Yesterday, Sens. Tom Coburn (R-OK) and Joe Lieberman (I-CT) introduced a bill that would reduce Medicare spending by $600 billion over 10 years “through premium increases, gradually raising the eligibility age and other changes.” Those include: 1) increasing monthly premiums for enrollees in Medicare Part B by 2 percent a year for five years, 2) asking individuals making more than $150,000 a year and couples making more than $300,000 a year to pay full Part B premiums, 3) instituting one deductible for both Medicare Part A, which covers hospitalization, and Part B, which covers doctors’ visits, 4) raising the age for Medicare eligibility from 65 to 67 by 2025, and 5) patching up the sustainable growth rate to eliminate payment cuts to doctors for three years.

The most striking provision is No. 4, and it’s part of the the reason why House and Senate Democratic leadership have already dismissed the plan as “a bad idea” and “unacceptable.” And for good reason. As the Incidental Economist’s Aaron Carroll explains, life expectancy is a fairly complicated measurement that varies drastically across geographical and economic lines. Any proposal that increases the program’s eligibility age would disproportionately affect people in both the poorest states and lowest income brackets:

But the other obvious problem is the cost shift to seniors: increasing monthly premiums would force beneficiaries to pay more at a time when they’re just scraping by. According to a new study from the Kaiser Family Foundation and the Urban Institute, half of seniors “had income lower than $22,000 in 2010; 25 percent had income lower than $13,000. Only five percent had incomes above $85,000.” Their savings aren’t any better: “half of seniors have savings less than $50,000; a quarter have less than $8,400 money set aside. Ten percent had more than half a million dollars, half of those people had a million dollars or more.”

The problem is that even if you ask seniors to pay more, health care spending would still continue to rise unsustainably — it’s just that individual beneficiaries rather than the federal government would be footing more of the bill.

Yesterday, the Ohio Assembly passed the “heartbeat abortion bill,” a measure that would prohibit doctors from performing abortions if a fetal heartbeat can be detected, thus outlawing the procedure as early as “six to seven weeks into pregnancy.” Republicans admitted that the measure would likely fall to a constitutional challenge, but offered a myriad of wacky reasons for rolling back a woman’s right to choose:

– REP. ROBERT MECKLENBORG: The easiest way is also to look at it in the context of Nazi Germany, where during the 1920s, these were the arguments postulated by the proponents of abortion as the Third Reich was growing in power. Note they will sound very similar to you because they are exactly the same arguments put forth to support the current positions in support of the abortion laws as we have them on the books.

– REP. RON YOUNG: I’m afraid in 1973, the Supreme Court took a different tact [and didn't consider life.] If fetuses had been allowed to vote, if they had formed a voting block and they were organizing in front of the court house that day, the vote probably would have been much different.

– REP. CHRISTINA HAGAN: Teens who aborted were also three times more likely to report having trouble sleeping and nine times more likely to report subsequent marijuana use.

Watch a compilation:

Unfortunately, the heartbeat bill — which is one of the most radical anti-abortion bills in the country — was just one of three anti-abortion measures to pass the House. Lawmakers also approved legislation outlawing abortion after 20 weeks and prohibited insurers from offering abortion coverage in the health care exchanges established under the Affordable Care Act.

Sexual orientation and gender identity questions are not currently asked on most national or state health surveys, and that lack of standardized data collection makes it “difficult to estimate the number of LGBT individuals and their health needs” and severely “hampers both government and community-based efforts to identify, track, and address health disparities among LGBT people.” But today, the Department of Health and Human Services unveiled a plan to change all that. For the first time, the federal government will start to “integrate questions on sexual orientation into national data collection efforts by 2013 and begin a process to collect information on gender identity.” The new effort is the result of section 4302 of the Affordable Care Act:

The proposed standards for collection and reporting of data on race, ethnicity, sex, primary language and disability status in population health surveys are intended to help federal agencies refine their population health surveys in ways that will help researchers better understand health disparities and zero in on effective strategies for eliminating them. [...]

“These new data standards, once finalized, will help us target our research and tailor stronger solutions for underserved and minority communities,” added HHS Director of the Office of Minority Health, Dr. Garth Graham. “To fully understand and meet the needs of our communities, we must first thoroughly understand who we are serving.”

“Data really drives everything. You can’t have a conversation about priorities, about funding, about where attention should be about, about what we should be working on unless we have the data to show what the issues are,” CAP’s Kellan Baker told the Metro Weekly’s Chris Geidner. Baker will offer a comprehensive analysis of the proposed rules in this space tomorrow. To read his report on LGBT health and the Affordable Care Act click here.

LGBT advocates and health organizations have long lobbied for comprehensive data collection. Professional bodies such as the American Medical Association, the American Public Health Association, and the American Psychological Association have all “issued statements in support of standardized data collection on sexual orientation and gender identity.”

Democrats and Republicans are working to implement the health insurance exchanges in the Affordable Care Act, but are looking to different states for guidance in how to best structure a marketplace that would allow consumers to compare and purchase comprehensive insurance beginning in 2014. Red states are typically guided by Utah’s flea-market type approach, in which almost any insurer can offer coverage in the exchange and is held to few standards or regulations, while blue states are following the Massachusetts model of prudent purchasing and price negotiation.

Today, the U.S. Pirg has published a blueprint “for creating a strong, pro-consumer exchange that lives up to its promise of a better marketplace” that could offer a more comprehensive guide to the states:

– It should be run and overseen by representatives drawn from the consumer and small business communities that the exchange is designed to serve, not insurers or providers who could benefit financially from the exchange’s decisions.

– That means it must have the authority to exclude plans that fail to deliver robust consumer protections, quality care, and reasonable costs, particularly if the plan has a history of unreasonable rate increases. And because the bigger the exchange, the greater its negotiating power, the state should plan to open the exchange to employees of large businesses as soon as possible, and work to enroll as many eligible consumers as possible.

– The exchange should provide a special “seal of approval” for the plans that do the best job at providing high quality care, and provide consumers with easily understandable information about what these reforms mean and how consumers can best make use of them.

– The state should prohibit insurers or brokers from steering people either onto or off of the exchange, through setting different broker commissions, adopting targeted marketing strategies, or by any other method. And because a larger exchange will have more stability, states should conduct strong outreach and enrollment and widen the eligibility rules for the exchange.

– The state’s system should obtain updated information from enrollees in both public programs and the exchange each year, and if the enrollee’s eligibility has not changed, their coverage should be automatically renewed.

As the CBPP’s Dave Chandra has pointed out, “virtually every state has made at least some progress toward setting up [the] health insurance marketplaces,” including states like Indiana, Mississippi, and Alabama — which are also challenging the the constitutionality of the health law. In total, 16 states have “passed exchange-related legislation,” 39 states have introduced exchange legislation this year, and “48 states (all except Louisiana and Florida) plus the District of Columbia are engaged in some level of exchange planning.” So far, “only Louisiana has publicly announced that it won’t set up an exchange.”

The Department of Health and Human Services is expected to release its exchange regulations sometime around July 7.

As Kansas regulators prepare to shut down the state’s only three abortion clinics for failing to “meet the requirements to get a license under a law that takes effect Friday,” doctors and clinics that perform abortions have filed or are preparing lawsuits to block the new licensing law. The measure, which was signed by Gov. Sam Brownback (R) just last month, establishes overly rigorous standards that abortion providers must meet in order to continue operating and is part of a broader Republican effort to effectively eliminate abortions in the state.

The Center for Reproductive Rights filed a suit in federal district court yesterday “on behalf of the Center for Women’s Health” (and physicians Herbert Hodes and Traci Nauser) and another abortion provider, Aid for Women in Kansas City — which was denied a license after acknowledging it would need extensive renovations to comply with the new regulations — is expected to challenge the law today. “Planned Parenthood of Kansas and Mid-Missouri’s abortion clinic in Overland Park was inspected last week and has a license application pending, though it also is considering a legal challenge“:

In their lawsuit, Hodes and Nauser said the new regulations are stricter than rules for other health care providers. The suit claims the state violated their right to due legal process. [...]

Court documents show that Hodes sent an email June 21 asking the health department to consider waiving some of the rules and granting a provisional license while the idea was considered. A department official replied in 12 minutes, saying the law didn’t permit either step.

“This is like living in a communist country, the way I was treated,” Hodes told The Associated Press.

These suits come on the heels of a separate legal action filed on Monday that challenges a separate “provision in the new state budget blocking Planned Parenthood of Kansas and Mid-Missouri from tapping into federal Title X funds to operate nonabortion clinics in Hays and Wichita.”

The lawsuits will only increase costs to taxpayers, who are already paying an “absurd” amount of money — $67,000 a year for six inspections at three clinics — to challenge Roe v. Wade and chase abortion providers out of the state.