OVERNIGHT HEALTH: Medicare messaging war reaches crescendo

Medicare, Medicare, Medicare: Senate Democrats hedged Tuesday when asked about House Minority Whip Steny Hoyer’s (D-Md.) statement that Medicare should be on the table as Congress looks for a plan to reduce the deficit. They cited Medicare provisions in the healthcare reform law that they say extended the life of the program, but didn’t specify any further cuts they might be willing to entertain. Instead, the day was focused on the continuing partisan battle to define a Senate vote on the House GOP’s budget proposal — and its Medicare component.

Republican leaders tried to downplay the vote as mere politics, while Democrats kept up their effort to hang the controversial Medicare voucher program on the entire GOP. Democratic leaders said it’s no longer Rep. Paul Ryan’s (R-Wis.) budget proposal, but the Republican party’s. Healthwatch’s Sam Baker has the story.

Biden talks: Meanwhile, the liberal group MoveOn.org sent emails to its supporters Tuesday urging them to pressure Democrats in Vice President Biden’s deficit working group to fight any cuts to Medicare. Read the Healthwatch story.

IPAB support: Several dozen economists signed on to a letter to the leaders of both chambers urging them not to repeal, but rather “strengthen,” a provision of the healthcare reform law that empowers a board of experts to recommend cuts to Medicare payments to providers if the program’s costs grow too fast. Republicans say the Independent Payment Advisory Board amounts to unelected bureaucrats rationing care, and several Democrats have joined onto legislation to repeal it.

“Public programs must be accountable to elected officials,” the letter reads. “But to carry out its job effectively, Congress should mobilize the expertise of professionals who can assemble evidence on how payment incentives affect care delivery and suggest sensible improvements. The IPAB is constituted to make such professional expertise available to the Congress.”

FDA budget cut: The House Agriculture Appropriations subcommittee on Tuesday approved major cuts to the Food and Drug Administration. The panel voted to cut the agency’s budget by 11.5 percent, or roughly $285 million.

Food safety cuts raise concerns: A broad coalition of consumer and industry advocates warned before the markup that the FDA won’t be able to fulfill its mission to keep the nation’s food and medicines safe if the funding levels in the House GOP budget are adopted. Under the proposed bill, FDA funding would be cut by $285 million from its FY 11 level of $2.457 billion.

House cuts primary care investment: The House approved along party lines legislation that would replace funding for graduate medical education in the healthcare reform law with an annual appropriation. The bill is part of the GOP’s to defund the healthcare reform law by either rescinding provisions altogether or giving the spending authority back to Congress.

Timing is everything: The vote comes just as the Journal of the American Medical Association published a study that found Medicare patients living in areas with higher levels of practicing primary care physicians have lower death rates and make fewer trips to the hospital for preventable conditions. 

Health centers worried: The National Association of Community Health Centers wrote to House leaders of both parties ahead of the vote to remind them that increasing the number of primary care doctors is a key priority for Democrats and Republicans. Community centers need another 15,000 primary care doctors and other professionals to meet demand, their letter says.

“We are heartened that this bill does not seek to eliminate the program,” their letter reads. “(H)owever, we are concerned that any change to the funding model for the Teaching Health Centers (THC) program will undermine the legislation’s two key policy goals: (1) cultivating and supporting the primary care workforce in order to reduce the current severe shortage of primary care providers, and (2) training physicians in the very settings where they will ultimately practice medicine and where they are most needed later in their careers.”

No veto: The Obama administration is not threatening to veto the medical bill. Read the Healthwatch story.

ACO do-over? Seven Republican senators demanded Tuesday that federal regulators scrap proposed regulations on care coordination and start over.

The request comes as a growing number of hospitals and clinics are warning that a proposal to reward them for the quality rather than quantity of care they provide is unworkable. The so-called Accountable Care Organizations are a centerpiece of the healthcare system reforms called for by the Democrats’ healthcare law, but hospitals say the proposed regulation is too costly and stringent for them to consider participating. Healthwatch’s Julian Pecquet has the story and the letter.

FDA scrutiny: Senate Aging Chairman Herb Kohl (D-Wis.) praised FDA Commissioner Margaret Hamburg for requiring post-market surveillance of some hip implants, but said it’s just a start.

“FDA should continue to advance its surveillance of high-risk devices,” he wrote in a letter, “especially those that have been approved through the fast-track, 510(k) process.”

CMS’s “atrocious” DME job: That’s what the Medicare agency is doing with competitive bidding for durable medical equipment, University of Maryland economics professor Peter Cramton told some 60 Hill staffers. Legislation to repeal the program now has 103 co-sponsors.

States get involved in DC healthcare challenge: Texas and 13 other states filed an amicus brief in the D.C. Court of Appeals in defense of five individuals who are challenging the healthcare reform law on religious and other grounds. The court is due to hear the case in September.

“The Patient Protection and Affordable Care Act is an extraordinary law that rests on unprecedented assertions of federal authority, pushing even the most expansive conception of the federal government’s constitutional powers past the breaking point,” says the brief. “The federal government embraces a sweeping view of the Commerce Clause … that would imperil individual liberty, render Congress’s other enumerated powers superfluous, and allow Congress to usurp the general police power reserved to the States.”

Health reform saves you money: $2 billion, to be exact. So says a new report released by Sen. Jay Rockefeller (D-W.Va.) that looks at how much Americans would have saved had the law’s requirement that insurance plans spend a minimum amount on medical care been in effect in 2010.

Wednesday’s agenda: 

Across state lines: The Energy and Commerce Health subcommittee meets in the morning for a hearing on the drawbacks and benefits of allowing consumers to buy health plans across state lines. The idea is a key plank of Republican healthcare reform efforts, along with medical malpractice reforms.

A memo from the panel says allowing such sales would increase competition and choice, drive down prices and could reduce the number of uninsured people by 12 million. 

Steve Larsen, the director of the CMS office implementing the healthcare law’s insurance reforms, will testify that “there are serious pitfalls” to the idea absent “adequate consumer protections.”

“The Affordable Care Act allows health care to be sold across State lines when both States agree and consumer protections are maintained,” Larsen says in his written testimony. “Without the consumer protections included in the Affordable Care Act, we run the risk of creating an environment where there is a ‘race to the bottom’ in which insurers have an incentive to sell plans from the State with fewest consumer protections.”

It’s personal: At noon, the Personalized Medicine Coalition and the House Medical Technology Caucus host a congressional briefing to members of Congress and congressional staff about personalized medicine, the tailoring of medical treatment to the individual characteristics of each patient in order to make healthcare better and more efficient.

Lobbying registrations: 

The Glover Park Group / Presbyterian Healthcare Services

The Wrenwood Group / US Against Alzheimer’s (education and advocacy group)

Valente and Associates / American Academy of Physician Assistants

Reading list: 

The Huffington Post skewers Rep. Rob Woodal (R-Ga.) for telling a constituent seniors should plan to take care of their health needs on their own rather than rely on Medicare.

Pfizer, Lilly, Sanofi Amgen and others are named in a clinical trial death compensation inquiry in India, reports the Pink Sheet (subscription required). 

What you might have missed on Healthwatch: 

Medical device makers are turning to Europe over concerns with FDA process.

Comments / complaints / suggestions?

Please let us know:

Julian Pecquet: jpecquet@digital-staging.thehill.com / 202-628-8527

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

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