Daily Health Policy Report

Monday, March 26, 2012

Last updated: Mon, Mar 26

KHN Original Reporting & Guest Opinion

Health Reform

Capitol Hill Watch

Campaign 2012

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Public Health & Education

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Editorials and Opinions

KHN Original Reporting & Guest Opinion

In Conservative California, Confusion And Contempt For Health Law

KQED's Sarah Varney, working in partnership with Kaiser Health News and NPR, reports: "Here, just a few miles from the entrance to Yosemite National Park, is the Sweetwater Steakhouse, a local watering hole where no one is shy about their opinions of President Obama's signature initiative.… By and large, conservative voters in the county despise the federal health law's mandate that all Americans have health coverage, and many suspect the health insurance system isn't really all that broken" (Varney, 3/24). Read the story.

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Free Health Clinics At A Crossroads

KCUR's Elana Gordon, working in partnership with Kaiser Health News and NPR, reports: "Free health clinics have long been places people turn to when they don't have health insurance or money to pay for care. But the health law's expansion of coverage puts free clinics in uncharted territory.  While the law goes before the Supreme Court this week, health providers are already gearing up for a surge in patients with insurance in 2014" (Gordon, 3/25). Read the story.


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Doctors' Smartphones And iPads May Be Distracting

Kaiser Health News staff writer Jenny Gold, working in collaboration with NPR, reports: "Doctors who carry mobile devices are often hit with a flurry of texts, e-mails, Facebook messages, tweets and other notifications that automatically pop up on the screen, he explains. And because the vast majority of smart phones and tablets are personal devices that belong to individual doctors, the problem can be hard for hospitals to control" (Gold, 3/26). Read the story.

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Capsules: Dozens Gather Outside Court Hoping To Witness, Shape History; Feds To Test Paying For Medicaid Patients With Psychiatric Emergencies

Now on Kaiser Health News' blog, Phil Galewitz reports from the steps of the Supreme Court: "Chanting 'ACA is here to stay,' and accompanied by a trumpet and drums, about 100 supporters of the 2010 health law rallied outside the Supreme Court Monday morning, as attorneys prepared for three days of oral arguments in the most anticipated high court hearing in years. Fewer than 20 health law opponents also demonstrated there, including a handful of tea party activists and anti-abortion demonstrators who wore tape over their mouths" (Galewitz, 3/26).

Also, Sarah Barr reports on a Medicaid pilot program: "A group of states is testing whether Medicaid patients who seek emergency psychiatric care at private psychiatric hospitals are better off if the federal government picks up part of the costs. Right now, the federal government does not help states pay for inpatient psychiatric care for many Medicaid patients—a longstanding policy meant to discourage states from cost-shifting to the federal government and institutionalizing patients" (Barr, 3/23). Read what else is on the blog.

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The Health Law Arguments At The Supreme Court: Day 1 - The Anti-Injunction Act

Monday's Supreme Court oral arguments are scheduled to last 90 minutes and focus on the Anti-Injuction Act, which is "a reconstruction-era statute that bars courts from considering the constitutionality of tax laws until payments are due." It would "apply here if the court deems the individual mandate's penalty provision a 'tax'" (Taylor, updated 3/23). For more information about the arguments, read KHN's Primer For The Upcoming Oral Arguments.

Also, check out Kaiser Health News resource page, The Supreme Court Decides: Health Law At The High Court, for our complete coverage. It includes KHN's scorecard, which tracks the course the legal challenges followed to arrive at the high court; as well as anaylsis, news, briefs and other documents. KHN also has a collection of its coverage related to the law's second anniversary and the high court's review, and will update the web site throughout the day with the latest information and news summaries.


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Political Cartoon: 'The Conductor?' By Adam Zyglis

Kaiser Health News provides a fresh take on health policy developments with "The Conductor?" by Adam Zyglis.

Meanwhile, today we have two health policy haikus: 


Through a glass clearly
Driving hard to disaster
Drunk on the present
-Dr. Joanne Lynn

And in honor of the Supreme Court's first day of oral arguments:


Eyes on Supreme Court
If you aren't wearing a robe
Please wear something nice

If you have a health policy haiku to share, please send it to us at http://www.kaiserhealthnews.org/ContactUs.aspx  and let us know if you want to include your name. Keep in mind that we give extra points if you link back to a KHN original story.

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Health Reform

Day 1 At The Court: Is Time Right For Health Law Review?

Today's oral arguments before the Supreme Court will focus on whether an 1867 law -- the Anti-Injunction Act - allows the court to consider the challenges to the health law before the individual mandate provision takes effect in 2014.  

The Washington Post: Supreme Court To Hear Arguments On Timing Of Health-Care Ruling
The Supreme Court begins its constitutional review of the health-care overhaul law Monday with a fundamental question: Is the court barred from making such a decision at this time? The justices will hear 90 minutes of argument about whether an obscure 19th-century law — the Anti-Injunction Act — means that the court cannot pass judgment on the law until its key provisions go into effect in 2014. It is the rare issue on which both sides agree: the Obama administration lawyers and those representing the states and private organization challenging the new law argue that the Supreme Court should decide the constitutional question now (Barnes, 3/25).

The New York Times: Health Act Arguments Open With Obstacle From 1867
The Supreme Court on Monday starts three days of hearings on the constitutionality of the 2010 health care overhaul law, an epic clash that could recast the very structure of American government. But it begins with a 90-minute argument on what a lawyer in the case has called "the most boring jurisdictional stuff one can imagine." The main event — arguments over the constitutionality of the law's requirement that most Americans obtain insurance or pay a penalty — will not come until Tuesday (Liptak, 3/26).

Stateline: Supreme Court Hears First Issue: Jurisdiction
If the Medicaid portion of the health law is upheld, the work of expanding Medicaid access will be squarely on states' shoulders, although the initial financial burden will be primarily on Washington. States have already been laying the groundwork for the Medicaid expansion, because waiting until the court decides would mean missing the law's deadlines. For the same reason, most states have been developing so-called health insurance exchanges, the law's central mechanism for extending health care access to millions of uninsured Americans (Vestal, 3/26). 

Fox News: First Round Of Supreme Court Health Care Hearings Not About Health Care
For all the anticipation leading up to this week's historic arguments, Monday morning's opener at the Supreme Court isn't about the law itself. It's about the rules of the game. The day may prove disappointing to anyone looking for a vigorous constitutional argument or a hint of how the justices will ultimately rule on the merits of the dispute. Still, the fate of the case rests on this opening round (Ross, 3/26).

Bloomberg: Court Opens Health-Care Debate With Law That Might Derail Case
The U.S. Supreme Court opens today its historic review of President Barack Obama’s health- care law, three days of arguments that might result in the president’s premier legislative achievement being found unconstitutional in the middle of his re-election campaign. The court will determine the fate of a measure designed to extend insurance to about 32 million people and revamp an industry that accounts for 18 percent of the U.S. economy. The six hours of planned debate is the most on a case in 44 years (Stohr, 3/26).

NewsHour: Health Care Reform Heads To The Supreme Court: A Guide To Day 1
Between Monday and Wednesday, the justices will consider several issues, including whether it's constitutional for the federal government to force Americans either to buy health insurance or pay a fine. ... What can we expect on the first day of arguments in this historic case? (Kane, 3/26).

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Spectator Point-By-Point Guides To The Supreme Court's Health Law Review

As the health law's challengers and defenders head to court, media outlets take big-picture looks at how the upcoming three days of arguments could play out, provide primers that detail the key aspects of the issues in play as well and give a heads up on what to watch for.   

The Wall Street Journal: Health Law Heads To Court
The court this week hears three days of arguments on the law's constitutionality, with a ruling expected in late June. The administration and its allies say the court must uphold the law to ensure that Congress can tackle national problems by employing comprehensive solutions. In jeopardy, critics say, is the fundamental American conceit that the federal government should be restricted in what it can require of citizens (Bravin, 3/26).

NPR: 4 Questions That Could Make Or Break The Health Law
At the U.S. Supreme Court, people have been lining up for days, waiting to hear this week's historic oral arguments on President Obama's health care law. The arguments will last for six hours over a three-day period, the longest argument in more than 40 years. The court has boiled the arguments down into four questions. The first, and threshold question is Monday, when the justices must decide whether an 1867 law called the Tax Anti-Injunction Act prevents the court from even considering this bill right now (Totenberg and Rovner, 3/26).

The Wall Street Journal: A Primer On The Issues, Likely Outcomes
With the Supreme Court set to hear arguments Monday on the 2010 health-overhaul law, here is a primer on some of the legal issues. Q: What will the Supreme Court try to determine when it reviews the health law starting Monday? A: There are multiple issues in the case, but the main one is whether the law's requirement that most people carry insurance or pay a fee, known as the "individual mandate," violates the Constitution (Radnofsky, 3/25).

Politico: 5 Things To Watch In Health Law Arguments
The Super Bowl for Supreme Court watchers kicks off this week as the justices hear three days of oral arguments in what could be the blockbuster case of a generation: whether President Barack Obama's signature law overhauling the American health care system is constitutional. The stakes couldn't be higher for Obama, for the balance of power between the states and federal government and for the reputation of the court itself (Haberkorn and Gerstein, 3/26).

Politico: Pick An Ending: 6 Ways The Supreme Court Might Rule
The health reform law is complex, and the Supreme Court has a lot of options, ranging from upholding the entire law to overturning it completely. Based on the arguments being made by the law's opponents and the Justice Department, these are the likely scenarios (Nather, 3/26).

Reuters: Supreme Court Weighs Historic Health Care Law
Two years after President Barack Obama signed into law a health care overhaul, the Supreme Court on Monday takes up a historic test of whether it is valid under the country's Constitution. The sweeping law intended to transform health care for millions of people in the United States has generated fierce political debate. Republicans challenging Democrat Obama for the presidency in November and Republican members of Congress have vowed to roll back the March 23, 2010, law they say will financially burden states, businesses and individuals. Now, the health care battle moves from the U.S. political arena to the less raucous world of its highest court (Biskupic and Vicini, 3/26).

USA Today: 3 Epic Days: Health Care Law Reaches High Court
Health coverage for more than 30 million people. The power of Congress to regulate interstate commerce. President Obama's re-election. The reputation of the Supreme Court and the legacy of its chief justice. And to hear some tell it: liberty. All that and more could be at stake today when the Supreme Court begins three days of historic oral arguments on a 2010 health care law that has become a symbol of the nation's deep political divide (Wolf, 3/25).

The Associated Press: How Health Care Case Will Unfold Before The Court
The Supreme Court will begin hearing arguments on Monday over President Barack Obama's health care overhaul, the Patient Protection and Affordable Care Act, derisively labeled "Obamacare" by its opponents. A look at how the case will unfold before the court in question-and-answer form (Holland, 3/26).

San Francisco Chronicle: U.S. Supreme Court Health Care Law Review To Start
The stakes couldn't be higher as legal and health policy experts parse each word the justices utter during six hours of oral arguments over three days this week, sifting for clues on how they will rule in what's shaping up as a landmark decision.The court's opinion, expected by the end of June, could well be its most significant statement on the limits of congressional regulatory power since the 1930s, when the justices struck down and then upheld President Roosevelt's New Deal (Freedman and Colliver, 3/26).

The Philadelphia Inquirer: Health Care Reform On The Docket
It is the legal equivalent of the Super Bowl, the World Series, and the NBA playoffs rolled into one. When the nine justices of the United States Supreme Court gather Monday in their ornate courtroom to begin three days of hearings on President Obama's overhaul of the nation's health care system, they will be deciding the constitutionality of what many experts say is the most far-reaching economic and social legislation since the Great Society programs of the 1960s. … Although the court is divided along ideological lines, there is no clear indication of how it will rule (Mondics, 3/25).

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Setting The Scene: Court Arguments Offer Different Kind Of Drama

With no Twitter, cameras or telephones allowing reports from inside the court, much of the action will take place on the outside. A range of groups have planned demonstrations. All the while, the lawyers involved in the arguments have been busy with "moot court" practice sessions; spectators have been waiting in line in hopes of getting a seat; and stakeholders, such as the health care industry, are anxiously watching for clues to the outcome.   

McClatchy: Supreme Court Health Care Arguments To Begin Monday
The circus surrounding the Supreme Court health care arguments this week will begin before dawn Monday. Demonstrators will be gathering around the Supreme Court steps. Nearby, assembled radio talk show hosts will be broadcasting live starting at 6 a.m. Civilians will be lined up, hoping for precious spots inside. Later, politicians will stroll in to claim reserved seats. The center ring, of course, should remain dignified, even as justices shortly after 10 a.m. commence the most anticipated oral arguments in years. And by the time arguments end Wednesday, spectators should know more about whether the court believes the Obama administration's signature health care law exceeds Congress's constitutional authority to regulate commerce (Doyle and Lightman, 3/25).

The New York Times: In Health Care Case, Lawyers Train For 3-Day Marathon
Last week, there were so many of the mock arguments that lawyers call moot courts that they threatened to exhaust something that had never been thought in short supply: Washington lawyers willing to pretend to be Supreme Court justices. The problem, said Paul D. Clement, who represents the 26 states challenging the law, was not just the length of the arguments the court will hear, but the variety of topics to be addressed (Liptak, 3/25).

The New York Times: Neither Phones, Nor Cameras, Nor Tweets In The Courtroom
On three mornings this week, a select group of reporters, lawyers and observers will crowd into the court's august chamber as the nine justices grill the advocates in a case freighted with huge legal and political implications. No Twitter messages will be allowed. No one in the room will be permitted to make a telephone call. There will be no BlackBerrys or laptops or iPads to blog with (Shear, 3/26).

The Associated Press: Decibel Alert: Partisans Dial Up Health Care Noise
America's national shouting match over health care will only get louder next week as the Supreme Court weighs the fate of President Barack Obama's overhaul. With formal arguments off-limits to cameras, supporters and detractors have laid elaborate plans to compete for the public's attention outside the Supreme Court building (Alonso-Zaldivar, 3/24).

The New York Times: Waiting (And Sleeping) In Line, For View Of Health Care History
Heading into the first of three days of Supreme Court arguments on Monday, the pavement occupied by the approximately 15 people in line Sunday morning was among the most coveted real estate in Washington. Tickets are scarce even for those connected to the case. And for everyone else, there's the line (Huetteman, 3/25).

Reuters: Two Sides On Health Care Law To Face Off Outside U.S. Top Court
A battle for American hearts and minds will rage outside the Supreme Court next week as justices inside hear arguments on President Barack Obama's signature health care law. An opposition rally, news conferences, squads of talk radio hosts, doctors in scrubs and Republicans opponents by the busload will all be part of the furor surrounding proceedings on the Patient Protection and Affordable Care Act (Simpson, 3/23).

Reuters: Tea Party Activists Defy Rain To Rip Obama Health Care Law
Several hundred rain-soaked Tea Party activists rallied on Saturday to call for the U.S. Supreme Court to repeal President Barack Obama's signature health care law after arguments next week. Speaker after speaker at the two-hour protest in the shadow of the U.S. Capitol tore up copies of the law and condemned it as a threat to American freedoms and a violation of the Constitution. The flag-waving rally by the Tea Party movement, which fueled a conservative Republican wave in 2010 mid-term elections, was an early start to demonstrations by opponents and supporters of the law around the Supreme Court arguments (Simpson, 3/24).

NPR: Employers Monitor Health Care Law Arguments
The Supreme Court won't rule on President Obama's health care case until June. Republicans vow to repeal the law if they win big in November. David Wessel, economics editor of The Wall Street Journal, talks to David Greene about how the ruling could affect doctors, hospitals, employers and consumers (Wessel and Greene, 3/26). 

Related, earlier KHN story: Health Industries Weigh In On Supreme Court Case (Hancock, 3/22).

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Politics Provides The Backdrop For Justices' Consideration Of Health Law

The proceedings at the high court could shake the fall elections in a variety of ways. Even before the arguments begin, both sides of the fight are a bit battleworn from the court's past rulings and the path that has led to this week's clashes.  

The Associated Press/Washington Post: Supreme Court Begins Review Of Far-Reaching Obama Health Law Amid Political Campaigns
A decision is expected by late June, in the midst of a presidential election campaign in which all of Obama's Republican challengers oppose the law and promise its repeal, if the high court doesn't strike it down first. People hoping for a glimpse of the action have waited in line all weekend for the relatively few seats open to the public. The justices allotted the case six hours of argument time, the most since the mid-1960s (3/26).

NPR: In Health Case, Combustible Mix Of Politics And Law
U.S. Supreme Court is set to begin hearing oral arguments Monday in a Republican-led challenge to the national health care law that has convulsed the country and its political class for more than two years -- and may well define President Obama's tenure in the White House (Halloran, 3/25).

The Associated Press: Court's Health Ruling Could Shake Fall Elections
No doubt, a decision to throw out the entire law would be a defeat for Obama. His judgment and leadership, even his reputation as a former constitutional law professor, would be called into question for pushing through a contentious and partisan health insurance overhaul only to see it declared unconstitutional by the court. But it would not spell certain doom for his re-election. In fact, it would end the GOP argument that a Republican president must be elected to guarantee repeal of the law. It also could re-energize liberals, shift the spotlight onto insurance companies and reignite a debate about how to best provide health care (Kuhnhenn, 3/26).

Roll Call: Supreme Court Ruffles Democrats' Feathers
When the Supreme Court begins to deliberate President Barack Obama's signature health care law Monday, it will serve as a bitter reminder to Democrats of the blows leveled at their causes by the conservative Roberts court. Though the outcome of the high-profile case reviewing the constitutionality of the health care law's marquee feature, the individual mandate, is unknown, plenty of other decisions have given Democrats pause or even rallied them to battle with the court in ways rarely seen before (Shiner, 3/26).

The Wall Street Journal: Health Law Foes' Rocky Road To High Court
If the lawsuit contesting President Barack Obama's health care overhaul is to succeed, it will have to overcome setbacks that left the challengers with unfavorable lower-court rulings and a less-than-ideal plaintiff. Some participants in the challenge say the setbacks could have been minimized with a more focused strategy that was proposed early on by some prominent conservative lawyers but never fully adopted, while others say any past stumbles will ultimately have little significance (Bravin, 3/24).

Politico: How The Legal Assault On Obama's Health Law Went Mainstream
When President Barack Obama signed the health care bill two years ago, the legal challenges to the law were widely belittled as long shots -- at best. But as the cases head to the Supreme Court this week, what looked to many like far-out legal arguments to undo "Obamacare" don’t seem so zany anymore (Gerstein, 3/25).

Des Moines Register: Harkin Fears Political Tilt In Justices' Health Law Ruling
U.S. Sen. Tom Harkin on Friday questioned whether the U.S. Supreme Court could set aside political predispositions when judging the constitutionality of President Barack Obama’s signature health care law ... He strongly defended its constitutionality: "Judges in the lower courts … have made it very clear that arguments against the act lack merit. They have no basis in law," he said. "To overturn this health reform bill would overturn 70 years of precedents. So I'm hopeful that on all those issues that they're going to hear next week that the court will rule that it is constitutional and we can move ahead" (Noble, 3/23).

Also in the news, polls tap into voters' expectations of the Supreme Court justices as well as public opinion of the law itself --

The Hill: Hill Poll: Voters Expect Justices' Personal Views To Decide Health Care
Half of likely voters want the Supreme Court to overturn President Obama's health care law, according to The Hill's latest poll. Just 42 percent said the court should uphold the law, with 50 percent saying it should be struck down. A majority of both men and women want the law voided. ...  While even the youngest voters oppose the law (47 percent to 42 percent among those aged 18-39), opposition grows to 53 percent among voters aged 65 and older (Baker, 3/26).

CBS: Poll: 47% Disapprove Of Obama Health Care Law
As the Supreme Court embarks on three days of historic arguments over President Obama's health care law -- two years after the law was enacted -- Americans remain skeptical about the legislation. A CBS News/New York Times poll shows 47 percent of Americans disapprove of the president's Affordable Care Act, including 30 percent who strongly disapprove. In the poll, conducted March 21-25, only 36 percent of those questioned said they support the law either somewhat or strongly (3/26).

Meanwhile, both The Associated Press and Politifact offer historical perspectives of this landmark legal challenge --

The Associated Press: America's Health Care Reform Through History
The three days of arguments beginning before the Supreme Court on Monday may mark a turning point in a century of debate over what role the government should play in helping all Americans afford medical care. A look at the issue through the years (Cass, 3/26).

Politifact: Switching Sides On The Individual Mandate
Once upon a time, the individual mandate was the preferred health care policy of many Republicans. The year was 1993. President Bill Clinton had proposed a complicated health bill ... In response, a group of Senate Republicans introduced their own plan, inspired by ideas from conservative think tanks in Washington like the Heritage Foundation. ... When Hillary Clinton released her plan, it too had an individual mandate. Obama's plan didn't. And when the candidates started debating the merits of their proposals, Obama leaned into the difference, releasing ads attacking the mandate as punitive (Holan, 3/25). 

And, The New York Times reports that, as the Supreme Court takes up the health law, it will be moving the focus of the health care debate from the campaign trail to Capitol Hill --

The New York Times: Debate Shifts From The Trail To The Capital
For months, the political debate in Washington has been defined largely by the seemingly constant confrontations on the Republican presidential campaign trail. That is about to change, at least for a while. … Here is a look at five issues that will return to the spotlight: HEALTH CARE The Supreme Court's decision to hold an unprecedented three days of oral arguments about President Obama's health care law is certain to push the issue to the forefront of the political debate this week -- and probably for the rest of the spring (Shear, 3/26).

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States Brace For Impact Of Health Law Ruling

Even with the health law's future in question, news reports indicate that some states are pressing forward with implementation, while another -- Massachusetts -- considers itself untouched by what becomes of the federal law. All the while, the politics of the health overhaul will play a significant role at the state level, too.

WBUR's State of Health blog: Why Historic SCOTUS Case Doesn't Really Matter For Massachusetts
The question for the high court is whether the requirement that residents have health insurance is constitutional. But either way, it is already part of state law in Massachusetts and would stand regardless of what the Supreme Court decides. ... Harvard Law School professor Lawrence Tribe says, "there are no legal issues before the Court in which a decision would either trump the Massachusetts law or compel a review of that law." ... What if the justices decide the federal government can't force states to expand coverage for low income residents? Massachusetts is doing this voluntarily (Bebinger, 3/26). 

Kaiser Health News: In Conservative California, Confusion And Contempt For Health Law
Here, just a few miles from the entrance to Yosemite National Park, is the Sweetwater Steakhouse, a local watering hole where no one is shy about their opinions of President Obama's signature initiative. ... By and large, conservative voters in the county despise the federal health law's mandate that all Americans have health coverage, and many suspect the health insurance system isn't really all that broken (Varney, 3/24).

Arizona Republic: Arizona Moves Forward On Health Law
The U.S. Supreme Court is opening its debate today on whether the nation's new health care law is constitutional. Regardless of its legality, the law already has delivered significant changes in how hundreds of thousands of Arizonans get care. And despite Gov. Jan Brewer's opposition to the law, millions of dollars are earmarked for the next steps in implementing it (Alltucker, 3/26).

The Detroit Free Press: 500,000 More In Michigan To Be Eligible For Medicaid Coverage
A half-million more Michiganders will be eligible for Medicaid, the government-funded health program for poor people, when the most sweeping provisions of the Patient Protection and Affordable Care Act take effect in 2014. Supporters of the law say covering more poor people is not just socially responsible, it ultimately saves money: Better care keeps chronic conditions in check. But opponents will argue this week to the U.S. Supreme Court that Congress is overstepping its bounds by pushing the expansion onto states, which will lose their federal Medicaid funds if eligibility is not expanded (Erb, 3/26).

The Philadelphia Inquirer: Health Care Law Gaining Momentum
After two years, the Affordable Care Act has yet to dramatically alter the health-care landscape in Pennsylvania and New Jersey, but the controversial law, facing a U.S. Supreme Court challenge this week, has expanded insurance coverage in small ways and added momentum to changes already under way in the health care system. … The biggest impact of the health-reform law so far in Pennsylvania and New Jersey is probably in the massive amount of preparation for 2014, when Medicaid is expanded -- a big worry for hospitals and doctor practices -- and health-insurance exchanges begin offering insurance to individuals (Brubaker, 3/25).

Minnesota Public Radio: State: Health Care Law Repeal Would Hit Harder Outside MN
Other states are likely to be affected more if the court dismantles the law, but Minnesotans still have reason to pay attention. One of the main goals of the federal health care law is to expand health care coverage to 30 million Americans who don't have insurance. That's a big deal for community clinics like the Community University Health Care Center in Minneapolis, where one out of every four patients has no insurance. ... Statewide, nearly half a million people do not have insurance (Stawicki, 3/26). 

Denver Post: Individual Mandate A Key Colorado Issue As High Court Reviews Health Care Act
Can the federal government require you to eat broccoli? To opponents of the Affordable Care Act, the requirement that all U.S. citizens buy health insurance sets a precedent that could be abused in the future -- from mandating the purchase of solar panels to leafy greens. To proponents of the national law facing Supreme Court scrutiny this week, health care is a unique marketplace that virtually every American -- even the homeless guy living under a bridge -- intersects at some point, so requiring everyone to contribute is constitutionally justified (Allison Sherry, 3/25).

Denver Post: Supreme Court Arguments This Week On 2-Year-Old Health Care Law Fan Old Flames Of Debate
Colorado's bad law/good law face-off over health care reform will begin anew Monday, when the U.S. Supreme Court starts an unprecedented three days of arguments over the constitutionality of the Affordable Care Act. With the two-year anniversary of the law's signing last Friday, backers and opponents of the act are counting up their gains and losses. The 2010 act has already transformed the cost of health care for hundreds of thousands of Coloradans. But it has yet to fulfill its promise of reining in health costs for business and government, leaving the dispute as bitter as ever (Booth, 3/25).

The Seattle Times: If 'Obamacare' Falls, McKenna Could Pay Political Price
Ever since he joined the multistate lawsuit challenging President Obama's health-care overhaul, state Attorney General Rob McKenna has taken pains to say his goal is not to kill the entire law. McKenna, the Republican gubernatorial hopeful, has voiced support for the more popular provisions -- such as allowing children to stay on their parents' health insurance until age 26, and the ban on insurers denying coverage to people with pre-existing medical conditions. The lawsuit will not strike down those patient protections, McKenna has repeatedly said. Its purpose was to challenge the constitutionality of just a couple provisions, he says, chiefly the requirement that most Americans buy private health insurance by 2014 or face a fine (Brunner, 3/24). 

The Atlanta Journal-Constitution: Georgia A Player In Health Law Case Today
When the Supreme Court begins hearing arguments Monday on the health care law, Georgia Attorney General Sam Olens will have a coveted seat in the courtroom, where where he will monitor the case on behalf of the state's residents. Georgia is one of the 26 states challenging the law on constitutional grounds. … The states selected high-profile attorney Paul Clement, who was President George W. Bush's solicitor general, to argue their case. While Clement will be in the spotlight, Olens said his office has helped prepare the legal briefs for the case. Georgia has also helped craft the legal strategy through a set of standing phone calls during which attorneys general from across the country weighed in on the case, Olens said (Teegardin, 3/26).

CQ HealthBeat: Beyond The Health Care Arguments: The Waiting Games
When the Supreme Court finishes its third and final day of arguments about the health care law on Wednesday, a national waiting game for a decision will begin. And for some of the states charged with the nitty-gritty work of implementing the overhaul, there will be a second waiting game that might not end until after the November elections. Experts in state health policy say that political leaders in Republican-controlled states that have fiercely resisted the overhaul might not let this matter drop, even if the justices uphold the entire health care law, which 26 states are challenging (Norman, 3/23).

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Capitol Hill Watch

On Capitol Hill, Both Parties See Political Advantage In Rep. Ryan's Newest Plan

The budget proposal offered last week by the Wisconsin Republican would revamp the Medicare system.

The Washington Post: In Budget Battle, GOP Regroups On Medicare Message
Congressional Republicans recognize that the $3.5 trillion budget proposal the GOP-led House is expected to adopt this week remains fraught with political peril, but they also believe they now know how to blunt Democratic attacks on its Medicare overhaul components and should be able to avoid the political pummeling they suffered as a result last year (Helderman and Kane, 3/25).

Reuters: U.S. Spending Cuts Bite In Paul Ryan's Home Town
Republican U.S. Representative Paul Ryan's budget-cutting vision has made him a hero to conservatives across the country. It's less popular in his hometown. As Ryan's proposal to slash taxes and spending started to move through Congress last week, local officials in this humble Rust Belt city scrambled to recover from last year's cutbacks. ... There's less money for job training, health clinics and the food bank; higher property taxes and higher car fees; larger school class sizes, crumbling roads, fewer firefighters (Sullivan, 3/25).

The Hill: Dems Again Seek To Stick Paul Ryan Medicare Reform Plan With 'Voucher' Label
What's in a name? No less than President Obama's reelection, Democrats hope -- if they can just get the dreaded "voucher" label to stick to Republicans' Medicare overhaul. House Budget Committee Chairman Paul Ryan (R-Wis.) prefers "premium support." The difference might seem like some arcane bit of inside-the-Beltway trivia, but Democrats will be repeating the V-word from now through November as they try to persuade seniors that Ryan wants to give them a worthless piece of paper that will leave them holding the bag as their health care costs skyrocket (Pecquet, 3/25).

Meanwhile, Republicans in the Senate are still considering options on their strategy to repeal the federal health law --

Modern Healthcare: Senate GOP Still Deciding On Further Repeal Votes, McConnell Says
Senate Republicans remain undecided about whether to push for additional votes on repealing the federal healthcare overhaul before the November election, according to their leader. Senate Minority Leader Mitch McConnell, of Kentucky, said at a Friday news conference that pushing for such a vote is "still under discussion" among Republican senators (Daly, 3/23).

Politico: Ben Nelson Stands By His Key Vote
But in an interview with POLITICO, Nelson -- who opted to retire rather than seek a third term -- expressed no regrets, saying there's little he would have done differently. Those who perpetuate the tale that he got a special deal for Nebraska are only interested in "fiction or folklore," he said. And he took some parting shots at Republicans for walking away from the negotiating table at the height of the 2009 health care debate (Wong, 3/25).

Also in the news, former Medicare chief Donald Berwick recently spoke about the health law.

The Washington Post: Conversations: Don Berwick Looks Ahead On Health Care
Berwick spoke with The Washington Post about how the Affordable Care Act has changed the health-care system, what challenges it faces in coming years and why his time as Medicare administrator may be his only stint in government service (Kliff, 3/25).

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Campaign 2012

Amped Up Health Law Debate Creeps Into Presidential, Congressional Races

Mitt Romney raises his attack on the Democrats' health care law while GOP presidential candidate Rick Santorum assails Romney for championing the Massachusetts health law -- and takes the fight to the steps of the Supreme Court.

The Associated Press: Romney: Obama's Health Law An 'Unfolding Disaster'
Mitt Romney on Friday looked to pre-empt Supreme Court arguments that will shine a spotlight on a key vulnerability for him in the Republican primary -- health care reform. Romney called Democratic President Barack Obama's signature overhaul "an unfolding disaster for the American economy, a budget-busting entitlement and a dramatic new federal intrusion into our lives" (Hunt, 3/23).

The Associated Press: Santorum: Romney 'Worst Republican' To Face Obama
An agitated Rick Santorum on Sunday called Mitt Romney "the worst Republican in the country to put up against Barack Obama" even as it appears the former Massachusetts governor is on pace to clinch the party's nomination in June. ... Santorum later tried to clarify that he was talking only about Romney's ability to campaign against the national health care law championed by Obama and the Democrats (Elliott, 3/25).

CNN: Santorum Takes Campaign To Steps Of U.S. Supreme Court
With more than a week until the next Republican presidential primary, Rick Santorum is expected to take his campaign to the steps of the U.S. Supreme Court on Monday as it takes up the issue of the health care reform law. It is the latest move for the contender trying to build momentum on his win over the weekend in the Louisiana GOP primary (3/26).

Boston Globe: Mitt Romney Names Health Advisory Board
On Friday, the two-year anniversary of President Obama's health care law, Mitt Romney ramped up his criticism of the plan by calling it an "unfolding disaster," while also announcing a new advisory board that would help guide the former Massachusetts governor's health care policies (Viser, 3/23).

Romney's Massachusetts health law is also a part of the conversation for campaigning Democrats and in the Supreme Court's consideration of the federal health law.

Boston Globe: Health Care Battle Focuses On Mass. Model
Because it became the first state to impose an "individual mandate"’ that requires most residents to obtain health insurance -- and because its law served as a model for President Obama's 2010 national health-care overhaul -- the Bay State invariably is held up as an example in the intense battle that is expected to be settled by the nation's highest court in June. The court's decision will determine the future of regional health-care markets like New England's, and Massachusetts will find out if it is on the cutting edge of national change or if it will remain a single square in a patchwork of disparate state health care laws (Jan, 3/25).

Bloomberg: Romneycare's 98% Success Rate Defies Gripes On Obama Law
The success of the Massachusetts health-care system is spurring President Barack Obama to extol the virtues of a law Mitt Romney signed as a governor. Romney, running for the Republican presidential nomination, says it shouldn't be the model for every state. About 98 percent of state residents are insured under the legislation Romney signed in 2006, a 10 percent rise from the previous three-year average (Armstrong and Wayne, 3/26).

In the meantime, Obama and his campaign team are taking their health care pitch on the road.

The Associated Press/Denver Post: Obama's Health Sales Pitch Includes Colo. Effort
President Barack Obama's push to sell women on his health care overhaul is playing out in key battleground states like Colorado, where moderate women could be the key to his re-election. Obama's campaign has stepped up its sales pitch nationwide as his administration's signature achievement heads to a legal challenge in the U.S. Supreme Court. Obama supporters put on events Friday marking the second anniversary of the health law. Events included a forum on women's health featuring a law student thrust into the center of the debate (Wyatt, 3/23).

Bloomberg: Plouffe Says Americans Don't Want 'Refight' On Health Care
Senior White House adviser David Plouffe defended the health care law enacted by President Barack Obama as the Supreme Court prepares for three days of hearings to determine the fate of the measure. "Where the American people are right now is they don't want to go refight this battle again," Plouffe said today on CNN's "State of the Union" program (Gallu and Riley, 3/25).

The Hill: Plouffe: GOP Will Regret 'ObamaCare' Tag, Says Law Will Be Upheld
Senior White House adviser David Plouffe predicted Sunday that Republicans will come to realize they made a big mistake by constantly calling the president's sweeping healthcare reform law "ObamaCare." "I am convinced that at the end of this decade, Republicans are going to regret turning this into 'ObamaCare,'" he said on Fox News Sunday. The remarks come two days after Obama's reelection campaign similarly embraced the term that conservatives have used to bash the health care statute that Democrats passed in 2010 (German, 3/25).

The Associated Press: Biden: GOP Changes Threaten Medicare For Millions
Campaigning in South Florida, Vice President Joe Biden lashed out against House Republicans' proposed changes to Medicare, telling a roomful of retirees that the plan would jeopardize the future health care for millions of older Americans. Biden said the Medicare plan contained in a House GOP budget would effectively dismantle Medicare as it is currently structured. Senior citizen-rich Florida, a key battleground state in the presidential race, has about 3.3 million Medicare recipients (Anderson, 3/23).

And other Democrats are considering what the health law debate will mean for their congressional and Senate races this year --

Roll Call: Five Races In Which The Health Care Debate Will Matter
About two-thirds of Democratic Members who lost in November 2010 voted for the law. This year, Republicans hope they can continue to tie vulnerable incumbents in tossup states and districts to their vote for the unpopular legislation, which would cut about $500 billion from future Medicare spending. But in 2012, Democrats believe they have a shield to deflect the attacks: House Budget Chairman Paul Ryan’s controversial budget, which would fundamentally change the way older Americans interact with popular Medicare program (Miller, 3/26).

St. Louis Beacon: McCaskill, Senate Rivals Continue To Focus On 'Obamacare' And Medicare 
The federal health insurance changes, dubbed by both sides as "Obamacare," already have become the top issue in Missouri's U.S. Senate contest. ... U.S. Sen. Claire McCaskill, D-Mo., acknowledged as much on Sunday, as she defended the federal health insurance changes while also pledging to defend military veterans' health benefits from the cuts that she asserts are included in the Republican budget plan before the U.S. House. Meanwhile, the Republicans competing for a chance to challenge her this fall have all condemned the health care changes – while also battling over who's been the toughest to oppose Medicare's existing prescription drug benefit (Mannies, 3/26). 

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Health Information Technology

Doctors Adjusting (Or Not) To E-Prescribing, Smartphones

The Centers for Medicare & Medicaid Services will penalize doctors who fail to reach electronic prescribing rules.

Medscape: Physicians Get Another Chance to Avoid E-Prescribing Penalty
The Centers for Medicare and Medicaid Services (CMS) has been giving bonuses to physicians and other clinicians for e-prescribing — defined as sending a script directly from their computer to a pharmacy's computer — under an incentive program created by Congress in 2008. However, the program also calls for CMS to reduce a physician's Medicare reimbursement by 1% — a "payment adjustment" — in 2012 if he or she failed to meet the agency's e-prescribing requirements in 2011 (Lowes, 3/23). 

Kaiser Health News: Doctors Smart Phones And iPads May Be Distracting
Doctors who carry mobile devices are often hit with a flurry of texts, e-mails, Facebook messages, tweets and other notifications that automatically pop up on the screen, [Dr. John Halamka] explains. And because the vast majority of smart phones and tablets are personal devices that belong to individual doctors, the problem can be hard for hospitals to control (Gold, 3/26).

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Public Health & Education

Cheney Surgery Sparks Discussion Of Age And Heart Transplants

Over the weekend, former Vice President Dick Cheney, who is 71, received a new heart after he had waited 20 months.

NPR: Cheney Operation Underscores Heart Transplant Issues
[H]eart transplant recipients are typically matched with donors with a similar body size and the same blood type. Hearts are in short supply and more than 3,000 people are on the waiting list. So hearts generally go to the sickest person who's closest geographically and has been waiting the longest. … In the Washington area, the median waiting time is nine months. Cheney waited 20 months, an aide said in a statement (Stein, 3/26).

Bloomberg: Cheney Transplant at 71 Shows Trend Threatening Younger Patients
Medical advances have made it increasingly common for older Americans such as Dick Cheney to receive heart transplants, extending their lives. The trend may make it more difficult for younger patients as aging Baby Boomers compete for available organs, top cardiologists say. ... Last year, 2,322 heart transplants were performed, including 332 among people older than 65, or about 15 percent, said Joel Newman, a spokesman for the United Network for Organ Sharing, or UNOS, which matches patients to organs (Fay Cortez, 3/26).

MedPage Today: Cheney Transplant Turns Focus to Age and HF Treatments
Clinicians contacted by ABC News and MedPage Today largely agreed that his receipt of an LVAD [left ventricular assist device] -- the HeartMate II -- enhanced the public's awareness of that treatment option, and his 20-month survival, combined with Saturday's transplant is likely to spark renewed enthusiasm for interventions aimed at extending the lives of patients with advanced heart failure (Neale, 3/25).

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State Watch

N.Y. Seeking Medicaid Waiver; Calif. Adult Services Lawsuit Now 'Unsettled'

A selection of Medicaid news.

Reuters: NY Eyes $18 Bln Of Medicaid Savings To Be Split With U.S.
New York plans to overhaul the nation's most expensive Medicaid health care system to save $18.3 billion over five years, and will ask the federal government for half of those savings. ... By the end of 2012, the state plans to ask the federal government to give it a waiver that will let it run the program more flexibly. ... Much of the savings would be achieved by switching to managed care (Gralla, 3/23).

California Healthline: Advocates File Contempt Motion Against State
Disability Rights California, which filed and then settled a lawsuit challenging the transition of adult day health care by the Department of Health Care Services, now has filed a contempt motion saying that DHCS officials have not been following the terms of the agreement. That settlement prompted the state's creation of the Community Based Adult Services program, due to launch Sunday, the day after ADHC is eliminated as a Medi-Cal benefit (Gorn, 3/26). 

Reuters: Texas, Johnson & Johnson Heading Back To Court
Representatives of Johnson & Johnson and the state of Texas will head back to court on Tuesday over a $158 million settlement agreement announced in January involving the drug Risperdal, a spokesman for Texas Attorney General Greg Abbott said on Sunday. ... [The settlement] -- the largest Medicaid fraud recovery ever in Texas -- was specific to the Lone Star State (MacLaggan, 3/25). 

Kaiser Health News: Capsules: Feds To Test Paying For Medicaid Patients With Psychiatric Emergencies
A group of states is testing whether Medicaid patients who seek emergency psychiatric care at private psychiatric hospitals are better off if the federal government picks up part of the costs. Right now, the federal government does not help states pay for inpatient psychiatric care for many Medicaid patients—a longstanding policy meant to discourage states from cost-shifting to the federal government and institutionalizing patients (Barr, 3/23). 

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Hospital Happenings: Arizona Nurse Shortage Complication, Other News

A selection of hospital news from New York, Arizona, Massachusetts, Texas and Colorado

The New York Times: At Ailing Brooklyn Hospital, Insider Deals And Lavish Perks
Many hospitals in downtrodden areas of New York City and across the state are faltering, raising concerns that a wave of closings will deprive poor people of badly needed care. A three-month investigation by The New York Times into Wyckoff, based on dozens of interviews and an examination of internal documents, offers a sobering portrait of how one such hospital has been undermined by the very people entrusted to run it (Hartocollis, 3/25).

Arizona Republic: Fallout From Nurse Wages Still Being Felt
Arizona hospitals last decade struggled to find enough nurses to fill shifts in critical hospital operations, prompting some hospitals to turn to temporary or traveling nurses to ensure enough medical help for patients. While the nursing market has largely stabilized in recent years as colleges graduate more nurses, hospitals are still grappling with one impact of the nursing shortage -- legal fallout from allegations that a hospital industry group fixed wages for temporary and traveling nurses (Alltucker, 3/24).

The Texas Tribune: Victoria Hospital Won't Hire Very Obese Workers
The Citizens Medical Center policy, instituted a little more than a year ago, requires potential employees to have a body mass index of less than 35 — which is 210 pounds for someone who is 5-foot-5, and 245 pounds for someone who is 5-foot-10. It states that an employee's physique "should fit with a representational image or specific mental projection of the job of a healthcare professional"  ... Employment lawyers say Citizens Medical Center's hiring policy isn't against the law (Ramshaw, 3/26). 

Modern Healthcare: Empty Threat
Boulder Community Hospital's calculation underscores two competing trends that have raised questions about how many hospital beds the nation needs: demographics and the push to curb health spending by treating patients anywhere but costly hospitals. The equation is complicated by policy changes under the Patient Protection and Affordable Care Act that will expand insurance coverage to millions, should the Supreme Court uphold the law (Evans, 3/24).

WBUR's State of Health blog: Tour With Us: Mass. Unveils $302M State Psychiatric Hospital
Introducing the Worcester Recovery Center and Hospital, on the drawing board for nearly a decade and unveiled for its first media tour on Friday. Its $302 million price tag, officials say, is the highest ever for a state building project that is not a road. ... In a state mental health system eternally plagued by a shortage of services, the new building only consolidates 320 beds rather than adding new ones (Goldberg, 3/23). 

Houston Chronicle: Texas Children's Expanding Into Services For Women
Texas Children's Hospital makes a fundamental shift this week, offering adult care on a broad scale for the first time with the opening of its $575 million Pavilion for Women. Officials expect the first baby to be born in the new labor and delivery suites sometime Monday. ... Any pregnant woman will be able to use the hospital's maternity center (Kever, 3/25).

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State Roundup: Wash. State Exchange Bill Now Law

A selection of state health policy and politics stories from Texas, Washington state, Georgia, Iowa, Oregon, Connecticut and Minnesota.

The Associated Press/The Seattle Times: Gregoire Signs Insurance-Exchange Bill Into Law
Gov. Chris Gregoire on Friday signed into law a bill setting rules for insurers preparing for the state's online-insurance exchange. ... The state exchanges for individual and small-group plans are set to go live on Jan. 1, 2014. ... State Insurance Commissioner Mike Kreidler said that his office is committed to getting the exchange in place on schedule. "If we slowed down to be anxious, we'd be in trouble," Kreidler said. "It's the [health] law, and we're proceeding as quickly and as prudently as we can" (Kaminsky, 3/23).

The Dallas Morning News: Hutchison Urges Fix To Women's Health Program That Fits State Law Barring Funding To Abortion Providers
One day after expressing support for Planned Parenthood in the fight over the state's Women's Health Program, Sen. Kay Bailey Hutchison appeared Friday to move closer to her fellow Texas Republicans by urging a solution that assures "compliance with state laws against funding abortion clinics." ... Hutchison’s comments Friday came in a letter asking U.S. Health and Human Services Secretary Kathleen Sebelius for “personal involvement” in the standoff between Texas and the federal government, which funds 90 percent of the program (Collins Walsh, 3/23).

Des Moines Register: State Funding Changes Could Lead To Mental Health Services Cuts In Some Counties
At the same time that state leaders are promoting jail diversion programs and other methods to help mentally ill Iowans, some counties are planning to cut such programs because of changes in state financing. ... Some legislative leaders have pledged action to avoid program cuts (Leys, 3/24).

The Lund Report (an Oregon news service): Southern Oregon Providers Work To Embed Behavioral Health into Primary Clinics
A quick, 15-minute appointment with a mental health counselor to talk about the effects of stress and anxiety when a person has an ulcer is radically different than a traditional hour long appointment with a counselor. But providers in southern Oregon are discovering that such appointments, which integrate mental healthcare in the same primary care setting, go a long way toward improving a patient's health (Waldroupe, 3/24). 

The Connecticut Mirror: Free Dental Clinic Draws Overnight Lines, Hundreds Of Regulars
[Tom] Loftus, 37, of Waterbury, works as a carpenter and has medical insurance through his job, but no dental coverage. It's a relatively common problem in Connecticut, where close to 400,000 people don't have health care coverage and the number without dental insurance is far higher; experts have placed it at 600,000 to 1 million. Even people with dental coverage can struggle to get treated, particularly adults in Medicaid, which pays rates so low few dentists will accept many -- or any -- patients with it (Levin Becker, 3/23). 

The Texas Tribune: Lawsuit Can't Cover All Kids in Long-Term Foster Care
The 5th Circuit Court of Appeals has ruled that the national child advocacy group Children's Rights cannot file its class-action suit on behalf of all 12,000 youth in Texas' permanent managing conservatorship, otherwise known as long-term foster care. The suit was originally filed on behalf of nine children, and attorneys later filed a motion to expand it (Ramshaw, 3/23).

(St. Paul) Pioneer Press: Hospitals, GOP Object To State Control In Health Program
The cuts and controversy surround the State Health Improvement Program, which was created as part of Minnesota's health reform legislation in 2008. The budget agreement last year that cut funding for the program - called SHIP, for short - also directed the Minnesota Department of Health to implement some SHIP strategies through what are known as "community benefit programs" administered by hospitals in the state. But hospitals strenuously object to the idea (Snowbeck, 3/24).

Georgia Health News: Obesity Is An Expensive Problem - And Getting More So
In Georgia, nearly one in three adults is obese, and our childhood obesity rates are second only to Mississippi's. The health care costs linked to excess weight in Georgia's adults are currently estimated at $2.5 billion per year, according to a 2009 report from United Health Foundation, the American Public Health Association and the Partnership for Prevention. But if trends continue, the report projects these costs could reach $10.8 billion by 2018 (Smith, 3/24). 

HealthyCal: Healthcare Access Limited In East Valley
Thousands of families in the eastern Coachella Valley work in low-wage industries with no health insurance; many are migrants who can’t see a doctor regularly; and many are undocumented, and thus must seek care at low-cost or free clinics or the nearest emergency room. ... A study done by The California Endowment showed that 36% of adults in the East Valley lack health insurance (Potter, 3/25). 

Sacramento Bee: Voters In Sacramento-Area District Hit With Political Claims Over Medicare
The messages in the phone calls and mail pieces targeting voters in one of the Sacramento region's most competitive congressional races vary, but the subject is the same: the future of Medicare. ... The efforts already are fierce in the 7th Congressional District ... The issue is fueling attacks and efforts to shore up support from outside groups looking to influence voters in the east Sacramento County swing district (Van Oot, 3/25). 

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Editorials and Opinions

Editorials: Newspapers Call For Justices To Dismiss Challenge To Health Law

Several major news organizations editorialized on the arguments beginning at the Supreme Court today.

Los Angeles Times: Healthcare Law's Day In Court
[W]e don't believe the law is the threat to individual liberty that its critics claim it is. Instead, the most controversial provision — the requirement that almost all adult Americans obtain insurance coverage — is a key piece of a broad effort to fix a healthcare system that is too expensive, inefficient and inaccessible to too many Americans. The justices should dismiss the challenge to this individual mandate, as well as the other claims against the law (3/26). 

The Washington Post: Health-Care Reform, Part One
The Supreme Court is set to convene on Monday for the long-awaited showdown over the Patient Protection and Affordable Care Act, President Obama's landmark health-care plan. The court has set aside an extraordinary six hours over three days to grapple with questions raised by the bill, including whether requiring individuals to obtain health insurance is constitutional. This is the first of three editorials that will assess the merits of the issues scheduled for argument each day. First the justices will spend 90 minutes on Monday contemplating whether they should even be hearing the case at this time (3/25).

The Philadelphia Inquirer: Health Care Law: Everyone Loses Without Reform
Since the health-care sector accounts for 17 percent of the economy -- and with costs galloping for decades -- it's unarguably an issue of interstate commerce in which Congress can set the rules. That's how the high court should rule. Yet, whatever the outcome, the fact remains that health reform is the only option, if the nation hopes to tame a cost spiral that threatens not only Americans' financial security but their very well-being due to the quality of medical care (3/26).

Bloomberg: Court Can't Let Broccoli Get In Way Of Health Care Law
This is not, when all is said and done, a hard case. Which raises two final questions: How did it ever reach the Supreme Court? And why is the court spending so much time on it?  To a certain extent the lower courts, with their divergent opinions on the case, forced the Supreme Court’s hand. ... The less charitable answer brings us back to where we started. The politics of health care date back not just three years or two decades but at least a century, and the politics of the courts are increasingly stark. ... The best contribution the court can make is a strong, lucid decision in favor of the law (3/25).

San Francisco Chronicle: Health Care On The Line On Supreme Court Case
The gulf between the popular and disputed parts of the law may give the court an out. It could bless some ingredients and reject the mandate, giving each side a win. But since the 1930s, the high court has taken a hands-off approach on a string of major federal laws that guaranteed voting rights, cleaned up the environment, improved working conditions and made cars safer. The White House is right to add health care to this list of worthy federal initiatives (3/26).

Detroit Free Press: Uphold Affordable Health Care
Having failed to persuade Congress that requiring Americans to carry health care insurance is a bad idea, opponents of federal health care reform will ask the U.S. Supreme Court this week to declare that enforcing such a requirement would be illegal. ... But unless they are determined to fundamentally reorder the relationship between the federal government and the states, we are confident a majority of the nine justices will rule that both provisions are well within Congress' broad constitutional authority (3/25).

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Viewpoints: Enzi, McDermott, Harkin, Nadler, Pelosi Make Their Arguments As Law Heads To Court

In a series of op-eds, several well-known politicians offer their views on the federal health law.

Roll Call: Enzi: Health Care Law's Legacy Is Broken Promises, Missed Opportunities
During the health care debate, my colleagues and I voiced concerns with how the new law could cause millions of Americans to pay higher health insurance premiums unless serious changes were made. The Congressional Budget Office estimated that the law would increase health insurance premiums by $2,100 for families purchasing coverage on their own. These concerns were ignored, and Americans are now seeing their health insurance premiums increase. ... Instead of lowering the cost of health care for everyone, this law will actually drive struggling middle-class families deeper into debt (Sen. Mike Enzi, R-Wyo., 3/23).

Roll Call: McDermott: Health Care Overhaul Will Remedy Current System's Flaws
As a keen advocate of a single-payer health care system, I am perhaps an unlikely defender of the Affordable Care Act. But I support the ACA because it promises to remedy some of the most fundamental weaknesses in our current health care structure: It extends health coverage to 32 million presently uninsured Americans, and it emphasizes preventive care over costly crisis treatment. I believe the ACA is both workable and constitutional, worthy of validation by the Supreme Court and prompt implementation by the states (Rep. Jim McDermott, D-Wash., 3/23).

Roll Call: Harkin: Law's Opponents Are Wrong On Policy, Wrong On Legal Merits
The law provides valuable benefits to American families: It will give 93 percent of Americans access to affordable health care coverage that can never be taken away; protect consumers against insurance company abuses; make unprecedented investments in prevention, wellness and quality of care; aggressively control runaway health care spending; lower health care costs for small businesses; and transform the health care delivery system to significantly improve the health of the American people (Sen. Tom Harkin, D-Iowa, 3/23).

Roll Call: Nadler: Individual Mandate Does Not Threaten Any American's Liberty
Critics of the law focus primarily on the minimum coverage requirement, or what they call the "individual mandate." This provision, which requires most people to purchase insurance or pay a penalty for failing to do so, helps all Americans by ensuring that coverage is available regardless of pre-existing conditions and by making the cost of health care and insurance premiums affordable (Rep. Jerrold Nadler, D-N.Y., 3/23).

San Francisco Chronicle: Affordable Care Act For A Healthier America
With the Affordable Care Act, we are making progress for our nation, and we are upholding what the late Sen. Ted Kennedy called "the character of our country." With health reform, our character has been strengthened by recognizing health care as a right for all, not a privilege for the few. And we will rebuild the pillars that have always kept our economy strong: small businesses, entrepreneurs and an all-inclusive and thriving middle class (Rep. Nancy Pelosi, D-Calif., 3/23).  

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Viewpoints: Walter Dellinger's Health Care Myths; A 'Moment Of Truth' Or End Of Health Reform?

Commentators from around the country offer their views of the historic case being heard at the Supreme Court today.

Politico: Killing The Mandate Won't Fix Health Care
From both a legal and practical perspective, the choice is clear. Congress was well within its authority in passing the individual mandate to regulate the interstate effects of an industry that is almost 20 percent of our nation’s economy — more than $2.5 trillion each year. ... it's virtually impossible to have anything close to universal coverage without a mandate (for individuals to get insurance). Insurance works when the cost of health care is spread among everyone — young, old, healthy and infirm. (Tom Daschle, 3/25).

Politico Pro: Healthy Reminder Of SCOTUS's Role
For Americans who seek, as we do, to preserve individual liberty and local control against an increasingly intrusive federal government, this is one of the most important cases the Supreme Court has heard in decades. ... There is no question that the unprecedented health care mandate raises serious constitutional questions about the scope of the federal government’s power (Greg Abbott, 3/25).

The New York Times: Could This Be The End Of Health Care Reform?
If the Supreme Court rules that the individual mandate is unconstitutional — in my opinion, an improbable and legally indefensible decision — it will not end health care reform. Hospitals and doctors will continue to work to improve care and control costs. But tens of millions of Americans will continue to be excluded from the health care system, which is hardly an optimal outcome (Ezekiel J. Emanuel, 3/23).

The Washington Post: Obamacare's Contract Problem
Hitherto, most attention has been given to whether Congress, under its constitutional power to regulate interstate commerce, may coerce individuals into engaging in commerce by buying health insurance. Now the Institute for Justice (IJ), a libertarian public interest law firm, has focused on this fact: The individual mandate is incompatible with centuries of contract law. This is so because a compulsory contract is an oxymoron (George Will, 3/23).

The Washington Post: The Washington Post: Five Myths About The Health-Care Law 
The main issue, on which the lower courts have split, is whether Congress had the power to pass this law under the Constitution's commerce clause. The answers to that and other questions are clouded by misperceptions about the law itself. Let's debunk them (Walter Dellinger, 3/23). 

The New York Times: A Moment Of Truth For Health Care Reform
The justices, like the rest of the country, are clearly aware of the politics of the moment. But a decision on the merits will endure long after this election season — it could alter the allocation of power within American government and Congress's authority to solve national problems. ... Here is a look at the issues to be argued over three days this week in this extraordinary case (Lincoln Caplan and Philip M. Boffey, 3/24).

The New York Times' Room For Debate: Is The Court Being Thoughtful Or Partisan?
Are the justices giving due consideration to a complicated legal dispute, or preparing to engage in "judicial activism" to reduce federal power? Read the discussion (3/25).

The Washington Post: Obama's Ego Trip
[T]he justices will probably share at least one assumption: that their decision will have a big effect on the health of Americans. Ideally, everyone ought to have insurance, and it's popular wisdom that this would significantly improve people's health. But it's not true. The ACA's fate will dramatically affect government and the health-care system; the impact on Americans' health will be far more modest (Robert J. Samuelson, 3/25).

USA Today: Health Care Law Too Ill For Court To Fix
Three days of oral arguments that begin Monday will be the longest in recent Supreme Court history, and the ruling will have wide ranging consequences on the future of the health care reform law. But the court's decision will not fix a system that is badly broken and in need of radical reconstructive surgery. Even calling the way services are provided a "system" is misleading, especially if you consider a few startling facts (David M. Walker, 3/25). 

CNN: Despite Flaws, Health Care Law Is Needed
I practice primary care in southern New Hampshire near the Massachusetts border, which gives me a firsthand look at how health reform has impacted my neighboring state. ... I believe that health care reform needs to move forward. Over the years, I have encountered too many cases of patients who are inadequately served by our current health care model (Dr. Kevin Pho, 3/25).

Arizona Republic: 2 Years In, Reforms In Health Care Working
State lawmakers have compromised and risked the health of thousands of Arizonans, killed jobs and made economic recovery more difficult through massive cuts to state Medicaid (AHCCCS) and KidsCare health coverage for children. But this month, we can celebrate steps forward in health care ... Health-care reform -- despite hysterics and dire warnings from critics -- is quietly beginning to work as advertised. In Arizona, where fewer people get health coverage through their job, that's worth celebrating (Dana Wolfe Naimark, 3/25).

Bloomberg: Supreme Court Should Heed Economic Sense On Health Care
An obscure law, the Tax Injunction Act, says that tax cases cannot be litigated until someone has actually been penalized by the government. ... If (Justice Anthony) Kennedy wants to avoid striking down the law, but is unprepared to uphold it, he might well follow this line of thinking. Other justices, to his left and to his right, might well join him. That might not be a perfect result -- but it would still be a win for common sense (Noah Feldman, 3/25).

Houston Chronicle: Setting The Record Straight On Faith And Health Care Reform
No child of God should want for health care because he can't afford it. That's why more than 60 national, state and local religious organizations, including Texas Impact, have filed a friend of the court brief with the U.S. Supreme Court in support of Medicaid expansions in the Affordable Care Act (Bee Moorhead, 3/23).

Reuters: Top U.S. Judges May Drown Out Healthcare Debate
If past patterns hold, the justices will spend more time testing each other than listening to the lawyers for each side. ... Recent University of Minnesota research found that the current justices, excluding the laconic Clarence Thomas, altogether talk more per case than any of their modern predecessors (Reynolds Holding, 3/23).

The Miami-Herald: Court Should Strike Down Affordable Care Act 
Striking down the law will be the first step toward achieving real reform, and NFIB and its members are ready to engage with Congress to develop a responsible and responsive healthcare solution — a solution that gives employers and their families access to quality, affordable healthcare and doesn’t violate the U.S. Constitution (Bill Herrle, 3/26).

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Viewpoints: Keeping High Court Arguments Away From TV Is 'National Shame'

Several news outlets call for the Supreme Court to open up to the public through television.

The Dallas Morning News: Health Care Arguments Should Be Live On TV
Why the U.S. Supreme Court continues to hold its oral arguments away from television cameras remains a mystery and national shame. The court is about to begin hearing six hours of arguments over three days in a lawsuit brought by more than half of the states in the nation to challenge the constitutionality of the Affordable Care Act, one of the most important pieces of economic legislation passed by Congress since the New Deal. … We should be outraged by this decision (Erwin Chemerinsky and Eric Segall, 3/25).

San Francisco Chronicle: Open The U.S. Supreme Court To Televised Hearings
When the U.S. Supreme Court speaks, the nation listens. But it can't see. That's because the high court remains averse to televising its hearings. Barring a last-minute change of mind, the justices will refuse to allow cameras to broadcast six hours of hearings that begin Monday on the Obama administration health care law. … Staying behind closed doors while it weighs historic choices is the wrong position for the nation's top bench (3/26).

Boston Globe: Health Care Case Highlights Need For Supreme Court Cameras
Since no one except Supreme Court junkies is likely to go back and listen to the tape, the practical effect of the court’s decision not to televise the hearings is that most Americans will learn about the case from pundits, in the crossfire manner of cable TV, in terms likely to reinforce political biases. The chance that average citizens will reconsider their positions based on legal arguments is greatly diminished (3/25).

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Viewpoints: Law On Generic Drugs Is 'Outrageous Denial' Of Patients' Rights; Could Romney Be The Best Spokesman Against Federal Law?

A selection of editorials and opinions on health policy from around the country.

The New York Times: A Bizarre Outcome On Generic Drugs
Dozens of suits against drug companies have been dismissed in federal and state courts because of a decision by the Supreme Court last year that makes it virtually impossible to sue generic manufacturers for failing to provide adequate warning of a prescription drug’s dangers. This outrageous denial of a patient’s right to recover fair damages makes it imperative that Congress or the Food and Drug Administration fashion a remedy (3/23).

Milwaukee Journal Sentinel: Plan Reverses Health Care Reforms, Destroys Medicare
There is no doubt that we need to slow health care spending, the fastest-growing area of local, state and federal budgets. But it shouldn't be done on the backs of seniors and the disadvantaged as the Ryan/Romney plan proposes. We must work together and continue steps taken through the Affordable Care Act to strengthen Medicare and improve our health care system so all Americans have access to quality, affordable health care (Rep. Ron Kind, D-Wis., 3/24).

The Washington Post: Ryan's Budget And The Path To Single-Payer Health Care
Let’s play a game: I’ll describe a health-care bill to you. Then you tell me if I'm describing President Obama's Affordable Care Act or the budget released this week by Rep. Paul Ryan (Ezra Klein, 3/24). 

Politico: 'Romney Care': GOP Albatross Or Asset?
The central tenet of the "Anybody-But-Romney" conservative theology is this article of faith: Nominating the former Massachusetts governor will take away the Republican Party's best 2012 issue — because "Romneycare" is so like "Obamacare." ... This conservative faith is wrong, however. To the extent that attacks on President Barack Obama's health care reform are good politics, the candidate best able to make them is Mitt Romney. Since he orchestrated and then signed the Massachusetts health care law, Romney is uniquely qualified to lead the GOP attacks against the federal health care reform bill (Paul Goldman and Mark J. Rozell, 3/25).

Minneapolis Star Tribune: Is Medical Board Protecting Patients?
A revealing Star Tribune series recently raised serious questions about whether the state Board of Medical Practice is doing all it can to protect the public from doctors whose mistakes harm patients. A rigorous, independent evaluation of the board's operations is needed, and the best organization for the job is right here in Minnesota -- the state's respected Office of the Legislative Auditor (3/25).

HealthyCal: Hitting Below The Belt
Call me crazy. I’m a few months from losing my health insurance coverage – the "COBRA" plan you can buy after you leave a job that initially provided the benefit. So I figured I should start planning now to find an individual policy to replace my current plan before I lose it. ... It couldn't be all that tough, I thought to myself, to find an affordable health plan. I was wrong (Herbert A. Sample, 3/25).

Arizona Republic: 'War On Women' A Dem Exaggeration
The effort by Democrats to make the case that Republicans are waging a "war on women" has been interesting to watch. As often is the case in politics, the accusation reveals more about the accuser than the accused. At the national level, that's been the spin to try to wrest control of the flap over the Obama administration not providing an exemption for religious-affiliated institutions -- principally Catholic schools, hospitals and charities -- from its mandate that all health-insurance plans include free contraceptives (Robert Robb, 3/24).

Houston Chronicle: Hispanics Bear Brunt Of Perry's Health Care Policies
Hispanics understand that the victims of (Gov. Rick) Perry's politics are real people who are struggling to do their best for their families. They have enough problems; they don't need more. You take away their access to health care, and you run up costs at emergency rooms. You take away their access to contraception, and sadly, you add to the number of abortions (José Rodríguez, Juan "Chuy" Hinojosa, Carol Alvarado, Rafael Anchia, Veronica Gonzales, Marisa Marquez, 3/23).

San Francisco Chronicle: Laura's Law Is Ineffective
Laura's Law has been on the books since 2002, promoting expensive, involuntary treatment of people with mental health disabilities on the basis that they might become dangerous to themselves or others. Although The Chronicle editorializes that it would be a crime for Laura's Law to sunset, the real crime is that as a result of California's bad economic climate, the state and counties too often have made drastic cuts to mental-health and other social-services funding, depriving individuals of the community-based services they need to avoid hospitalization (Daniel Brzovic, 3/26).

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Stephanie Stapleton

Andrew Villegas

Lisa Gillespie
Shefali Luthra

The Kaiser Daily Health Policy Report is published by Kaiser Health News, an editorially independent program of the Kaiser Family Foundation. (c) 2014 Kaiser Health News. All rights reserved.