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House and Senate Republicans release their 2016 budgets this week, mapping out a conservative blueprint for shrinking federal spending and challenging the vision laid out by President Barack Obama in his budget last month. ... If House and Senate Republicans can agree on a budget, they would be able to tap into a procedural shortcut known as reconciliation, which would enable the GOP to bypass Senate Democrats on related legislation, likely including changes to the Affordable Care Act. Should internal GOP fissures derail passage of the budget resolution, the party’s best chance at sending its most conservative bills to Mr. Obama’s desk this year is gone. (Peterson and Timiraos, 3/15)

Republicans now in charge of Congress offer their budget blueprint this week with the pledge to balance the nation's budget within a decade and rein in major programs such as food stamps and Medicare. More pressing for many Republicans, however, is easing automatic budget cuts set to slam the military. (3/16)

The idea is to pass a budget this month that sticks to the spending caps, but then negotiate a budget law this summer that ends sequestration. The $540 billion in cuts still to come under the Budget Control Act would be replaced by savings from entitlement programs like Medicare and Social Security as well as new revenue from closing some tax loopholes.(Weisman, 3/15)

In the House, Speaker John Boehner of Ohio, Majority Leader Kevin McCarthy of California and Majority Whip Steve Scalise of Louisiana are stuck between the budget-cutting demands of conservatives and the desire of defense hawks to provide the military with more robust funding. In the Senate, Republicans are already getting hit by Democrats after indicating they’ll target Medicaid and food stamps. (Kim and Sherman, 3/15)

First up is a nonbinding measure called a budget resolution. It sets out, in broad strokes, goals for spending, tax revenues and changes to crucial programs like Medicare, Medicaid, food stamps and student loans as well as the health care law. Lawmakers in the House and Senate vote on the resolution, but it stays in Congress, never reaching the president's desk. Instead, it requires follow-up legislation to implement any changes proposed by the resolution, and that's often a major challenge. (3/16)

New Jersey Gov. Chris Christie (R) told leading GOP policy analysts this week that he will make overhauling Medicare, Social Security and other long-term entitlement programs a centerpiece of his likely presidential campaign, according to participants in the talks. Christie’s decision to embrace a politically risky campaign theme is central to an attempt to revive his wilting national prospects, according to people familiar with his plans. (Costa, 3/13)

In a rare display of bipartisanship, House leaders are actively pursuing a deal to permanently change the way Medicare pays doctors and extend a children’s health program for two years. ... While details are still being ironed out, the basic contours are clear: The plan would permanently eliminate the Sustainable Growth Rate, the outdated formula that calls for frequent and deep cuts to Medicare providers, and replace it with a new payment system. This is a priority for both parties to end the need for frequent “doc fixes.” The plan would also extend funding for two years for the Children’s Health Insurance Program, which is set to expire in September. (Haberkorn and Rogers, 3/15)

House leaders are closing in on a deal to permanently avert cuts in payments to physicians under Medicare, two House aides confirmed Friday. The deal would offset only about $70 billion of the more than $200 billion cost of making the permanent fix, however. This would likely draw opposition from conservatives over budget concerns. (Ferris and Sullivan, 3/13)

Democratic senators would oppose a potential House bipartisan deal preventing cuts in physicians' Medicare payments if it doesn't finance a children's health program for four years, senior Senate Democratic aides said Sunday. The aides issued the threat as House bargainers try preventing a 21 percent reduction in doctors' Medicare reimbursements scheduled for April 1. Negotiators want to craft an agreement annulling a 1997 formula that annually threatens deep cuts in those payments. (Fram, 3/15)

The doctors who treat Medicare patients would avoid a cut in their government reimbursements under a proposal to be presented to U.S. House members next week, according to Republican and Democratic aides. The bipartisan $200 billion framework to replace Medicare’s cost-containment formula for doctor reimbursement was negotiated by House leaders of both parties and members of the committees with jurisdiction over Medicare. (Rowley, 3/13)

With a deadline fast approaching, bipartisan negotiations are heating up in the House to find a permanent replacement for Medicare’s physician payment formula. But the tentative package being hammered out behind closed doors contains some key provisions that are likely to raise objections from both Republicans and Democrats. Unless Congress takes action by the end of this month, doctors who treat Medicare patients will see a 21 percent payment cut. (Carey, 3/16)

There are things that happen every year even though they don’t have to — or clearly shouldn’t. That includes the annual crisis over adjusting the payments to Medicare providers, which is now looming again over Capitol Hill. Unless Congress takes action by the end of the month, reimbursement levels will drop by 21 percent. (Garver, 3/13)

A planned overhaul of Medicare payments to long-term hospitals doesn’t go far enough, a congressional advisory panel said, and it called for further changes to discourage timing patients’ discharges to financial incentives. Long-term-care hospitals get smaller payments for short visits, but after patients stay for a certain number of days the payments jump to much larger lump sums. (Weaver, Wilde Mathews and McGinty, 3/15)

The Supreme Court case will decide whether consumers in the 34 states that use the federal marketplace can continue to receive tax credits to help pay for their coverage. Plaintiffs argue that the subsidies can go only to people in the 16 states, plus Washington, D.C., that operate their own health insurance marketplaces. If the plaintiffs prevail, an estimated 5.6 million people will lose their tax credits next year in the 15 HealthCare.gov states where Hospital Corporation of America has facilities, according to the Urban Institute, a centrist research center. (Pugh, 3/13)

The Internal Revenue Service warns that unscrupulous tax preparers have told consumers to pay them directly instead of the federal government to settle potential fines assessed to those who don't have health insurance. (Soules, 3/15)

Unscrupulous tax preparers are using President Barack Obama's health care law as a ploy to pocket bogus fines from unsuspecting taxpayers, including some immigrants not bound by the law's requirements, the IRS warned Friday. In an advisory, the tax agency said consumers can be sure something is wrong when a tax preparer says they collect the health law fines that may be due the government. The law requires virtually everybody in the country to have coverage or risk fines. (Alonso-Zaldivar, 3/13)

As the Affordable Care Act pushes doctors and hospitals to join forces to slash health care costs, those with the least-expensive solutions say they're still largely being ignored. Community health groups and companies that specialize in healthy eating and fitness are arguing for more recognition of non-medical ways to prevent and treat chronic conditions such as diabetes, hypertension and heart disease. Physicians and hospitals are rapidly forming what's known as accountable care organizations (ACOs) to reduce the duplication of services and keep large groups of patients well. But community groups, which could be far less expensive partners, have to fight for a "seat at the table" on the doctor-dominated boards of ACOs, according to a 2014 report by a North Carolina physicians' coalition. (O'Donnell and Ungar, 3/15)

When Peter and Alison Roithmayr logged onto healthcare.gov to buy insurance in December, they were impressed with the new, user-friendly Affordable Care Act website. The Malvern couple, who had bought a plan in 2013 on the error-prone website, noted how healthcare.gov had improved and "let you do a nice comparison" of plans. (Calandra, 3/15)

Several million people hit with new federal fines for going without health insurance will get a second chance to sign up starting Sunday, and that could ease the sting of rising penalties for being uninsured. But as the enrollment window reopens, it's unclear how many know about the time-limited opportunity, let alone will take advantage of it. (Alonso-Zaldivar, 3/15)

The Obama administration and health reform advocates are gearing up for a new push to sign people up for the Affordable Care Act as enrollment reopens on Sunday for a limited time. The so-called “special enrollment period” begins Sunday and ends on April 30. It is designed to fall around tax-filing season, giving people a chance to sign up if they realize only while filing their taxes that they have to pay a penalty for not having insurance. (Sullivan, 3/14)

A House committee voted along party lines Sunday to allow the state’s Medicaid expansion to expire on Dec. 31, 2016. a move a spokesman for Gov. Maggie Hassan called “misguided.” Hassan had called for the expansion to be extended as part of her proposed fiscal year 2016-2017 budget. During a Sunday budget review session, members of the House Finance Committee, Division III, voted 6-3 to remove an item from the budget that would have extended Medicaid expansion in the state into 2017 and beyond. Six Republicans voted to end the program, while three Democrats voted to extend it. (Feely, 3/15)

For weeks, state Sen. Todd Gardenhire of has felt activists' wrath for voting with six other GOP senators on a Senate panel to kill fellow Republican Gov. Bill Haslam's Insure Tennessee proposal. Advocates held a mock funeral outside his Chattanooga office in early February and followed up with a prayer service in front of GOP headquarters here while he was speaking about his vote to local Republicans. Someone also chalked graffiti outside his downtown office. (Sher, 3/16)

After two years of failing to convince Republican lawmakers to expand Medicaid in Missouri, Gov. Jay Nixon is pitching an alternative he hopes will sway enough of them to come aboard. But key Republicans remain cool to the idea. (Griffin, 3/15)

An aggressive price cut by Colorado's nonprofit health insurance cooperative this year led to it capturing the biggest market share of the state exchange, but analysts warn the move carries financial risk. A similar co-op serving Iowa and Nebraska was shut down by regulators in January after heavy losses, and the Colorado HealthOP's losses were even greater when compared to its remaining funds, according to one analysis report. (Draper, 3/16)

Health plans that don’t comply with the Affordable Care Act no longer will be allowed in Colorado after this year. The decision will affect about 190,000 people. (Kerwin McCrimmon, 3/13)

Almost a year after ordering a massive shake-up of the Veterans Affairs Department, President Obama gave one troubled outpost a once-over Friday to see whether his massive staff housecleaning led to improvements. In a trip to the VA hospital in Phoenix, where a whistle-blower exposed the existence of waits so long that dozens of veterans may have died awaiting treatment, Obama declared that his new VA leadership was “chipping away at those problems.” (Parsons and Memoli, 3/13)

The nation’s largest hospital system has made only halting progress in hiring new doctors, replacing incompetent supervisors, upgrading outdated computers and rebuilding trust with veterans, nine months after President Obama concluded that a “corrosive culture” had led to systemic problems at hospitals run by the Department of Veterans Affairs. Now, patients, veterans groups and doctors say delays in receiving care are still common, and they accuse department officials of failing to provide opportunities to see private doctors. Critics, including Republican lawmakers on Capitol Hill, say far too few senior managers have been held accountable for mismanagement at the hospital in Phoenix and at others around the country. (Shear and Philipps, 3/13)

President Obama’s visit to the Department of Veterans Affairs hospital that was the epicenter of last summer’s nationwide scandal highlighted the work that VA must still do to weed out incompetent executives and win back the confidence of veterans. ... The president pointed to signs of progress over the past nine months: More doctors have been hired, and waiting times have been cut at some VA facilities. But the focus of Obama’s visit to Phoenix was the problems that remain. The president talked about the need to continue improving mental health care and suicide prevention programs for veterans, as well as changing a culture in which veterans’ needs were too often ignored. (Jaffe, 3/13)

Amid persistent complaints about veterans' health care, President Obama acknowledged lingering weaknesses Friday in the federal government's response to the chronic delays and false waiting lists that triggered a national outcry last year over the Veterans Affairs health system. Obama said that while VA Secretary Robert McDonald was "chipping away" at the problem, it was clear there was still more work to do. (Kuhnhenn and Hoffner, 3/14)

A year after explosive accusations that patients had died waiting for appointments at the VA Medical Center in Phoenix, Arizona, the administration’s path to making health care more accessible for America’s veterans remains on shaky ground. (Vlahos, 3/15)

Veterans Affairs Department officials are investigating whether patients have been exposed to antibiotic-resistant superbugs from tainted medical scopes in the wake of several hospital outbreaks. The VA said Friday it began looking into the possibility of patient infections in late February after a deadly outbreak was disclosed at UCLA's Ronald Reagan Medical Center. (Terhune, 3/13)

The Department of Veterans Affairs medical center in Denver has generated more appeals than any other VA hospital for denials of financial assistance to those caring for injured soldiers in their homes. The program, intended to help spouses and other relatives provide care to war veterans seriously hurt since 2001, has been growing rapidly nationwide. Yet the Denver hospital and its satellite offices in cities including military-heavy Colorado Springs have reduced the numbers of approved caregivers since May. (Olinger, 3/15)

Four American health-care workers were being flown to Nebraska on Saturday after being exposed to the Ebola virus and possibly having contact with an American health-care worker who recently contracted the deadly disease while treating patients in Sierra Leone, Nebraska Medical Center in Omaha said. At least 10 Americans in all may be brought back to the U.S. from Sierra Leone for monitoring because of possible exposure to the Ebola-stricken health-care worker, the U.S. Centers for Disease Control and Prevention said. A spokesman said none has been diagnosed with Ebola or shown symptoms of the disease. (Calvert and McKay, 3/14)

The first of a group of 10 American aid workers who may have come into contact with the Ebola virus in Sierra Leone were evacuated on Saturday, American government and aid officials said. They will be the largest group of Americans to have returned home over fears of exposure to the virus since an outbreak in three West African countries was declared last year. (Fink, 3/14)

On a rainy day in February three years ago, about 30 men and women recently hired by the state filed into a dull government classroom to begin a week of training for their new positions. Texas funnels a river of federal and state money — at that time $28 billion and change each year — out to doctors, dentists, labs and other medical providers to pay them for treating Medicaid patients. There is little doubt, the trainees were told, that some percentage of it is wasted, paid out by mistake or flat-out stolen by fraudulent providers. (Langford, 3/14)

The next round of contracts awarded to companies to manage health care for thousands of Missouri Medicaid recipients includes a new focus: patient wellness. Consumer wellness incentives are trending throughout the health insurance market, most notably in employer-sponsored plans. Now Missouri is getting in on the action on behalf of its roughly 400,000 managed care customers. (Shapiro, 1/15)

As a convicted killer out on supervised release, Ronald A. Vashone-Caruso couldn't drive a taxi or hold certain jobs in Colorado. But in 2013 and 2014, Vashone-Caruso ferried Medicaid patients to and from their medical appointments in his car under a state program that doesn't closely monitor its drivers. One Medicaid patient filed a complaint alleging Vashone-Caruso texted her repeatedly after driving her to the doctor, frightening her. The Colorado Public Utilities Commission licenses companies to provide drivers for the state's non-emergency medical transport program. The commission, however, does not require background checks of those drivers as it does with cabbies. (Osher, 3/15)

Ohio nursing homes could receive an $84 million increase in Medicaid payments under Gov. John Kasich’s budget plan, but many of the institutions would have to step up their game to get the additional money. Medicaid Director John McCarthy said nursing facilities would have to meet five new quality measures to receive full Medicaid reimbursement. The goals, he said, are to ensure residents are well cared for and tax dollars are well spent. (Candisky, 3/15)

Legislatures in two states this week backed away from bills that would require more kids to get vaccinated, measures similar to one pending in California. (Rosenhall, 3/13)

The Minnesota Department of Human Services’ mental health proposals for the 2015 legislative session focus on further strengthening the state’s mental health system — and filling gaps in coverage in many regions of the state. The set of legislative strategy proposals, which focus on the needs of children and adults, acknowledge that mental-health concerns are a growing issue statewide. Mental illness affects one in four Minnesotans, the proposals claim, saying state budgets must be adjusted to reflect that reality and support new systems designed to address the needs of the thousands in the state living with mental illness. (Steiner, 3/13)

A state health study has found that the benefits of paid sick and family leave are not equally available to Minnesotans of different ethnic backgrounds. The Minnesota Health Department study noted that access to paid sick and family leave promotes a variety of benefits, including lower infant mortality and healthier babies and mothers. (Zdechlik, 3/13)

A federal judge has deemed unconstitutional Washington’s practice of holding mentally ill people in jails while they await competency evaluations and treatment and during a trial that starts Monday, lawyers for mentally ill defendants and the state will try to find a remedy. The trial in U.S. District Court in Seattle comes as the Legislature debates bills that seek to fix the problem ahead of a court ruling. But one lobbyist for a state defender’s group said the judge is unlikely to approve either of the measures lawmakers are considering to shorten wait times and provide treatment. (3/14)

The current recommendation from the National Association for School Nurses is to have 1 nurse per 750 students. Georgia’s 2,264 public schools serve 1.7 million students, so the recommended number of nurses for the state is 2,267. But as of October 2014, there were only 1,555 licensed nurses who work in the state’s schools, Howard said. That leaves a shortage of more than 700. (Stewart, 3/13)

Gov. Nathan Deal is giving select nursing homes another shot at a $27 million rate increase only a few months after the same boost was stalled by the agency that regulates the industry. (Salzer, 3/14)

More Iowa high schoolers are using e-cigarettes than regular cigarettes, a new state survey suggests. Eleven percent of high school juniors said they had used e-cigarettes in the previous 30 days, according to the 2014 Iowa Youth Survey, released Friday by the state Department of Public Health. That compares to 9 percent who had smoked regular cigarettes in the previous 30 days. (Leys, 3/13)

The days of mystery meat and soda-dispensing vending machines may be gone, but that doesn't mean that the new era of school meals and snacks hasn't come without its own challenges. Nutrition guidelines for schools, which have gradually gone into effect since Congress passed the Michelle Obama-backed Healthy Hunger-Free Kids Act in 2010, can be logistically and financially difficult for already strapped district budgets. (Leonard, 3/13)

Colorful and glittery, they dangle from lawmakers' ears and lobbyists' lapels, drawing inquisitive looks and plenty of questions. What is it? The answer usually draws surprise, sometimes a few laughs and often another question. Really? "It's fun to see if people notice them or not," says state Rep. KC Becker, a Boulder Democrat. "Usually it's the women who can identify what that is. They are most familiar with what it looks like." (Frank, 3/13)

So maybe progress on health care is possible after all: Congress is close to repealing a two-decade budget cheat and reforming the entitlement state for the first time in the Obama Presidency. Miracles happen, though some members of both parties are trying to derail this one. An emerging deal would permanently void the formula that automatically reduces Medicare’s price controls on physicians, known as the sustainable growth rate, or SGR. These spending caps were introduced by Bill Clinton and Newt Gingrich in 1997 to supposedly contain entitlement costs, and reimbursement is scheduled to fall 18% in April. (3/15)

Spring is almost here: time for the annual Washington ritual known as the “doc fix.” ... The path of least resistance would be the well-trod one, passing yet another short-term patch. Yet there is increasing, bipartisan discussion of, at long last, a permanent solution. ... The big question is whether lawmakers would pay for such a plan through offsetting spending reductions or revenue increases, as they have paid for all previous short-term doc fixes. (3/13)

After a massive recession and years of partisan gridlock depleted their ranks, lobbyists are returning to Capitol Hill. The prospect of changes in health-care law -- something many deemed unlikely -- may be one reason. In the past four months, almost one in five new lobbying registrations listed "health issues" as a legislative interest. If the Supreme Court rules in June against Obamacare subsidies for millions of recipients, it could bring the health care debate roaring back by summer. (Jeanne Cummings, 3/13)

Residents in Florida and Texas stand to be the big losers if the court overturns subsidies in federal-exchange states. An estimated 1.5 million Floridians receive the subsidies, which reduce their average monthly premiums from $376 to $82; for a total flowing into the state of $5.2 billion a year. In Texas, more than 1 million residents get help, which reduces their average premiums from $328 to $89, or a total of nearly $3 billion a year. This is money that residents of those states could use for many other purposes, while still enjoying the benefits of health insurance. When you see figures like that, you have to ask of [Sen. Marco] Rubio, [Sen. John] Cornyn and [Sen. Ted] Cruz: Who in the world do you think you represent? (Michael Hiltzik, 3/13)

A number of states that had previously refused to expand their Medicaid programs for the poor are reconsidering that policy. They would be smart to embrace expansion as soon as possible to cover millions of people who would be left uninsured if the Supreme Court wipes out federal subsidies for low-income people buying insurance on the federal health exchanges. (3/16)

There is nothing like a budget crisis to remind some members of the Florida Legislature that, unlike wine, problems don’t get better with time. Tallahassee is poised to lose anywhere from $1 billion to $2 billion in federal funds for not expanding Medicaid, possibly crippling public hospitals statewide. ... There is some good news. Last Tuesday, the Senate Health Policy Committee moved ahead with a novel Medicaid-expansion program that provides vouchers to consumers to purchase health insurance. The plan mirrors one recently approved in Indiana under the leadership of Gov. Mike Pence who also opposed ACA. Under Florida’s Senate plan, Medicaid is expanded ,and the beneficiaries would pay $3 to $25 a month, depending upon income. (Helen Aguirre Ferré, 3/14)

My neighbor, a man in his 70’s, had mild epigastric (abdominal) pain. He was treated for ulcer disease, and when the pain did not disappear, he went to visit his cardiologist. The patient had several risk factors for heart disease, including high blood pressure, high cholesterol and diabetes. The cardiologist was a conservative physician, and he suggested that instead of doing a coronary angiogram or a nuclear stress test, which are the tests usually ordered in this situation, the patient should have a CT angiogram. The CT angiogram required approval by Medicare before it would agree to pay. The cardiologist waited for several days after submitting his request and then received a denial. Payment for the procedure was again denied. Needless to add, the cardiologist received no reimbursement for his time and effort in advocating for the patient. (Dr. Paula L. Stillman, 3/13)

Currently, only Oregon, Washington, Vermont, New Mexico and Montana allow health care providers, under strict guidelines, to hasten the death of terminally ill patients who wish to spare themselves and their loved ones from the final, crippling stages of deteriorating health. Lawmakers in 15 other states and the District of Columbia have introduced so-called aid in dying bills in recent months to make such a humane option available to millions of Americans at a time when the nation’s population of older adults is growing. (3/14)

Is Prime Healthcare bluffing? That's always been the big question about the company's promises to maintain medical services at the six California Catholic medical institutions it proposed to take over in an $843-million deal. Last month, state Atty. Gen. Kamala Harris forced Prime to show its cards. In approving the sale to Prime of five hospitals and a skilled nursing facility owned by the financially strapped Daughters of Charity chain, she etched some of those promises into stone — for at least 10 years. Now that Prime has exited from the deal with a snarl, we have a definitive answer. Yes, Prime was bluffing. (Michael Hiltzik, 3/13)

The financial crisis faced by the Daughters of Charity Health System appeared to be solved last year when Prime Healthcare Services of Ontario agreed to buy the chain and keep its six hospitals, including St. Francis Medical Center of Lynwood, open for at least five years. On Tuesday, however, Prime backed out of the deal, saying state Atty. Gen. Kamala D. Harris had gone too far in requiring a 10-year commitment to maintain most of the hospitals and their services. Now, everyone involved needs to focus on one thing: keeping the hospitals, and particularly the trauma centers that four of them operate, open for the long term. (3/13)

The Food and Drug Administration seems determined to show it is impervious to reform, even if it means dying on the smallest of hills. Now the bureaucracy is defying Congress and the White House by refusing to approve the modern sunscreens that everyone else in the world is allowed to use. Sunscreen’s active ingredients are regulated by the FDA like new medicines, albeit with even less moral urgency than usual. In this case the problem is skin cancer, most types of which are preventable. But their incidence is rising rapidly in the U.S. even as other cancer rates fall, and part of the explanation is the FDA’s unfathomable, dozen-year blockade of better sunblocks. (3/13)

It is estimated that 100,000 children each year are trafficked for sex in the United States. Lax laws and modern technology enable the predators, while their young victims often are treated like criminals instead of getting the help they need. Congress last week seemed poised to do something about this. Then politics intervened. This week the question will be whether senators can put the interests of scared, abused children ahead of the chance to score political points. (3/15)