OVERNIGHT HEALTH: Facing the cliff

The prospects for a deal on the fiscal cliff seem to be dimming — so what happens to healthcare programs if the country goes over?

The cuts actually aren't much bigger, in terms of dollars, than some of the proposals for cutting healthcare programs to avoid going over the cliff. But the automatic cuts, known as sequestration, are a much blunter instrument.

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Medicaid and Social Security are both exempt from the sequester — a relief to liberal Democrats who have said neither program should be on the table in negotiations between President Obama and Speaker John Boehner (R-Ohio).

Medicare cuts are limited to 2 percent. The Congressional Budget Office said last year it expected those cuts would be implemented as a 2 percent cut to each specific account in Medicare (or at least most accounts), saving the federal government about $123 billion over 10 years, which is only slightly more than would come from raising the program's eligibility age.

The cuts just in fiscal 2013 would come to about $4 billion, according to CBO.

Key vote: The American Health Care Association (AHCA) warned lawmakers Thursday that it will track their votes on the sequester replacement bill (H.R. 6684), which would cut the statutory threshold for Medicaid provider assessments to 5.5 percent. In a letter to members, AHCA President Mark Parkinson said the bill would "defer the [sequester's] defense cuts on the backs of the poorest, oldest Americans." The cut, he wrote, will "make it even harder for states to finance a program that is already underfunding nursing providers by $7 billion in 2012." The AHCA represents U.S. nursing homes.

Contracting questions: Rep. Darrell Issa (R-Calif.) and Sen. Orrin Hatch (R-Utah) are pushing for a complete list of contractors and subcontractors hired to implement the federal insurance exchanges. The lawmakers wrote to Health and Human Services Secretary Kathleen Sebelius Thursday saying that companies involved in the work "will have access to tremendous amounts of sensitive and valuable information" through the federal data hub. In a second letter, they asked specifically about the contractor hired to build the hub, Quality Software Services. Issa and Hatch are chairman of the House Government Oversight and Reform Committee and ranking member of the Senate Finance Committee, respectively. Read their letters here and here.

Another blow: Hobby Lobby was denied injunctive relief under the birth control mandate in a ruling Thursday. The 10th Circuit Court of Appeals agreed with U.S. District Judge Joe Heaton that the administration policy did not appear to substantially burden religious exercise in the case, though it still must issue a formal ruling on the merits. Ashley McGuire with the Catholic Association, a group formed to oppose the birth-control policy, called the decision to deny a preliminary injunction "shocking" and an "utter rebuke of religious freedom," since Hobby Lobby will soon face fines for non-compliance. Read more about the decision at Healthwatch. 

Reauthorize SAMHSA: That's the message from Sen. Roy Blunt (R-Mo.), who published an op-ed Thursday reflecting on the Newtown, Conn., shooting. The piece called for greater attention to mental health problems in the United States. Blunt also urged Congress to fully reauthorize the federal mental health agency — the Substance Abuse and Mental Health Services Administration (SAMHSA).

"Federal focus – and the dollars that follow – must facilitate proactive and cohesive collaboration across other agencies that work with the mentally ill and their caregivers," Blunt wrote. He did not mention guns. Read the piece and Healthwatch's write-up

Obesity bill: Sen. Tom Carper (D-Del.) introduced legislation Thursday to fight obesity by requiring federal health officials to develop and implement a comprehensive prevention strategy among U.S. adults. The bill would also increase access to weight-management counseling and drugs for Medicare beneficiaries. "With more than two of every three American adults overweight and vulnerable to diabetes, heart disease, disability, stroke, and other chronic conditions due to obesity, our nation clearly faces a growing epidemic that must be addressed," Carper said in a statement. The bill is the Treat and Reduce Obesity Act. 

State by state
Medicaid spending hampered several states' budgeting for 2013

Michigan governor signs bills about veterans, prescriptions

Iowa funding woes could mean mental health cuts

Colorado wins $43 million Medicaid bonus for its kids programs


Lobbying registrations
African Federal Group / self-registration

The Conafay Group / Cary Pharmaceuticals


Reading list
Medical tech companies face job cuts, excise tax or not

Darden profits plunge after bad 'ObamaCare' publicity

Audit of back braces reveals overcharges to Medicare

The gun lobby's favorite part of the healthcare law

Poor children have highest in-hospital death rate

Eli Lilly to pay $29.4 million to end SEC foreign bribe case


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Harkin passes on Approps gavel to continue at HELP

Health advocates applaud Obama for gun comments

Patty Murray quips about Boehner, 'Plan B' birth control


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

Elise Viebeck: eviebeck@thehill.com / 202-628-8523

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