KHN Morning Briefing

Summaries of health policy coverage from major news organizations.

Kaiser Health News Original Stories

When Health Care Is Far From Home

The biggest barrier to treatment for residents of a tiny town in the mountains of Northern California isn’t insurance coverage-- it’s distance. (Daniela Hernandez, 3/2)

Political Cartoon: 'The Tooth Fairy?'

Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'The Tooth Fairy?'" by Darrin Bell.

Here's today's health policy haiku:


Bill to renew CHIP
Don’t let it die on the floor
Or in committee.

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.

Health Law Issues And Implementation

Angst, Sense of Impending Crisis Surround Wednesday's Health Law Arguments

The Supreme Court justices will again hold the fate of the health law in their hands as they hear arguments in the latest legal challenge to the overhaul. News outlets analyze what's at stake in the case -- for policy makers and consumers -- as well as the contingency plans, or lack thereof, if the court rules against the subsidies.

The Wall Street Journal: As Supreme Court Weighs Subsidies, Health-Law Opponents Face Hurdle
Opponents of the health-care law face a potential challenge Wednesday in persuading the Supreme Court to strike down nationwide insurance subsidies: Doing so could put the law at odds with part of the court’s blockbuster health-care decision three years ago. In 2012, the justices largely upheld the Affordable Care Act but ruled by a 7-2 vote that Congress couldn’t put excessive financial pressure on the states to implement a portion of the law that expanded Medicaid, the federal-state health-insurance program for the poor. That ruling was a consolation prize to conservatives who failed to win a broader decision gutting the health-care law. (Kendall and Bravin, 3/1)

Los Angeles Times: If Supreme Court Rules Against Obamacare, States Have Few Options
With Supreme Court arguments in the latest challenge to the Affordable Care Act just days away, a sense of impending crisis has hit state officials and patient advocates in many parts of the country. Many worry they have no good options. If the justices rule in favor of the challenge, it would wipe out insurance subsidies for millions of consumers in nearly three dozen states that use the federal marketplace established through the health law. (Levey, 3/2)

The St. Louis Post-Dispatch: Outcome Of Obamacare Subsidy Case Could Have Drastic Consequences For Missouri, Illinois
When the U.S. Supreme Court hears arguments this week on a legal challenge to the federal health care law, affordable health insurance for many Missourians and Illinoisans will hang in the balance. At issue is whether residents in the two states — and about 30 others — qualify for government subsidies to help offset the cost of their insurance. If the court finds that they don’t, about 500,000 residents in both Missouri and Illinois would lose their financial assistance and likely their health coverage. (Shapiro, 3/1)

McClatchy: The Health Care Case: Fear And Loathing At The Supreme Court
On Wednesday, the U.S. Supreme Court will hear oral arguments in a case that might deny tax credits next year to Newsome and an estimated 9.3 million people in 34 states that use the federal health insurance marketplace at Roughly two-thirds of them, or 6.3 million, probably would become uninsured in 2016, according to estimates by the Urban Institute, a centrist research center. (Pugh, 2/27)

Politico: No Easy Fix If Supreme Court Halts Obamacare Cash
The Obama administration says it has no contingency plan for the 7 million to 8 million people who would lose health subsidies if the Supreme Court were to invalidate a key provision of Obamacare. On Wednesday, the high court will hear arguments in King v. Burwell, a case that will determine whether the health law’s premium subsidies are legal in 34 states that did not set up their own insurance exchanges and rely on to enroll their residents. If the court decides they’re not, an estimated 7 million to 8 million people would be cut off. (Pradhan and Norman, 3/2)

The Washington Post: Six Words Might Decide The Fate Of Obamacare At The Supreme Court
When the Supreme Court takes up the latest challenge to President Obama’s health-care law this week, how the justices interpret a six-word phrase in the bill could determine its fate. The law, adopted in 2010, says the federal government can pay subsidies to help people afford insurance bought through “an Exchange established by the state.” (Rein, 3/1)

The Washington Post: At Least 6 Republican States Revisit Their Stance Of Resisting Obamacare
Officials in several Republican states that balked at participating in President Obama’s ­health-care initiative are now revisiting the issue amid mounting panic over a possible Supreme Court decision that would revoke federal insurance subsidies for millions of Americans. The discussions taking place in state capitals around the country are part of a flurry of planning and lobbying by officials, insurance and hospital executives, and health-care advocates to blunt the possible impact of a court ruling. (Somashekhar, Millman and Sun, 2/27)

The Associated Press: AP EXPLAINS: Supreme Court Case Against Obama's Health Law
The U.S. Supreme Court this week hears a challenge to President Barack Obama's health care overhaul. If successful, the lawsuit would cripple Obama's prized domestic achievement, a program that has brought the U.S. as close as it has ever come to universal health care. The Affordable Care Act passed Congress in 2010 without a single Republican vote in favor. (3/2)

Modern Healthcare: Reform Law's Fate Will Hinge On How Justices Interpret A Few Words
After months of nervous speculation, it's finally the U.S. Supreme Court's turn this week to consider the legal case that could solidify or savage President Barack Obama's landmark healthcare reform law. The justices on Wednesday will hear arguments in King v. Burwell, which turns on whether the language of the Affordable Care Act allows Americans in up to 37 states using the federal insurance exchange to receive premium tax credits. The Internal Revenue Service has interpreted the law to allow subsidies in all states. But the four individual plaintiffs challenging the rule say the ACA language is clear and that interpretation is wrong. (Schencker, 2/28)

NBC News: Obamacare Faces Toughest Test in Supreme Court Challenge
The Supreme Court is preparing to hear a challenge to Barack Obama's signature healthcare policy that could deal it a crippling blow, if not a fatal one. The case comes before the justices on Wednesday, nearly three years after the Supreme Court saved Obamacare during a legal battle at the law's inception. (Williams, 3/2)

Oregon Lawmakers Pass Bill To Abolish State Corp. That Ran Failed Health Marketplace

The measure, which now goes to the governor, would dissolve the independent corporation that has been running Cover Oregon -- the failed state health insurance exchange -- and move its operations into the Oregon Department of Consumer and Business Services. Meanwhile, legal issues between the exchange and Oracle America, its developer, continue. News outlets also report on developments related to exchanges in Rhode Island and Tennessee.

The Associated Press: Covering Cover Oregon's Bills Won't End With Dissolution
A bill dissolving the independent corporation that runs Cover Oregon is on its way to Gov. Kate Brown. The agency has spent hundreds of millions of dollars on a health exchange that failed — with more millions in legal fees and other expenses still to come. Cover Oregon spent $300 million in federal funds, much of it to have Oracle America Inc. build an exchange for Oregonians to buy health insurance. The health exchange web portal failed to launch in 2013. (Wozniacka, 3/1)

Reuters: Oracle Sues Oregon Officials In Health Care Website Dispute
Oracle America Inc, the software giant in charge of developing Oregon's failed health exchange website, has filed suit against five former staff and campaign advisers to the state's former governor, saying they worked behind the scenes to kill the site for political reasons, court documents showed. (Seben, 2/27)

The Associated Press: Bid To Block Health Exchange In Tennessee Seen As 'Overkill'
Some Republican lawmakers still reveling in the recent defeat of a proposal to expand Medicaid to 280,000 low-income Tennesseans are now setting their sights on 230,000 people enrolled through the federal health insurance exchange. State Sen. Brian Kelsey's latest proposal would ban Tennessee from creating a state-run exchange should the Supreme Court rule that the federal government can't pay subsidies in states that declined to set up their own insurance markets. Oral arguments in that case are scheduled for March 4. (Schelzig, 2/28)

Date Set For Ariz. High Court Case On Funding For Medicaid Expansion

Elsewhere, Florida is scheduled to lose $1 billion in federal health funds at the end of June and that is threatening the governor's budget. But the low-income hospitals that have funding at stake see the issue as a way to bolster the case for Medicaid expansion.

The Associated Press: Medicaid Fight May Cost Florida $1B Federal Grant
Florida is scheduled to lose $1 billion in federal health funds at the end of June, a hole in the state budget the Legislature must fill in its upcoming session if a settlement isn't reached between the administrations of Gov. Rick Scott and President Barack Obama. The state has known for about a year about the impending cut in funding to cover uninsured, low-income hospital patients, but Scott has included the money in his proposed 2015-16 budget, which takes effect July 1. The hospitals are using the issue to bolster arguments to expand Medicaid during the 60-day Legislative session that begins Tuesday. (Kennedy, 3/1)

Capitol Hill Watch

3 GOP Senators Pledge Help If High Court Strikes Down Health Law's Insurance Subsidies

The Republicans, who oppose the law, are focusing on temporary fixes to avoid chaos -- and voters' backlash -- if the Supreme Court bars federal exchange subsidies. The senators have not described what those fixes might be or how they would pay for them.

The Fiscal Times: GOP Considers Plan To Spare Millions From Anti-Obamacare Decision
For months, Republicans have rallied around the latest Supreme Court challenge to Obamacare—embracing it as their last real opportunity to bring down the president’s health care law once and for all. ... Now, with a week before oral arguments, they’re scrambling to come up with ways to quell the potential backlash of an adverse ruling—before they get blamed. (Ehley, 2/27)

In other Capitol Hill news -

The Associated Press: Congressional Republicans Name New Budget Referee
Congressional Republicans Friday named economist Keith Hall to serve as Capitol Hill’s budget referee as director of the nonpartisan Congressional Budget Office. ... Hall replaces Doug Elmendorf, who was appointed by Democrats but earned the respect of lawmakers in both parties. He led CBO as it scored both the controversial Affordable Care Act and House Republicans’ contentious plan to overhaul Medicare. (2/27)


Health Care Data Poses Opportunities, Dangers

The Lewin Group looks for an analyst to parse health care data to help the government prepare for the next crisis. Meanwhile, Pro Publica reports that federal fines are rare despite the increasing number of health data breaches.

The Washington Post: Preparing For The Next National Crisis — By Digging Through Insurance Claims
The Lewin Group, a health-care research consultancy based in Fairfax County, is looking for a managing consultant and health economist to help the federal government prepare for the next crisis. As a lead researcher with the firm’s national security and emergency preparedness practice, the new hire is to delve into insurance-claims data to help federal agencies learn more about the nation’s health-care system. Because Lewin is owned by UnitedHealth Group, one of the nation’s largest health insurers, the health economist will have access to troves of claims data not available to the public. (Gregg, 3/1)


Antipsychotic Drugs Overused For Dementia Patients

Federal investigators are recommending that Medicare reduce unnecessary psychiatric prescriptions for seniors suffering from dementia, reports The New York Times. Another report finds that more than a quarter of children taken from their homes and put in foster care aren't getting required medical care.

Kaiser Health News: More Than One In Four Foster Kids Miss Required Checkups
Twenty-nine percent of children taken from their families and placed in foster care failed to receive at least one required medical checkup, the Health and Human Services Department Office of the Inspector General said in a report out today. Such screenings can help spot health problems, including troubles with vision, hearing, development and mental health issues. Those exams are particularly important for children in foster care because some have suffered neglect, abuse and other problems that could affect their health.(Appleby, 3/2)

Public Health And Education

Poll: Childhood Trauma, Poverty, Among Factors That Shape Health

A survey by NPR, the Robert Wood Johnson Foundation and the Harvard T.H. Chan School of Public Health found that Americans believe their health is affected by a range of social and cultural factors, from poverty, exposure to pollutants and stress to lack of access to quality medical care.

NPR: Poll Finds Factors Large And Small Shape People's Health
We often think of health as a trip to the doctor or a prescription to treat or prevent diseases. Or maybe it's an operation to fix something that's gone wrong. But a new poll by NPR, the Robert Wood Johnson Foundation and the Harvard T.H. Chan School of Public Health reveals that Americans perceive health as being affected by a broad range of social and cultural factors. Much of our series, What Shapes Health, explores how doctors and other health professionals pay little attention to early childhood experiences as a fundamental cause of health problems. We look at efforts to change this. (Neel, 2/2)

NPR: People With Low Incomes Say They Pay A Price In Poor Health
When you ask people what impacts health you'll get a lot of different answers: Access to good health care and preventative services, personal behavior, exposure to germs or pollution and stress. But if you dig a little deeper you'll find a clear dividing line, and it boils down to one word: money. People whose household income is more than $75,000 a year have very different perceptions of what affects health than those whose household income is less than $25,000. This is one key finding in a poll conducted by NPR, the Robert Wood Johnson Foundation and the Harvard T.H. Chan School of Public Health. One third of respondents who are low income say lack of money has a harmful effect on health. (Neighmond, 2/2)

Kaiser Health News: The Extra Cost Of Extra Weight For Older Adults
Bayou La Batre calls itself the seafood capital of Alabama. Residents here depend on fishing and shrimping for their livelihood, and when they sit down to eat, they like most things fried. It’s here that former U.S. Surgeon General Dr. Regina Benjamin has been trying to reverse the nation’s obesity epidemic one patient at a time. Benjamin grew up near Bayou La Batre and has run a health clinic in this town of seafood workers and ship builders since 1990. As obesity became commonplace around the U.S., health care providers like Benjamin began seeing the impacts of obesity all around them. (Varney, 3/2)

State Watch

State Highlights: State Medicaid Fraud Units Net More Than $2B

A selection of health policy stories from Connecticut, Georgia, California, Maryland, Texas, Idaho, Louisiana, Pennsylvania, Oregon, Wisconsin, Kansas and Washington.

Reuters: More Than $2B Netted By State Medicaid Fraud Units In 2014
State Medicaid fraud units recovered just over $2 billion in fiscal year 2014, down from nearly $2.5 billion the previous year, according to new data released by the federal government. About $1.71 billion of the recoveries came from civil investigations and about $290 million from criminal ones, according to the U.S. Department of Health and Human Services' Office of the Inspector General. (Pierson, 2/27)

Connecticut Mirror: Legislators Grappling With Fast-Changing Health Care Landscape
Some are wary of the idea of out-of-state, for-profit companies buying Connecticut's nonprofit hospitals. Others see for-profit purchasers as a needed option for small hospitals looking for partners and capital, and worry the state’s regulatory climate will scare them off. The result is a flurry of proposed legislation that, together, reflect the challenge of adapting to a fast-changing industry – one that is both a top employer in many communities and a big driver of the health care costs that are straining state, local and business budgets. (Levin Becker, 3/2)

Kaiser Health News: When Health Care Is Far From Home
For decades, Hayfork had been fortunate. Well after the rise of urban health systems and their intricate business models, it had a tight-knit local "system" founded on the simple, generous commitment of two people: a general practitioner and a pharmacist. "He was everybody’s doctor," Barnett says of Dr. Earl Mercill, a GP who moved up from the Central Valley almost 50 years ago. "You never thought about going to anyone else." But it’s been years since Mercill retired. Now his clinic is staffed by doctors who rotate in from Weaverville once or twice a week, and otherwise it’s run by physician’s assistants. There are no hospitals for miles, though helicopters swoop in for emergencies when needed. (Hernandez, 3/2)

The Associated Press: Concierge Medicine Grows In Maryland
Three years ago, Dr. Wayne Benjamin — then 67 years old — was considering retirement. He was worn out, frustrated with the daily grind of his family medicine practice and the increasing pressure to see “more and more patients in shorter and shorter” amounts of time. (Gulin, 3/1)

Los Angeles Times: Scope Maker Olympus Faces Scrutiny Over Patient Deaths, Infections
Three years ago, Japanese electronics giant Olympus Corp. was in crisis amid a massive accounting scandal and plunging sales of its signature cameras. Executives vowed to save the 93-year-old firm by turning aggressively to healthcare and selling more medical scopes to doctors and hospitals in the U.S. and worldwide. The bet paid off: Medical sales soared 25% last year, and Olympus boasts a commanding 70% share of the global market for gastrointestinal endoscopes. But now the industry leader finds itself at the center of superbug outbreaks at U.S. hospitals, including UCLA, where two patients have died and nearly 180 more people may have been exposed to deadly bacteria on contaminated Olympus scopes. (Terhune and Peterson, 3/1)

The Associated Press: Settlement Could Be Near In Idaho Health Care Case
There are signs that a landmark lawsuit over juvenile mental health care in Idaho may be reaching a conclusion, resulting in a systemwide overhaul. But the Jeff D. case has a long history of being reopened as federal judges repeatedly have found the state has done too little to care for children with developmental disabilities and behavioral health issues. (Clark, 3/1)

The New York Times: Facing A Huge Deficit, Louisiana Governor Reconsiders Some Tax Credits
The proposed cuts are substantial, coming after years of routine and severe reductions. They would potentially result in the closures of community health care clinics and historic sites. Hospitals partly privatized by Mr. Jindal would get $142 million less than they had sought. Spending on higher education would be lower by $141 million, a further 6 percent reduction after years of cuts. (Robertson, 2/27)

The Associated Press: Wolf Proposes Increasing In-home Health Care For Seniors
Gov. Tom Wolf said Friday he wants more seniors to obtain health care in their home instead of a nursing facility. In an event at the AARP office in downtown Philadelphia, Wolf told about 30 people that his upcoming 2015-16 state budget plan would expand home- and community-based long-term care for an additional 5,500 people. The Democrat said the proposal would make long-term care for seniors more convenient and personal. (2/28)

The Associated Press: Oregon Weighs Banning Most Vaccine Exemptions
Jennifer Margulis has her kids vaccinated and she gets shots herself. But she doesn't like the idea of government telling parents they must get their children immunized. That's why she spoke at a recent legislative hearing to oppose an amendment to an Oregon bill that takes aim at the state's highest-in-the-nation rate of non-medical vaccine exemptions. (Kumar, 3/1)

The Associated Press: Walker Cuts Might Hit Disabled Hard, Advocates Say
Gov. Scott Walker's proposed cuts to programs that help people with disabilities live independently are being criticized as potentially devastating by advocates and those who use the services. Walker's proposed budget would expand the state's Family Care program by Jan. 1, 2017, at which point all other long-term care programs would be discontinued, including the IRIS program, which benefits 11,000 adults with long-term care needs. Walker has proposed cutting $14 million in funding to the Family Care program over the next two years. (Ferguson, 3/1)

Los Angeles Times: Christie Tells California GOP To Let Presidential Race Play Out
He did not mention these matters, instead touting his election -- twice -- in a blue state, five balanced budgets and tax cuts for businesses. He highlighted a healthcare and pension agreement with teachers unions last week as a way opposing forces can work together, an area where he said President Obama has failed. “We announced in New Jersey that we have signed a road map of reform with the teachers union to try to fundamentally change the way our pension and health systems work,” Christie said, to gasps of incredulity from the audience. (Mehta and Mason, 2/28)

The Baltimore Sun: Hogan Wades Into Maryland's Long Battle Against Heroin
With the creation of two panels devoted to combating heroin use, Gov. Larry Hogan has waded into a worsening crisis — one that has defied solutions for decades. It once looked as if Maryland had brought some measure of control to its long-standing battle against the drug, driving down fatal overdose rates for years. In Baltimore, for example, overdose deaths plunged from more than 300 in 1999 to around 100 in 2010. (Duncan and Puente, 2/28)

The Kansas Health Institute News Service: Legislative Change Affects Kansas Survey On Teen Substance Abuse
For more than 20 years, Kansas secondary students have taken a survey to track alcohol and drug abuse. But a new law requiring parents to give written permission to allow their children to take the survey is affecting the survey data, and those who use the data say it could be more challenging to obtain funds for prevention efforts. The Kansas Communities That Care (KCTC) survey, which was taken by nearly 100,000 sixth-, eighth-, 10th and 12th-grade students last year, is expected to have an estimated 60,000 fewer responses this year, according to officials at the Southeast Kansas Education Service Center at Greenbush. (Booker, 2/27)

The Peninsula Daily News: Abortion Referral A Practicality, Not Policy, Jefferson Healthcare Says Following ACLU Suit
Jefferson Healthcare's practice of referring women elsewhere for abortion services adequately serves those seeking such services, said the hospital's chief medical officer. The hospital does not perform abortions on-site because of practicality, not policy, according to staff members. The Seattle office of the American Civil Liberties Union has said it believes a public hospital that provides maternity care but not abortion services is in violation of state law. (Bermant, 3/1)

The Charlotte Observer: Former Mooresville Child Compensated By Federal ‘Vaccine Court’
Angelica’s case is one of thousands that have sought compensation from the National Vaccine Injury Compensation Program. Since 1988, when the vaccine court was established by Congress, about 4,000 victims have received more than $2.8 billion in compensation for vaccine injuries, according to federal records. In fiscal year 2014 alone, the court granted $202 million to 365 vaccine-injury victims. Most people have never heard of the vaccine court or the compensation program. (Garloch, 2/28)

Editorials And Opinions

Supreme Court Case Commentary: Millions Could Lose Coverage; A GOP Plan To Fix Health Care

Opinion writers from a variety of publications offer their views of the legal arguments and the stakes involved as the high court prepares to review a key provision of the health law.

USA Today: If Obamacare Plaintiffs Win, Millions Lose: Our View
On Wednesday the Supreme Court will hear the most serious challenge to Obamacare since a single vote at the high court kept the law alive in 2012. As legal challenges go, the latest complaint is bizarre: If the plaintiffs lose, they face little or no harm. If they win, about 8 million people around the USA face substantial injury. (3/1)

USA Today: Obamacare Rule Harms Millions: Opposing View
In King v. Burwell, four Virginia residents are a challenging an IRS Obamacare rule in the Supreme Court. While the case involves only a handful of plaintiffs, it is really about the millions of Americans who are victims of Obamacare's mandates and penalties. Like the King plaintiffs, millions are harmed by Obamacare's individual mandate, which forces them to either buy insurance that they don't want or to pay a tax penalty. But the IRS rule also has devastating consequences for countless other Americans and their families. (Sam Kazman, 3/1)

The Washington Post: We Have A Plan For Fixing Health Care
Wednesday, the Supreme Court will hear oral arguments about whether the Obama administration used the IRS to deliver health insurance subsidies to Americans in violation of the law. Millions of Americans may lose these subsidies if the court finds that the administration acted illegally. If that occurs, Republicans have a plan to protect Americans harmed by the administration’s actions. When the court rules in King v. Burwell, we anticipate that it will hold the administration to the laws Congress passed, rather than the laws the administration wishes Congress had passed, and prohibit subsidies in states that opted not to set up their own exchanges, as the language in the law clearly states. Such a ruling could cause 6 million Americans to lose a subsidy they counted on, and for many the resulting insurance premiums would be unaffordable. (Sen. Orrin Hatch, R-Utah; Sen. Lamar Alexander, R- Tenn.; and Sen. John Barasso, R-Wyo.; 3/1)

The Wall Street Journal: Unconstitutional After All?
Next week the U.S. Supreme Court hears oral arguments in one of the term’s most-watched cases: King v. Burwell, which raises the question whether the Obama administration has been violating the Patient Protection and Affordable Care Act of 2010. That law, popularly known as ObamaCare, authorizes income-tax subsidies for taxpayers who purchase medical insurance policies from an exchange “established by the State.” A 2012 Internal Revenue Service decree nullified that qualification—improperly, the appellants argue—by interpreting it to include an exchange established by the federal government. In short, unlike 2012’s big ObamaCare case, National Federation of Independent Business v. Sebelius, King is all about statutory interpretation; it does not challenge the constitutionality of ObamaCare. (James Taranto, 3/27)

Los Angeles Times: Is GOP Finally Getting Nervous That The Supreme Court Might Gut Obamacare?
It wasn't so long ago that Republicans were viewing the prospect that the Supreme Court might overturn a key provision of the Affordable Care Act with unalloyed glee. The court might "ultimately take it down," Senate Majority Leader Mitch McConnell (R-Ky.) crowed in December. "You could have a mulligan here, a major do-over of the whole thing, that opportunity presented to us by the Supreme Court." We're not hearing that so much these days. (Michael Hiltzik, 2/27)

The Washington Post: In Affordable Care Act Case, Context Is Key
As with everything else here these days, the talk about the Affordable Care Act case before the Supreme Court next week will focus on ideological splits: Will any conservative justice join the four liberals all but certain to back the administration? In fact, the correct conservative legal position would be to rule for the administration. (Ruth Marcus, 3/1)

Reuters: The Supreme Court Hears An Obamacare Fairytale
Congress knew exactly what it wanted to do when it passed the Affordable Care Act in 2010, and contrary to the plaintiffs’ claim, that included wanting subsidies for buying health insurance on the Obamacare exchanges to be available to all citizens, even those residing in the 36 states that did not set up their own exchanges, instead relying on the exchange set up by the federal government. (Steven Brill, 3/2)

The New York Times' The Upshot: How An Adverse Supreme Court Ruling Would Send Obamacare Into A Tailspin
Even if you don’t receive Obamacare subsidies, you could still be harmed by the Supreme Court case that could take them away. A court ruling for the plaintiffs in the case, King v. Burwell, would have wide-reaching effects for the individual insurance markets in around three dozen states. The approximately six million people currently receiving subsidies in those states would be hit hard, of course. But so could the millions who now buy their own insurance without subsidies. The results could be surging prices and reduced choice for health insurance shoppers across the income spectrum. (Margot Sanger-Katz, 2/27)

The New York Times: Hello, Justices? It’s Reality Calling
Tough luck, say the plaintiffs: The harsh consequences of a ruling in their favor should be irrelevant to the justices, whose only job is to interpret the statutory text. In any event, the plaintiffs contend, those harsh consequences are perfectly consistent with what Congress meant the law to accomplish. But the plaintiffs are mistaken. It’s not irrelevant that a ruling in their favor would inflict such damage. To the contrary, that fact helps us correctly interpret the statute’s text. Indeed, it shows that the plaintiffs’ understanding of that text is wrong. (Nicholas Bagley, 2/2)

The Washington Post: James Blumstein On The Administration, The IRS And The ACA: Will The Courts Rein In The President’s Pen?
The IRS regulation being challenged in King is of a piece with the overall Obama Administration strategy of unilaterally extending executive power. President Obama has not been cute about this, asserting his intent to use his “pen” to push the envelope of executive powers and his “phone” to announce and secure support for his unilateral initiatives. No sub rosa stealth there. ... King therefore reflects a challenge to what is perhaps the most significant of the Obama Administration’s executive actions in stretching the ACA. This is what the case is about. (James Blumstein, 2/27)

Viewpoints: GOP Plan Could Hurt CHIP; Abusing Painkillers; Privacy Issues And Genetic Testing

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

The New York Times: Undermining Children’s Insurance
Senior Republicans in Congress are seeking major changes to the Children’s Health Insurance Program when the program’s money runs out in September. Their proposal, labeled a “discussion draft” for legislation yet to be written, could deprive more than a million children of insurance or force their families to pay higher out-of-pocket costs for their coverage. It also would shift costs to states, which would be left holding the bag to pay for the children’s insurance or for the care of the children as uninsured patients. (2/27)

The New York Times: Governors Can Run, But They Can’t Hide
[Wisconsin Gov.Scott] Walker and the other governors jostling for the nomination, like Chris Christie of New Jersey and Bobby Jindal of Louisiana, are finding that for all their powers and spotlighted opportunities, governors can run for the White House, but they can’t hide from their state records. ... One Republican governor mentioned as a candidate, Mike Pence of Indiana, could offer the virtue of a budget surplus. But this healthy fiscal status was bolstered by his acceptance of Medicaid expansion funds under health care reform — a no-go zone for Republican zealots like Mr. Walker and former Gov. Rick Perry of Texas as they campaign for the White House by denouncing Obamacare. (2/28)

The Washington Post's Post Partisan: The Exquisite Hypocrisy Of GOP Medicaid Expansion Rhetoric
In the current fight over expanding health-care coverage to low-income people, Republican state leaders often deploy some version of this argument: States shouldn’t accept billions in federal money to expand their Medicaid programs because the debt-burdened federal government won’t keep its financial commitments. Responsible leaders shouldn’t structure their budgets on the fiction that the federal government will maintain the same level of support in the future, lest states be left with the expansion bill years down the road. But in policy areas outside the Affordable Care Act’s Medicaid expansion, GOP state leaders don’t demonstrate the same amount of concern that a tottering federal Treasury is likely to renege on its obligations to the states. (Stephen Stromberg, 2/27)

The New York Times: Government Is Not The Enemy
In health care, government has created a staggeringly inefficient system that often answers to the needs of centralized management rather than consumers. There’s no motivation to provide better care at lower costs. The solution is not for government to define every service or set every price but to infuse health care with market principles, creating competition and giving consumers more choices, not fewer. ... What conservatives should be aiming for is not a slightly less costly liberal welfare state or simply slowing government’s one-way ratchet toward progressivism. They should be more ambitious and more creative: transforming government programs to make them more modern, efficient, responsive and accountable — to have them support and encourage individual initiative, not replace it. (Peter Wehner, 2/28)

Bloomberg: Give Jonathan Gruber A Break
Jonathan Gruber -- yes, that Jonathan Gruber -- is in trouble again. This time he's being pummeled by liberal state governments for whom he's done work. Massachusetts Governor Charlie Baker demanded Gruber's resignation from the board of the state's Health Connector insurance website. And more troubling, the Vermont state auditor has raised questions over bills Gruber submitted to the state government for consulting work. ... It's another bad week for a guy who's had a lot of bad weeks recently. Is it merited? For all that Gruber and I vehemently disagree about health-care policy, and for all that I think his comments about stupid voters displayed a galloping case of unseemly arrogance toward the people he professed to be serving, I'm not entirely sure it is. (Megan McArdle, 2/27)

The New York Times' The Upshot: L.B.J. And Truman: The Bond That Helped Forge Medicare
Lyndon B. Johnson was often derided for being egocentric, but when it came time to sign his landmark bill creating Medicare, 50 years ago this July, he graciously insisted on sharing the credit with the 81-year-old Harry Truman. At almost the last moment, Johnson decided to change the location from Washington to Truman’s presidential library in Independence, Mo. During the ceremony, Johnson noted that in 1945, the newly installed President Truman had called for national health insurance, planting “the seeds of compassion and duty which have today flowered into care for the sick, and serenity for the fearful.” Johnson then presented his host with the nation’s first Medicare card. Deeply moved, Truman later wrote in a letter to Johnson that the ceremony was “the highlight of my post-White House days.” (MIchael Beschloss, 2/28)

The New York Times: Painkiller Abuses And Ignorance
The epidemic of deaths and addiction attributable to opioid painkillers continues unabated even as an authoritative new review of scientific studies has found no solid evidence that opioids are effective in relieving long-term chronic pain. (3/2)

USA Today: Bad Feds, Deadly Meds
In December, the Department of Justice indicted 14 people who worked at the New England Compounding Center. The company manufactured drugs in insanitary conditions that produced a fungal meningitis outbreak that killed 64 people and made 751 gravely ill in 2012. One of the owners and a senior pharmacist face charges of racketeering and second-degree murder. ... The indictments are good news. If convictions are obtained, they will serve as some deterrent to further misconduct within an industry that continues to be virtually unregulated.(Rena Steinzor, 2/28)

The New York Times' Room For Debate: 23andMe And The Promise Of Anonymous Genetic Testing
The F.D.A. has allowed 23andMe to market genetic tests for mutations directly to the public. The agency said that, for the most part, so-called carrier tests would no longer need advance approval before being marketed this way. But 23andMe is also offering access to its data for research, opening up questions about privacy and anonymity. Should commercial companies share genetic information for research purposes? Is it an invasion of privacy or is the potential for scientific breakthrough more important? (3/2)

The Wall Street Journal: Debt-Saddled Municipal Budgets Get A Lifeline
While underfunded public-employee pensions capture the headlines, health-insurance benefits for retired state and local workers are also a huge problem. But a recent ruling by the Supreme Court may help state and local governments scale back these benefits. Unlike public pension plans, retiree health benefits aren’t funded in advance; they are typically paid out of current tax revenues, so they compete with other budget priorities like schools and police. This competition will only grow more intense, as unfunded retiree health benefits are close to $1 trillion, according to a recent study in the Journal of Health Economics. (Robert C. Pozen and Ronald J. Gilson, 3/1)

USA Today: Taming Retiree Health Care
Good news: Recurring, predictable out-of-pocket health care expenses remain somewhat stable over the course of retirement. The bad news: Non-recurring unpredictable expenses — such as surgery, hospitalizations, and nursing home care — increase with age, tend to be more expensive, and, in the absence of a plan to manage those costs, can wreak havoc on a household's finances, according to research just published by the Employee Benefit Research Institute (EBRI), a nonpartisan research institute based in Washington, D.C. (Robert Powell, 2/28)