Kaiser Health News Original Stories

2. Political Cartoon: 'Rear Its Head?'

Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'Rear Its Head?'" by Paul Fell.

Here's today's health policy haiku:


Come on Supreme Court
We have waited long enough
Let's hear what you think.

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Health Law Issues And Implementation

3. Best For Last: Supreme Court Will Rule On Six Highly Anticipated Cases By Monday

It's not just King v. Burwell that court watchers are awaiting: Big issues remaining on the docket are gay marriage, execution methods, power-plant emissions, housing discrimination and congressional redistricting. The justices will hand down decisions Thursday, Friday and Monday before the end of the term.

The Wall Street Journal: Supreme Court Guide: Six Big Decisions Remain
The Supreme Court is scheduled to issue decisions Thursday, with six major cases remaining on the docket, and is expected to release opinions again on Friday and perhaps next week. Still to be decided are the health-law subsidies and gay-marriage cases, along with closely watched rulings involving congressional redistricting and power plant emissions. Here’s a list of the remaining cases. ... King v. Burwell Issue: Whether the Affordable Care Act authorizes tax credits for insurance bought on healthcare.gov, as well as on state-operated insurance exchanges. The case turns on a single word in the 2,000-plus-page statute, in a clause authorizing the tax credits for policies purchased on an exchange established “by” the state. Only 13 states and the District of Columbia currently run their own exchanges. The court could potentially strike down subsidies in as many as 37 states that depend on HealthCare.gov. (6/24)

USA Today: The Six Major Cases Awaiting Supreme Court Rulings
The future of President Obama's health care law is on the line for the second time in three years, and it's anyone's guess how the court will rule. Passed in 2010 and narrowly upheld by the court in a 5-4 ruling in 2012, the law has extended health insurance to 12 million Americans. But four words in its lengthy text — "established by the state" — now endanger federal subsidies relied upon by 6.4 million participants in 34 states that did not create their own exchanges or marketplaces. The justices must decide whether the law prohibits that financial aid. (Wolf, 6/25)

Business Insider: Justice Kennedy Could Save Obamacare And Screw The Federal Government At The Same Time
The Supreme Court is preparing to hand down a decision in the all-important King v. Burwell case, and Justice Anthony Kennedy could again play a key role in deciding the fate of healthcare reform. Kennedy made a comment during the case's oral arguments that led some observers to speculate that he was leaning toward siding with the Obama administration in the case, which centers on a key provision of the Affordable Care Act. (Logiurato, 6/24)

4. A Decision Upending Subsidies Could Undermine The Health Industry's Agenda

Media coverage in advance of the Supreme Court's decision in King v. Burwell examines a variety of ways in which the ruling will make an impact.

Some entrepreneurs, though, see opportunity -

Marketplace: Bridging A Political Divide, Hoping To Make A Profit
If the court rules against the Obama administration, millions of people in states using the federal exchange could lose their subsidies. Enter entrepreneurs, who think they’ve found a way to help states set up exchanges almost immediately. Sanjay Singh is one of them. He's CEO and co-founder of hCentive, a tech start-up that supplies the software for state health care exchanges. hCentive helped Kentucky and New York set up their exchanges. They're two of the more glitch-free state marketplaces. (Marshall-Genzer, 6/24).

Meanwhile, news outlets also examine how the loss of subsidies would play out in their states -

MLive: Obamacare Ruling Could Spell Trouble For Michigan Medicaid Expansion And 600,000 Enrollees
Michigan's popular Medicaid expansion program will face an uncertain future if the U.S. Supreme Court strikes down a key plank of the Affordable Care Act this month. A case before the nation's highest court seeks to invalidate premium tax credits that more than 225,000 Michigan residents have used to purchase private health insurance through a federal exchange. Those same tax credits are featured in a pending waiver the state must win from the Obama administration in order to continue Healthy Michigan, a federally-funded Medicaid expansion program that has enrolled roughly 600,000 low-income residents since implementation but could be rolled back in 2016. (Oosting, 6/24)

The Associated Press: Michigan Health Care Expansion To 828,000 Rests On DC Action
The expansion of medical insurance to 828,000 Michigan residents under two major components of the federal health care law is unsettled at the U.S. Supreme Court and inside the Obama administration. The court will rule in the coming days on the legality of tax subsidies for 228,000 residents who have bought private insurance through a federal marketplace. Michigan, where participants' premiums are offset by an average $273 monthly tax credit, is among 34 states that could be affected. (Eggert, 6/24)

Health News Colorado: Supreme Court Ruling Could Leave Colorado Without ‘Escape Hatch’
Since Colorado created its own exchange, you might think that the relevance of the King v. Burwell boils down to one word for you: “whatever.” Think again. The King case is likely to have profound reverberations throughout the U.S. Without subsidies in a majority of states, the “individual mandate,” which requires people to buy health insurance, likely would fall apart. And if fewer healthy people buy health insurance, prices could shift dramatically — even in states with their own exchanges. (Kerwin McCrimmon, 6/25)

Connecticut Health I-Team/San Antonio Press Express: Connecticut And The Supreme Court Challenge To Obamacare
Tens of thousands of Connecticut residents who receive federal subsidies to help pay for health insurance won’t be affected immediately by the latest challenge to the Affordable Care Act before the U.S. Supreme Court. But experts say there’s a good chance Connecticut residents will experience some political fallout from the court decision challenging the validity of federal premium tax credits to those in states with federally-operated insurance marketplaces (also known as exchanges). The ruling could come as soon as Thursday. (Olivero, 6/24)

Nashville Tennessean: King Vs. Burwell Decision Lingers, Glimpses Emerge
With a ruling for "the plaintiff, King, we could find a short-term drop in health care stocks. The for-profit providers and health insurers? (The exchanges have) been good for them," said Fletcher Lance, managing director at consulting firm North Highland. "This could be a short-term blip." The ruling for Team King may have an immediate impact on stock prices of health care companies, but its long-term implications could reverberate far beyond those who invest in stocks or even those who receive tax credits. "It may not impact you directly, but it's going to impact everyone indirectly. Those marketplaces are key to having a fair and just health system that helps those of modest needs get covered," said Leibold, chief advocacy officer for Ascension Health. (Fletcher, 6/24)

What about states that established their own insurance marketplaces? News outlets report on what could occur in a state like California, and also how these states could help others that haven't set up their own exchanges -

The Sacramento Bee: U.S. Supreme Court Ruling Won’t Stop State’s Health Exchange
A U.S. Supreme Court decision due as early as Thursday could end health care subsidies for nearly 6.4 million residents of states that take part in the federal health insurance exchange under the Affordable Care Act, but most experts say Californians who have subsidized insurance under the state’s own exchange needn’t worry – at least in the short term. (Sangree, 6/24)

The Huffington Post: Obama May Have To Lean On Democratic Governors To Resell His Health Care Law
If the Supreme Court strikes down Obamacare subsidies in two-thirds of the country, President Barack Obama won't be the only leader offering to assist states that want to undo the damage. Officials in states that created their own health insurance exchanges under the Affordable Care Act -- thereby shielding their residents from the possible consequences of the lawsuit currently pending before the high court -- are standing by to help their counterparts in other states get marketplaces up and running that would allow subsidies in those states to flow again. (Young, 6/24)

In other health law news, continuing coverage of a recent report that details how the health law has impacted the uninsured rate  -

Nashville Tennessean: TN Official: 30% Health Insurance Hike May Not Be Enough
There's a chance some of the health insurance premium increases requested by insurers won't be enough [to] cover losses, a state official testified in Washington, D.C. Julie Mix McPeak, commissioner of the Tennessee Department of Commerce and Insurance, said raising rates by 30 percent or more might not even be "sufficient" to cover the soaring costs of medical claims. (Fletcher, 6/24)

The Charlotte Observer: Report: NC Uninsured Fell 13% In ACA's First Year
North Carolina’s uninsured rate dropped 13 percent in 2014, the first year that most Americans were required to have health insurance under the Affordable Care Act. The new information from the National Center for Health Statistics is the first official government tally of the federal health law’s effect on the uninsured. Government statistics on uninsured rates lag by about year-and-a-half, so that last year’s data from the U.S. Census Bureau is not expected to be issued until September. (Murawski, 6/24)

5. Public Opinion Of Obamacare Remains Sharply Divided In Latest Poll

In a new NBC-Wall Street Journal survey, 48 percent said the health law is either working well or only needs minor improvements, while 50 percent said it needs a major overhaul or should be eliminated. Ahead of the Supreme Court's decision on the law's health insurance subsidies, those polled were also divided on the political leanings of the justices, with 39 percent believing the court is too liberal, 38 percent saying it's too conservative and 6 percent saying it's "about right."

The Wall Street Journal: Poll Finds Backing For Gay Marriage And A Split On Health Law
The American public strongly favors the prospect of the Supreme Court legalizing same-sex marriage nationwide but remains split over the 2010 health law, a Wall Street Journal/NBC News poll finds just ahead of expected high-court rulings on both matters. ... The court is also expected soon to rule on whether low-income residents of states that didn’t set up insurance marketplaces under the 2010 health law are entitled to the same subsidized health insurance as those in states that created their own marketplaces. Support for the law has improved since the disastrous rollout of the new marketplaces in the fall of 2013. The latest poll, which surveyed 1,000 adults between June 14 and 18, found Americans almost evenly divided on the law. (O'Connor, 6/25)

The Associated Press: 5 Things: Public Opinion Backs Gov't In Health Care Case

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