OVERNIGHT HEALTH: Approaching fiscal cliff

President Obama reiterated in Wednesday’s news conference that he’s open to some type of entitlement reform. But which entitlements to cut, and where, is a hard — and changing — balancing act. Obama has backed a handful of Medicare and Medicaid changes in previous budget talks, but it was clear Wednesday that some of those proposals will draw fire from his allies.

The liberal Center for American Progress argued Wednesday that a deal to avert the fiscal cliff shouldn’t make major Medicaid cuts. Although Obama has put Medicaid on the table before, CAP experts said the calculus changed once the Supreme Court said states can opt out of the Medicaid expansion in the Affordable Care Act. The White House is trying hard to persuade states to get on board, so it might not want to cut back on its share of Medicaid costs right in the middle of that process.


"We think it would be a mistake if the debt talks or the fiscal cliff negotiations start off where they left off. That makes very little sense to us," CAP President Neera Tanden said.

Healthwatch has more on the Medicaid pushback and CAP’s plan to save $385 billion in healthcare spending without cutting benefits.

Medicare, too: Medicaid has a closer tie to President Obama’s signature healthcare law, but Medicare is more politically sensitive. And AARP, the nation’s largest seniors’ lobby, said Wednesday that Medicare should be off the table in fiscal-cliff discussions. AARP released a poll showing that most Americans want the debate over Medicare’s future to be separate from the fiscal cliff.

In a statement, AARP Executive Vice President Nancy LeaMond said older Americans have "significant concerns" about any attempt to reform Medicare or Social Security in the heat of talks on the fiscal cliff. Healthwatch has the story.

Price cut: Rep. Tom Price (R-Ga.) — a prominent leader both among House Republicans and their large caucus of doctors — fell short Wednesday in his bid for the No. 4 spot in the House GOP caucus. Price had the backing of influential conservatives, including Rep. Paul RyanPaul Davis RyanBush, Romney won't support Trump reelection: NYT Twitter joins Democrats to boost mail-in voting — here's why Lobbying world MORE (R-Wis.), while his opponent, Rep. Cathy McMorris RodgersCathy McMorris RodgersGOP lawmakers voice support for Israeli plan to annex areas in West Bank Trio of GOP lawmakers asks Zoom to clarify China ties after it suspends accounts Bipartisan senators call for investigation of TikTok's child privacy policies MORE (R-Wash.), was leadership’s preference. Her victory is a setback for conservatives within the caucus; Price had also vowed since Election Day to keep fighting “ObamaCare,” even after Speaker John BoehnerJohn Andrew BoehnerLott says lobbying firm cut ties to prevent him from taking clients Lobbying firm cuts ties to Trent Lott amid national anti-racism protests Bush, Romney won't support Trump reelection: NYT MORE conceded that it’s now the law of the land.

House Republicans have not attacked ObamaCare enough, apparently: At least that’s what Rep. Doc HastingsRichard (Doc) Norman HastingsCongress just resolved a 20-year debate over Neolithic remains Boehner hires new press secretary GOP plots new course on Endangered Species Act reform MORE (R-Wash.) seemed to suggest with a letter asking his colleagues to rearrange their committee structure in the name of fighting President Obama’s healthcare overhaul. Hastings said the House GOP should consolidate all healthcare jurisdiction into one new healthcare committee.


"How can we possibly hope to repeal ObamaCare if we cannot even reform the House over which we have total control?" Hastings asked.

Hastings is technically correct that healthcare jurisdiction is divided among several committees. But even so, the House managed to pass more than 30 bills over the past two years repealing or weakening all or part of the healthcare law. Healthwatch has the lowdown on Hastings’s pitch.

FDA under fire: House lawmakers came down hard on the Food and Drug Administration (FDA) Wednesday at Congress's first hearing on the fungal meningitis outbreak. FDA Commissioner Margaret Hamburg testified before a subpanel of the Energy and Commerce Committee, where members pushed her on the agency's oversight of compounding pharmacies — the kind of firm responsible for the 32 meningitis deaths. Hamburg said that her agency shares oversight responsibilities with state regulators, complicating enforcement actions. Healthwatch has more on the story.

Let them smoke: Reps. Ron Paul (R-Texas) and Barney Frank (D-Mass.) wrote a letter to President Obama asking him not to interfere with decisions to legalize marijuana in Colorado and Washington. The lawmakers, both retiring, argued that allowing the state measures to take full effect will "provide valuable information in an important national debate."

Frank and Paul have criticized Obama for cracking down on medical marijuana dispensaries in states where they are legal. They have also sponsored legislation that removes criminal penalties for marijuana use. Under current federal law, the drug is classified as a Schedule I controlled substance alongside heroin and ecstasy. Read more about the letter and new polling on legalization at Healthwatch.

Cost controls: U.S. employers are making special efforts to hold down healthcare costs as they prepare to comply with the Affordable Care Act, according to a new survey.

Mercer, the human resources consulting firm, found that employers' healthcare costs grew 4.1 percentage points in 2012 — the smallest increase in 15 years. The firm attributed the trend to the rise in high-deductible, consumer-directed health plans (CDHPs) and wellness programs.

Mercer also found that few firms plan to cut coverage as the healthcare law takes effect. Seven percent of large employers believe it is "likely" or "very likely" they will terminate employee health insurance in the next five years, the survey found. Among smaller firms, the number was slightly higher, at 22 percent. Read more at Healthwatch. 

Thursday's agenda

The Senate Health, Education, Labor and Pensions Committee will hold hearings to examine pharmacy compounding, focusing on implications of the 2012 meningitis outbreak.

The National Committee to Preserve Social Security and Medicare will hold a briefing and release new polling on seniors' views about cutting program benefits to reduce the deficit.

The Senate Defending Social Security Caucus will hold a summit to discuss legislative and grassroots efforts protect Social Security, Medicare and Medicaid.

State by state

Missouri, Kansas reject state-run health exchanges

Ark. governor proposes new spending, cuts to address Medicaid shortfall

Md. releases breast-feeding recommendations for hospitals

D.C. ambulance plan draws opposition

Reading list

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

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

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