Viewpoints: Turning to new legal challenges to ACA; is the law working?; Medicaid problems in N.C.

Jul 11 2014

The Washington Post: Courts Won't Void The Affordable Care Act Over Semantics
The Supreme Court's term ended in June with another Affordable Care Act ruling, and the ACA survived largely unscathed. Burwell v. Hobby Lobby has important ramifications for women's health and religious freedom but does not invalidate a single section of the law. There are, however, a number of ACA lawsuits percolating up through the courts that could be much more destructive (Timothy Jost, 7/9). 

The New York Times' Taking Note: Democrats Will Vote To Undo The Hobby Lobby Decision
The Supreme Court's ruling last week in the Hobby Lobby case wasn't based on a fundamental right found in the First Amendment or anywhere else in the Constitution. When the justices said that closely held corporations have religious rights that let them refuse to pay for insurance plans that cover contraceptives, they based their decision on a 1993 law passed by Congress, the Religious Freedom Restoration Act. That means Congress has the ability to rewrite federal law to overrule the court's decision, and Senate Democrats have wasted little time coming up with a bill to do just that (David Firestone, 7/9).

The Fiscal Times: Harry Reid's Crafty Ploy To Fight The Hobby Lobby Ruling
Senate Majority Leader Harry Reid plans to rebut the Supreme Court by amending the (Religious Freedom Restoration Act). Democrats in both chambers of Congress began working on bills that would exempt Obamacare from the bill passed in 1993 and signed by then-President Bill Clinton in an attempt to circumvent the Hobby Lobby decision and force employers to provide free contraception and sterilization to their employees. Reid announced the effort on Tuesday by announcing that Democrats wouldn't allow women's lives to be "determined by virtue of five white men," which must have come as a shock to Justice Clarence Thomas, one of the five justices to support the majority in the Hobby Lobby decision. That, however, was just the start of the insanity. Let's start with a refresher course on the RFRA (Edward Morrissey, 7/10).

The New York Times: Reading Hobby Lobby In Context
To grasp the full implications of the Supreme Court's Hobby Lobby decision, it helps to read it not in isolation but alongside the court's other major religion case of the term, Town of Greece v. Galloway. Issued eight weeks before Hobby Lobby and decided by the same 5 to 4 division, Town of Greece rejected a challenge to a town board's practice of beginning its public sessions with a Christian prayer. A federal appeals court found the practice unconstitutional, concluding that it violated the First Amendment's Establishment Clause by conveying an official endorsement of one particular religion (Linda Greenhouse, 7/9). 

Los Angeles Times: What Do The Hobby Lobby Backers Want Women To Be?
In the fallout surrounding last week's Supreme Court Hobby Lobby decision, a lot of people have been wondering exactly what role the Christian right thinks women should play in society and how birth control detracts from it (Meghan Daum, 7/9). 

The Wall Street Journal's Washington Wire: How Proposals For Obamacare Subsidies In 2015 Could Cost Taxpayers
In a Think Tank post last week, I explained why the number of unresolved inconsistencies in applications on the federal insurance exchanges probably exceeds the 2.9 million cited in two recent Department of Health and Human Services reports. Recent HHS proposals could allow many income-related inconsistencies to persist in 2015–potentially risking taxpayer funds (Chris Jacobs, 7/9). 

JAMA: How Well Is The Affordable Care Act Working?
The American people are still divided in their views of the Affordable Care Act (ACA), which is perhaps not surprising given how partisan the debate has been and the fundamental ideological differences in the country about the appropriate role for government in health care, as in other spheres. There are legitimate differences of opinion about the law, just as there are about any important policy issue. But the politics of the ACA often get confused with the question of whether the law is working as intended, whatever one may think of the wisdom of those intentions. That is largely a factual question, though facts about the ACA are often blurred when looked at through ideologically tinted lenses (Larry Levitt, 7/9).

Bloomberg: Obamacare Is Working. Unless You're Black.
A new survey shows that Obamacare has done a fantastic job of reducing the uninsurance rate -- for everybody except blacks. The share of Americans age 19 to 64 without health insurance fell from 20 percent last summer to 15 percent this spring, according to a telephone survey of 4,425 people from the Commonwealth Fund, a nonprofit health-care research group. ... When the Commonwealth Fund conducted a survey from July to September last year, 21 percent of blacks reported being uninsured. This year, in a similar survey conducted from April to June, that level was effectively unchanged, at 20 percent. Blacks were about half as likely as Latinos to be uninsured a year ago; now the rates for the two groups are almost the same (Christopher Flavelle, 7/9).

Forbes: Intervention: Will North Carolina Clean Up Its Medicaid Program?
What started out as a pro forma session to pass North Carolina's budget has turned into an intervention over the state Medicaid program's big-spending, poor-performing ways. And it's about time-;North Carolina spends more than $14 billion per year on its Medicaid program, has run over budget the last four years, and, perhaps most shocking, the Medicaid agency doesn't even know how many people are currently enrolled (Josh Archambault, Jonathan Ingram and Christie Herrera, 7/10). 

Arizona Republic: Brewer Was Right On Medicaid Expansion (We Have Proof)
Gov. Jan Brewer's victory in the fight for Medicaid expansion paid off. Big time. A survey by the Arizona Hospital and Healthcare Association found a 31 percent reduction in the amount of uncompensated care in the first four months of this year compared to the same period last year. We're talking real money. Responses from 75 percent of the state's hospitals showed they wrote off $170 million in uncompensated care through April this year. During those same months in 2013, the cost of uncompensated care was $246 million (7/8).

Georgia Health News: To Help Struggling Hospitals, Replace Georgia's Malpractice System
A panel of health care and political leaders appointed by Gov. Nathan Deal kicked off its work this summer to address the ongoing crisis in rural medical care. Its focus: the very survival of hospitals outside metropolitan communities through the state. ... Four rural Georgia hospitals have closed in the past two years. ... While some continue to urge the governor to expand the state's Medicaid rolls as a solution to the hospitals' financial challenges, there is a healthier avenue to create revenue to sustain these hospitals. Under the proposed Patients' Compensation System (PCS) before the General Assembly, state taxpayers could save $6.9 billion over the next decade. That state revenue could be reinvested in rural hospitals that are barely surviving and others losing these federal grants (Wayne Oliver, 7/9).