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Morning Briefing

Summaries of health policy coverage from major news organizations

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Wednesday, Mar 4 2015

麻豆女优 Health News Original Stories 3

  • No Medicaid Expansion? No Problem For Many Safety-Net Hospital Profits
  • FAQ: What Are The Penalties For Not Getting Insurance?
  • Texas GOP Leaders Say They Won't Expand Medicaid

Note To Readers

Health Law 6

  • For Obamacare, Today Is A Big Day In Court
  • Looking Forward: Health Law Supporters See Dire Consequences If They Lose King V. Burwell
  • Poll: Majority Wants Congress To Step In If High Court Nullifies Health Law Subsidies
  • High Court Face-Off: Today's Arguments A Rematch For Attorneys Arguing The Case
  • Chief Justice Returns To Hot Seat In The Latest Health Law Challenge
  • Utah's GOP-Controlled House To Hear Medicaid Expansion Plan After All

Coverage And Access 1

  • Report: More Doctors Needed To Treat Aging Baby Boomers

Public Health 2

  • Study: Unplanned Pregnancies Cost Taxpayers $21 Billion Per Year
  • FDA Orders Drug Makers To Add Heart, Stroke Warnings To Testosterone Drugs

State Watch 1

  • State Highlights: Wyo. House Cuts Funding To Help Hospitals With Uninsured; Walker To Sign 20-Week Abortion Ban

Editorials And Opinions 1

  • Viewpoints: High Stakes At The High Court; Gov. Scott Insists Obama Needs Plan For States

From 麻豆女优 Health News - Latest Stories:

麻豆女优 Health News Original Stories

No Medicaid Expansion? No Problem For Many Safety-Net Hospital Profits

In some of the largest states that did not expand Medicaid, many safety-net hospitals turned in strong performances in 2014, according to financial documents. ( Phil Galewitz , 3/4 )

FAQ: What Are The Penalties For Not Getting Insurance?

A consumer鈥檚 guide to the tax penalties for not having insurance. ( Michelle Andrews , 3/9 )

Texas GOP Leaders Say They Won't Expand Medicaid

Republican lawmakers asked the Obama administration for greater flexibility to administer the state-federal insurance program and reiterated their lack of interest in expanding eligibility under the federal health law. ( Edgar Walters, Texas Tribune , 3/3 )

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Note To Readers

Help inform Kaiser Health News鈥 reporting: Do members of Medicaid managed care plans have adequate access to doctors and hospitals? Click one of these links to fill out a very brief form: if you are a doctor or other caregiver; if you are a patient or know a patient.

Summaries Of The News:

Health Law

For Obamacare, Today Is A Big Day In Court

The Supreme Court will hear oral arguments in a case -- King v. Burwell -- that challenges the overhaul's health insurance subsidies, one of the fundamental components of the law. If the justices rule that these subsidies are not legal, the law's future could be in jeopardy.

The Supreme Court on Wednesday will hear oral arguments in King v. Burwell, the most serious challenge to the Affordable Care Act (a.k.a. Obamacare) since the justices upheld it as constitutional almost three years ago. Here鈥檚 how this works. (Barnes, 3/4)

At issue is whether millions of Americans who receive tax subsidies to buy health insurance are doing so illegally. If the justices rule that the payments are not allowed, the entire health-care law could be in jeopardy. The latest showdown between the Obama administration and the conservative legal strategists who have targeted the law since its passage in 2010 focuses on a once obscure phrase in the legislation: 鈥渆stablished by the State.鈥 (Barnes, 3/4)

Round 2 in the legal battle over Obamacare hits the Supreme Court's intellectual boxing ring Wednesday. In one corner is the Obama administration, backed by the nation's hospitals, insurance companies, physician associations and other groups like Catholic Charities and the American Cancer Society. In the other corner are conservative groups, backed by politicians who fought in Congress to prevent the bill from being adopted. (Totenberg, 3/3)

The U.S. Supreme Court will weigh a second major case targeting President Barack Obama's healthcare law on Wednesday when it considers a conservative challenge to tax subsidies critical to the measure's implementation. The case is set for a one-hour oral argument starting just after 10 a.m. ... with a ruling due by the end of June. (Hurley, 3/3)

President Obama's health care law squeaked through the Senate in 2009, the House in 2010 and the Supreme Court in 2012. Wednesday, the high court will consider whether it can survive its infancy. The case is far narrower than the one brought 鈥 and nearly won 鈥 by opponents three years ago. Opponents of the law claim it allows health insurance premiums to be subsidized only in states that set up exchanges, or online marketplaces. If the court agrees, those subsidies can't continue to flow to residents in at least 34 states that use a federally operated exchange. (Wolf, 3/3)

The case, by the numbers: 4: Words in the law that are in dispute ("established by the state"); 34: States using the federal health insurance exchange, where tax credits could be eliminated; 9.3 million: People who would lose tax credits if the court sides with the law's opponents; 8.2 million: People at risk of becoming uninsured. (Wolf, 3/3)

The fundamental question facing the justices in the latest challenge to the 2010 Affordable Care Act has nothing to do with health care: how to interpret a tiny snippet 鈥 specifically, four words 鈥 embedded in the voluminous law. First, some background: Congress in the law authorized the government to provide tax credits for insurance purchases by middle- and low-income people. The credits are vital to the program. (Jones, 3/3)

The arguments could provide hints about whether the justices believe the law does not authorize the government to provide federal subsidies for Obamacare beneficiaries in the 34 states that didn't establish their own exchange. If the Court ultimately rules against the Obama administration, more than 5 million individuals will no longer be eligible for the subsidies, shaking up the insurance market and potentially dealing the law a fatal blow. (de Vogue, 3/4)

The Affordable Care Act, a.k.a. Obamacare, dodged a bullet in 2012 when the Supreme Court upheld the individual mandate. Wednesday, it faces a second major legal challenge; this one to the taxpayer-funded premium subsidies that underpin the entire law. (Dwyer, 3/4)

People sometimes wonder why David M. King would fight health insurance subsidies all the way to the Supreme Court, which is scheduled to hear his case on Wednesday. Even his sister is puzzled. Asked what motivated her brother, who is the lead plaintiff in the latest challenge to the Affordable Care Act, Deborah K. Siebols said: 鈥淚 don鈥檛 have any idea. I am clueless. He鈥檚 my brother, but we are so opposite in our beliefs 鈥 have been all our lives. We don鈥檛 discuss politics.鈥 (Pear, 3/3)

Looking Forward: Health Law Supporters See Dire Consequences If They Lose King V. Burwell

News outlets detail how the Supreme Court's ruling could impact the insurance marketplace, the health care delivery system and million's of Americans who gained health coverage as a result of the health law.

Obamacare supporters have not hesitated to predict the drastic consequences that could come from King v. Burwell, the case the Supreme Court considers Wednesday. The plaintiffs in the case argue that the Affordable Care Act only allows the federal government to provide subsidies in states that run their own health care marketplaces. If the Supreme Court agrees, it would cut off subsidies in the 34 states that rely on the federal government to run their Obamacare marketplaces, or "exchanges." That would leave millions of Americans, concentrated largely in GOP-led states like Texas and Florida, without the financial support that puts the "affordable" in the Affordable Care Act. (Condon, 3/4)

The Supreme Court will hear arguments on Wednesday in another case that threatens the survival of Obamacare. This one doesn't challenge the constitutionality of the law itself, it merely challenges the legality of one of the most important parts of the system 鈥 subsidies so that everyone can afford health care. If the court strikes down the subsidies for people who live in states that chose not to set up their own exchanges, and who get their health coverage from the federal marketplace 鈥 healthcare.gov 鈥 it would begin to unravel the entire Obamacare project. (Liasson, 4/3)

A decision halting the credits might unravel the Affordable Care Act, making other core provisions ineffective and potentially causing the market for individual insurance policies to collapse in much of the country. Hospitals would potentially be left with billions of dollars in unpaid bills. 鈥淭his would be the greatest instance of judicial overreach in the modern history of the court,鈥 Senator Chris Murphy, a Democrat from Connecticut, told reporters on Tuesday. The court will rule by the end of June. (Stohr, 3/4)

Billions of dollars in Obamacare tax subsidies could come to an abrupt end this summer if the Supreme Court rules against the White House in the latest challenge to the president鈥檚 health care law. (Haberkorn, 3/4)

As the Supreme Court hears arguments on Wednesday in the latest challenge to the Affordable Care Act, health insurers are struggling to prepare for a decision that could unravel the marketplaces created by the law. The ruling could come in June鈥攂ut insurers must make regulatory filings before then about their 2016 plans. Utah鈥檚 Arches Health Plan, for one, says it may propose an array of insurance product designs this spring. Then, depending on what the court decides, the insurer would be poised to drop some of them before they鈥檙e finalized with regulators and offered to consumers. The insurer may also come up with two different sets of rates for next year, one for each potential court outcome. (Wilde Mathews, 3/3)

King v. Burwell, a lawsuit that originated in conservative and libertarian think tanks, alleges that a stray phrase in the Affordable Care Act -- 鈥渁n exchange established by the state鈥 -- means the federal government isn鈥檛 allowed to provide subsidies to the residents of states that refused to establish health insurance exchanges under the law. Only 13 states and the District of Columbia have their own exchanges. If this bid to derail the Affordable Care Act succeeds, the subsidies would disappear -- maybe immediately, maybe a little later -- for Obamacare enrollees everywhere else. Behind the numbers, however, is a very human story. Without the subsidies, health insurance costs would spike beyond the means of low- and moderate-income recipients. As a result, close to 10 million people would lose their health coverage. Many others would face major increases in the premiums they pay for insurance. The Huffington Post interviewed six Americans at risk of the worst effects of a high court ruling against Obamacare. (Young and Stein, 3/3)

A closely watched case headed to the U.S. Supreme Court Wednesday, King v. Burwell, could have major national impacts on health insurance markets and the millions who benefited from the federal reform law that kicked in last year. But it may not have much of an impact on Oregonians who benefited from the law -- in the short term, at least. (Budnick, 3/3)

Poll: Majority Wants Congress To Step In If High Court Nullifies Health Law Subsidies

According to a Wall Street Journal/NBC News poll, a majority of voters believe that a law should be passed on Capitol Hill to help low-income Americans who could lose their health coverage without this assistance. Meanwhile, Republican lawmakers seem to agree that some action will be necessary -- but there's little consensus beyond this point.

A majority of voters wants Congress to take action if the Supreme Court voids the health law鈥檚 tax credits in much of the country, a new Wall Street Journal/NBC News survey finds. The court is set to hear arguments Wednesday over whether the Obama administration can issue federal tax credits to offset the cost of health premiums to millions of Americans who live in states that haven't set up their own insurance exchanges. The tax credits are closely tied to other provisions in the law, including requirements that most Americans buy coverage or pay a penalty, and insurers can鈥檛 reject people based on their medical history. (Radnofsky, 3/3)

A majority of voters believe that Congress should pass a law to aid millions of lower-income Americans who could lose their health care coverage if the Supreme Court invalidates the subsidies they receive for living in states that didn't establish their own insurance marketplaces. (Dann, 3/3)

Several key conservative lawmakers aren't ruling out support for proposals to temporarily extend people鈥檚 ObamaCare plans if the Supreme Court strikes down subsidies under the law. (Sullivan, 3/3)

Top Republicans in the House and Senate agree that a Supreme Court ruling against the White House on Obamacare tax subsidies would leave millions of Americans with health insurance bills that they can鈥檛 afford 鈥 and they all want to do something about it. That鈥檚 where most of the consensus ends. (Haberkorn, 3/3)

Congressional Republicans are proposing long and short-term alternatives to ObamaCare as the Supreme Court begins hearing oral arguments Wednesday in a case that has the potential to unravel the health care law. (3/4)

And, in the background, health law backers and opponents alike have been working behind the scenes to shape the justices' opinions and to brace for the decision's impact -

War rooms of lawmakers and their aides in the U.S. Congress are working furiously to try to influence the Supreme Court's nine justices who will hear arguments on Wednesday on the future of President Barack Obama's landmark healthcare law. These informal working groups, staffed by Republican and Democratic members of Congress, have gone into high gear in recent days. (Cowan, 3/4)

For more than 30 years, the Federalist Society has worked behind the scenes to shape Supreme Court outcomes to a conservative agenda. In King v. Burwell, its influence could eliminate health insurance subsidies for millions of people. (Martin, 3/3)

But even physicians who think the court will uphold the subsidies are gearing up for the worst. Worried about newly-insured patients such as those who have just begun treatment for cancer or other serious illnesses, they are dusting off playbooks they retired when Obamacare slashed the number of uninsured people. Interviews with doctors reached through professional groups show that they are lining up free clinics to care for patients with chronic illnesses, asking pharmaceutical companies to provide discounted drugs, and moving up preventive-care appointments and complicated procedures. (Begley, 3/4)

High Court Face-Off: Today's Arguments A Rematch For Attorneys Arguing The Case

Michael Carvin will argue for plaintiffs seeking to undo a key aspect of the health law, and Solicitor General Donald Verrilli Jr. will again defend the federal government.

One attorney is known for his measured, authoritative approach, the other for a brash, confrontational style. And when the Affordable Care Act brings both of them back before the Supreme Court on Wednesday, these differences may be on display as much as their legal points. In what鈥檚 arguably the most important case of the court鈥檚 term, Michael Carvin will argue for plaintiffs seeking to upend a fundamental aspect of Obamacare, and Solicitor General Donald Verrilli Jr. will again defend the government. Both are hailed as brilliant litigators steeped in case law, and their first round in 2012 concluded with each man able to claim a victory of sorts. (Wheaton, 3/3)

Washington lawyer Michael A. Carvin will be back at the Supreme Court on Wednesday for the second great battle over the Affordable Care Act, once again facing off against a familiar adversary in Solicitor General Donald B. Verrilli Jr. With hardly a trace of deadpan, Carvin said it would be wrong to characterize the case as a rare second chance to bring down President Obama鈥檚 health-care law. 鈥淢e, personally?鈥 he said. 鈥淚鈥檓 a libertarian. I鈥檇 get rid of three-quarters of the U.S. Code if I could.鈥 But he added, 鈥淭he ACA is the law of the land. We want it to be implemented the way Congress intended for it to be.鈥 (Barnes, 3/3)

Three years ago this month, Solicitor General Donald B. Verrilli Jr. stood before the Supreme Court to defend President Obama鈥檚 health care law against a constitutional challenge that threatened to destroy its central provision. His oral argument drew harsh reviews, but in the end he managed to persuade five justices to accept his backup argument, saving the law. Mr. Verrilli will return to the lectern on Wednesday morning to defend the law once again, and he has reason to be nervous. (Liptak, 3/4)

Attorney Michael Carvin on Wednesday will for the second time argue against the health-care law at the Supreme Court, hoping to do what opponents couldn鈥檛 do in 2012: cripple President Barack Obama 鈥檚 signature domestic achievement. Challengers to the law fell one vote short three years ago when Chief Justice John Roberts stunned fellow conservatives with a vote to uphold most of the Affordable Care Act. This time, Mr. Carvin says things should go more smoothly. (Bravin, 4/3)

In March 2012, a blunt-talking and rumpled lawyer named Michael A. Carvin told Supreme Court justices that President Obama鈥檚 health care law was an unconstitutional attempt to 鈥渞egulate every activity from cradle to grave.鈥 He lost that case 鈥 and has never quite gotten over it. (Stolberg, 3/4)

The case that comes before the Supreme Court on Wednesday with the potential to unravel President Obama's landmark healthcare law began in a conference room at the American Enterprise Institute, a few blocks from the White House and the K Street corridor. It was December 2010, and voters had recently elected a new crop of Republicans, many of whom had ridden to victory on their objections to Obamacare. GOP attorneys general in several states, along with a major business group, had headed to court in Florida, arguing the entire law was unconstitutional. (Savage, 3/3)

Chief Justice Returns To Hot Seat In The Latest Health Law Challenge

Chief Justice John Roberts was pivotal in the Supreme Court's 2012 decision and observers will again be watching him for clues on the outcome of King v. Burwell.

The most uncomfortable seat at Wednesday鈥檚 Supreme Court argument on health-law insurance subsidies might be the one held by Chief Justice John Roberts. Both sides will be trying to sway his vote on the assumption the court is otherwise split 4-4 along ideological lines, as it was three years ago when it heard an earlier challenge to the law. (Bravin, 3/3)

Opponents of the Affordable Care Act failed to kill the law in an epic, election-year Supreme Court case in 2012. Chief Justice John Roberts joined with the court鈥檚 liberal justices and provided the crucial vote to uphold the law in the midst of Obama鈥檚 re-election campaign.Partisan and ideological divisions remain stark for a law that passed Congress in 2010 with no Republican votes. ... Of the judges who have ruled on lawsuits over the subsidies, Democratic appointees have sided with the administration and Republican appointees have been with the challengers. Roberts was the only justice to essentially cross party lines with his vote in 2012. His fellow conservatives on the court voted to strike down Obamacare in its entirety. (3/4)

Utah's GOP-Controlled House To Hear Medicaid Expansion Plan After All

Lawmakers reversed course to consider Gov. Gary Herbert's plan. Meanwhile, Texas state lawmakers reiterate that they will not expand the program and New Hampshire hospitals report fewer uninsured patients in their emergency rooms since that state expanded the insurance program for the poor.

Utah's Republican controlled-House of Representatives has reversed course and decided to consider Gov. Gary Herbert's Medicaid plan, despite comments from the Republican House speaker that the measure had no support and would not be heard. A panel that assigns bills to House committees sent Herbert's Medicaid proposal and a House alternative forward on Tuesday, setting up both proposals for a hearing this week. (Price, 3/3)

Leaders of the Texas Senate have sent a letter to President Barack Obama about Medicaid. It says that if Texas can鈥檛 make changes to how it runs Medicaid now, there鈥檒l be no Medicaid expansion for Texas in the future. The Affordable Care Act gives states the option to expand Medicaid to cover more people, or in the case of Texas and some other states, not expand it. (Zaragovia, 3/3)

Emergency rooms are seeing fewer uninsured patients since the state expanded its Medicaid program to cover more poor adults, according to the New Hampshire Hospital Association. The plan passed by the Legislature last year made adults making less than 138 percent of the federal poverty limit 鈥 about $15,856 a year 鈥 eligible for Medicaid, and more than 35,000 have signed up since enrollment began July 1. (3/4)

Hospitals that treat many poor and uninsured patients were expected to face tough financial times in states that did not expand Medicaid under the federal law known as Obamacare. That鈥檚 because they would get less Medicare and Medicaid funding under the Affordable Care Act, while still having to provide high levels of charity care. (Galewitz, 3/4)

Other media look at a special聽enrollment period in Connecticut and GOP support of the law's聽employer wellness incentives -

Access Health CT, the state's insurance exchange, said Tuesday it will hold a special enrollment period for those who did not have health insurance in 2014 and, as a result, paid a penalty on their federal income taxes. The special enrollment, which will run from April 1 through midnight April 30, will allow the uninsured who sign up to limit penalties on their 2015 taxes. (3/3)

Republicans are trying to fend off a legal attack against one of the few pieces of ObamaCare that has achieved bipartisan support in Congress. A half-dozen Republicans in the House and Senate introduced legislation Tuesday to protect an employee wellness program that discounts healthcare costs for workers who demonstrate healthy lifestyles. (Ferris, 3/3)

Coverage And Access

Report: More Doctors Needed To Treat Aging Baby Boomers

A report by the Association of American Medical Colleges says the United States faces a shortage of 90,000 doctors by 2025, lower than their previous estimate, to treat a sicker, older population. Elsewhere, a program to provide primary care for underserved areas is in danger of shutting down.

The United States faces a shortage of as many as 90,000 physicians by 2025, including a critical need for specialists to treat an aging population that will increasingly live with chronic disease, the association that represents medical schools and teaching hospitals reported Tuesday. (Bernstein, 3/3)

The demand for doctors in 2025 will exceed the number of practicing physicians by 46,100 to 90,400, the trade association for medical colleges predicted Tuesday, downgrading its earlier estimates of a medical labor squeeze. In 2010, the Association of American Medical Colleges projected a shortfall of 130,600 physicians. The estimates are often used by lobbyists and lawmakers to justify increased federal spending for the training of physicians through Medicare and Medicaid. (Adams, 3/3)

Like many states, Missouri is facing a doctor shortage. The supply of doctors isn't keeping up, even as the population ages and more people have health insurance to pay for medical care. The American Association of Medical Colleges estimates that the country will have a void of about 90,000 physicians by 2020鈥攈alf of them in primary care. (Bouscaren, 3/4)

A government program that is providing care for some 500,000 patients and has successfully increased the number of primary-care physicians in underserved areas is in danger of folding. The federal Teaching Health Center program was created with a $230 million appropriation in Section 5508 of the Affordable Care Act and, as of 2014, it was helping to train 550 residents at 60 centers in 27 states and the District of Columbia in underserved rural areas and urban neighborhoods. (Robeznieks, 3/3)

Public Health

Study: Unplanned Pregnancies Cost Taxpayers $21 Billion Per Year

That's $366 for every woman of childbearing age in the U.S., a new Guttmacher Institute analysis contends. Also, teen pregnancy rates for Latina and black girls have dropped, but they are still higher than for whites.

Unintended pregnancies cost American taxpayers $21 billion each year, according to a new analysis released by the Guttmacher Institute. That averages out to a cost of about $366 per every woman of childbearing age in the U.S. Overall, more than half of U.S. pregnancies are unintended, and roughly 1-in-20 American women of reproductive age have an unplanned pregnancy each year. (Ingraham, 3/3)

It鈥檚 a problem once thought to be intractable, and yet pregnancy and birth rates for black and Latina teens have dropped precipitously in the past two decades鈥攁t a much faster clip than that of white teens. Despite this, black and Latina girls are more than twice as likely as white girls to become pregnant before they leave adolescence. (Wlitz, 3/3)

In other news related to women's health -

UnitedHealth, the country鈥檚 largest insurer, will soon require doctors to get permission before performing most types of inpatient hysterectomies, a procedure in which the uterus is removed, often to prevent or treat cancer. The move follows lengthy debate over a surgical device believed by many medical researchers to spread cancer in patients -- and highlights how insurers can also play watchdog. (Panquette, 3/3)

FDA Orders Drug Makers To Add Heart, Stroke Warnings To Testosterone Drugs

The move is in response to controversial marketing of the drugs in recent years to help fight the effects of aging in men.

Following months of deliberation, the FDA is now requiring drug makers to add information on product labeling about the possible increased risk of heart attacks and strokes associated with low testosterone treatments. And the agency is also cautioning these medications have not been shown to help men with low testosterone levels reverse the aging process. The move comes after sustained controversy over the cardiovascular safety and allegations of inappropriate marketing of these widely prescribed drugs, which have attracted sustained regulatory scrutiny as a result. Testosterone treatments have, at times, been widely promoted to help reverse aging, but safety concerns prompted heated debate amid dueling medical studies. (Silverman, 3/3)

The Food and Drug Administration said Tuesday that it is requiring drugmakers to warn patients that testosterone products may increase the risk for heart attacks and strokes. Testosterone replacements are approved to treat men with low testosterone related to medical problems, such as genetic deficiencies, chemotherapy or damaged testicles. But the level of the hormone can fall as men grow older. And testosterone is increasingly being prescribed to men to stave off aging, something the agency never approved. Doctors and specialized clinics have jumped on the bandwagon, offering testosterone replacements to treat what some refer to as "Low T." (Stein, 3/3)

Earlier KHN coverage:聽 (Varney, 4/28/14)

State Watch

State Highlights: Wyo. House Cuts Funding To Help Hospitals With Uninsured; Walker To Sign 20-Week Abortion Ban

A selection of health policy stories from Wyoming, Wisconsin, Virginia, Pennsylvania, New York, Missouri and Iowa.

The Wyoming House voted Tuesday to cut most of the funding from a bill that Senate lawmakers had passed to help hospitals in the state cover the cost of treating uninsured patients. The House on Tuesday voted to cut the funding in the bill from $5 million to $1 million. (Neary, 3/3)

Shifting his tone to reassure social conservatives, Wisconsin Gov. Scott Walker declared Tuesday that he intends to sign a state law in the coming months that bans abortion after 20 weeks. (Hohmann, 3/3)

Wisconsin Department of Health Services Secretary Kitty Rhoades says no one will get kicked off the state鈥檚 popular prescription drug program SeniorCare under Gov. Scott Walker鈥檚 budget. Walker鈥檚 proposal requires that SeniorCare enrollees first sign up for the Medicare Part D prescription drug program and use state benefits under SeniorCare as a supplement. (3/3)

But the session was a mixed bag for McAuliffe, who saw many of the liberal causes he championed, as well as his renewed push for expansion of Medicaid under the federal Affordable Care Act, go nowhere in the Republican-controlled legislature. ... But this year, social issue bills, including those that would have prohibited abortion after 20 weeks or expanded gay rights, died quietly. Two antiabortion measures made it to a vote of the full House, but only because they were attached to the budget. They later died in behind-closed-doors budget negotiations. ... But the budget plan does provide the millions the governor had sought to expand mental-health services and school breakfast programs. (Portnoy and Vozzella, 3/3)

This year marks a half-century since Congress created the Older Americans Act, the major vehicle for delivering social and nutrition services to people over 60. But there鈥檚 little to celebrate on the golden anniversary of the law that helps people age at home. Federal funding hasn鈥檛 kept up with the skyrocketing number of America鈥檚 seniors, now the largest elderly population in history. That鈥檚 left states and communities struggling to provide the in-home support, meals, case management and other nonmedical services that help seniors avoid more costly nursing home care and enrolling in taxpayer-funded Medicaid. (Beamish, 3/4)

The Wolf administration is restoring more than two dozen public health nursing positions eliminated under the Corbett administration. The move comes almost four months after the Pennsylvania Supreme Court ordered the Corbett administration to reverse course on its plan to eliminate 26 nurse consultant positions - half of the statewide total - and close 26 state health centers, mostly in rural parts of the state. (3/3)

New York state is seeking to extend a contract with Computer Sciences Corp. to run its Medicaid computer system because a deal for Xerox Corp. to take over the program is stalled. The length of the extension is still being negotiated, though it will reflect the time needed for Xerox鈥檚 five-year, $500 million contract to be finished, Jeffrey Hammond, a state Health Department spokesman, said by e-mail. More than nine months after it was awarded, the Xerox accord is awaiting approval from Comptroller Thomas DiNapoli. (Kopott, 3/3)

Newly proposed legislation would make it a felony in New York to film patients receiving medical treatment without prior consent. State Assemblyman Ed Braunstein, a Queens Democrat, filed the bill last month in response to a ProPublica article, published in January with the New York Times. The story detailed how the TV show 鈥淣Y Med鈥 aired the final moments of Mark Chanko鈥檚 life while he was being treated at NewYork-Presybterian Hospital/Weill Cornell Medical Center. Neither Chanko nor his family had given the show permission to film him. Although Chanko鈥檚 face was blurred on the broadcast and his voice altered, his widow immediately recognized him when the episode aired in August 2012. (Ornstein, 3/3)

When Missouri regulators approved his proposal Monday, St. Louis developer Paul McKee got one step closer to realizing his $6.8-million dollar project to build an urgent care center in north St. Louis. It's a start but won't fully address the area's needs, health experts say. The three-bed clinic is to be built at the former Pruitt-Igoe site at 1120 North Jefferson Ave., covering 12 percent of the 33-acre site. A spokesman for McKee told St. Louis Public radio that the developer intends to purchase the $1 million tract of land from the city鈥檚 land bank within the next year. (Bouscaren, 3/3)

After weeks of talking about it, Democratic lawmakers have formally started the debate over whether Iowa should expand its limited medical marijuana law. Sen. Joe Bolkcom, D-Iowa City, introduced a bill Monday that would let patients use the drug for a range of chronic health conditions besides epilepsy, which is the only disease for which marijuana possession is legal under the state's current law. The bill also would allow tightly-regulated production and distribution of marijuana products for medical purposes. (Leys, 3/3)

Editorials And Opinions

Viewpoints: High Stakes At The High Court; Gov. Scott Insists Obama Needs Plan For States

A selection of opinions on health care from around the country.

On Wednesday, the Affordable Care Act faces its next test in front of the Supreme Court. This time, the justices will consider who is eligible to receive subsidies to help cover the cost of health insurance. That may sound technical, maybe even minor, but it鈥檚 high stakes 鈥 because the subsidies are at the heart of the law. (Dan Gorenstein, 3/3)

Unsurprisingly, liberals are also mounting an all-out push to convince the Supreme Court that the very legitimacy of the institution is at stake. This is first-class flummery: What they really mean is that they will be very angry at the Supreme Court if the case goes against them. This is completely true. It is not completely true that the Supreme Court will somehow destroy itself, or its place in American society, if it offers a ruling that American liberals don't like. I realize that it may feel this way if you are an American liberal. But if the institution survived Roe v. Wade's "emanations and penumbras," and the sudden discovery after a couple of centuries that capital punishment violated the Constitution, it can certainly survive a narrow statutory case that overturns a still-unpopular program. (Megan McArdle, 3/4)

Prresident Obama came to Florida last week to give a big speech, but he didn鈥檛 say a word about how 1.6 million Floridians on the federal exchange under Obamacare would continue to access healthcare if the White House loses their argument in the King v. Burwell Supreme Court case over healthcare exchanges this month. Florida is one of 34 states without a state exchange. That means that 14 insurance companies in Florida receive about $5 billion annually from the federal government to offer Obamacare-compliant policies to about 90 percent of our 1.6 million Floridians on the federal exchange. We could assume from their silence that the White House wants 34 states to set up state exchanges if they lose at the Supreme Court; but state exchanges are collapsing under their own weight throughout the country. (Gov. Rick Scott, 3/4)

Just how stupid does Paul Ryan think we are? The Wisconsin Republican and two other House committee chairmen claim in an op-ed today that they are just about ready to propose an Obamacare 鈥渙ff-ramp" if the Supreme Court decides in King v. Burwell to destroy the federal health-insurance markets in more than half the states. No fooling around. 鈥淗ouse Republicans have formed a working group to propose a way out for the affected states if the court rules against the administration.鈥 A working group! No, I鈥檓 not impressed. (Jonathan Bernstein, 3/3)

When the Supreme Court examines the Affordable Care Act again Wednesday, it will have several logical, principled paths to avoid tearing apart a law that has slowly but surely found its footing. It should take at least one of them. (3/3)

As if Obamacare weren't problematic enough, two federal courts have found that the IRS unlawfully expanded the health care law's individual and employer mandates, by imposing them on tens of millions of Americans whom Congress exempted. On Wednesday, the Supreme Court will hear King v. Burwell, a case challenging that illegal and ongoing attempt to expand Obamacare outside the legislative process. (Michael F. Cannon, 3/3)

The arguments upon which the plaintiffs鈥 case are based were first aired on the VC in this post from September 2011. Additional posts followed. It doesn鈥檛 make sense to link to them all, but here are some of the highlights from VC blogging on this case over the past few years. (Jonathan H. Adler, 3/3)

Before a House rules change in January, CBO generally had not applied 鈥渄ynamic scoring鈥 to major legislation, or considered likely macro-economic effects when analyzing a bill鈥檚 potential impact on the deficit. On Friday, in response to follow-up questions from a January congressional hearing, CBO said that had it conducted such an analysis of Obamacare, it would have found that the bill reduced the federal deficit by less than its original projections. (Chris Jacobs, 3/3)

In the United States, where doctors write more than 250 million prescriptions for painkillers a year, the frequency of abuse and overdose represents a public health crisis. More than 15,000 Americans died from an overdose of prescription opioids in 2013. In other parts of the world, however, the crisis is that strong painkillers such as morphine aren't available at all. More than 70% of the world's population live in countries with no access to opioids. That has been the case in India, where I am a palliative care physician. Though the situation is slowly improving as result of reforms made in 2014, most people in India can't get an opioid painkiller even when they're dying of cancer. Like torture victims, these people say that their suffering is simply unbearable and that they would do anything to make it stop. (M.R. Rajagopal, 3/3)

I met Mr. C. because he was dying and his wife needed someone to sit with him Saturday nights while she attended Mass. I was a relatively new hospice volunteer, not long out of training, and Mr. C. was my first assignment with a patient at home, rather than in a hospital or health care facility. He had been given a diagnosis of Parkinson鈥檚 disease 25 years before I first entered their small apartment in the Baruch housing projects, which stand where the Williamsburg Bridge meets Manhattan. (Ann Neumann, 3/4)

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