KHN’s ‘What the Health?’: Democrats roll dice on SCOTUS and the ACA

Reviewed by Kate Anderton, B.Sc. (Editor)Jan 9 2020

Democratic state attorneys general are asking the Supreme Court to intervene this term in a case that could invalidate the entire Affordable Care Act. In December, a federal appeals court panel ruled that the "individual mandate" provision of the health law is unconstitutional now that Congress has reduced the penalty for not having insurance to zero. But it sent the case back to the lower-court judge to determine how much else of the law can remain in light of that finding.

Democrats want the high court to rule on the case now, which would be unusual but not unprecedented.

Meanwhile, Republicans on Capitol Hill are asking the Supreme Court to use a Louisiana abortion case already on this year's docket to overturn the landmark abortion rights case, Roe v. Wade. The Louisiana law — requiring doctors who perform abortions to have admitting privileges at nearby hospitals — is similar to a Texas law struck down by the court in 2016. But the court has added anti-abortion justices since then.

This week's panelists are Julie Rovner from Kaiser Health News, Joanne Kenen of Politico, Stephanie Armour of The Wall Street Journal and Paige Winfield Cunningham of The Washington Post

Among the takeaways from this week's podcast:

• The Democratic push to get the Supreme Court to quickly review the latest ACA challenge could have political benefits for the party in the campaign season. Democrats are eager to be seen as protecting new health care benefits. And if President Donald Trump is elected next fall, the high court could well become more conservative as several liberal-leaning justices may leave the court in the next few years.
• Some advocates for a "Medicare for All" health care system are convinced that if the Supreme Court were to strike down the ACA, the resulting vacuum would make a government-run program more attractive to Americans.
• Amid increasing efforts by states to restrict abortions and a more conservative majority on the Supreme Court, abortion may become a more potent voting issue for Democrats. It has long motivated Republican voters, but Democrats have been less driven by that single issue.
• The much-publicized administration rules to cut back on flavored vaping products include a lesser-known provision allowing companies to go through a Food and Drug Administration process to prove their products have a net health benefit: helping adults quit smoking.
• States continue to seek Trump administration approval for work requirements for their Medicaid programs, but if Democrats win the presidency in 2020, those approvals are likely to be reversed. Meanwhile, most of the state plans are tied up in court.

Also this week, Rovner interviews NPR's Richard Harris, who reported the latest KHN-NPR "Bill of the Month" installment about a very expensive laboratory bill for a New York woman who had a cold. If you have an outrageous medical bill you would like to share with us, you can do that here.

Plus, for extra credit, the panelists recommend their favorite health policy stories of the week they think you should read too:

Julie Rovner: Stat News' "Washington Took a Decade to Approve an Obscure Drug-Pricing Bill. That's a Bad Omen for More Ambitious Reforms," by Nicholas Florko

Joanne Kenen: The New Yorker's "A World Without Pain," by Ariel Levy

Stephanie Armour: The New York Times' "In the U.S., an Angioplasty Costs $32,000. Elsewhere? Maybe $6,400," by Margot Sanger-Katz

Paige Winfield Cunningham: KHN's "Reduce Health Costs By Nurturing The Sickest? A Much-Touted Idea Disappoints," by Dan Gorenstein and Leslie Walker. You can hear the episode of Dan's podcast, "Tradeoffs," about this study here.

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