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Kaiser Health News Original Stories

2. Political Cartoon: 'Call It A Day'

Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'Call It A Day'" by Rina Piccolo.

Here's today's health policy haiku:


Docs anticipate
How their performance rates, 'cause
MIPS evaluates.

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Summaries Of The News:

Health Law Issues And Implementation

3. House Republicans Win Lawsuit Over Obamacare Subsidies

A federal judge rules in favor of lawmakers who sued the Obama administration over funding for the Affordable Care Act's cost-sharing subsidy program. Anticipating an appeal, the judge stayed the order. The ruling, if it stands, could be a significant financial setback for the millions of low-income Americans who benefit from the cost-sharing subsidies.

The Associated Press: Judge Sides With House Republicans Against Health Care Law
In a setback for the Obama health care law, a federal judge ruled Thursday that the administration is unconstitutionally subsidizing medical bills for millions of people while ignoring congressional power over government spending. The ruling from U.S. District Judge Rosemary Collyer was a win for House Republicans who brought the politically charged legal challenge in an effort to undermine the law. (5/12)

The New York Times: Judge Backs House Challenge To A Key Part Of Health Law
Judge Rosemary M. Collyer sided with the House in its challenge to the administration’s funding of a program to help as many as seven million lower-income people pay deductibles, co-payments and other out-of-pocket expenses under the law. Congress never provided explicit authority for the spending, she ruled. “Such an appropriation cannot be inferred,” the judge said in her opinion. She blocked further spending under the program but said that order would be suspended pending an appeal by the Obama administration. No immediate disruption in the program was anticipated. (Hulse, 5/12)

USA Today: Federal Judge Strikes Down Obamacare Payments
Cost-sharing subsidies reduce consumers' insurance payments — an important feature of the Affordable Care Act, because deductibles are rising. Under the law, subsidies are available to people who earn between 100% and 400% of the federal poverty level, with extra assistance available for those up to 250%. For a family of four, that’s about $24,000 to $61,000. (Wolf, Korte and O'Donnell, 5/12)

The Washington Post: Judge Strikes Down Obama Health Law Insurance Subsidy In Victory For House GOP
The House GOP argued that the administration’s decision to subsidize deductibles, co-pays and other “cost-sharing” measures was unconstitutional because Congress rejected an administration request for funding in 2014. Obama officials said they withdrew the request and spent the money, arguing that the subsidies were covered by an earlier, permanent appropriation. House Republicans have tried repeatedly, without much success, to repeal parts or all of the health-care law, holding dozens of votes on the matter over the past five years. Thursday’s ruling may represent their most significant victory in trying to dismantle the ACA. (Hsu, Jaffe and Sun, 5/12)

Los Angeles Times: Federal Judge Rules Obamacare Is Being Funded Unconstitutionally
The 38-page opinion highlights the repeated complaint from Republicans that Obama and his administration have ignored constitutional limits on their authority. The Constitution says "No Money shall be drawn from the Treasury, but in Consequence of Appropriations made by Law," Collyer noted, but the administration has continued to pay billions to insurers for their extra cost of providing health coverage. "Paying [those] reimbursements without an appropriation thus violates the Constitution," she wrote. "Congress is the only source for such an appropriation, and no public money can be spent without one." (Savage, 5/12)

Politico: House GOP Wins Obamacare Lawsuit
The ruling, if it stands, could be a significant financial setback for the millions of low-income Americans who benefit from the cost-sharing subsidies, which help people pay for out-of-pocket costs like co-pays at a doctor’s office. It would not be a fatal blow to the future of the president’s signature domestic policy achievement, but it could push insurance costs higher. (Haberkorn, 5/12)

The Wall Street Journal: Obama’s Health Law Wrongly Repaying Funds to Insurers, Judge Says
The White House had hoped to move beyond years of blockbuster court battles, most of which it won. The ruling gives a boost to GOP arguments that Mr. Obama has exceeded limits on his authority. And if it holds up on appeal, the decision could hobble the health law. White House spokesman Josh Earnest referred questions about an appeal to the Justice Department, but said the lawsuit was an unprecedented use of the courts to resolve a political dispute between the two parties. “It’s unfortunate that Republicans have resorted to a taxpayer-funded lawsuit to refight a political fight that they keep losing. They’ve been losing this fight for six years. And they’ll lose it again,” he said. (Kendall, Armour and Wilde Mathews, 5/12)

Politico: Insurers Could Face Financial Blow If Obamacare Subsidies Struck Down
Health plans would likely feel the financial hit if the courts ultimately strike down Obamacare's cost-sharing subsidies. That's because those payments go directly to insurers to make up for lower payments from their poorest customers. A federal court ruled today that the Obama administration has been improperly funding the cost-sharing subsidies. The ruling is stayed pending appeal, so there will be no immediate fallout for health plans. But at stake is approximately $175 billion over a decade that insurers would receive to subsidize their Obamacare customers. (Demko, 5/12)

The Associated Press: Ongoing Legal Challenges To Health Overhaul
More than six years after becoming law, the Affordable Care Act continues to face legal challenges, including the case decided Thursday by a federal district judge in Washington. Among the pending lawsuits: House of Representatives v. Burwell ... West Virginia v. Health and Human Services Department ... [and] Contraceptive mandate cases. (5/12)

4. GOP's Obamacare Replacement Would Include Changes To Medicare, Taxes On Insurance

The House Republican task force drawing up plans for an alternative health plan offers some details at a closed-door meeting on Capitol Hill.

Morning Consult: House GOP Mulling Medicare Age Changes And Taxation On Premiums
The details of House Republicans’ plan to replace Obamacare are beginning to emerge. ... The plan, even in its draft stages, touches on all aspects of the healthcare system. It discusses the individual insurance market, updates to Medicaid, and possible changes to Medicare. ... [Rep. John] Fleming said other topics discussed in Thursday’s meeting included the tax treatment of individual and employer insurance, which would likely be equalized under the GOP plan. ... Medicare changes discussed at the meeting included enhancing Medicare Advantage, the private alternative to traditional fee-for-service Medicare, and raising the Medicare eligibility age. (Owens, 5/12)

The Hill: GOP Closing In On ObamaCare Alternative, Lawmakers Say
Rep. Phil Roe (R-Tenn.), the co-chairman of the GOP Doctors Caucus, said the plan Republicans have drafted would address ObamaCare, Medicare and Medicaid. The plan will not be put into legislative text, however, meaning it will be less specific and the cost and effect on coverage levels will be harder to assess. Instead, the plan will be a “white paper,” according to Rep. Joe Pitts (R-Pa.). The proposal will include a version of Speaker Paul Ryan’s (R-Wis.) long-standing proposal to make Medicare more market-based, giving seniors a kind of voucher to use for private insurance, according to two Republican lawmakers who attended the meeting. (Sullivan and Ferris, 5/12)

A recent study looks at coverage of lower income children following the implementation of the health law —

Kaiser Health News: Health Coverage Rates For Lower Income Children Improving
Bolstered by the federal health care law, the number of lower income kids getting health coverage continues to improve, a recent study found. During 2014, the first full year of the law’s implementation, 91 percent of children who were eligible for Medicaid or the Children’s Health Insurance Program were enrolled, according to the study by researchers at the Urban Institute. In 2013, that figure was 88.7 percent and only 81.7 percent in 2008. (Andrews, 5/13)

And in insurance marketplace news from Kansas —

The Kansas Health Institute News Service: Selzer: Two More Companies File To Sell Insurance In Marketplace
Kansas Insurance Commissioner Ken Selzer announced Thursday that two companies have filed to sell health insurance plans in Kansas on the individual market, including the federal Affordable Care Act’s online marketplace. UnitedHealthcare’s announcement that it would be pulling out of the marketplace in 2017 opened the possibility that Kansans who shop there would be left with only one choice of insurer. (Marso, 5/12)

Capitol Hill Watch