Viewpoints: No reason to delay health law; GOP may need an alternative message; shrinking abortion options

Mar 11 2014

The Washington Post: Stop Stalling On The Affordable Care Act 
HealthCare.gov is working better, so the technical barriers to pushing people into new plans aren't as high. The law, meanwhile, attempts to establish a norm that all Americans should have coverage of a certain quality and comprehensiveness. In general and over time, this is good for them and for the system as a whole. There's no reason, other than avoiding another wave of cancellation notices before this year's elections, to delay the transition again (3/7).

Bloomberg: How To Tell Good Obamacare Changes From Bad
The many updates, exclusions, delays and revisions that have marked the administration's implementation of the Affordable Care Act in part validate [Republicans'] concerns about how cumbersome the law is. But with an effort as sweeping and necessary as Obamacare, some unwieldiness is inevitable. What's important is getting the law right, and that calls for judgments separating good changes from bad (3/7).

Los Angeles Times: So How Many People Had Their Insurance Canceled? Fewer Than You Think
In a debate almost totally infected with myth, perhaps the most tenacious myth about the Affordable Care Act involves the tsunami of old insurance policies that were supposedly canceled by insurers because they didn't comply with the ACA. How many policies? The figures are all over the place -- some say 17 million, some say 4.7 million. The implication is also murky -- however many cancellations happened, were all these people left without insurance? (Michael Hiltzik, 3/7). 

Bloomberg: How Not To Help The Uninsured
With Obamacare in train, who is buying insurance? Half of uninsured adults have looked for insurance online, according to an Urban Institute survey cited in the Washington Post. But only 10 percent of them have actually bought it, according to a different survey from McKinsey & Co. Overall, McKinsey says, just one quarter of the people who bought insurance on the exchange were previously uninsured (Megan McArdle, 3/7).

The Wall Street Journal: Do Republicans Need A Plan B?
But the more immediate concern for the GOP is this year's midterm elections, and there are at least two schools of thought on how to win back the Senate and increase their House majority. One side-;which includes most of the Republican leadership in Congress-;wants to stay laser-focused on the president's unpopular health-care law. According to the Real Clear Politics average, public support for ObamaCare is just 38 percent, and opposition is now 53 percent. The president's decision this week to make additional changes to the law is further acknowledgment that the issue is hurting his party politically as the midterm elections approach. But another group of Republican pols insists that ObamaCare-bashing can only get you so far and may have diminishing political returns (Jason L. Riley, 3/7). 

The Wall Street Journal: Obamacare And The Midterms
Twenty-seven House Democrats voted with 223 Republicans this week to delay the ObamaCare individual mandate for a year. While the measure is dead on arrival in the Senate, the vote was instructive in exposing potential Democratic trouble spots in this year's midterm elections (Allysia Finley, 3/7). 

The Richmond Times-Dispatch: This Time, McAuliffe Wrestles Political Alligators
Terry McAuliffe is wrestling alligators again. This time, they could tear a chunk out of him. In 1980, as a youthful fundraiser for President Jimmy Carter's re-election campaign, McAuliffe grappled with an 8-foot, 260-pound gator in return for a $15,000 contribution from the Seminole Indian tribe. The beast was toothless and tranquilized, ensuring McAuliffe's stunt could not literally come back to bite him. Thirty-four years later, as a neophyte governor, McAuliffe is tangling with two figurative alligators, both of which are baring their teeth: A House Republican majority resisting him on Obamacare and pro-gay rights Democrats in revolt over his choice of Richmond Mayor Dwight Jones, an opponent of same-sex marriage, for state party chairman (Jeff E. Schapiro, 3/9).

Bangor Daily News: With More Poverty And Less Health Care, Rural Maine Would Benefit Most From Medicaid Expansion 
Both nationally and in Maine, data show that rural residents are less healthy and face greater obstacles to health care compared with their urban counterparts. They are more likely to die prematurely, suffer from chronic disease and lack insurance. Maine's rural rim counties have the highest percentages of uninsured residents (17 percent of Washington County residents are uninsured) due to a combination of factors, including lower annual incomes and higher rates of self-employment. ... Because a significant percentage of working Americans earns too little to afford private coverage, the Affordable Care Act provides federal dollars for states to expand their Medicaid programs to cover low-income, working people (Christy Daggett, 3/9).

And on other issues -

The New York Times: Cloudy And Cold
If the courts don't intervene, by the end of the year Texas may be down to six places where a woman can go to end a pregnancy. That's in a state of 268,000 square miles, with 26 million people. ... The state now requires that any doctor who performs abortions have admitting privileges at a hospital. Few of them do, and it's not medically necessary. ... Texas is leading the pack on this crusade, but other states are right behind it, restrained only by legal challenges. If Mississippi's admitting privileges law is upheld, the state's last abortion clinic will be closed. Alabama and Wisconsin are in the same situation; if their laws are upheld, they would be down to two clinics each (Gail Collins, 3/7).

NPR's SHOTS blog: When Facts Are Scarce, ER Doctor Turns Detective To Decide On Care
In the last hour, five ambulances have arrived at the emergency room where I work. A sixth pulls up. The paramedics wheel out a stretcher carrying a man, 73, strapped to a hard board, a precaution in case his spine is fractured. ... Medical history? None the paramedics could find. Same goes for whatever medications the patient might be taking. The only thing they know is his name and address. ... The next day, I get a call from the patient's son and daughter-in-law. They're irate. ... We emergency physicians frequently hear complaints from other doctors about how we order too many tests and admit too many patients. While medical overuse is a problem -; and fear of malpractice and financial conflicts of interest sometimes play a role -; it's easy to make harsh judgments after the fact (Dr. Leana Wen, 3/8). 

The New York Times: When Health Costs Harm Your Credit
[T]here are few standards governing medical debts: One billing office might give you -; or your insurer -; 60 days to pay before pursuing collection. Another might allow you to pay off a bill slowly over a year. Many will sell the debt to collection companies .... The problem is accelerating for several reasons. Charges are rising. Insurance policies are requiring more patient outlays in the form of higher deductibles and co-payments. More important, perhaps, is that while doctors' practices traditionally worked out deals for patients who had trouble paying, today many doctors work for large professionally managed groups and hospital systems (Elisabeth Rosenthal, 3/8). 

Los Angeles Times: Courts To Decide Which Comes First, The Chickens Or The Eggs
The individual mandate in the 2010 Affordable Care Act forced the courts to consider anew the limits of Congress' power to regulate the insurance market. Now, a California law governing the size of hens' cages is testing the limit of a state's power to regulate interstate food sales. At issue is a 2010 law that bans the sale of eggs from hens kept in cages that California voters deemed too small in 2008, when they passed Proposition 2. Sponsored by the Humane Society of the United States, the ballot measure requires the state's egg-laying hens, calves raised for veal and pregnant pigs to be housed in a way that allows them to stand up, turn around and extend their limbs fully (John Healey, 3/8). 

Bloomberg: E-Cigarettes Aren't For Kids
Could someone please send the U.S. Food and Drug Administration a copy of the latest study on teenagers and e-cigarettes? The agency obviously needs a push to come out with its overdue regulations. Drawn from two surveys of tens of thousands of American middle-school and high-school students, the research found that adolescents who tried battery-powered nicotine vaporizers were more likely to smoke tobacco cigarettes. And if the kids were already regular smokers at the time they experimented with "vaping," they became less likely to quit (3/10).