health law

Arkansas and Kentucky, followed by Oregon, Washington and West Virginia, had the sharpest reductions in their uninsured rates among adult residents, Gallup reports. Of the 11 states that had the greatest increases in the number of their residents who have health insurance, 10 expanded Medicaid.

Massachusetts has the lowest uninsured rate in the country at 4.6 percent, and Texas has the highest at 24.4 percent.

The California Supreme Court has ruled that health officials must provide more information about the citations given to facilities found to be lax in treating developmentally and mentally ill people, Sacramento Bee's Denny Walsh reports. The unanimous court ruled that the state Department of Public Health provided too little information in response to a public-records request about citations issued against the seven largest state-owned-and-operated treatment facilities, Walsh further reports. The DOH argued that another law required heavy redactions in order to protect the privacy of the patients, but the Supreme Court ruled that the state Long-Term Act was a special exception.

Next month, the US Supreme Court is going to hear a case over whether the Affordable Care Act authorizes the federal government to give subsidies to people who purchase health-insurance policies through the federally run insurance exchange. The argument against allowing the subsidies is that the law may have been drafted to only authorize subsidies given to people who buy their policies through state-run exchanges. If the justices rule in favor of that argument, Florida could lose $441.9 million in subsidies, Texas $247.5 million, North Carolina in $163.2 million and so on, the Washington Post's Greg Sargent blogs.

Sargent also notes that a number of states have argued that they had no notice that their decision not to set up their own exchanges would imperil the tax subsidies: "Thus, they argue, if the Supreme Court guts subsidies, it would impose a “dramatic” hidden punishment on them and their residents for their decision not to set up an exchange, despite the fact that they had no clear warning of the consequences of that decision. This raises serious Constitutional concerns, and as a result, the states argue, the Supreme Court should opt for the interpretation of the statute that doesn’t raise those concerns — the government’s interpretation that subsidies are universal."

Peter Suderman, writing on Reason's blog, piggybacks off the concerns that Dr. Jeffrey Singer made about the government mandate for electronic health records in the Wall Street Journal's op-ed section. Singer pointed to research that found that physicians think that electronic health records drive up healthcare costs because, among other reasons, of high implementation costs, which is particularly burdensome for small private practices. A bigger concern is that current health IT systems are not interoperable and don't operate across multiple provider networks, Suderman also notes.

The future of three of President Barack Obama's signature policies rest in the hands of federal judges: health care, immigration and climate change, the Washington Post's David Nakamura and Juliet Eilperin report. "'We’re getting used to getting sued,'” John Podesta, White House counselor, said last week.

U.S. District Judge Andrew S. Hanen ruled Monday that the administration's deferred-deportation program should not move forward while a lawsuit brought by 26 states is pending; the judge found that the executive action on immigration doesn't comply with the rulemaking process of the Administrative Procedure Act.

On March 4, the U.S. Supreme Court will hear oral arguments in a case in which the plaintiffs argue that Obamacare does not authorize subsidies to low-income people buying healthcare insurance policies on the federally run insurance exchange. And in April, the U.S. Court of Appeals for the District of Columbia Circuit will hear cases challenging the Environmental Protection Agency’s right to use the Clean Air Act to regulate greenhouse-gas emissions from power plants.

The Third Circuit has ruled that the religious exception from the mandate that all health insurance plans cover contraception is fair, The Legal Intelligencer's Saranac Hale Spencer reports. The accommodation for nonprofit religious organizations requires a head of a religious nonprofit to submit a self-certification to insurers that it will be claiming the exception so that the insurer, not the employer, is paying for the contraceptive portion of insurance coverage. The challengers argued "the act of sending the notification to the insurance company makes them complicit in providing the contraceptive services to which they object, which qualifies as a substantial burden under the Religious Freedom Restoration Act," but the appellate panel reasoned that "'the regulatory notice requirement does not necessitate any action that interferes with the appellees' religious activities,'" Spencer reports.

Republican-sponsored bills to expand Medicaid in Wyoming died last week, the Casper Star Tribune's Trevor Graff and Laura Hancock report. The proposal would have expanded healthcare to 17,600 uninsured Wyomites, they report. One bill died in a Senate committee, and a similar bill was pulled from the House. Eric Boley, president of the Wyoming Hospital Association, "hospitals around the state are stuck with hundreds of millions of dollars in uncompensated costs annually as uninsured people are treated at emergency rooms." Proponents, however, plan to try again in the future.

The stars were aligned for Tennessee Gov. Bill Haslam to expand Medicaid in his state to 280,000 low-income Tennesseans: "Hospitals and chambers of commerce endorsed the plan. A recent poll showed Haslam had an 86 percent approval rating among Republicans in the state, and he has a GOP supermajority in the House and Senate." But the plan died this week after a state Senate committee voted the plan down, The Tennessean's Dave Boucher reports. Haslam said that he didn't realize how deeply Republican legislators had issues with the federal government: '"I think this whole sense of distrust of the federal government. Well, I could've told you that was, that our legislature felt that way (before the special session). It was so much bigger than I thought.'"

Linda Greenhouse, writing in her regular column for the New York Times about the U.S. Supreme Court, suggests that the latest challenge to Obamacare may also fail before the justices because they would have to upend traditional ways of interpreting federal statutes in order to find for the challengers. At issue is "the validity of the Internal Revenue Service rule that makes the tax subsidies available to those who qualify by virtue of their income, regardless of whether the federal government or a state set up the exchange on which the insurance was bought. The challengers’ argument that the rule is invalid depends on the significance of two sub-clauses of the act that refer to 'an exchange established by a state,' seemingly to the exclusion of the federally established exchanges." A coalition of Democratic and Republican attorneys general argued in a brief that, finding that tax subsidies are only available on state-run exchanges, would surprise states with "'a dramatic hidden consequence of their exchange election.”' There is much Supreme Court precedent that Congress must give "'clear notice'" to states of the consequences of their choices in federal law, Greenhouse said, and a narrow reading of the exchange language in Obamacare would undermine that.

After the Republican governor of Indiana reached an agreement to expand Medicaid under Obamacare by imposing new costs on poor adults, promoting healthy behaviors and relying on financing from smokers and hospitals, other Republican-led states might be more interested in signing up more Medicaid enrollees, Kaiser Health News's Phil Galewitz reports. Indiana is the 28th state to expand Medicaid.

The Obama administration granted Governor Mike Pence's administration a three-year waiver from the federal government to make Medicaid more like private insurance by including cost-sharing for receipients below the poverty level.

While advocates favor the expansion, there is criticism for the part of the plan that would lock people out of their Medicaid coverage for six months if they don't pay their premiums, Galewitz reports.