KHN Morning Briefing

Summaries of health policy coverage from major news organizations.

Kaiser Health News Original Stories

The Red State Solution On Medicaid: Georgia’s Not Part Of It

The final piece in the Atlanta Journal-Constitution’s series on Arkansas’ privatized Medicaid expansion looks at how several red states are considering such a model as a politically palatable way to extend coverage to the poor. (Misty Williams, Atlanta Journal-Constitution, 4/1)

Political Cartoon: ‘Last But Not Least?’

Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: ‘Last But Not Least?’" by Chip Bok.

Here's today's health policy haiku:

STYLE ALERT!

Hospital patients
Need coverage and comfort.
Gowns need a re-do.

If you have a health policy haiku to share, please Contact Us and let us know if you want us to include your name. Keep in mind that we give extra points if you link back to a KHN original story.

Medicaid

Supreme Court: Medicaid Providers Can't Sue States To Raise Reimbursement Rates

In a 5-4 decision, the high court ruled Tuesday that hospitals and other health care providers can't sue a state in an effort to have Medicaid rates increased in keeping with rising medical costs.

Reuters: U.S. Top Court Says Medical Providers Can't Sue States Over Medicaid Funding
The U.S. Supreme Court on Tuesday ruled in a case from Idaho that private medical providers that deliver residential care services cannot sue a state in [an attempt] to raise Medicaid reimbursement rates to deal with rising medical costs. The justices, on a 5-4 vote, ruled in favor of the state of Idaho, which asserted that medical providers have no legal recourse to sue. The ruling is a loss for the healthcare industry, with trade groups and the U.S. Chamber of Commerce backing the providers in the case. (Hurley, 3/31)

The Associated Press: Supreme Court Sides With Idaho In Medicaid Pay Dispute
Private health care providers cannot sue to force states to raise their Medicaid reimbursement rates to keep up with rising medical costs, the Supreme Court ruled Tuesday. In a 5-4 decision that broke across ideological lines, the justices said medical companies have no private right to enforce federal Medicaid funding laws against states if Congress has not created such a right. (Hananel, 3/31)

Bloomberg: Hospitals Can’t Sue Over Medicaid Reimbursement, Court Says
Hospitals and other health-care providers can’t sue to challenge reimbursement rates set by states under the Medicaid insurance program for the poor, the U.S. Supreme Court ruled. ... Providers now will have to take any objections to rates to the U.S. agency that oversees the joint federal-state program. (Stohr, 3/31)

The Wall Street Journal: Supreme Court Rules Medicaid Providers Can’t Sue States For Higher Pay
Federal law gives states discretion in setting Medicaid rates, as long as they follow a broad set of factors intended to ensure health services remain available to the poor without encouraging the “unnecessary utilization of such care.” In Idaho, several companies that provide home care for intellectually disabled people sued state officials claiming reimbursement rates set by the state were too low. (Bravin, 3/31)

Politico Pro: High Court Ruling Keeps HHS As Medicaid Rates Arbiter
The Supreme Court on Tuesday punted the ball to the Obama administration to decide whether states’ Medicaid reimbursement rates are adequate for providers. In a decision with high stakes given Medicaid’s growth, the court ruled 5-4 that private parties do not have the right under the Constitution’s Supremacy Clause to sue states over low reimbursement rates. They initially must seek relief from HHS, Justice Antonin Scalia wrote in the majority opinion, and the department can withhold funds if it determines that a state is not complying with the law. (Pradhan, 3/31)

USA Today: Justices Limit Lawsuits Against State Medicaid Programs
The court's majority said that section of the law was written too broadly to allow for private lawsuits, such as the one filed by home-care providers in Idaho claiming insufficient reimbursement rates. Justice Antonin Scalia, writing for the majority, called it "judicially unadministrable," adding, "It is difficult to imagine a requirement broader and less specific." Scalia was joined by three other conservatives and by liberal Justice Stephen Breyer. Justice Sonia Sotomayor wrote the dissent, joined by two other liberals and by Justice Anthony Kennedy, who most often is in the middle. (Wolf, 3/31)

The Washington Post: Supreme Court Says State Medicaid Payments Not Open To Private Lawsuits
Five justices — Chief Justice John G. Roberts Jr. and Justices Antonin Scalia, Clarence Thomas, Stephen G. Breyer and Samuel A. Alito Jr. — agreed. Scalia wrote the majority opinion, but Breyer’s was the controlling vote. “I recognize that federal courts have long become accustomed to reviewing for reasonableness or constitutionality the rate-setting determinations made by agencies,” Breyer wrote. But he said he feared that siding with the providers would lead to “increased litigation, inconsistent results, and disorderly administration of highly complex federal programs that demand public consultation, administrative guidance and coherence for their success.” (Barnes, 3/31)

Los Angeles Times: Supreme Court Bars Judges From Setting Medicaid Rates
Tuesday's ruling reverses a decision from the U.S. 9th Circuit Court of Appeals in San Francisco, which has repeatedly blocked California from making cutbacks in its Medicaid payments. It is not clear what effect the ruling will have on the Medicaid program because significant cutbacks are not pending. (Savage, 3/31)

High Court Decision Likely To Chill Medi-Cal Lawsuits

Experts say the decision tilts the legal landscape in future disputes between Medi-Cal and health care providers and their patients.

Los Angeles Times: U.S. Supreme Court Decision Could Curtail Medi-Cal Lawsuits
During California's budget crisis, attempts to cut costs by reducing public services often became tied up in litigation. But on Tuesday, the U.S. Supreme Court significantly curtailed that legal avenue for advocates protesting spending cuts. The justices, in a 5-4 decision, said healthcare providers could not sue when they think Medicaid rates in their state are too low. (Megerian, 3/31)

The Sacramento Bee: Supreme Court Ruling Limits Medi-Cal Lawsuits
For years, some of the nation’s biggest legal fights over how much government should pay doctors and other health providers to care for the poor played out in California. But on Tuesday, a U.S. Supreme Court decision in a case stemming from Idaho stood to limit those battles in the future. (Siders, 3/31)

Health Law Issues And Implementation

Fla. Lawmakers' Medicaid Expansion Plans Draw Attacks From Conservative Group

The Americans for Prosperity, an advocacy group financed by the Koch brothers, is taking aim at Florida Senate President Andy Gardiner, a Republican, and others in the state senate. In response, a coalition of business leaders released a letter thanking them for their work on the issue. In other Medicaid news, California will seek a federal waiver to continue its health reform plans, and Sen. Claire McCaskill, D-Mo., places blame for future shortcomings in geriatric care on Missouri legislators' failure to pursue an expansion of the state-federal health insurance program for people with low incomes.

Orlando Sentinel: Koch Brothers Group Attacks Gardiner, Senate Over Medicaid Expansion
Americans for Prosperity, the free-market advocacy group financed by the billionaire industrialists Charles and David Koch, is going on the attack. The group sent mail ads Monday to the districts of Senate President Andy Gardiner, R-Orlando, and 24 other senators over their support for a plan to expand Medicaid under the Affordable Care Act, or Obamacare. ... AFP sent the mailers to the districts of senators who voted for the Medicaid expansion plan in committee. Gardiner, who is vice president of external affairs at Orlando Health, doesn’t sit on any committee as Senate President, but pushed expansion from the onset of the legislative session. (Rohrer, 3/30)

Miami Herald: Conservative Group Targets Senators Who Voted For Medicaid Expansion Plan
The Senate has been advancing plan to use federal money to extend healthcare coverage to nearly one million low-income Floridians. The proposal is not Medicaid expansion as envisioned under the Affordable Care Act. Instead, it would require Florida create a state-run marketplace for private health insurance. What's more, beneficiaries would have to pay small monthly premiums and meet a work requirement. Still, House Speaker Steve Crisafulli, R-Merritt Island, has said he isn't interested. (McGrory, 3/30)

Tampa Bay Times: Business Group Thanks Senate For 'Bold Leadership' On Medicaid Expansion
One day after a conservative advocacy group sent out mailers attacking the senators who support Medicaid expansion, a coalition of business leaders released a video thanking the Senate for its "bold leadership and courage." The group, a Healthy Florida Works, was instrumental in drafting the Senate's plan to expand healthcare coverage to nearly one million poor Floridians. (McGrory, 3/31)

The Associated Press: Florida Senators Meet With Feds Over Health Care Money
Amid growing budget discord that could derail this year's session of the Florida Legislature, Senate President Andy Gardiner dispatched two top Republican senators to Washington to talk with federal officials about more than $1 billion in health care grants the state could soon lose. Gardiner, an Orlando Republican who works for a hospital, took the unusual step even as top officials with the administration of Gov. Rick Scott are directly negotiating with the U.S. Department of Health and Human Services and the Obama administration. (Fineout, 3/31)

St. Louis Public Radio: McCaskill: Elderly Among Those Hurt By Missouri's Refusal To Expand Medicaid
As U.S. Sen. Claire McCaskill sees it, the Missouri General Assembly will be sharing more of the blame as the state’s medical professionals find it more difficult to provide the services and funding needed to care for Missouri’s growing elderly population. McCaskill, D-Mo., told local geriatric specialists Tuesday that the state’s refusal to expand Medicaid – as sought by the federal Affordable Care Act – will be felt particularly in nursing homes and hospitals around the state. (Mannies, 3/31)

Eyeing Presidential Bids, Some GOP Governors Attack Obamacare, Even Though It's Big Money For Their States

Reuters reports how states like Wisconsin, New Jersey and Louisiana have experienced infusions of health law funds despite their Republican governors' staunch opposition to the health law. Meanwhile, a Facebook request by Rep. Cathy McMorris Rogers asking users to share negative stories about the overhaul led to many positive responses.

Reuters: Exclusive: Republican White House Hopefuls Attack Obamacare But Take Money
Several Republican governors likely to run for president have secured hundreds millions of dollars under Obamacare while working to dismantle the healthcare law, according to a Reuters review of federal spending records. Governors Scott Walker of Wisconsin, Chris Christie of New Jersey, Bobby Jindal of Louisiana and former Texas Governor Rick Perry, all staunch opponents of President Barack Obama's 2010 Affordable Care Act, have collectively applied for and won at least $352 million through grant programs set up by the law, federal records show. (4/1)

Spokesman Review: McMorris Rodgers Says Facebook Kudos For Obamacare Mostly About Parts With Bipartisan Support
[U.S. Rep. Cathy McMorris Rodgers,] the Eastern Washington congresswoman, who has voted dozens of times to repeal all or parts of President Barack Obama’s signature legislation, asked users earlier this month to share their stories of difficulties with the law, paired with a picture of the president holding cupcakes and looking sullen. ... Instead, many users shared stories of how they benefitted from the law by receiving previously unavailable coverage or seeing a decline in their monthly premiums. McMorris Rodgers said Monday that many of the success stories seemed to be centered on reforms that both parties agreed on, rather than her concerns with the health care package. (Hill, 3/30)

In the meantime, private companies say they have a solution if the Supreme Court upends some health law subsidies --

Capitol Hill Watch

GOP Leaders Negotiate Budget Differences During Congressional Recess

Top House and Senate Republican budget negotiators are working over this two-week break to iron-out differences between the two chambers' budget blueprints, including changes to the Medicare program. But wariness remains, according to one Washington Post report, about whether lawmakers will be able to use momentum from the pending Medicare physician pay measure to fashion other compromise legislation.

Reuters: U.S. Congressional Budget Leaders Haggle During Recess
Top Republican budget writers in the U.S. Senate and House of Representatives were working over a two-week congressional recess to iron out differences between their budget plans passed last week, including ideas for changing Medicare. Aides said House Budget Committee Chairman Tom Price and his Senate counterpart, Mike Enzi, want Congress to approve a combined budget by April 15 - just three days after lawmakers return to Washington from their Easter and Passover break. (3/31)

The Washington Post: Congress Congratulates Itself For The ‘Doc Fix’ Deal, But Can It Happen Again?
The heretofore “do-nothing” Congress is on the cusp of becoming a “did-something” Congress, and Capitol Hill couldn’t more pleased with itself. As Congress prepared to leave Washington for a two-week Easter break, lawmakers celebrated a bipartisan deal that would end the dreaded yearly ritual known as the “doc fix” while extending popular federal health-care programs for low-income families. (DeBonis, 3/31)

And a Democrat introduces a bill for Medicare to cover hearing aids --

The Hill: Dem Wants To Fill Medicare Gap For Hearing Aids
Rep. Debbie Dingell (D-Mich.) has introduced legislation so that seniors can use their Medicare coverage to pay for hearing aids. The Michigan Democrat argued that allowing Medicare to cover hearing aids would help more seniors afford the devices. Digital hearing aids can cost around $4,000, while other hearing aids are priced at less than $1,000. (Marcos, 3/31)

Marketplace

Indictment Charges Patients Lured To New York 'Medicaid Mill' By Free Shoes

Twenty-three people, including nine doctors, are accused of bilking Medicare and Medicaid of nearly $7 million in unnecessary medical tests. And in Maine, a nursing facility agrees to pay $1.2 million to settle allegations of inflated Medicare claims.

The Wall Street Journal: 23 People Charged In ‘Sneakers Case’
The patients were recruited by the hundreds: Medicaid cardholders picked up at homeless shelters and welfare agencies with the promise of free sneakers and shoes, then brought to corrupt clinics for unnecessary medical tests and devices. Those tests and devices brought in nearly $7 million in fraudulent Medicaid and Medicare billings, according to a 199-count indictment unsealed Tuesday by the Brooklyn district attorney’s office. (Davis O'Brien, 3/31)

The Associated Press: Prosecutors: Medicaid Scam Exploited Poor Who Needed Shoes
Authorities investigating allegations of a Medicaid scam involving doctors and others in New York City recall coming across something curious in a lower floor of a clinic: stacks of shoe boxes containing cheap, off-brand sneakers, boots and sandals in a variety of sizes. Prosecutors say the footwear stockpile was further proof that the clinic was part of a ring that used shoe giveaways to lure poor people into a scheme that cheated Medicaid out of nearly $7 million over a two-year period. An investigation publicly revealed Tuesday resulted in health care fraud, money laundering and other charges against 23 people, including nine physicians. ... The people were offered free shoes if they could produce a valid Medicaid card and agreed to be taken by van to one of five clinics in Brooklyn and the Bronx, the papers said. (Hays, 3/31)

The Associated Press: Maine Skilled Nursing Facility Agrees To Pay $1.2M To Feds
Federal prosecutors say an elderly living center has agreed to pay $1.2 million to settle allegations of inflated Medicare claims for rehabilitation therapy. The U.S. attorney's office in Boston says Ross Manor in Bangor failed to prevent a subcontractor, RehabCare Group East, Inc., from engaging in a pattern and practice of providing high levels of therapy that weren't reasonable or necessary. (3/31)

Meanwhile, a New Jersey senator may face corruption charges as early as Wednesday -

Politico: Robert Menendez Indictment Could Come Wednesday
An indictment of Democratic Sen. Robert Menendez on federal corruption charges is expected as early as Wednesday, according to sources familiar with the case. The FBI and the Justice Department have been investigating Menendez’s ties to Dr. Salomon Melgen, a close friend and financial backer of the New Jersey senator, for months. It’s not clear exactly what charges Menendez could face, although honest services fraud, receiving improper gifts, and misusing his office for personal gain are all possibilities, according to the sources. Both Menendez and Melgen have repeatedly denied any wrongdoing. (Bresnahan and Raju, 3/31)

Quality

Tapping Technology, Patient Involvement For Healing

The New York Times looks at potential health gains when patients have full and easier access to their medical information, while Reuters reports on using web searches to predict population disease risks. Other stories examine the growing focus on wellness and prevention during physicals and how doctors are altering their practices.

The New York Times: The Healing Power Of Your Own Medical Records
Steven Keating’s doctors and medical experts view him as a citizen of the future. A scan of his brain eight years ago revealed a slight abnormality — nothing to worry about, he was told, but worth monitoring. And monitor he did, reading and studying about brain structure, function and wayward cells, and obtaining a follow-up scan in 2010, which showed no trouble. ... So when he started smelling whiffs of vinegar last summer, he suspected they might be “smell seizures.” (Lohr, 3/31)

Reuters: Web Searches May Predict Disease Risk Among Populations
Internet search data might someday help estimate the prevalence of noncommunicable diseases like stroke, heart disease or cancer, a new study suggests. Web searches are often linked with behavior, said Svetha Venkatesh, one of the study’s co-authors. (Doyle, 3/31)

The Philadelphia Inquirer: Annual Physicals Are Back In Fashion, But With A Difference
Health economists and medical groups including the American College of Physicians and the Centers for Disease Control and Prevention, have concluded that the standard checkup and battery of routine tests waste money, do not prolong life, and often result in overdiagnosis and unnecessary treatment. ... "Today, it is a conversation about wellness and prevention. An opportunity to ask your patient about smoking, nutrition, and personal relationships." (Dribben, 3/31)

Minnesota Public Radio: How Primary Doctors Are Making It Personal
A growing number of primary care doctors are leaving the traditional medical clinic and insurance systems behind and working more directly with patients. Sometimes called "concierge care" or "direct primary care," the goal is to strip out layers of management that can come between patients and doctors. (Miller, 3/31)

Veterans' Health Care

Make It Easier For Vets To Get Mental Health Care, Senator Says

New legislation introduced by Sen. Joni Ernst, D-Iowa, seeks to expand veterans' ability to receive mental health services outside of the VA system and reduce wait times. Meanwhile, reports and documents from the Department of Veterans Affairs describe two cases of mismanagement, one by a hospital chief in Puerto Rico and another by a VA office supervisor in Hawaii.

The Hill: Ernst Offers Bill To Improve Veterans' Access To Mental Health Care
Sen. Joni Ernst (R-Iowa) has introduced legislation to strengthen veterans' mental healthcare by making it easier to get help outside of the Department of Veterans Affairs. The proposal would amend the Veterans’ Access, Choice, and Accountability Act, to allow veterans access to non-VA mental healthcare if they can show the agency is not giving them "adequate or timely" care. (Carney, 3/31)

The Associated Press: VA Inspector General: Hawaii Supervisor Manipulated Vets' Benefit Data
A supervisor at the Veterans Administration office in Honolulu was manipulating data to make it look as though the agency was processing veterans' benefits claims faster than they actually were, according to a new report by the VA Office of Inspector General. The data manipulation happened last year, when there was heightened scrutiny nationwide over how long veterans were waiting to see doctors. (Bussewitz, 3/30)

Washington Examiner: Veterans Affairs Hospital Chief Draws $179K Salary Despite Missing 80 Days A Year
DeWayne Hamlin, the top official of the Department of Veterans Affairs' Puerto Rico hospital, was absent from the hospital some 80 days in a one-year period, according to documents obtained by the Washington Examiner. Hamlin was paid $179,700 despite being absent from the hospital approximately one in three business days last year, according to "delegation of authority" documents by which he temporarily transferred his job responsibilities to deputies. (Rosiak, 3/30)

State Watch

Ohio Lawsuit Seeks To Stop State's Re-Determination Of Medicaid Eligibility

In other state Medicaid news, the Missouri state senate will consider a proposal to increase eligibility for people with disabilities. Meanwhile, Vermont's medicaid managed care monitoring is under scrutiny.

Columbus Dispatch: Group Tries To Stop State From Terminating Medicaid Benefits
The Legal Aid Society of Columbus has asked a federal judge to stop state officials from terminating health-care benefits to tens of thousands of Medicaid recipients. In a lawsuit filed yesterday in U.S. District Court in Columbus, attorneys argue that removing beneficiaries from the rolls violates federal and state law because they were given no reason for termination nor told of their right to appeal. (Candisky, 3/31)

The Associated Press: Missouri Senate Votes To Raise Caps For Some To Get Medicaid
Missouri's Republican-controlled Senate has advanced a bill to expand eligibility for persons with disabilities to receive Medicaid. Senators advanced the bill in a voice vote Tuesday and will vote a second time before it moves to the House. Currently single Missourians can't have more than $1,000 in assets to qualify for the federal and state health care program, with married couples capped at $2,000. (4/1)

The Associated Press: Vermont Documents: Little Monitoring Of Medicaid Spending
During the past decade, Vermont has spent $675 million setting up Medicaid managed-care programs but has done such a spotty job monitoring them that they can't even be audited. That's the upshot from a letter state Auditor of Accounts Douglas Hoffer sent to lawmakers last week. It followed up on an internal report in January by the Agency of Human Services detailing gaps in answers to this question: Have the state and federal governments — and taxpayers — been getting their two-thirds of a billion dollars' worth? (Gram, 3/31)

State Highlights: Ind. Lawmakers Approve Ban On Building New Nursing Homes; Conn. Hospitals Seek To Undo Gov.'s Proposed Budget Cuts

A selection of health policy stories from Indiana, Connecticut, Texas, Kansas, Iowa and Arizona.

The Associated Press: Indiana Lawmakers Back 3-year Ban On Building Nursing Homes
Three-year moratorium on construction of most new nursing homes around Indiana has been approved by state lawmakers. Supporters say the moratorium is needed because Indiana has thousands of unused nursing home beds, which are costing the state millions in annual Medicaid costs based on a payment formula that includes construction costs. (3/31)

The Associated Press: Hospitals Ask Connecticut Lawmakers To Replenish Budget Cuts
Leaders of state hospitals urged state lawmakers Tuesday to replenish the cuts in Democratic Gov. Dannel P. Malloy's proposed budget, predicting the suggested changes could lead to deep reductions in medical services and staff. They said Malloy's suggested budget plan is especially worrisome considering recent cuts in federal funding. (Haigh, 3/31)

The Dallas Morning News: AIDS Healthcare Foundation Sues To Get Portion Of Federal Funds
A local agency serving AIDS patients is suing Dallas County, its health department and director Zachary Thompson, hoping to get nearly $1 million in federal funding this year. The AIDS Healthcare Foundation, which has had a North Dallas clinic since mid-2013, accused the county of not giving the agency a fair chance to qualify for federal AIDS funding. (Jacobson, 3/31)

Health News Florida: Hospice Seeks Stay In Dispute With AHCA
Warning of potentially "devastating consequences," a Central Florida hospice firm Monday sought a stay from the 1st District Court of Appeal in a dispute with the Agency for Health Care Administration about the firm's license. Compassionate Care Hospice of Central Florida Inc., which serves patients in Polk, Highlands and Hardee counties, was notified March 9 that its license had expired and that it would have to cease operations in the area. (3/31)

Stateline: How Severe Is The Shortage Of Substance Abuse Specialists?
The number of people with insurance coverage for alcohol and drug abuse disorders is about to explode at a time there’s already a severe shortage of trained behavioral health professionals in many states. Until now, there’s been no data on just how severe the shortage is and where it’s most dire. Jeff Zornitsky of the health care consulting firm Advocates for Human Potential (AHP) has developed the first measurement of how many behavioral health professionals are available to treat millions of adults with a substance use disorder, or SUD, in all 50 states. (Vestal, 4/1)

The Kansas Health Institute News Service: Changes To Mental Health Drugs, KanCare Committee Advance
Changes to Kansas Medicaid’s mental health drug reimbursements and the KanCare oversight committee moved forward Tuesday. Officials with the Kansas Department of Health and Environment had worked to hammer out a compromise on House Bill 2149 after mental health advocates objected to ending a ban on the state using regulatory tools like prior authorization for mental health prescriptions in Medicaid. The new bill, which allows for prior authorization subject to review by an advisory board that includes mental health professionals, passed both chambers unanimously. (Marso, 3/31)

The Des Moines Register: Mammogram Bill Not Being Considered By House
A bill that would require clinics give more specifics in mammogram reports to patients has apparently run aground in the Iowa House of Representatives for the second straight year. Senate File 205 would require that clinics tell patients if their mammograms indicated they had dense breast tissue. Supporters of the bill say such tissue can make it harder for radiologists to spot tumors in breast scans, which could raise the risk of cancer growing before it's noticed. Women who receive such notices might consider obtaining other types of scans beyond their initial mammogram. (Leys and Pfannenstiel, 3/31)

CQ Healthbeat: States Aim To Make Vaccine Exemptions Harder To Get
Lawmakers in a dozen states are debating whether to make childhood vaccine exemptions harder to get, with some considering more paperwork and others proposing to eliminate personal belief and religious exemptions. The debates began after a measles outbreak at Disneyland in California over the 2014 holiday season and a growing number of parents seeking the exemptions forced lawmakers to consider if the requirements should be tightened. Twenty-one states have bills related to vaccine exemption laws, according to the Immunization Action Coalition. (Evans, 4/1)

The New York Times: Arizona Doctors Must Say That Abortions With Drugs May Be Reversed
Once again, Arizona finds itself on the frontier of anti-abortion legislation: Late Monday, it became the first state to pass a law requiring doctors who perform drug-induced abortions to tell women that the procedure may be reversible, an assertion that most doctors say is wrong. The provision is part of a broader law signed by Gov. Doug Ducey, a Republican, meant to prevent plans offered in Arizona through the federal health care exchange from providing coverage for most abortions. (Rojas, 3/31)

Editorials And Opinions

Viewpoints: Lawmaker's Obamacare Surprise; Conn.'s Stiff Medicaid Cuts; Fla. Budget Debate

A selection of opinions on health care from around the country.

The Washington Post's Plum Line: Leading GOP Critic Of Obamacare Accidentally Shows Why Anti-ACA Lawsuit Could Be Disaster For GOP, Too
As you may have heard, GOP Rep. Cathy McMorris Rodgers tried to celebrate Obamacare’s fifth anniversary by calling on constituents to share their horror stories about the law — whereupon many people responded by talking about how much the law has helped them. The story drew national attention. Now McMorris Rodgers has responded to all the praise for the ACA by dismissing its significance: She now suggests people were only praising the parts of the law Republicans also support. But in the process, she has inadvertently demonstrated why Republicans should be hoping the King lawsuit against the ACA — currently the GOP’s best shot at doing the law serious damage — fails. (Greg Sargent, 3/31)

Bloomberg: Catch Of The Day: GOP Retreat On Obamacare
McMorris Rodgers's explanation, according to the Spokesman-Review, was that most of the praise was for provisions with “broad, bipartisan support” such as coverage for those with “pre-existing conditions and those that are getting health insurance up to age 26.” In other words: We're going to vote to repeal every single word of Obamacare. Except for the stuff people like. The problem for Republicans is that all the benefits of Obamacare are popular. It’s the costs that people don't like -- the taxes and Medicare cuts to pay for those benefits, and the individual mandate to make the system work. The more the Republicans reinforce the idea that the goals of the health-care law are worthwhile, the more they are trapped into supporting it no matter how many times they vote to repeal it or promise a replacement. (Jonathan Bernstein, 3/31)

The Wall Street Journal: Close Encounters Of The Medicaid Kind
Medicaid enrollment has surged 19% nationally since ObamaCare’s expansion—50% in New Mexico, 65% in Oregon, 81% in Kentucky—and spending is exploding. So taxpayers ought to be grateful that the Supreme Court declined 5-4 on Tuesday to convert this entitlement—and all the others—into a private right. Medicaid, the joint state-federal program originally meant for the poor and disabled, sets price controls for all health-care services. And in the law that created the program, Congress instructed the states to “assure that payments are consistent with efficiency, economy, and quality of care and are sufficient to enlist enough providers” equal to those available to the general population. In Armstrong v. Exceptional Child Center, a group of in-home care companies sued Idaho for setting reimbursement rates too low, thus purportedly violating this amorphous standard. (3/31)

Bloomberg: What Do You Mean, I Can't Sue My State?
When your state breaks federal law in a way that affects you, can you sue in federal court to make it do the right thing? On Tuesday, the U.S. Supreme Court made doing so substantially harder. In a case involving private health-care providers in Idaho, the justices held that the health workers can’t sue Idaho -- even though the state was paying them less than required under federal Medicaid law. If this sounds weird to you, the fault isn’t yours. The problem lies with the version of federalism that underlies the 5-4 decision. (Noah Feldman, 3/31)

Hartford Courant: State Medicaid Cuts For Births Leave Providers Stunned
Everyone at Women's Health Connecticut was expecting the state to enact Medicaid cuts in the range of 5 percent this summer, a tough but workable hit for the Avon firm that manages 50 obstetrics-gynecology groups in the state. But the hammer that's falling suddenly on ob-gyns, nurse-midwives and their low-income patients across the state on Wednesday is something else altogether. Many of them learned just last week that the state will slash Medicaid payments by as much as 40 percent for ob-gyn services — as of April 1. (Dan Haar, 3/31)

The Wall Street Journal's Washington Wire: Americans Don’t Feel The Slowdown In Health Costs
National spending on health care and insurance premiums has risen at historically low rates in recent years. But ... even when spending and premiums experienced record-low growth in 2013, only 3% of Americans said health costs had been rising slower than usual, and 52% said they had been growing faster than usual. The American people are not out to lunch; their view of the problem of health costs is very different from that of experts. (Drew Altman, 3/31)

The New York Times: The False Hope Of A Smaller Government, Built On Tax Breaks
In the early years of the Reagan Revolution, Senator Robert Packwood, then the powerful Republican chairman of the Senate Finance Committee, offered a robust — if unusual — defense of the tax exclusion for employer-provided health insurance: It prevented the government from getting bigger. “The one reason we do not have any significant demand for national health insurance in this country among those who are employed is because their employers are paying for their benefits,” he argued. “I hate to see us nibble at it for fear you are going to have the demand that the federal government take over and provide the benefits that would otherwise be lost.” This reasoning drives American policy making to this day. (Eduardo Porter, 3/31)

The Miami Herald: Tale Of Two Budgets
At the core of the [state budget] debate is a philosophical difference on how to spend most of the money. And healthcare — specifically, how we pay for the medical needs of millions of low income Floridians — is shaping up to be the battle royal. The heftiness of the Senate’s budget is mainly because it includes federal dollars to cover the uninsured at Florida hospitals through the Low Income Pool, or LIP. ... An alternative to Medicaid expansion, now called the Florida Health Insurance Affordability Exchange or FHIX, is also on the table and also merits approval. ... But the gauntlet has been thrown down. House Speaker Steve Crisafulli, R-Merritt Island, has said the House is not for any expansion, whatever it’s called. (3/31)

The Washington Post: The Pelosi-Boehner Compromise On Medicare Is A Rare Bird
The John Boehner-Nancy Pelosi agreement on Medicare doctors’ payments — permanently easing up on scheduled cuts, funded (partially) by means testing — has been praised as an incremental gain and criticized as a small backward step. In either case, it is a rare bird: the result of a March 4 meeting between leaders in a metaphorical smoke-filled room (and, given Boehner’s smoking habit, perhaps an actual one). (Michael Gerson, 3/31)

The Washington Post's Volokh Conspiracy: The Supreme Court’s Next Obamacare Case(s)
On Monday, the Supreme Court denied certiorari in Coons v. Lew, a constitutional challenge to provisions in the Affordable Care Act (ACA) creating the Independent Payment Advisory Board (IPAB), an independent federal agency charged with responsibility for controlling the growth of health-care costs by constraining the growth of Medicare. ... The Court’s denial of certiorari in the Coons case does not mean the justices won’t revisit the ACA next term. Another cert petition is pending in Mayhew v. Burwell, Maine’s challenge to the constitutionality of the ACA’s maintenance of eligibility requirements for Medicaid. ( Jonathan H. Adler, 3/31)