First Editon: April 6, 2011

Today's headlines include stories and analysis of how the Ryan budget plan would change Medicare, Medicaid and the shape of the federal government.

Kaiser Health News: CBO: Seniors Would Pay Much More For Medicare Under Ryan Plan
Kaiser Health News staff writers Julie Appleby, Mary Agnes Carey and Laurie McGinley report: "Seniors and the disabled would pay sharply more for their Medicare coverage under a new plan by House Republicans aimed at curbing the nation's growing deficit, a Congressional Budget Office analysis shows" (Appleby, Carey and McGinley, 4/5). KHN also provides video excerpts of House Budget Committee Chairman Paul Ryan, R-Wis., and Rep. Chris Van Hollen, D-Md., sparring over the Medicare provisions.

Kaiser Health News: CBO Outlines 'Key Features' Of Ryan Budget Proposal: 'Substantial' Changes To Medicare, Medicaid
Kaiser Health News provides excerpts of the  Congressional Budget Office report, focusing on the Ryan proposal's key features, including how it would change Medicare, Medicaid and the health law. KHN also links to the full report.

Kaiser Health News: Health On The Hill - House Republicans' Budget Plan: What It Means, What's Next
KHN's Mary Agnes Carey talks with CQ HealthBeat's Rebecca Adams about the fiscal 2012 budget plan from House Budget Committee Chairman Paul Ryan. It would dramatically change Medicaid and Medicare (4/5). Read the transcript or watch the video.

Kaiser Health News Column: Fix The Class Act. Don't Repeal It.
In his latest Kaiser Health News column, Howard Gleckman writes: "If it survives, the Community Living Assistance Services and Supports (CLASS) Act would, for the first time, create a national, voluntary long-term care insurance program to help pay for personal care for the frail elderly and younger adults with disabilities. It is a modest first step toward turning long-term care from an unsustainable and inappropriate welfare program into an insurance-based system" (4/6).

The Wall Street Journal: Medicare Cost Would Rise For Many Under Ryan Plan
The House Republican plan for overhauling Medicare would fundamentally change how the federal government pays for health care, starting a decade from now, likely resulting in higher out-of-pocket costs and greater limits to coverage for many Americans (Adamy, 4/5).

The Associated Press: GOP Budget Seen Raising Health Costs For Retirees
Most future retirees would pay more for health care under a new House Republican budget proposal, according to an analysis by nonpartisan experts for Congress that could be an obstacle to GOP ambitions to tame federal deficits (Alonso-Zaldivar, 4/6).

Politico: Alice Rivlin: I don't Back 'Ryan-Rivlin' Plan
Rep. Paul Ryan (R-Wis.) touted the help of former Clinton advisor Alice Rivlin — "a great, proud Democrat" — in promoting a key Medicare provision in his budget proposal Tuesday. The only problem? Rivlin said she told the Republican she doesn't support the final version of the measure he wrote into his budget — a provision Ryan referred to generally as the "Ryan-Rivlin" plan when rolling out his sweeping economic blueprint (Shiner, 4/5).

The Washington Post/Kaiser Health News: Rep. Ryan's Proposed Changes Would Be Biggest Yet For Medicare
When House Budget Chairman Paul Ryan announced his plan to redefine Medicare, as part of a broader Republican budget proposal, he did not sketch in all the details. But the outlines make clear that his ideas would represent the biggest change to the federal health insurance program for the elderly since its creation nearly five decades ago (Appleby, Carey, Galewitz, Serafini and Weaver, 4/5).

The Washington Post: Republicans Embrace Rep. Ryan's Government Budget Plan For 2012
House Republicans announced a far-reaching vision for a leaner federal government on Tuesday, presenting a 2012 budget blueprint that would privatize Medicare for future retirees, cut spending on Medicaid and other domestic programs, and offer sharply lower tax rates to corporations and the wealthy (Montgomery and Rucker, 4/5).

The Wall Street Journal: Proposal Transforms Role Of Government
House Republicans laid out a blueprint for a dramatically smaller federal government Tuesday, diminishing Washington's role in health care and other areas in a budget they said would spend $6.2 trillion less over 10 years than what President Barack Obama has proposed (Weisman, 4/6).

Los Angeles Times: GOP Bets Voters Will Choose Fiscal Well-Being Over Healthcare Safety Net
The largest savings in their plan would come from slashing popular programs that cover about 100 million Americans. The GOP proposal would phase out direct payments to doctors and hospitals under Medicare, scale back the Medicaid program for the poor and disabled, and throw out government insurance subsidies that the new healthcare law is to make available to millions of Americans starting in 2014. That would force seniors to pay more for their healthcare and would likely make states cut back their Medicaid programs, the Congressional Budget Office concluded (Levey and Hennessey, 4/5).

NPR: GOP's 2012 Budget Plan: Courageous Target For Democrats
Ryan would radically change Medicare and Medicaid although he mostly leaves Social Security alone. … For those younger than 55 years old, Ryan would reshape Medicare to turn it into a "premium-support" program. In other words, instead of the current single-payer approach of Medicare, under Ryan's approach seniors would get payments of up to $15,000 a year to buy health insurance from private insurers. Critics doubt this would do anything to control healthcare inflation which, along with the aging of the Baby Boom, help explain why Medicare's costs are expected to drive deficits if nothing is done (James, 4/5).

The Wall Street Journal: Budget Talks Head To The Brink
Republicans and Democrats stumbled one day closer to a government shutdown on Friday, as the two parties escalated what has become a broader battle over Washington's role in the U.S. economy. The two fights—one over funding the government for the next six months, the other over a sweeping plan to reshape the government for decades to come—showed how far apart the two parties are on basic fiscal issues ahead of the 2012 elections (Bendavid, Weisman and Lee, 4/6).

The Washington Post: Senate Votes To Repeal Health-Care Law's 1099 Tax-Reporting Provision, Sending Bill To Obama
The Senate on Tuesday voted overwhelmingly to repeal the health-care law's 1099 tax-reporting provision, ending nearly a year's worth of efforts to do away with one of its most unpopular requirements. The repeal measure, which passed the House last month, now goes to President Obama for his signature (Sonmez, 4/5).

Politico: Senate Finally Votes To Repeal 1099 Measure In Health Care Reform Law
The Senate on Tuesday voted to repeal the health care overhaul's 1099 tax reporting requirements, finally ending months of debate and votes over a provision that, by the end, had few defenders (Haberkorn, 4/5).

Los Angeles Times: Tax Rule That Would've Hurt Small Business Is Repealed
Congress has repealed a tax provision that small businesses said would have buried them in paperwork and forced them to pay for hours of extra accounting services. The provision, passed last year as a way to raise money to pay for healthcare reform, would have forced all businesses to file special tax forms to report anyone with whom they did more than $600 worth of business in a given year (Bernstein, 4/6).

The New York Times: Inquiry Into Payments By Device Maker
Nevada state officials have begun an investigation to determine if payments to cardiologists there by a little-known heart device company were legitimate consulting fees or inducements to the doctors for using its products (Meier, 4/5).

The Associated Press/Chicago Tribune: Ill. Judge Throws Out Rule On Contraception
A judge has ruled that Illinois pharmacists can't be forced to dispense emergency contraception. Sangamon County Circuit Judge John Belz said Tuesday that requiring pharmacists to sell the so-called "morning-after" pill violates state right-of-conscience law (4/5).