Kaiser Health News Original Stories

3. Political Cartoon: 'On The Bright Side?'

Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'On The Bright Side?'" by John Darkow, The Columbia Daily Tribune.

Here's today's health policy haiku:

HEALTH LAW CONVERSATIONS

A new dialogue
Change from repeal to improve…
That’s what the prez wants.

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Health Law Issues And Implementation

4. On His Victory Lap, Obama Aims To Change The Conversation To Ways To Improve The ACA

News reports note that, although President Barack Obama does not expect GOP opponents to back off of their opposition to the health law, he still plans to attempt to reframe the discussion to ways it can be improved. Meanwhile, other talk focuses on what is necessary to ensure the measure's long-term success and how lobbyists are gearing up to secure changes.

Politico: Barack Obama Takes An Obamacare Victory Lap
White House aides say the president isn’t under any illusions that Republicans will drop their objections to the Affordable Care Act just because the administration won the last Supreme Court fight. So while Obama will “discuss how we can move forward and continue building on the progress made under the Affordable Care Act,” according to the trip announcement, he’s not planning to get confrontational, avoiding the more controversial elements, one official said. In particular, the president intends to praise the efforts of Tennessee’s Republican governor, who has embraced key parts of Obamacare and is working to expand Medicaid in his state, a key part of the health care reforms and a top Obama priority. (Wheaton, 7/1)

The Associated Press: Obama Aims To Change Conversation Around Health Care Law
President Barack Obama is aiming to change the conversation around his health care law from talk about undoing it to talk of how to make it better. Obama was headed to the Nashville, Tennessee-area on Wednesday to discuss ways to improve the Affordable Care Act, including by extending Medicaid coverage to more low-income people. Tennessee is among about 20 states that have rejected Obama's offer of billions of dollars to help pay to expand the federal-state health care program for the poor. (Superville, 7/1)

The Huffington Post: If Obamacare Is Here To Stay, It's Going To Need Some Fixing. Here Are 5 Ways How
Obamacare is here to stay. That’s the message from President Barack Obama and other supporters of the Affordable Care Act after their victory at the Supreme Court last week. But dodging a lethal legal bullet is not the same thing as ensuring long-term success. And if health care reform is going to achieve the latter, it’s going to need reforms of its own. “We’ve got more work to do,” Obama acknowledged after the high court ruled in his favor on Thursday. (Young, 6/30)

The Hill: Obamacare Ruling Paves Way For Lobbying Blitz
Healthcare lobbyists across Washington are hoping to win long-sought changes to ObamaCare now that the Supreme Court has affirmed the law is here to stay. Last week’s ruling in King v. Burwell has unfrozen the field for dozens of healthcare groups that have been stymied in their efforts to tweak the law while it was still fighting for survival in the courts. (Ferris, 7/1)

The Nashville Tennessean: Lawmakers Downplay Obama's Impact On Insure Tennessee
The specific issues, bills or lawmakers might change, but if there's any constant within the Republican caucuses in the Tennessee House and Senate, it's this: They aren't big fans of President Barack Obama. At the same time, Democrats and supporters of Gov. Bill Haslam's controversial Insure Tennessee plan are using the president's visit Wednesday to a Nashville elementary school as their latest rallying cry to push for Haslam's health insurance plan. (Boucher, 6/30)

5. How The Liberal Justices Steered The Supreme Court In Its Recent Health Law Decision

News outlets analyze the high court dynamics that led to this term's blockbuster decisions, including King v. Burwell.

The New York Times: Right Divided, A Disciplined Left Steered The Supreme Court
The stunning series of liberal decisions delivered by the Supreme Court this term was the product of discipline on the left side of the court and disarray on the right. In case after case, including blockbusters on same-sex marriage and President Obama’s health care law, the court’s four-member liberal wing, all appointed by Democratic presidents, managed to pick off one or more votes from the court’s five conservative justices, all appointed by Republicans. ... For example, in King v. Burwell, the case brought by groups hostile to the Affordable Care Act, Chief Justice John G. Roberts Jr. and Justice Anthony M. Kennedy joined the court’s four liberals in rejecting the challenge to health insurance subsidies provided through federal exchanges. Justices Antonin Scalia, Clarence Thomas and Samuel A. Alito Jr. dissented. (Liptak, 7/1)

Los Angeles Times: A Liberal But Restrained Supreme Court Term
The Supreme Court in the just-completed term passed up a number of opportunities to upend existing law, including the Affordable Care Act. ... The court’s hesitation to strike down existing laws was evident in several cases. ... Justice Kennedy’s votes with the court’s liberals are a major factor in their success. But another conservative justice, Chief Justice Roberts, wrote the majority opinion rejecting a conservative-backed lawsuit that would have gutted the Affordable Care Act. He was joined by the liberal bloc and Justice Kennedy. (Braven, 6/30)

And here's a breakdown of how the ruling will play out in Florida -

The Tampa Tribune: What King V. Burwell Ruling Means For Floridians
Now that the ruling has been made, it’s important for Floridians to understand what it means for them. One of the predictions was that after taking advantage of the insurance subsidies to buy coverage, over 1 million Floridians would owe thousands of dollars to the IRS at tax time. With the subsidies upheld, this is an obstacle averted for 1.3 million Floridians who would have collectively owed more than $4 billion for the 2015 tax year. (Naff, 7/1)

Coverage And Access

6. Negotiations Between Employers, Unions Could Feel The Impact Of Health Law Requirements

These developments are occurring, according to the Wall Street Journal, amidst other cost- and risk-shifting trends.

The Wall Street Journal's CFO Journal: Unions Face Battle-Tested Executives In Talks
While wrangling over benefits is a cornerstone of union negotiations, looming threats facing several big companies—including coping with the requirements of The Affordable Care Act– exacerbate the conflicts, as we reported today in CFO Journal. ... With major tenets of the health law in place for the long haul, labor and management will have to figure out the “subtle, million-and-one smaller points of the bigger package,” he said, such as the excise tax on high-cost plans, or Cadillac tax. Companies could terminate their health care plans, or move employees to higher deductible plans. (Johnson, 6/30)

The Wall Street Journal: Bosses Reclassify Workers To Cut Costs
As courts and regulators increase their scrutiny of the relationship between businesses and independent contractors, employers are turning to a range of tactics to classify workers, taking them off the formal payroll and lowering costs. ... All this is happening against the backdrop of a broader shifting of risk from employers to workers, who shoulder an increasing share of responsibility for everything from health-insurance premiums to retirement income to job security. Alleged misclassification of workers has been one of the primary battlegrounds of this shift. (Weber,6/30)

And what about that expected overtime rule -

Modern Healthcare: Healthcare Workers Wonder How Expected Overtime Rule Affects Them
The home-care sector is keeping an eye out for an expected move by the White House to make up to 5 million more people eligible for overtime pay. Some say it could benefit fee-based employees while others believe it could cause employers to scale back on hiring specialized workers. A new rule from the Labor Department would more than double the threshold at which employers can avoid paying overtime, to $970 a week, by next year. (Sandler, 6/30)

7. Same-Sex Marriage Ruling Has Huge Impact On Private, Public Employers

The Wall Street Journal examines the implications for companies that offer spousal health benefits and fund those through a separate insurance company, as well as for those that are self-insured. The Texas Tribune reports that starting Wednesday, employees of Texas government agencies, universities and schools can enroll a same-sex spouse in their benefit program. And Modern Healthcare delves into the implications for Medicaid programs.

The Wall Street Journal: What Employers Need To Know About Court’s Gay-Marriage Ruling
The Supreme Court on Friday ruled that same-sex couples have a constitutional right to marry, meaning that same-sex marriages must be recognized nationwide. The ruling will have vast implications for employers, which until now have been operating under a patchwork of different state and federal laws governing the legal and tax treatment of same-sex unions. ... Companies that offer spousal health benefits and use a separate insurance company to fund their benefits will now be required to cover both gay and straight spouses. ... But companies that are self-insured, which means they assume the insurance risks for their own employees, a common practice among large companies, aren’t under the same legal constraints. (Silverman, 6/30)

Modern Healthcare: Marriage Ruling Brings Medicaid Costs And Benefits For Same-Sex Spouses
The U.S. Supreme Court's decision last week to legalize same-sex marriage across the country will have mixed effects for same-sex couples when it comes to Medicaid. In Obergefell v. Hodges, the court ruled 5-4 that same-sex marriage is a fundamental right guaranteed by the 14th Amendment. Prior to the ruling, same-sex marriage only was allowed in 37 states and the District of Columbia. Experts say the ruling will affect coverage rules for both Medicaid medical and long-term-care benefits. (Dickson, 6/30)

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