House Republicans approved a budget in April that would drive up Medicare costs for seniors, and Mitt Romney has embraced the plan crafted by Rep. Paul Ryan (R-WI). But not all in the party are in agreement. Ten Republicans voted against Ryan’s budget in April, and now, Rep. David McKinley (R-WV) is campaigning on his opposition to it.

McKinley’s office outlines his opposition to the GOP-backed plan in a flier sent to his constituents, many of whom receive Medicare benefits. . “Congressman McKinley recently voted against the 2012 budget passed by the House because of the plan’s negative impact on northern West Virginia seniors,” it reads. Here’s the flier:

The GOP plan that McKinley opposes would give seniors the option of enrolling in traditional Medicare or taking a stipend to buy their own health care policy on the private market. Republicans have argued it would slow the federal government’s rising costs for Medicare, but the Congressional Budget Office says the plan would increase seniors’ out-of-pocket costs by privatizing Medicare.

In the flier, McKinley says Congress “must balance the budget,” but not on the backs of seniors. McKinley spokesman Jim Forbes told the Los Angeles Times that the congressman “is standing for what he believes in,” but in an election cycle dominated by health care and budget issues, McKinely’s stance is out of step with the rest of his party.

Rep. Jared Polis (D-CO), a staunch advocate for the legalization of medical marijuana, rebuked Michele Leonhart, the head of the Drug Enforcement Agency, yesterday at a Congressional hearing because she would not say if crack is worse than marijuana.

Polis grilled Leonhart, ticking off a list of illicit drugs — including crack, meth, and heroin — and asking whether each was just as bad for a person as smoking marijuana. Leonhart refused to concede that marijuana has significantly fewer potential health risks, or that medicinal use of pot might alleviate the high numbers of patients who struggle with addiction prescription drugs, which have much higher health risks:

POLIS: Is crack worse for a person than marijuana?

LEONHART: I believe all the illegal drug –

POLIS: Is methamphetamine worse for somebody’s health than marijuana?

LEONHART: I don’t think any illegal drug –

POLIS: Is heroin worse for someones health than marijuana?

LEONHART: Again, all the drugs –

POLIS: I mean, either yes, no, or I don’t know. I mean, if you don’t know, you can look this up you should know this as the chief administrator for the Drug Enforcement Agency. I’m asking you a very straightforward question. Is heroin worse for someone’s health than marijuana?

LEONHART: All the illegal drugs are bad.

POLIS: Does this mean you don’t know?

LEONHART: Heroin causes an addiction that causes many problems that’s very hard to kick.

POLIS: Does that mean that the health impact is worse than marijuana, is that what you’re telling me?

LEONHART: I think that you are asking a subjective question.

Watch it:

Heroin addiction can lead to “bone and muscle pain, nausea, diarrhea and vomiting.” Use of methamphetamine “[inhibits] the body’s ability to repair itself. Acne appears, sores take longer to heal, and the skin loses its luster and elasticity.” Crack can lead to side effects “as severe as heart attack, stroke, increased heart rate and even, in some cases, death.”

The long term side effects of marijuana use include “irritability, sleeplessness, decreased appetite, anxiety, and drug craving,” according to the government’s drug abuse website, “These symptoms begin within about 1 day following abstinence, peak at 2-3 days, and subside within 1 or 2 weeks following drug cessation.”

House Minority Leader Nancy Pelosi (D-CA) doubled down on the importance of the individual mandate Thursday morning, just days before the Supreme Court is expected to rule on the constitutionality of the Affordable Care Act.

“You have to have the mandate for [health reform] to work from a financial standpoint,” Pelosi told reporters at her weekly press conference, implying that some Democrats may advocate for a mechanism that requires individuals to purchase insurance even if the existing provision is ruled unconstitutional. “I believe the court will rule in favor. We’re iron clad constitutionally, we’re iron clad on the constitution,” Pelosi — who has long maintained that the Court will uphold the law in a 6 to 3 decision — said, but noted that it would be difficult to retain some of the law’s popular provisions in the absence of the individual requirement:

PELOSI: You have to eat your vegetables — you have to have the mandate in order for this to work from a financial standpoint…If Americans like the idea that they and their children cannot be deprived for a lifetime of health care insurance because of a pre-existing health care condition, then that will require some other action if that is to happen. And what would that be? There could be something passed in the Congress, similar to what we had originally in the House bill, which was a surcharge on the wealthy to pay for aspects of that … States can take their own actions … We cannot say to the American people, we are going to throw you on the mercy of insurance companies who refuse coverage to you.

Watch it:

“Let’s hope and pray that the Court will love the Constitution more than it loves broccoli and that we will have a decision that is based on the merits and the Constitution of the United States,” Pelosi concluded.

Her tone is a stark contrast to the stance of some Democrats who have hinted that they will stress the law’s other benefits should the court invalidate the unpopular individual requirement.

As the Affordable Care Act continue to be implemented, the Department of Health and Human Services (HHS) announced Wednesday that $128.6 million in new grants have been awarded to local health centers. More than 200 clinics received grants to help expand access to health care for 1.25 million patients, and the grants are expected to fund 300 new clinics and create 5,600 jobs by infusing “critical dollars into health centers and their surrounding communities.”

HHS Secretary Kathleen Sebelius said the grants should be seen as symbolic of Obamacare’s impact more generally, adding, “the health care law is making our community health centers stronger and ensuring more Americans get the care they need.” And HHS underscored the connection between the health care reform law and the expansion of quality health care:

As community-based and patient-directed organizations, health centers are well positioned to be responsive to the specific health care needs of their community. Through the Affordable Care Act’s commitment to expand access to high quality health care for all Americans, these grants will support establishment of new full-time service delivery sites. [...]

Since the beginning of 2009, health centers have added more than 25,300 new full-time positions. The awards announced today will infuse critical dollars into health centers and their surrounding communities, enhancing health centers’ ability to serve more patients and creating thousands of jobs across the country.

But if the Supreme Court rules that Obama is unconstitutional, then HHS will have to “unravel several programs like these that have distributed money to parts of the healthcare system,” potentially endangering access to health care for millions of Americans.

–-Nina Liss-Schultz