health law

Now that the U.S. Supreme Court has upheld the use of tax subsidies for people buying health insurance on the federal exchange in King v. Burwell, business groups are going to press Congress to modify elements of the Affordable Care Act, Hospitals & Health Networks Daily's Marty Stempniak reports: "Trade groups representing employers — such as the National Retail Federation and American Benefits Council — urged Congress to 'seize the opportunity' and address what they say are shortcomings in the law. Those include repealing the employer mandate and Cadillac tax on pricier plans, reforming reporting requirements, and upping the 30-hour work week standard for eligibility to 40 hours."

Healthcare advocates also are going to push for the expansion of Medicaid in the Republican-led states that have refused to allow for it. Dr. John Ayanian, director of the Institute for Healthcare Policy and Innovation at the University of Michigan, told Stempniak that federal regulators may allow more flexibility in Medicaid programs, which could entice more states to participate in Medicaid expansion.

The U.S. Supreme Court has ruled that the federal government can provide tax subsidies to help low-income and midde-class Americans buy health insurance, whether they buy their policies on the federally-run exchange or state-run exchanges, The New York Times' Adam Liptak reports. The decision was 6-3 with only Justices Antonin Scalia, Clarence Thomas and Samuel A. Alito Jr. dissenting.

At issue was whether subsidies were only available to people buying insurance on "an exchange established by the state."

About 85 percent of customers using the exchanges qualify for subsidies, Liptak reports.

Last week, the Iowa Supreme Court struck down that state's ban on doctors prescribing abortion-inducing pills to patients via video teleconferencing, the Associated Press reports. Iowa was the first state to allow doctors to dispense abortion-inducing medications through telemedicine.

The court ruled that it placed an undue burden on a woman's right to get an abortion. The Iowa Board of Medicine enacted a rule requiring a doctor be physically present with a patient before prescribing such drugs. However, the board had allowed telemedicine for other procedures.

MedicalResearch.com has an interview with Eric T. Roberts and Darrell Gaskin, who reported on their research finding that the Affordable Care Act's expansion of Medicaid is going to require 2,100 more primary care providers, especially in low-income areas. The good news is they think "that this need for additional providers is manageable, particularly if Congress fully funds key primary care workforce training programs, such as the National Health Service Corps."

Arkansas has decided against imposing cost-sharing on people who are receiving Medicaid coverage under the Obamacare expansion if they are below the federal poverty level, Modern Healthcare's Virgil Dickson reports.

President Obama's administration has allowed Arkansas to mandate that beneficiaries make monthly contributions to "health independence accounts" if they enrolled in private plans on the new insurance exchange. Cost-sharing will be imposed for people above the poverty line.

Attempts by legislative leaders to use Alaska's budget to stop the governor from accepting federal funds to expand Medicaid are likely unconstitutional, the Alaska Dispatch's Pat Forgey reports.

The governor wants to expand healthcare coverage to 20,000 or more low-income Alaskans. Legislators included provisions in the operating budget aiming to stop Governor Bill Walker from unilaterally accepting $130 million in federal money for the program.

Counsel for both the governor and for the legislature have concluded the legislative language is likely unconstitutional because the state constitution confines budget bills to appropriations.

The U.S. Supreme Court is considering whether low-income taxpayers can only receive subsidies for health insurance if they purchased their policies on state-run insurance exchanges, not federal exchanges. The four words at issue in the Affordable Care Act? "Established by a state." The New York Times' Robert Pear reports that the two dozen Democrats and Republicans involved in writing the law say those four words were not meant to make tax subsidies in the law available only in states that established their own health insurance marketplaces.

For example, former Senator Jeff Bingaman, Democrat of New Mexico, said the words in dispute are a "'drafting error."' Christopher E. Condeluci, who was a staff lawyer for Republicans on the Finance Committee, told Pear that, when senators drafted a backup plan to allow the federal government to establish an exchange in any state that didn't have its own, it was an oversight to not include a cross-reference to the section of the tax code providing subsidies.

But Pear notes that some Supreme Court justices, including Justice Antonin Scalia, interpret laws based not on "'what Congress would have wanted, but what Congress enacted.”'

The Canadian province Ontario has empowered patients and their caregivers to control the types of services they receive at home, The Canadian Press reports. The self-directed care program will start with pilot projects first with the goal "to give patients and their caregivers more flexibility and control over the care they receive by involving them more in the planning and coordination at the start." Additional funding will provide 80,000 additional nursing hours for patients with more complex needs so they can stay at home instead of being cared for at a hospital or nursing home.

Even though the Supreme Court is going to issue rulings that could affect health care, capital punishment and same-sex marriage in the next few weeks, Pew Research Center's Meredith Dost reports that polling shows many Americans know very little about the highest court in the country. For example, only one-third knew that there are three women on the court and only 28 percent correctly identified Justice Anthony Kennedy as the swing vote.

There was an interesting bioethics ruling in Canada last month at the crossroads of traditional medicine and modern medicine. A young aboriginal girl has leukemia, and a Canadian judge ruled that her mother has a constitutional right to seek indigenous medicine, rather than chemotherapy, to treat her daughter, the Toronto Star's Jacques Gallant reports. The judge later clarified his ruling, writing that "'recognition and implementation of the right to use traditional medicines must remain consistent with the principle that the best interests of the child remain paramount.”'

The girl's treatment team includes a "doctor, a senior pediatric oncologist recommended by the government, and a Haudenosaunee chief who practises traditional medicine and was invited by the family," Gallant reports.