An obscure IRS rule takes effect on Wednesday under which small businesses that get caught helping their workers buy insurance or pay medical bills can be fined 18 times more than larger employers that don’t provide coverage at all, warned the National Federation of Independent Business (NFIB) today.

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Before we hold a going-out-of-business sale for the rule of law, following Thursday’s King v. Burwell ruling at the Supreme Court, let’s review some between-the-lines highlights. The Scalia dissent already took care of the fundamental analysis of how the Court veered so far off course.

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Many opponents of the health law are putting away their legal wrecking balls and reaching for chisels.

Thomas Miller, one of the strategists behind the Supreme Court case that aimed to strike down subsidies on the federal exchange, said he thought he would be celebrating now. But after Thursday’s decision upholding the subsidies, he is setting up meetings to discuss narrower attacks on the Affordable Care Act.

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The next bit of scrutiny on SCOTUScare — to borrow a new name for the federal health reform act coined by U.S. Supreme Court Justice Antonin Scalia — in health care is all about the workplace now that health insurance tax credits are securely in place.

The jeopardy of tax credits overshadowed that employers have big changes ahead under the employer mandate of the Affordable Care Act. The Supreme Court affirmed in King vs. Burwell Thursday the federal government’s position that tax credits, which help many people afford monthly insurance premiums, are available on both federally and state-run exchanges.

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Emergency room usage has spiked sharply in recent years. That’s the depressing finding from a new survey by the American College of Emergency Physicians – and it’s putting those who need emergency care at grave risk. The survey concluded that three in four emergency room doctors have experienced a surge of new patients since the Affordable Care Act became law.

That isn’t a coincidence.

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If you thought the legal fight over the health care overhaul was finally over, think again. At least four issues related to the Affordable Care Act still are being sorted out in the courts, although none seems to pose the same threat to the law as the challenge to nationwide subsidies that the court rejected on Thursday, or the constitutional case that the justices decided in favor of the law in 2012.

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Obamacare is dead. Long live Robertscare.

With Thursday’s U.S. Supreme Court decision in King v. Burwell, Chief Justice John Roberts, writing for the majority, cemented the Affordable Care Act as the law of the land. Oh, there will still be plenty of legal challenges to it, and there will be an attempt to replace it should a Republican occupy 1600 Pennsylvania Ave. in 2017; but for all intents and purposes, the individual and employer mandates, and now the subsidized federal health insurance exchange, are now in concrete.

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Last year, 95 American hospitals merged or were acquired — a 40 percent increase from 2010. Over roughly the same period, the percentage of physician practices owned by hospitals doubled — from about 30 percent to nearly 60 percent.

This rapid consolidation among U.S. healthcare providers is dizzying to behold, even for those who have spent careers in healthcare. Its effects are only starting to be felt, but could be profound.

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It’s an established fact of social science, replicated in surveys dating to the Nixon administration, that conservatives are happier than liberals. It stands to reason, then, that liberals whine more than their counterparts on the right. The litany of liberal complaints includes Republicans, Fox News, global warming “deniers,” conservatives’ silly fixation with religious freedom, and the United States Supreme Court.

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King v. Burwell is in the history books. Subsidies on federal exchanges will continue to flow and supporters of the ACA will (correctly) see this as a big win for the president. But to pretend that this means smooth sailing for Obamacare from here on out would be disingenuous at best.

Obamacare subsidies are just one important leg of a three-legged stool. And two of them may start wobbling after 2016.

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