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NEWS FLASH

McDonald’s Announces 20 Percent Calorie Decrease In Happy Meals | McDonald’s says it initially experimented with eliminating French Fries from Happy Meals but faced a rebellion from children and parents. And so instead, responding to pressure from health groups, the company has pledged to “add a serving of fruit or vegetable to all of the meals” and shrink the portion of fries. The new meals will represent, on average, “a 20 percent decrease in calories,” the chain estimates. First Lady Michelle Obama, who has prioritized reducing childhood obesity, praised the decision: “I’ve always said that everyone has a role to play in making America healthier, and these are positive steps toward the goal of solving the problem of childhood obesity.”

NEWS FLASH

20: Number Of States That Made Health Cuts In 2012 Budgets | A new Center on Budget and Policy Priorities (CBPP) report finds that at least “20 states have made deep, identifiable cuts in health care that will reduce access to care for low-income children, seniors, families and people with disabilities.” According to the report, “Arizona has frozen enrollment in part of its Medicaid program, so that an estimated 100,000 low-income people who previously would have qualified will not be able to enter the program, and another 150,000 will face more stringent rules for retaining eligibility. Washington has frozen enrollment for a state-run health plan serving 60,000 low-income residents, which is expected to reduce the number of participants by 3,000 each year.”

Yglesias

Health Care Rules Everything Around Me

Yuval Levin and I disagree about a lot, but the truth contained in this chart is a profound one:

All the negotiations about this and that aside, over the long-term, budget policy is about health care policy. We need to choose some combination of the following options:

— 1. Higher taxes.
— 2. Systematic change to the cost structure of American health care.
— 3. Abandonment of the government’s commitment to provide health care to the poor and the elderly.

Government-provided health insurance is obviously more expensive to the government than is simple failure to provide it. But I think the fact that the government has a substantial cost advantage over the private sector when it comes to the provision of health insurance is a good reason to shy away from option (3). We ought to seek to improve the systematic cost-efficiency of the health care system, and then we ought to pay in higher taxes what it costs to provide what that gets us.

NEWS FLASH

Obama Pressured GOP To Abandon Health Care Repeal Efforts In Debt Ceiling Talks | The AP offers this interesting account of the debt ceiling negotiations: “Democratic officials said Obama called Boehner on Saturday night, one day after the collapse of compromise talks, and offered to reduce his demand for new tax revenue by $400 billion. In return, Obama said that he wanted Republicans to abandon their demand to cancel parts of the year-old health care law if future deficit cuts did not materialize. This official said Boehner rejected the proposal on Sunday.” [HT: AmericaBlog]

NEWS FLASH

Bennet Asks Sebelius To Accept IOM’s Recommendations On Preventive Care | Colorado Sen. Michael Bennet (D) is urging HHS Secretary Kathleen Sebelius to “follow the Institute of Medicine’s recommendation that insurers offer no-cost preventative services for women,” Inside Health Policy’s Amy Lotven reports. Sebelius is under pressure from Democrats to adopt the Institute’s recommendations, while a small group of conservative organizations is opposing the measure on the basis that greater access to contraception would increase unwanted pregnancies and could lead to more abortions. HHS is expected to make a decision on the recommendations by Aug. 1.

LGBT

HHS Identifies Final Areas Of Study Before FDA Can Lift Ban On Gay Blood Donations

The Department of Health and Human Services has released a document laying out the “four final areas for additional study” before the government can reverse the 1983 ban prohibiting men who have had sex with men since 1977 from donating blood. Responding to a request from Sen. John Kerry (D-MA) and Rep. Mike Quigley (D-IL), HHS identified the following areas of research:

– How the risk of blood transmissible diseases in the current donor population relate to risk factors in donors;

– The root cause of Quarantine Release Errors (QRE), the accidental release of blood not cleared for use;

– If potential donors correctly understand the current questionnaire and if men who have sex with men (MSM) would comply with modified deferral criteria; AND

– If alternative screening strategy (e.g. pre- and/or post-qualifying donation infectious disease testing) for MSM (and potentially other high-risk donors) would assure blood safety while enabling collection of data that could demonstrate safe blood collection from a subset of MSM or other currently deferred donors.

The Food and Drug Administration reviewed the ban — in place since 1983 and a relic of the HIV/AIDS epidemic — last year and voted to preserve it, despite overwhelming support from the medical community for eliminating the policy. American Red Cross, America’s Blood Centers, American Association of Blood Banks, American Medical Association, and a coalition of other organizations argue that advancements in HIV/AIDS detection — now possible nine to 11 days after contact — have significantly lowered the risk of passing along infected blood and made a lifetime ban unnecessary. They also point to the nation’s low blood supply as a reason to expand donor eligibility.

The policy itself is discriminatory. As Slate’s William Saletan put it, “Maybe you fooled around with a guy 30 years ago and have spent the rest of your life as a celibate priest. Maybe you’ve been in a faithful same-sex marriage for 40 years. Maybe you’ve passed an HIV test. It doesn’t matter. You can’t give blood, because you’re in the wrong ‘group.’ On the other hand, if you’re in the right group—heterosexuals—you can give blood despite dangerous behavior. If you had sex with a prostitute, an IV drug user, and an HIV-positive opposite-sex partner 13 months ago, you’re good to go.”

In upholding the ban last year, the FDA promised to reverse itself “if given data that show doing so wouldn’t pose a ‘significant and preventable‘ risk to blood recipients.”

Yglesias

The Price Of Life?

How much is a life worth, from the point of view of cost-benefit analysis? Well, as Kate Sheppard helpfully reminds us, it depends on which regulatory agency you ask:

I have to say that I don’t really understand the objection to valuing the lives of older people on a pro-rated basis. Refusing to do so just seems to lead to a situation in which the inevitable outcome is to undervalue the lives of young people.

Public Opposition To Medicare, Medicaid Cuts In Debt Ceiling Deal Leads To Local Protests

From a protest in Ohio

A group of protesters delivered petitions with 1,600 doctors’ signatures to John Boehner’s district office yesterday, asking the House Speaker to reject additional cuts to Medicare and Medicaid as part of any debt ceiling deal. “Let’s not dismantle it, let’s try to innovate, but do not amputate this wonderful program,” Don Nguyen, the state director of Doctors for America, said to Boehner’s representative.

Throughout the debt ceiling talks, Republicans have offered a series of proposals — from Ryan’s budget, to Cut, Cap and Balance, to Boehner’s latest deficit proposal — that would significantly lower Medicare and Medicaid spending. Democrats had also reportedly endorsed a series of entitlement cuts in exchange for revenue increases, although Sen. Harry Reid’s latest plan does not include any of these reductions.

Still, Americans are deeply opposed to cutting social safety net program and have been protesting such Congressional proposals throughout the country. Below is a sampling of recent actions:

– MICHIGAN: Seniors, parents, workers, and advocates called on Rep. Justin Amash (R-MI) to reject any deal to raise the debt ceiling that includes cuts in Medicaid, Medicare and Social Security. [7/21/2011]

– WISCONSIN: Seniors delivered a return receipt to Rep. Paul Ryan’s (R-WI) District office in Racine, WI calling on him to return his government insurance. [7/19/2011]

– NEW MEXICO: Seniors and health advocates held a press conference in front of Rep. Steve Pearce’s (R-NM) district office calling on him to return his government insurance.” [7/14/2011]

– WISCONSIN: Advocates asked the five Wisconsin Congressmen to return their government-funded health insurance coverage for voting in favor of Paul Ryan’s plan. [7/13/2011]

– FLORIDA: Local representatives and senior groups asked members who voted for the Paul Ryan plan to return their government-sponsored insurance. [7/12/2011]

The latest July 14-17 Washington Post/ABC News poll found that 72 percent of Americans oppose cutting Medicaid spending — including 59 percent of self-identified Republicans — and 54 percent are against raising the Medicare eligibility age.

NEWS FLASH

Ohio Gathers Enough Signatures To Vote On Constitutional Amendment Against ACA | In an attempt to abolish the Affordable Care Act’s provision mandating all Americans acquire health insurance, Ohio groups have gathered enough signatures from voters to add a constitutional amendment to the Nov. 8 ballot. Ohio Secretary of State Jon Husted today certified over 425,000 signatures in favor of the constitutional amendment – -around 40,000 over what the state’s election law required. One liberal watchdog has already taken issue with about 20 percent of the petitions, however, hinting that signature-authenticity challenges could lower that total. The Ohio Healthcare Freedom Amendment, if passed by voters, would prohibit any local, state, or federal law that would “compel, directly or indirectly, any person, employer, or health care provider to participate in a health care system.” –Sarah Bufkin

McKinsey Redux: The Problem With The Latest ‘Employers Will Drop Coverage’ Report

Former CBO head Douglas Holtz-Eakin appeared on Fox News this morning to hawk a National Federation of Independent Businesses (NFIB) study, which found that some small businesses would drop coverage if their employees purchase insurance coverage through the state-based exchanges:

HOLTZ-EAKIN: Number one, every time an employee takes advantage of the exchanges, it means the taxpayers are forking out a lot of money. The subsidies are quite generous, as much as $7,000 to a person making $70,000, 10 percent of their income. So that’s a real taxpayer burden. The second is it means employers are dropping coverage. There are insurance arrangements that they already have, and they’re going to go away. One of the central promises of the Affordable Care Act was if you like your insurance, you get to keep it, and that’s increasingly not true.

Watch it:

Holtz-Eakin forgot to mention that tax payers are already “forking out a lot of money” — some $200 billion a year — to encourage employers to continue providing health insurance to their employees, most of whom would not be able to apply for subsidies within the exchanges. That’s because “subsidies aren’t available to anyone whose company offers a healthcare plan that costs less than 9.5 percent of his or her income.” So the NFIB survey and Holtz-Eakin have it backwards “employees would head to the exchanges if their companies quit offering healthcare, rather than employers dropping coverage because their employees aren’t taking it.”

And despite Holtz-Eakin’s claims to the contrary, there is very little evidence to suggest that employers would benefit from eliminating the health care benefit and making up the difference in higher wages (an added cost, particularly for higher-paid employees). As NFIB senior fellow Denny Dennis, who wrote the report, admitted on a conference call with Politico’s Jason Millman, there’s no “slam dunk” evidence that that businesses will dump coverage are a result of the law.

NEWS FLASH

Senators Introduce Bill To Beef Up Regulations Of Medigap Plans | Via Politico’s Pulse: “Rep. Pete Stark and Sen. John Kerry are introducing companion bills today that would apply the health care law’s new medical loss ratio rules to private Medigap plans. Currently, Medigap plans have a 65 percent MLR requirement for the individual market and a 75 percent requirement in the large group market.” Under the proposed legislaiton, they would be required to spend 80 percent of premium dollars on medical care in the individual market, and 85 percent in the large group market. Seniors purchase Medigap plans to fill the “gaps” between what Medicare plan covers and what the beneficiary will have to end up paying.

How Boehner’s Debt Plan Produces ‘The Greatest Increase In Poverty And Hardship’ In American History

John Boehner’s debt ceiling proposal would add $1 trillion to the current $14.3 trillion debt limit (which would be expected to allow the government to continue borrowing into April of 2012), reduce spending immediately and cap future spending to save $1.2 trillion over 10 years, and establish a 12-member joint committee of Congress charged with reporting back to both chambers by Nov. 23 with recommendations to reduce the deficit by an additional $1.8 trillion over 10 years. The plan also calls for a vote on a constitutional balanced budget amendment before the end of 2011.

It’s a plan that the usually “mild-mannered” Robert Greenstein of the Center on Budget and Policy Priorities (CBPP) is describing as “tantamount to a form of ‘class warfare’” that “if enacted, it could well produce the greatest increase in poverty and hardship produced by any law in modern U.S. history.” Since Boehner’s blueprint contains no tax increases and his first round of cuts targets discretionary spending, the joint committee will have no choice but to achieve its $1.8 trillion in budget reductions by cutting entitlement spending, Greenstein explains:

– As a result, virtually all of that $1.8 trillion would come from entitlement programs. They would have to be cut more than $1.5 trillion in order to produce sufficient interest savings to achieve $1.8 trillion in total savings.

– To secure $1.5 trillion in entitlement savings over the next ten years would require draconian policy changes. Policymakers would essentially have three choices: 1) cut Social Security and Medicare benefits heavily for current retirees, something that all budget plans from both parties (including House Budget Committee Chairman Paul Ryan’s plan) have ruled out; 2) repeal the Affordable Care Act’s coverage expansions while retaining its measures that cut Medicare payments and raise tax revenues, even though Republicans seek to repeal many of those measures as well; or 3) eviscerate the safety net for low-income children, parents, senior citizens, and people with disabilities. There is no other plausible way to get $1.5 trillion in entitlement cuts in the next ten years. [...]

In short, the Boehner plan would force policymakers to choose among cutting the incomes and health benefits of ordinary retirees, repealing the guts of health reform and leaving an estimated 34 million more Americans uninsured, and savaging the safety net for the poor. It would do so even as it shielded all tax breaks, including the many lucrative tax breaks for the wealthiest and most powerful individuals and corporations.

Congressional Quarterly’s Richard E. Cohen also reports that Boehner’s powerful panel has “no precise parallel” and will have to overcome severe logistical hurdles. “The panel would then be required to complete its work before Thanksgiving — a period of less than four months that includes the monthlong congressional August recess, two additional weeks of scheduled House breaks and three other weeks when the Senate is slated to be gone.”

It would also “have to work with existing House and Senate committees with longstanding jurisdictional claims on the issues in play and build majority support in both chambers of a divided Congress. The GOP has already cautioned that it “will not appoint any members who will approve tax hikes,” a selection criterion that “Reid and Pelosi would most certainly not follow.” The committee’s recommendations would then face up-or-down floor votes in the House and Senate without additional amendments.

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Morning CheckUp: July 26, 2011

Welcome to Morning CheckUp, ThinkProgress Health’s 7:00 AM round-up of the latest in health policy and politics. Here is what we’re reading, what are you?

Reid plan: Raise the debt ceiling by $2.4 trillion, enough to last the government through 2012, and would include $1.2 trillion in discretionary spending cuts decided in earlier bipartisan talks led by Vice President Joseph R. Biden Jr. An additional $100 billion would come from “savings” in mandatory programs, including the sale of spectrum and changes to farm subsidies and $1 trillion would come from “savings from winding down the wars in Iraq and Afghanistan. [CQ]

Boehner alternative: Immediately cut spending and impose a 10-year cap on discretionary spending to save $1.2 trillion, force a vote on a constitutional amendment by October 1, and raise the debt limit by $1 trillion, an amount expected to satisfy the government’s borrowing needs until next February. The caps would include a sequester mechanism that would be triggered if the spending limits were not met in any year, forcing across-the-board spending cuts in all non-exempt accounts. The specifics of the proposal to cut an additional $1.8 trillion in federal spending would be prepared by a 12-member joint congressional committee in December made up of three lawmakers from each party and each chamber. [CQ]

A possible compromise: “The final plan could adopt Reid’s initial spending cuts, which are both slightly larger and more impressively stated than Boehner’s, and Reid’s longer debt-ceiling increase. But it could adopt Boehner’s idea for across-the-board spending cuts — perhaps in an augmented form that includes penalties designed to bring Republicans to the table — if a second round of deficit reduction doesn’t pass. It could also include a vote on a balanced-budget amendment, though I personally dislike this policy and consider it a mistake.” [Ezra Klein]

Obama’s prepares for stalemate: “I’m not really sure what Obama was trying to accomplish in his speech. I thought he would try to find some kind of lowest common denominator between the Reid and Boehner plans that would stand a chance of passing Congress. He didn’t. Instead he appealed once again to the Grand Bargain. If Obama thinks Congress will pass something like that, he’s nuts. The Senate might, but the House never, ever would. The most rational explanation for Obama’s speech is that he’s positioning himself for failure. He’s explaining his position so that when Congress fails to lift the debt ceiling, Americans will blame the Republicans and not him.” [Jonathan Chait]

Boehner’s plan could still lead to downgrade: “Minutes before House Speaker John Boehner delivered a prime-time address in which he framed his latest deficit-reduction deal as a silver bullet for the nation’s economic uncertainty, reports surfaced that the plan being crafted by the Ohio Republican would potentially lead to a downgrading of the AAA credit rating of the United States.” [Sam Stein]

Feds to begin rate review: “Starting Sept. 1, federal and state officials will begin to scrutinize proposed rate increases of more than 10 percent to determine if they are justified. White House officials say their ability to publicize excessive, unreasonable rates will be a major protection for consumers under President Obama’s health care law.” [NYT]

Kansas tout sovereignty in Planned Parenthood defunding: “The state of Kansas defended a budget provision which defunded a Planned Parenthood chapter as a matter of state sovereignty, arguing in a court document that a proposed injunction would unconstitutionally replace the state’s discretion with the court’s judgment.” [AP]

Chris Van Hollen holding firm against Medicaid cuts: “Walking away from the federal commitment to Medicaid doesn’t solve the problem; it just passes health care costs down to states. Because almost every state, including Maryland, is required by law to balance its budget every year, it means cuts in services and more financial strains for already suffering families, cuts in provider payments, lost jobs in the health care sector, and dampened business activity as the consequences of lost jobs and unmet health care needs ripple through the economy.” [Baltimore Sun]

Louisiana Medicaid privatization: “Louisiana health officials announced Monday that five health plans won bids to manage care for 892,000 low-income Medicaid patients — a first for the state that will be worth an estimated $2.2 billion in new revenues for the companies.” [Kaiser Health News]

Remember the children: “Forty House Democrats signed onto a letter spearheaded by Rep. Danny Davis (D-IL) urging leaders of both parties to hold children harmless in any deal to raise the debt ceiling, including cuts to Medicaid and the Children’s Health Insurance Program.” [The Hill]

Mammogram confusion: “The American College of Obstetricians and Gynecologists updated its recommendations last week, saying that women at average risk for breast cancer should be offered a mammogram every year, starting at age 40. The group previously advised women to get the test every one to two years in their 40s and then annually starting at age 50.” [WSJ]

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