OVERNIGHT HEALTH: Medicare cutoff age still up in the air

The House Budget Committee has not agreed on whether to change Medicare benefits for people 55 years and older in the fiscal blueprint it will release next week, lawmakers said Wednesday. According to Reps. Bill FloresWilliam (Bill) Hose FloresThe Hill's Campaign Report: Warren, Sanders overtake Biden in third-quarter fundraising The Hill's Morning Report — Trump broadens call for Biden probes Pete Sessions announces bid for Bill Flores's Texas House seat MORE (R-Texas) and Rob WoodallWilliam (Rob) Robert WoodallHere are the lawmakers who aren't seeking reelection in 2020 House Democrats target 2020 GOP incumbents in new ad The House Republicans and Democrats not seeking reelection in 2020 MORE (R-Ga.), both Budget panel members, the age could be 55 or 56 come Tuesday's budget unveiling. "Things will continue to be changed and tweaked and moved right up until the rollout," Woodall said.

Analysts are waiting to see how House budget chief Paul RyanPaul Davis RyanAmash: Trump incorrect in claiming Congress didn't subpoena Obama officials Democrats hit Scalia over LGBTQ rights Three-way clash set to dominate Democratic debate MORE (R-Wis.) will kill the deficit in 10 years without breaking the GOP's promise not to change Medicare benefits for people who are less than a decade away from enrolling in the program. Ryan said Wednesday that his new proposal will only be modestly different from last year's and will not represent a major step to the right as some have predicted. “For a number of reasons, and with some honest policy changes, we can get to balance,” he said. “It doesn’t take enormous changes in our budget to get there.”

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Ryan faces a balancing act between conservatives who want swift budget cuts and centrists who fear that raising the Medicare cut-off to 56 or older will alienate voters. He can only afford to lose 15 GOP votes on the measure. Read more about lawmakers' comments at Healthwatch.

Ryan and the Medicare slowdown: The reason to pull more people into Ryan's Medicare plan would be to help balance the budget more quickly. But that goal is also somewhat more attainable because of the recent drop in Medicare spending. In a briefing with reporters Wednesday, Ryan noted that the Congressional Budget Office has projected slower growth in Medicare spending, which affects the baseline for budgeting and alleviates some of the pressure for steep cuts. 

Ryan also said Medicare cost growth will be contained for a while by the Affordable Care Act, which includes specific payment reductions as well as a new cost-control panel. The Hill has more from Ryan's preview.

House bypasses funding fight: The House passed its 2013 spending bill Wednesday without answering GOP lawmakers' calls to re-litigate the Affordable Care Act. A group of House Republicans had said Tuesday that the continuing resolution should target the healthcare law's contraception mandate, and past spending debates have been rife with political showmanship over defunding the implementation effort. But House leaders bypassed those fights this time.

The same decision is now facing Senate Republicans. Conservative senators made clear Wednesday that they intend to pick a fight over funding for the healthcare law. Sen. Ted CruzRafael (Ted) Edward CruzThe Hill's Morning Report - Presented by Better Medicare Alliance - Trump has had a rough October Hillicon Valley: GOP lawmakers offer election security measure | FTC Dem worries government is 'captured' by Big Tech | Lawmakers condemn Apple over Hong Kong censorship Lawmakers condemn Apple, Activision Blizzard over censorship of Hong Kong protesters MORE (R-Texas) said he would object to considering a continuing resolution that does not delay the law's funding, and Sen. Mike LeeMichael (Mike) Shumway LeeZuckerberg launches public defense of Facebook as attacks mount Overnight Defense — Presented by Boeing — Pence says Turkey agrees to ceasefire | Senators vow to move forward with Turkey sanctions | Mulvaney walks back comments tying Ukraine aid to 2016 probe On The Money: Senate fails to override Trump veto over border emergency | Trump resort to host G-7 next year | Senators to push Turkey sanctions despite ceasefire | McConnell tees up funding votes MORE (R-Utah) jumped in to offer his support. Healthwatch has more on their demands.

Nay votes on the CR: Despite leadership's decision to skip a funding battle, healthcare still factored into both Republican and Democratic votes Wednesday against the continuing resolution to avoid a government shutdown on March 27. The spending bill passed 267-151 with 14 Republican votes against it. Among these lawmakers was Rep. Paul BrounPaul Collins BrounJoe Lieberman's son running for Senate in Georgia California lawmaker's chief of staff resigns after indictment Republican candidates run against ghost of John Boehner MORE (R-Ga.), who spoke for several GOP members when he said the bill should have killed funding for President Obama's healthcare law, "one of the greatest attacks on our personal freedom in the history of this nation." The Club for Growth had threatened to score against the vote for this reason, circulating a letter last Friday from Reps. Jim BridenstineJames (Jim) Frederick BridenstineTrump speaks with NASA astronauts on all-female spacewalk NASA makes historic all-female spacewalk NASA reveals new spacesuits for next moon mission MORE (R-Okla.) and Tim Huelskamp (R-Kan.) urging colleagues to remember their opposition to the healthcare law. 

On the Democratic side, members including Rep. Tim Ryan (D-Ohio) defended their nay votes by pointing to the sequester cuts the CR did not undo. "We had a chance today to overturn the sequester, adequately fund our government, and bring some stability to our economy," Ryan said in a statement. "We had a chance today to ensure proper cancer screenings will continue — and that the Affordable Health [sic] Care Act can be properly implemented." Read more here about Wednesday's floor vote.

Arkansas abortion crackdown: Arkansas legislators voted Wednesday to ban abortions after 12 weeks of pregnancy — the earliest cutoff of any state. The state legislature overrode a veto from Gov. Mike Beebe to impose the restrictions. Earlier in the week, the legislature also voted to ban abortions later than 20 weeks.

The Planned Parenthood Action Fund condemned the move.

“We are deeply disappointed that the Arkansas legislature voted to impose the most restrictive ban on safe and legal abortion in the country," Planned Parenthood President Cecile Richards said in a statement. "The majority of Arkansans — and the majority of Americans — don’t want politicians involved in a woman’s personal medical decisions about her pregnancy."

The new law would ban about 1 in 10 abortions in the state, according to the Washington Post. Read the Post's coverage here.

Employers skittish: Employers are still citing the healthcare law as a reason for layoffs and slow hiring. Business groups' opposition to the law is well known, and employers reiterated their concerns for the Federal Reserve's "beige book," which examines economic conditions across the country.

"Employers in several Districts cited the unknown effects of the Affordable Care Act as reasons for planned layoffs and reluctance to hire more staff," the beige book stated.

The Hill's coverage is here.

TANF talk: The House Ways and Means Committee endorsed a bill Wednesday to prevent the Obama administration from issuing waivers under welfare reform. The 28-14 approval moves the measure — a priority for Republicans — one step closer to a floor vote. In debate, Republicans and Democrats squared off on their interpretations of the Obama policy, which is designed to give states desired flexibility under the Temporary Assistance for Needy Families (TANF) program, per administration officials. Panel chairman Dave Camp (R-Mich.) said the waivers are meant to weaken welfare's work requirements, "pure and simple." House Democratic Caucus Chairman Xavier BecerraXavier BecerraProgressive group releases Supreme Court shortlist for 2020 Democrats Trump administration ends five-year oil and gas drilling moratorium in California  Feds won't pursue charges against Sacramento officers who fatally shot Stephon Clark MORE (D-Calif.) said the GOP bill is a political stunt that "handcuffs" governors. 

Also on Wednesday, Rep. Dave ReichertDavid (Dave) George ReichertLymphedema Treatment Act would provide a commonsense solution to a fixable problem Yoder, Messer land on K Street Ex-GOP lawmaker from Washington joins lobbying firm MORE (R-Wash.), who leads the Ways and Means subcommittee on human resources, introduced a TANF reauthorization bill to extend program funding through Dec. 31. The bill would maintain current spending levels and also block Obama from issuing waivers. TANF is currently authorized through March 27. Read more about the Ways and Means vote at Healthwatch.

Thursday's agenda

Mental Health America will hold a panel on mental health and the implementation of the Affordable Care Act at the National Press Club.

The Heritage Foundation will unveil a market-base healthcare reform plan.

Health and Human Services Secretary Kathleen SebeliusKathleen SebeliusJerry Moran: 'I wouldn't be surprised' if Pompeo ran for Senate in Kansas Mark Halperin inks book deal 2020 Democrats fight to claim Obama's mantle on health care MORE will give remarks on U.S. policy priorities for women's global health.

The Partnership for a Healthier America will continue its Building a Healthier Future summit in Washington.


State by state

Jeb Bush opposed to Florida Medicaid expansion

Next NYC health campaign: too-loud earphones

NC Medicaid director: 'We want bold proposals'

Miss. Dems offer new Medicaid proposal


Reading list

UnitedHealth seeks 'doc fix' in push to kill rate cuts

Grayson 'no cuts' coalition adds several lawmakers

For-profit hospitals expected to withstand Medicare cut [free reg. req'd]

Despite obesity rise, US calories trending downward


What you might have missed on Healthwatch

GOP leaders push Obama on pre-existing conditions plan

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Comments / complaints / suggestions?


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

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

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