Los Angeles Times: Obama Administration Offers States Ideas On How To Cut Medicaid
Facing a revolt from states confronted by huge budget shortfalls and tattered health care safety nets, the Obama administration is intensifying a drive to help state leaders wring savings from their Medicaid programs (Levey, 2/4).

The New York Times: Governors Get Advice For Saving On Medicaid
Fearing wholesale cuts in Medicaid by states with severe budget problems, the Obama administration told governors on Thursday how they could save money by selectively and judiciously reducing benefits, curbing overuse of costly prescription drugs and attacking fraud (Pear, 2/3).

Kaiser Health News: States May Face Showdown With Feds Over Cutting Medicaid Rolls
Kaiser Health News staff writers Marilyn Werber Serafini and Julie Appleby report (in an updated story): “The Obama administration Thursday offered to help budget-strapped governors find ways to reduce Medicaid costs, but did not agree to urgent requests to sharply cut eligibility for the program, which covers 48 million poor, disabled and elderly people” (Werber Serafini and Appleby, 2/3).

CQ HealthBeat: Sebelius Reminds Governors Of Ways To Cut Medicaid Costs Without Slashing Eligibility
In the face of pressure from governors who want to cut Medicaid spending, federal health officials on Thursday sent information to state officials explaining how current law allows them to change the federal-state program. The effort seemed designed to persuade governors not to take draconian steps that would slash benefits and eligibility for low-income people (Adams, 2/3).

The Hill: Sebelius Offers Alternatives To Medicaid Waivers
In a new letter to the nation’s governors, President Obama’s top health official is trying to dampen calls from states for the federal government to loosen Medicaid requirements (Millman, 2/3).

Bloomberg: U.S. States To Be Allowed To Reduce Medicaid To Help in Balancing Budgets
The Obama administration is encouraging U.S. states to reduce health benefits to the poor instead of trimming eligibility for Medicaid, according to a letter to governors sent today. The administration’s message is an attempt to preserve access to Medicaid, the federal-state health program for the poor, while balancing states’ financial concerns, according to the letter sent by Health and Human Services Secretary Kathleen Sebelius. Along with cutting benefits and increasing the share Medicaid patients have to pay to save costs, Sebelius encourages states to save money on drugs, fight fraud, and better manage the most expensive patients (Armstrong, 2/3).

The Associated Press: Feds Give States Menu For Cutting Medicaid
Answering a fiscal 911 call from the nation’s governors, the Obama administration Thursday gave cash-strapped states a menu for cutting Medicaid spending, one of their biggest budget headaches. It didn’t have one item that many governors, particularly Republicans, are looking for. In a letter to governors, Health and Human Services Secretary Kathleen Sebelius was cool to the idea of cutting beneficiaries from the Medicaid rolls by restricting eligibility, as Arizona has requested and other states are considering (1/3).

Meanwhile, Stateline details how some states are using managed care as a cost conscious way to target new populations.  

Stateline: Crushed By Medicaid Costs, States Expand Managed Care
States have been using managed care to cut Medicaid costs for more than 15 years. Up to now, however, the vast majority of plans covered only children and pregnant women — a large, but relatively healthy and inexpensive segment of the more than 60 million people covered by Medicaid. What’s different today is that states are beginning to target new populations for managed care. They include adults with disabilities and seniors who require long-term care, relatively small groups that nevertheless account for the lion’s share of Medicaid costs (Vestal, 2/4).

Related, earlier KHN story: Health Law Expected To Boost Medicaid Enrollees In Managed Care (Galewitz, 11/12/10).

And new research explores how income changes could impact the interplay between Medicaid and insurance exchanges.

Modern Healthcare: Researchers Expect Income Changes To Spur Movement Between Medicaid, Insurance Exchanges
Changes in income among those who will be eligible for subsidized health insurance under the Patient Protection and Affordable Care Act could lead to coverage disruption for about 28 million Americans within the first year as their eligibility shifts between Medicaid and the new state insurance exchanges, according to a study in the journal Health Affairs (Zigmond, 2/3).

The Washington Post: Virginia To Seek Expedited Supreme Court Review Of Suit Over Health Care Law
Virginia will ask that the U.S. Supreme Court immediately review the state’s constitutional challenge to the federal health-care overhaul, a rare legal request to bypass appeals and ask for early intervention from the nation’s highest court, Attorney General Ken T. Cuccinelli II said Thursday (Helderman, 2/3).

The New York Times: Virginia To Ask Supreme Court To Rule On Health Law
Virginia’s attorney general announced on Thursday that he hoped to bypass an initial appellate review by asking the United States Supreme Court to consider the constitutionality of the Obama health care law on an expedited basis (Sack, 2/3).

Fox News: Virginia Attorney General Urges Supreme Court To Hear Health Law Challenge Now
Virginia’s attorney general has asked the Supreme Court to fast-track his state’s legal challenge to the federal health care overhaul, saying state governments and businesses deserve to know the fate of the law as soon as possible (2/3).

Reuters: Virginia To Ask Top Court To Review US Health Law
Virginia said on Thursday it will ask the U.S. Supreme Court to hear its challenge to President Barack Obama’s health care overhaul, bypassing the appeals process in a rarely used move to try to speed up a definitive ruling on the year-old law. The Obama administration opposed the move and said the case should follow the regular process, which could put off until 2012 a Supreme Court ruling on the sweeping law that aims to provide more than 30 million uninsured Americans with medical coverage and cracks down on unpopular insurance industry practices (Vicini and Lambert, 1/3).

Bloomberg: Obama Go-Slow Approach At Supreme Court On Health Law May Build Support
A U.S. Supreme Court showdown over President Barack Obama’s health care overhaul may be inevitable. His administration is in no rush for the court to get involved. The Justice Department yesterday said it will oppose Virginia Attorney General Ken Cuccinelli’s request that the court immediately review the law, which a federal trial judge said was unconstitutional. … The government’s approach would give it a chance to rack up lower court victories and perhaps build popular support for the law before the justices take up the case. It might also set the stage for a Supreme Court ruling only months before the 2012 presidential election (Stohr and Blum, 1/4).

The Wall Street Journal: Health Foes Try Divergent Tactics
States challenging the massive health care law enacted last year are employing different tactics in their push for swift Supreme Court review of their legal cases (Kendall, 2/4).

The Washington Post: Activists Slowly Chip Away At Health Care Law
The effort to block, repeal or merely chip away at the health care law has exploded into a single-minded political industry since Congress and state legislatures across the nation began convening last month. Twenty-eight states have filed or signed onto lawsuits challenging the measure. Thirty-eight legislatures are considering state laws to curtail its effects. Operatives and organizers are spraying their membership lists with action alerts and calls to arms. And an army of activists is writing e-mails and making phone calls to urge state and federal lawmakers to take the measure down (Gardner, 2/3).

Health Affairs: Nearly Half Of Families In High-Deductible Health Plans Whose Members Have Chronic Conditions Face Substantial Financial Burden – “Enrollment in high-deductible plans” is on the rise, yet little is known of “the financial burden experienced by families with children and those with chronic health conditions who participate in high-deductible plans,” according to the authors, who analyzed survey and health plan claims data. They found that 48 percent of families in high-deductible plans experienced financial burden compared to 21 percent of families in traditional plans. And, “[a]lmost twice as many lower-income families in high-deductible plans spent more than 3 percent of income on health care expenses as lower-income families in traditional plans (53 percent versus 29 percent)” (Galbraith et al., February 2011).

Annals of Internal Medicine: Hospital Spending And Inpatient Mortality: Evidence From California – Although previous studies have shown “high Medicare spending is not associated with better health outcomes at a regional level,” less well known is the association between hospital spending and inpatient mortality, according to this study of 208 California hospitals. “For each of 6 diagnoses at admission—acute myocardial infarction, congestive heart failure, acute stroke, gastrointestinal hemorrhage, hip fracture, and pneumonia—patient admission to higher-spending hospitals was associated with lower risk-adjusted inpatient mortality,” the authors write. “Our findings suggest that although greater overall medical spending in the United States is not associated with better quality of care or better health outcomes, specific types of medical spending (for example, acute care hospital spending) may be efficacious,” they conclude (Romley, Jena and Goldman, 2/1).

British Medical Journal: Impact Of A Statewide Intensive Care Unit Quality Improvement Initiative On Hospital Mortality And Length Of Stay: Retrospective Comparative Analysis – This study measured the effects of the implementation of Michigan’s Keystone ICU program, a statewide initiative to reduce infections, on hospital length of stay and death in patients 65 and older admitted to the intensive care units (ICUs). Analysis of Medicare claims data for these patients revealed: “Implementation of the Keystone ICU project was associated with a significant decrease in hospital mortality in Michigan compared with the surrounding area. The project was not, however, sufficiently powered to show a significant difference in length of stay” (Lipitz-Snyderman et al., 1/31).

Health Affairs: Enrolling More Kids In Medicaid And CHIP – “In 2008, 1.7 million children gained coverage through Medicaid and CHIP. This increased coverage was associated with a reduction in the number of uninsured children, despite reductions in employer-sponsored coverage occurring during the same time. Even with this progress, an estimated 7.3 million children were still uninsured in 2008, and 65 percent of them, close to 5 million, were eligible for public coverage, mostly through Medicaid,” according to this policy brief, which highlights some of the challenges parents may face when trying to enroll a child for public health coverage and outlines changes expected with the Medicaid expansion scheduled for 2014 under the new health law. (Cassidy, 1/27).

Institute of Medicine: HIV Screening And Access To Care: Exploring The Impact Of Policies On Access To And Provision of HIV Care – This consensus report “examine[s] the extent to which federal, state, and private health insurance policies inhibit HIV-positive individuals from initiating or continuing their care,” as outlined by the IOM’s Committee on HIV Screening and Access to Care during a public workshop in June. “Although the Affordable Care Act will improve access to HIV care in some respects [such as Medicaid] … it may aggravate the situation in other ways,” such as reduced or cut funding for the Ryan White programs, according to the report. “Current reimbursement policies, particularly under Medicaid, restrict access to providers with HIV/AIDS expertise. Even under the ACA, infectious disease physicians who provide primary care to HIV/AIDS patients may not be able to benefit from advantageous primary care provider reimbursement policies under Medicaid” (Cleary et al., 1/31).

Commonwealth Fund: Securing A Healthy Future: The Commonwealth Fund State Scorecard on Child Health System Performance, 2011 – “Although federal action to extend insurance to children has made a critical difference in reducing the number of uninsured children across states and maintaining children’s coverage during the recent recession … where children live and their parent’s incomes significantly affect their access to affordable care, receipt of preventive care and treatment, and opportunities to survive past infancy and thrive,” write the authors of this report that examines states’ performance on 20 measures assessing “access and affordability, prevention and treatment, and the potential to lead healthy lives.” States scoring in the top quartile in overall performance ranking included Iowa, Massachusetts, Vermont, Maine and New Hampshire while Florida, Texas, Arizona, Mississippi and Nevada scored in the bottom quartile (How et al., 2011).

The Wall Street Journal: ObamaCare’s Repeal Has Begun
Mark this date: On Feb. 2, 2011, a Democratic Senate killed the first piece of the health-care law it passed less than a year ago. Bowing (finally) to reality, 34 Democrats rushed to be among the 81 senators who axed the bill’s odious 1099 tax reporting requirement. Let the ObamaCare dismantling begin (Kimberley A. Strassel, 2/3). 

McClatchy / San Jose Mercury News: Judge’s Health Care Ruling Smacks Of Judicial Activism
Step aside, Sarah Palin. The tea party has a new darling: Florida federal Judge Roger Vinson. … The most outrageous part of Vinson’s ruling – aside from a quirky reference to the 1773 Tea Party – is the absurd assertion that “the mere status of being without health insurance, in and of itself, has absolutely no impact whatsoever on interstate commerce.” Tell that to the taxpayers and employers who are now picking up the tab for the 50 million uninsured Americans (2/3).

McClatchy / The Anchorage Daily News: Fast-Track Health Care Bill To Supreme Court
Democrats and Republicans are at fierce odds over the health care bill, but they should agree with Florida Sen. Bill Nelson’s call for the Supreme Court to decide whether the provision requiring purchase of health insurance is constitutional — sooner than later. Let’s have a decision that counts. So far we have dueling rulings that don’t settle the issue (2/3).

The Fort Worth Star-Telegram / McClatchy: Health Care Law Moves Closer To Supreme Court
The Supreme Court will have final say. But what the justices ultimately will decide, most likely not for at least another year, is only whether Congress can require all Americans to either buy health insurance or pay a penalty. That won’t be a verdict on whether other aspects of the law are wise or popular or will be effective. And it certainly won’t resolve whether congressional Republicans have better ideas for tackling acknowledged problems in the U.S. healthcare system (2/3). 

The Wall Street Journal: The States Can’t Afford ObamaCare 
By opening Medicaid to applicants 33% above the poverty line in 2014, ObamaCare could expand Medicaid enrollment by as much as 25%, according to the plaintiffs in the Florida suit. … The framers of ObamaCare seem to have been too clever by half in their attempt to shift costs to the states. However the courts may eventually rule, you can’t get blood out of a turnip (George Melloan, 2/4). 

The Seattle Times: No GOP Prescription For Health Care
Republicans, with their repeal vote in the House of Representatives and Wednesday’s charade in the Senate, truly reveal how much they do not get it. They rant about Obamacare as they willfully distort the fiscal impacts, and fail to offer a single idea of their own. Random speeches do not count. Where is their star-spangled legislation to provide relief for anxious families? (Lance Dickie, 2/3).

The Wall Street Journal: House Of Waxman
In the glass-houses department, Henry Waxman is accusing Republicans of “an abuse of the oversight process” … Mr. Waxman claims [Rep. Fred] Upton is “unduly disruptive” because he is asking for basic HHS communications about an office set up under ObamaCare to write and enforce regulations on private insurance companies. Originally, that office directly reported to HHS Secretary Kathleen Sebelius, but it was suddenly relocated to the Medicare center after Republicans took Congress. The bureaucratic reshuffling was likely meant to counter GOP attempts to defund the office, which has nothing to do with Medicare (2/4). 

The Arizona Republic: Restore Funding That Saves Lives
Nearly 100 Arizonans were on the waiting list when the state cut off funding last year for pancreas, liver, heart, lung and bone-marrow transplants. The issue for them isn’t data, it’s life or death… Gov. Jan Brewer insists that the small sum necessary to provide transplant coverage for a handful of desperately ill Arizonans – an estimated $1.4 million this fiscal year – can’t be discussed separately from the overall state budget. This is one of the rare times, though, when the alternative to funding is death (2/4). 

San Francisco Chronicle: California’s Nursing Shortage Hasn’t Been Fixed
As each state’s economy recovers, each will be hit with an increase of vacancies in both registered nurse and faculty nursing positions as Baby Boomers retire. Many have closed their eyes to the ripple effect of today’s nursing shortage, but it is impossible to discuss the need for more nurses without looking to how this will change the future of health care. We might stumble upon a solution that will enable each state to fill the gap by tomorrow, but we will still be left with the problems stemming from today and yesterday (Randy M. Caine, 2/4).

The Washington Post: Putting Fraud In Global Health Spending In Context
When scandals fit preexisting ideological narratives, they assume a life of their own. This particular narrative – the story of useless, wasted aid – is durable. It is also misleading and might be deadly. The Global Fund controversy illustrates the point. … the $34 million in fraud that has been exposed represents about three-tenths of 1 percent of the money the fund has distributed. The targeting of these particular cases was not random; they were the most obviously problematic, not the most typical (Michael Gerson, 2/4). 

Kaiser Health News: Blumenthal To Leave Obama’s Health IT Office
Kaiser Health News staff writers Phil Galewitz and Christopher Weaver report: “Dr. David Blumenthal, appointed by President Barack Obama to speed the health care system’s switch from paper to electronic records, announced Thursday that he is stepping down this spring to return to his teaching post at Harvard University” (Galewitz and Weaver, 2/3).

Kaiser Health News: States May Face Showdown With Feds Over Cutting Medicaid Rolls
Kaiser Health News staff writers Marilyn Werber Serafini and Julie Appleby report (in an updated story): “The Obama administration Thursday offered to help budget-strapped governors find ways to reduce Medicaid costs, but did not agree to urgent requests to sharply cut eligibility for the program, which covers 48 million poor, disabled and elderly people” (Werber Serafini and Appleby, 2/3).

The Washington Post: Virginia To Seek Expedited Supreme Court Review Of Suit Over Health-Care Law
Virginia will ask that the U.S. Supreme Court immediately review the state’s constitutional challenge to the federal health-care overhaul, a rare legal request to bypass appeals and ask for early intervention from the nation’s highest court, Attorney General Ken T. Cuccinelli II said Thursday (Helderman, 2/3).

The New York Times: Virginia To Ask Supreme Court To Rule On Health Law
Virginia’s attorney general announced on Thursday that he hoped to bypass an initial appellate review by asking the United States Supreme Court to consider the constitutionality of the Obama health care law on an expedited basis (Sack, 2/3).

The Wall Street Journal: Health Foes Try Divergent Tactics
States challenging the massive health-care law enacted last year are employing different tactics in their push for swift Supreme Court review of their legal cases (Kendall, 2/4).

The Washington Post: Activists Slowly Chip Away At Health-Care Law
For Marilyn Shacter, 66, a homemaker and tea party activist in Raleigh, N.C., the Senate’s vote to repeal the national health-care overhaul was anything but symbolic – no matter how shy the final tally. Wednesday’s vote was another in a series of steps to overturn a law that Shacter and others say eventually will fall. It put Democrats who might be vulnerable in 2012 on record voting against repeal. And it gave tens of thousands of activists still fuming over the health-care legislation a reason to stay passionate, engaged and organized (Gardner, 2/3).

Los Angeles Times: Obama Administration Offers States Ideas On How To Cut Medicaid
Facing a revolt from states confronted by huge budget shortfalls and tattered healthcare safety nets, the Obama administration is intensifying a drive to help state leaders wring savings from their Medicaid programs (Levey, 2/4).

The New York Times: Governors Get Advice For Saving On Medicaid
Fearing wholesale cuts in Medicaid by states with severe budget problems, the Obama administration told governors on Thursday how they could save money by selectively and judiciously reducing benefits, curbing overuse of costly prescription drugs and attacking fraud (Pear, 2/3).

Check out all of Kaiser Health News’ e-mail options including First Edition and Breaking News alerts on our Subscriptions page.

The Washington Post: Senate Rejects Repeal Of Health-Care Law As Fight Shifts To Court
On Capitol Hill, the battle over the health-care overhaul law has become a kind of scripted political theater. On Wednesday, Republicans in the Senate tried to repeal the law, as expected. Democrats had the votes to beat them, as expected. But now, the legal fight over the law threatens to overshadow the drama that Washington has been rehearsing (Fahrenthold and Aizenman, 2/3).

The Associated Press: GOP: Repeal Defeat Is Step Toward Victory In 2012
To hear Senate Republicans tell it, the defeat of their attempt to repeal the Democrats’ health care overhaul was really a victory of sorts on the long the march to the 2012 congressional and presidential elections. The repeal effort sank Wednesday along party lines. … But in the process, Republicans forced Democrats on the record in favor of President Barack Obama’s signature overhaul and launched what they described as a two-year effort to discredit it in the lead-up to a bid for a second term (Kellman, 2/3).

USA Today: GOP Senators’ Effort Fails To Repeal Health Care Law
An effort Wednesday by Republican senators to repeal last year’s health care law failed as expected, but some political watchers say the vote may help influence the courts that will ultimately decide the law’s fate (Kennedy, 2/3).

The Hill: GOP Plans ‘Unrelenting’ Repeal Effort, Even After Senate Defeat
Senate Republicans have vowed a sustained, unrelenting push to repeal President Obama’s health care reform law, despite falling short in their first effort Wednesday. Republicans say they are not content to wait idly until the Supreme Court rules on the constitutionality of the health care law in 2012 or later (Bolton, 2/3).

Reuters: U.S. Senate Rejects Bid To Repeal Health Care Law
President Barack Obama’s fellow Democrats in the U.S. Senate blocked a Republican bid on Wednesday to repeal his health care overhaul, a year-old law whose ultimate fate likely rests with the U.S. Supreme Court. On a party-line vote of 51-47, the Senate rejected a Republican measure to rescind the law that aims to provide more than 30 million uninsured Americans with medical coverage while requiring nearly all to be insured or pay a fine. Sixty votes were needed to clear a procedural hurdle against repeal (Smith and Ferraro, 2/2).

The New York Times: Senate Rejects Repeal Of Health Care Law
Senate Democrats on Wednesday defeated a bid by Republicans to repeal last year’s sweeping health care overhaul, as they successfully mounted a party-line defense of President Obama’s signature domestic policy achievement (Herszenhorn, 2/2).

Los Angeles Times: Senate Rejects GOP-Led Bid To Repeal Health Care Law
Senate Democrats on Wednesday turned aside a bid by Republicans to repeal the new health care law, in the first Senate test of the sweeping overhaul that President Obama signed in March. The 47-51 party-line vote on a procedural motion came two weeks after House Republicans pushed a repeal resolution through that chamber (Levey, 2/2).

The Wall Street Journal: Senate Votes Down Health Care Repeal
The Senate on Wednesday voted against repealing the health-care overhaul but approved a measure eliminating a tax requirement that had irked small businesses. In a debate reshaped by this week’s court strike against the law, the Senate voted 51-47 against repeal. All of the chamber’s Democrats who were present and one independent who caucuses with them voted against it, and every Republican voted for it. The measure, which Republicans tacked on to an unrelated aviation bill, had been expected to fail (Adamy, 2/3).

Bloomberg: Democrats In U.S. Senate Thwart Republican Bid To Repeal Health Care Law
The 2010 overhaul, which would expand health insurance coverage to another 32 million Americans, is President Barack Obama’s biggest domestic achievement. Republicans campaigned against it in last year’s elections as an unwarranted expansion of government and cite the issue as a major reason they won the House majority and picked up six Senate seats. Republican leaders vowed to continue bringing up measures designed to dismantle the law, contending that over time they can force the wall of Democratic support for it to crumble (Litvan, 2/2).

McClatchy: Senate Rejects GOP Bid To Repeal Health Care Law
The Senate on Wednesday rejected the Republican effort to repeal the 2010 health care law, a vote likely to reverberate politically, as both sides used the debate to make partisan points they see boosting them for 2012 elections. The final vote was 51-47 against repeal, which needed 60 votes to pass. The outcome was no surprise, since Democrats control 53 of the Senate’s 100 seats, and none supported repeal. But the two days of partisan bickering over the measure underscored how this issue continues to dominate political discussion and is likely to for some time. The Senate did agree to one change Wednesday, voting 81 to 17 to repeal a paperwork requirement that business interests found chafing (Lightman, 2/2).

Detroit Free Press: Senate Votes In Favor Of Measure To Remove Provision From Health Care Reform Bill
The U.S. Senate voted 81-17 in favor of a measure that removes from last year’s health care reform bill a provision that businesses complained would swamp them in paperwork beginning next year. The so-called 1099 provision would require businesses to file tax forms listing every purchase they make over $600 — in what was initially seen as a way to make sure company vendors were reporting their actual income. But businesses — especially small business owners — complained it would mean tons of additional paperwork they’d have to send each year to the Internal Revenue Service. Michigan’s Debbie Stabenow, a Democrat, sponsored the amendment to a Federal Aviation Administration bill that strips the provision — which would go into effect next year — from the law (Spangler, 2/2).

Modern Healthcare: Senate Rejects Reform Repeal; Measure To Kill 1099 Provision OK’d
The Senate on Wednesday rejected a Republican-sponsored amendment to repeal last year’s Patient Protection and Affordable Care Act. Senator Minority Leader Mitch McConnell (R-Ky.) had introduced the amendment, a measure that was identical to the health care reform repeal bill that the U.S. House of Representatives passed late last month. Had the Senate amendment passed, it would have been attached to an air traffic safety bill. … One of the law’s mandates that many have found burdensome — the contentious 1099 reporting provision — was the topic of another Senate vote on Wednesday. The Senate voted 81 to 17 to approve Sen. Debbie Stabenow’s (D-Mich.) amendment to repeal that provision in the law, which requires American businesses to file a form with the Internal Revenue Service for every vendor with which they conduct transactions worth $600 or more (Zigmond, 2/2).

The Washington Post: The Fact Checker: McConnell’s Claims Of Wide Backing For Health Care Repeal
The Republican leader in the Senate on Wednesday pressed his party’s case for repeal of the new health care law, arguing that the courts, “the American people,” and “job creators” are demanding repeal. His cadence is excellent. How valid are his claims (Kessler, 2/3).

The Washington Post: The Fact Checker: Harry Reid’s Imaginary $4 Billion Credit To The Health Care Law
Reid argued that it is time to “stop re-fighting yesterday’s fights” and ticked off the benefits that he said were already flowing from the bill, including the claimed $4 billion in restitution and fines. He also argued that repealing the law would “add a trillion dollars to the deficit,” which is a claim we have debunked before. But is it possible that a bill that passed just 10 months ago has already yielded $4 billion from health care fraudsters (Kessler, 2/2).

Kaiser Health News Video: The Senate’s Partisan Debate On Health Reform Repeal
This Kaiser Health News video documents some of the debate. Senate Minority Leader Mitch McConnell, R-Ky., introduced an amendment to an unrelated bill today that would repeal the health law. Senators from both sides took to the floor, with Republicans arguing that the country wants repeal and Democrats maintaining that the benefits of the law are popular and outweigh any flaws in the legislation. Watch excerpts from the debate (2/2).

Related, earlier KHN story: Assessing Cuomo’s Efforts To Cut N.Y.’s Medicaid Budget (Miles, 1/27)

The Dallas Morning News: Texas Businesses Serving Frail Warn Cuts Would Close Their Doors
Business owner after business owner warned Wednesday that proposed cuts would shutter their operations serving Texas’ disabled children and frail adults. The grim warnings came as the Senate Finance Committee opened two days of public comment on GOP leaders’ two-year, $158.7 billion budget proposal. The spending blueprint would reduce payments to some social service providers by more than 30 percent (Garrett, 2/2).

The Texas Tribune: Health Care Advocates Offer Emotional Pleas
From patients and parents to nurses and practitioners, the many faces of Texans affected by potential health care budget cuts gathered at the Capitol today to give an earful to lawmakers on the Senate Finance Committee. The onslaught of emotional testimony appeared to sway some senators, while others had been waiting for such a display (Aaronson, 2/2). (Related) Video: Senators Get Strong Message On Health Funds

California Healthline: Seniors Making Noise Over Budget Cuts
They hit Sacramento in force this week, hundreds of seniors and the disabled, milling in front of the Capitol Building with walkers and wheelchairs, chanting about what they want (senior health services) and when they want it (now!). But most of the political rhetoric in Sacramento has focused on the grim reality of the $25.4 billion deficit and the need to make cuts that no one wants to make. That includes many health services, from establishing Medi-Cal co-pays and putting a hard cap on the number of provider visits allowed (Gorn, 2/2).

The Arizona Republic: Arizona Lawmakers Grapple With Cut In Transplant Coverage
Arizonans who lost coverage for lifesaving organ transplants had political winds at their backs last fall, with national media attention and a sympathetic key Republican lawmaker. But Rep. John Kavanagh’s support has evaporated, and there now appears little chance legislators will restore funding to return nearly 100 people to waiting lists for heart, liver, bone-marrow and lung transplants (Reinhart, 2/3).

Connecticut Mirror: Nursing Homes Offer Plan To Raise Their Revenues, At The Right Price
The state’s largest nursing home association says it has a plan to boost funding for the struggling industry by 4 percent at just the right price for the state–nothing. … The association’s plan hinges on what is commonly known as the “provider tax,” a back-and-forth revenue arrangement that Connecticut and many other states use to leverage additional federal aid (Phaneuf, 2/2).

WBUR in Boston: Provider Shortage Leaves Parents Searching, Doctors Overwhelmed
More often than not what many parents hear when they’re looking for a children’s mental health care professional is a voice recording saying the doctor isn’t in: “I will not be making calls back to new clients at this time due to the volume of calls I’m presently receiving.” Accessing care is arguably the biggest problem in the children’s mental health system (Becker, 2/3).

San Francisco Chronicle: California Ranks Near Bottom In Kids’ Health Care
California fares poorly when it comes to delivering health care to children, especially those from low- and middle-income families, according to a report released today. The study, by the Commonwealth Fund, ranked the state 44th in comparison with the other 49 states and the District of Columbia. The study found California especially inadequate in delivering affordable care for children (Colliver, 2/2).

Health News Florida: Scott Roils Medical Board — Again
Gov. Rick Scott ousted the chair and vice-chair of the Florida Board of Medicine on Wednesday, just two days before they were to lead disciplinary hearings against dozens of physicians charged with wrongdoing. It’s not clear whether Scott’s action will interfere with the hearing (Gentry, 2/3).  

Los Angeles Times: Obama Administration Offers States Ideas On How To Cut Medicaid
Facing a revolt from states confronted by huge budget shortfalls and tattered health care safety nets, the Obama administration is intensifying a drive to help state leaders wring savings from their Medicaid programs (Levey, 2/4).

The New York Times: Governors Get Advice For Saving On Medicaid
Fearing wholesale cuts in Medicaid by states with severe budget problems, the Obama administration told governors on Thursday how they could save money by selectively and judiciously reducing benefits, curbing overuse of costly prescription drugs and attacking fraud (Pear, 2/3).

Kaiser Health News: States May Face Showdown With Feds Over Cutting Medicaid Rolls
Kaiser Health News staff writers Marilyn Werber Serafini and Julie Appleby report (in an updated story): “The Obama administration Thursday offered to help budget-strapped governors find ways to reduce Medicaid costs, but did not agree to urgent requests to sharply cut eligibility for the program, which covers 48 million poor, disabled and elderly people” (Werber Serafini and Appleby, 2/3).

CQ HealthBeat: Sebelius Reminds Governors Of Ways To Cut Medicaid Costs Without Slashing Eligibility
In the face of pressure from governors who want to cut Medicaid spending, federal health officials on Thursday sent information to state officials explaining how current law allows them to change the federal-state program. The effort seemed designed to persuade governors not to take draconian steps that would slash benefits and eligibility for low-income people (Adams, 2/3).

The Hill: Sebelius Offers Alternatives To Medicaid Waivers
In a new letter to the nation’s governors, President Obama’s top health official is trying to dampen calls from states for the federal government to loosen Medicaid requirements (Millman, 2/3).

Bloomberg: U.S. States To Be Allowed To Reduce Medicaid To Help in Balancing Budgets
The Obama administration is encouraging U.S. states to reduce health benefits to the poor instead of trimming eligibility for Medicaid, according to a letter to governors sent today. The administration’s message is an attempt to preserve access to Medicaid, the federal-state health program for the poor, while balancing states’ financial concerns, according to the letter sent by Health and Human Services Secretary Kathleen Sebelius. Along with cutting benefits and increasing the share Medicaid patients have to pay to save costs, Sebelius encourages states to save money on drugs, fight fraud, and better manage the most expensive patients (Armstrong, 2/3).

The Associated Press: Feds Give States Menu For Cutting Medicaid
Answering a fiscal 911 call from the nation’s governors, the Obama administration Thursday gave cash-strapped states a menu for cutting Medicaid spending, one of their biggest budget headaches. It didn’t have one item that many governors, particularly Republicans, are looking for. In a letter to governors, Health and Human Services Secretary Kathleen Sebelius was cool to the idea of cutting beneficiaries from the Medicaid rolls by restricting eligibility, as Arizona has requested and other states are considering (1/3).

Meanwhile, Stateline details how some states are using managed care as a cost conscious way to target new populations.  

Stateline: Crushed By Medicaid Costs, States Expand Managed Care
States have been using managed care to cut Medicaid costs for more than 15 years. Up to now, however, the vast majority of plans covered only children and pregnant women — a large, but relatively healthy and inexpensive segment of the more than 60 million people covered by Medicaid. What’s different today is that states are beginning to target new populations for managed care. They include adults with disabilities and seniors who require long-term care, relatively small groups that nevertheless account for the lion’s share of Medicaid costs (Vestal, 2/4).

Related, earlier KHN story: Health Law Expected To Boost Medicaid Enrollees In Managed Care (Galewitz, 11/12/10).

And new research explores how income changes could impact the interplay between Medicaid and insurance exchanges.

Modern Healthcare: Researchers Expect Income Changes To Spur Movement Between Medicaid, Insurance Exchanges
Changes in income among those who will be eligible for subsidized health insurance under the Patient Protection and Affordable Care Act could lead to coverage disruption for about 28 million Americans within the first year as their eligibility shifts between Medicaid and the new state insurance exchanges, according to a study in the journal Health Affairs (Zigmond, 2/3).

Health Affairs: Nearly Half Of Families In High-Deductible Health Plans Whose Members Have Chronic Conditions Face Substantial Financial Burden – “Enrollment in high-deductible plans” is on the rise, yet little is known of “the financial burden experienced by families with children and those with chronic health conditions who participate in high-deductible plans,” according to the authors, who analyzed survey and health plan claims data. They found that 48 percent of families in high-deductible plans experienced financial burden compared to 21 percent of families in traditional plans. And, “[a]lmost twice as many lower-income families in high-deductible plans spent more than 3 percent of income on health care expenses as lower-income families in traditional plans (53 percent versus 29 percent)” (Galbraith et al., February 2011).

Annals of Internal Medicine: Hospital Spending And Inpatient Mortality: Evidence From California – Although previous studies have shown “high Medicare spending is not associated with better health outcomes at a regional level,” less well known is the association between hospital spending and inpatient mortality, according to this study of 208 California hospitals. “For each of 6 diagnoses at admission—acute myocardial infarction, congestive heart failure, acute stroke, gastrointestinal hemorrhage, hip fracture, and pneumonia—patient admission to higher-spending hospitals was associated with lower risk-adjusted inpatient mortality,” the authors write. “Our findings suggest that although greater overall medical spending in the United States is not associated with better quality of care or better health outcomes, specific types of medical spending (for example, acute care hospital spending) may be efficacious,” they conclude (Romley, Jena and Goldman, 2/1).

British Medical Journal: Impact Of A Statewide Intensive Care Unit Quality Improvement Initiative On Hospital Mortality And Length Of Stay: Retrospective Comparative Analysis – This study measured the effects of the implementation of Michigan’s Keystone ICU program, a statewide initiative to reduce infections, on hospital length of stay and death in patients 65 and older admitted to the intensive care units (ICUs). Analysis of Medicare claims data for these patients revealed: “Implementation of the Keystone ICU project was associated with a significant decrease in hospital mortality in Michigan compared with the surrounding area. The project was not, however, sufficiently powered to show a significant difference in length of stay” (Lipitz-Snyderman et al., 1/31).

Health Affairs: Enrolling More Kids In Medicaid And CHIP – “In 2008, 1.7 million children gained coverage through Medicaid and CHIP. This increased coverage was associated with a reduction in the number of uninsured children, despite reductions in employer-sponsored coverage occurring during the same time. Even with this progress, an estimated 7.3 million children were still uninsured in 2008, and 65 percent of them, close to 5 million, were eligible for public coverage, mostly through Medicaid,” according to this policy brief, which highlights some of the challenges parents may face when trying to enroll a child for public health coverage and outlines changes expected with the Medicaid expansion scheduled for 2014 under the new health law. (Cassidy, 1/27).

Institute of Medicine: HIV Screening And Access To Care: Exploring The Impact Of Policies On Access To And Provision of HIV Care – This consensus report “examine[s] the extent to which federal, state, and private health insurance policies inhibit HIV-positive individuals from initiating or continuing their care,” as outlined by the IOM’s Committee on HIV Screening and Access to Care during a public workshop in June. “Although the Affordable Care Act will improve access to HIV care in some respects [such as Medicaid] … it may aggravate the situation in other ways,” such as reduced or cut funding for the Ryan White programs, according to the report. “Current reimbursement policies, particularly under Medicaid, restrict access to providers with HIV/AIDS expertise. Even under the ACA, infectious disease physicians who provide primary care to HIV/AIDS patients may not be able to benefit from advantageous primary care provider reimbursement policies under Medicaid” (Cleary et al., 1/31).

Commonwealth Fund: Securing A Healthy Future: The Commonwealth Fund State Scorecard on Child Health System Performance, 2011 – “Although federal action to extend insurance to children has made a critical difference in reducing the number of uninsured children across states and maintaining children’s coverage during the recent recession … where children live and their parent’s incomes significantly affect their access to affordable care, receipt of preventive care and treatment, and opportunities to survive past infancy and thrive,” write the authors of this report that examines states’ performance on 20 measures assessing “access and affordability, prevention and treatment, and the potential to lead healthy lives.” States scoring in the top quartile in overall performance ranking included Iowa, Massachusetts, Vermont, Maine and New Hampshire while Florida, Texas, Arizona, Mississippi and Nevada scored in the bottom quartile (How et al., 2011).