Medicaid

At least in public, Republicans have been clear that they see the current budget negotiations as a chance to address what they see as the source of Washington's deficit problem: major entitlement programs.

The Affordable Care Act, as passed by Congress in 2010, assumed that every low-income person would have access to health insurance starting in 2014.

That's when about 17 million Americans — mostly unmarried healthy adults with incomes up to 133 percent of poverty, or about $15,000 a year — would gain access to Medicaid.

A liberal think-tank closely allied with the Obama administration is proposing a health care spending plan it says could save hundreds of billions of dollars in entitlement spending without hurting middle- and low-income patients.

After a shaky few years, President Obama's health care legacy looks secure.

His health overhaul law barely made it through Congress and to his desk. Then there were the legal challenges, launched when the ink of his signature was barely dry, that were resolved by a surprising Supreme Court ruling in June.

Obstetricians, gynecologists and emergency room doctors will be shut out of the higher Medicaid pay that primary care doctors will start collecting in January.

The Obama administration made the ruling late Thursday.

Under the Affordable Care Act, Medicaid rates for primary care doctors will soon be on par with what Medicare pays. The overhaul law included the hike to encourage doctors to see the larger number of patients who will be covered by a Medicaid expansion.

Medicaid is already the nation's largest health insurance program in terms of number of people covered: It serves nearly 1 in 5 Americans. Yet at the same time it's putting increasing strain on the budgets of states, which pay about 40 percent of its costs.

It's not so much what Mitt Romney said about whether the government should guarantee people health care in his interview on CBS's 60 Minutes Sunday that has health care policy types buzzing. It's how that compares to what he has said before.

To back up a bit, Scott Pelley asked the former Massachusetts governor if he thinks "the government has a responsibility to provide health care to the 50 million Americans who don't have it today?"

Dr. Ilse Levin specializes in internal medicine, but you could say she really focuses on incarceration medicine.

Fewer boys are being circumcised these days, and that could add to health costs down the road.

Over the past two decades, circumcision rates in the U.S. have fallen to 55 percent from a peak of about 79 percent. Insurance coverage for the procedure has also fallen — particularly under Medicaid — and is a factor in the decline.

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Changes in the health insurance industry are at the top of NPR's business news.

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