Viewpoints: Supreme Court on religion and health; a GOP Senate's effect on health law; where are the young adults?

Mar 20 2014

USA Today: Obamacare Challenge Could Empower Discriminators 
Should corporations have the right to get out of obeying federal law and refuse services and deny health care coverage to some people because of the corporate owners' religious beliefs? That's the question the U.S. Supreme Court is weighing this month – and the answer could affect millions of Americans' everyday lives (Cecile Richards and Chad Griffin, 3/18).

Los Angeles Times: Obamacare And Religious Rights In A For-Profit World
Next week, the Supreme Court will hear arguments on whether the Affordable Care Act's contraception mandate -; the requirement that employers provide employee health insurance that covers contraception -; impermissibly infringes on the religious liberty of religiously motivated corporations. The legal battles over the mandate have been legion; more than 300 plaintiffs have field more than 90 cases across the country, all contending that providing health coverage for contraception would require them to violate their faith (Michael A. Helfand, 3/18). 

Bloomberg: Can Republicans Kill Obamacare If They Win the Senate?
With Republicans running both sides of Congress, Obamacare would receive no discretionary funding. Indeed, funding for key aspects of the law's implementation has already been spent down or restricted by congressional action. That's not fatal. The law's mandatory funding -- mostly Medicaid expansion and tax credits to help consumers buy insurance on the exchanges -- can't be stripped out by a hostile Congress. In addition, the user fees ..., which will be paid by insurance companies to the health care exchanges, will probably yield at least hundreds of millions of dollars. And Barack Obama presumably will rely on one more thing: a new constituency of millions of Americans who are insured through Obamacare and won't want to lose their subsidized health care (Francis Wilkinson, 3/18).

The Washington Post's Right Turn: What's A Democrat To Do?
Multiple presidential campaign loser Robert Shrum intones: "[Alex] Sink didn't lose because of Obamacare. . . . Obamacare's numbers are getting better and better -; in both public opinion and enrollments. Democrats have the specifics on their side." Hmm. Actually support for Obamacare is pretty weak, especially in the red states in which many vulnerable Democrats must operate (Jennifer Rubin, 3/18).

The Washington Post's The Plum Line: What The Obamacare Enrollment Numbers Mean
The Obama administration announced late yesterday that 800,000 people have signed up for new health insurance so far in March. That brings the total under the Affordable Care Act to over 5 million and makes it likely that 6 million will have enrolled by March 31, the last day to sign up before getting a fine. That 6 million number would meet a projection made by the Congressional Budget Office. So what are we to make of those numbers? (Paul Waldman, 3/18). 

The Washington Post: President Uses March Madness To Sell People On Health Care Before The Buzzer
But the Obama administration is using the excitement over the brackets for the NCAA basketball tournament to sell people on the Affordable Care Act and get them covered at HealthCare.gov before the end of open enrollment on March 31 (Michelle Singletary, 3/18). 

Bloomberg: March Madness Opens Door To Political Madness
You may notice something a little different about this year's March Madness, a little something extra. In addition to all of the buzzer-beating, bracket-busting action, you're going to be hearing a lot about Obamacare, the fate of which is also going down to the wire (Jonathan Mahler, 3/18).

Bloomberg: Young Invincibles Are Killing Obamacare
As the clock ticks down to the end of open enrollment for health coverage, one thing is becoming clearer: what the final demographics will look like. Demographics matter a lot because they will help determine whether the health insurance market goes into a death spiral (or requires hefty federal subsidies to keep it from doing so). Young healthy people, and a lot of them, are needed to keep the market stable and premiums low. As we head into the final few weeks, we have a pretty good idea of how many young healthy people there will be, and the answer is: a whole lot fewer than the health-care wonks were expecting (Megan McArdle, 3/18).

The Fiscal Times: A Procrastinator's Guide To Picking An Obamacare Plan
The final enrollment deadline for getting Obamacare coverage this year is coming up at the end of March. If you're still thinking about signing up, or plan to, you're going to need to do some math. Of course, nobody likes doing the gnarly math when picking an insurance policy. It would be great if the Obamacare exchanges all offered a flexible calculator to do this, but they don't, so you have to crunch the numbers on your own (John F. Wasik, 3/19).

The Tennessean: Good, Affordable Health Insurance Is Here
Right now, 800,000 uninsured Tennesseans have an incredible opportunity before them, one that was unavailable just six months ago. The health insurance marketplace offers quality, affordable coverage to uninsured and underinsured Tennesseans, but only two weeks remain to enroll. As the mayors of Tennessee's four largest cities, we're coming together because we want to see our own residents -; and folks all over the state -; take advantage of these benefits by getting covered (Nashville Mayor Karl Dean, Chattanooga Mayor Andy Berke, Knoxville Mayor Madeline Rogero and Memphis Mayor A.C. Wharton Jr., 3/16).

The Witchita (Kan.) Eagle: Bring Medicaid Money Back To State
It is true: There is no such thing as free money. ... In 2013 and 2014, Kansans will have contributed $161.7 million in "pay-fors" for Medicaid expansion. These "pay-fors" will continue whether or not our state decides to expand Medicaid. These "pay-fors" come in the form of Medicare cuts to hospitals and providers, insurance provider fees and, in the future, employer penalties. We all are affected by these losses to our state. ... Kansas hospitals as well as 72 percent of Kansans (according to a recent poll by the American Cancer Society) would like to see our money returned to Kansas to cover more of the uninsured, and not go to states like California, Colorado and Ohio (Tom Bell, 3/19).

Lincoln (Neb.) Journal Star: Fiscal Conservatives Should Support Medicaid Expansion
I would suggest its time for fiscal conservatives to support LB887. The proposed Wellness in Nebraska Act, LB887, is our state's version of Medicaid expansion. ... Medicaid expansion under LB887 will have a total net cost to Nebraska taxpayers of just over $62 million in general and cash funds, while ensuring health care for an additional 65,000 Nebraskans by 2020. But during that same period, the fiscal note indicates that LB887 will result in the Federal government injecting almost $2.2 billion into the Nebraska economy to help fund the program. ... fiscal conservatives should want to recoup these dollars (Tom Briese, 3/19). 

And on other health issues -

WBUR: Doctors 'Aghast' That Surgeon General Nominee Blocked For Gun Control Views
In another time and place, a nominee like Dr. Vivek Murthy, with a narrative so akin to conservative politicians like Sens. Ted Cruz and Marco Rubio, would sail through Senate confirmation as the nation's surgeon general. But in our time and place, special interest groups have hijacked Dr. Murthy's nomination, as they have the entirety of the American political process. As physicians and students of public service, we are aghast (Ali Khan, Sanjay Kishore and Christopher Lillis, 3/18).

The Journal of the American Medical Association: Transforming From Centers Of Learning To Learning Health Systems
Society needs academic health centers to train the next generation of health professionals and advance scientific knowledge and its application to improve health. Academic health centers must become more attentive to patient-centeredness, population health, and health care value. As centers of learning, academic health centers should accept the challenge to become exemplars of learning health systems and transform practices at their own institutions under a unified mission to improve health and health care through advancing, applying, and disseminating knowledge (Drs. Kevin Grumbach, Catherine R. Lucey and S. Claiborne Johnston, 3/18).

The Journal of the American Medical Association: Breaking Good
A patient recently complained to me that her oncologist never called to let her know her test results. ... When I asked my associate about it, he said, "As a matter of policy, I call back only if results are abnormal." Did he inform the patient of policy? ... I found this "policy" to be not only insensitive toward patients but also self-defeating for physicians. They forfeit opportunities to savor positive moments, reduce risk of burnout, and capture professional highs. Giving good news can also be a make-or-break process in the evolution of patient-physician relationships and it, too, isn't easy. As we return to the long-neglected emotional underpinnings of medicine, our profession will achieve new insights into the science of communicating. The good news is we're learning. Now the question: how do we communicate that good news so that all can clearly hear (Dr. Benjamin W. Corn, 3/18).