Finally, campaigners get specific on Medicare reform: Most Republicans this campaign season have declined to offer specific solutions to the budget troubles facing the nation's entitlement programs, particularly Medicare and Medicaid. (See, for instance, the GOP's "Pledge to America"). But no one sent Rand Paul the memo. 

The Republican hopeful to replace retiring Sen. Jim Bunning in Kentucky said this weekend that he would scale back Medicare and Social Security benefits for younger Americans. 

"You don't do anything to people who are currently receiving Medicare or Social Security," Paul told Fox News Sunday. "[But] for the younger generation, there will be — have to [be] — changes in eligibility."

The discussion shouldn't be limited to eligibility, Paul said, but should also focus on pushing higher deductibles and premiums for Medicare beneficiaries. 

"All younger people — if they're honest and will admit to it and have an adult discussion and not demagogue the issue — will admit that younger people will have to have different rules," he said.

Meanwhile, Paul's opponent, Kentucky Attorney General Jack Conway, isn't shying away from the issue either: Conway told Fox News that the Democrats should never have made that deal with the pharmaceutical lobby to prohibit the government from negotiating drug prices on behalf of the nation's lowest income seniors.

"We need Medicare bulk purchasing," Conway said. "It was wrong during this health care debate to take Pharma out of it. We ought to let Medicare negotiate for lower prices the way we let Medicaid and the [Veterans Affairs Department] do that. That would save about $200 billion."

Here's what he's talking about: Prior to 2003 enactment of the Medicare prescription drug benefit, so-called dual eligibles — the roughly 9 million Americans who qualify for both Medicare and Medicaid — got their drugs through Medicaid, which is allowed to negotiate drug prices with pharmaceutical companies.  With passage of Part D, however, drug purchasing for duals shifted to Medicare, which is explicitly prohibited from negotiating prices with those companies. As a result, the government currently pays about 30 percent more for dual eligibles’ drugs under Medicare than it would under Medicaid, according to a 2008 study from the House Oversight and Government Reform Committee. 

To get the drug lobby behind the health reform law, Sen. Max Baucus (D-Mont.), chairman of the Finance Committee, cut an early deal with the Pharmaceutical Research and Manufacturers of America (PhRMA), vowing not to switch those drug purchases back into the hands of Medicaid negotiators. http://bit.ly/aUdMB

But many Democrats are vowing not to give up that fight — and now you can add Conway to the list. http://bit.ly/5MtjMg

"That needs to be implemented," he said. Read more...

A leading voice for the mining lobby predicted partisan gridlock all but ensures that Congress won't pass new miner protections anytime soon.

New data posted Friday on the government's health insurance Web portal offer consumers a "pretty good measure" of their chances of being denied coverage, the deputy director of HHS's Office of Consumer Support said.

"It's not perfect," said Karen Pollitz, "but it gives you a pretty good idea about what to expect in the marketplace today."

The comments come as America's Health Insurance Plans raises questions about the denial rates that come up on Healthcare.gov when consumers search for insurance in their ZIP code. HHS added pricing information to the website on Friday, along with information gathered from insurers about the percentage of people who applied for insurance and were denied coverage and the percentage of applicants who were charged higher premiums because of their health status.

"Healthcare.gov makes the insurance marketplace more open and more transparent than ever before," said Todd Park, chief technology officer at HHS. "And a more transparent marketplace is one where there's more competition between insurance companies for consumers' business; more competition means lower costs and better value for consumers."

AHIP Spokesman Robert Zirkelbach said the denials include people turned down because they applied for plans in the wrong state or who were eventually sold a different plan than the one they first applied for.

That's still a denial, Pollitz argued.

"Sometimes," she said, "an insurer will say, 'Well, based on what you've told me about your health policy, I'm not going to sell you this policy; I refuse to sell you this policy that you asked for — but I'd offer you this other policy,' " she said. "Maybe it has a higher deductible, maybe it doesn't include a drug benefit ... It has sufficiently less coverage that it kind of cures the insurer from having to worry about being exposed to paying for whatever health needs it is that you've disclosed."

She added that the denials don't include people who were persuaded not to apply in the first place because of their pre-existing conditions, a practice sometimes referred to as "street underwriting."

Pollitz added that the private insurance rates quoted on the portal were for healthy people; those with pre-existing conditions can expect to pay higher premiums or have further restrictions on their coverage.

"We don't put you through medical underwriting on this site," she said.

Sen. Tom Harkin (D-Iowa) on Friday downplayed the significance of a finance company's recent decision to get out of the health insurance business.

Harkin, who chairs the Senate health committee, said the move by Des Moines-based Principal Financial Group to shed its insurance sector hardly represents a trend. 



“A business decision made by one company that was already decreasing their focus on the health insurance market should not serve as any indication of the success of this landmark law," Harkin said in a statement. "In fact, Iowans will continue to see their benefits grow as more provisions of the Affordable Care Act take effect in the months and years to come."

On Friday, The New York Times indicated that Principal's decision was, at least in part, spurred by the new restrictions on insurance companies contained in the new law. The move, The Times wrote, is "another sign of upheaval emerging among insurers as the new federal health law starts to take effect." 

Yet Susan Voss, Iowa's insurance commissioner, is siding with Harkin. She told Politico Thursday that "there's no correlation between health reform and Principal." 

"They have been slowly decreasing the medical percentage of their revenue base for 10 years now, from something like 30 percent down to 3 percent," Voss said. "We knew a decade ago they were focusing on a different market. … This is a strict business decision."

The Obama administration's top health official was in Florida Friday touting the benefits of the new health reform law to a group most likely to vote in November's midterms: senior citizens. 

Health and Human Services (HHS) Secretary Kathleen Sebelius conceded that the sweeping reforms are a great deal to digest, but she blamed much of the public's confusion on the misleading statements of Republicans through the initial debate and now on the campaign trail. The many consumer benefits under the law, she added, have often been overshadowed. 

"With so much else on Americans' minds and a 24-hour news cycle that gets louder every day, it's been hard for those very facts to break through," Sebelius told members of the AARP in Orlando, according to The Associated Press. "The reality of what's in the law begins to collide with some of the outrageous claims that people have been making."

Sebelius was in Florida primarily to announce the administration's apology for STD research conducted on unwitting Guatemalans in the 1940s. 

Administration officials apologized for a government research program in which subjects were infected with syphilis in the 1940s.

The lobby says the superstore's Humana venture will penalize seniors who want to buy their drugs from local pharmacies.

The group charged with certifying new health technologies under the administration's "meaningful use" guidelines announced its approval of 33 new products Friday.

The move by the Certification Commission for Health Information Technology (CCHIT) means that doctors and hospitals purchasing those products will be eligible for financial incentives designed to encourage their adoption of more efficient medical technologies. 

In a statement, CCHIT Chairwoman Karen M. Bell said the certifications come "in time for the 2011-2012 incentives."

The HIT incentive program, included in the Health Information Technology for Economic and Clinical Health Act, was enacted in 2009 as part of the Democrats’ economic stimulus bill. 

To govern adoption of those technologies, the Health and Human Services Department in July finalized its meaningful use rules, which are designed to ensure that healthcare providers don't just purchase new health technologies, but actually use them to benefit patients. 

A list of the 33 products is available here.

Physicians who want a single-payer government health plan will be marching at Saturday's "One Nation Working Together" rally in Washington, D.C. While the main focus of the march will be on jobs and the economy, part of the rally's theme — "demanding the change we voted for" — relates to dissatisfaction with the healthcare reform law, according to Physicians for a National Health Program.

The group's 18,000 members don't believe the new healthcare reform law will put an end to rising healthcare costs, but rather it will make things worse by entrenching the role of private insurance companies.

"Reforming our health care system is unfinished business," PNHP President Oliver Fein said in a statement. Physicians will be marching "to say we need a massive movement to press forward to the only rational remedy for our nation's health care crisis: single-payer Medicare for all."