Obama Visits California To Drum Up Support for Deficit-Reduction Plan

On Wednesday, President Obama continued a three-day, three-state tour to promote his new proposal to narrow the federal deficit by $4 trillion over the next 12 years through a combination of spending cuts and tax increases on high-income U.S. residents, the Washington Post reports (Kang, Washington Post, 4/21).

The highlight of the tour's second day was a visit to the Facebook headquarters in Palo Alto, Calif., where he led a town hall-style discussion about the plan with Facebook employees, business and technology executives, and California Democrats (Pace, AP/Boston Globe, 4/20).

Details of President's Deficit Plan

Under Obama's proposal -- which he unveiled during a speech on April 13 -- $480 billion would be cut from Medicare and Medicaid, but Obama promised that his plan would preserve the programs. Among its proposals, the deficit-reduction plan would:

• Reduce Medicare growth per beneficiary to the growth of gross domestic product per capita plus 0.5%. The federal health reform law aims to hold Medicare spending growth to GDP expansion per capita plus 1%;
• Strengthen the Independent Payment Advisory Board, which was created under the federal health reform law, and require the board to make recommendations to Congress if spending exceeds the new limit;
• Give IPAB more enforcement mechanisms, including an "automatic sequester" to cut spending;
• Implement stronger efforts to curb abuse and fraud in Medicare and Medicaid filings, as well as stronger incentives for hospitals to reduce medical errors and unnecessary readmissions; and
• Encourage pharmaceutical companies to grant rebates to U.S. residents who qualify for both Medicare and Medicaid, known as "dual eligibles" (California Healthline, 4/20).

Facebook Town Hall

During Wednesday's discussion at Facebook, Obama stepped up his criticism of House Budget Committee Chair Paul Ryan's (R-Wis.) fiscal 2012 budget resolution (H Con Res 34), the New York Times reports (Calmes, New York Times, 4/20).

Ryan's proposal would make $6 trillion in federal spending cuts over the next decade and attempt to repeal and defund the health reform law. The plan would provide Medicare beneficiaries with lump-sum vouchers to purchase private insurance and give states fixed annual block grants of $11,000 per Medicaid beneficiary to use as they choose. Although the House approved the plan on April 15, the Democrat-controlled Senate is not expected to approve it (California Healthline, 4/20).

Obama characterized Ryan's plan as "fairly radical," adding, "I wouldn't call it particularly courageous." He noted that the plan's objective to reduce health spending by reforming the Medicare and Medicaid programs would not actually curb health care costs (New York Times, 4/20).

He said, "I guess you could call [the GOP plan] bold. I would call it shortsighted," adding, "Nothing is easier than solving a problem on the backs of people who are poor or people who don't have lobbyists or people who don't have clout" (Fowler/Lee, Wall Street Journal, 4/20).

Republicans Respond to Criticism

House GOP lawmakers immediately responded to Obama's criticism of Ryan's plan, the Post reports.

A spokesperson for House Speaker John Boehner (R-Ohio) said, "House Republicans are the only ones with a detailed plan to preserve Medicare and Medicaid, create jobs and put us on a path to paying down the debt," adding, "By comparison, the president has offered little more than campaign speeches. Solving these challenges will require a greater degree of seriousness than the White House has thus far demonstrated" (Washington Post, 4/21).

Obama Touts Health IT During Town Hall

During Wednesday's town-hall meeting, Obama also discussed the benefits of health information technology and adoption incentives, eWeek reports.

Obama said the "health care system is one of the few aspects of our society where a lot of stuff is still done on paper." He suggested that it was leading to unnecessary and costly physician's visits and duplicate tests. Obama said the federal government has attempted "to provide incentives to providers to start getting integrated, automated systems," adding, "By providing some (tax) incentive help for front-end investments for community hospitals and individual providers, we can slowly get this system [to become] more effective -- that's priority No. 1."

Obama also cited the Veterans Administration as an example in which health IT has provided benefits, noting that "it's a fully integrated system" that has "been able to achieve huge cost savings just because everybody's on a single system" (Preimesberger, eWeek, 4/20).

Antireform Group Temporarily Disables Town Hall's Facebook Page

In related news, ForAmerica -- a group opposed to the overhaul -- caused the Facebook page that hosted Wednesday's town-hall meeting to shut down temporarily, the Los Angeles Times reports.

The group reportedly urged its one million Facebook supporters to flood the town-hall page, which was soliciting questions for the event, with a message calling for the repeal of "ObamaCare." A spokesperson for the group said the page was down for about 40 minutes (Memoli, Los Angeles Times, 4/20).

GOP Leaders Seek Details on Obama's Plan

On Wednesday, House Energy and Commerce Committee Chair Fred Upton (R-Mich.) and House Ways and Means Committee Chair Dave Camp (R-Mich.) sent a letter to Obama seeking details on how his administration plans to generate the $480 billion in savings by 2023 through cuts in Medicaid and Medicare, Modern Healthcare reports (Zigmond, Modern Healthcare, 4/20).

The letter, which the lawmakers also submitted to The Hill's "Congress Blog," asked:

"What specifically do you mean by 'giving the IPAB additional tools to improve the quality of care while reducing costs, including allowing it to promote value-based benefits designs'?"; and

"Would this require a statutory change given that IPAB is not currently allowed to consider changes to the Medicare benefit package?"

Upton and Camp also sought details about the patient safety and Medicare Part D proposals in Obama's plan (Camp/Upton, "Congress Blog," The Hill, 4/20).