Contraception Battle, Round Two
ACCOMMODATION CHALLENGE: On the heels of its Hobby Lobby ruling, the Supreme Court turned around late last week and granted Wheaton College's request for a temporary exemption from another part of Obamacare's contraception mandate. Wheaton isn't a for-profit business, like Hobby Lobby, and it objected to part of the process for claiming the "accommodation" for religious nonprofits -- which was already set to become the next battleground in the contraception mandate.
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WHEATON COLLEGE: In a 6-3 decision, the court granted the Christian school a temporary injunction Thursday from the ACA's requirement to provide birth control coverage, as long as it tells the government it objects on religious grounds. Thursday's order allows the college to refrain from providing birth control coverage without filing the accommodation form, while the case continues to play out in lower courts. (Adam Liptak, New York Times)
- Read the decision here.
- Challenges to the contraception mandate from religious schools and nonprofits could make it to the Supreme Court this fall. (Jennifer Haberkorn, Politico)
OBAMA ADMINISTRATION CONSIDERS CONTRACEPTION COVERAGE WORK-AROUND: The White House is trying to find a feasible way to provide coverage in the wake of the Hobby Lobby and Wheaton College decisions. The pressure is great to find a quick solution, as experts expect challenges to flood in, and about 100 cases are currently pending. No one has yet figured out how an alternative would be paid for or administered. (Robert Pear and Adam Liptak, New York Times)
THE COURT RULING THAT COULD WRECK OBAMACARE: "The U.S. Court of Appeals for the D.C. Circuit is expected to rule any day now in a lawsuit that aims to block the law's insurance subsidies in more than half the country...For now, the stakes are a lot higher than the odds of success—challenges to the insurance subsidies have a 0-2 record in federal courts. But the pending D.C. Circuit ruling may be the one to break that streak, according to legal experts on both sides of the issue." (Sam Baker, National Journal)
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WHEATON DECISION CREATES DIVIDE AMONG JUSTICES: The order split among gender, and garnered a scathing dissent from the three female justices, who said it denies coverage to many woman, opens the door to more exemptions, and contradicts the Hobby Lobby ruling by invalidating the accommodation that the justices specifically noted was an alternative option available. (Irin Carmon, MSNBC)
- "Those who are bound by our decisions usually believe they can take us at our word. Not so today," Sotomayor wrote in the dissent. "After expressly relying on the availability of the religious-nonprofit accommodation to hold that the contraceptive coverage requirement violates [the Religious Freedom Restoration Act] as applied to closely held for-profit corporations, the Court now, as the dissent in Hobby Lobby feared it might, retreats from that position." (Jess Bravin, Wall Street Journal)
- Where was Justice Breyer in the Wheaton injunction fight? (Tom Goldstein, SCOTUSblog)
WHAT THE WHEATON DECISION DOES (AND DOESN'T) MEAN FOR COVERAGE: "While the Court did 'expressly rely' on the accommodation's existence to conclude that the mandate was not the least-restrictive alternative, this in no way precludes the Court from upholding RFRA claims against the accommodation if and when such a claim is before the Court in a future case." (Jonathan H. Adler, Washington Post)
HOBBY LOBBY FALLOUT BEGINS: Natural foods company Eden Foods won't cover contraception for employees. (Clare O'Connor, Forbes)
FOR MANY WOMEN, THE PILL IS NOT ABOUT BIRTH CONTROL: It's also treatment for major medical problems. (Lucia Graves, National Journal)
OBAMACARE HAS STILL HAD A MAJOR IMPACT ON ACCESS TO REPRODUCTIVE HEALTH SERVICES FOR WOMEN…: The Hobby Lobby ruling doesn't touch most of the health law's expansion of reproductive health coverage. (Ezra Klein, Vox)
...BUT NOT FOR MEN: The ACA does not include coverage for vasectomies. (Adrianna McIntyre, Vox)
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COLORADO SAYS CONTRACEPTION PROGRAM REDUCED TEEN BIRTH RATE: A state initiative that has provided more than 30,000 contraceptive devices at low or no cost has resulted in a 40 percent drop in the teen birth rate since 2009, according to Gov. John Hickenlooper. (Electa Draper, Denver Post)
MASSACHUSETTS PREPARES ABORTION CLINIC PROTECTIONS: Democratic Gov. Deval Patrick and Attorney General Martha Coakley announced that they are working on new public safety protections around clinics in the state following the Supreme Court's decision at the end of last month to strike down the 35-foot protest buffer zone, including new and rewritten laws to disperse crowds around clinics, and imposing criminal penalties for harassing patients. They plan to pass the laws by the close of the legislative session at the end of the month, and aides say they've received commitments from lawmakers to move quickly. (Kyle Cheney, Politico)
WISCONSIN CITY WILL STOP ENFORCING BUFFER ZONE: City Attorney Michael May said that in light of the Supreme Court ruling on Massachusetts's law, Madison will not enforce the buffer zone restrictions contained in a new ordinance passed in February, which creates a 100-foot buffer zone around any kind of health care facility. The city will continue to enforce the section of the ordinance that stops people from physically obstructing those trying to enter health facilities. (Dean Mosiman, Wisconsin State Journal)
CMS ISSUES PROPOSED REGULATIONS ON PAYMENT RATES TO DOCTORS AND HOSPITALS: Among the changes included are a reversal to an exclusion within the Sunshine Act, which would now require companies to report payments to physicians for continuing medical education. (Joe Carlson and Jaimy Lee, Modern Healthcare)
- Read the full regulations here and here.
- The 1,296 pages of regulations were, in typical fashion, released just ahead of the holiday weekend. (Philip Klein)
LONG WAITS FOR DOCTOR APPOINTMENTS HAVE BECOME THE NORM: Americans are more likely to wait longer for office appointments that are not as lucrative for doctors and hospitals. (Elisabeth Rosenthal, New York Times)
CONSOLIDATION FOR ACADEMIC MEDICAL CENTERS COULD BE COMING: The pending merger of Arizona's only academic medical center with the state's largest nonprofit hospital system could be an early sign of a looming major shake-up of U.S. academic medicine to cut costs and fund research. (Bob Herman, Modern Health Care)
CALIFORNIA MEDI-CAL BACKLOG UNDER OBAMACARE REDUCED BY ONE-THIRD: The state announced that the backlog of applications for its Medicaid program has been reduced from 900,000 to 600,000 since May. (Eryn Brown, Los Angeles Times)
FLORIDA TRIES NEW APPROACH TO MENTAL HEALTH TREATMENT UNDER MEDICAID: This month, Florida became the first state to offer a Medicaid plan designed exclusively for patients with serious mental illnesses, such as schizophrenia, bipolar disorder, or severe depression. Mental illness is twice as common among Medicaid beneficiaries as the general public, and the state hopes the new plan will improve care and lower costs. (Phil Galewitz, USA Today/Kaiser Health News)
INDIANA GOV. SUBMITS REQUEST FOR MEDICAID EXPANSION ALTERNATIVE: Republican Gov. Mike Pence proposed expanding coverage for low income residents using the state's existing Healthy Indiana plan. (Tom LoBianco, Associated Press)
BATTLE BREWING OVER PREMIUM HIKES AHEAD OF MIDTERMS: The White House is trying to anticipate and get ahead of GOP attacks over likely Obamacare premium increases announced in September. (Edward-Isaac Dovere, Politico)
NEW YORK PREMIUMS COULD INCREASE SIGNIFICANTLY: Insurers on the state exchange are asking for double-digit rate increases next year, ranging from average increases of about 15 percent to 28 percent. The average proposed rate increase for plans both in and out of the exchange is 13 percent in 2015. A decision on the rate proposals is expected in August. (Anemona Hartocollis, New York Times)
HOW BOTH SIDES ARE PLAYING THE OBAMACARE CARD IN KEY SENATE RACES: Republicans are focused on tying Democrats to Obamacare, while Democrats are focused on anything else. (Charles Babington, Associated Press)
SHOULD REPUBLICANS ONLY CAMPAIGN ON OBAMACARE?: Operatives say despite the focus on Obamacare, Republicans may need to address other issues in their campaigns as well, to win over hardened voters who already have their minds made up about the health care law. (Alex Roarty, National Journal)
PRESSURE BUILDING FOR VA DEAL: Lawmakers have only 28 workdays remaining before election day, leaving limited time to reach a compromise bill in the House and Senate to reform VA health care. (Martin Matishak, The Hill)
WHAT CONGRESS NEEDS TO DO TO PUSH VA HEALTH REFORM: Though members on a joint House and Senate conference committee agree they are committed to a bipartisan solution to VA health care delays, they made little progress before recess, as several—especially Republicans—are still hung up over cost concerns. (Stacy Kaper, National Journal)
WHY LIBERALS ARE ABANDONING THE ACA EMPLOYER MANDATE: "More and more liberal activists and policy experts who help shape Democratic thinking on health care have concluded that penalizing businesses if they don't offer health insurance is an unnecessary element of the Affordable Care Act that may do more harm than good. Among them are experts at the Urban Institute and the Commonwealth Fund and prominent academics like legal scholar Tim Jost." (Paige Winfield Cunningham and Kyle Cheney, Politico)
VACCINE COSTS ARE SKYROCKETING: Prices have gone from single to sometimes triple digits in the past two decades. (Elisabeth Rosenthal, New York Times)
Happening This Week
The House Committee on Veterans' Affairs will hold a hearing titled "VA Whistleblowers: Exposing Inadequate Service Provided to Veterans and Ensuring Appropriate Accountability" at 7:30 p.m.
The House Energy and Commerce Committee "21st Century Cures" initiative continues with a hearing on how to modernize clinical trials to more quickly find cures and treatments, at 10 a.m.
The House Committee on Veterans' Affairs hearing titled "Service should not lead to suicide: Access to VA's Mental Health Care" at 9:15 a.m.
House Committee on Oversight and Government Reform hearing on Medicare appeals reform at 2 p.m.
The House Energy and Commerce Committee will hold another "21st Century Cures" hearing, on ways to better gather and use patient perspectives in drug development and care, at 9 a.m.
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