The impact of ObamaCare on doctors and patients, companies inside and outside the health sector, and American workers and taxpayers

“WASHINGTON — More than half of privately insured women are getting free birth control under President Barack Obama’s health law, a major coverage shift that’s likely to advance.
This week the Supreme Court allowed some employers with religious scruples to opt out, but most companies appear to be going in the opposite direction.
Recent data from the IMS Institute document a sharp change during 2013. The share of privately insured women who got their birth control pills without a copayment jumped to 56 percent, from 14 percent in 2012. The law’s requirement that most health plans cover birth control as prevention, at no additional cost to women, took full effect in 2013.”

“WASHINGTON — The Obama administration, reeling from back-to-back blows from the Supreme Court this week, is weighing options that would provide contraceptive coverage to thousands of women who are about to lose it or never had it because of their employers’ religious objections.
The administration must move fast. Legal and health care experts expect a rush to court involving scores of employers seeking to take advantage of the two decisions, one involving Hobby Lobby Stores, which affects for-profit businesses, and the other on Wheaton College that concerns religiously affiliated nonprofit groups. About 100 cases are pending.
One proposal the White House is studying would put companies’ insurers or health plan administrators on the spot for contraceptive coverage, with details of reimbursement to be worked out later.”

“The Supreme Court struck a second blow against the health-care law Monday with its decision to narrow its contraception mandate, an aspect of the federal program that was not central to its existence but was deeply cherished among liberals and many women’s groups.
Two years ago, the court, while upholding the constitutionality of the Affordable Care Act, also gutted the law’s mandatory Medicaid expansion, severely limiting the law’s reach. By contrast, the effect of Monday’s decision is peripheral. The contraception provision was not part of the main law but was laid out in regulatory language issued by the Obama administration. Millions of women who receive birth control at no cost through their company health plans are likely to keep it.
Still, women who work for closely held, for-profit companies whose owners have religious objections to contraceptives may feel an impact. The ruling also is a symbolic setback for a law that has survived a series of legal and political challenges since its enactment four years ago but today stands not entirely whole.”

“Much has been written about the possibility that Republicans could win control of the Senate in the 2014 elections. In fact, some prognosticators have given Republicans a better-than-even-money shot at taking the Senate back. If Republicans keep the House and garner the net six seats necessary to win a Senate majority, what does that mean for health policy and politics in the next Congress? In particular, what does it mean for the continued implementation and expansion of the Patient Protection and Affordable Care Act, otherwise known as Obamacare?
I hear these questions a lot, having served as the Republican health policy director for one of the key Senate health policy committees in 2006, the last time Republicans held a majority in both houses of Congress. The one thing I know for sure is that Republicans simply can’t pick up where they left off in 2006, but that answer is far from satisfying.
This much, we know: if Republicans regain both houses in January 2015, health policy in the 114th Congress will be dominated by a showdown between a Republican Congress and a Democratic White House over the future of Obamacare. The challenge for Republicans will be how to balance the desire of the party faithful for repealing Obamacare with the reality that President Obama would never permit it under his watch.”

“The Supreme Court decision upholding Hobby Lobby’s ability to refuse to cover certain contraceptive services based on its owners’ religious beliefs has set off a wave of analysis of what the decision means. That will not be resolved anytime soon. But we do know what women think of the policy issue at the core of the case.
Overall, by a margin of 59% to 35%, women oppose the idea of letting companies deny coverage of contraceptives based on their owners’ religious beliefs. But women’s views on this issue–studied in the Kaiser Family Foundation Health Tracking Poll last month–differ by party, ideology and their religion.
White evangelical protestants, conservatives and women who are Republican are more supportive of Hobby Lobby’s position. Women who are liberal, Democrats, and protestant and Catholic are much more likely to oppose the company’s position.”

“The Supreme Court’s decision on contraceptives and employer health plans could affect companies and workers far beyond Hobby Lobby and the other plaintiffs.
But nobody seems to know how far.
The ruling applies to “closely held for-profit corporations,” a small subset of employers, Justice Samuel A. Alito Jr. wrote for the majority. But in a dissenting opinion, Justice Ruth Bader Ginsburg suggests the impact will be far broader.
“Although the court attempts to cabin its language to closely held corporations, its logic extends to corporations of any size, public or private,” she said.”

“The Supreme Court today rang a victory bell for religious freedom as it ruled 5-4 that “HHS’s contraceptive mandate substantially burdens the exercise of religion” of three closely held companies – Hobby Lobby, Conestoga Wood Specialties, and Mardel.
The companies objected to the Obama administration’s mandate that they must provide, at no cost to their employees, coverage for products that can terminate life in the womb, violating their religious beliefs.”

“By a vote of 5 to 4, the Supreme Court has ruled that family-owned, closely held corporations do not have to comply with the health law’s contraception coverage requirements if they violate the owner’s religious views. Legal analyst Stuart Taylor Jr. joins us now to discuss the decision. Thanks for being with us.
STUART TAYLOR: Nice to be with you.
MARY AGNES CAREY: Why did the court rule this way?
STUART TAYLOR: Well, the court held that under an act of Congress passed in 1993, the Religious Freedom Restoration Act, the right is conferred on all religious groups, including, the court said in this case for the first time, for-profit corporations as well as churches and, say, nonprofit religious groups — they all get broad protection of their religious freedoms.”

A sampling of news articles on the Hobby Lobby Supreme Court decision:

“Kaiser Health News: Supreme Court Limits Contraceptive Mandate For Certain Employers
A sharply divided Supreme Court ruled Monday that at least some for-profit corporations may not be required to provide contraceptives if doing so violates the owners’ religious beliefs.But the five-justice majority writing in Burwell v Hobby Lobby, et al., took pains to try to limit their ruling only to the contraceptive mandate in the health law and only to “closely held” corporations like the family-owned businesses represented by the plaintiffs in the case (Rovner, 6/30).

The Wall Street Journal: Supreme Court Makes Religious Exception To Health-Care Law
The U.S. Supreme Court on Monday in a 5-4 split said “closely held” companies can on religious grounds opt out of a federal health-care law requirement that companies provide contraception coverage for employees, carving another piece from President Barack Obama’s signature domestic achievement”
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“President Obama is bragging that the administration has surpassed its target of 7 million people enrolled in the ObamaCare exchanges, but he isn’t talking about the millions of people who are being harmed so the insurance-salesman-in-chief could make his numbers.”