First Edition: July 12, 2011

Jul 12 2011

In today's headlines, reports about the new HHS rule on health exchanges rule and how its nod to state flexibility may help states move forward.

Kaiser Health News: After Much Scrutiny, HHS Releases Health Insurance Exchange Rules
Kaiser Health News staff writers Julie Appleby and Christopher Weaver report: "State flexibility takes center stage in proposed federal rules governing marketplaces where individuals and small businesses can shop for health insurance starting in 2014. The long-anticipated rules released Monday are less prescriptive than some consumer advocates desired, but grant states' requests that they be given broad leeway to design and regulate the marketplaces, called exchanges" (Appleby and Weaver, 7/11).

Kaiser Health News: Insuring Your Health: Insurance  Usually Covers Diagnosis, Treatment Of Most Sleep Problems
In her latest Kaiser Health News consumer column, Michelle Andrews writes: "Insurance usually covers the diagnosis and treatment of sleep problems, with some exceptions. For example, snoring on its own is not a medical problem and insurance won't cover its treatment, to the great disappointment of many a snorer's bed partner" (Andrews, 7/12).

Kaiser Health News (Video): President Calls For 'Meaningful Changes' To Medicare, Medicaid
In his news conference yesterday, President Barack Obama discussed the debt ceiling, the deficit, negotiating with Republicans and paid some attention to entitlements including Social Security, Medicare and Medicaid. Here are video excerpts and a transcript.

Kaiser Health News: A Medicare Reform Model Everyone Can Love (Guest Opinion)
In his latest Kaiser Health News column, Michael Cannon writes: "Democrats and Republicans may not be able to agree on whether to increase taxes as part of a deal to raise the federal debt ceiling. But they can at least agree on this much: Congress must restrain Medicare spending. The trick is how to do it without sacrificing access to necessary care?" (7/11).

The New York Times: Obama Administration Rolls Out Standards For Health Insurance Marketplaces
In a big step to carry out the new health care law, the Obama administration unveiled standards on Monday for insurance marketplaces that will allow individuals, families and small businesses in every state to shop for insurance, compare prices and benefits and buy coverage (Pear, 7/11).

The Washington Post: 'Flexibility' May Help States Meet Key Part Of Health-Care Law
Faced with the possibility that many states may not be ready to meet a crucial requirement of the federal health-care law passed last year, the Obama administration has proposed rules redefining what "ready" means. To boot, officials did just that in a setting designed to win over that most politically sought-after of groups: small-business owners (Aizenman, 7/11).

Los Angeles Times: Health Officials Ease Requirements For States' Insurance Exchanges
The Obama administration moved Monday to ease some requirements on states to help them set up new insurance exchanges in 2014, a key feature of the healthcare law the president signed last year. The state-based exchanges are intended to make buying health insurance comparable to shopping the Internet for an airline ticket or a hotel room (Levey, 7/12).

The Wall Street Journal: States Get Leeway On Shape Of New Insurance Exchanges
Proposed rules released Monday give states wide latitude on how to create the new insurance marketplaces scheduled to open in 2014 under the federal health-care law. The marketplaces, known as exchanges, are expected to allow individuals and small businesses to purchase coverage much the way consumers can now shop for airfares or hotels online. States are supposed to set up exchanges that meet federal guidelines, or their residents will be offered a national version (Mathews, 7/12).

Politico: Health Reform Rule Unveiled
The administration released a proposed regulation Monday that sets the standards for new marketplaces — health insurance exchanges — that are supposed to launch in every state by 2014. They're supposed to be where individuals and small businesses can browse a wide selection of easily comparable health plans and pick the one that's best for them. If the exchanges don't work well, it's a good bet that the rest of President Barack Obama's health care law won't work, either (Kliff, 7/11).

The Washington Post: Partisan Divide On Debt Talks Growing Deeper; Obama Says He Won't Accept Stopgap Plan
During the meeting, Obama challenged Boehner to buck the anti-tax hard-liners in his party, who, the president suggested, are blocking the path to a landmark compromise. … Boehner and House Majority Leader Eric Cantor (R-Va.) responded by urging Democrats to settle for a more modest reductions-only deal that would save $2.4 trillion but would not touch tax breaks for the nation's richest households. In addition to major cuts to domestic agencies, the House GOP proposal calls for slicing about $250 billion from Medicare over the next decade by asking well-off seniors to pay more for health coverage, placing new restrictions on Medigap policies and putting in place new co-payments and cost-sharing provisions for home health care, among other changes (Montgomery, 7/11).

The New York Times: Budget Talks Beginning To Take On A Testy Air
Mr. Obama, after restating his pitch for a far-reaching deal that could produce savings of $4 trillion or so over a decade, turned the floor over to the House majority leader, Representative Eric Cantor of Virginia. Mr. Cantor, Democratic officials said, presented a Republican proposal for a more modest agreement that drew heavily on earlier negotiations steered by Vice President Joseph R. Biden Jr. Those talks had led to proposals for nearly $1.2 trillion in federal agency cuts. … More than $350 billion would also come from the federal Medicare and Medicaid health programs. Much of that would come from Medicare, where Republicans proposed to squeeze $246 billion in savings by reductions in payments for home health care, as well as increasing co-payments for laboratory services (Landler and Hulse, 7/11).

Los Angeles Times: Debt Talks Get Testy As Obama Raises Pressure
Obama used a news conference Monday morning and a private session in the afternoon to urge Republicans to reconsider their refusal to accept a large-scale deficit-reduction package that would combine revenue increases, cuts in Medicare and Medicaid, and reductions in a long list of government programs to reduce the long-term debt by about $4 trillion over 10 years (Parsons and Mascaro, 7/11).

The Wall Street Journal: President's Focus: $4 Trillion
The White House and congressional leaders made no progress Monday toward reaching a deficit-reduction deal that would clear the way for raising the federal borrowing limit in less than three weeks. President Barack Obama pressed congressional leaders Monday to forge a $4 trillion, 10-year deal. But after another contentious meeting at the White House, the odds that Democrats and Republicans can bridge their differences over taxes and social programs to reach such a sweeping plan ahead of an Aug. 2 debt-limit deadline appeared to diminish (Lee and Hook. 7/12).

NPR: Medicare Payment Board Draws Brickbats
One thing both Democrats and Republicans agree on is that they can't solve the deficit problem without slowing the growth of the massive Medicare program for the elderly and disabled. But here's an irony. Republicans and a growing number of Democrats also seem to agree that they don't like the one aspect of last year's Affordable Care Act that actually would effectively reduce Medicare spending (Rovner, 7/12).

The Associated Press: Report: Systems To Catch Medicaid Fraud Inadequate
The federal government's systems for analyzing Medicare and Medicaid data for possible fraud are inadequate and underused, making it more difficult to detect the billions of dollars in fraudulent claims paid out each year, according to a report released Tuesday (Kennedy, 7/12).