Morning Briefing
Summaries of health policy coverage from major news organizations
Viewpoints: Obama's Budget And Entitlements; A Guide To Health Law Case At The Supreme Court
Although Congress has already rejected a number of those ideas, Obama is right to press lawmakers to reframe the budget debate. ... Meanwhile, the growing cost of federal healthcare programs and other entitlements is leaving a diminishing pot of funds for other federal priorities. Obama's budget seeks to slow the growth of Medicare and Medicaid, but his cost cutting wouldn't solve the long-term problems in federal entitlements or end the year-in, year-out accumulation of debt. That's a real shortcoming. (2/2)
The great unmentionables in Mr. Obama鈥檚 budget are entitlements, which roll on largely untouched. The share of the budget that is 鈥渕andatory鈥濃攏ot part of annual appropriations鈥攊s 15.1% of GDP in 2016 and jumps to 16.6% by 2020, gradually crowding out everything else the government is supposed to do. Medicaid spending will nearly double to $567 billion in 2025 from $301 billion in 2014. Most of that is ObamaCare. Meanwhile, the Social Security 鈥渙ff-budget surplus鈥 that has long financed current spending on everything except retirement is shrinking and goes negative in 2017. This means senior benefits will soon have to be paid out of general tax revenues. (2/2)
The real problem is that neither Obama nor Congress wants to tackle the cost of popular entitlements such as Medicare, Medicaid, Social Security, food stamps and veterans' benefits. Those programs are surging in cost because the number of retirees is growing and because health care costs have, until recently, risen much faster than inflation. But mostly, they are going up because they operate on autopilot. Together, the entitlements are expected to cost a staggering $2.3 trillion this year, according to CBO. That's three-fifths of all spending. In 10 years that figure is forecast to hit $3.6 trillion 鈥 nearly the cost of Obama's entire budget. Early in his presidency, Obama claimed to care about that danger. (2/2)
And at a time when senior poverty is increasing, we must expand, not cut, Social Security, Medicare and Medicaid benefits. As most Americans know, billionaire campaign contributors and corporate lobbyists exercise enormous influence in Washington, which is why the rich get richer while almost everyone else gets poorer. Enough is enough! Let's join together and fight for a budget that helps working families, and not just the top 1%. (Sen. Bernie Sanders, I-Vt., 2/2)
This spring, the Supreme Court will rule in a case that could devastate Obamacare's health insurance expansion. Here's The Upshot's guide to the King v. Burwell case. (Margot Sanger-Katz, 2/3)
A bunch of people are about to find out that they got too much in subsidies, and now they owe the IRS hundreds, possibly even thousands, of dollars. Many of those people won't have the money, and they are about to get very upset. So the Barack Obama administration did what it has done before: nursed the program forward with administrative rulings that minimize the political blowback. Presumably the idea is that by the time it actually lets the cost side take effect, so many people will be getting subsidies that it will be effectively impossible to repeal. (Megan McArdle, 2/2)
Gov. Steve Bullock made waves with the unveiling of his 鈥淗ealthy Montana Plan,鈥 which would expand Medicaid under the Affordable Care Act. He and his allies support the plan with claims the expansion will be accomplished with 鈥渇ree money鈥 from the federal government and will provide high-quality health care to 70,000 people. But Montanans should not be fooled. This is nothing more than ObamaCare by another name 鈥 and it will cost Montana taxpayers hundreds of millions of dollars and do little to improve the health conditions of the most vulnerable. (Zachary Lahn, 2/2)
Daughters of Charity Health System, a Catholic nonprofit that operates six hospitals primarily for poor and elderly Californians, is reaching the last bead on its fiscal rosary. The chain is losing money at an alarming rate and wants to sell itself to Prime Healthcare Services, but prominent Democrats and a powerful union have called on Atty. Gen. Kamala Harris to block the deal. For all its faults, however, Prime remains the best hope for keeping the six hospitals open and their vital services operating. Harris should approve Prime's purchase with conditions designed to keep it from abandoning the Daughters' mission and abusing the healthcare system. (2/2)
When Pope Francis put in a word for 鈥渞esponsible parenthood鈥 on his way back from the Philippines the other day, he added an off-the-cuff remark that grabbed headlines: Catholics, he said, do not need to breed 鈥渓ike rabbits.鈥 The problem, however, is precisely the opposite: If only Catholics could breed like rabbits. Given rabbit biology, and the church's restrictions on contraception, that would make 鈥渞esponsible parenthood鈥 easier for the faithful to accomplish. (Malcolm Potts, 2/2)
As we wrote last week, many fewer people benefit from medical therapies than we tend to think. This fact is quantified in a therapy鈥檚 Number Needed to Treat, or N.N.T., which tells you the number of people who would need to receive a medical therapy in order for one person to benefit. N.N.T.s well above 10 or even 100 are common. But knowing the potential for benefit is not enough. We must also consider potential harms. (Aaron E. Carroll and Austin Frakt, 2/2)
The message from supporters and the media is clear: Like women's rights, voting rights, gay marriage and hikes to the minimum wage, it's only a matter of time before physician-assisted suicide becomes legal because, after all, it is the right thing to do. If this bill [introduced in the California Assembly] fails, supporters promise a ballot initiative in 2016. As someone who supports all those other liberal causes, yet opposes physician-assisted suicide, I'd ask my fellow progressives to shine a cold hard light on this issue. We have been the target of a decades-long branding campaign that paints hastening death as an extension of personal freedoms. We should bring the same skepticism to physician-assisted suicide that we do to fracking and genetically modified food. (Ira Byock, 1/30)