Morning Briefing
Summaries of health policy coverage from major news organizations
Viewpoints: A Legal 'Win' For House Republicans; Dispute 'Has No Business' In Court
When the House of Representatives filed a lawsuit last year contesting President Obama鈥檚 implementation of ObamaCare, critics variously labeled it as 鈥渞idiculous,鈥 鈥渇rivolous鈥 and certain to be dismissed. Federal District Judge Rosemary Collyer apparently doesn鈥檛 agree. On Wednesday she ruled against the Obama administration, concluding that the House has standing to assert an injury to its institutional power, and that its lawsuit doesn鈥檛 involve鈥攁s the administration had asserted鈥攁 鈥減olitical question鈥 incapable of judicial resolution. (David B. Rivkin Jr. and Elizabeth Price Foley, 9/10)
In truth, this lawsuit seems to be an effort to get around a legislative defeat 鈥 basically a typical, garden-variety political dispute 鈥 that has no business being in the court system. If the Republicans want to end all cost-sharing subsidies, they could make that explicit by rewriting the health reform law. ... It would be a travesty if this lawsuit ends up creating the same havoc as other baseless challenges to the Affordable Care Act, which took up enormous resources and time, only to be struck down by the Supreme Court. (9/11)
Another far-fetched lawsuit against the Affordable Care Act won a victory in the lower courts on Wednesday. And while few members of the legal establishment have taken this lawsuit seriously, few members of the legal establishment took the last one seriously. That case, King v. Burwell, made it all the way to the Supreme Court before failing. So what happens if this latest legal assault does that -- and more? What if it actually prevails? At the moment, it's really hard to tell. (Jonathan Cohn, 9/10)
The Affordable Care Act has helped slow the overall growth of healthcare costs in the U.S., but for many Americans, health insurance premiums have continued to rise at an alarming rate. To lower their rates, consumers may have to switch insurers, which may also mean switching doctors. That's not an easy decision, but two bills are pending in the Legislature to make the process less fraught for Californians. (9/10)
How much should you know before your baby is entered into a medical study? That complicated and heartbreaking question has been at the center of a controversy about a clinical trial that tested the effects of different oxygen levels on premature infants with extremely low birth weights. A federal judge in Alabama rejected last month the legal claims of parents whose children suffered adverse effects after participating. The court's decision was correct -- but not because the consent form given to parents was adequate for them to understand the risks, which as an ethical matter it probably wasn't. The judge was right because subtle and complicated problems of medical ethics have no place in a court of law. (Noah Feldman, 9/10)
Should 30 percent of Medicare beneficiaries shoulder a 52 percent premium hike next year while the other 70 percent pay no more at all? Advocates for seniors do not think so, and they are making a push to convince Congress to stop it from happening. The Medicare population vulnerable to shouldering the larger premium includes some federal and state government employees, people who sign up for Medicare for the first time next year, low-income seniors whose premiums are paid by state Medicaid plans and high-income seniors who already pay premium surcharges. (Mark Miller, 9/10)
This summer marks the 50th anniversary of a monumental change for our country: President Lyndon Baines Johnson signing into law the bill that created Medicare and Medicaid. While there has been much publicity over the past several months about this milestone for Medicare and its positive impact on the health of the elderly, it鈥檚 disappointing that there has been less attention paid to Medicaid, which has been providing access to health care for the poor and chronically ill for the same 50 years. (Liz Williams, 9/10)
Two things are notable about our current Medicare system. First, while Medicare has undergone a number of changes and expansions of the program since 1966, one thing that has not changed in 50 years are the paper cards that beneficiaries use to access services. Those cards are outdated and unsafe, exposing seniors to potential identity theft, because a beneficiary鈥檚 identification number is his or her Social Security number鈥攁nd it鈥檚 printed right on the front of the card. Second, the Medicare program currently reimburses providers using a 鈥榩ay-and-chase鈥 model. That means the government pays out claims first and asks questions later, after the money has already been spent. However, not only does Medicare have no way of approving transactions before paying providers, the program also lacks the ability to electronically confirm when a patient actually received care. (Kelli Emerick, 9/10)
The FDA is considering proposals to regulate e-cigarettes that would discourage their use. The Los Angeles City Council has banned them in public places, and the California Legislature may vote on an anti-"vaping" law this week. Blanket laws discouraging the use of e-cigarettes are the wrong policy move. E-cigarettes have already shown themselves to be an appealing alternative to many smokers who are trying to quit. Because almost 500,000 Americans die annually from tobacco-related diseases, a lot is at stake. (Stephen D. Sugarman, 9/10)
The highly skewed distribution of health spending is a phenomenon well known to health economists. About 5% of the population accounts for half of spending and the most costly 1% accounts for one-fifth of it. Less widely known is the extent to which high spending persists over time, despite the important health policy and financing consequences that follow from it. For many of those costly patients, their health coverage may provide inadequate protection against the burden of persistent and substantial medical expenses. (Austin Frakt, 9/10)
Roughly two-thirds of nursing home patients are on Medicaid, the federal-state partnership for the medically indigent. Medicaid rates, which are set entirely by states and then matched by the federal government, have historically fallen far below care costs. ... Not only has the federal government refused to require states to adequately meet Medicaid costs, it recently pushed, successfully, in the U.S. Supreme Court to make it impossible for providers to challenge the adequacy of Medicaid payments. Because government鈥檚 expectations drive care costs, this ruling frees government to pile on new expectations without paying for them. (Brendan Williams, 9/10)