First Edition: October 4, 2012

Today's headlines include highlights, analysis and fact-checking from last night's presidential debate.

Kaiser Health News: How Will The Election Change Medicaid?
Kaiser Health News staff writer Phil Galewitz, working in collaboration with the PBS Newshour, reports: "The future of Medicaid -- the state-federal workhorse of the nation's health system that provides health coverage to the poorest and sickest Americans -- hangs in the balance on Election Day. President Barack Obama and Republican nominee Mitt Romney have vastly different approaches to the program" (Galewitz, 10/3).

Kaiser Health News: Capsules: Sebelius Touts Health Law Benefits For Older Hispanics
Now on Kaiser Health News' blog, Shefali S. Kulkarni writes: "Just hours before the first presidential debate, Health and Human Services Secretary Kathleen Sebelius delivered a message about the dire need to protect Medicare and Medicaid funding to a critical electoral constituency. Sebelius was the keynote speaker at the National Hispanic Council on Aging's National Summit in Washington, an annual meeting of Hispanic health care, housing, aging and nutrition experts" (Kulkarni, 10/3).

The Associated Press/Washington Post: Romney, Obama Tangle Over Health Care Reform Law In First Presidential Debate
Republican Mitt Romney is vowing to repeal President Barack Obama's health care law, saying it adds costs to the health system and has led to Medicare cuts. Romney says in the first presidential debate that Obama spent his energy pushing through a massive health care law rather than trying to fix the struggling economy. … Obama says his administration worked on the health care law at the same time he was working to create jobs. He says the law has helped people with pre-existing conditions and those who have children under age 26. The president counters that he based the law on Romney's own plan when he was governor (10/3).

The New York Times: Obama And Romney, In First Debate, Spar Over Fixing The Economy
But for all of the anticipation, and with less than five weeks remaining until Election Day, the 90-minute debate unfolded much like a seminar by a business consultant and a college professor. Both men argued that their policies would improve the lives of the middle class, but their discussion often dipped deep into the weeds, and they talked over each other without connecting their ideas to voters (Zeleny and Rutenberg, 10/3).

The Washington Post: Romney Goes On Offense, Forcing Obama To Defend Record
An energetic Mitt Romney launched a series of attacks against President Obama here Wednesday night, calling into question the president's record on the economy, health care and the deficit, and arguing that he would take the country in a fundamentally different direction. Obama sought to parry Romney's criticisms, charging that his presidential rival favors a top-down approach to the economy that would reward the wealthiest Americans at the expense of the middle class and that the details of the Republican's proposals don't add up. But he found himself on the defensive repeatedly during their first debate, held at the University of Denver (Balz and Gardner, 10/3).

Los Angeles Times: In First Debate, Obama And Romney Politely Disagree Sharply
President Obama and challenger Mitt Romney differed sharply Wednesday night over taxes, Medicare and, especially, the record of the last four years in a pointed but largely polite debate that highlighted the deep substantive divide between the two philosophical foes (Barabak, 10/3).

The Wall Street Journal: Candidates Spar Over Taxes
The way the candidates answered questions showed their core differences on the role of government in the economy, in particular on whether the government or the private sector can best provide health care for Americans (Lee and Murray, 10/4).

The Wall Street Journal: A Wonkfest With Few Zingers
Take, for instance, one provision of the Obama health-care law, which creates an independent board that can make recommendations for cuts to Medicare spending if the program grows too quickly. If lawmakers fail to act, the cuts take effect automatically. Mr. Romney brought up the board on his list of complaints with the law. "It puts in place an unelected board that's going to tell people, ultimately, what kind of treatments they can have. I don't like that idea," he said. Mr. Obama started to respond by explaining that he wants to reduce the cost of delivering health care. He said policy makers can either leave people uninsured or figure out how to reduce costs. From there, he was off to explain how the Cleveland Clinic is able to provide excellent care for less than average costs by having doctors work together. And then he shifted to a discussion of how providers are reimbursed for care (Meckler and Nelson, 10/4).

The New York Times: News Analysis: A Clash Of Philosophies
Both cast their positions in terms of concern over everyday Americans, but from opposite ends. Mr. Obama expressed worry about those who would lose out if government programs are cut too deeply, while Mr. Romney talked about those who feel constrained by excessive government taxation and regulation. "The magnitude of the tax cuts that you're talking about, governor, would end up resulting in severe hardship for people, but more importantly would not help us grow," Mr. Obama said. Referring to possible cuts in Medicaid, he said, "that may not seem like a big deal when it just is, you know, numbers on a sheet of paper, but if we're talking about a family who's got an autistic kid and is depending on that Medicaid, that's a big problem" (Baker, 10/4).

The Washington Post: Fact Check: The $700B Medicare Cut
Romney accused Obama of taking $716 billion from Medicare. This $700 billion figure comes from the difference over 10 years (2013-2022) between anticipated Medicare spending (what is known as "the baseline") and the changes that the law makes to reduce spending. The savings mostly are wrung from health-care providers, not Medicare beneficiaries -; who, as a result of the health-care law, ended up with new benefits for preventive care and prescription drugs. While it is correct that anticipated savings from Medicare were used to help offset some of the anticipated costs of expanding health care for all Americans, it does not affect the Medicare trust fund. In fact, the Obama health-care law also raised Medicare payroll taxes by $318 billion over the new 10-year time frame, further strengthening the program's financial condition (Kessler, 10/3).

The Washington Post: Romney's Federal Health Care Funding
Romney said he did not raise taxes to pay for the health care law that he implemented while serving as governor of Massachusetts. This claim deserves some context, because the federal government has provided substantial help in paying for the program (Hicks, 10/3).

Los Angeles Times: Romney Shines Rare Spotlight On His Massachusetts Record
Romney has barely mentioned his stint as governor in his campaign advertising and rarely talks about it in public remarks. He has fought especially hard to avoid the subject of the landmark healthcare law that he signed as governor, lest he remind conservatives of its close resemblance to Obama's healthcare overhaul. So it was all the more noteworthy that Romney used the high-profile forum of a nationally televised presidential debate to contrast his work with Democrats on the Massachusetts healthcare law to Obama's party-line passage of the Affordable Care Act (Finnegan, 10/3).

The Washington Post: Romney Embraces His Health Care Plan
Mitt Romney embraced his role as the architect of Massachusetts's universal health care plan, an issue that has vexed him since he entered the race for president. During a segment of the debate devoted to health care, President Obama reminded the audience that the 2010 national health care overhaul that has made him a target among conservatives was inspired by a similar plan pioneered by Romney while he was serving as governor of Massachusetts (Somashekhar, 10/3).

Los Angeles Times: Fact Check: 'Obamacare' Hasn't Yet Reduced Health Insurance Costs
President Obama reiterated a claim that his healthcare law will reduce costs, a promise he made when he started pushing for an overhaul as a candidate four years ago. Then, Obama said he would cut family health insurance premiums by $2,500 by the end of his first term. Today, this stands as one of the president's biggest unfulfilled promises. In fact, the average employee share of an employer-provided health plan jumped from $3,515 in 2009 to $4,316 in 2012, an increase of more than 22%, according to a survey from the Kaiser Family Foundation and the Health Research & Educational Trust (Levey, 10/3).

Los Angeles Times: Fact Check: Romney's Charge On Obama's $716-Billion Medicare Cut
Mitt Romney repeated a somewhat misleading claim that President Obama cut $716 billion out of the Medicare program for current beneficiaries. The president's healthcare law does reduce future spending on Medicare, but those savings are obtained by reducing federal payments to insurance companies, hospitals and other providers, and do not affect benefits for people in the Medicare program (Levey, 10/3).

Los Angeles Times: Fact Check: Romney Repeats Erroneous Claims On Healthcare
Mitt Romney repeated a number of erroneous claims during Wednesday's debate about President Obama's healthcare law, including that it relies on a board that will decide "what kind of treatment" patients can get. This is a myth advanced repeatedly by critics of the Affordable Care Act and debunked consistently by independent fact-checkers (Levey, 10/3).

Los Angeles Times: Presidential Debate: It Always Comes Back To The 'Death Panels'
Just what to do with the nation's healthcare system has been argued time and again – but it always seems to come back to the "death panels." Such was the case at the debate in Denver on Wednesday night, when moderator Jim Lehrer asked the candidates whether Obamacare, one of the most contentious issues this election season, should be repealed (Semuels, 10/3).

Politico: Debate Fact Check: Analyzing Health-Care Statements
President Barack Obama and Mitt Romney had at it out over health care Wednesday night -; providing some of the toughest, and wonkiest, moments of the night. Both candidates also showed they had done their research, citing studies to back their claims about Obama's health care law and how the other would cut Medicare spending -; but they both managed to stretch the truth (Nather and Kenen, 10/4).

The Washington Post: About That Unelected Medicare Board
Just how will the IPAB work? Its powers kick in only if federal spending on Medicare exceeds yearly targets set by the law. At that point the board must propose spending cuts. Congress could overrule the panel, but only if it musters a super-majority in the Senate, or comes up with an alternate plan that saves at least as much (Aizenman, 10/3).

NPR: Romney Goes On Offense, Pay For It In First Wave Of Fact Checks
Has the president put in place a plan that would cut Medicare benefits by $716 billion? Romney says yes. The president says no. According to PolitiFact, Romney's charge is "half true." "That amount -; $716 billion -; refers to Obamacare's reductions in Medicare spending over 10 years, primarily paid to insurers and hospitals," says PolitiFact. So there is a basis for the number. But, it adds, "the statement gives the impression that the law takes money already allocated to Medicare away from current recipients," which is why it gets only a "half true" rating. … In listing his objections to the Affordable Health Care Act, Romney said it "puts in place an unelected board that's going to tell people, ultimately, what kind of treatments they can have. I don't like that idea."  But the Times and National Journal have reported that the board in question wouldn't make treatment decisions, a point Obama made during the debate. National Journal called Romney's characterization of what this board would do "one of the biggest whoppers of the night." PolitiFact gave Romney's claim a "mostly false" rating (Memmott and Montgomery, 10/4).

The New York Times: Check Point: Taking Stock Of Some Of The Claims And Counterclaims
Mitt Romney repeatedly questioned President Obama's honesty at Wednesday night's debate -; likening the president and vice president at one point to his five sons repeating things that were not true -; but he made a number of misleading statements himself on the size of the federal deficits, taxes, Medicare and health care (Cooper, Calmes, Lowrey, Pear and Broder, 10/4).

The New York Times: Tester And Rehberg Fight Over Outsider Label In Montana
The mustachioed Mr. Rehberg campaigns in cowboy boots and denim, telling stories about his family's old ranch and his days at Billings West High School. His speeches and advertisements are aimed at yoking Mr. Tester to President Obama, bailouts, deficits and health care reform -; none of which are popular here. …Mr. Tester, sporting an $8 buzz cut, argues he is the real agrarian. His family runs an organic millet and alfalfa farm near Big Sandy, and in his campaign ads, he drives a red combine across his fields and talks about understanding the lives of farmers. He has dismissed Mr. Rehberg as a "mansion rancher" who converted much of his ranchland to housing developments (Healy, 10/3).

Politico: 5 Dem Govs Miss Health Benefits Plan Date
It's not just Republican-led states that didn't turn in their homework when the teacher asked for it -; a handful of states with Democratic governors didn't meet HHS's suggested target for submitting their essential health benefit benchmark plans either (Millman, 10/4).

Politico: AARP Faces Conservative Competition
Looking to counter what they see as AARP's liberal slant, a new organization aims to rally conservative senior citizens. The National Association of Conservative Seniors says it will provide seniors "membership benefits while working together to protect conservative American values" -; benefits that include "financial planning services, health and wellness offers, Medicare insurance plans and competitive pricing on auto insurance and roadside assistance," according to a release (Gavin, 10/3).