HCR Update from Mark Sanna: A new survey from the Center for Studying Health System Change and the Robert Wood Johnson Foundation shows that one in five Americans reported trouble paying medical bills last year.

HCR Update from Mark Sanna: Yesterday the U.S. House of Representatives and the U.S. Senate passed legislation extending a Social Security tax cut, which included a provision that delays--for two months--the 27.4 percent cut in reimbursement to Medicare providers, including doctors of chiropractic.

HCR Update from Mark Sanna: Most members of the U.S. House of Representatives joined their Senate colleagues on Tuesday in going back home to their districts without agreeing on a tax measure that also contained a provision calling off the scheduled 27.4% cut in reimbursement to Medicare providers, including doctors of chiropractic.

HCR Update from Mark Sanna: The Supreme Court will hear arguments on President Obama's healthcare law over a three-day span from March 26-28. The schedule further confirms the universal expectation that the court will issue a ruling on the healthcare law next June, at the height of the 2012 campaign.

HCR Update from Mark Sanna: As part of the 2009 stimulus bill, the federal government provides incentive payments to doctors and hospitals to adopt electronic health records. Some 57 percent of office-based physicians now use electronic health records, a 12 percent jump from last year, according to the Centers for Disease Control.

HCR Update from Mark Sanna: In a major surprise on the politically charged new health care law, the Obama administration said Friday that it would not define a single uniform set of “essential health benefits” that must be provided by insurers for tens of millions of Americans. Instead, it will allow each state to specify the benefits within broad categories.

HCR Update from Mark Sanna: The specter of nursing strikes is looming on both coasts, as newly empowered nurses’ unions confront hospitals pressed to cut costs amid changes in health care financing. In New York, over 6,000 registered nurses are poised to walk out of three of the city’s most prestigious hospitals before the year’s end. A 24-hour walkout is set for Dec. 22 in California.

HCR Update from Mark Sanna: On Tuesday, the U.S. House of Representatives, largely on a party-line vote, passed a bill which contained language calling off the scheduled 27.4% cut in reimbursement to Medicare providers, including doctors of chiropractic. The measure calls for a 1% increase in reimbursement rates in years 2012 and 2013.

HCR Update from Mark Sanna: Unless lawmakers step in, doctors treating Medicare patients will see a 27% cut in reimbursements in January. House Republicans would block the cut and replace it with increases of 1% a year in 2012 and 2013. That would cost $39 billion, the budget office estimates. The cost of a 10-year fix, $300 billion or more, is so high that Congress is not seriously considering it.

HCR Update from Mark Sanna: A state legislative audit says Maryland paid $426,000 in Medicaid to 10 people who were dead. The audit, released Wednesday, also found that between January 2008 and August 2011, $2.5 million in erroneous payments were made for 323 people who may have already been dead.

HCR Update from Mark Sanna: The latest United Health Foundation’s America’s Health Rankings unveiled today has a scary message for the nation: Obesity has ballooned from 11.6% of the adult population in 1990 to 27.5% in 2011.

HCR Update from Mark Sanna: The House and Senate are already heading in different directions as they work towards a catchall, end-of-the-year bill that, in part, holds off a 27% Medicare physician pay cut. That's largely because they're looking at completely different ways to pay for it — leading to a potential year-end clash over the $22 billion price tag.

HCR Update from Mark Sanna: Dr. Donald M. Berwick, the official in charge of Medicare and Medicaid for the last 17 months, says that 20% to 30% of health spending is “waste” that yields no benefit to patients, and that some of the needless spending is a result of onerous, archaic regulations enforced by his agency.

HCR Update from Mark Sanna: The Department of Health and Human Services today released its final medical loss ratio rule. The rule will ensure that health insurance companies spend at least 80 percent of consumers' health insurance premiums on medical care rather than on income, overhead and marketing expenses.

HCR Update from Mark Sanna: More than 2,400 health care providers and advocates sent a letter to Secretary of HHS today objecting to recommendations made by a panel of the Institute of Medicine regarding what benefits must be covered in state health insurance marketplaces developed under the Affordable Care Act. The critics objected to the group's decision to start with a typical small business plan rather than a more comprehensive plan offered by larger employers.

HCR Update from Mark Sanna: It's become a symbol of sorts for the federal government's budget dysfunction: Unless Congress acts before Jan. 1, doctors will again face steep Medicare cuts that threaten to undermine health care for millions of seniors and disabled people. This time it's a 27.4% cut.

HCR Update from Mark Sanna: A report published today shows that the United States spent about $7,960 per person on health care in 2009 – about 2.5 times the average of the countries studied. It also found that health spending in the U.S. has increased faster than in all other high-income countries since 1970, even accounting for population growth.

HCR Update from Mark Sanna: The failure of the congressional super committee could mean automatic budget cuts totaling billions of dollars for everything from Medicare to biomedical research, starting in 2013.

HCR Update from Mark Sanna: A dispute has erupted between President Obama and Democrats in Congress over a proposal to broaden the exemption from new rules that require health insurance plans to cover contraceptives for women free of charge. The White House is considering a change that would grant a broad exemption to health plans sponsored by employers who object to such coverage for moral and religious reasons.

HCR Update from Mark Sanna: Despite serving as the "foundational element" of the U.S. healthcare system, the nation's primary-care network is experiencing "diminishing economic margins, and increasing workforce attrition compounded by diminishing recruitment of new physicians, nurses and physician assistants into primary care," according to the U.S. Agency for Healthcare Research and Quality.

HCR Update from Mark Sanna: A state-by-state analysis finds that from 2003 to 2010, premiums for family coverage increased an average of 50%. At that rate, the average family premium would balloon to nearly $24,000 by 2020, according to the study, which was conducted by The Commonwealth Fund, a nonprofit health policy foundation.

HCR Update from Mark Sanna: More and more employers are demanding that workers who smoke, are overweight or have high cholesterol shoulder a greater share of their health care costs, a shift toward penalizing employees with unhealthy lifestyles rather than rewarding good habits. Policies that impose financial penalties on employees have doubled in the last two years to 19% of 248 major American employers recently surveyed.

HCR Update from Mark Sanna: With the high court's announcement Monday that it would decide on the constitutionality of the individual mandate in the Affordable Care Act, we are assured of a decision coming smack dab in the middle of the 2012 general election campaign.

HCR Update from Mark Sanna: At 10 a.m. today, the Supreme Court issued its orders for the upcoming 2012 term, which includes the details of how the oral arguments related to the health law will shape up.

HCR Update from Mark Sanna: This week conservative legal activists renewed their calls for Supreme Court Justice Elena Kagan to abstain from cases involving President Obama's healthcare law. Conservatives say Kagan should recuse herself from suits over the law's individual mandate because the administration began planning its defense while she was solicitor general.

HCR Update from Mark Sanna: Poorly designed, hard-to-use computerized health records are a threat to patient safety, and an independent agency should be set up to investigate injuries and deaths linked to health information technology, according to a federal study released Tuesday. The report by the Institute of Medicine comes as the government is spending billions of dollars in incentive payments to encourage doctors and hospitals to adopt electronic health records. 

HCR Update from Mark Sanna: A federal appeals court in Washington upheld the Obama administration’s health care law on Tuesday in a decision written by a prominent conservative jurist. The decision came as the Supreme Court is about to consider whether to take up challenges to the Affordable Care Act, a milestone legislative initiative of the administration. Of four appellate court rulings on the health care law so far, this is the third to deal with the law on the merits, and the second that upholds it.

HCR Update from Mark Sanna: Most Americans also think the overall health of the public isn't improving, according to a new poll commissioned by the Robert Wood Johnson Foundation. The poll found that 45% of people thought the health of Americans had become worse during the past five years, and 40% thought it had stayed about the same. Only 13% thought it was better.

HCR Update from Mark Sanna: As the super committee struggles to meet its Thanksgiving deadline. Republicans have been steadfast in their refusal to raise taxes, and Democrats are only willing to engage in cuts to Medicare and other entitlement programs if new revenues are part of the mix. Meanwhile, health care providers, worried about Medicaid cuts and other programs, have taken out big ads around Washington to make their case.

HCR Update from Mark Sanna: If the Supreme Court next year gets rid of the health reform law's requirement to buy insurance, Republicans could gain momentum to get rid of the rest of the law — and President Barack Obama would suffer a huge embarrassment at the height of an election year. But Democrats and supporters of the law also see a silver lining: If the least popular part of the law goes away, they think what's left could become stronger and more popular with the public.

HCR Update from Mark Sanna: A $5 billion fund created as part of the health care overhaul to pay for health insurance for early retirees will run out of money by September 2012, according to a federal report released Monday. Around 6,000 employers are currently getting subsidies through the program to help pay for benefits for retired workers between the ages of 55 and 64.

HCR Update from Mark Sanna: Public support of last year's health care law hit an all-time low in October as many Democratic voters lost confidence that one of President Barack Obama's major programs will improve their lives, a new poll finds. For the first time, as many people believe the law won't make the country better off as believe it will. The poll found that 51% of the public now dislikes the law and only 34% favor it.

HCR Update from Mark Sanna: Monthly Medicare premiums for most beneficiaries will rise next year by $3.50, to $99.90, a much smaller increase than had been expected, the Obama administration said Thursday. Administration officials rejoiced at the modest increase, which could pay political dividends to President Obama as he tries to win the votes of older Americans in his bid for re-election.

HCR Update from Mark Sanna: GOP presidential hopeful Rick Perry's new plan, which includes a national flat tax, would cut discretionary funding by at least $100 billion a year, and would overhaul Medicare and Medicaid. In other news, a new poll uncovers deep distrust of the government, with about a quarter of the public in favor of repealing the entire health law.

HCR Update from Mark Sanna: Four GOP governors sent a letter Monday to the congressional joint committee tasked with drafting a plan to reduce the country's debt, urging the 12-member panel to rule out tax increases and any proposals that would shift Medicaid costs from the federal government to the states.

HCR Update from Mark Sanna: The final rule on the ACOs or (Accountable Care Organizations) was published. While it was determined that only an MD and DO would be able to form an ACO, It was clearly written that doctors of chiropractic should be participants and will be eligible to participate in the savings incentives of such plans. The fact that DCs cannot form one as primary care physicians is mitigated by the fact that those who form them are limited to participating in only that one. However, a DC who is a participant can join multiple ACOs. A true benefit to the doc in the field.

HCR Update from Mark Sanna: The Obama administration released its new plans for Medicare Accountable Care Organizations (ACOs) this week and relaxed requirements for doctors and hospitals to participate in the program. Some insurers and employers, however, complained that the changes will increase the chances that providers will consolidate, which could reduce competition and drive up costs.

HCR Update from Mark Sanna: The Obama administration and challengers of the health care overhaul are pushing for Supreme Court consideration of the law in late March, judging by the speed with which they are filing legal papers. This week, the Obama administration, the 26 states that have joined in opposition to the law and the association of small businesses that also wants the law struck down filed their briefs more than a week before they were due.

HCR Update from Mark Sanna: After three years of study, Massachusetts’s legislative leaders appear close to producing bills that would make it the first state — again — to radically revamp the way doctors, hospitals and other health providers are paid. The plan would encourage flat “global payments” to networks of providers for keeping patients well, replacing the fee-for-service system that creates incentives for excessive care by paying for each visit and procedure.

HCR Update from Mark Sanna: For the first time, a government-backed quality rating will have a financial meaning to health insurance companies looking to attract millions of older Americans to privately run Medicare coverage next year. Medicare Advantage Plans are expected to use quality ratings unveiled this week to attract more business and promote their ratings, given that the federal government is dangling a carrot in the form of bonus payments ranging from 3 to 5 percentage points.

HCR Update from Mark Sanna: The Obama administration announced Friday that it was scrapping a long-term care insurance program created by the new health care law because it was too costly and would not work. The program, which was intended for people with chronic illnesses or severe disabilities, was known as Community Living Assistance Services and Supports, or Class.

HCR Update from Mark Sanna: The House on Thursday returned to an abortion issue that nearly sank President Obama's health care law last year with legislation that bars an insurance plan regulated under the new law from covering abortion if any of its customers receive federal subsidies. Providers that offer abortion coverage would have to set up identical plans without abortion coverage to participate in the health insurance exchanges to be set up under the new law.

HCR Update from Mark Sanna: For the first time, a government-backed quality rating will have a financial meaning to health insurance companies looking to attract millions of older Americans to privately run Medicare coverage next year. Medicare Advantage Plans are expected to use quality ratings unveiled Wednesday to attract more business and promote their ratings, given that the federal government is dangling a carrot in the form of bonus payments ranging from 3 to 5 percentage points.

HCR Update from Mark Sanna: A watchdog agency in the US Department of Health and Human Services (HHS) wants to know how many office visits, consultations, eye exams, skin grafts, and other services are performed by unqualified nonphysicians under Medicare's "incident-to" billing rules. This is just one new investigation that the HHS Office of Inspector General (OIG) plans to conduct next year.

HCR Update from Mark Sanna: Medicare supplemental health plans, popular among politically powerful retirees, could come under the budget knife being wielded by the special deficit-reduction panel of Congress, according to sources keeping close watch on its work. ... While the elderly buy the private plans, studies suggest they boost government Medicare costs as the extra coverage for deductibles and co-pays encourages greater use of medical services.

HCR Update from Mark Sanna: The government moved a step closer today toward defining what 'essential benefits' would be offered by companies selling coverage to millions of Americans in new insurance exchanges. In a 297-page report, the Institute of Medicine, a federal advisory panel, laid out criteria and methods the Department of Health and Human Services should use in developing the package. But, as expected, the report left to HHS the job of deciding specific benefits.

HCR Update from Mark Sanna: A top GOP House lawmaker hopes the deficit-cutting panel will focus entirely on health care costs to reach the $1.2 trillion savings target. Meanwhile, in the background, the Wall Street Journal reports that nearly half of all U.S. households receive government benefits, with about 34% getting means-tested assistance such as Medicaid.

HCR Update from Mark Sanna: The Supreme Court justices opened their new term Monday by hearing a major health care case that tests whether judges can stop California and other cash-strapped states from cutting their payments to doctors and hospitals who serve low-income patients.

HCR Update from Mark Sanna: Companies next year will push more health care costs onto their workers, who may see an increase of nearly 11 percent in what they have deducted from their paychecks for health insurance, according to a new annual study by Aon Hewitt, a large Chicago benefits consultancy.

HCR Update from Mark Sanna: The Supreme Court will hear arguments Monday in a healthcare case that pits states against the federal government — and Democrats against Democrats. At issue is whether patients and healthcare providers can sue to block states from cutting their Medicaid rates. The suit was filed after California proposed a series of Medicaid cuts, some as high as 10%.

HCR Update from Mark Sanna: The 2010 health care overhaul law has provoked an unprecedented clash between the federal government and 26 states, dividing them on fundamental questions about the very structure of the federal system. But the two sides share a surprising amount of common ground, too, starting with their agreement in briefs, filed on Wednesday, that the Supreme Court should resolve the clash in its current term.

HCR Update from Mark Sanna: The Obama administration asked the Supreme Court on Wednesday to hear a case concerning the 2010 health care law. The development, which came unexpectedly fast, makes it all but certain that the court will soon agree to hear one or more cases involving challenges to the law, with arguments by the spring and a decision by June, in time to land in the middle of the 2012 presidential campaign.

HCR Update from Mark Sanna: The Obama administration must decide today whether to ask the full U.S. 11th Circuit Court of Appeals to reconsider a 2-1 August decision declaring unconstitutional the health law's individual mandate. If it does seek the full court's review, which could take weeks or months, it will likely push back a Supreme Court ruling until 2013.

HCR Update from Mark Sanna: Data released yesterday by the Centers for Disease Control and Prevention show that in the first quarter of 2011, the percentage of adults between ages 19 and 25 without health insurance fell 3.5 percentage points — to 30.4%. That translates to about an additional 1 million people that got coverage from the previous year. It's the third survey in recent weeks to credit a piece of the health law with giving more young adults insurance.

HCR Update from Mark Sanna: Carolyn and Matthew Bucksbaum have donated $42 million to the University of Chicago Medical Center to create an institute devoted to improving medical students’ handling of the doctor-patient relationship. The Bucksbaum Institute for Clinical Excellence, to be announced today, will be led by Dr. Mark Siegler, a doctor the couple found compassionate and humble. “To care for a patient,” Dr. Siegler said, “you have to care about a patient.”

HCR Update from Mark Sanna: Aetna, Humana, Kaiser Permanente and UnitedHealthcare have agreed to provide their claims data to a new nonprofit research initiative called the Health Care Cost Institute. The institute will have more than 5 billion medical claim records representing more than $1 trillion of health care spending in private plans and Medicare Advantage plans. The researchers’ are salivating because the patterns of medical care for people with private insurance — two thirds of the covered population — mostly remain a mystery, even as health care costs threaten to bankrupt the nation.

HCR Update from Mark Sanna: President Obama’s budget director said Monday that the president’s new deficit-reduction plan would impose “a lot of pain,” and that is clearly true of White House proposals to cut $320 billion from projected spending on Medicare and Medicaid in the coming decade. A large share of the Medicare savings would be used to pay doctors, who would otherwise face deep cuts in the fees they receive for treating Medicare patients.

HCR Update from Mark Sanna: Obama's debt reduction proposal, which is scheduled for release today, will include $320 billion in health care savings, but it will not raise Medicare's eligibility age. Half of its savings result from new tax revenue. President Obama is also sending a warning to congressional Republicans: If they send him a bill that cuts programs for poor and elderly Americans but doesn't impose sacrifice on corporations or ask others to sacrifice, he will veto it.

HCR Update from Mark Sanna: President Obama on Monday will call for a new minimum tax rate for individuals making more than $1 million a year to ensure that they pay at least the same percentage of their earnings as middle-income taxpayers. He is expected to call for $300 billion in savings from changes to Medicare and Medicaid as a way of reducing the deficit.

HCR Update from Mark Sanna: Three journalism organizations on Thursday protested a decision by the Obama administration to remove a database of physician discipline and malpractice actions from the Web. The National Practitioner Data Bank, created in 1986, is used by state medical boards, insurers and hospitals. The “public use file” of the data bank, with physician names and addresses deleted, has provided valuable information for many years to researchers and reporters investigating oversight of doctors, trends in disciplinary actions and malpractice awards.

HCR Update from Mark Sanna: In the latest advance for health care accountability, the country’s leading hospital accreditation board, the Joint Commission, released a list on Tuesday of 405 medical centers that have been the most diligent in following protocols to treat conditions like heart attack and pneumonia. None of the 17 medical centers listed by U.S. News & World Report on its “Best Hospitals Honor Roll” this year are on the list.

HCR Update from Mark Sanna: Laughter is regularly promoted as a source of health and well being, but it has been hard to pin down exactly why laughing until it hurts feels so good. The answer, reports Robin Dunbar, an evolutionary psychologist at Oxford, is not the intellectual pleasure of cerebral humor, but the physical act of laughing. The simple muscular exertions involved in producing the familiar ha, ha, ha, he said, trigger an increase in endorphins, the brain chemicals known for their feel-good effect.

HCR Update from Mark Sanna: Today, hospitals and doctors use a system of about 18,000 codes to describe medical services in bills they send to insurers. A new federally mandated version will expand the number to around 140,000 — adding codes that describe precisely what bone was broken, or which artery is receiving a stent. The system, known as ICD-10, will provide a more exact accounting of diagnoses and inpatient procedures, which could improve payment strategies and care guidelines.

HCR Update from Mark Sanna: Americans seem to be paying the price for the unrelenting rise in health care costs in this country, according to several studies being published last week in Health Affairs, an academic journal. The higher cost of coverage has taken a huge cut in the increase in income earned by the average family, says one study, and lower-income families are particularly hard hit, according to another. Meanwhile, the numbers of people who cannot afford insurance or do not have enough coverage have significantly increased, according to a third study.

HCR Update from Mark Sanna: A federal appellate court in Richmond, Va., on Thursday threw out a pair of cases challenging the constitutionality of President Obama’s 2010 health care law, ruling for varying reasons that the plaintiffs did not have legal standing to sue. Still other cases continue to progress through the appellate process. The Supreme Court has yet to signal whether it will accept one or more of the cases.

HCR Update from Mark Sanna: Doctors are paid higher fees in the United States than in several other countries, and this is a major factor in the nation’s higher overall cost of health care, says a new study by two Columbia University professors, one of whom is now a top health official in the Obama administration. “U.S. primary care physicians earn about 1/2 more than do their counterparts elsewhere because a much larger share of their incomes is derived from private insurance,” the study said.

HCR Update from Mark Sanna: Fewer adults in the United States are smoking and those who do are smoking fewer cigarettes each day, but the trend is weaker than the government had hoped. A report released Tuesday by the Centers for Disease Control and Prevention showed that 19.3% of adults said they smoked last year, down from about 21% in 2005. The rate for smoking 30 or more cigarettes daily dropped to about 8% from almost 13% over the same period.

HCR Update from Mark Sanna: Starting this past Thursday, insurers that propose to increase their rates by 10% or more must submit their request to state or federal reviewers, who will determine if those hikes are reasonable, according to HHS. As part of this process, independent experts will study information about underlying costs trends in health care and will indicate when insurance companies raise their costs unjustly.

HCR Update from Mark Sanna: Signaling its commitment to tackling the social issues that affect childhood obesity, the White House announced on Friday that Dr. Judith S. Palfrey will head Michelle Obama’s “Let’s Move” campaign to fight childhood obesity. A pediatrician for more than 30 years, Dr. Palfrey recently served as president of the American Academy of Pediatrics and director of the Children’s Hospital of Boston’s global health efforts.

HCR Update from Mark Sanna: After the collapse of negotiations between Atlanta’s public hospital, Grady Memorial, and the world’s largest dialysis provider, a dozen immigrants suffering from renal failure were refused treatment at an Atlanta clinic, operated by Fresenius Medical Care North America, on Thursday and advised to wait until their conditions deteriorated enough to justify life-saving care in an emergency room.

HCR Update from Mark Sanna: The results of an analysis performed by researchers in Ontario on 30,000-year-old bacteria whose DNA has been recovered from the Yukon permafrost shows that they were able to resist antibiotics. Experts had long predicted this on theoretical grounds, but they say the new finding underlines the need to use antibiotics sparingly, given that the genes for antibiotic resistance are ubiquitous and can easily be promoted by antibiotics.

HCR Update from Mark Sanna: According to a recent AP poll, the largest generation may now be the fattest generation ever. And that spells trouble for the health care system. Studies show that baby boomers — 81 million born between 1946 to 1964 — are losing the battle of the bulge. About a third of boomers are obese and an additional 36 percent are overweight.

HCR Update from Mark Sanna: A study published this month in the Journal of Health Affairs, asked hundreds of physicians and administrators in private practices across the United States and Canada how much time they spent each day with insurers and other third-party payers, tracking down information for claims that were denied or incorrectly paid, resolving questions about insurance coverage for prescription drugs or diagnostic tests, and filing the different forms required by each and every insurance company. American doctors in the study spent far more dealing with multiple health plans: more than $80,000 per year per physician, or roughly four times as much as their northern counterparts. And their offices spent as many as 21 hours per week with payers, nearly 10 times as much as the Canadian offices.

HCR Update from Mark Sanna: Right-wing radio host Rush Limbaugh vowed to flee to Costa Rica if President Barack Obama's health care reforms took effect. Limbaugh might have overlooked a couple of critical details: Costa Rica's respected universal healthcare system is highly socialized. It's also on the verge of going broke.

HCR Update from Mark Sanna: As part of The Lancet's ongoing series on obesity, the authors used a simulation model to project the probable health and economic consequences in the next two decades from a continued rise in obesity in ageing populations. They project millions more cases of diabetes, heart disease, stroke, cancer and conclude: "The combined medical costs associated with treatment of these preventable diseases are estimated to increase by $48—66 billion/year in the USA.

HCR Update from Mark Sanna: A report published today by the Institute of Medicine found "convincing evidence" that certain vaccines can cause 14 adverse effects — including seizures, brain inflammation and fainting — in rare cases. It also found "indicative though less clear data" linking certain vaccines to four other effects, including allergic reactions and temporary joint pain.

HCR Update from Mark Sanna: The Congressional Budget Office projects that rebounding revenue, combined with the force of the debt-reduction deal that became law earlier this month, will reduce the deficit by an estimated $3.3 trillion.

HCR Update from Mark Sanna: The deficit panel has already set to work, holding conference calls and using the congressional recess to begin their process. As its members face a Thanksgiving deadline for making their recommendations to find $1.5 trillion in budget savings over 10 years, speculation continues regarding their chances for success.

HCR Update from Mark Sanna: Texas would be among the biggest beneficiaries of President Barack Obama's health care overhaul, standing to gain coverage for nearly 4 million uninsured residents. But according to the AP, Gov. Rick Perry blocked moves to lay the groundwork for that expansion of coverage, and among the alternatives he's supported is an untested regional solution that could prove as controversial as president Obama's remake.

HCR Update from Mark Sanna: Hospitals are increasingly employing physicians in their efforts to grow market share and revenue yet the practice does not guarantee clinical integration and may lead to higher costs at hospitals, according to a new study from the Center for Studying Health System Change. The center found that hospitals can improve quality by aligning with physicians but employing physicians is not a guarantee of clinical integration.

HCR Update from Mark Sanna: As health care costs continue to rise, businesses are increasingly passing on the added burden to their employees. Higher cost-sharing for employees is the primary way in which employers are trying to control their own health care spending, according to a new survey from the National Business Group on Health.

HCR Update from Mark Sanna: State policymakers are growing increasingly anxious in the face of administration signals that key guidance on federal exchanges may not be coming until late 2011 or early 2012 — if they're coming at all. The administration appears to have decided that it does not need to issue a rule outlining the operation of a federal fallback exchange.

HCR UPdare from Mark Sanna: Consumers shopping for health insurance will soon get a peek at a new standard form—akin to the nutrition label on food products—that will lay out the details of each policy, from deductibles to how much it might cost to have a baby. Federal regulators are expected to unveil the proposed summary form, part of the health-care overhaul law today.

HCR Update from Mark Sanna: American medical care is rife with such treatments, whose usefulness is uncertain not just to the doctors who deliver them but also to the patients who receive them.  These days, however, many people are pinning their hopes on "comparative effectiveness research" as way to solve the dilemma of how best to treat this and hundreds of other common problems in day-to-day medicine.

HCR Update from Mark Sanna: Friday's federal court ruling against a key provision of the health care reform law makes it almost certain the Supreme Court will decide the law's constitutionality in the 2012 term. The court has very strong reasons to take the case now.

HCR Update from Mark Sanna: The 11th Circuit Court of Appeals on Friday ruled that the health care reform law's requirement that nearly all Americans buy insurance is unconstitutional, a striking blow to the legislation. The suit was brought by 26 states — nearly all led by Republican governors and attorneys general. The Department of Justice is expected to appeal.

HCR Update from Mark Sanna: The newly appointed members of the budget Super Committee - six Democrats and six Republicans — have received more than $3 million total during the past five years in donations from political committees with ties to defense contractors, health care providers and labor unions. That money went to their re-election campaigns.

HCR Update from Mark Sanna: As markets continue to rise and dive in a post-downgrade free-for-all and lawmakers face angst-ridden constituents on the town hall circuit, Capitol Hill is looking at the lineup of the new deficit reduction "super committee" as a critical chance to prove Congress can function during a crisis.

HCR Update from Mark Sanna: In a USA TODAY/Gallup Poll, six in 10 of those surveyed say members of the joint panel established in the debt-ceiling negotiations should be willing to reach an accord, even if it means making major compromises. Just over a third say the members should stand firm on principle, even if doing so blocks an agreement.

HCR Update from Mark Sanna: Okay, super committee — ready to cut some entitlements? Oh, stop making those excuses. Like, "We haven't been appointed yet." Or, "We like our town halls quiet." The super committee is going to have to come up with at least $1.2 trillion in spending cuts by Nov. 23, and it's going to be awfully hard to get that without dipping into the big health care entitlement programs — Medicare and Medicaid.

HCR Update from Mark Sanna: For many consumers, the ultimate test for the embattled health-care law is simple: Will it push down insurance premiums -- or at least slow their relentless rise? It's a pressing question for the Obama administration, which is hoping its signature domestic policy achievement doesn't end up as an election year albatross.

HCR Update from Mark Sanna: Congressional Democrats successfully opposed cuts to Medicare benefits, but lawmakers didn't completely shield the program. Although there will be no initial reductions, there would be an automatic 2 percent cut to providers if the new joint committee cannot agree on a new deficit reduction package.

HCR Update from Mark Sanna: Doctors, hospitals, and others in the health care industry are deeply worried about how the debt ceiling agreement — in particular, a second phase of deep spending cuts to be outlined later this year — could impact their financial stability and patients' access to care ... For example, the commission proposed cuts to graduate medical education funding.

HCR Update from Mark Sanna: An appeals court panel on Wednesday said that a group of New Jersey doctors don't have the legal right to challenge the health care law and threw out their suit. It represented a small win for the Obama administration in its long slog to defend the law.

HCR Update from Mark Sanna: Slashes to Medicare payments to doctors and hospitals are among the automatic cuts – along with deep slices from the Pentagon budget – that will occur in December if Congress does not accept $1.5 trillion in deficit reduction proposals from a bipartisan committee that will be free to propose tax hikes or cuts in Social Security.

HCR Update from Mark Sanna: The Obama administration issued new standards on Monday that require health insurance plans to cover all government-approved contraceptives for women, without co-payments or other charges. The standards also guarantee free coverage of other preventive services for women, including annual preventative care visits.

HCR Update from Mark Sanna: The Debt-Ceiling deal announced on Sunday by Congressional leaders and the White House would make across-the-board cuts in military spending, education, transportation and Medicare payments to health care providers if Congress does not enact further deficit-cutting legislation by the end of the year.

HCR Update from Mark Sanna: Here's one attempt to decode the debate and figure out what a deficit-reduction deal — any deal — would mean for the health care sector and the Affordable Care Act, starting with the programs and initiatives that are most at risk. Prevention Funds: High Risk ... Medicaid Eligibility and Funding Expansions: High Risk ... CLASS Act: Moderate Risk ... Individual Mandate: Low Risk.

HCR Update from Mark Sanna: The Thomas Moore Law Center formally asked the Supreme Court Tuesday to reverse an appeals court decision upholding the health care reform law. Marking the first appeal of its kind to reach the nation's highest court, the conservative legal group continues to insist the mandate requiring all Americans to purchase health insurance is unconstitutional.

HCR Update from Mark Sanna: Democratic and Republican leaders are preparing their own backup plans as possibilities for a bipartisan approach appear increasingly dim. Both political and policy-oriented differences are making the process difficult. Medicare, Medicaid, other entitlement programs and even Tricare are in play.

HCR Update from Mark Sanna: Democratic and Republican leaders are preparing their own backup plans as possibilities for a bipartisan approach appear increasingly dim. Both political and policy-oriented differences are making the process difficult. Medicare, Medicaid, other entitlement programs and even Tricare are in play.

HCR Update from Mark Sanna: A key provision in President Obama's health care law that would allow Americans to save money for elderly long-term care has been put on the chopping block as part of a sweeping $3.7 trillion deficit-reduction plan proposed by a bipartisan group of senators known as the "Gang of Six." The provision is known as the CLASS Act, or the Community Living Assistance Services and Support Act, and was designed to relieve pressure on Medicaid and help keep Americans out of nursing homes by enabling them to save for future senior assistance with issues like eating, bathing or dressing as they get older.

HCR Update from Mark Sanna: Efforts to fix a glitch in the health care reform law could backfire on thousands of people with disabilities, The Hill has learned. Republicans want to change a part of the law that made 3 million middle-income people eligible for Medicaid. The law excludes Social Security income when determining eligibility for health insurance exchange subsidies or Medicaid, causing many middle-class people to become eligible for Medicaid starting in 2014.

HCR Update from Mark Sanna: New consumer-controlled health insurance plans could get seed money from the government to increase competition – and maybe cut prices -- under new rules announced Monday by the Department of Health and Human Servives. The health department hopes at least one "co-op" will launch in each state and anticipates funding a total of 57 around the country.

HCR Update from Mark Sanna: At a closed-door meeting Friday morning, GOP leaders turned to their most trusted budget expert, Rep. Paul D. Ryan of Wisconsin, to explain to rank-and-file members what many others have come to understand: A fiscal meltdown could occur if Congress fails to raise the debt ceiling.

HCR Update from Mark Sanna: The $350 billion or so in potential cuts to Medicare and Medicaid over 10 years that were identified in budget negotiations would shift the cost of medicine to public hospitals, the states and individuals, but wouldn't do much to tackle rising health care costs themselves.

HCR Update from Mark Sanna: In a big step to carry out the new health care law, the Obama administration unveiled standards on Monday for insurance marketplaces that will allow individuals, families and small businesses in every state to shop for insurance, compare prices and benefits and buy coverage.

HCR Update fromMark Sanna: Political leaders retreated to hard-line positions Sunday after talks to reach a comprehensive deficit reduction deal sought by President Barack Obama effectively broke down over Republican resistance to tax increases. House Speaker John Boehner said Saturday that the insistence by Obama and Democrats on raising revenue through higher taxes prevented any chance that Republicans could support a major deal that also would cut spending and reform entitlement programs such as Medicare.

President Obama is pressing congressional leaders to consider a far-reaching debt-reduction plan that would force Democrats to accept major changes to Social Security and Medicare in exchange for Republican support for fresh tax revenue.

HCR Update from Mark Sanna: President Barack Obama called a budget-deficit summit Thursday at the White House, suggesting he and congressional leaders are moving closer to a deal that would clear the way for a vote to raise the government's borrowing limit and avoid default.

HCR Update from Mark Sanna: CMS issued proposed Medicare rules that would increase hospital outpatient rates by 1.5%, increase ambulatory surgical center payments by 0.9%, and decrease physician reimbursement by 29% beginning Jan. 1, 2012. The proposal also would establish performance periods, standards and a "weighting scheme" for the fiscal 2014 hospital program.

HCR Update from Mark Sanna: Obama administration officials are offering to cut tens of billions of dollars from Medicare and Medicaid in negotiations to reduce the federal budget deficit, but the depth of the cuts depends on whether Republicans are willing to accept any increases in tax revenues. Administration officials and Republican negotiators say the money can be taken from health care providers like hospitals and nursing homes without directly imposing new costs on needy beneficiaries or radically restructuring either program.

HCR Update from Mark Sanna: The Centers for Medicare & Medicaid Services officially agreed this week to pay for Provenge, an expensive new "vaccine" to treat prostate cancer. CMS announced the final decision to immediately start covering Provenge, which costs $93,000 a patient, and typically gives men suffering from an incurable stage of the disease an extra four months to live.

HCR Update from Mark Sanna: Insurance brokers won a round in their battle over the future of sales commissions on Thursday when a key committee of state insurance regulators voted to endorse a controversial bill now before Congress. The task force of the National Association of Insurance Commissioners said they would endorse the bill, which would remove sales agent fees from administrative costs insurers must report under a provision in the federal health law.

HCR Update from Mark Sanna: The Obama administration prevailed Wednesday in the first appellate review of the 2010 health care law as a three-judge panel from the United States Court of Appeals for the Sixth Circuit held that it was constitutional for Congress to require that Americans buy health insurance.

HCR Update from Mark Sanna: Senators Coburn and Lieberman jumped into Congress’ cut-the-deficit competition on Tuesday, proposing to raise the age of Medicare eligibility to 67 and increase monthly premiums for millions of current beneficiaries. Democrats reacted with criticism of the proposal. Republicans betrayed no sign of support either.

HCR Update from Mark Sanna: As the high-level negotiations continue, health care advocates are stepping up their campaigns to protect against Medicare and Medicaid cuts, and physicians groups maintain that a permanent fix to Medicare's physician payment formula should be included in the debt-ceiling legislation.

HCR Update from Mark Sanna: Alarmed by a shortage of primary care doctors, Obama administration officials are recruiting a team of "mystery shoppers" to pose as patients, call doctors' offices and request appointments to see how difficult it is for people to get care when they need it. It will also try to discover whether doctors are accepting patients with private insurance while turning away those in government health programs that pay lower reimbursement rates.

HCR Update from Mark Sanna: A federal judge ruled Friday that the State of Indiana could not cut off money for Planned Parenthood clinics providing health care to low-income women on Medicaid. Planned Parenthood provides services other than abortion, including family planning and screenings for cancer and sexually transmitted diseases.

HCR Update from Mark Sanna: Google is giving up on its vision of helping people live healthier lives with online personal health records. In the drive to apply information technology to health care, personalized health records are the element that relies most heavily on individual motivation and efforts. They are controlled by the consumer, and require individuals to put in, update and edit their health data.

HCR Update from Mark Sanna: Both Democrats and Republicans appear to be increasingly entrenched on key issues, including changes to entitlement programs like Medicare. Meanwhile, the Congressional Budget Office issued a daunting report, warning that the national debt will exceed the size of the national economy by 2021.

HCR Update from Mark Sanna: Federal regulators are pushing back a deadline for states to establish consumer protection standards for health plan denials, appeals and independent reviews. States will now have until Jan. 1, 2012, to approve legislation that complies with these standards, instead of the original deadline of July 1.

HCR Update from Mark Sanna: The American Medical Association reaffirmed its support for the most contentious plank of the new health care law — requiring most Americans to carry insurance or pay a fee — but not before a lengthy debate at its annual meeting in Chicago this past weekend.

HCR Update from Mark Sanna: The future of Medicare and Medicaid will be a hot topic as negotiations on the debt ceiling continue this week. At least three bipartisan meetings helmed by Vice President Biden have been scheduled, and both parties began to make concessions this past week as a possible deal appeared to emerge.

HCR Update from Mark Sanna: The Obama administration said Friday that it was shutting down a program that had provided exemptions from the new health care law for many employers and labor unions offering bare-bones insurance coverage to workers. No more applications will be accepted after Sept. 22, federal health officials said.

HCR Update from Mark Sanna: Congress took aim Wednesday at physicians who inappropriately order MRIs and concluded that Medicare costs in this area are surging partially because physicians are increasingly buying their own high-tech equipment. When they can perform diagnostic tests in their own offices, doctors get to pocket the profits.

HCR Update from Mark Sanna: The Republican presidential nomination debate featured a question about the new health law. The candidates pledged to repeal it and Mitt Romney defended the health reform law he signed while governor of Massachusetts. Former Minn. Gov. Tim Pawlenty made news when he backed away from confronting Romney on the Massachusetts plan.

HCR Update from Mark Sanna: Even as Vice President Joe Biden gave his most optimistic assessment yet of budget talks he’s leading, President Barack Obama's Democratic allies in the Senate signaled a harder line on Medicare. That stance is complicating any effort to produce a deal to cut the deficit by $2 trillion or more over the coming decade.

HCR Update from Mark Sanna: If the Obama administration had any doubt that its signature healthcare law faces a severe challenge in court, it was erased soon after Chief Judge Joel Dubina opened the proceedings here. "I can't find any case like this," Dubina said. "If we uphold this, are there any limits" on the power of the federal government?

HCR Update from Mark Sanna: In perhaps the weightiest of the dozens of challenges to the Obama health care law, a panel of appellate judges grappled Wednesday with the essential quandary of the case: if the federal government can require Americans to buy medical insurance, what constitutional limit would prevent it from mandating all manner of purchases and activities?

HCR Update from Mark Sanna: Blue Shield of California, is promising to limit its profits and give the bulk of any excess income it makes back to policyholders who are buying coverage. The insurer plans to cap its profits at 2% of its revenues. If in any given year it makes more money because the cost of providing health care was lower than it expected or because it made more money from its investments, it will give the excess back to the community.

HCR Update from Mark Sanna: Last month, insurer Aetna received approval from Connecticut regulators of its request to reduce premiums on individual policies by an average 10 percent, starting in September. Yes, you read that right: reduce the premium. The decrease, which affects 15,000 consumers will save those policyholders $259 annually, on average.

HCR Update from Mark Sanna: Medicaid will stop paying for about two dozen "never events" in hospitals, such as operations on the wrong body part and certain surgical-site infections. Currently, about 21 states have such a nonpayment policy. The 2010 federal health law expands the ban nationwide. The rule published gives states until July 2012 to implement it.

HCR Update from Mark Sanna: Say goodbye to the food pyramid, that symbol of healthy eating for the last two decades. In its place officials are dishing up a simple, plate-shaped symbol. It consists of four colored sections, for fruits, vegetables, grains and protein. Beside the plate is a smaller circle for dairy, suggesting a glass of low-fat milk or perhaps a yogurt cup.

HCR Update from Mark Sanna: In the last two years, personal medical records of at least 7.8 million people have been improperly exposed, according to the government data. One particularly egregious case involved information about 1.7 million patients, staff members, contractors and suppliers of NY hospitals and clinics operated by the Health and Hospitals Corporation.

HCR Update from Mark Sanna: Arizona says it is no longer able to finance its Medicaid adequately. As part of a plan to cut costs, the state has proposed imposing a $50 fee on childless adults on Medicaid who are either obese or who smoke. In Arizona, almost half of all Medicaid recipients smoke; about one in four Arizonans is overweight, according to the CDC.

HCR Update from Mark Sanna: Patients would be able to find out who has looked at their electronic medical records under a proposed change to the HIPAA rule opened up for public comment on Tuesday. Patients would obtain the information by requesting an access report, which would document who electronically accessed and viewed their protected health information. Although providers are currently required to track access to such information, they don't have to tell patients.

HCR Update from Mark Sanna: Medicare will soon track spending on millions of individual beneficiaries, reward hospitals that hold down costs and penalize those whose patients prove most expensive. Hospitals could be held accountable not only for the cost of the care they provide, but also for the cost of services performed by doctors and other health care providers in the 90 days after a Medicare patient leaves the hospital.

HCR Update from Mark Sanna: Researchers reported in JAMA this week that no improvement in health outcomes was measured in Medicare beneficiaries residing in areas with the highest level of adult primary care physicians per population.

HCR Update from Mark Sanna: Democratic leaders are terming this week's Senate vote on the House-passed Ryan budget, including its proposal to revamp Medicare, a "defining issue." Meanwhile, some Republican senators have announced that they won't back the plan.

HCR Update from Mark Sanna: Most Americans say they don't believe Medicare has to be cut to balance the federal budget, and ditto for Social Security, a new poll shows. The Associated Press-GfK poll suggests that arguments for overhauling the massive benefit programs to pare government debt have failed to sway the public

HCR Update from Mark Sanna: Despite all of the bashing by conservative commentators and politicians — and the predictions of doom for national health care reform — the program Mitt Romney signed into law as governor has been a success. The real lesson from Massachusetts is that health care reform can work, and the national law should work as well or even better.

HCR Update from Mark Sanna: Despite opposition from insurers, the Department of Health and Human Services finalized a rule stipulating that health insurance premium increases greater than 10 percent will trigger extra regulatory scrutiny.

HCR Update from Mark Sanna: Seizing on a political opportunity, the Senate's top Democrat, Harry Reid, told USA TODAY on Wednesday that he will schedule a vote next week in an effort to tie Senate Republicans to a House GOP plan to dramatically revamp the popular Medicare health care program.

HCR Update from Mark Sanna: A study published in the Journal of the American Medical Association reports that the number of emergency departments has been declining for the past two decades. Hospital ERs, particularly those serving the urban poor, are closing at an alarming rate even as emergency visits are rising,

HCR Update from Mark Sanna: Medicare will start running out of money in 2024 – 5 years earlier than projected last year — as a result of the sluggish economic recovery, the program’s trustees reported today. The outlook for the federal health insurance program that covers 47.5 million elderly and disabled Americans is a dramatic shift from last summer. That's when the trustees proudly projected that the new health law had extended the solvency of the program by 12 years from 2017 to 2029.

HCR Update from Mark Sanna: By their comments and questions Tuesday, the judges signaled they were likely to uphold provisions in the law that require virtually all Americans to have health insurance by 2014 or pay a penalty.

HCR Update from Mark Sanna: Tuesday's arguments were the first among the thirty health law legal challenges to reach the federal appeals court level. Almost everyone agrees the cases will eventually go to the Supreme Court.

HCR Update from Mark Sanna: President Obama's health care law faces a series of challenges in three appeals courts starting Tuesday as Republican lawyers from 27 states will urge the courts to strike down the law as unconstitutional. In a sign of the high stakes and the partisan divide, one case will feature a rare courtroom clash between the Obama administration's top appellate lawyer and his counterpart from the George W. Bush administration.

HCR Update from Mark Sanna: A five-week flurry of federal appellate hearings on the constitutionality of the Obama health care law kicks off Tuesday in Richmond, Va., beginning the second round of a race to the Supreme Court among a multitude of litigants eager to strike down the president’s signature domestic achievement.

HCR Update from Mark Sanna: House Republicans signaled Thursday that they were backing away from the centerpiece of their budget plan — a proposal to overhaul Medicare — in a decision that underscored both the difficulties and political perils of addressing the nation’s long-term fiscal problems.

HCR Update from Mark Sanna: More than two dozen states challenging the health care overhaul urged a U.S. appeals court on Wednesday to strike down the Obama administration's landmark law, arguing it far exceeds the federal government's powers. The motion, filed on behalf of 26 states, urges the 11th Circuit Court of Appeals in Atlanta to uphold a Florida federal judge's ruling that the overhaul's core requirement is unconstitutional.

HCR Update from Mark Sanna: Medicare changes in the deficit reduction plan championed by House Budget Committee Chairman Paul D. Ryan, R-Wis., will be a bigger issue in the 2012 election campaign than the health care overhaul law, Republican pollster William McInturff predicted in an appearance Tuesday. That’s a big plus for Democrats McInturff said — but he nevertheless predicted that the GOP would retain control of the House and said the party may gain narrow control of the Senate.

HCR Update from Mark Sanna: House Republicans say their budget proposal would make Medicare work just like the health insurance that covers federal employees, including members of Congress. But a close examination shows the two plans are very different. Under the federal employees’ health plan, the government pays a fixed share of premiums. No such guarantee exists under the Republicans’ plan.

HCR Update from Mark Sanna: There's a chance that the Supreme Court could rule the so-called "individual mandate" in the healthcare reform law unconstitutional, but on the whole the bill will stay intact, former President Bill Clinton said. "Well, I think that they would strike down the mandatory purchase. I mean you can make people buy automobile liability insurance," Clinton said in an interview taped Friday.

HCR Update from Mark Sanna: Government financing of human embryonic stem cell research can continue, a federal appeals court ruled Friday. The decision was an important victory for the Obama administration in a legal battle that is far from over. The 2-to-1 ruling, by a panel of judges from the US Court of Appeals for the District of Columbia Circuit, blocks a lower-court decision last August holding that such research is illegal under a law that bans public spending on research in which human embryos are damaged or destroyed.

HCR Update from Mark Sanna: The Centers for Medicare & Medicaid Services is finalizing details for a new reimbursement method, required by last year’s health care law. Consumer advocates say tying patient opinions to payments will result in better care. But many hospital officials are wary, arguing the scores don’t necessarily reflect the quality of the care and are influenced by factors beyond their control.

HCR Update from Mark Sanna: Senior citizens, whose fierce opposition to the 2010 health overhaul law helped propel Republicans' midterm election gains, have little appetite for the House GOP's plans to turn Medicare into a voucher-type program that sends beneficiaries to private plans but limits the amount of federal funding, according to a poll released today.

HCR Update from Mark Sanna: Political push back surrounding the Paul Ryan budget plan continues to feed the Democrats' view that they may have a 2012 opportunity with older voters. For instance, at home in their districts this week some Republicans are facing voter anger. And House Speaker John Boehner, R-Ohio, says he is "not wedded" to the Ryan approach to reduce Medicare spending by transforming the program.

HCR Update from Mark Sanna: The Supreme Court has rejected a call from Virginia's attorney general to depart from its usual practice and put review of the health care law on a fast track. Instead, judicial review of President Barack Obama's signature legislation will continue in federal appeals courts.

HCR Update from Mark Sanna: Anxiety is rising among some Republicans over the party’s embrace of a plan to overhaul Medicare, with GOP lawmakers facing tough questions back in their districts. House leaders have scheduled a Tuesday conference call to discuss strategies for defending the vote they took this month on a budget that would transform the Medicare as part of a plan to cut trillions in federal spending.

HCR Update from Mark Sanna: At home in their districts, Republicans are taking positions — and heat — on the Ryan budget plan, which would make significant changes to the Medicare program. Meanwhile, President Barack Obama is taking his message on the road.

HCR Update from Mark Sanna: President Barack Obama declared Wednesday that congressional Republicans are pushing a radical plan to trim Medicare and Medicaid, ramping up the rhetoric before a friendly crowd at the headquarters of Facebook. Still, as Obama and Congress approach crucial decisions on spending and the national debt the president said he thinks a bipartisan accord is possible.

HCR Update from Mark Sanna: Democrats and Republicans are joining to oppose one of the most important features of President Obama’s new deficit reduction plan, a powerful independent board that could make sweeping cuts in the growth of Medicare spending. Mr. Obama wants to expand the power of the 15-member panel, which was created by the new health care law, to rein in Medicare costs.

HCR Update from Mark Sanna: President Barack Obama is planning to ignore language in the 2011 spending package that would ban several top White House advisory posts. House Republicans tacked on language to the contentious spending bill to cut the salaries for four so-called czars — policy advisers appointed to assist the president on health care, climate change, autos and manufacturing, and urban affairs.

HCR Update from Mark Sanna: House Republicans on Friday muscled through a budget plan that pares federal spending by an estimated $5.8 trillion over the next decade while reshaping Medicare in a proposal that immediately touched off a fierce clash with Democrats.

HCR Update from Mark Sanna: A bold but politically risky plan to cut billions of dollars from the federal budget is coming to a House vote, with insurgent Republicans rallying behind the idea of fundamentally reshaping the government's role in health care for the elderly and the poor.

HCR Update from Mark Sanna: Even as President Obama laid out his own deficit reduction plan, House Speaker John Boehner was forging ahead with plans for his caucus to vote on Rep. Paul Ryan's sweeping blueprint to radically reshape Medicare and Medicaid — and he offered unswerving support for the proposal.

HCR Update from Mark Sanna: In a stinging rebuke to Republican budget-cutters, Obama acknowledged that the debt must be tackled faster than he has previously proposed, but he rejected GOP calls to make fundamental changes to Medicare and Medicaid and to scale back his initiative to expand health care coverage to the uninsured.

HCR Update from Mark Sanna: President Obama will focus on four items in today's speech on reducing the federal debt, the White House says in a statement: Lower domestic spending, less defense spending, excess spending in Medicare and Medicaid, and elimination of tax breaks that favor the wealthy.

HCR Update from Mark Sanna: Health and Human Services Secretary Kathleen Sebelius today announced a national program to help save 63,000 lives and up to $35 billion in health care costs over the next three years by preventing hospital-related injuries. ... Sebelius said under the Partnership for Patients, HHS would invest up to $1 billion in federal funding through the Affordable Care Act.

HCR Update from Mark Sanna: In a speech Wednesday, Obama will propose cuts to entitlement programs, including Medicare and Medicaid, and changes to Social Security, a discussion he has left to Democrats and Republicans in Congress. He also will call for tax increases for people making over $250,000 a year, a proposal contained in his 2012 budget, and changing parts of the tax code he thinks benefit the wealthy.

HCR Update from Mark Sanna: With the high-stakes negotiations currently at an impasse, the differences among the GOP, Democrats and the White House involve more than just the total dollar figure attached to spending cuts. It also involves controversial "policy riders." Meanwhile, without resolution, a government shutdown is just hours away.

HCR Update from Mark Sanna: Remember all those allegations from Republicans that the Affordable Care Act would inevitably lead to health care rationing? It turns out the same might be true of the House GOP budget plan for Medicare. At least that's the conclusion of the Congressional Budget Office.

HCR Update from Mark Sanna: The budget document unveiled yesterday by House Budget Committee Chairman Paul Ryan, R- Wis., includes sweeping changes to the Medicare program. For instance, the plan would mean that, for people younger than 55, Medicare would be transformed into a "premium-support" program. It would also raise Medicare's eligibility age and leave the program's "doughnut hole" intact.

HCR Update from Mark Sanna: House Republicans plan to propose Tuesday historic changes to Medicare, Medicaid and other popular programs that pour federal money into Americans' lives, arguing that a sacrifice now will keep those programs solvent for the future.

HCR Update from Mark Sanna: House Republicans plan this week to propose more than $4 trillion in federal spending reductions over the next decade by reshaping popular programs like Medicare, the Budget Committee chairman said Sunday in opening a new front in the intensifying budget wars.

HCR Update from Mark Sanna: The 11th U.S. Circuit Court of Appeals in Atlanta is scheduled to hear oral arguments on the constitutionality of the nation's sweeping health care reform law on June 8, according to an order by the appellate court. The order grants the Obama administration's motion for an early hearing, which could enable the Supreme Court to get the case as soon as late this year or early in 2012.

HCR Update from Mark Sanna: Hospitals, insurers and groups of doctors will be able to form networks called Accountable Care Organizations (ACOs) with the aim of cutting health-care costs by pooling services under regulations the Obama administration released. The program may save the government as much as $960 million in the next three years after any performance incentives are paid to providers.

HCR Update from Mark Sanna: The House Ways and Means Committee is scheduled to vote on a bill Thursday that would prevent taxpayers from deducting the cost of an abortion from their taxable income. It would also prevent small businesses and taxpayers from using tax credits in the new health care law to provide or pay for insurance policies that cover the procedure.

HCR Update from Mark Sanna: The Senate inched closer to a repeal of a much-maligned 1099 tax-reporting provision on Tuesday evening, with a potential agreement that could send the bill straight to President Obama's desk. The chamber could vote Wednesday morning on an amendment from Sen. Mike Johanns, R-Neb., on the small-business bill currently on the Senate floor.

HCR Update from Mark Sanna: This could be the week the federal government releases delayed regulations for a major piece of the health care law, which aims to bring down health costs by grouping together doctors, nurses, nursing homes and other providers and holding them accountable for the health of their patients.

HCR Update from Mark Sanna: The U.S. Justice Department is widening a probe into whether Blue Cross Blue Shield health-insurance plans are artificially raising premiums in several states by striking agreements with hospitals that stifle competition from rival insurers.

HCR Update from Mark Sanna: Speaking at a meeting of the America's Health Insurance Plans association on Thursday, Berry, director of the Office of Personnel Management, told representatives of companies providing coverage through the Federal Employees Health Benefits Program that they should encourage healthy lifestyles by offering "concrete incentives to participate in wellness and prevention activities".

HCR Update from Mark Sanna: Health insurance companies are at least partly to blame for the lack of an increase in public support for the Patient Protection and Affordable Care Act in the year since its enactment, according to a vocal Democratic defender of the law. Rep. Anthony Weiner told liberal activists at the Center for American Progress Wednesday that the law has not gained in popularity since its enactment, in part, because some of its supporters are "hiding under the desk" in the face of Republican criticisms.

HCR Update from Mark Sanna: A law signed by Gov. Dennis Daugaard on Tuesday makes the state the first to require women who are seeking abortions to first attend a consultation at such "pregnancy help centers," to learn what assistance is available "to help the mother keep and care for her child."

HCR Update from Mark Sanna: Anthem Blue Cross, the largest health plan in California, said Monday it will delay and reduce rate hikes that would have hit some 600,000 policyholders at an estimated cost of $40 million. Anthem is one of four major health insurers in the state who earlier agreed to put off premium increases for at least 60 days at the request of California Insurance Commissioner Dave Jones.

HCR Update from Mark Sanna: President Obama's health-care overhaul law will be repealed by early 2013, according to Republican presidential hopeful Newt Gingrich. Gingrich, speaking Friday at the National Press Club said, even if Republicans can't repeal the law before 2014, the point at which the law becomes fully implemented, the former Speaker of the House said Republican leadership will be able to defund it.

HCR Update from Mark Sanna: The Obama administration next week will embark on a fresh pitch for the health-care overhaul, seeking to boost public support for the law on its one-year anniversary. But lawmakers and some policy experts say the next phase of the overhaul will be more difficult to sell. Between now and the 2012 presidential election, few consumer-oriented changes kick in.

HCR Update from Mark Sanna: Angry ratepayers found some relief Wednesday when Blue Shield of California dropped its plan to further raise insurance rates on hundreds of thousands of its customers in 2011. Hikes that average 6.5 percent were set to go into effect in May and would have been the third since October levied by the San Francisco-based health insurer.

HCR Update from Mark Sanna: Some Democrats say their party should embrace the law in the upcoming campaign season, just as some tea party lawmakers are questioning the GOP leadership's commitment to repeal it. In the background, "death panels" have again emerged as a topic of congressional investigation.

HCR from Mark Sanna: Expect the talk in Washington about the federal health care law to intensify as we approach the one-year anniversary of the passage of the Patient Protection and Affordable Care Act next week. Congress is holding several hearings, including the Senate Finance Committee meeting on Wednesday morning to discuss "Health Reform: Lessons Learned During the First Year."

HCR Update from Mark Sanna: Exceptions may become the rule as the Affordable Care Act heads into its second year. Officials at the Department of Health and Human Services have approved no fewer than 1,040 requests for so-called mini-med waivers, which would allow companies to cap their annual payouts at a lower level than dictated by the law.

HCR Update from Mark Sanna: House lawmakers are stepping up their pressure on the Senate to complete work this week on a repeal of the 1099 provision included in the health care law despite a dispute over how the $22 billion cost is covered. The House-passed measure now appears to have Democratic leadership support in the upper chamber, could be sent to President Obama this week.

HCR Update from Mark Sanna: The Obama administration has asked a Florida court to hurry up and decide on its appeal of an order that declared the health care law unconstitutional. The Justice Department filed a motion in the 11th Circuit Court of Appeals for an expedited review of the administration's appeal, filed on Tuesday.

HCR Update from Mark Sanna: The Obama administration Tuesday appealed Florida Judge Roger Vinson's ruling that the entire health reform law is unconstitutional. The quick action of the government prevents the judge’s order from taking effect and shutting down implementation of the law for now.

HCR Update from Mark Sanna: A background memo from House Energy and Commerce Republicans in preparation for a Wednesday hearing outlines alternatives for eliminating mandatory funding included in the health care law. The items the GOP would eliminate include mandatory funds states would use for activities related to setting up exchanges, a prevention and public health fund, and school-based health centers. The memo also proposes that lawmakers consider changing mandatory funding for a "personal responsibility education" program for teens and for primary care residency programs in teaching health centers so that the funding is considered instead through regular appropriations.

HCR Update from Mark Sanna: Across the U.S., governors are contemplating ways to ease the fiscal pressure Medicaid has placed on their state budgets. The approaches currently on the table include freezing the enrollment of childless adults, transforming Medicaid into a block grant program and convincing Congress to give states more flexibility to administer the program.

HCR Update from Mark Sanna: As Congress continues to debate the new health care law, health insurance costs are still rising, particularly for small businesses. Across the country, premiums have more than doubled in the last decade, with smaller companies particularly hard hit in recent years, federal officials say. Republicans are seizing on the trend as evidence that the new law includes expensive features that are driving up premiums. But the insurance industry says premiums are rising primarily because of the underlying cost of care and a growing demand for it.

HCR Update from Mark Sanna: A long-term spending bill pitched by the Senate will not include language to strip federal funds from Planned Parenthood and implementation of the healthcare reform law, according to new highlights released by the Senate Appropriations Committee on Friday afternoon.

HCR Update from Mark Sanna: A federal judge in Florida issued a stay regarding his own January ruling in which he overturned the health law. However, this breathing room is only temporary - he also put the health law on the fast track to the Supreme Court.

HCR Update from Mark Sanna: President Obama on Wednesday intervened in a partisan brawl that threatens to shut down the government, inviting congressional leaders of both parties to sit down with Vice President Biden and work out a compromise to fund federal programs through the end of the fiscal year.

HCR Update from Mark Sanna: Governors told Congress on Tuesday that President Obama had not gone far enough in proposing to let states opt out of major provisions of the new health care law in 2014, and they said they needed more immediate relief from the growing financial burden of Medicaid.

HCR Update from Mark Sanna: President Obama, who has stood by his landmark health care law through court attacks and legislative efforts to repeal it, told the nation's governors on Monday that he was willing to amend the measure to give states the ability to opt out of its most controversial requirements right from the start, including the mandate that most people buy insurance.

HCR Update from Mark Sanna: Governors of both parties have proposed cuts in healthcare, one of the largest single expenses for states, as they struggle to balance their budgets. Many, including some Democrats, want the Obama administration to loosen a requirement in the new healthcare law that prevents them from dropping large numbers of low-income people from Medicaid. About 53 million poor children and adults are covered by the program, which is funded jointly by the state and federal governments.

HCR Update from Mark Sanna: The temporary budget compromise proposed this week would not defund the new health law. In the ongoing saga of whether Congress and the president will avert a government shutdown, the potential solution does not include GOP language taking away funds for health law implementation or Planned Parenthood.

HCR Update from Mark Sanna: The nation's governors will be in Washington this weekend for the National Governors Association winter meeting. Budget issues, especially related to Medicaid spending and other health costs, will be a hot topic. Already, the administration is seeking to sooth state executives' nerves regarding the costs of implementing the health care law by reiterating a message of flexibility.

HCR Update from Mark Sanna: With the nation's governors about to descend on Washington for their winter meeting, the Department of Health and Human Services today continued its campaign to calm their concerns that the health law is too expensive and complex for cash-strapped states to implement.

HCR Update from Mark Sanna: Taking a position that the Obama administration's request for "clarification" from U.S. District Court Judge Roger Vinson regarding his recent ruling on the 26-state challenge to the health law's individual mandate is "wishful thinking," the involved states maintain that the judge's meaning was clear: he meant to stop work on the law's rollout.

HCR Update from Mark Sanna: A federal judge in Washington, D.C., became the third judge to uphold the constitutionality of the health overhaul's individual mandate. The decision was issued Tuesday evening.

Update from Mark Sanna: One of Senator Edward Kennedy’s legacies in the new health care law, intended to allow the chronically ill and people with disabilities to continue living in their homes, is too costly to survive without major changes, Obama administration officials now say. Republican lawmakers, who have vowed to repeal the health care law, cite the administration’s acknowledgment as yet another reason to do so.

Update from Mark Sanna: On Friday, HHS overturned the controversial Bush 'conscience' regulation for health-care workers. The rule was widely interpreted as shielding workers who refuse to participate in a range of medical services, such as providing birth control pills, caring for gay men with AIDS and performing in-vitro fertilization for lesbians or single women. Friday's decision was condemned by proponents of stronger protections, who say doctors, nurses, pharmacists and other workers regularly face discrimination, firing and other punitive measures because of their deeply held convictions.

HCR Update from Mark Sanna: The House approved a Republican proposal to block federal aid for Planned Parenthood. The 240-185 vote was a victory for anti-abortion forces led by Indiana GOP Rep. Mike Pence. He says taxpayer money should not go to groups that provide or promote abortion. Democrats say Planned Parenthood provides contraception and other valuable family planning services, and that cutting off the money will make it hard for women to get such basic help.

HCR Update from Mark Sanna: After a free-wheeling, week-long debate, the House early Saturday morning passed a bill to fund the government through the end of September. It included several amendments to defund the new health law. The bill now goes to the Senate.

HCR Update from Mark Sanna: Federal authorities on Thursday charged more than 100 doctors, nurses and physical therapists in nine cities with Medicare fraud. In all, dozens of people were accused of illegally billing Medicare more than $225 million. The indictments were for suspects in Miami; Los Angeles; Dallas; Houston; Detroit; Chicago; Brooklyn; Tampa, Fla.; and Baton Rouge, La. Among those charged was Dr. Errol Sherman, a Detroit podiatrist who performed partial toenail removals that the authorities said amounted to little more than clipping toenails. A Brooklyn proctologist, Dr. Boris Sachakov, was charged with billing $6.5 million for hemorrhoid removals, most of which the authorities say he never performed.

HCR Update from Mark Sanna: The Obama administration said Wednesday that it had granted broad waivers to four states allowing health insurance companies to continue offering less generous benefits than they would otherwise be required to provide consumers this year under the new federal health care law. The states are Florida, New Jersey, Ohio and Tennessee.

HCR Update from Mark Sanna: Rep. Steve King said he's putting GOP leaders on notice that he wants to be taken seriously in his efforts to defund the health care overhaul law. The Iowa Republican voted "present" Tuesday on a rule to proceed to a continuing resolution to keep the government funded for the remainder of fiscal 2011 because it did not include his amendment to halt funding for the health care law.

HCR Update from Mark Sanna: Critics quickly pounced on President Barack Obama’s proposal to head off scheduled cuts in Medicare payments to doctors, saying his funding method would cause serious problems. Some analysts predicted the payment fix would get little traction on Capitol Hill as lawmakers focus on the broader problem of finding ways to cut the budget and reduce the deficit.

HCR Update from Mark Sanna: President Obama faces two major challenges when he unveils his health budget today: showing that he's serious about fiscal discipline while making sure implementation of his health care reform law has a clear path. His health budget will receive extra scrutiny this year given that his fiscal commission called health care spending the nation's "single largest fiscal challenge" and Republicans are angling to defund the law. But Obama's budget likely won't provide too many surprises because the reform law has already done a lot of the heavy lifting on spending cuts, lobbyist sources said on Friday. The Affordable Care Act slows the growth of Medicare spending by about $500 billion over 10 years.

HCR Update from Mark Sanna: The Obama blueprint seeks to eliminate a budget gimmick that Congress has long used to mask the true depth of the red ink: His proposal would offset higher Medicare payments to doctors by cutting $62 billion from other areas of federal health spending.

HCR Update from Mark Sanna: The spending bill, put forward by the Appropriations Committee for consideration on the floor next week, proposes slashing a wide portfolio of domestic programs and foreign aid. It blocks the spending of about $2 billion in unused economic stimulus money and seeks to prevent the Internal Revenue Service from enforcing the new health care law.

HCR Update from Mark Sanna: CBO Director Douglas Elmendorf told the House Budget Committee on Thursday that the health care law will reduce employment by 0.5 percent by 2021 because some people will no longer have to work just to afford health insurance.

HCR Update from Mark Sanna: News outlets reported that Virginia's attorney general has asked the Supreme Court to expedite a review of the health law. Meanwhile, House Democrats sent a letter to Justice Clarence Thomas asking him to recuse himself.

HCR Update from Mark Sanna: A second appellate court has set an expedited schedule for hearing a constitutional challenge to the new health care law. The United States Court of Appeals for the Sixth Circuit, in Cincinnati, announced Tuesday that it would hear oral arguments during a term that stretches from May 30 to June 10. The appeal stems from a decision upholding the law by a federal judge in Detroit. The United States Court of Appeals for the Fourth Circuit, in Richmond, Va., has already announced it will hear arguments in mid-May in the Obama administration’s appeal of a Virginia judge’s decision to strike down a central provision of the law.

HCR Update from Mark Sanna: Supporters of the new health care law have tapped a top Democratic strategist to help defend it against Republican criticism as they settle in for what many expect will be a protracted battle to shape the public's view of the law through the 2012 elections and beyond. … The initiative is being headed by Paul Tewes, a political consultant who directed field operations in key states for President Obama's campaign.

HCR Update by Mark Sanna: Lawmakers and their staffers this week will get an earful about the ailments facing the medical profession as more than 500 members of the American Medical Association arrive in Washington, D.C., for their annual National Advocacy Conference.

HC Reform by Mark Sanna: This week the CEOs of 16 medical device companies descended on Capitol Hill to make the case for their industry. Asking for the repeal of the medical device tax in the health care law and continued improvements to the FDA’s 510(k) regulatory process, they said they worried the booming industry.

HC Reform Update by Mark Sanna: Virginia's attorney general announced on Thursday that he hoped to bypass an initial appellate review by asking the United States Supreme Court to consider the constitutionality of the Obama health care law on an expedited basis.

HC Reform Update by Mark Sanna: To hear Senate Republicans tell it, the defeat of their attempt to repeal the Democrats' health care overhaul was really a victory of sorts on the long the march to the 2012 congressional and presidential elections. The repeal effort sank Wednesday along party lines.

HC Reform Update from Mark Sanna: The Senate on Wednesday voted down a repeal of President Obama’s healthcare law in a 47-51 party-line vote. ... Republicans have vowed to carry the fight forward, saying they will seek to de-fund the law as it is implemented. The GOP also has promised Wednesday’s repeal vote will not be the last in this Congress.

HC Reform Update from Mark Sanna: The Senate plans to vote today on legislation to repeal President Obama's health care overhaul, following a deal between Democrats and Republicans to schedule the largely symbolic roll call.

HC Reform Update from Mark Sanna: Top executives from UnitedHealth Group Inc. and WellPoint Inc. are meeting almost monthly with their counterparts from Aetna Inc., Cigna Corp. and Humana Inc. in an informal lobbying alliance aimed at blunting parts of the health-care law, say people with knowledge of the sessions.

HC Reform Update from Mark Sanna: U.S. District Judge Roger Vinson in Pensacola, Florida, declared the law unconstitutional in a ruling today. ... Vinson's ruling may be appealed to the U.S. Court of Appeals in Atlanta. A federal appeals court in Richmond, Virginia, is already slated in May to hear challenges to two conflicting federal court rulings in that state, one of which upheld the legislation while the other invalidated part of it. The U.S. Supreme Court may ultimately be asked to consider the issue.

HC Reform Update from Mark Sanna: A Florida judge could on Monday become the second judge to declare President Barack Obama's health care reform law unconstitutional, in the biggest legal challenge yet to federal authority to enact the law. The judge, Roger Vinson of the U.S. District Court in Pensacola, Florida, was expected to rule on a lawsuit brought by governors and attorneys general from 26 U.S. states, almost all of whom are Republicans.

HC Reform Update from Mark Sanna: House Republicans are preparing to push through restrictions on federal financing of abortions far more extreme than previously proposed at the federal level. Lawmakers have made it one of their highest priorities to take the decision about a legal medical procedure out of the hands of individuals and turn it over to the government. The anti-abortion forces almost derailed health care reform last year over whether people could buy policies that cover abortion on new insurance exchanges.

HC Reform Update from Mark Sanna: Financially strapped governors, Congress and the Obama administration could be headed for a showdown over the Medicaid health care program that covers 48 million poor, disabled and elderly people nationwide. Arizona's governor has already asked for permission to drop people from the joint federal-state program, which states say is eating up huge portions of their budgets.

HC Reform Update from Mark Sanna: President Obama will address the annual conference for Families USA today armed with a new HHS report that shows health insurance premiums will be 14-20 percent lower in 2014 than they would have been without the law.

HC Reform Update from Mark Sanna: House Republicans launched a two-pronged attack on health reform Wednesday, ripping apart the idea that it cuts spending and painting it as a disaster for business. The first hearing of the Budget Committee took on the spending argument, while the Ways and Means Committee went after the law as anti-business.

HC Reform Update from Mark Sanna: President Barack Obama made two things clear about health care in his State of the Union speech: he is willing to change it around the edges and he is ready to put it in the rearview mirror. "Instead of re-fighting the battles of the last two years, let's fix what needs fixing and move forward."

HC Reform Update from Mark Sanna: President Barack Obama will have two challenges when he talks about his signature health care law Tuesday night: Get the public back on his side, and don't spend too much time on it. It will be Obama's first State of the Union address since he signed health care reform into law in March, and the public is still deeply divided over his biggest legislative accomplishment.

HC Reform Update from Mark Sanna: Perhaps nothing signifies the changing of the health care guard in Congress more than the Republicans' decision to pivot from a vote on repealing the overhaul to a debate over medical malpractice. Even before the floor votes were tallied on a Republican resolution instructing committees to start rewriting the health care law, the House Judiciary Committee held its first oversight hearing on a longtime favorite GOP issue: curbing malpractice claims.

HC Reform Update from Mark Sanna: The new Republican chairmen of a powerful House committee and its investigative subcommittee want Obama administration officials to explain exactly how they're implementing the health law. It's the first of what's expected to be a long list of investigations that could keep Obama health officials busy gathering documents and testifying on Capitol Hill for much of the year.

HC Reform Update from Mark Sanna: The U.S. House of Representatives voted 253-175 on a resolution that instructs four House committees to work on legislation to replace the Patient Protection and Affordable Care Act, with 14 Democrats supporting the measure. Included in the resolution was one amendment to include a permanent fix to the Medicare physician payment formula.

HC Reform Update from Mark Sanna: In what is considered to be a symbolic vote, House Republicans joined with three Democrats to fulfill a campaign pledge to pass a bill that would undo the sweeping health overhaul. The vote represented the Republican House majority's first official rebuke of the Obama agenda. Senate action, however, is unlikely.

HC Reform Update from Mark Sanna: A key reason the House is voting on the repeal bill even though leaders know it's unlikely to even get a vote in the Democratic-controlled Senate is that dozens of new Republican members got elected last November, nearly every one of them promising to fight to get rid of it.

HC Reform Update from Mark Sanna: Immediately after House Republicans take up the health care overhaul repeal resolution today, they report they will begin crafting an alternative with the goal of reducing insurance premiums, expanding coverage, preserving Medicare and holding down taxes.

HC Reform Update from Mark Sanna: House Republicans plan on Wednesday to fulfill a tea party priority: voting to repeal the health care law passed by Democrats last year. GOP leaders are sticking with a title for their resolution that Democrats say is inaccurate and unseemly in light of the six people killed in Tucson: "Repealing the Job-Killing Health Care Law Act."

HC Reform Update from Mark Sanna: House Republicans plan to debate and vote next week on repealing last year's health care overhaul in an early test of whether partisan rhetoric softens in the aftermath of the Arizona shootings. They expect to pass their repeal measure the next day and, later, pass another measure that instructs House committees to delve into new health legislation to replace the law passed last March.

HC Reform Update from Mark Sanna: Republican leaders in the House have scheduled debate to begin on Tuesday. And, although the vote — which will follow a day later — is largely considered symbolic, it will kick off the GOP push to defund the bill and undo some of its more unpopular provisions.

HC Reform Update from Mark Sanna: Even as House Republicans press to repeal the health care law, government advisers this week are preparing to wade into one of the most contentious questions raised by the legislation: What benefits must insurers cover? While the law outlines 10 broad categories of coverage – among them hospital and emergency services, prescription drugs, childbirth and pediatric care – it leaves the specifics to the government. The required package affects all policies to be sold in state-based insurance exchanges.

HC Reform Update from Mark Sanna: Both sides in the bitter health care debate say their truce over the controversial law is only temporary. Republicans say they will soon renew their efforts to repeal the law, while supporters say their timeout from publicly arguing against repeal will run out as soon as the House brings its bill back to the floor.

HC Reform Update from Mark Sanna: House Republicans have called off this week's legislative action, including a planned Wednesday vote on a GOP bill to repeal President Obama's health care law, because of the shooting attack on Rep. Gabrielle Giffords and others in Tucson.

HC Reform Update from Mark Sanna: President Barack Obama urged newly empowered Republicans on Saturday not to wage “symbolic battles” against him but to instead work together to help spur job growth and economic recovery. Obama issued his appeal in his weekly radio address ... “What we can't do is refight the battles of the past two years that distract us from the hard work of moving our economy forward,” he said.

HC Reform Update from Mark Sanna: Legislation repealing President Obama's health care overhaul cleared a key procedural hurdle in the House of Representatives on Friday, advancing a top priority of the new Republican congressional majority. The sharply partisan 236-181 vote probably will set up a final House vote to undo the measure next Wednesday. Almost every Republican voted to advance the measure; nearly every Democrat opposed it. While a successful repeal vote would fulfill a GOP campaign promise, the measure is considered to have virtually no chance of surviving either the Democratic-controlled Senate or a promised presidential veto.

HC Reform Update from Mark Sanna: The nonpartisan budget scorekeepers in Congress said on Thursday that the Republican plan to repeal President Obama’s health care law would add $230 billion to federal budget deficits over the next decade, intensifying the first legislative fight of the new session and highlighting the challenge Republicans face in pursuing their agenda.

HC Reform Update from Mark Sanna: Republicans officially take control of the House and a vote to repeal the health care reform law is at the top of their agenda. But with President Obama in the White House and a Democratic-controlled Senate, any House repeal vote will likely be symbolic — the repeal effort is unlikely to advance any further, and provisions of the law scheduled to go into effect this year will continue on course.

HC Reform Update from Mark Sanna: With the countdown on until the Jan. 12 House repeal vote, Democrats who initially voted against the health overhaul are now considering where they stand on the repeal effort. Meanwhile, the Obama administration and other Democratic officials "hit back" at the GOP push to the undo the health law by detailing the negative repercussions it would have for consumers.

HC Reform Update from Mark Sanna: House Republicans have set Jan. 12 as their day to vote on a repeal of President Obama's health-care law, after a midterm election in which they campaigned against the landmark legislation as a government takeover of the health industry.

HC Reform Update from Mark Sanna: Republicans in the House plan to make good on a campaign promise to repeal President Obama’s health care overhaul. The vote, which Republican leaders pledged would occur before the president’s State of the Union address later this month, is intended both to appeal to the Tea Party-influenced factions of the House Republican base and to emphasize the muscle of the new party in power.

HC Reform Update from Mark Sanna: The new health care law explicitly grants permission to employers to offer rewards of at least 30 percent of the total cost of health insurance to employees. Those winnings, often in the form of lower premiums, will go to people who join wellness programs and hit certain health goals.