Daily Health Policy Report

Thursday, June 28, 2012

Last updated: Thu, Jun 28

KHN Original Reporting & Guest Opinion

Health Reform

KHN Original Reporting & Guest Opinion

Justices Uphold Individual Mandate, Set Limits On Medicaid Expansion

Kaiser Health News staff writers Julie Appleby and Jordan Rau report: "The U.S. Supreme Court today upheld nearly all of the landmark federal health law, affirming its mandate that most everyone carry insurance, but complicating the government's plan to extend coverage to the poorest Americans. Chief Justice John Roberts Jr. joined the court's four liberals in upholding the mandate, the best-known and least popular part of the law. The court also upheld hundreds of other rules embedded in the law designed to help millions more Americans obtain insurance and to refashion the health care industry. But a majority of the justices voted that the government could not compel states to expand Medicaid, the federal state program for the poor, by threatening to withhold federal money to existing Medicaid" programs (Appleby and Rau, 6/28). Read the story.

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Ruling Puts Pressure On States To Act

Kaiser Health News staff writers Phil Galewitz and Marilyn Werber Serafini report: "The Supreme Court has given states a way out of expanding the Medicaid program under the health law, but governors will be under strong pressure to take the federal money that would pay for coverage for millions of low-income people" (Galewitz and Werber Serafini, 6/28). Read the story.

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Stuart Taylor: 'Most Amazing Supreme Court Theater I've Ever Seen' (Video)

Kaiser Health News' legal analyst Stuart Taylor talks to Jackie Judd about the source of constitutional authority that the Supreme Court found to uphold the law -- and the new options states will have for the Medicaid program (6/28). Watch the video or read the transcript.

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After The Ruling: A Consumer's Guide

Kaiser Health News staff writer Mary Agnes Carey reports: "The Supreme Court Thursday upheld the 2010 federal health care law, dismissing the challenge by states to the law’s requirement that individuals get insurance. The justices, however, did give states the right to opt out of a critical provision requiring them to expand Medicaid programs for the poor and disabled" (Carey, updated 6/28). Read the story.  

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Excerpts From The Chief Justice's Opinion: Roberts Says Law's Offer To States On Medicaid 'Is A Gun To The Head'

Kaiser Health News provides edited excerpts from the opinion written by Chief Justice John Roberts on the challenge by 26 states and others to the 2010 health care law. 

KHN also provides exerpts from the dissenters' opinion. In their review of the 2010 federal health law, a minority of four justices -- Antonin Scalia, Anthony Kennedy, Clarence Thomas and Samuel Alito -- wrote that they did not believe the law was constitutional.

Read excerpts from both the majority and minority opinions.

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Political Leaders Sound Off On Health Law Decision With Speeches

In this Kaiser Health News collection of video excerpts, Senate Majority Leader Harry Reid, House Speaker John Boehner, House Minority Leader Nancy Pelosi, GOP presidential candidate Mitt Romney and President Barack Obama react to Thursday's Supreme Court decision on the health law with speeches. Watch the video.

Kaiser Health News also has posted transcripts of remarks by Obama and Romney.   

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Capsules: Hospital Stocks Soar As Court Upholds Health Act; Decision Day Live Blog; How The Ruling Is Playing On Twitter

Now on Kaiser Health News' blog, Jay Hancock reports that hospital stocks got a boost from today's Supreme Court ruling: "A decision to strike down the act would have maintained hospitals’ responsibility of caring for the uninsured while removing the means for patients to gain coverage, resulting in a severe financial pinch, analysts said. So stocks of for-profit hospital companies soared on Wall Street today even as the overall market fell" (Hancock, 6/28).

Also on the Capsules, Jenny Gold has spent today - Decision Day - live blogging a wealth of information and reaction regarding the court's opinion while Shefali S. Kulkarni is following how it's all playing on Twitter

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Political Cartoon: 'What's The Prognosis?'

Kaiser Health News provides a fresh take on health policy developments with "What's The Prognosis?" by David Fitzsimmons.

Meanwhile, here's today's health policy haiku: 

THE COURT HAS SPOKEN. WHAT'S NEXT?

Mandate? It's a tax!
The Hill prepares for battle
In the off-season.
-Anonymous  

 

 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

The Individual Mandate Survives As A Tax, Justices Find Fault With Medicaid Expansion

In the end, according to Justice Ruth Bader Ginsburg, the Affordable Care Act survives "largely unscathed."

Kaiser Health News has the text of the court's decision.

You can also watch a replay of Kaiser Health News' live video webcast featuring KHN's Mary Agnes Carey, Stuart Taylor and Julie Appleby as well as SCOTUSblog's Tom Goldstein and Lyle Denniston as they break down Thursday's landmark Supreme Court decision on the constitutionality of the health law.

Kaiser Health News: Justices Uphold Individual Mandate, Set Limits On Medicaid Expansion
The U.S. Supreme Court today upheld nearly all of the landmark federal health law, affirming its mandate that most everyone carry insurance, but complicating the government's plan to extend coverage to the poorest Americans. Chief Justice John Roberts Jr. joined the court's four liberals in upholding the mandate, the best-known and least popular part of the law. The court also upheld hundreds of other rules embedded in the law designed to help millions more Americans obtain insurance and to refashion the health care industry. But a majority of the justices voted that the government could not compel states to expand Medicaid, the federal state program for the poor, by threatening to withhold federal money to existing Medicaid programs (Appleby and Rau, 6/28).

Kaiser Health News (Video): Stuart Taylor: 'Most Amazing Supreme Court Theater I've Ever Seen'
Kaiser Health News' legal analyst Stuart Taylor talks to Jakie Judd about the source of consitutional authority that the Supreme Court found to uphold the law -- and the new options states will have for the Medicaid program (6/28).

The Washington Post: Supreme Court Upholds Health-Care Law, Individual Mandate
Chief Justice John G. Roberts Jr. sided with the majority in voting to uphold the law, Obama’s signature domestic initiative. ... The health-care issue thrust the Supreme Court into the public spotlight unlike anything since its role in the 2000 presidential election. The court’s examination of the law received massive coverage — especially during three days of oral arguments in March — and its outcome remained Washington's most closely guarded secret (Barnes and Aizenman, 6/28).

Los Angeles Times: Supreme Court Upholds Healthcare Law As Tax Measure
The ruling was not a total victory for the Obama administration. Chief Justice Roberts, who wrote the opinion for a 5-4 majority, said the required expansion of Medicaid violates states' rights may be unconstitutional. "The states are given no choice in this case. They must either accept a basic change in the nature of Medicaid or risk losing all Medicaid funding," he wrote. He said the federal government cannot require the states to follow this part of the law (Savage, 6/28).

The Wall Street Journal: Supreme Court Upholds Mandate As Tax
It upheld the mandate as a tax, in an opinion by Chief Justice John Roberts. The justices also found fault with part of the health-care law's expansion of Medicaid, a joint federal-state insurance program for the poor. The justices made some changes to the Medicaid portion of the law. The court said Congress was acting within its powers under the Constitution when it required most Americans to carry health insurance or pay a penalty—the provision at the center of the two-year legal battle (Kendall, Radnofsky and Bravin, 6/28).

The New York Times: Supreme Court Lets Health Law Largely Stand
The Supreme Court on Thursday largely let stand President Obama's health care overhaul, in a mixed ruling that Court observers were rushing to analyze (Cushman, 6/28).

Politico: Supreme Court Upholds Health Law Mandate
The Supreme Court upheld the health care law's individual mandate Thursday, ruling that Congress did not overstep its power by requiring nearly all Americans to buy health insurance. Chief Justice John Roberts joined with the court's four liberal justices in the ruling, which says Congress had the authority for the mandate under Congress's taxing power (Haberkorn, 6/28).

USA Today: Supreme Court Upholds Obama Health Care Law
The Supreme Court upheld the health care law today in a splintered, complex opinion that gives President Obama a major victory. Basically. the justices said that the individual mandate -- the requirement that most Americans buy health insurance or pay a fine -- is constitutional as a tax (Jackson, 6/28). 

Reuters: Supreme Court Upholds Centerpiece Of Obama Healthcare Law
"The Affordable Care Act's requirement that certain individuals pay a financial penalty for not obtaining health insurance may reasonably be characterized as a tax," Chief Justice John Roberts wrote for the court's majority in the opinion (Vicini, 6/28).

ABC News: The Mandate Can Stay, Supreme Court Says In Health Care Ruling
In a landmark ruling with wide-ranging implications, the Supreme Court today upheld the so-called individual mandate requiring Americans to buy health insurance or pay a penalty, the key part of President Obama's signature health care law. The court ruled that the mandate is unconstitutional, but it can stay as part of Congress's power under a taxing clause. The court said that the government will be allowed to tax people for not having health insurance (Negrin and de Vogue, 6/28).

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Medicaid Expansion: What Will States Do Now?

News outlets explore how the high court's ruling on the health law's Medicaid expansion might play out.

The New York Times: Uncertainty Over Whether States Will Choose To Expand Medicaid
After the Supreme Court ruled on Thursday that a huge expansion of Medicaid in the 2010 health care law was an option and not a requirement for states, experts disagreed on whether states would take the option (Pear, 6/28).

Kaiser Health News: Ruling Puts Pressure On States To Act
The Supreme Court has given states a way out of expanding the Medicaid program under the health law, but governors will be under strong pressure to take the federal money that would pay for coverage for millions of low-income people (Galewitz and Werber Serafini, 6/28).

Reuters: US Ruling Casts Doubt On Expanding Healthcare For The Poor
While the Supreme Court upheld a U.S. healthcare overhaul on Thursday, its decision cast doubt on whether the plan to extend health coverage to more than 30 million uninsured people will reach some of the poorest Americans. In its ruling, the court allows states to opt out of an expansion of Medicaid benefits for low-income earners with household incomes of up to 133 percent of the federal poverty line, or about $30,000. The current Medicaid threshold varies geographically, but in 33 states is under the $22,000 per household definition of poverty (Morgan and Lambert, 6/28).

The Fiscal Times: Will States Opt Out Of Medicaid Expansion?
Now states are facing another crossroads in the evolution of the program, assuming the Affordable Care Act, better known as Obamacare, politically survives beyond the fall elections. The Supreme Court on Thursday reaffirmed the right of states to reject expanding Medicaid to cover poor-but-working adults and prohibited the federal government from withdrawing support for other parts of the program to penalize non-participation (Goozner, 6/28).

Modern Healthcare: Public Hospitals Wary Of Ruling On Medicaid
Public hospital representatives voiced concern about part of the U.S. Supreme Court's decision on the constitutionality of the Patient Protection and Affordable Care Act, saying the ruling could stymie the Medicaid expansion that is essential to safety net hospitals (Barr, 6/28).

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Obama, Congressional Dems Claim 'Victory For America' In Court's Health Law Decision

In a statement after the verdict, President Barack Obama said it was time to stop fighing over the law and "move forward."

Politico: Obama Wins Big In Supreme Court Health Care Ruling
Obama quickly declared victory, praising the ruling in a statement from the White House. "Whatever the politics, today's decision was a victory for people all over this country whose laws will be more secure because of this law and the Supreme Court's decision to uphold it," he said. The force of the ruling is breathtaking in political terms. It gives Obama the Supreme Court's credibility in arguing that his law was not a massive, unconstitutional overreach. Republican Mitt Romney gets to ride the Tea Party backlash as he promises to tear down the law if he is elected" (Allen and Haberkorn, 6/28).

Reuters: Obama Calls Supreme Court Healthcare Decision A Victory
U.S. President Barack Obama pledged on Thursday to implement and improve his signature healthcare law after the Supreme Court upheld it, a decision the president described as a victory for Americans that should put to rest the fight over reform. ... "What we won't do - what the country can't afford to do - is re-fight the political battles of two years ago or go back to the way things were. With today's announcement, it's time for us to move forward" (Mason, Bull and MacInnis, 6/28).

CNN: Obama: Supreme Court Ruling On Health Care A Victory For All Americans
An administration official described the White House reaction as elation, while GOP opponents criticized the high court's reasoning and promised an immediate repeal effort. ... Obama used the focus on the issue to spell out the benefits of the law that remains unpopular with many Americans. The principle upheld by the high court's ruling is that no American should go bankrupt because of illness, the president said (Mears and Cohen, 6/28).

Kaiser Health News: Obama: Health Law Decision A 'Victory For People All Over This Country' (Transcript)
President Obama said the Supreme Court's landmark decision Thursday to uphold the health care reform law was a victory for all Americans who will now be more secure because of it. Read the transcript of his remarks (6/28).

The Hill: Pelosi: Ruling Is 'Victory' For Americans
"With this ruling, Americans will benefit from critical patient protections, lower costs for the middle class, more coverage for families, and greater accountability for the insurance industry," Pelosi said in a statement. The liberal Democrat had for months predicted the high court would rule 6-3 in favor of the law, calling the Affordable Care Act "ironclad" and constitutional. She was off by one vote (Lillis, 6/28).

Los Angeles Times: Dems 'Ecstatic,' GOP Vows Fight As Court Upholds Healthcare Law
"Passing the Affordable Care Act was the greatest single step in generations toward ensuring access to affordable, quality healthcare for every person in America, regardless of where they live, how much money they make," Reid said. "I'm happy and I'm pleased the Supreme Court put the rule of law ahead of partisanship" (Mascaro and Simon, 6/28).

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GOP Leaders React To Ruling By Renewing Pledges To Repeal The Health Law

From Republican presidential hopeful Mitt Romney to key House and Senate leaders, the call to repeal the sweeping health overhaul came loud and clear in the wake of the Supreme Court's decision largely upholding it.

The Associated Press/Washington Post: Romney Calls Supreme Court Ruling Incorrect, Says Health Care Remains Bad Law, Bad Policy
Republican Mitt Romney is promising that he will repeal the federal health care law the Supreme Court just upheld. He called the decision incorrect and said Thursday that it is “bad law.” He says it raises taxes and cuts Medicare. Romney says that, if elected in November, he will work to repeal and replace the law. But he hasn’t said precisely how (6/28).

Kaiser Health News: Romney: Health Law Bad Policy, No Matter SCOTUS Decision (Transcript)
GOP presidential candidate Mitt Romney said after the Supreme Court ruling on the health law Thursday that though the court said the law wasn't unconstitutional, it didn't say that the law was good policy either. Romney reiterated his promise to repeal the law if elected. Here's a transcript via Fox News (6/28).

The Associated Press/San Francisco Chronicle: Boehner: Health Ruling Shows Need To Repeal Law
House Speaker John Boehner says the Supreme Court ruling upholding the individual insurance requirement at the heart of President Barack Obama's health care overhaul shows the need to repeal the law. The Ohio Republican says in a statement that the law is hurting the economy by increasing health care costs and making it difficult for small businesses to hire (6/28).

The Washington Times: Cantor: House Will Vote To Repeal Health Care Law
And Majority leader Eric Cantor said the House will vote to repeal the health care law next month, delivering on GOP promises to try to repeal the rest of the law even if the court upheld it (Cunningham, 6/28).

Politico: GOP Leaders Rip Health Care Law, Not SCOTUS Decision
Republican Congressional leaders did not blast the Supreme Court or its ruling upholding the health care law on Thursday. Instead, they targeted the law itself, saying it hinders growth and must be repealed. "Today's ruling underscores the urgency of repealing this harmful law in its entirety," House Speaker John Boehner said in a statement. ...  Senate Minority Leader Mitch McConnell called for "new leadership in the White House and Senate" in order to repeal the law (Slack, 6/28).

The Hill: McConnell: Ruling Shows Health Law Was Sold 'On A Deception'
Senate Minority Leader Mitch McConnell (R-Ky.) said the Supreme Court's ruling on the 2010 healthcare law reveals that the individual mandate is constitutionally acceptable when defined as a tax, though Democrats tried to argue that it wasn't a tax to help get it passed. "The president of the United States himself promised up and down that this bill was not a tax," McConnell said on the Senate floor. "This was one of the Democrats' top selling points, because they knew it would never have passed if they said it was a tax (Kasperowicz, 6/28).

The Wall Street Journal: Ruling Gives Obama Big Boost, Could Aid Romney
The Supreme Court's decision to uphold the federal health care law, President Barack Obama's signature legislative achievement, hands the White House a major legal victory just ahead of a tight presidential election. But the ruling also could energize Republicans, whose fierce opposition to the law propelled the issue to the high court. ... [T]he opinion, written by conservative Chief Justice John Roberts, provides an undeniable jolt of energy for Mr. Obama, who has faced a weak economy and accusations from Republicans that he had overreached the bounds of the presidency (Lee and Bendavid, 6/28).

Detroit Free Press: Democrats Applaud, Republicans Growl Over Health Care Ruling
The conservative Club for Growth issued a statement decrying the opinion. And the Republican Natonal Committee weighed in, with chairman Reince Priebus saying, "Today's Supreme Court decision sets the stakes for the November election. Now, the only way to save the country from Obamacare's budget-busting government takeover of health care is to elect a new president." ...  but the court’s split decision upholding the law's mandate that people buy insurance or pay a penalty on Thursday was clearly a victory for President Barack Obama – especially with many court watchers expecting the decision to go the other way (Spangler, 6/28).

MSNBC: Republican VP Hopefuls'  Reactions To Health Reform Ruling
Among the flurry of conservatives vowing to redouble their efforts to repeal President Obama's health reform law was the handful of Republicans whom Mitt Romney might pick as a running mate (O'Brian, 6/28).

Politico: RNC Responds: Health Care A 'Toxic Political Asset' For Obama
RNC Political Director Rick Wiley is out with a memo on how the Supreme Court's decision this morning will hurt President Obama, particularly in swing states where the health care law is highly unpopular (Schultheis, 6/28).

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EDITOR:
Stephanie Stapleton

ASSOCIATE EDITOR:
Andrew Villegas

WRITERS:
Ankita Rao
Marissa Evans

The Kaiser Daily Health Policy Report is published by Kaiser Health News, an editorially independent program of the Kaiser Family Foundation. (c) 2012 Kaiser Health News. All rights reserved.