First Edition: January 24, 2013

Today's headlines include reports about what will come next in terms of addressing the deficit and possibly trimming entitlment programs, now that Congress appears to have temporarily dealt with the debt ceiling. 

Kaiser Health News: Fighting Painful Misconceptions About Sickle Cell Disease In The ER
Reporting for Kaiser Health News, Beryl Lieff Benderly writes: When sickle cell patients arrive at emergency rooms, they often have great difficulty getting the treatment they need. Paula Tanabe, an associate professor at the Duke University School of Nursing, is making it her mission to change that” (Lieff Benderly, 1/24). Read the story.

The New York Times: House Votes Sidesteps An Ultimatum On Debt
Senator Harry Reid of Nevada, the majority leader, … said he would take up and pass the House bill without changes as soon as next week. … He said he would then move quickly on a budget plan for the first time since 2009. "Democrats are eager to contrast our pro-growth, pro-middle-class budget priorities with the House Republicans' Ryan budget that would end Medicare as we know it,…" said Senator Patty Murray of Washington, the chairwoman of the Senate Budget Committee. House Republicans appeared eager for that fight. For two years, the House has passed detailed but nonbinding budget plans that would cut domestic programs…, enact changes to Medicare that would offer older people fixed subsidies to buy private health insurance, and mandate a much-simplified tax code. … Now, Republicans said, the debate will be over numbers (Weisman, 1/23).

Los Angeles Times: House GOP Seeks Steep Cuts While Raising Debt Ceiling
Stepping up their austerity campaign, House Republicans plan to demand far deeper spending cuts from President Obama to balance the federal budget in just 10 years, an extraordinary goal that would hit Medicare and other safety-net programs. House Speaker John A. Boehner (R-Ohio), confronted with a more conservative Republican majority, agreed to the dramatic initiative to coax reluctant rank-and-file lawmakers Wednesday to approve a temporary suspension of the $16.4-trillion debt limit without any cuts in spending (Mascaro, 1/23).

The Associated Press/Washington Post: A Revised Deficit Collision Course: Senate Dems Eye New Taxes, GOP Seeks Deeper Spending Cuts
The nation's sharp disagreements over taxes and spending are on a re-routed collision course, as Senate Democrats launch a plan that includes new taxes and House Republicans vow to speed up their plan to balance the federal budget with spending cuts alone. The Republicans' new approach would require even deeper cuts in social programs than they pushed last year. Liberals denounced those earlier plans as severe and unfair, and they say the new version would be worse (1/24).

The Wall Street Journal: Passing Debt Bill, GOP Pledges End To Deficits
The House defused one potential debt crisis Wednesday, while a top Republican set the stage for a far broader debate over whether it is possible to actually balance the U.S. budget in coming years (Hook, Boles and O'Connor, 1/23).

The Wall Street Journal's Washington Wire: Ryan Expects 'Big Down Payment' On Debt
The Wisconsin Republican, long a favorite of conservative activists, said the budget would rely on the new tax revenue Congress agreed to earlier this month. But he provided few other details for how he would plan to erase deficits that exceed $1 trillion beyond broad promises to cut additional money from popular entitlements and other safety nets for the poor and elderly, highlighting Medicaid, the health-care program for low-income Americans (O'Connor and Boles, 1/23).

Politico: Next Up: Sequester, Budget Resolution
The dueling House and Senate budget resolutions could force the two parties into a serious policy debate over cuts to Medicare, Social Security and Medicaid — as well as whether to raise new taxes through a reform of the Tax Code — something that was largely avoided in the previous Congress. How this is resolved will define Obama's second term in office and whether Capitol Hill can finally get a handle on its finances — or fall into yet another crisis (Raju and Bresnahan, 1/23).

The Associated Press/Washington Post: Massachusetts' Law Set Stage For National Health Overhaul, Becomes A Template For Other States
When Massachusetts adopted its landmark health care law in 2006, the goals were ambitious and the potential solutions complex. More than 90 percent of its residents already had health insurance, but the state hoped to cover nearly everyone by plugging as many holes as possible in its system, short of a so-called single payer option (1/24).

Politico: States Hustle To Modernize Medicaid
Whether states accept or reject the Medicaid expansion under the health law, they’ve got plenty of work to do to get ready for big changes in coverage next year. And as of Jan. 1, 47 states had grabbed or requested bonus federal dollars to upgrade their aging Medicaid enrollment systems, according to a state survey released Wednesday from the Kaiser Commission on Medicaid and the Uninsured and the Georgetown University Center for Children and Families (Millman and Smith, 1/23).

The Associated Press/Washington Post: States That Turn Down Medicaid Would Leave Citizens Uninsured While Immigrants Get Covered
Governors who reject health insurance for the poor under the federal health care overhaul could wind up in a politically awkward position on immigration: A quirk in the law means some U.S. citizens would be forced to go without coverage, while legal immigrants residing in the same state could still get it (1/23).

Politico: Nelson: From 60th Vote To ACA's Implementation
As CEO, earning nearly $1 million a year, Nelson will be a leading intermediary between the states and Washington. The states are trying to implement the wide-ranging law without sinking their health insurance markets — or giving up too much of their traditional regulatory turf. And the U.S. Department of Health and Human Services is working like mad to get the law ready in time for 2014 — including in states that aren't exactly bending over backward to help (Millman, 1/23).

Los Angeles Times: WellPoint's 4th Quarter Profit Jumps
But the company said it remains cautious about the year ahead in light of federal budget battles over Medicare and Medicaid and upheaval in the health insurance markets from the federal Affordable Care Act. WellPoint estimated full-year earnings of $7.60 a share, below analysts' expectations of $7.94 a share compiled by FactSet. The Indianapolis company said the search is still underway for a new CEO to replace Angela Braly, who stepped down in August after major shareholders expressed dissatisfaction with the company's performance (Terhune, 1/23).

The Associated Press/Washington Post: WellPoint 4th Quarter Profit Jumps 38 Percent; Insurer Says Costs Could Weigh On 2013 Performance
WellPoint Inc.'s fourth-quarter earnings jumped 38 percent compared to the final quarter of 2011, when the nation’s second largest health insurer incurred a big hit from its Medicare Advantage business (1/23).

The Wall Street Journal: WellPoint Earnings Rise 38% Amid Light Commercial Costs
Health insurers are preparing for the planned opening of state-based exchanges for individuals and small businesses. People will be able to seek plans there for coverage starting in 2014, potentially putting millions of new members in play for health insurers. Meantime, the industry is also aiming to add business as states expand Medicaid coverage under the health law and create new plans to cover high-cost people on Medicaid and Medicare, known as dual eligibles. WellPoint recently closed on a $4.46 billion purchase of Medicaid insurer Amerigroup to help chase the emerging dual-eligible market while lessening its tilt toward individual and small-group markets, which are considered most exposed to the exchanges (Kamp, 1/23).

Politico: Ex-Medicare Chief Moves Toward Run For Governor
Former Medicare chief Don Berwick stepped closer to a run for Massachusetts governor this week, organizing a fundraising committee that will test the traction of a potential candidacy. "This does not represent a change. In other states, this would be called an exploratory committee," Berwick, a Democrat, told POLITICO on Wednesday. "I've not set a deadline for a final decision" (Cheney, 1/24).

The Associated Press/Washington Post: After Shootings, Some States Rethink Deep Cuts To Mental Health Care, Consider More Spending
Dozens of states have slashed spending on mental health care over the last four years, driven by the recession's toll on revenue and, in some cases, a new zeal to shrink government. But that trend may be heading for a U-turn in 2013 after last year’s shooting rampages by two mentally disturbed gunmen (1/23).

The Associated Press/New York Times: Louisiana: Hospice Cuts Rescinded
Gov. Bobby Jindal's administration on Wednesday scrapped plans to shutter the state's Medicaid hospice program in February, meaning it will continue to provide end-of-life care to people who cannot afford private insurance (1/23).

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