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

“President Obama’s healthcare law could be dealt a severe blow this week if a U.S. appeals court rules that some low- and middle-income residents no longer qualify to receive promised government subsidies to pay for their health insurance.
The case revolves around a legal glitch in the wording of the Affordable Care Act, which as written says that such subsidies may be paid only if the insurance is purchased through an “exchange established by the state.”
That would seem to leave out the 36 states in which the exchanges are operated by the federal government.
A ruling could come as early as Tuesday.
The administration has argued that Congress intended to offer the subsidies nationwide to low-and middle-income people who bought insurance through an exchange, without making a distinction.”

“Planned Parenthood unveiled a text helpline Monday for women who have lost or will lose contraception coverage in their healthcare plans after last week’s Supreme Court Hobby Lobby ruling.
The pro-abortion rights group says women who have lost birth control coverage or have questions about their healthcare can text the helpline to learn about their options.
The Supreme Court ruled last week some employers could deny workers access to free contraception coverage under their health insurance plans if it would infringe on the employer’s religious beliefs.
The group says women can text “birth control” to 69866 to report an employer’s refusal to pay for coverage. Those who use the text service get an email or phone follow-up from Planned Parenthood explaining what options the worker has and help on how to get free birth control.”

“Senate Majority Leader Harry Reid said Monday that Democrats will take up legislation in the “coming weeks” to address last month’s Supreme Court decision that allowed some employers with religious objections to opt out of Obamacare’s contraception mandate.
Democrats on Capitol Hill have overwhelmingly criticized the high court’s ruling in the Hobby Lobby case and are working to craft a response that would restore the coverage, though no specifics have yet been outlined.”

“Several indicators suggest that the political waters may be calming for the Affordable Care Act (ACA). This doesn’t guarantee that the law will achieve its goals and be judged a success. It means that the law stands a better chance of being implemented free of constant political turmoil–and will have a better shot at success.
Consider:
*Public support for the ACA fell after the Web site debacle last fall, but while overall opinion toward the law continues to tilt negative, the falloff in the polls has stopped, according to the June Kaiser Family Foundation Health Tracking poll.
*After the administration rapidly repaired the Web site, the ACA exceeded the widely cited 7 million target for the first open-enrollment season, which had become a political litmus test for the law. And with no similarly big controversy, the ACA has become a far less juicy, and less prominent, media story.
*Some Republicans seem to be shifting their midterm strategy to focus less on the ACA and more on other issues they have with the president and the direction of the country.
*More people say that they are getting their information on the law from personal experience and from the experiences of family and friends, and fewer say that they are getting it from the news media, which they also say focuses mostly on politics and not what the law means for them. Increasingly, public perception of the law is about people’s experiences–whether good or bad–rather than ideology and partisan politics.”

“The Supreme Court’s ruling this week that “closely-held” companies like Hobby Lobby aren’t obligated to comply with the health law’s contraception mandate because it conflicts with their religious beliefs has put a renewed focus on the employer-sponsored healthcare.
Consumers getting their healthcare through their employers is a deeply ingrained practice in the United States (although that trend has been diminishing in recent years), and the court ruling has sparked all kinds of arguments pertaining to that the arrangement. Some have concluded that it will lead workers to seek alternatives outside the workplace, which they can find on the federal health exchanges created under Obamacare.
However, a new poll from Morning Consult found that the public isn’t there yet.
In fact, a strong majority of workers are worried that their employers will stop offering health insurance altogether and move them into the Obamacare exchanges. Workers with employer-sponsored health plans largely have a negative view of what such a move would mean for their coverage, and would even consider looking for a new job under that scenario, the poll found.”

“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.”