OVERNIGHT HEALTH: House moves toward IPAB repeal

The IPAB is one of the central cost-control efforts in President Obama’s healthcare law, but Republican critics say it would ration care and put too much power in the hands of unelected experts. The 15-member panel would cut Medicare payments to doctors and other providers if overall Medicare costs rise beyond a certain rate. Congress could block the cuts, but only if it comes up with alternative savings elsewhere in the federal budget.

Read The Hill’s story on the beginning of the six-hour IPAB debate.

BoehnerJohn BoehnerLobbyists bounce back under Trump Business groups silent on Trump's Ex-Im nominee Chaffetz won't run for reelection MORE defends strategy: The House has voted 25 times this year to repeal or defund all or part of the healthcare law — prompting criticism from some conservatives who say the piece-by-piece repeal bills are distracting from the push for all-out repeal. Boehner defended the piecemeal strategy on Wednesday, noting that the House has passed a comprehensive repeal bill that died in the Senate. (Almost all of the piece-by-piece ones died in the Senate, too.) The Hill has the story.

Where’s the White House?
Republicans say it speaks volumes that President Obama won’t hold a public event to mark the second anniversary of his healthcare law. Senate Republicans sent around a fake invitation to the White House celebration — location “TBD.” Obama’s silence contrasts with a big East Room event marking six months since the law was signed. The Hill has more on Obama’s decision to stay quiet about healthcare on Friday.

Democrats, meanwhile, are fine with Obama’s decision and say they’re happy to take the public-relations lead. Healthwatch has the details.

A little something:
It’s not the president, but the White House posted a YouTube video Wednesday in which first lady Michelle ObamaMichelle ObamaHollywood, DC come together for First Amendment-themed VIP party Capitol File partygoers praise low-key start to correspondents’ dinner weekend USDA to ease school meal standards MORE touts the healthcare law and summarizes some of its most popular provisions. She asks women to spend next week — the week healthcare is in front of the Supreme Court — extolling the virtues of healthcare reform. The video is here.

Medicare showdown:
The day-long House Budget Committee mark-up of Rep. Paul RyanPaul RyanRyan's home state highlights challenge for GOP high-risk insurer pools Trump 'disappointed' in congressional GOP Bipartisan push grows for new war authorization MORE's (R-Wis.) FY 2013 budget started off with a showdown over Medicare. Republicans defeated along party lines an amendment from Rep. Allyson Schwartz (D-Pa.) that would have struck the budget's Medicare overhaul, which caps federal spending and gives seniors an option to receive subsidies — aka "premium support" — to buy private coverage. 

Another amendment, sponsored by Rep. Kathy Castor (D-Fla.), would have preserved the healthcare reform law's benefits for seniors — the Ryan budget eliminates the health law — including "the gradual closing of the prescription drug coverage gap, coverage of key preventive services and annual wellness visits with no co-pays or deductibles, better coordinated care for chronic diseases, expanded support for alternatives to nursing homes, and protections against abuse for nursing home residents."

Price tag: On a (somewhat) related note, the Campaign to End Obesity released a report urging the Congressional Budget Office to adopt a new scoring window for legislative proposals that tackle the epidemic. The report says the current 10-year window ties lawmakers' hands because it's too short to capture the potential economic value of preventing related diseases such as diabetes and heart disease.

"Despite the abundance of evidence that obesity is crippling America's fiscal and physical health — something the authors deftly describe — policies to reduce its prevalence have often been hampered by our federal budget scoring process," Stephanie Silverman, co-founder of the Campaign to End Obesity, said in a statement. "By widening our lens to reflect the reality of health care costs, we can target meaningful prevention programs that yield the greatest cost savings and lessen the burden of the obesity epidemic on our economy."

The campaign says obesity-related medical costs have soared in recent decades, and now make up almost 10 percent of all medical spending — some $147 billion per year. 

Replacement roadmap: Republican governors on Wednesday laid out their principles for replacing Obama’s healthcare law. They didn’t prescribe specific policies, as lawmakers will have to do if the Supreme Court strikes down the entire law, but rather outlined broad themes they say are essential to a new approach. The governors called for more state control over Medicaid and said healthcare reform should better align payments with quality. You can read the full outline here.

Thursday's agenda

The Senate Finance subcommittee on Health Care holds a hearing on "Prescription Drug Abuse: How are Medicare and Medicaid Adapting to the Challenge?" Here's the agenda.

The Center for Business and Public Policy at Georgetown University's McDonough School of Business releases a report on Massachusetts's healthcare reform experience and the implications for federal reform. Here's the announcement.

The Children's Hospital Association spearheads a briefing on Medicaid Innovations, focusing on the flexibility within the Medicaid program, including waivers and private initiatives. This is the second in four briefings in the Medicaid Matters for Kids series. 

State by state

New Jersey offers a case study of what could happen to insurance reforms if the Supreme Court strikes down the reform law's individual mandate.

Utah is the fifth state to adopt a "Health Care Compact."

The Missouri Senate voted down a state-run health insurance exchange.

Bill tracker

Rep. Cathy McMorris-Rodgers (R-Wash.) introduced legislation calling for new auditing standards for Pharmacy Benefit Managers in the Medicare prescription drug program (H.R.4215).

Rep. James Sensenbrenner (R-Wis.) has a bill toughening penalties on people who tamper with medical products that have not yet been made available for retail purchase by a consumer (H.R. 4223)

Rep. Paul BrounPaul BrounCalifornia lawmaker's chief of staff resigns after indictment Republican candidates run against ghost of John Boehner The Trail 2016: Let’s have another debate! MORE (R-Ga.) introduced legislation endorsed by the Tea Party group FeedomWorks that would repeal the healthcare reform law and replace it with free-market provisions (H.R. 4224). These include 100 percent deductibility for all healthcare expenses (including health insurance); moving Medicare to a more flexible premium assistance program; allowing consumers to purchase health insurance across state lines; and making it easier for groups to establish Association Health Plans.

Here's Broun's press release about his bill.

Reading list

NPR examines why the White House hasn’t been able to make a more convincing sales pitch for healthcare reform over the past two years.

Two years in, there are still myriad questions about how the healthcare law will work, The Wall Street Journal reports.

A study published in Health Affairs makes the case for delaying the new “ICD-10” billing system, which doctors say is overly burdensome.

Comments / complaints / suggestions? Please let us know:

Julian Pecquet: jpecquet@thehill.com / 202-628-8527

Sam Baker: sbaker@thehill.com / 202-628-8351

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