health law

Now that American consumers can start shopping for private health insurance through exchanges, the Washington Post has a great explainer on how the exchanges will work. 

Some things I learned that I didn't know:

1. If folks can't find an affordable plan, they don't have to buy coverage if it's more than 8% of their income.

2. The proportion of people who won't be affected by the law is higher than I thought. Only 20% of Americans don't get insurance from employers or the government and will need to access the exchanges.

3. Smokers have to disclose their tobacco use and will be charged extra for their health insurance.

The clash over the requirement that most employers, as well as insurers for religious institutions that are not directly associated with houses of worship, cover female employees' contraception is primed for the U.S. Supreme Court, UPI reports. The Sixth and Third Circuits ruled against challenges to the insurance mandate to cover contraception, but the 10th Circuit has ruled in favor of a challenge by two private, secular companies, UPI also reported. The Solicitor General has asked the Supreme Court to grant certiorari on the issue, and such requests tend to be granted by the justices, UPI also reports.

The Mental Health Parity and Addiction Equity Act of 2008 was supposed to ensure mental-health treatment and addiction-treatment services get the same coverage from insurers as physical ailments. "But five years after President George W. Bush signed the law, there is widespread agreement that it has fallen short of its goal of creating parity for mental health coverage," the New York Times reports. One of the issues is regulations to put meat on the bones of the statute have never been written by federal regulators. 

A physician-legislator opined this weekend in The Washington Post that a moratorium should be declared on rolling out electronic health records. One problem is "entry errors and inconsistencies are becoming common." Another problem is different institutions all have different systems. Another problem is doctors end up staring at computer screens, not listening to patients during visits. The columnist wants one national system.

Two separate cases have reached the U.S. Supreme Court seeking certiorari on the mandate that all health insurance cover contraception and other means of ending pregnancies. The Tenth Circuit sided with an employer opposing providing such coverage, while the Third Circuit sided against an employer, according to this clip from The Cardinal Newman Society, which promotes Catholicism. The stage is now set for a circuit split on the tension between women's reproductive rights and religious beliefs.

Rather than expanding Medicaid to cover more Pennsylvanians when the mandate to have health insurance kicks into effect, Pennsylvania Tom Corbett proposed yesterday that funds for the expansion instead be used to help state residents get private health insurance. The pitch will need federal approval.

When the US Supreme Court upheld the constitutionality of the insurance mandate under Congress' taxing power, the court separately rejected making the expansion of Medicaid mandatory upon the states. Some Republican governors have accepted the expansion, while others like Corbett have not.

 The Harrisburg Patriot News editorial board welcomed Corbett's efforts to expand insurance coverage for poorer Pennsylvanians but said requiring participants to look for work in exchange for coverage and imposing a modest co-pay might make the plan unworkable. Read the full piece here: http://www.pennlive.com/opinion/index.ssf/2013/09/corbett_rolls_the_dice...

In closing the board said: "The insurance gap remains one of the most pressing public policy questions of our time. The first and only priority should be closing that gap. Ideology, if it is a factor at all, should finish a distant second."

The Lawrence Journal-World reports: "One group that won't be required to have health insurance when the Affordable Care Act's individual mandate goes into effect next year is American Indians, of which Douglas County has a larger-than-average population. The health reform law often known as Obamacare mandates that Americans carry some type of health insurance in 2014 or be fined. The 2010 law does, however, exempt certain people from that requirement: members of religious groups opposed to insurance, undocumented immigrants, prisoners, Americans who either don't make enough money to file taxes or would have to spend more than 8 percent of their income on premiums, and American Indians eligible for care through the Indian Health Service."