Daily Health Policy Report

Tuesday, July 1, 2014

Last updated: Tue, Jul 1

KHN Original Reporting & Guest Opinion

Health Reform

Health Care Marketplace

Administration News

Women's Health

Medicare

State Watch

Editorials and Opinions

KHN Original Reporting & Guest Opinion

Hobby Lobby Decision May Not Be The Last Word On Birth Control Coverage

Kaiser Health News staff writer Julie Rovner reports: "The Supreme Court’s decision Monday saying that 'closely held corporations' do not have to abide by the contraceptive coverage mandate in the Affordable Care Act may not give those firms the ability to stop providing that coverage after all. More than half the states have 'contraceptive equity' laws on the books that require most employers whose health insurance covers prescription drugs to also cover FDA-approved contraceptives as part of that package. Unlike the ACA, those laws do not require that coverage to be available without deductibles or co-pays" (Rovner, 6/30). Read the story.

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FAQ: High Court's Hobby Lobby Ruling Cuts Into Contraceptive Mandate

Kaiser Health News staff writer Mary Agnes Carey reports: "In a 5-4 decision Monday, the Supreme Court allowed a key exemption to the health law’s contraception coverage requirements when it ruled that closely held, for-profit businesses could assert a religious objection to the Obama administration’s regulations. Here are some frequently asked questions and answers about the case" (Carey, 6/30). Read the story.

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Supreme Court Limits Contraceptive Mandate For Certain Employers

Kaiser Health News staff writer Julie Rovner reports: "A sharply divided Supreme Court ruled Monday that at least some for-profit corporations may not be required to provide contraceptives if doing so violates the owners’ religious beliefs. But the five-justice majority writing in Burwell v Hobby Lobby, et al., took pains to try to limit their ruling only to the contraceptive mandate in the health law and only to 'closely held' corporations like the family-owned businesses represented by the plaintiffs in the case" (Rovner, 6/30). Read the story.

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What The Hobby Lobby Decision Means For Employers

Kaiser Health News staff writer Mary Agnes Carey and legal analyst Stuart Taylor discuss Monday's ruling on the health law's contraception mandate, examining what the decision could mean for future challenges to the law. Listen to the audio or read the transcript.

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Court Suggests Narrow Application Of Birth Control Case, But Others See Broader Impact

Kaiser Health News staff writer Jay Hancock reports: "The Supreme Court's decision on contraceptives and employer health plans could affect companies and workers far beyond Hobby Lobby and the other plaintiffs. But nobody seems to know how far. The ruling applies to 'closely held for-profit corporations,' a small subset of employers, Justice Samuel A. Alito Jr. wrote for the majority. But in a dissenting opinion, Justice Ruth Bader Ginsburg suggests the impact will be far broader" (Hancock, 6/30). Read the story.

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Proposal To Add Skimpier 'Copper' Plans To Marketplace Raises Concerns

Kaiser Health News consumer columnist Michelle Andrews reports: "If you offer it, will they come? Insurers and some U.S. senators have proposed offering cheaper, skimpier "copper" plans on the health insurance marketplaces to encourage uninsured stragglers to buy. But consumer advocates and some policy experts say that focusing on reducing costs on the front end exposes consumers to unacceptably high out-of-pocket costs if they get sick. The trade-off, they say, may not be worth it" (Andrews, 7/1). Read the story.

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Capsules: Poll: New Hampshire Medicaid Expansion Starts Tuesday; Americans Bristle At Penalties In Wellness Programs; Pelvic Exams No Longer Recommended For Well-Woman Visits

Now on Kaiser Health News' blog, Phil Galewitz looks at another state expanding Medicaid: "New Hampshire on Tuesday became the latest state to begin enrolling low-income residents in an expanded Medicaid program, a step toward moving many into plans sold on the online federal marketplace" (Galewitz, 7/1).

Also, Jordan Rau reports on employees' views of workplace wellness programs: "Workers believe employer wellness programs should be all gain but no pain, according to a poll released Tuesday. The poll from the Kaiser Family Foundation found employees approve of corporate wellness programs when they offer perks, but recoil if the plans have punitive incentives such as higher premiums for those who do not take part" (Rau, 7/1).

Jenny Gold reports on new recommendations for well-woman visits: "The American College of Physicians announced a major change to their screening guidelines Monday evening: Healthy women should no longer receive pelvic exams during their annual well-woman visits" (Gold, 7/1). Check out what else is on the blog.

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Political Cartoon: 'Party Line Judge?' By Pat Bagley, Salt Lake Tribune

Kaiser Health News provides a fresh take on health policy developments with "Party Line Judge?" by Pat Bagley, Salt Lake Tribune.

Meanwhile, here's today's haiku:

BUMPED OFF THE FRONT PAGE

Lost amid the news
Of court’s birth control ruling
Was new VA chief
-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

Other Challenges To Contraceptive Mandate Still Awaiting Review

Those cases generally involve nonprofit and religious organizations. Meanwhile, some employers who say their religious beliefs prevented them from complying with the contraceptive mandate say they plan to halt coverage of some methods following the Supreme Court decision, reports The Wall Street Journal, Meanwhile, attention moves to the administration as it attempts to draft new rules.

The New York Times: More Cases On Religion Await, With Eye On Opinion By Alito
Battles over health care and religious rights are sure to continue, even after the Supreme Court ruled Monday that family-owned for-profit corporations like Hobby Lobby are not required to provide insurance coverage of contraceptives to their employees if the companies object on religious grounds. About 50 cases involving nonprofit organizations and a similar number involving for-profit companies are pending in federal courts around the country, and many of those plaintiffs intend to push forward with the argument that they should be able to opt out of providing or authorizing coverage that conflicts with their religious beliefs (Pear, 6/30). 

The Wall Street Journal: Obama, Congress Likely Face Tough Decision On Contraceptive Coverage
The Obama administration could face another thorny decision on contraception-coverage rules in the wake of Monday's Supreme Court ruling in favor of religious owners of for-profit companies. ... Dozens of universities and charities are challenging the accommodation in a wave of separate lawsuits. ... Now all eyes will be on the administration to see what rules it crafts to exempt employers with objections and allow workers affected by the ruling to obtain contraception by another means (Radnofsky, 6/30).

The Wall Street Journal: Some Companies To Halt Contraception Coverage After High-Court Ruling
Some employers that had argued their religious beliefs prevented them from complying with federal health-law regulations said they are planning to stop covering certain contraceptives following Monday's Supreme Court decision (Feintzeig, 6/30). 

The Washington Post: Contraception Ruling Is A Symbolic Blow To The Health-Care Law
Two years ago, the court, while upholding the constitutionality of the Affordable Care Act, also gutted the law’s mandatory Medicaid expansion, severely limiting the law’s reach. By contrast, the effect of Monday’s decision is peripheral. The contraception provision was not part of the main law but was laid out in regulatory language issued by the Obama administration. Millions of women who receive birth control at no cost through their company health plans are likely to keep it (Somashekhar, 6/30). 

Politico: Practical And Legal Hurdles Remain In Contraception Fight
The Obama administration and Senate Democrats promised to fight the Supreme Court rebuke of Obamacare's contraception coverage requirement on Monday, even as a second round of legal fights over birth control head to the court. ... The court devoted several pages of its opinion Monday explaining that the government could choose to provide birth control to women directly, without involving employers (Haberkorn, 6/30). 

Kaiser Health News: Hobby Lobby Decision May Not Be The Last Word On Birth Control Coverage
The Supreme Court’s decision Monday saying that "closely held corporations" do not have to abide by the contraceptive coverage mandate in the Affordable Care Act may not give those firms the ability to stop providing that coverage after all. More than half the states have "contraceptive equity" laws on the books that require most employers whose health insurance covers prescription drugs to also cover FDA-approved contraceptives as part of that package. Unlike the ACA, those laws do not require that coverage to be available without deductibles or co-pays (Rovner, 6/30). 

The Fiscal Times: After SCOTUS: The Hunt for Cheap Birth Control
The Supreme Court ruled that some corporations have the right to be exempted from paying for specific types of contraceptives for their employees, reigniting the hunt for cheap birth control methods. Obamacare required that employers provide four birth control methods that some consider forms of abortion as part of their health insurance plans; the Supreme Court found that specific provision violates the religious liberties of some businesses. The four birth control methods are two morning-after pills (Plan B One-Step, which is available over the counter, and Ella, for which you need a prescription) and two intrauterine devices (Paragard and Mirena) (Cole, 6/30).

The Star Tribune: Health Ruling Sets Stage For Minnesota
Businessman Greg Hall felt torn between his Catholic teachings and a piece of the federal health law that required him to pay the full cost of his employees’ birth control. On Monday, he was part of a cadre of Minnesota business owners cheering the U.S. Supreme Court’s decision to allow certain firms to skirt the rule by citing religious objections. "I’m grateful and gratified," said Hall, whose company in St. Joseph, Minn., manufactures drilling pumps and parts. "It seemed the only option was to violate my moral beliefs by offering the services or by stripping our employees of medical insurance" (Crosby, 6/30).

Denver Post:  Colorado Companies Affected By High Court's Hobby Lobby Decision 
Three Colorado companies are among the for-profit plaintiffs suing over the federal contraception mandate limited by the Supreme Court ruling on religious freedom Monday. "The decision should mean they will all prevail in their cases," said Greg Baylor with the Alliance Defending Freedom, which represents the three Colorado plaintiffs. "Whether the government will concede all its cases are lost, or whether it will argue other cases have distinguishing features, I don't know. But we don't think (it) can win." The 5-4 ruling by the court is the first to recognize the religious rights of corporations — at least those closely owned by religious families (Draper, 6/30). 

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White House, Members Of Congress, Candidates React To High Court Ruling

News outlets tracked the immediate political fallout of the Supreme Court's Burwell v. Hobby Lobby Stores decision.

Politico: White House: Hobby Lobby Ruling 'Jeopardizes' Women's Health
President Barack Obama believes that the Supreme Court’s ruling in the Hobby Lobby case on contraceptives "jeopardizes" women's health and will press Congress to respond, White House press secretary Josh Earnest said Monday. "Today’s decision jeopardizes the health of women employed by these companies," Earnest told reporters (Epstein, 6/30).

USA Today: Dems Discuss Response To Contraception Ruling
The White House and congressional Democratic leaders said Monday they will seek legislation to reverse a Supreme Court decision that corporations can opt out of providing contraception coverage if they claim religious objections. It is unlikely a divided Congress could pass any bill on the issue. "President Obama believes that women should make personal health care decisions for themselves rather than their bosses deciding for them," said White House spokesman Josh Earnest. "Congress needs to take action to solve this problem that's been created, and the administration stands ready to work with them to do so" (Davis, 6/30). 

Politico: SCOTUS Decision Ignites Obamacare, Contraception Fight
The contraception coverage mandate isn't central to the law, the way the individual mandate is. By letting some closely held employers — like family-owned businesses — opt out of the coverage if they have religious objections, the justices haven't blown a hole in the law that unravels its ability to cover millions of Americans. They didn't even overturn the contraception coverage rule itself. They just carved out an exemption for some employers from one benefit, one that wasn't even spelled out when the law was passed. But politically, that doesn't matter (Nather and Haberkorn, 6/30). 

The New York Times: A Ruling That Both Sides Can Run With
The Supreme Court's ruling on Monday that the government cannot force certain employers to pay for birth control was more than a rebuke to President Obama. It was vindication of the conservative movement's efforts to chip away at laws it finds objectionable by raising questions of freedom of expression. ... leaders predicted Monday’s decision would infuse Republicans with energy as they fight to take control of the Senate this year and reclaim the White House in 2016. ... Yet even as conservatives celebrated coming out on the winning side of a divisive social issue, their court victory may have also handed Democrats an issue that will turn out liberal voters in the fall. Democrats have spent hundreds of millions of dollars in the last several years to cast Republicans as callous and extreme on women’s health issues (Peters and Shear, 6/30).

The Wall Street Journal: Hobby Lobby Ruling Galvanizes GOP And Democrats
The latest Supreme Court ruling on the Affordable Care Act reinforces the lines of attack both parties are using to mobilize their political bases for the 2014 midterm, while potential presidential candidates signaled the case would resonate into 2016 (Reinhard, 6/30). 

ABC News: Hobby Lobby Ruling Reignites Calls For Repeal By Possible GOP Candidates
Several high-profile Republicans possibly eyeing a presidential bid in 2016 praised the Supreme Court’s decision in Burwell v. Hobby Lobby as a victory for religious liberty while also sharply attacking the Obama administration for executive overreach through his signature legislative achievement (Parkinson and Zeleny, 6/30).

McClatchy: Politicos Rush For Gain In Court Ruling On Contraceptive Coverage
Democrats and Republicans eagerly seized on Monday’s Supreme Court birth-control ruling as an important electoral momentum-builder, but it's doubtful the decision will have a big impact on November's congressional races. People are far more concerned about the jobs and the economy, and political history suggests that midterm elections tend to be referendums on incumbents. That didn't stop both parties from moving for advantage within minutes of the court ruling (Lightman, 6/30).

USA Today: Clinton: Supreme Court Contraception Ruling 'Deeply Disturbing'
Hillary Rodham Clinton blasted the Supreme Court’s 5-4 decision saying some privately held companies with religious objections cannot be forced to offer insurance coverage for certain kinds of birth control. ... She said the ruling in the so-called Hobby Lobby case could mean companies "can impose their religious beliefs on their employees" and end up "denying women contraception as part of their health care plan" (Camia, 6/30). 

Politico: Hillary Clinton Blasts Hobby Lobby Ruling
Hillary Clinton on Monday called the Supreme Court’s ruling in the contraception-related Hobby Lobby case "deeply disturbing." The former secretary of state and possible Democratic front-runner skewered the decision during an appearance at the Aspen Ideas Festival in Colorado, hours after the Supreme Court ruled that for-profit employers don’t have to provide contraception coverage, mandated under Obamacare, if they have religious objections (Glueck, 6/30). 

Politico: Democrats: Hobby Lobby Ruling Could Boost 2014 Hopes
Democrats may be decrying the Supreme Court’s Hobby Lobby ruling, but the party’s campaign strategists believe they can use it to their benefit in this year’s midterm elections. Despite the legal setback for Obamacare, the strategists hope the ruling will boost Democrats’ efforts to keep the Senate by persuading some Republican-leaning women to defect in states with competitive races while galvanizing younger women who typically don’t vote in midterms (Hohmann, 6/30). 

CNN: Do Democrats Win By Losing Obamacare Decision?
At first glance, Monday's Supreme Court ruling that closely held companies cannot be required to cover some types of contraceptives for their employees appears to be a defeat for the White House, Democrats and the health care reform measure they pushed into law. Most Republicans were quick to celebrate the ruling. "This decision protects the religious freedom that is guaranteed to all Americans by the First Amendment, and we're grateful the Court ruled on the side of liberty," Republican National Committee Chairman Reince Priebus said. And most Democrats were equally fast in slamming the court's opinion (Steinhauser, 6/30).

The Washington Post: Faith Groups Divided In Their Reaction To Court's Decision Affirming Religious Rights
U.S. faith groups were starkly divided in their reaction Monday to the Supreme Court’s decision affirming the religious rights of corporations, with some seeing a narrow decision protecting the religious liberty of business owners and others seeing a profane intrusion into the beliefs of employees. Traditional Christians and Jews in particular celebrated Monday’s decision, which comes at a time when many feel conservative religious beliefs — especially around sexuality and marriage — are slipping in official status. ... Some faith groups saw a dangerous, broadly worded decision. They pointed to the dissent written by Justice Ruth Bader Ginsberg (Boorstein, 6/30).

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How Many Companies Might Be Affected By Contraceptive Ruling?

Although Justice Alito said the Hobby Lobby decision would affect only a narrow group, others say many firms could fit in the definition of  'closely held.'

The Wall Street Journal: Hobby Lobby Ruling Raises Question: What Does 'Closely Held' Mean?
The three firms in the lawsuit—Hobby Lobby Stores Inc., Conestoga Wood Specialties Corp. and Mardel—all have the same business structure: they are owned and controlled by members of a single family. But closely held firms can take other ownership forms (Armour and Feintzeig, 6/30). 

NPR: How Many Companies Will Be Touched By Court's Contraception Ruling?
When the Supreme Court ruled Monday that "closely held" corporations don't have to pay for workers' contraception, you may have assumed the decision applied only to family-owned businesses. Wrong. An estimated 9 out of 10 businesses are "closely held." However, some benefits experts question just how many of those companies would want to assert religious views (Geewax, 6/30).

Kaiser Health News: Court Suggests Narrow Application Of Birth Control Case, But Others See Broader Impact
The Supreme Court’s decision on contraceptives and employer health plans could affect companies and workers far beyond Hobby Lobby and the other plaintiffs. But nobody seems to know how far. The ruling applies to "closely held for-profit corporations," a small subset of employers, Justice Samuel A. Alito Jr. wrote for the majority. But in a dissenting opinion, Justice Ruth Bader Ginsburg suggests the impact will be far broader (Hancock, 6/30).

Kaiser Health News: What The Hobby Lobby Decision Means For Employers
Kaiser Health News staff writer Mary Agnes Carey and legal analyst Stuart Taylor discuss Monday's ruling on the health law's contraception mandate, examining what the decision could mean for future challenges to the law.

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Court Decision Allows Some Employers To Bypass Contraceptive Mandate

The 5-4 ruling says some closely held corporations cannot be forced to provide services that are at odds with the owners' religious beliefs.

The Washington Post: Supreme Court Sides With Employers Over Birth Control Mandate
The Supreme Court struck down a key part of President Obama's health-care law Monday, ruling that family-owned businesses do not have to offer their employees contraceptive coverage that conflicts with the owners’ religious beliefs. The decision deeply split the court, not only on its holding that the federal Religious Freedom Restoration Act (RFRA) protects some businesses from offering contraceptive coverage but also on how broadly the ruling will apply to other challenges in which businesses say laws impose on their religious beliefs (Barnes, 6/30). 

The New York Times: Supreme Court Rejects Contraceptives Mandate For Some Corporations
The Supreme Court ruled on Monday that requiring family-owned corporations to pay for insurance coverage for contraception under the Affordable Care Act violated a federal law protecting religious freedom. It was, a dissent said, "a decision of startling breadth." The 5-to-4 ruling, which applied to two companies owned by Christian families, opened the door to many challenges from corporations over laws that they claim violate their religious liberty (Liptak, 6/30).

The New York Times: Between The Lines Of The Contraception Decision
Justice Samuel A. Alito Jr., writing for the court, declared that family-owned corporations like Hobby Lobby cannot be forced to pay for insurance coverage for contraception for employees over their religious objections. The ruling means that the Religious Freedom Restoration Act of 1993 applies to corporations, that the contraception requirement placed a substantial burden on companies like Hobby Lobby, and that the government has not chosen the least restrictive means to further a compelling governmental interest — the most demanding test in constitutional law (Schwartz, 6/30). 

The Wall Street Journal: Supreme Court Makes Religious Exception To Health-Care Law
The Supreme Court ruled Monday that "closely held" companies can invoke religious objections to avoid covering contraception in workers' health plans, carving out another piece of the Affordable Care Act. Breaking 5-4 along the justices' conservative-liberal divide, the final decision of the court's term extended the religious protections enjoyed by people and churches to certain employers, in one of the most important rulings on religion in years (Bravin, 6/30). 

NPR: High Court Allows Some Companies To Opt Out Of Contraceptives Mandate
For the first time, the U.S. Supreme Court has ruled that a for-profit corporation can refuse to comply with a general government mandate because doing so would violate the corporation's asserted religious beliefs. By a 5-4 vote, the court struck an important part of President Obama's health care law — the requirement that all insurance plans cover birth control — because it conflicted with a corporation owners' religious beliefs (Totenberg, 6/30). 

USA Today: Justices Rule For Hobby Lobby On Contraception Mandate
The Supreme Court put freedom of religion above reproductive freedom Monday in the most closely watched case of its term, ruling that companies cannot be forced to offer insurance coverage for certain birth control methods they equate with abortion (Wolf, 6/30). 

Los Angeles Times: Supreme Court, Citing Religious Liberty, Limits Contraceptive Coverage In Obamacare
The Supreme Court ruled for the first time Monday that private companies had a religious right to be exempted from federal law, saying a business owned by devout Christians may refuse to pay for insurance covering contraceptives for female employees. The 5-4 ruling was a victory for social conservatives and the high court's most significant statement on religious liberty in years (Savage, 6/30). 

Politico: SCOTUS Sides With Hobby Lobby On Birth Control
The ruling deals directly with only a small provision of Obamacare and will not take down the entire law but it amounts to a huge black eye for Obamacare, the administration and its backers. The justices have given Obamacare opponents their most significant political victory against the health care law, reinforcing their argument that the law and President Barack Obama are encroaching on Americans’ freedoms (Haberkorn and Gerstein, 6/30). 

Kaiser Health News: Supreme Court Limits Contraceptive Mandate For Certain Employers
A sharply divided Supreme Court ruled Monday that at least some for-profit corporations may not be required to provide contraceptives if doing so violates the owners’ religious beliefs. But the five-justice majority writing in Burwell v Hobby Lobby, et al., took pains to try to limit their ruling only to the contraceptive mandate in the health law and only to "closely held" corporations like the family-owned businesses represented by the plaintiffs in the case (Rovner, 6/30).  

Kaiser Health News: FAQ: High Court's Hobby Lobby Ruling Cuts Into Contraceptive Mandate
In a 5-4 decision Monday, the Supreme Court allowed a key exemption to the health law’s contraception coverage requirements when it ruled that closely held, for-profit businesses could assert a religious objection to the Obama administration’s regulations. Here are some frequently asked questions and answers about the case (Carey, 6/30). 

Associated Press: Court: Can't Make Employers Cover Contraception
The justices' 5-4 decision, splitting conservatives and liberals, means the Obama administration must search for a different way of providing free contraception to women who are covered under the health insurance plans of objecting companies. Justice Samuel Alito wrote in his majority opinion, over a dissent from the four liberal justices, that forcing companies to pay for methods of women's contraception to which they object violates the 1993 Religious Freedom Restoration Act. He said the ruling is limited and there are ways for the administration to ensure women get the birth control they want (Sherman, 7/1). 

The Fiscal Times: SCOTUS Hobby Lobby Ruling Chips Away At Obamacare
The Supreme Court just dealt a blow to the White House by ruling that the Obamacare provision requiring employers to provide four forms of birth control as part of their health insurance plans violates the religious liberties of some small businesses. Those forms, including the morning after pill, are considered abortive by some religious groups (Ehley, 6/30).

CBS News: Supreme Court's Hobby Lobby Decision Could Impact Millions Of Women
The Supreme Court today upheld a challenge to a key provision of Obamacare -- the one that requires coverage for birth control. Many religiously affiliated employers were already exempt from the requirement. On Monday, the court said some for-profit companies don't have to pay for contraceptives either, if they object on religious grounds. The Supreme Court case was a political firestorm, pitting women's rights against religious freedom. Inside the court, the justices were also deeply divided and sharply at odds in their approach to the case (Crawford, 6/30).

Fox News: Supreme Court Rules ObamaCare Provision Can't Force Some Employers To Cover Contraception
The 5-4 decision, in favor of arts-and-crafts chain Hobby Lobby and one other company, marks the first time the court has ruled that for-profit businesses can cite religious views under federal law. It also is a blow to a provision of the Affordable Care Act which President Obama's supporters touted heavily during the 2012 presidential campaign (6/30).

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Businesses Prepare For Next Phase Of Health Law Implementation

Large employers around the country are hard at work to meet requirements that take effect in 2015. Also, in health law-related coverage, a look at proposals for cheaper plans on the marketplaces.

Cincinnati Enquirer/USA Today: Businesses Tackle The Obamacare Equation
David Tramontana is still crunching the numbers. His firm has spent thousands of dollars hiring consultants to walk him through the ins and outs of complying with new rules on the horizon under health reform. ... Across the country, large employers like Black Stone are hustling to comply with requirements of the Patient Protection and Affordable Care Act that are set to move into full swing in 2015 (Bernard-Kuhn, 6/30). 

Kaiser Health News: Proposal To Add Skimpier 'Copper' Plans To Marketplace Raises Concerns
If you offer it, will they come? Insurers and some U.S. senators have proposed offering cheaper, skimpier 'copper' plans on the health insurance marketplaces to encourage uninsured stragglers to buy. But consumer advocates and some policy experts say that focusing on reducing costs on the front end exposes consumers to unacceptably high out-of-pocket costs if they get sick. The trade-off, they say, may not be worth it (Andrews, 7/1).  

And a new poll examines consumer attitudes about wellness programs -

Kaiser Health News: Poll: Americans Bristle At Penalties In Wellness Programs
Workers believe employer wellness programs should be all gain but no pain, according to a poll released Tuesday. The poll from the Kaiser Family Foundation found employees approve of corporate wellness programs when they offer perks, but recoil if the plans have punitive incentives such as higher premiums for those who do not take part. ... Wellness programs, which are encouraged under the federal health law, are structured in various ways. (Rau, 7/1).

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Reform Roundup: Georgia Exchange Attracts More Insurers; Kansas Embraces One Part Of Health Law

Developments in Massachusetts and New Hampshire are also examined.

Georgia Health News: More Insurers Seek To Join 2015 Georgia Exchange
UnitedHealthcare, Coventry, Cigna and Time Insurance Company have each submitted plans with the state to offer health insurance in the federally run exchange in Georgia next year. They join the five holdovers from this year’s exchange that are also submitting rates for review: Alliant Health Plans, Blue Cross and Blue Shield of Georgia, Humana, Kaiser Permanente, and Peach State Health Plans. The state’s deadline for applications for the Georgia exchange was midnight Monday (Miller, 6/30).

The Boston Globe: No Money Set Aside For Shift In Medicaid
The stopgap program that enrolled tens of thousands of people in temporary Medicaid coverage after the failure of the Massachusetts health insurance website is not going to have a big effect on the state budget, at least not by the Legislature’s reckoning. The spending plan approved Monday contains about the same for Medicaid as Governor Deval Patrick had proposed in January, before the transitional program started: $13.6 billion. That’s because legislators expect that a trend showing lower use of health care services will provide the leeway to absorb the temporary population. The budget does, however, require the administration to calculate and report, by the end of July, the financial impact of the Massachusetts Health Connector’s inability to develop a website that meets the terms of the federal Affordable Care Act (Freyer, 7/1).

Kansas Health Institute News Service:  Where KanCare Meets Obamacare
Gov. Sam Brownback once called Obamacare "an abomination," and with the federal health reform law now four years on the books, bad-mouthing it has become a conservative Republican ritual. But this week, after more than a year of planning and preparation by Kansas and federal officials, the Affordable Care Act and Brownback’s own KanCare initiative begin coming together in ways that will make the two programs indistinguishable to as many as 72,000 Kansas Medicaid beneficiaries. Kansas officials will launch the Medicaid health homes program, which is a key but little-publicized Obamacare component, by sending letters to the thousands of potential participants informing them they will be included in it unless they opt out (Shields, 6/30). 

Kaiser Health News: Capsules: A Uniquely New Hampshire Approach’ To Medicaid Expansion
New Hampshire became the 26th state today to embrace the federal health law’s expanded Medicaid program, with as many as 50,000 low-income residents expected to begin signing up (Galewitz, 7/1).

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Health Care Marketplace

Justices Rule Home Health Care Aides Can't Be Forced To Pay Union Dues

The high court's ruling will make it more difficult for unions in some states to continue organizing the aides, a rapidly growing segment of the workforce.

The New York Times: Ruling Against Union Fees Contains Damage To Labor
The Supreme Court dealt a limited blow to organized labor on Monday by ruling that some government employees did not have to pay any fees to the unions representing them. But the court declined to strike down a decades-old precedent that required many public sector workers to pay union fees. ... Justice Alito wrote that home-care aides who typically work for an ill or disabled person, with Medicaid paying their wages, should be classified as partial public employees and should not be treated the same way as public schoolteachers or police officers who work directly for the government (Greenhouse, 6/30).

The Wall Street Journal: Justices Rule Certain Workers Can't Be Forced To Pay Union Fees
Home-based care workers in Illinois aren't full-fledged public employees so they can't be forced to pay dues to a union they don't want to join, a divided Supreme Court said. But the limited ruling stopped short of barring organized labor from collecting fees from government workers who object to union representation (Kendall and Trottman, 6/30). 

The Washington Post: Supreme Court: Home Health-Care Workers Can’t Be Required To Pay Union Fee
Thousands of home health-care workers cannot be forced to pay union fees if they are not in a union, the Supreme Court ruled Monday, dealing a defeat to organized labor and foreshadowing a potentially far more serious blow to come. ... The case had prompted widespread concern among public-sector unions because Illinois had deemed the aides, who are paid by the state, to be public employees. But the court said the aides are only quasi-public because their real employers are their patients (Markon and Barnes, 6/30). 

Los Angeles Times: Supreme Court Ruling On Home Healthcare Workers A Setback For Unions
In a 5-4 opinion written by Justice Samuel A. Alito Jr., the court said the home healthcare assistants, some of whom care for their own loved ones, had a constitutional right not to support a union they opposed. The decision will make it more difficult in some states for unions to continue organizing home healthcare assistants, a rapidly growing segment of the workforce that is expected to double in the next decade thanks to the aging U.S. population (Phelps and Savage, 6/30). 

The CT Mirror: Connecticut Closely Scrutinizing Supreme Court’s Home Care Union Ruling
In a decision that could have implications for two controversial Connecticut unions, a divided U.S. Supreme Court ruled Monday in favor of Illinois home care workers who objected to paying fees to a union representing them. The case had been closely watched by people in Connecticut involved in unions that represent home care workers and day care providers -- units formed under circumstances similar to those in Illinois. The Connecticut unions represent workers who are paid with funds from state programs. But the workers are considered to be employed by the people they serve -- people with disabilities, seniors or parents of children in day care (Becker, 6/30).

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Administration News

Former Procter & Gamble CEO Tapped To Turn Around VA System

President Barack Obama highlighted Robert McDonald’s management experience at P&G more than his military career as an Army Ranger in the 82nd Airborne Division. However, the West Point graduate has never run a health care system, let alone a sprawling one with 1,700 hospitals and clinics.

The Wall Street Journal: Former Procter & Gamble CEO Tapped As New VA Secretary
In turning to Robert McDonald to fix the Department of Veterans Affairs, President Barack Obama is banking that a longtime corporate executive has the skills to revamp the beleaguered veterans' health system. Mr.  McDonald's 33-year tenure at consumer-products giant Procter & Gamble Co. offers a glimpse at the skills he would bring to the job. He was known as a straight shooter with a tireless work ethic. ... At the same time, during his years as CEO from 2009 to mid-2013, P&G stumbled with weak financial results and some delayed or poorly executed product launches (McCain Nelson and Ng, 6/30). 

The New York Times: V.A. Nominee McDonald Faced Criticism At Procter & Gamble
On Monday, Mr. McDonald, a 61-year-old former Army captain and West Point graduate, became President Obama’s pick to unscramble the Department of Veterans Affairs, a $154-billion-a-year agency of 300,000 employees that has become an enterprise of dysfunction and has lost the trust of many of the nine million people it serves. ... Mr. McDonald had critics at Procter & Gamble, but on Monday some analysts, including one who was a harsh judge of his tenure there, said that trying to turn around a government bureaucracy might be more suited to Mr. McDonald’s skills (Oppel, 6/30). 

The Washington Post: Obama Taps Robert A. McDonald To Lead VA, Tackle Troubled Agency’s Many Challenges
Speaking at the department’s headquarters, Obama said McDonald was well-suited to fix what an administration report has found to be “significant and chronic system failures,” a “corrosive culture” and major dysfunction at the Veterans Health Administration, which has faced scandal over long waits encountered by veterans seeking care (Goldfarb and Eilperin, 6/30). 

Politico: Barack Obama Announces VA Pick
President Barack Obama announced his intention Monday to nominate former Procter & Gamble executive Robert McDonald to lead the Department of Veterans Affairs, as he vowed to continue to push to reform the troubled agency. ... Leading efforts to improve the agency — and the Veterans Health Administration, which is part of the department — “is not going to be an easy assignment,” the president said, but he believes that McDonald is well-suited for the task. The ex-P&G CEO “has a reputation for being ready, for jumping into tough situations and going all the way” (Epstein, 6/30). 

The Chicago Sun-Times: Chicago-Area Native Brings Consumer Approach To VA
President Barack Obama’s pick to fix the scandal-plagued Department of Veterans Affairs is Robert McDonald, a former Procter & Gamble CEO and a graduate of West Point and the now-closed Arlington High School in Arlington Heights. In announcing McDonald as his pick on Monday, Obama highlighted McDonald’s management experience at P&G more than his military career as an Army Ranger in the 82nd Airborne Division. To quickly fix problems in delivering health care to veterans, many lawmakers on Capitol Hill — and top White House aides — concluded that a new model was needed: Not a military officer but rather someone with experience in running massive, complex consumer-oriented operations (Sweet, 6/30).

The Fiscal Times: McDonald’s VA ‘To-Do-List’ Includes 6 Urgent Fixes
Bob McDonald, the former Proctor & Gamble chief executive who was nominated by President Obama on Monday to take charge of the Veterans Affairs Department, will face a great challenge as he tries to reform the agency’s sprawling and scandal-ridden medical treatment system -- a system that may have led to the deaths of many veterans who were forced to wait too long for care. McDonald, 61, is a well-regarded corporate strategist and a one-time military officer who graduated from the U.S. Military Academy at West Point, N.Y., but he’s had no direct involvement in managing a huge medical treatment system. He’ll need all the good advice and counsel he can get to manage the VA’s 1,700 hospitals and clinics, assuming the Senate confirms him (Pianin, 7/1).

Meanwhile, a Pentagon official responds to a New York Times probe of the military health system -

The New York Times: Official Seeks Restored Trust In Military Care
The Pentagon’s senior health-affairs official said Monday that the armed forces’ global network of hospitals and clinics must work to restore trust in the caliber of health care following disclosures of shortcomings in maternity and surgical care and a pattern of avoidable errors that have led to injuries and contributed to some deaths (LaFraniere, 6/30). 

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Women's Health

American College Of Physicians: Doctors Should Not Perform Routine Pelvic Exams

The procedure is currently recommended as part of well-woman visits, but the group found no evidence that cancer is detected by pelvic exams alone.

The New York Times: Guideline Calls Routine Exams Of The Pelvis Unnecessary 
Doctors should stop performing routine pelvic exams, a key component of regular physicals for women, an influential medical group said Monday. There is no evidence that such pelvic exams are useful and plenty to suggest that the procedure provokes fear, anxiety and pain in many women, the American College of Physicians said in a new practice guideline for doctors (Rabin, 6/30).

Kaiser Health News: Pelvic Exams No Longer Recommended For Well-Woman Visits
[T]he latest evidence review found that in non-pregnant adult women without symptoms, there are no studies showing that cancer is actually detected by pelvic exams alone. And the screenings are more likely to hurt women than help them. The most likely harms include pain, discomfort, anxiety, embarrassment and fear for the woman, says  Bloomfield. But in more serious cases, doctors may also identify false positives that can subject the patient to "a diagnostic cascade" of unnecessary tests and even surgery (Gold, 7/1).

The Washington Post: Healthy Women Do Not Need Routine Pelvic Exams, Influential Physicians Group Says 
As a result, in a new guideline it issued Monday, the organization “recommends against performing screening pelvic examination in asymptomatic, non-pregnant, adult women” who have no elevated risk of cancer or other disease. Healthy women should continue to have Pap smears as recommended by their doctors, the group said (Bernstein, 6/30). 

NPR: Skip The Stirrups: Doctors Rethink Yearly Pelvic Exams 
Not all doctors agree about these new guidelines. "This recommendation will be controversial," obstetrician-gynecologist Dr. George Sawaya wrote in an accompanying editorial with a colleague at the University of California, San Francisco. "Pelvic exams have long been considered a fundamental component of the well-woman visit" (Doucleff, 6/30).

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Medicare

UnitedHealth Subsidiary Helps Hospitals Get More From Medicare

The company, Executive Health Resources, is often at the center of battles between hospitals and Medicare over how the facilities bill, reports The New York Times. Meanwhile, more health providers are participating in Medicare's experiments with bundled payments. 

The New York Times: UnitedHealth, An Insurer Switching Roles, Helps Hospitals On Medicare Billing
To hospitals, billions of dollars depend on how they define a patient’s stay. Even though a patient may be in the hospital for a simple surgery, Medicare might classify the procedure as outpatient care and pay a lower fee to the hospital. ... UnitedHealth also owns a little-known consultant that is flourishing by helping hospitals exploit what they describe as a gray area in Medicare payments for hospital stays, fighting to get what can amount to thousands of dollars more per patient. The consultant, Executive Health Resources, is often at the center of battles between hospitals and Medicare over how the facilities bill (Abelson, 6/30).

Modern Healthcare:  CMS To Expand Bundle Payment Initiative 
More hospitals, nursing homes and healthcare providers are poised to join Medicare's ambitious test of bundled payments, and the expansion underscores federal policymakers' eagerness to accelerate reforms in healthcare financing -- even ahead of evidence that new models will succeed (Evans, 6/30). 

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State Watch

State Roundup: Christie Vows Overhaul Of Pension, Health Benefits; Ill., Fla. Move More Into Medicaid Managed Care

The Wall Street Journal: New Jersey's Chris Christie Vows To Persevere On Pension Reform
Gov. Chris Christie said he would propose an overhaul to the state's pension and health benefits system later this summer, revisiting an issue that burnished his national political image in 2011 but challenged him this spring when he scaled back promised funding. As the governor signed a $32.5 billion budget on Monday, he vetoed tax increases designed to offset pension costs and called changing the pension and benefits system his main economic priority for 2014 (Dawsey and Haddon, 6/30).

Texas Tribune: The Widow Vs. The Insurer: A Wife's Fight For Her Families Future
After Crystal Davis' husband died, the state ruled his death a workplace fatality and awarded her family benefits under the workers’ compensation system. But the insurance company is fighting the order in court. The lawyers have even sued her two young children to take away their half of the proceeds. ... Crystal felt like they were adding insult to her husband’s fatal injury. ... In Texas, where disputes in the workers’ compensation system tend to cut the way of the insurer, critics say she is not alone (Root, 7/1). 

Miami Herald: Medicaid Managed Care Arrives Tuesday In South Florida 
Beginning Tuesday, more than a half million South Floridians, mostly children and women, will begin receiving their government-subsidized healthcare through private insurers, part of an effort to move about 3.6 million Floridians on Medicaid to a managed care model that lawmakers believe will cut costs. Broward, Miami-Dade and Monroe counties are the latest to transition their entire Medicaid populations to private insurers, though nearly 350,000 Medicaid recipients in the region — and 1.1 million across the state — have participated in experimental managed care programs since 2005 (Chang, 7/1). 

Associated Press: Illinois Pushes Ahead With Medicaid Managed Care 
Facing a Jan. 1 deadline, the state's top Medicaid official announced a timetable Monday for moving hundreds of thousands of low-income patients into managed care health plans. Department of Healthcare and Family Services Director Julie Hamos said 1.7 million people will get packets in the mail by the end of the year outlining their health plan choices and giving an enrollment phone number. The change affects Medicaid patients in about 30 counties in central and southwestern Illinois and in regions including Rockford, Chicago and the Quad Cities. Those who don't choose a plan will be assigned to one. Patients can switch during the first 90 days (Johnson, 6/30). 

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Editorials and Opinions

Viewpoints: Hobby Lobby Decision Celebrated And Panned; Gender And Religious Politics Explored

Los Angeles Times: Hobby Lobby ruling: Bad For Women's Rights, Bad For The Religious Freedom Restoration Act
In ruling 5 to 4 that "closely held" companies can refuse on religious grounds to include contraceptives in their employees' health plans, the Supreme Court has needlessly interfered with an important provision of the Affordable Care Act. And it has done more than that (7/1).

The New York Times: Limiting Rights: Imposing Religion On Workers
The Supreme Court’s deeply dismaying decision on Monday in the Hobby Lobby case swept aside accepted principles of corporate law and religious liberty to grant owners of closely held, for-profit companies an unprecedented right to impose their religious views on employees (6/30).

The Wall Street Journal: Religious Liberty Affirmed 
Judging by the liberal reaction, you would think the Supreme Court majority that struck down part of ObamaCare's birth-control mandate on Monday has suddenly imposed Shariah law. Yet as a matter of law rather than political opportunism, the narrow decision is an important vindication of religious liberty in this (still, blessedly) pluralistic constitutional republic (6/30).

The Washington Post: Congress Should Narrow The Religious Freedom Restoration Act 
Justice Alito discouraged speculation that the court’s decision will lead to the weakening of other public health mandates, such as those covering vaccines or blood transfusions. Even if corporations enjoy religious protections, he wrote, the court must apply a balancing test before requiring exceptions, a balancing test the contraception mandate — and, at this point, only the contraception mandate — did not pass. But that balancing test may be tough for the government to satisfy in other circumstances, too, if it is applied as aggressively as the court did in this instance. ... If this is the sort of balancing that the Supreme Court will conduct, Congress should change the law (6/30).

USA Today: Hobby Lobby Decision Creates A Minefield: Our View 
The most generous reading of the Supreme Court's 5-4 decision Monday in the so-called Hobby Lobby case is that it narrowly upheld the right of deeply religious business owners not to be forced by the government to violate their beliefs. The majority took pains to say how limited the decision is. ... But in even raising these issues, the court crossed a new threshold, extending legal guarantees of religious freedom to for-profit businesses, with uncertain and potentially troubling consequences (6/30).

USA Today: Justices Uphold Religious Freedom: Opposing View 
The Supreme Court's decision does not open a can of worms. It is a specific interpretation of the Religious Freedom Restoration Act, a federal law. The merits of future cases will be carefully determined, as done by the court for centuries, on a case-by-case basis. Undeniably, religious freedom is a basic human right. When it comes to issues of religion in our country, we expect two things from our government: tolerance and evenhanded justice. The contraception mandate never came close to satisfying either. It forced Americans to violate their religious beliefs under threat of devastating fines (Erin Mersino, 6/30).

The Boston Globe: Supreme Court Loses Its Way In Vague Contraceptive Decision
The Supreme Court decision on Monday that curtailed the federal rule requiring some big employers to provide contraceptive coverage in their health insurance plans was a setback for employees, but hopefully not a calamity. The much-anticipated ruling in the Burwell v. Hobby Lobby case limited the mandate, but spelled out a way for the federal government to provide contraceptive coverage for affected employees anyway. Doing so would uphold the law’s overriding goal: ensuring that Americans have equal access to adequate reproductive health care. Still, the ruling holds the potential to create great mischief by keeping alive the flawed legal notion that companies can pick and choose which laws to follow so long as they cite a religious justification (6/30).

The New York Times' Room For Debate: Congress, Religion And The Court
The Supreme Court ruled on Monday that requiring family-owned corporations to pay for insurance coverage for contraception under the Affordable Care Act violated the Religious Freedom Restoration Act. That act requires that federal laws meet stringent standards if they interfere with religious practices. Does that go too far in protecting those rights? (6/30).

The New York Times: The Political Repercussions Of The Hobby Lobby Decision
Normally it’s not a good idea to jump right into the political implications of a major Supreme Court decision like Hobby Lobby, but in this case there’s no point in waiting. This was a political decision and it is absolutely proper for Democrats to use it as a weapon in the midterm election campaign (David Firestone, 6/30). 

The New York Times: How Hobby Lobby Ruling Could Limit Access to Birth Control
The Supreme Court ruling in the Hobby Lobby case raises at least two questions: How will it affect access to contraception, and what do the drugs and devices the company objected to on religious grounds actually do? A growing body of evidence shows that it is already hard to obtain certain kinds of contraception, and the ruling seems likely to increase barriers (Aaron E. Carroll, 6/30).

The Washington Post: Hobby Lobby Should Walk The Moral Path It Talks About
Okay, Hobby Lobby. You can still fix this. There’s one way to come out of this looking decent, walking that righteous, pious, moral path you talk about. The Supreme Court has decided that you have the right to deny covering contraception for thousands of your female employees. Now you should provide the most fantastic, bang-up, paid and protected parental leave in the United States (Petula Dvorak, 6/30).

The Washington Post: In Hobby Lobby Ruling, The Supreme Court Uses A 'Fiction'
Mitt Romney said it, and on Monday the Supreme Court upheld it: Corporations are people, my friend. ... In its last day in session, the high court not only affirmed corporate personhood but expanded the human rights of corporations, who by some measures enjoy more protections than mortals -- or "natural persons," as the court calls the type of people who do not incorporate in Delaware. In 2010, the court ruled that corporations are people for the purposes of making unrestricted political contributions. Now, the court has decided that some corporations have religious beliefs, just like other people (Dana Milbank, 6/30).

The Washington Post: Sandra Fluke: The Hobby Lobby Case Is An Attack On Women
Today’s cases weren’t about those types of religious organizations. They were about privately owned, closely held, for-profit corporations. Today, the Court ruled that such corporations have religious rights under federal statute, just as individuals do. Corporations are not people. Corporations cannot have religious views. And this decision sends us in a dangerous direction (Sandra Fluke, 6/30). 

The Wall Street Journal: What Women Think Of The Core Issue In The Hobby Lobby Case
The Supreme Court decision upholding Hobby Lobby’s ability to refuse to cover certain contraceptive services based on its owners’ religious beliefs has set off a wave of analysis of what the decision means. That will not be resolved anytime soon. But we do know what women think of the policy issue at the core of the case. Overall, by a margin of 59% to 35%, women oppose the idea of letting companies deny coverage of contraceptives based on their owners’ religious beliefs. But women’s views on this issue–studied in the Kaiser Family Foundation Health Tracking Poll last month–differ by party, ideology and their religion (Drew Altman, 6/30).

The Washington Post's Plum Line blog: The Common Thread Of Supreme Court Decisions: You’re On Your Own
Although the Supreme Court’s decision in the Hobby Lobby case is getting most of the attention today, the other major case the justices decided, regarding public-sector unions, could prove to be even more significant. And in both cases, the court had a common message: You’re on your own (Paul Waldman, 6/30). 

Los Angeles Times: The Craziest Thing About The Supreme Court's Hobby Lobby Decision
But something else is troublesome about the case, at least to me. And that is the idea that the justices simply accepted without question the claim by the Greens, a Christian family who own the Hobby Lobby chain of craft stores, that the four types of birth control they refuse to cover -- two kinds of IUDs and two morning-after pills -- cause abortion. They do not (Robin Abcarian, 6/30).

Los Angeles Times: Get Ready For An Even Bigger Threat To Obamacare
Now that the Supreme Court has issued its ruling in the Hobby Lobby case, the legal fight over the Affordable Care Act will shift a few blocks away to another Washington courtroom, where a far more fundamental challenge to Obamacare is about to be decided by the powerful U.S. Court of Appeals for the D.C. Circuit. Indeed, if Hobby Lobby will create complications for Obamacare, Halbig vs. Burwell could trigger a full cardiac arrest (Jonathan Turley, 6/30).

Los Angeles Times: The Broad Reach Of The Narrow Hobby Lobby Ruling
The Supreme Court's decision striking down the contraceptive mandate for family-owned businesses seems narrow, but its implications are broad and disturbing. The Supreme Court, in a 5-4 ruling Monday, held that it violated the federal Religious Freedom Restoration Act to require that a family-owned business, technically called a "closely held" corporation, include contraceptive coverage for women in the insurance it provides its employees (Erwin Chemerinsky, 6/30).

Los Angeles Times: Alito Agrees: Your Birth Control Is Not Your Boss' Business
Abortion-rights protesters gathered outside the Supreme Court on Monday holding signs that read "Birth Control: Not My Boss's Business." Much to their chagrin, Supreme Court Justice Samuel A. Alito Jr. agreed in his ruling in the Hobby Lobby case. Of course, that's not how supporters of the government's contraception mandate see it. They actually believe that birth control is their boss' business, and they want the federal government to force employers to agree (Jonah Goldberg, 6/30).

Fox News: Hobby Lobby Ruling: Why Supreme Court Got It Right
Monday’s ruling in the case of Sebelius vs. Hobby Lobby is an important victory for religious liberty for people of all faiths, regardless of what secularists will argue in their criticism of the Supreme Court’s decision. Liberals have tried to obfuscate the real issue in the case by insisting that it was about the merits of employer-mandated healthcare, the propriety of contraception, or the right of a woman to have an abortion.  In reality, Hobby Lobby already provided health care for its employees. Additionally, the company’s insurance covers 16 of the 20 contraceptives required under the HHS mandate (Robert Jeffress, 6/30).

And on other issues-

The New York Times: Limiting Rights: A Hit To Collective Bargaining
In Harris v. Quinn, eight home-care aides, who are paid by their customers with Medicaid funds, challenged an Illinois law that required them to pay what are known as “fair share” fees to the Service Employees International Union, even though they had chosen not to join the union. The union — which is legally compelled to represent both members and nonmembers — used those fees (which are less than members’ dues) to negotiate on the aides’ behalf for higher wages and other benefits. Under this common arrangement, everybody won: Illinois’ 20,000-plus home-care aides, who have been among the poorest-paid workers, saw their hourly wages rise from $7 in 2003 to $13 in 2014. They got state-financed health insurance, better training and more protective workplace-safety measures. Meanwhile, the state avoided the high costs of institutionalizing their customers (6/30).

The New York Times: Renouncing Corporate Citizenship
The same chief executive who said he was so "proud of our Illinois heritage" is now considering moving the company’s headquarters to Switzerland as part of a merger with Alliance Boots, a European drugstore chain. Why? To lower Walgreen’s tax bill even further. ... In Walgreen’s case, an inversion would be an affront to United States taxpayers. The company, which also owns the Duane Reade chain in New York, reaps almost a quarter of its $72 billion in revenue directly from the government; it received $16.7 billion from Medicare and Medicaid last year (Andrew Ross Sorkin, 6/30).

The Milwaukee Journal Sentinel: Ending The Cycle Of Poverty And Poor Health
Health disparities in our community are undeniable. The Milwaukee Journal Sentinel's "Poor Health" series of special reports highlights the complex economic and social factors that influence health care delivery and determine health outcomes — especially for low-income individuals and people of color. Indeed, research and our community's experience have shown that there is a direct link between poverty, racism and poor health (Cathy Jacobson and Joy Tapper, 6/30).

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EDITOR:
Stephanie Stapleton

ASSOCIATE EDITOR:
Andrew Villegas

WRITERS:
Lisa Gillespie
Marissa Evans

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.