A project of the Galen Institute

Issue: "Mandates"

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."

Low-Wage Workers Feel the Pinch on Health Insurance

Drew Altman
Wall Street Journal
Fri, 2014-09-19
"We did not see big changes in employer-based coverage in the Kaiser-HRET annual Employer Health Benefit Survey released last week. Mostly this is good news, particularly on the cost side where premiums increased just 3%. But one long-term trend that is not so good is how this market works for firms with relatively large shares of lower-wage workers (which we define as firms where at least 35% of employees earn less than $23,000). These low-wage firms often do not offer health benefits at all. And, as the chart below shows, when they do offer coverage, it has lower premiums on average (likely meaning skimpier coverage) and requires workers to pay more for it. Workers in low-wage firms pay an average of $6,472 for family coverage, compared with $4,693 for workers in higher wage firms."

Lawmakers call for more complete information on Medicaid privatization program going forward

Cole Avery, NOLA.com
Fri, 2014-09-19
"Lawmakers told officials with the Department of Health and Hospitals on Wednesday they needed to provide more complete information going forward about Bayou Health, Gov. Bobby Jindal's Medicaid privatization program. The Legislative Audit Advisory Council heard testimony from DHH and the Legislative Auditor's Office about an audit that raised a number of questions about the program. Auditors testified 74 percent of the transparency report was based on self-reported data with no corroborating documentation."

Big Health Insurance: Obamacare's Worst Bad Guys

Ryan Ellis
Forbes magazine
Wed, 2014-09-17
"Very few industries in bed with Obamacare come off smelling like a rose. But if one had to pick a bad actor above all others, it would probably be Big Health Insurance. America’s largest and most influential health insurance companies actively supported passage of Obamacare in Congress, and continue to do so today. That’s not surprising, since the heart of Obamacare is a mandate on Americans to purchase the product the health insurance companies are selling (the individual mandate). The “essential minimum coverage” on “qualified health insurance plans” as dictated by the Department of Health and Human Services tend to emphasize first dollar insurance coverage whenever possible, which increases insurance company profits. Worst of all, insurance companies are the beneficiaries of a giant taxpayer bailout that makes their Obamacare participation a “heads they win, tails taxpayers lose” kind of scenario."

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.

The Three Words That Shift Views On Medicaid

Marissa Evans, Morning Consult
Mon, 2014-09-15
"Three little words is all it takes to change voters’ minds about Medicaid expansion. Morning Consult polling shows using the term “Affordable Care Act” can make a difference in how a voter feels about expanding Medicaid. When asked if Medicaid should be expanded for low income adults below the federal poverty line, 71 percent of registered voters said yes. When asked if Medicaid should be expanded “as encouraged under the Affordable Care Act”, support dropped nine percentage points."

A GOP Senate could take on Obamacare — but not repeal it

Jennifer Haberkorn
Politico
Mon, 2014-09-15
"A Republican-controlled Senate cannot repeal Obamacare, no matter how fervently GOP candidates pledge to do so on the campaign trail this fall. But if they do win the majority, Senate Republicans could inflict deep and lasting damage to the president’s signature law. Republicans are quick to say they are not yet measuring the proverbial drapes. But they are taking the political measurements of repealing large parts of the health law, considering which pieces could be repealed with Democratic support, and how to leverage the annual appropriations and budget process to eliminate funding or large pieces of the law. Initial targets are likely to include the medical device tax, the individual and employer mandates, the 30-hour workweek to qualify for coverage, and spending on a preventive health fund that Republicans call a slush fund."

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."

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