- Kaiser Health News Original Stories
- The Red State Solution On Medicaid: Georgia’s Not Part Of It
- Political Cartoon: ‘Last But Not Least?’
- Supreme Court: Medicaid Providers Can't Sue States To Raise Reimbursement Rates
- High Court Decision Likely To Chill Medi-Cal Lawsuits
- Health Law Issues And Implementation
- Fla. Lawmakers' Medicaid Expansion Plans Draw Attacks From Conservative Group
- Eyeing Presidential Bids, Some GOP Govs Attack Obamacare, Even Though It's Big Money For Their States
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)
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:
Need coverage and comfort.
Gowns need a re-do.
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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.
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)
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)
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)
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)
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)
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.
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)
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)
Health News Florida:
Koch-Backed Political Group Targets Senators Supporting Medicaid In Florida
The conservative political group Americans for Prosperity is taking aim at Florida Senate President Andy Gardiner’s Medicaid expansion plans. ... The group, backed by the Koch brothers, wants to expand telemedicine, eliminate government oversight of health care and allow some health care workers to do more. (Aboraya, 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)
State Submits $17B Waiver Plan; Advocates Urge Medi-Cal Rate Review
California health officials submitted a Medicaid waiver request to federal regulators calling for $17 billion in health care reform projects in a five-year proposal. (Gorn, 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)
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.
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)
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 --
Private Companies Say They’re The ACA’s Subsidy Solution
The Supreme Court case that could upend Obamacare has led to a flood of questions about federal and state back-up plans to keep the law afloat. And private companies are streaming in to say they have the answers. (Pradhan, 4/1)
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 close the deal surrounding the Medicare physician pay legislation that passed the House last week but is still pending in the Senate.
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 --
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)