A project of the Galen Institute

Issue: "Legal Challenges"

Employer Groups Launch New Effort To Change ACA 30-Hour Workweek

Rachana Dixit Pradhan, Inside Health Policy
Mon, 2014-09-22
"Employer groups are ramping up their efforts to revise the ACA's 30-hour full-time employee definition in hopes of getting it changed before the employer mandate kicks in for some large employers next year. The initiative, titled “More Time for Full-Time,” was announced Friday (Sept. 19) and is the latest tactic by employers to change the standard so that it defines a full-time employee as one who works 40 hours per week. Groups involved in the initiative include the National Restaurant Association, the National Retail Federation, the U.S. Chamber of Commerce, the National Grocers Association and the International Franchise Association. “As all Americans have known for decades, 40 hours represents the widely-accepted definition of a full-time work week.

Republicans Switch Firm Handling Obama Suit

Ashley Parker, NY Times
Mon, 2014-09-22
"House Republicans on Friday replaced the firm handling their lawsuit against President Obama after the lawyer representing them pulled out over what was said to be political backlash among his colleagues at the firm, Baker Hostetler. The lawyer, David B. Rivkin Jr., had taken the case on behalf of House Republicans in August, right after they voted to sue the president, accusing him of overstepping the powers of the presidency. Two people with knowledge of the situation said Mr. Rivkin withdrew from the case under pressure after facing criticism that he had taken on an overly partisan lawsuit. Some members of the firm feared the case against Mr. Obama could drive off potential clients and hurt Baker Hostetler’s credibility, according to one of the people with knowledge of the case. Both people said they were prohibited from publicly discussing such a delicate case."

GOP finds ObamaCare opening

Sarah Ferris
The Hill
Mon, 2014-09-22
"Republicans have found a new opening against ObamaCare after struggling for months to craft a fresh strategy against a healthcare law that now covers millions of people. Lifted by a pair of federal audits that found major flaws with the law’s implementation, Republicans see their first chance in months to launch a serious attack against the law. “The news that we’ve seen over the last week and a half really emphasizes what conservatives and Republicans were trying to do last year, which was preventing a lot of this from happening,” said Dan Holler, a spokesman for the conservative political group Heritage Action for America. “What I hope happens is that the Republican Party as a whole says, ‘Yes, there is a reason besides politics that we’re fighting ObamaCare: It’s hurting people,’” Holler said."

GOP finds ObamaCare opening

Sarah Ferris, The Hill
Mon, 2014-09-22
"Republicans have found a new opening against ObamaCare after struggling for months to craft a fresh strategy against a healthcare law that now covers millions of people. Lifted by a pair of federal audits that found major flaws with the law’s implementation, Republicans see their first chance in months to launch a serious attack against the law. "The news that we’ve seen over the last week and a half really emphasizes what conservatives and Republicans were trying to do last year, which was preventing a lot of this from happening,” said Dan Holler, a spokesman for the conservative political group Heritage Action for America. “What I hope happens is that the Republican Party as a whole says, ‘Yes, there is a reason besides politics that we’re fighting ObamaCare: It’s hurting people,’” Holler said."

Getting There: How to transition from Obamacare to real health care reform

James Capretta and Yuval Levin
Weekly Standard
Wed, 2014-09-17
"Obamacare—or at least the version of it that the president and his advisers currently think they can get away with putting into place—has been upending arrangements and reshuffling the deck in the health system since the beginning of the year. That’s when the new insurance rules, subsidies, and optional state Medicaid expansions went into effect. The law’s defenders say the changes that have been set in motion are irreversible, in large part because several million people are now covered by insurance plans sold through the exchanges, and a few million more are enrolled in Medicaid as a result of Obamacare. President Obama has stated repeatedly that these developments should effectively shut the door on further debate over the matter. Of course, the president does not get to decide when public debates begin or end, and the public seems to be in no mood to declare the Obamacare case closed.

The Federal Courts' Role in Implementing the Affordable Care Act

MaryBeth Musumeci and Laurie Sobel , Kaiser Family Foundation
Wed, 2014-09-17
"Since the Affordable Care Act’s (ACA) passage, a number of lawsuits have been filed challenging various provisions of the law. The Supreme Court has decided cases about the constitutionality of the ACA’s individual mandate and Medicaid expansion as well as the applicability of the contraceptive coverage requirement to closely held for-profit corporations with religious objections. In addition, several cases challenging the availability of premium subsidies in the Federally-Facilitated Marketplace (FFM) are currently progressing through the federal courts. All of this litigation has altered, or has the potential to alter, the way in which the ACA is implemented and consequently could affect the achievement of the law’s policy goals.

Brady Questions HHS Authority To Put Forward Hospital Appeals Settlement

http://insidehealthpolicy.com/brady-questions-hhs-authority-put-forward-hospital-appeals-settlement
Tue, 2014-09-16
"House Ways & Means health subcommittee chair Kevin Brady (R-TX) questions HHS' authority to settle hospitals' appeals of denied inpatient claims and is urging HHS Secretary Sylvia Burwell to retract what he views as an "ill thought" settlement process. Brady wants Burwell to work with lawmakers to come up with a different "fair, transparent and conclusive settlement process." Brady wrote to Burwell Tuesday (Sept. 16) that he is dismayed by HHS' reluctance to work with the committee on an equitable settlement process that is fully legal, adding that the "lack of engagement makes it challenging for the Congress to solve the current appeals problems and prevent similar problems in the future." CMS announced late last month (Aug. 29) that it will pay hospitals 68 percent of denied inpatient status claims in the appeals queue if hospitals take them out of the backlogged appeals process.

How Does Where You Work Affect Your Contraceptive Coverage?

Kaiser Health News
Fri, 2014-09-12
"The Affordable Care Act (ACA) requires most private health insurance plans to provide coverage for a broad range of preventive services including Food and Drug Administration (FDA) approved prescription contraceptives and services for women. Since the implementation of this provision in 2012, some nonprofit and for profit employers with religious objections to contraceptives have brought legal challenges to this rule. For many women today, their contraceptive coverage depends on their employer or when they purchased their individual insurance plan."

Ohio: Law Against Lies Is Nullified

The Associated Press
The New York Times
Fri, 2014-09-12
"A federal judge on Thursday struck down Ohio’s law barring people from knowingly or recklessly making false statements about candidates in a case that the United States Supreme Court said needed to be heard. The judge, Timothy Black, said that the answer to false statements in politics is “not to force silence, but to encourage truthful speech in response, and to let the voters, not the government, decide what the political truth is.” The case began in the 2010 congressional race after Steve Driehaus, a congressman at the time, filed a complaint when the Susan B. Anthony List planned to post billboards claiming the Democrat’s support for President Obama’s health care overhaul equated with support for abortion, even though he opposed abortion."

Apparent Retail Glitch Triggers Copays For Birth Control

Shefali Luthra, Kaiser Health News
Fri, 2014-09-12
"CVS Health is investigating a potential glitch in its drug pricing system that appears to have charged women copayments for prescription birth control – though the scope of the error is unclear. The problem came to the attention of Rep. Jackie Speier, D-Calif., after one of her staffers attempted to buy generic prescription birth control in Washington D.C. and was charged a $20 copay. The retailer’s error, highlighted in a letter to the company from Speier, runs counter to a provision of the federal health law that mandates insurance coverage of women’s preventive care – a category including generic prescription birth control – without cost sharing."

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