health law

Alabama Governor Robert Bentley, who "campaigned as an opponent of expanding Medicaid under the Affordable Care Act," now supports expanding Medicaid block-grant funding to more low-income Alabamans, Media Group's Mike Cason reports: Bentley said "he would support an Alabama-designed plan that required recipients to be working or in a work training program. ... Bentley [also] said with a block grant the state could request proposals from private insurers to provide the expanded coverage."

Bentley also suggested that President Barack Obama's administration might be more receptive to his version of a Medicaid expansion because the U.S. Supreme Court has taken up a case posing an existential threat to Obamacare: can the federal government provide tax credits and subsidies to low-income and moderate-income consumers shopping for insurance on the federally-run insurance exchange, instead of state-run exchanges?

The Centers for Medicare and Medicaid Services has proposed a rule that would require long-term care facilities to extend spousal rights to same-sex married couples, McKnight's Tim Mullaney reports. CMS said in the proposed rule "'our goal is to provide equal treatment to spouses, regardless of their sex, whenever the marriage was valid in the jurisdiction in which it was entered into, without regard to whether the marriage is also recognized in the state of residence or the jurisdiction in which the healthcare provider or supplier is located.'"

Even in states that don't recognize same-sex marriage, the stick to make facilities follow the rule would be that their funding from Medicare and Medicaid would be contigent on their obedience to the regulation.

Tennessee Gov. Bill Haslam has proposed expanding Medicaid to cover more poor residents of his state, although the plan, if accepted by regulators and conservative legislators, would not follow traditional Medicaid rules, The New York Times' Abby Goodnough reported. Haslam said he still opposes the Obamacare plan to expand Medicaid to everyone earning up to 138 percent of the federal poverty level, but he is proposing a second option to use "federal Medicaid funds available under the law to cover some 200,000 low-income residents through their employer’s health insurance plan or the state’s Medicaid program," Goodnough reported.

Hospitals have found that the amount they spend on charity care or uncompensated care has risen in states that don't have the Medicaid expansion, but fallen in states that do have the expansion.

There is an interesting twist in Haslam's plan that would keep the expansion revenue-neutral for Tennessee, Goodnough reports: Tennessee Hospital Association has agreed to pay expansion costs beyond what the federal government covers. 

U.S. Senators Michael Bennett and Orrin Hatch are circulating a draft bill to exempt some electronic health records, including medical charts and health histories, from the FDA's oversight, Reuters' Christina Farr reported last week. Medical technology that is classified as posing a low risk to patient safety would be exempt from FDA regulation. Bradley Merrill Thompson, an FDA-specialist with the Washington D.C.-based legal firm Epstein Becker & Green, told Reuters the bill would have unintended consequences.

According to a report in Reuters, several leaders of major American corporations are threatening to start siding with the foes of healthcare reform if President Barack Obama's administration does not stop challenging some workplace wellness programs: "The programs aim to control healthcare costs by reducing smoking, obesity, hypertension and other risk factors that can lead to expensive illnesses. A bipartisan provision in the 2010 healthcare reform law allows employers to reward workers who participate and penalize those who don't." But the Equal Employment Opportunity Commission has filed lawsuits challenging wellness programs at Honeywell and two other companies, Reuters reports. The EEOC argues that the programs require medical testing in violation of the Americans with Disabilities Act.

According to Reuters, big companies could pursue several strategies to challenge Obamacare: support legal challenges to the subsidies given to people with low incomes to buy health insurance on the federal exchange, make executives available to testify at hearings on Obamacare, and radically change employer-sponsored health insurance by giving workers a fixed amount of money to buy coverage on private insurance exchanges.

The Los Angeles Times' David G. Savage reports that President Obama's use of executive action to shield immigrants from deportation won't just raise the ire of Congressional Republicans: "By claiming the power to forge ahead based on his executive authority, the president may well lose the one conservative he still really needs: Chief Justice John G. Roberts Jr." Savage wonders if Obama's immigration action could influence how Roberts views the latest challenge to the Affordable Care Act: "At issue is whether the administration must abide by one provision in the healthcare law, which says subsidies may be paid to those who enrolled in state health exchanges, or whether the president can extend those benefits to include people who signed up on the federally run exchange."

Virginia Governor Terry McAuliffe's efforts to expand Medicaid under the Affordable Care Act was thwarted because former Senator Phillip P. Puckett quit the state Senate, The Washington Post's Laura Vozzella reports. McAuliffe had hoped to sneak budget language past the Republicans to expand Medicaid on his own: "Then McAuliffe’s camp found an obscure bit of language in the previous year’s budget that appropriated extra Medicaid funds if — and only if — a newly formed (and hopelessly deadlocked) state Medicaid commission agreed to expansion. If the language was ripped out of that context, the thinking went, McAuliffe could claim that it authorized him to spend an extra $2 billion a year in federal Medicaid funds."

Puckett was enticed to quit by Republicans who discussed jobs for himself and his daughter, Vozzella reports. The jobs nor the Medicaid expansion have come to fruition.

Courthouse News' Jack Bouboushian reports that the First Circuit ruled that the Affordable Care Act requires the state of Maine to keep providing Medicaid coverage to 19- and 20-year-olds from low-income families: "the federal Department of Health and Human Services would not approve the change, because the Patient Protection and Affordable Care Act requires states accepting federal Medicaid funds to 'freeze' their Medicaid eligibility standards for children until 2019." The First Circuit ruled the requirement "does not step on state sovereignty ... as setting conditions of eligibility for participation in Medicaid is not a core state function, such as, for example, regulating state elections," Bouboushian further reports.

Montana Governor Steve Bullock, a Democrat, has asked legislators once again to expand health coverage for 70,000 low-income Montanans, the Independent Record reports: "Legislative Republicans rejected a Medicaid-expansion proposal in 2013, arguing the state couldn’t afford it and that they didn’t want to implement part of 'Obamacare,' the 2010 federal health-care law. Bullock ... said his new plan is a unique proposal for expanding Medicaid. It would use federal money to contract with a private administrator to process claims and run a network of physicians, hospitals and other providers to serve the newly covered population, he said."

The costs of health-insurance policies bought under the Affordable Care are projected to go up in 2015--even as much as 20 percent, the New York Times reports. The solution? Switching plans: "The new data means that many of the seven million people who have bought insurance through federal and state exchanges will have to change to different health plans if they want to avoid paying more — an inconvenience for consumers just becoming accustomed to their coverage."