits provided in [Indian Health Service] and tribal hospitals and clinics." Sebelius said the reduced funding would also result in 424,000 fewer HIV tests conducted by grantees of the Centers for Disease Control and Prevention and "2,100 fewer domestic and foreign facility inspections of firms that manufacture food products to verify that domestic and imported foods meet safety standards" by the Food and Drug Administration (Rovner, 2/19).

The Wall Street Journal: Simpson And Bowles Offer Up Deficit Fix
The new $2.4 trillion Simpson-Bowles proposal would identify $600 billion in spending reductions through changes to health-care programs such as Medicare and Medicaid. That is roughly $200 billion more than the White House has said it is willing to accept. The health-care component is perhaps the most detailed of any part of the package, calling for "improving provider and beneficiary incentives throughout the health care system, reducing provider payments, reforming cost-sharing, increasing premiums for higher earners, adjusting benefits to account for population aging, reducing drug costs, and getting better value for our health care dollars" (Paletta, 2/19).

Los Angeles Times: Bowles, Simpson Unveil Plan To Cut Deal $2.4 Trillion Over 10 Years
Erskine Bowles and Alan Simpson, who have been pushing for a major deficit reduction plan since co-chairing a bipartisan commission on fiscal reform, released a new proposal Tuesday to cut the nation's debt by $2.4 trillion over the next decade. Called "A Bipartisan Path Forward to Securing America's Future," the plan attempts to avoid the large automatic spending cuts set to hit March 1 while also dealing with long-term debt drivers such as Medicare (Puzzanghera, 2/19).

Politico: ACA Mental Health Plan’s Growing Pains
Aided by the health care law, some states have already put in place a model that creates a dramatically different way of caring for Medicaid mental health patients. But if the slow state uptake of the program is any indication, the patterns of spotty care for most low-income people with big mental health problems won’t change quickly (Smith, 2/20).

The New York Times: Supreme Court Gives FTC A Win On Hospital Mergers
The Supreme Court on Tuesday strengthened the power of the Federal Trade Commission to block hospital mergers, issuing an opinion that could limit the ability of public hospital authorities to claim immunity from federal antitrust laws (Pollack, 2/19).

The Wall Street Journal: FTC Gets More Muscle In Policing Hospital Mergers
The U.S. Supreme Court on Tuesday gave more muscle to federal antitrust enforcers' ability to police hospital mergers, the latest win for the government in its campaign to monitor the fast-consolidating industry. The court, in a unanimous decision, revived the Federal Trade Commission's challenge to a Georgia hospital deal, ruling the merger wasn't immune to federal antitrust scrutiny. The decision placed limits on the circumstances in which local governments are exempt from federal antitrust laws (Kendall, 2/19).

The Associated Press/Washington Post: Health Insurer Stocks Slip Over Possible Medicare Advantage Payment Cuts
Health insurance stocks wobbled Tuesday after data released by the federal government pointed to possible steep Medicare Advantage payment cuts in 2014, which could lead to reduced coverage or fewer options for people buying the plans. The Centers for Medicare and Medicaid Services said Friday after markets closed that it expects costs per person for Medicare Advantage plans to fall more than 2 percent in 2014, a bigger drop than many analysts who cover the industry anticipated (2/19).

The Wall Street Journal: Health Insurers Tumble Amid Medicare Proposal
Shares in Humana Inc. and other major health insurers fell Tuesday after analysts said a government proposal for Medicare Advantage rates in 2014 is unfavorable for the companies. The late-Friday proposal is open to outside comments until March 1, ahead of a final announcement due April 1, so there is time for the industry to lobby for less pressure on rates. Insurers see Medicare Advantage—their version of the government health plan for seniors—as a key growth area, but expanding any presence there means taking on exposure to government payment decisions (Kamp, 2/19).

The New York Times: A Digital Shift On Health Data Swells Profits In An Industry
The approach came in 2009, in a presentation to doctors by Allscripts Healthcare Solutions of Chicago, a well-connected player in the lucrative business of digital medical records. That February, after years of behind-the-scenes lobbying by Allscripts and others, legislation to promote the use of electronic records was signed into law as part of President Obama’s economic stimulus bill. The rewards, Allscripts suggested, were at hand. But today, as doctors and hospitals struggle to make new records systems work, the clear winners are big companies like Allscripts that lobbied for that legislation and pushed aside smaller competitors (Creswell, 2/19).

Los Angeles Times: Health Insurance Rate-Setting Map Would Increase Costs, Official Says
A proposal to split California into six zones for setting health insurance rates would drive premiums up as much as 23% for some policyholders next year as part of the federal healthcare overhaul, the state insurance commissioner is warning (Terhune, 2/20).

The Washington Post: $12.7 Million Contract Approved To Overhaul D.C.-Owned Hospital
The D.C. Council voted Tuesday to approve a $12.7 million, two-year contract to overhaul management of United Medical Center, the city-owned hospital that has bedeviled officials for a decade. The 8 to 3 vote followed a lengthy debate that touched on various aspects of the hospital deal, including concerns about the contracting process, the necessity of the costly turnaround and what form the hospital might take afterward (Craig and DeBonis, 2/19).

The Washington Post: O'Malley Agrees To Tougher Gun Prohibition Aimed At The Dangerously Mentally Ill
Maryland Gov. Martin O'Malley's (D) administration will bow to mounting opposition from members of his own party and back significantly tougher rules to get guns out of the hands of the dangerously mentally ill, administration officials said Tuesday (Davis, 2/19).

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