“At the heart of Halbig v. Burwell[1] and the series of cases that are following it through the federal court system is an attempt to understand what state and federal legislators were thinking last year, two years ago, even four years ago when the Affordable Care Act (ACA) passed. While many experts and lawyers in this case have hypothesized about Congress’ intent, contrary to the claims of the Government, at least one establishing and one non-establishing state understood the language of the statute to condition subsidies on state establishment of Exchanges when they made their determination on whether to establish an Exchange. Furthermore, this understanding was timely in the chronology of ACA implementation.”

“Last week, Americans for the first time could look up their doctor to see what payments, if any, they received from pharmaceutical and medical device companies. And Morning Consult polling shows patients will make decisions based off that information: The majority of registered voters say they would be less likely to choose a certain physician if they took money from a drug or medical device company. It’s this mindset that has physicians, pharmaceutical and medical device companies worried.
The database, which was established in the Affordable Care Act, went public Tuesday afternoon. It allows users to see how much money doctors were paid by drug and medical device companies between August and December 2013. There were 4.4 million payments made totaling $3.5 billion, according to the Centers for Medicare and Medicaid Services (CMS). Payments were made to 546,000 physicians and nearly 1,360 teaching hospitals. CMS directly acknowledges the database does not differentiate between payments that could be interpreted as a positive, like a physician doing clinical research, or negative, like money for a trip to promote a certain drug or device.”

“Medicare is fining a record number of hospitals because they readmitted too many patients within 30 days for more treatment, according to federal records released this week.
During the next year, 2,610 hospitals will see their reimbursement levels reduced and 39 hospitals will be hit with the largest penalty allowed, according to Kaiser Health News.
The federal government’s penalties are designed to make hospitals pay more attention to their patients after they are discharged.”

“Proposition 45 offers a simple choice for voters: Do they want the state insurance commissioner to regulate health care rates for small businesses and individual health plans?
The campaign fight over whether that would be beneficial for consumers is much more complicated.
Initiative proponents, led by Democratic Insurance Commissioner Dave Jones and Consumer Watchdog, a Santa Monica-based consumer group with backing from attorneys, say the initiative would add transparency to the rate-setting process.”

“As soon as Air Force One touched down in Indiana on Friday, Gov. Mike Pence met President Barack Obama on the tarmac with a plea: Expand the state’s access to government-sponsored health insurance.
The catch: Pence wants to do it with a conservative twist.
At least, that’s how he’s selling his proposal. And his political future could hinge on whether the first-term Republican can convince conservatives that he’s not just rebranding Obamacare.
Pence has spent much of his first two years in office trying to strike a bargain on one of the health care law’s core components. Indiana will expand Medicaid coverage, Pence says, but only if it’s allowed to do it through a tweaked version called the “Healthy Indiana Plan,” which also requires users to make small payments into health savings accounts.”

“The Supreme Court on Monday returns to work to face a rich and varied docket, including cases on First Amendment rights in the digital age, religious freedom behind bars and the status of Jerusalem.
Those cases are colorful and consequential, but there are much bigger ones on the horizon.
“I’m more excited about the next 12 months at the Supreme Court than about any Supreme Court term in its modern history,” said Thomas C. Goldstein, who argues frequently before the court and is the publisher of Scotusblog.
In the coming weeks, the justices will most likely agree to decide whether there is a constitutional right to same-sex marriage, a question they ducked in 2013. They will also soon consider whether to hear a fresh and potent challenge to the Affordable Care Act, which barely survived its last encounter with the court in 2012.”

“When Congress passed the Affordable Care Act, it required health insurers, hospitals, device makers and pharmaceutical companies to share in the cost because they would get a windfall of new, paying customers.
But with an $8 billion tax on insurers due Sept. 30 — the first time the new tax is being collected — the industry is getting help from an unlikely source: taxpayers.
States and the federal government will spend at least $700 million this year to pay the tax for their Medicaid health plans. The three dozen states that use Medicaid managed care plans will give those insurers more money to cover the new expense. Many of those states – such as Florida, Louisiana and Tennessee – did not expand Medicaid as the law allows, and in the process turned down billions in new federal dollars.”

“The top executive for H&R Block, the nation’s largest tax preparer, on Wednesday said he expected President Obama’s health care law to add “significant complexity” to next year’s tax season.
Speaking on H&R Block’s quarterly earnings conference call, CEO William Cobb said that the company was already taking steps to train its tax preparers based on the draft forms that the Internal Revenue Service has released to comply with Obamacare.
“As expected, the forms are very detailed and can present significant complexity, depending on a filer’s coverage status during the year, income level, and household composition,” Cobb said. “Depending on their situation, there are instances where filers may need to file multiple new tax forms and complete additional worksheets.””