A project of the Galen Institute

Issue: "Legal Challenges"

Getting There: How to transition from Obamacare to real health care reform

James Capretta and Yuval Levin
Weekly Standard
Wed, 2014-09-17
"Obamacare—or at least the version of it that the president and his advisers currently think they can get away with putting into place—has been upending arrangements and reshuffling the deck in the health system since the beginning of the year. That’s when the new insurance rules, subsidies, and optional state Medicaid expansions went into effect. The law’s defenders say the changes that have been set in motion are irreversible, in large part because several million people are now covered by insurance plans sold through the exchanges, and a few million more are enrolled in Medicaid as a result of Obamacare. President Obama has stated repeatedly that these developments should effectively shut the door on further debate over the matter. Of course, the president does not get to decide when public debates begin or end, and the public seems to be in no mood to declare the Obamacare case closed.

The Federal Courts' Role in Implementing the Affordable Care Act

MaryBeth Musumeci and Laurie Sobel , Kaiser Family Foundation
Wed, 2014-09-17
"Since the Affordable Care Act’s (ACA) passage, a number of lawsuits have been filed challenging various provisions of the law. The Supreme Court has decided cases about the constitutionality of the ACA’s individual mandate and Medicaid expansion as well as the applicability of the contraceptive coverage requirement to closely held for-profit corporations with religious objections. In addition, several cases challenging the availability of premium subsidies in the Federally-Facilitated Marketplace (FFM) are currently progressing through the federal courts. All of this litigation has altered, or has the potential to alter, the way in which the ACA is implemented and consequently could affect the achievement of the law’s policy goals.

Brady Questions HHS Authority To Put Forward Hospital Appeals Settlement

http://insidehealthpolicy.com/brady-questions-hhs-authority-put-forward-hospital-appeals-settlement
Tue, 2014-09-16
"House Ways & Means health subcommittee chair Kevin Brady (R-TX) questions HHS' authority to settle hospitals' appeals of denied inpatient claims and is urging HHS Secretary Sylvia Burwell to retract what he views as an "ill thought" settlement process. Brady wants Burwell to work with lawmakers to come up with a different "fair, transparent and conclusive settlement process." Brady wrote to Burwell Tuesday (Sept. 16) that he is dismayed by HHS' reluctance to work with the committee on an equitable settlement process that is fully legal, adding that the "lack of engagement makes it challenging for the Congress to solve the current appeals problems and prevent similar problems in the future." CMS announced late last month (Aug. 29) that it will pay hospitals 68 percent of denied inpatient status claims in the appeals queue if hospitals take them out of the backlogged appeals process.

How Does Where You Work Affect Your Contraceptive Coverage?

Kaiser Health News
Fri, 2014-09-12
"The Affordable Care Act (ACA) requires most private health insurance plans to provide coverage for a broad range of preventive services including Food and Drug Administration (FDA) approved prescription contraceptives and services for women. Since the implementation of this provision in 2012, some nonprofit and for profit employers with religious objections to contraceptives have brought legal challenges to this rule. For many women today, their contraceptive coverage depends on their employer or when they purchased their individual insurance plan."

Ohio: Law Against Lies Is Nullified

The Associated Press
The New York Times
Fri, 2014-09-12
"A federal judge on Thursday struck down Ohio’s law barring people from knowingly or recklessly making false statements about candidates in a case that the United States Supreme Court said needed to be heard. The judge, Timothy Black, said that the answer to false statements in politics is “not to force silence, but to encourage truthful speech in response, and to let the voters, not the government, decide what the political truth is.” The case began in the 2010 congressional race after Steve Driehaus, a congressman at the time, filed a complaint when the Susan B. Anthony List planned to post billboards claiming the Democrat’s support for President Obama’s health care overhaul equated with support for abortion, even though he opposed abortion."

Apparent Retail Glitch Triggers Copays For Birth Control

Shefali Luthra, Kaiser Health News
Fri, 2014-09-12
"CVS Health is investigating a potential glitch in its drug pricing system that appears to have charged women copayments for prescription birth control – though the scope of the error is unclear. The problem came to the attention of Rep. Jackie Speier, D-Calif., after one of her staffers attempted to buy generic prescription birth control in Washington D.C. and was charged a $20 copay. The retailer’s error, highlighted in a letter to the company from Speier, runs counter to a provision of the federal health law that mandates insurance coverage of women’s preventive care – a category including generic prescription birth control – without cost sharing."

Healthcare Expert: Obamacare's 'Quiet Summer' is About to End in a Big Way

Guy Benson
Townhall.com
Wed, 2014-09-10
"Dan wrote up yesterday's Washington Post/ABC News poll, which was jammed with crooked numbers for President Obama. Most striking was the (30/55) majority deeming Obama's presidency "a failure," along with the prevailing opinion that he's divided the country, and his unsightly leadership score. The survey also included a dreadful (38/56) presidential approval rating on the implementation of Obamacare; support for the law itself was also underwater, with an outright majority opposed, despite this polling series' silly question wording that omits any mention of 'Obamacare' or the 'Affordable Care Act.' A new Kaiser Family Foundation poll produces similar findings, with support for the president's signature domestic accomplishment swamped by opposition. It's been this way for years, across hundreds of national surveys. One major reason for the enduring opposition is that the law has violated virtually every major promise erected in dishonest ideologues' sales pitch.

Healthcare Expert: Obamacare's 'Quiet Summer' is About to End in a Big Way

Guy Benson
Townhall.com
Wed, 2014-09-10
" Dan wrote up yesterday's Washington Post/ABC News poll, which was jammed with crooked numbers for President Obama. Most striking was the (30/55) majority deeming Obama's presidency "a failure," along with the prevailing opinion that he's divided the country, and his unsightly leadership score. The survey also included a dreadful (38/56) presidential approval rating on the implementation of Obamacare; support for the law itself was also underwater, with an outright majority opposed, despite this polling series' silly question wording that omits any mention of 'Obamacare' or the 'Affordable Care Act.' A new Kaiser Family Foundation poll produces similar findings, with support for the president's signature domestic accomplishment swamped by opposition. It's been this way for years, across hundreds of national surveys. One major reason for the enduring opposition is that the law has violated virtually every major promise erected in dishonest ideologues' sales pitch.

Obama Administration ‘Doubles Down’ on Fight Against Nuns

Kelsey Harkness
The Daily Signal
Wed, 2014-09-10
"The Obama administration has decided to continue its legal battle against Little Sisters of the Poor, a Catholic charity that objects to Obamacare’s mandate that employee health plans cover contraceptives and abortion-inducing drugs. The order of Catholic nuns argues that the rule fashioned by the Department of Health and Human Services requires them to violate their religious beliefs by offering insurance coverage for 20 specific drugs and devices — some of which the nuns believe could destroy what they consider a human life. If the Little Sisters of the Poor choose not to abide by the HHS mandate, they face devastating fines by the Internal Revenue Service that could result in millions of dollars a year being diverted from their mission of caring for elderly women and men."

Republicans Remain Focused on Risk Corridors

Meghan McCarthy
Morning Consult
Mon, 2014-09-08
"When Congress returns this week, action in both chambers will mostly be a show for the voters back home ahead of the midterm election. In the House, that will include a vote on a bill to allow insurance companies to continue offering any plan that was sold in the group market in 2013. Noticeably absent from congressional politicking in the next few weeks is the Affordable Care Act’s risk corridor program, which was, as recently as a few months ago, a major Republican criticism of the law. But that doesn’t mean the “insurer bailout” fight is dead. Republicans in both chambers are quietly working to challenge the legality and projected cost of the program.

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