Healthcare Wednesday

THE MEDICAID SAGA

It just might end today.

The Congressional Budget Office (CBO) last night estimated that the latest version of the Democrats' plan to extend emergency Medicaid benefits will reduce the federal deficit by almost $1.4 billion over the next decade.

The $16.1 billion Medicaid provision — part of a $26.1 billion package that also provides education funding to prevent teacher layoffs — ran into a buzz saw earlier in the week, after the CBO said the costs weren't fully offset. The initial estimate forced Democrats back to the chopping block to find more savings in hopes of convincing at least one Republican to support the bill — support they'll need to get around a GOP filibuster.

The short list of GOP centrists includes Maine Sen. Susan Collins, who thinks the Medicaid funding extension "is necessary," her office told The Hill recently. But a spokesman also warned that her support would come only if "the enhanced FMAP rate is largely offset and would not contribute to our country’s fiscal problems."

Collins office didn't respond to a request for comment Tuesday, but Democratic leaders say the new CBO score gives budget hawks nothing more to gripe about.

"This amendment meets every test Republicans claim to be concerned about," Senate Majority Leader Harry Reid (D-Nev.) said in a statement. "They have no more excuses, and tomorrow, they will have a choice: lay off teachers weeks before the new school year starts and fire the first responders who keep us safe, or help these workers keep their jobs and help our economy recover.”      

Oddly enough, the savings comes largely from another program designed to help the economy recover: food stamp benefits will be cut by almost $12 billion to pay the freight of the Medicaid package. That's sure to raise eyebrows, not only among liberal lawmakers, but among economists like Mark Zandi, who's estimated that every $1 spent on food stamps returns $1.74 to the economy — the highest "bang-for-the-buck" stimulus program out there.

IN THE NEWS

• Missouri voters on Tuesday overwhelmingly approved a state law prohibiting the government from requiring individuals to buy health insurance or face a fine — a central provision of the Democrats' healthcare reform law. The vote — the first of its kind since the reform bill passed in March — is largely symbolic: a state law won't trump the federal requirement, if the courts decide that requirement is constitutional. (A number of cases challenging the constitutionality of the provision are moving through the courts already.)

There's plenty of time left to haggle: the individual insurance requirement doesn't take effect until 2014.  

• Consumer advocates and the medical device lobby are at odds over Tuesday's proposed FDA safety rules governing new products that resemble previously approved ones.

The changes, warned Stephen Ubl, chief executive officer of the Advanced Medical Technology Association, "could result in a significant disruption to a program that has served patients well for more than 30 years.”

Not so, Diana Zuckerman, president of the National Research Center for Women & Families, told Bloomberg. “We need more scientific clinical studies to make sure that people getting medical devices are better off than people who don’t get them,” she said, adding that the new proposals are "very industry-focused." 

• Rand Paul, GOP hopeful to replace Sen. Jim Bunning (R) in Kentucky, is all over the place when it comes to mine safety. At a campaign stop in May, he told an audience that local government, not Congress, should be responsible for writing mine-safety guidelines. 

"The bottom line is I'm not an expert, so don't give me the power in Washington to be making rules," Paul said, according to a recent profile in Details magazine. "You live here, and you have to work in the mines. You'd try to make good rules to protect your people here. If you don't, I'm thinking that no one will apply for those jobs." 

This week, his campaign backtracked — sort of. 

"Dr. Paul has never said that Congress should not be involved in mine safety," spokesman Ryan Hogan said in an e-mail. "He has been clear that he does favor more local and state control over mine safety, done by experts in the field, rather than ham-fisted, one-size-fits-all dictates from Washington. ... That does not exclude the federal government, but rather sets Dr. Paul's belief in who can best handle this vital function."

That should clear things up.

• America is getting more and more obese, the Centers for Disease Control and Prevention reported Tuesday, costing the country roughly $150 billion in unnecessary treatments each year. 

CALENDAR

• The Senate Health, Education, Labor and Pensions Committee meets this morning to discuss emerging trends in the for-profit education business. Those schools are pumping out a huge percentage of the health professionals needed to meet the ever-rising demand for healthcare services, but there's a growing concern on Capitol Hill that a disproportionate share of the tuition — much of it in the form of federal grants — is going to profits, rather than education services.

• The Alzheimer's Association hosts a news conference Wednesday on the diagnostic criteria surrounding the disease.  

• The Cato Institute will mediate a Capitol Hill briefing to examine the effects of the new healthcare reform law. 

• And the Consumer Product Safety Commission meets this morning to examine pool and spa safety.