Special enrollment and SCOTUS: The administration is scheduled to announce an Obamacare change today that will allow individuals who started the enrollment process but were unable to complete it because of technical issues to finish applying after the March 31 deadline. The extension was first reported by the Washington Post Tuesday evening, and is in anticipation of an expected enrollment surge that could cause technical problems with HealthCare.gov. However, the extension will be on an honor system--individuals will simply check a box on the federal website indicating that they tried to enroll ahead of the deadline. The announcement applies only to the 36 states participating in the federal marketplace, but some states that have had issues with their own exchanges are planning on similar special enrollment exceptions, including Maryland, Minnesota, Oregon, and Nevada. Officials have not yet determined exactly how long the extension will be.
Meanwhile, the Supreme Court was deeply divided during yesterday's oral arguments over Obamacare's contraception mandate. The three female justices dominated the first half with aggressive questions about the other legal requirements insurers could try to get out of, from health care services to non-discrimination laws. The court's conservative bloc--led by Justice Samuel Alito-- argued that corporations and their owners can sue to defend a right to religious freedom, and that the Justice Department hadn't met the high bar for defending the contraception mandate. Justice Anthony Kennedy was, as ever, in the middle, and likely holds the key vote. He appeared skeptical of the Justice Department's position, but did ask probing questions of both sides.
Top Health Care News
ENROLLMENT: "The constituency that has been most wary of extra sign-up time has been the insurance industry. Insurance firms selling plans in the new marketplace want to minimize the possibility that people might wait to get coverage until they become sick — a practice that would undermine the central idea of keeping costs in check by balancing people who are expensive to insure with those who are healthy and require little medical treatment. On the other hand, consumer advocates say it is important to give as many people as possible a chance to obtain insurance." (Amy Goldstein, Washington Post)
SCOTUS: "Chief Justice John Roberts indicated he was inclined to rule in favor of closely held businesses like Hobby Lobby, which has roughly 600 stores and is based in Oklahoma City, and Conestoga, of East Earl, Pa., while leaving for another day the thornier questions of religious rights for public companies with complex ownership setups. It was unlikely, he said, that 'a large, publicly traded corporation' was going to start claiming religious exemptions from federal law." (Jess Bravin, Wall Street Journal)
Transcript available here.
D.C. CIRCUIT COURT OF APPEALS APPEARS DIVIDED ON FEDERAL SUBSIDIES CHALLENGE: "It's fair to say that based on the oral arguments, two of the three justices seemed at least open to the idea of striking down the IRS rule, which would almost certainly send the issue to the Supreme Court. Even this possibility should be enough to make Obama administration officials a bit nervous, given how dramatically an adverse ruling could affect their implementation strategy for the health care law." (Philip Klein, Washington Examiner)
Audio available here.
More on Contraception
WHY YOU SHOULDN'T WORRY ABOUT LOSING YOUR BIRTH CONTROL: "If the Supreme Court rules in favor of these two for-profit entities, the justices are not likely to rule broadly enough to encompass a significant number of employers." (Clara Ritger, National Journal)
CONSERVATIVE JUSTICES APPEAR READY TO STRIKE BIRTH CONTROL MANDATE: "'Under your view, a profit corporation...could be forced in principle to pay for abortions,' Justice Anthony Kennedy, the traditional swing vote, told U.S. Solicitor General Donald Verrilli, who was defending the law." (Sahil Kapur, Talking Points Memo)
ENROLLMENT SURGE AHEAD OF OPEN ENROLLMENT DEADLINE: "A day earlier, officials said the federal exchange's website, [HealthCare.gov], had more than 1.1 million visitors, the second most ever. State exchanges also were busy with Washington state enrolling 12,000 people last week while almost 1,200 signed up yesterday in Connecticut, officials said." (Alex Wayne, Bloomberg News)
HIGHER RATE OF YOUNG ADULTS ENROLLING IN COVERAGE OFF THE ACA EXCHANGES: "Since Jan. 1, about 45 percent of those picking new health plans through eHealth were between 18 and 34 years old, the company says. By comparison, the all-important demographic accounted for 27 percent of signups on Obamacare exchanges the past couple of months...An administration official points out that insurers have to consider exchange and off-exchange enrollment in ACA-compliant plans as part of the same risk pool. So, if more young people are going off the exchanges to sign up in new plans, the administration is just fine with that." (Jason Millman, Washington Post)
HIGH RATES OF ACA ENROLLEES WERE PREVIOUSLY UNINSURED IN KENTUCKY, NEW YORK: "In Kentucky, 75 percent of the nearly 65,000 people who enrolled in private Obamacare insurance sold on the state-run exchange were uninsured at the time they enrolled, according to questionnaires they filled out when they applied. And 75 percent of people who enrolled in Medicaid via the exchange likewise had been uninsured. In New York, 59 percent of the nearly 343,000 private Obamacare plan enrollees reported being uninsured when they picked their plans. And 90 percent of the Medicaid enrollments via the state's exchange reported having been uninsured." (Dan Mangan and Jodi Gralnick, CNBC)
POLL: HALF OF UNINSURED NOT PLANNING TO ENROLL IN COVERAGE: "The Kaiser Family Foundation's latest poll, conducted in mid-March, found that 50 percent of adults under age 65 who still lack coverage plan to remain without insurance, while 40 percent aim to sign up by the deadline at month's end...Of the uninsured, two out of three said they have not tried to get coverage yet...Only four in 10 of the uninsured knew the deadline to sign up for coverage, the poll found." (Jordan Rau, Kaiser Health News)
A BRIEF HISTORY OF OBAMACARE DELAYS: The announcement of a special enrollment period beyond March 31 is not unprecedented. (David Nather and Susan Levine, Politico)
ADMINISTRATION LIMITS SEQUESTER IMPACT ON ACA AGAIN: A new HHS rule seeks to interpret the sequester of risk adjustment and reinsurance payments as pushing back the cuts by several months, rather than actually cutting the payments. The change follows the administration's exemption of the ACA's cost-sharing subsidies from the sequester. (Committee For a Responsible Federal Budget)
NEW HAMPSHIRE HOUSE PASSES MEDICAID EXPANSION: The bill will go to Democratic Governor Maggie Hassan, who has said she will sign it. The plan will expand coverage to about 50,000 low-income state residents. (Sophie Novack, National Journal)
STUDY: MENTAL HEALTH CARE LIMITED IN SOME COUNTIES: "Some of the nation's counties have only one mental health provider per 55,989 people, [the County Health Rankings and Roadmaps] study released Wednesday shows...Those who live in the West and Northeast are most likely to have better access to a provider.The Affordable Care Act requires insurers to cover mental health as they would physical health, but insurance does little good if no one exists to provide the care." (Kelly Kennedy, USA Today)
MARCH HEALTHCARE UPDATE FROM BLOOMBERG GOVERNMENT: A 2 pm. webinar with Bloomberg health analysts look at the state of the Affordable Care Act enrollment, the president's health care budget request, and the SGR.
AMERICA'S ADDICTION TO OPIOIDS: HEROIN AND PRESCRIPTION DRUG ABUSE: The Senate Caucus on International Narcotics Control holds a hearing at 2:30 p.m.