“Legal challenges to various aspects of Obamacare (aka the Affordable Care Act) keep traveling on a rollercoaster. Today’s episode of the law’s continuing courtroom soap opera involves a ruling by a federal district court in Oklahoma, which overturned a 2012 IRS rule authorizing premium assistance tax credits in federal exchanges (since rebranded as “federally facilitated marketplaces”). The decision improves the likelihood that the Supreme Court ultimately will consider this issue on appeal; either in the spring of 2015 or during its next 2015-2016 term.
Judge Ronald White ruled in State of Oklahoma v. Burwell that the IRS rule is “arbitrary, capricious, an abuse of discretion not in accordance with law, pursuant to 5 U.S.C. section 706(2)(A), in excess of statutory jurisdiction, authority, or limitations, or short of statutory right, pursuant to 5 U.S.C. section 706(2)(C), or otherwise is an invalid implementation of the ACA, and is hereby vacated.”
In other words, it was not just a “bad idea,” but an illegal one, too.”

“In a legal setback for the Obama administration, a federal judge in Oklahoma ruled Tuesday that people in states that rely on the federal insurance exchange are not eligible for Obamacare premium subsidies to help them pay for coverage.
Judge Ronald White, a George W. Bush appointee, invalidated an Internal Revenue Service rule interpreting the Patient Protection and Affordable Care Act to allow the premium tax credits in states that have not established their own exchange. “The court holds that the IRS Rule is arbitrary, capricious, an abuse of discretion or otherwise not in accordance with law,” White wrote.
In his ruling, White rejected the argument that striking down the subsidies would cripple the entire healthcare reform law. “Congress is free to amend the ACA to provide for tax credits in both state and federal exchanges, if that is the legislative will,” he wrote.”

“As we start the final stretch before the midterm elections, many analysts are convinced that Obamacare isn’t the hot political issue it once was. While the flood of negative publicity about the law has subsided of late, a majority of people still oppose it, according to a Real Clear Politics average of polls taken from Sept. 2-15. And I’ve always believed the voters’ negative impressions of the law were “baked” into their assessments of Democratic incumbents.
That’s partly why Democratic Senators such as Kay Hagan of North Carolina, Mark Pryor of Arkansas and Mark Begich of Alaska find themselves barely breaking 40 percent in recent public polls.
But a new study out this week from Bloomberg Government threatens to bring the Affordable Care Act back to center stage — and in a way that will likely hurt the electoral chances of incumbent Democrats, all of whom voted for the law.”

“CMS decided not to include some payments disputed by doctors and teaching hospitals in the Open Payments database published Tuesday (Sept. 30) in order to give physicians and hospitals more time to review the information, but the highly anticipated database includes de-identified data in cases where it was unclear exactly to which physician the payments should have been linked.
The Open Payments site will include 4.4 million payments valued at almost $3.5 billion, according to CMS. Payments from drug and device makers, as well as group purchasing organizations, which were disputed by physicians or hospitals and not corrected before the end of the review and dispute period (Sept. 11) were not included in the most recent batch of Open Payments data because of timing issues, CMS officials said on a call.”

“Confused by President Barack Obama’s health care law? How about the debate over government surveillance? The way the Federal Reserve affects interest rates?
You’re far from alone.
Most people in the United States say the issues facing the country are getting harder to fathom.
It’s not just those tuning out politics who feel perplexed.
People who vote regularly, follow news about November’s election or simply feel a civic duty to stay informed are most likely to say that issues have become “much more complicated” over the past decade, an Associated Press-GfK poll shows.”

“Views of Obamacare hold steady again this week, with over half of voters continuing to express an unfavorable opinion of the national health care law and overwhelming majorities still calling for choices in health insurance that the law doesn’t allow.
The latest Rasmussen Reports national telephone survey finds that 42% of Likely U.S. Voters share a favorable view of the health care law, while 52% view it unfavorably. This includes 19% with a Very Favorable opinion and twice as many (37%) with a Very Unfavorable one.”

“Normally, no one would care that in a recent Atlantic essay — “Why I Hope to Die at 75” — 57-year-old Dr. Ezekiel Emanuel argued that living to be 75 years old was long enough for anyone. After 75, Emanuel suggests, “We are no longer remembered as vibrant and engaged but as feeble, ineffectual, even pathetic.”
But Emanuel is no garden-variety crackpot. Nor is he a wannabe science-fiction writer dreaming of a centrally planned planet of robust youthful humanoids. Unfortunately, he was one of the chief architects of the troubled Affordable Care Act and a key medical advisor to the Obama administration.”

“The Obama administration has dragged its feet on revoking Obamacare coverage for people who can’t prove U.S. citizenship or legal residency, allowing some of the estimated 11 million illegal immigrants in the U.S. to continue enjoying taxpayer-funded benefits, a Republican senator charged Monday.
“The Obama administration is bending over backwards to give Obamacare to illegal immigrants but won’t protect hardworking American citizens who are losing their health care coverage,” said Sen. David Vitter, Louisiana Republican and an outspoken critic of President Obama’s health care law.”

“Governors suggest in a new report that states consider easing restrictions on physician assistants to help deal with swelling Medicaid rolls. The National Governors Association says states should consider including PAs in the definition of “provider,” loosening so-called scope-of-practice laws to let physicians delegate more tasks to PAs, opening clinical training sites and encouraging PAs to work in primary care.
“To increase the use of the physician assistant workforce, states should review the laws and regulations affecting the profession and consider actions to increase the future supply of PAs,” an NGA release states.”

“Are death panels on the rebound? Obamacare envisioned Medicare paying physicians to discuss end-of-live-care with their patients. When this sparked fierce blowback from citizens who feared that “death panels” would ration care to elderly patients, the Administration backed off.
However, the American Medical Association (AMA) has been lobbying for the execution (pun intended) of this provision. The AMA is a business which profits from its monopoly over the billing codes that physicians use when they submit claims to Medicare. The more billing codes there are, the better it is for the AMA.
For patients, however, it is risky to allow the government to pay physicians to counsel us on end-of-life issues. There is another approach, but it is so emotionally challenging that it may be impossible to implement.”