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House and Senate Republicans steamed ahead Tuesday toward likely approval of balanced budget outlines, essential early steps along a path to send President Barack Obama legislation to wipe out his 5-year-old health care law and eliminate deficits within a decade. Obama is all but certain to veto the legislation if and when it reaches his desk, but Republican rebels and establishment-minded conservatives alike in the House paid that little mind. (Espo, 3/25)

After stumbling several times since taking control of Congress earlier this year, House Speaker John A. Boehner (R-Ohio) and Senate Majority Leader Mitch McConnell (R-Ky.) have an opportunity to demonstrate on two important fronts that Republicans can effectively govern. But it remains unclear if they will be able to deliver. Boehner acknowledged Tuesday the momentous days ahead, as Republicans will try to pass their annual budget for fiscal 2016 and approve a sweeping bipartisan accord to overhaul the way doctors are paid under Medicare. (Mascaro, 3/24)

After weeks of stumbling through one embarrassing crisis after another, GOP leadership and the rank and file — for once — seem surefooted about their strategy to pass a 2016 budget resolution and fix a Medicare physician formula that’s long bedeviled Congress. (Sherman, Bresnahan and Kim, 3/24)

Sen. Rob Portman (R-Ohio) has introduced an amendment to the Republican budget that would boost Medicaid funding for "medically complex" children. The Ohio Republican's amendment would create a deficit neutral fund that would focus on increasing integrated and coordinated care for children on Medicaid who have multiple, serious, rare or chronic illnesses. (Carney, 3/24)

U.S. House of Representatives Speaker John Boehner said on Tuesday that prospects were good for passage of a permanent fix to Medicare's flawed doctor-pay formula, a move that would spare physicians from impending pay cuts. ... The plan's prospects brightened in the Senate, as well, when Democratic Leader Harry Reid said he would look at the bipartisan House proposal, which would change the way doctors are reimbursed for Medicare costs. It was introduced earlier on Tuesday by Boehner and House Democratic Leader Nancy Pelosi. Last week, through a spokesman, Reid expressed opposition to abortion restrictions on community health centers in a draft of the proposal. (3/24)

The deal is as politically remarkable as it is substantive: a long-term plan to finance health care for older Americans, pay doctors who accept Medicare and extend popular health care programs for children and the poor. It was cobbled together by none other than House Speaker John A. Boehner and Representative Nancy Pelosi, the leader of House Democrats, who rarely agree on anything, with the apparent blessing of a majority of their respective members. (Steinhauer and Pear, 3/24)

A $200 billion bipartisan deal preventing Medicare physician cuts and extending a popular children's healthcare program will become law in short order, the second-ranking House Democrat predicted Tuesday. Some lawmakers on both sides of the aisle are wary of the deal — liberals because of the erosion of some Medicare benefits and conservatives because much of the cost is not offset by changes elsewhere in the budget. (Lillis, 3/24)

An extraordinary bipartisan accord between House Speaker John Boehner and Minority Leader Nancy Pelosi is letting both parties exhale as they move toward ending the nagging annual threat of Medicare cuts to physicians. Yet each side is bragging about far more than that. For Boehner, R-Ohio, the package announced Tuesday lets him claim a rare if modest bipartisan pact to strengthen the finances of the costly Medicare health care program for seniors. (Fram, 3/25)

Highlights of the compromise released Tuesday by House Republican and Democratic leaders to permanently avoid yearly cuts in reimbursements for physicians treating Medicare patients. Cost figures were not released but are based on interviews with lawmakers, lobbyists and congressional staff. (3/24)

Maybe the “doc fix” shouldn’t be fixed. Pressured by the health-care industry, Congress is rushing to permanently raise pay for doctors who participate in Medicare. A new bill would replace the decade-long practice of funding periodic pay increases for physicians by cutting spending in other parts of the $622 billion program. This Washington rite is known as the doc fix. Overlooked, though, is the benefit of the regular legislative exercise to taxpayers. Each raise has to be paid for, forcing doctors, health-care lobbyists and patients to the table to negotiate ways to keep Medicare spending in check. (Wayne, 3/24)

With deep pockets and huge memberships, politically influential physician organizations think they’re on the cusp of achieving something they’ve aggressively sought for years: a congressional cure for a Medicare payment system that regularly threatens to cut their fees. (Douglas, 3/24)

Senate Democrats suggested Tuesday that they may not block the House’s deal to enact a permanent “doc fix” and extend the Children’s Health Insurance Program for two years. (Haberkorn, Pradhan and Mershon, 3/24)

New momentum for a lasting fix to Medicare's doctor-payment problem shows that lawmakers may finally be recognizing what has long bothered their constituents. Year after year, the threat of 20 percent payment cuts averted at the last minute has seemed a curious way to run a program that lives depend on. (Alonso-Zaldivar, 3/25)

Hospitals are poised to get an additional six months of relief from certain audits related to short patient stays under the emerging "doc fix" deal to permanently replace Medicare's physician payment formula. The draft also contains a provision that would put on hold much of the work of recovery audit contractors, or RACs, until the end of September, extending a moratorium due to expire at the end of this month. (Young, 3/24)

Ted Cruz is going on Obamacare. The newly announced Republican presidential candidate told CNN's Dana Bash on Tuesday that he will sign up for health care coverage through the Affordable Care Act -- a law he has been on a crusade to kill. (Bash and Lee, 3/24)

Ted Cruz, who once spent 21 straight hours speaking on the Senate floor railing against Obamacare, plans to sign up for Obamacare. (Lightman, 3/24)

So, irony of all ironies — Sen. Ted Cruz could now be joining Obamacare. Cruz said Tuesday he may sign up for the health insurance program he's promised to repeal "every word of" because he's no longer on his wife's plan. His wife, Heidi, is taking a leave of absence from Goldman Sachs during her husband's newly unveiled presidential campaign, meaning the Cruzes will need to find health insurance elsewhere. (Millman, 3/24)

“We will presumably go on the exchange and sign up for health care, and we’re in the process of transitioning over to do that,” Cruz, a Republican candidate for president, told The Des Moines Register Tuesday. (Jacobs, 3/24)

The first-term senator from Texas said he is looking at options available on a health insurance exchange, or a clearinghouse of policies available to Americans who don't receive coverage through their employers. ... Under an amendment to the law crafted by Sen. Chuck Grassley, R-Iowa, the government can only offer members of Congress and their staff health care insurance that's sold through an exchange. (3/24)

Senator Ted Cruz helped lead an effort to shut down the government in 2013 in an attempt to defund President Obama’s health care law. Now the Texas senator, a newly announced Republican presidential candidate, is signing up for coverage under it. ... So Mr. Cruz is now turning to the very thing he has spent more than two years vowing to repeal. (Haberman, 3/24)

In September 2013, efforts by Cruz and House of Representatives conservatives to gut Obamacare by holding up a government spending bill led to a 16-day government shutdown. Cruz, a conservative firebrand who is a favorite of the Tea Party movement, on Monday became the first major figure in either party to enter the 2016 presidential race (3/24)

"But there are other options that the senator is considering before making a final decision about how to make sure his family is insured." The clarification from Cruz's camp came after an interview in which he hinted he would sign up for coverage through the health care law's exchanges. (Cervantes, 3/24)

President Obama will tout the Affordable Care Act on its fifth anniversary Wednesday as he continues his bid to frame the health care law as a success in the face of legal and political challenges. Obama is set to make remarks at an event with Health and Human Services Secretary Sylvia Mathews Burwell, where they will announce the creation of a network of public and private partners tasked with ensuring that the health care law improves services for medical patients. (Nakamura, 3/25)

President Barack Obama will celebrate the fifth anniversary of his controversial signature health care act on Wednesday, joining Health and Human Services Secretary Sylvia Burwell to kick off a new effort to pitch the Affordable Care Act. (Clark, 3/25)

President Barack Obama wants to cut health care costs by reducing unnecessary treatments, tests and hospital visits that rack up big bills. Obama on Wednesday will launch what the White House calls a Health Care Payment Learning and Action Network. The White House says more than 2,800 health care providers, patients and consumer groups have agreed to take part. (3/25)

President Obama spends Wednesday touting one of his legacies: The health care law he signed five years ago. In a speech at the White House, Obama will unveil what he calls the Health Care Payment Learning and Action Network. This group of public and private groups will look for ways to reduce costs by eliminating unnecessary treatments, tests, and hospital visits. More than 2,800 health care providers and consumer groups have agreed to participate, the White House says. (Jackson, 3/25)

President Barack Obama and HHS Secretary Sylvia Mathews Burwell will launch a health care network on Wednesday that aims to bring public and private groups together and help speed a shift toward rewarding the quality and value of care Americans receive over the quantity. (Villacorta, 3/25)

Dignity Health, Rite Aid and Cigna are among healthcare players that have joined an HHS network convened to help the CMS tie 30% of Medicare payments to alternative payment models by the end of 2016. The group, called the Health Care Payment Learning and Action Network, will hold its first meeting Wednesday in Washington and is expected to set goals for alternative payment models by September. (Dickson, 3/25)

In Obamacare’s first two years, enrollment reached more than 11.7 million people—surprising skeptics and putting the law on pace to reach its goal of enrolling 21 million Americans in health coverage by 2016. While this is good news for the administration (and the millions of people who now have health insurance), some experts are afraid that Obamacare may soon hit peak enrollment. (Ehley, 3/24)

The Affordable Care Act, signed by President Obama five years ago this week, sparked a host of changes. For some workers, the law’s legacy amounts to fewer hours of paid work. The law’s requirement that larger employers provide affordable insurance to workers putting in 30-plus hour weeks has led some companies to cap the number of hours employees can log. A new survey out Tuesday from the Society for Human Resource Management finds that 14% of employers have cut back on hours for part-time employees, and an additional 6% plan to do so. The survey, which included more than 740 human resources professionals, found that a small subset of companies were considering reducing hours for full-time employees too. (Feintzeig, 3/25)

Detroit’s negotiations this summer to reach a new four-year labor deal won’t just be an argument about wages. Generous health-care benefits for about 135,000 unionized factory workers are at risk of being cut to prepare for the Affordable Care Act’s “Cadillac” tax. Health care has long been a fiercely protected benefit for United Auto Worker members, remaining generous even as the union has made other concessions. But the so-called Cadillac tax on companies with high-cost health plans is scheduled to take effect in 2018. (Rogers, 3/24)

A heavy workload caused by the Affordable Care Act, government technology limits and staff shortages are causing unusually long delays in filling public records requests, federal health officials say. The waits in some cases could stretch out a decade or more. The Freedom of Information Act requires federal agencies to respond to records requests in 20 working days, though providing documents often takes much longer. The FBI, for instance, recently reported that complex requests could average more than two years to fill. (Schulte, 3/24)

Senator Edward J. Markey, Democrat of Massachusetts, introduced legislation Tuesday to repeal the 2.3 percent excise tax on medical devices, a two-year-old levy that has been the target of a national industry with a strong presence in the state. (Weisman, 3/24)

On health, the Affordable Care Act has considerably boosted insurance coverage among Latinos, yet many were still not familiar with key aspects of the law. (Lilley, 3/24)

First of all, let’s start with the numbers that [Rep. Pete] Sessions cited on the floor. He claimed that the cost of insuring 12 million people would be $108 billion. Then he did some “simple multiplication” and came up with a figure of $5 million per newly insured person. Actually, if you divide $108 billion by 12 million, you end up with $9,000 a person. That’s a pretty big difference. We might understand why $5 million would be “immoral” or “unconscionable,” as Sessions thundered in his speech, but it turns out to be less than 1/500th of that amount. (Kessler, 3/25)

Texas Republicans have long considered the Affordable Care Act a favorite political punching bag. But that hasn’t stopped state budget writers from spending extra money flowing out of Washington under the law sometimes known as “Obamacare.” (Walters, 3/25)

Fifty six percent of those who would benefit from Louisiana's expansion of the Affordable Care Act are employed in occupations that most people rely on almost every day, says a new report from a group that supports the 2010 health law. The report by Families USA estimates that 362,000 state residents would benefit from the expansion, higher than some other estimates, and breaks down some demographics to describe those losing out on health care coverage. (Albert, 3/24)

Baton Rouge hospital is closing the only emergency room on the city's impoverished north side, a real- world ripple effect of the ideological clash over President Barack Obama's health-care law. The shutdown on April 1 serves as an early warning for hospitals in states like Louisiana, where Republican Gov. Bobby Jindal turned down federal money to expand the Medicaid program for the poor. Charity hospitals will lose billions of federal aid beginning late next year, a cut that was supposed to be offset as more residents were covered by Medicaid. (Newkirk, 3/25)

Supporters of people too poor to buy subsidized health insurance under the federal Affordable Care Act contend North Carolina lawmakers and others opposing President Barack Obama's signature legislation are turning their backs on billions of tax dollars and thousands of jobs. Advocates argued Tuesday that would translate to thousands of health care jobs while saving hospitals millions of dollars a year in unpaid bills for treatment they're required to give sick patients who can't pay. (Dalesio, 3/24)

Federal officials told lawmakers Tuesday that the 340B drug discount program needs greater transparency and more clarity about which providers and patients should be eligible. Such changes will improve oversight of a program that has seen a stark rise in its participation over the past decade, they said. (Johnson, 3/24)

The rapid expansion of the federal 340B discount drug program may require new legislation to make sure that its benefits reach the intended population, the neediest Americans, lawmakers said Tuesday. Rep. Larry Bucshon, R-Ind., was among those who raised concerns at a House Energy and Commerce subcommittee hearing about the lack of firm directives to hospitals about how savings from the program should be used. Hospitals, clinics and other health agencies enrolled in the program saved about $3.8 billion in 2013 by acquiring steeply discounted drugs, according to the Health Resources and Services Administration. (Young, 3/24)

Humana Inc, one of the largest U.S. providers of Medicare Advantage healthcare plans for older people, said on Tuesday that it believes a previously disclosed government query for information is part of a wider review involving many healthcare companies. Humana first said the U.S. Department of Justice had asked it to volunteer information about risk adjustment matters on Feb. 18. (Humer, 3/24)

Health Diagnostic Laboratory Inc.’s likely settlement of a U.S. Department of Justice review will relieve uncertainty for the company, but likely will result in tighter government oversight of its business practices for at least five years. (Blackwell and Geiger, 3/24)

The Supreme Court ruled Tuesday a lower court made it too easy for investors to proceed with a lawsuit alleging Omnicare Inc. misled investors in details for a plan to sell new shares. ... Shareholders brought the case in 2006, alleging Omnicare, the nation’s largest provider of pharmaceutical services in nursing homes, deceived the investing public about its relationships with drug companies. Rebate programs in which Omnicare received discounts from drug makers were really illegal kickback arrangements in which drug companies paid Omnicare to promote their products in long-term care facilities, investors alleged. (Kendall, 3/24)

Even in an occupation that women overwhelmingly dominate, they still earn less than men, a study of nurses found. The gender gap for registered nurses’ salaries amounts to a little over $5,000 yearly on average and it hasn’t budged in more than 20 years. That pay gap may not sound big — it’s smaller than in many other professions — but over a long career, it adds up to more than $150,000, said study author Ulrike Muench, a professor and researcher at the University of California, San Francisco. (Tanner, 3/24)

Even though nine out of 10 nurses are women, men in the profession earn higher salaries, and the pay gap has remained constant over the past quarter century, a study finds. The typical salary gap has consistently been about $5,000 even after adjusting for factors such as experience, education, work hours, clinical specialty, and marital and parental status, according to a report in JAMA, the journal of the American Medical Association. (Rapaport, 3/24)

Women outnumber men in the nursing profession by more than 10 to 1. But men still earn more, a new study finds. The report in this week’s Journal of the American Medical Association found that even after controlling for age, race, marital status and children in the home, males in nursing out-earned females by nearly $7,700 per year in outpatient settings and nearly $3,900 in hospitals.(Rovner, 3/24)

Predictions that doctors would be overwhelmed by new patients as a result of the Affordable Care Act have not come true a year after the law's coverage expansions took effect. That's according to a study to be released Wednesday from the Robert Wood Johnson Foundation and health care technology company Athenahealth. By gathering data from 15,700 of Athenahealth's clients, mainly physicians, the study measured how the Affordable Care Act has affected doctors. (Hinchliffe, 3/24)

Thirty years ago, insurance companies had the answer to the soaring cost of caring for the elderly. Plan ahead and buy a policy that will cover your expenses. Now, there's a new problem: Even insurers think it's unaffordable. (Craft, 3/24)

Just about everybody who has studied the hospital industry agrees that it needs to confront the epidemic that plagues many of its staff: Tens of thousands of nursing employees suffer debilitating injuries every year, mainly from doing part of their everyday jobs — moving and lifting patients. The problem is, nobody agrees how to get hospitals to take aggressive action. As NPR has been reporting in its Injured Nurses series, nursing employees suffer more back and arm injuries than just about any other occupations. (Zwerdling, 3/24)

Certain cancer hospitals get significantly higher payments from Medicare in part because it's assumed they care for sicker populations. A federal report suggests that's not generally the case. (Rubenfire, 3/24)

The Department of Veterans Affairs on Tuesday announced plans to relax the agency’s rule on how far patients must live from the nearest VA medical center before the government pays for treatment at a closer private facility. Under the original guidelines, veterans had to reside at least 40 miles in a straight shot, or as the crow flies, from the nearest VA clinic. The new guideline will instead measure the distance in driving miles, as calculated by commercial mapping services such as Google Maps and Mapquest. (Hicks, 3/24)

The Department of Veterans Affairs on Tuesday changed its interpretation of a law after months of criticism from Congress and veterans groups, making it easier for veterans to get health care outside of the VA system. Under a federal law passed in 2014 known as the Veterans Choice Act, veterans forced to wait longer than 30 days for an appointment, or who have to travel more than 40 miles to a VA facility, are eligible to get appointments outside of the VA system. (Kesling, 3/24)

The VA said it will now measure the 40-mile trip by driving miles as calculated by Google maps or other sites, rather than as the crow flies, as currently interpreted. The rule change is expected to roughly double the number of veterans eligible for the VA’s new “Choice Card” program. The change could add billions of dollars in annual costs as tens of thousands of new veterans receive private medical care, which typically costs more than traditional care at VA hospitals and clinics. (Daly, 3/24)

Nonprofit insurer Blue Shield of California is spending $1.25 billion on its acquisition of Monterey Park health plan Care1st, records show. Blue Shield had refused to disclose the purchase price when it announced the deal in December and then sought confidentiality from state regulators in late January. The California Department of Managed Health Care turned over Blue Shield's filings late Monday in response to a public-records request from The Times. (Terhune, 3/24)

With drug overdoses skyrocketing across the USA, a growing number of states are expanding access to a fast-acting rescue drug called naloxone, which can revive a dying addict in minutes. But while these new laws have broad support in the public health community, some doctors and drug-treatment professionals say they are just Band-Aids for an overwhelming addiction problem requiring a much broader solution. (Ungar, 3/24)

California labor officials have issued a warning to insurance companies that a new workers’ compensation law shouldn’t be used to reopen old cases and deny previously approved home health care to injured workers. The notice follows a ProPublica and NPR investigation earlier this month that featured a worker paralyzed in an on-the-job accident whose home health aide was abruptly taken away by his company’s insurer, leaving him to sit in his own waste for hours at a time. (Grabell, 3/24)

Mr. Kasich is known as a social conservative and fiscal hawk. He has been traveling the country to urge state legislatures to pass a balanced-budget amendment to the Constitution, and in his first term he promoted an effort to limit the bargaining powers of public-sector unions, which failed. Those stances put him in step with the party base. But his record also has policy land mines that could blow up in a Republican primary. Mr. Kasich engineered the expansion of Medicaid in Ohio under the 2010 health-care law; he has supported the national education standards known as Common Core; and he has said he is willing to consider offering a pathway to citizenship for people in the U.S. illegally. (Hook, 3/24)

A week after the Texas Senate passed a bill to prevent minors from buying electronic cigarettes, House lawmakers on Tuesday considered similar legislation they say would protect young Texans from addictive nicotine products. The House Public Health Committee took up five bills that would extend current restrictions on tobacco products to vapor products like e-cigarettes. Texas retailers are banned from selling cigarettes and other tobacco products to customers younger than 18, but sales of e-cigarettes to minors are allowed. (McCrimmon, 3/24)

After years of fighting for the authority to practice independently, some of Minnesota's highly skilled nurses will soon lead their own primary care clinic. (Benson, 3/24)

Rather than vote the bill out of committee through the usual process, members voted simply to refer the measure to the Appropriations Committee. Majority Democrats on the committee said it was important to move the bill forward as part of the budget process, despite their disagreements with its substance, and some said voting to simply to refer it to another committee was a form of protest. But Republicans said that wasn’t enough of a protest, and that committee members owed it to their constituents to vote on the substance of the bill. Cuts in the bill include: Reducing Medicaid eligibility for pregnant women and parents of minor children, which is expected to cut about 34,200 people from the program. Reducing Medicaid payment rates for pharmacies. Freezing admission to a state-funded program for seniors that serves those who don’t require nursing home-level care but are at risk of hospitalization or short-term placement in a nursing home if they don't receive care at home. (Levin Becker, 3/24)

Washington state’s insurance commissioner announced Tuesday a multistate investigation into this winter’s cyberattack on Premera Blue Cross. Insurance Commissioner Mike Kreidler said he plans to work with his counterparts in Alaska and Oregon to look into operations at Premera, which is based in Mountlake Terrace. The investigation will explore the cyberattack disclosed by Premera last week, in which hackers accessed the personal information of 11 million consumers, including 6 million in Washington, between last May and the exploit’s Jan. 29 discovery. (Nunnally, 3/24)

In the wake of legislators filing a new bill that would all but remove religious exemptions from childhood vaccinations for schoolchildren, several dozen opponents of vaccine mandates descended on Jones Street Tuesday to protest the measure. (Hoban, 3/25)

For months I have worried that Capitol Hill legislative deadlines would all but guarantee more governing by crisis, a theory, of course, reinforced by standoffs of the past few years. But I’m starting to think that deadlines may provide an opening–or forcing mechanism–to get a few things done. For example: Cuts in Medicare payments to doctors are set to kick in March 31; Congress usually avoids these reductions with its “doc fix.” The Highway Trust Fund is set to expire May 31. Funding for the Children’s Health Insurance Program (CHIP) runs out in September, and funding for the federal government ends Sept. 3o. The big kahuna is the debt limit, which will need to be extended again this year, most likely in the fall. The hyper-partisanship that has gripped the Hill in recent years meant that nothing got done until the last second of the last minute before deadline. But could things be changing? (Jim Manley, 3/24)

Like bickering siblings who keep quibbling over childhood slights, Republicans and Democrats keep finding new ways to fight over abortion. The latest episodes involve Republicans' attempt to apply the long-standing limitation on federal funding for abortion - known in Washington as the "Hyde amendment" after its author, the late Rep. Henry Hyde (R-Ill.) - outside its usual turf. In particular, some Democrats balked when the restriction turned up in bills to create another federal fund for victims of human trafficking and a wide-ranging proposal to amend and renew Medicare and other federal health programs. ... The problem with the two bills in question is that they would simultaneously authorize and spend money. That shift from the norm set up the fight over abortion. (Jon Healey, 3/24)

Here’s some interesting accountability journalism: CNN’s Dana Bash asked Sen. Ted Cruz, a freshly announced 2016 presidential candidate, how his family would get health insurance now that his wife has taken an unpaid leave from her job at Goldman Sachs. “We’ll be getting new health insurance and we’ll presumably do it through my job with the Senate, and so we’ll be on the federal exchange with millions of others on the federal exchange,” the Texas Republican told her. (Erik Wemple, 3/24)

The Families USA study illustrates the people left behind when Gov. Bobby Jindal opted not to accept the federal Medicaid expansion. They aren't covered on the job. They make too much money to qualify for Medicaid currently in Louisiana, but not enough for the insurance tax credits that are part of the Affordable Care Act. So they are caught in the middle without health coverage. Maybe they will be lucky and stay healthy, but people shouldn't have to count on that. ... The Legislature or the next governor could reverse the decision and accept the Medicaid expansion, which covers families earning up to 138 percent of the poverty level. But the state has missed out on the first of three years of the program when the federal government is paying 100 percent of the cost. (3/25)

Virginia Democrats, along with their editorial supporters in the state’s major dailies, champion a Medicaid expansion they say could cover upward of 400,000 needy citizens currently without health-care insurance. They decry Virginia Republicans’ opposition to this proposal as immoral, if not racist. That’s strong stuff. And it may also fail to heed some sage advice from the late Martin Luther King Jr.’s “Letter from a Birmingham Jail.” Let’s assume your opponent’s position is immoral. As King pointed out, this doesn’t mean your position is the moral one. (Norman Leahy and Paul Goldman, 3/24)

The Senate Republicans' different approaches to Medicare, Medicaid, and the ACA may be because the first is a widely popular universal program that benefits all Americans regardless of income; if they try to restructure Medicare, they know they will be accused of seeking to “end Medicare as we know it.” ... With the 2016 elections looming and a number of senators thinking of running for president, Senate Republicans are acutely aware that people who benefit from Medicare vote at a high rate and often base their votes on Medicare. (Harris Meyer, 3/24)