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Waiting For Halbig - Health Care Edge: Brought to you by ACS CAN

Waiting For Halbig 

By Sophie Novack and Sam Baker

 

SUBSIDIES IN THE BALANCE: The D.C. Circuit Court of Appeals is expected to issue its decision any day now -- meaning, as early as today -- in Halbig v. Burwell, the case challenging Obamacare's insurance subsidies in federally run exchanges. The anti-subsidy argument has been around for a while, and two lower courts have ruled against it, but the case is getting more attention now because lawyers on both sides of the issue say the D.C. Circuit's ruling could break the challengers' losing streak. The case was accepted on an expedited basis, and oral arguments were held in March, which is why the legal world is expecting a ruling soon.

Top Health Care News

GLITCHES LEAVE SOME ACA ENROLLEES WAITING FOR COVERAGE: In what appears to be a small but serious fraction of cases, backlogs and technical issues have prevented consumers who enrolled in coverage and paid their premiums from actually being insured. The stalled coverage has led some people to put off treatment, or pay out of pocket. (Stephanie Armour, Wall Street Journal)

JUDGE HEARS ARGUMENTS IN SEN. RON JOHNSON'S ANTI-OBAMACARE LAWSUIT: The Wisconsin Senator says the administration overstepped its bounds in allowing lawmakers and their staff to receive subsidies through the health care law. The district judge did not offer a specific timeline for when a decision would be made. (Matt Smith, ABC2 WBAY)

 

Implementation

ILLINOIS HAS SPENT $56 MILLION FROM OBAMACARE'S PREVENTION FUND: The health law emphasizes prevention to lower health costs, so this year, the Prevention and Public Health Fund will distribute almost $1 billion to local organizations and health departments to address issues such as obesity, diabetes, smoking, early cancer detection, and more. By comparison, the Congressional Budget Office and the Joint Committee on Taxation project that the ACA's insurance provisions will cost $36 billion this year. (Karen Springen, Kaiser Health News/Chicago Tribune)

MISSOURI GOV VETOES NAVIGATOR LIMITS: The Democratic governor vetoed legislation Monday that would have limited who could work as an Obamacare Navigator in the state by requiring applicants for state licenses as enrollment aides for the federal marketplace to have criminal background checks, and would prevent those with past convictions involving fraud or dishonesty from participating. (David A. Lieb, Associated Press)

SOME BROKERS STILL WAIT TO BE PAID THROUGH D.C. EXCHANGE: Technical issues have prevented some D.C. insurance brokers who helped sign people up for plans through the District's ACA exchange from receiving their commission. (Mike DeBonis, Washington Post)

Contraception

OBAMACARE ALLIES WORRY HOBBY LOBBY IS ONLY THE BEGINNING: The Supreme Court's decision to temporarily block the contraception mandate for Wheaton College last week has supporters of the requirement nervous that when cases come before the justices in the future, they will grant exemptions beyond the scope of Hobby Lobby. Currently more than 50 lawsuits seeking further mandate exemptions are already working their way through the legal system, and some are near certain to end up in front of the Supreme Court. (Sam Baker, National Journal)

 

HARRY REID SAYS DEMS WILL 'DO SOMETHING' ON HOBBY LOBBY: The Majority Leader said on the Senate floor Monday that Democrats will take up legislation to restore contraception coverage to women whose employers object on religious grounds, following the Supreme Court ruling last week. The administration is also working on crafting a solution, though no specifics have been announced yet on either. (Seung Min Kim, Politico)

HOBBY LOBBY AND THE RUSH LIMBAUGH EFFECT: "While [Sandra Fluke] made a nuanced argument for the medical benefits of birth control, all we remember is later she got labeled a slut. Call it the Rush Limbaugh effect and chalk it up to mistakes made 2012. The trouble is, it's still happening, and the ruling in the Hobby Lobby case last week is a perfect example of how.

The Supreme Court's majority opinion, which found that closely held corporations may for religious reasons deny their employees certain forms of contraceptive coverage, made zero mentions of women who rely on the pill for medical reasons. It's not because it wasn't in any of the legal literature presented to the Court before the decision.

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"Polycystic ovarian syndrome" just doesn't have the same ring to it as "slut." (Lucia Graves, National Journal)

PLANNED PARENTHOOD SETS UP CONTRACEPTION HELPLINE: The reproductive rights group announced Monday that women can now text "birth control" to 69866 to report an employer's refusal to cover contraception, and learn about options for getting it free. (Ferdous Al-Faruque, The Hill)

Drugs

YOU CAN SOON FIND OUT WHAT DRUG COMPANIES ARE PAYING YOUR DOCTOR: An Obamacare provision intended to promote transparency will go into effect this summer, which requires drug and device companies to report payments to doctors and teaching hospitals of more than $100 over the year. The Centers for Medicare and Medicaid Services will then post the information in a public database, accessible to patients. (Jason Millman, Washington Post)

NEW YORK LEGALIZES MEDICAL MARIJUANA: Gov. Andrew Cuomo signed the bill Monday, making New York the 23rd state to legalize marijuana for seriously ill or injured patients. (John Campbell, USA Today)

WASHINGTON BEGINS RECREATIONAL MARIJUANA SALES: The first legal marijuana retail stores are set to open in the state today. (Evan Bush, Seattle Times)

Medicare

MEDICARE UNVEILS CHANGES TO ACOS: CMS has proposed increasing the number of quality measures used in the Medicare Shared Savings Program for ACOs from 33 to 37, according to the proposed 2015 Medicare physician fee schedule released last week. (Daily Briefing, Advisory Board Company)

CMS PROPOSES QUALITY INITIATIVES: The agency intends to expand public reporting through the Physician Compare website and mandate that more practices share data on patient-experience, according to the 2015 physician fee schedule. (Sabriya Rice, Modern Health Care)

NEWT GINGRICH WAS RIGHT: Gingrich's 1995 prediction that if beneficiaries could chose between Medicare and private insurance, Medicare is "going to wither on the vine because we think people are voluntarily going to leave it — voluntarily," is largely being proven correct with a surge in enrollment in Medicare Advantage plans. (Austin Frakt, New York Times)

Happening Today

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.

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Health Care Edge is one of my top resources."

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