OVERNIGHT HEALTH: Dems dig in on Medicare age

If the White House has indeed abandoned the higher Medicare age proposal, it would be the second time the administration has backed away from one of its own proposals for entitlement reform. The administration said Monday that it no longer supports a plan to streamline Medicaid payments in a way that would shift costs to states, which was part of Obama's budget proposal this year.

Speaking of Medicaid ... The administration's new position on the Medicaid "blended rate" isn't sitting well with congressional Republicans. Sen. Orrin Hatch, the top Republican on the Finance Committee, and Rep. Fred Upton (R-Mich.), the chairman of the Energy and Commerce Committee, called the position a "bait and switch" on Thursday. They said the administration is trying to coax states into taking up the health law's Medicaid expansion (which no one disputes), but then said Medicaid funding is sure to be cut in the future.

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"States should be aware that when fiscal realities later dictate cuts to the Medicaid program, they may be left to finance a larger share of the Medicaid expansions," the lawmakers said. Their letter to HHS is available here.

Not so fast: Hatch also signed on to a separate letter Thursday asking for a delay in implementation. Hatch and a group of Republican senators sought delays on several regulations, including rules outlining essential benefits and new market rules such as the ban on pre-existing conditions. The senators criticized HHS for only recently releasing the regulations.

"While we understand the urgency in implementing the law due to delays caused by its unpopularity, the Administration has had two years to draft and publish regulations," they wrote. "Considering that OMB had more than 30 days to review the proposed rules, it is surprising that the Administration should give the public and key stakeholders tasked with implementing the law less than that amount of time to review and comment on the proposed regulations. Such haste raises concerns that politics are being put before policy."

Here's the letter.

Not gonna happen: Gary Cohen, the director of the HHS office leading the bulk of the implementation effort, was asked by reporters Thursday whether he'll consider a delay. Here's his answer:

"No. People are saying there's not a lot of time between now and October, and there isn't, and they're saying we need to get these rules — the industry in particular (is) saying we need to get these rules finalized so we know how to develop plans, price plans, get them in to the states. A lot of these rules, we previewed what the contents were going to be in earlier bulletins, guidance, white papers, etc., so we think the comment period is certainly adequate for us to get input from the public."

Exchanges, on the other hand: Cohen testified Thursday before the House Energy and Commerce Committee, where he said exchanges — whether federally run or state-based — will definitely be operational on schedule.

“I am confident that states and the federal government will be ready in 10 months," Cohen said.

Healthwatch has more details.

Medicaid meeting: Louisiana Gov. Bobby Jindal (R) is upping pressure on President Obama to meet with GOP governors on reforming Medicaid. Jindal, who leads the Republican Governors Association, wrote to Obama Thursday after a previous meeting request went unanswered.

"It is clear that a meeting to discuss the future of Medicaid is more important than ever," Jindal wrote, citing the Obama administration's recent announcement that states will not be allowed to partially expand Medicaid under the healthcare law.

Read more about the letter at Healthwatch.

Reform agenda: A duo of health experts is out with a new paper that recommends improving Medicare through better care coordination and measures to reduce chronic conditions. The analysis comes from Ken Thorpe, a professor at Emory University's Rollins School of Public Health, and Daniel Perry of the Alliance for Aging Research.

"Reforms focused on prevention and care coordination should serve as the foundation for the next wave of discussions regarding entitlement reform," Thorpe and Perry write. "These key prevention and care coordination initiatives include transitional care, comprehensive medication therapy management, health coaching, and providing team based care. In addition, evidence-based programs ... should be added to the Medicare program."

Thorpe is also co-chairman of the Partnership for the Future of Medicare, an advisory group focused on reforming the program. Read the paper here and more about the group here.

Bad vibes: The American Academy of Pediatrics (AAP) endorsed a bill from Rep. Dennis Kucinich (D-Ohio) that would require warning labels on cellphones because of the electromagnetic fields they produce. The bill also orders a "comprehensive research program" to study the effects of cellphones on children, pregnant women and other vulnerable groups.

"Children are disproportionately affected by environmental exposures, including cell phone radiation. The differences in bone density and the amount of fluid in a child’s brain compared to an adult’s brain could allow children to absorb greater quantities of [radiofrequency] energy deeper into their brains than adults,” wrote AAP President Thomas K. McInerny, M.D., FAAP. The International Agency for Research on Cancer classifies cellphones' electromagnetic fields as possibly carcinogenic.

The Kucinich bill is the Cell Phone Right to Know Act (H.R. 6358). Read the AAP's letter of support here


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