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http://khn.org/news/birth-control-coverage-saves-women-significant-money/

Birth Control Coverage Saves Women Significant Money

Women are saving a lot of money as a result of a health law requirement that insurance cover most forms of prescription contraceptives with no additional out-of-pocket costs, according to a study released Tuesday. But the amount of those savings and the speed with which those savings occurred surprised researchers.

The study, in the July issue of the policy journal Health Affairs, found that the average birth control pill user saved $255 in the year after the requirement took effect. The average user of an intrauterine device (IUD) saved $248. Those savings represented a significant percentage of average out-of-pocket costs.

“These are healthy women and this on average is their No. 1 need from the health care system,” said Nora Becker, an MD-PhD candidate at the University of Pennsylvania and lead author of the study. “On average, these women were spending about 30 to 44 percent of their total out of pocket (health) spending just on birth control.”

[...]

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http://www.politico.com/story/2015/07/senate-obamacare-repeal-no-deadline-119872.html
Senate downplays Obamacare repeal
‘No deadline,’ says Sen. John Barrasso, as House conservatives cry foul.

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http://www.washingtonexaminer.com/the-aca-is-dead-long-live-obamacare/article/2567953

The ACA is dead -- long live Obamacare

Obamacare supporters are mistaken if they think the Supreme Court's King v. Burwell ruling settles the issue. Even in defeat, King threatens Obamacare's survival, because it exposes Obamacare as an illegitimate law.

Say what you will about the Affordable Care Act. Democrats passed it in haste. In desperation. Without knowing what was in it. With no bipartisan support. By one vote. In the dead of night. Over public opposition. Using lies. With disdain for "the stupidity of the American voter." Still, barring some constitutional defect, the ACA as enacted was the law of the land.

Yet President Obama and the Supreme Court now have amended the ACA to the point where it has been transformed into something no Congress ever enacted — indeed that no Congress ever had the votes to enact. The executive and the judiciary have effectively repealed the ACA and replaced it with "Obamacare," which enjoys no such legitimacy.

Before the ink was dry on the Affordable Care Act, President Obama began amending it in dozens of ways that only Congress is authorized to do. Simply usurping Congress' legislative powers would have been bad enough. But Obama's changes were designed to prevent Congress from legislating.

The ACA immediately threw members of Congress out of their health plans, effectively cutting their pay by $10,000. Obamacare, in contrast, gives Congress a special exemption that lets them keep their health plans and slips $10,000 per year into the pockets of lawmakers, without the constitutional hassles of an act of Congress and an intervening election.

The ACA required many employers to buy more robust health plans six months after enactment. Obamacare, on the other hand, offered waivers to politically connected employers and union plans, lest they lobby Congress for relief.

The ACA requires large employers to buy coverage for their workers beginning in 2014. Obamacare, on the other hand, delays that mandate by up to two years, lest a backlash give rise to legislation. (Even Obamacare's supporters had trouble stomaching that one.)

The ACA threw millions out of their health plans in 2014. But Obamacare allows people to keep the very health plans Congress outlawed. Obama even threatened to veto bipartisan legislation that would have done the same thing, but legally.

Congress forgot to appropriate $135 billion for cost-sharing subsidies. Obamacare spends that trifling sum without an appropriation. And the list goes on…

The Supreme Court, led by Chief Justice John Roberts, has done even more to amend the ACA.

Roberts found that the ACA unconstitutionally forced Americans to buy health insurance — but then decided Obamacare can stay because it actually just imposes a tax on the uninsured. Never mind that Democrats deliberately decided against such a tax because they didn't have the votes.

Roberts found it would be unconstitutional for the ACA to threaten to revoke existing federal Medicaid grants from states that didn't expand Medicaid — but then he decided Obamacare could stay if he rewrote it to withhold just the new funding that comes with the Medicaid expansion. Never mind that's not what Congress intended.

In King v. Burwell, the ACA died yet another death. The ACA authorizes certain taxes and entitlements, but only in states where there is "an Exchange established by the State." President Obama nonetheless imposed those taxes on 70 million employers and individuals in the 38 states that did not establish exchanges.

Roberts admitted that the arguments by the King plaintiffs, who complained that the IRS was taxing them illegally, "are strong," and that their interpretation is "the most natural reading of the pertinent statutory phrase." He even acknowledged that Congress defined "State" in a manner "that does not include the Federal Government." Yet he amended the ACA again by allowing the IRS to impose the disputed taxes and entitlements. Never mind that he identified no statutory language authorizing those measures. Never mind that the operative language of the statute clearly prohibits them.

If the actual words Congress uses no longer constrain the IRS, what will?

By overriding the operative language of the statute, the Supreme Court colluded with the president to impose taxes and entitlements that no Congress ever approved; to deprive states of powers Congress granted them to block parts of the ACA; and to disenfranchise Republican and independent voters who swept ACA opponents into state office in 2009, 2010 and 2011 for the purpose of blocking the ACA.

The Supreme Court did not lose its legitimacy with King v. Burwell — it has made worse mistakes. Obamacare did. Having been rewritten over and over by the president and the Supreme Court rather than Congress, Obamacare cannot claim to be a legitimate law.

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A top insurer is dropping from Washington, D.C.’s Obamacare exchange in 2016, leaving customers with fewer options than ever in the nation’s capital.

Aetna Life Insurance will no longer offer individual plans on D.C. Health Link, Washington’s own Obamacare exchange, in 2016, The Washington Post reports. Aetna is sending letters to customers notifying them that their plans will be canceled at the end of this year. The company says it has “determined we can no longer meet the needs of our customers while remaining competitive in the market.”

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http://www.slate.com/articles/business/the_bills/2015/07/health_care_premiums_going_up_obamacare_has_been_solidified_but_it_s_failed.single.html

Even Supporters of Obamacare Have to Admit the Law Has Failed to Stop Skyrocketing Premiums

Now that the Supreme Court has once again saved Obamacare, can we have an honest talk about it?

Let me explain. On one side—you don’t need me to spell out which—the Affordable Care Act was demonized. It was going to bankrupt the health care system; destroy the United States’ reputation for excellent service; steal you away from your doctor; and, by some means never quite explained, lead us straight to communism. Today, subsidized health care premiums and an end to pre-existing condition exclusions; tomorrow, Stalin and FEMA detention camps located in semisecret parts of Texas. You know how it goes.

Under this assault, all too many ACA defenders turned into fanboys and fangirls, dismissing any issue raised against the law as inconsequential and exaggerated. And besides, it’s not like legislation to improve any aspect of it would get through our paralyzed, polarized, and now Republican-run Congress anyway.

But this strategy might well come back to bite the Democrats. The bill for the health care expansion is coming due, just as the recipients will be heading to the ballot box to vote in the first primaries for the 2016 election. More than a few are likely to be annoyed.

Last week Oregon’s insurance commissioner, Laura Cali, announced that the state had approved a 25 percent premium increase for the largest health insurer on the state’s exchanges. The second largest insurer did even better: It received permission to boost its monthly charge to consumers by 33 percent.

Oregon might be the first health insurance exchange equivalent of a penguin getting shoved off an ice floe, but it won’t be alone in the freezing-cold waters for long. For example, BlueCross BlueShield of Tennessee requested an average 36 percent price increase for the plans it offers—after receiving a 19 percent bump last year. And that sounds like a relative bargain compared with Minnesota and New Mexico, where the BlueCross BlueShield family is looking for increases of more than 50 percent. Even if the final numbers are lower than the asks, it seems quite likely these states will approve substantive premium increases.

The problem is simple. As Trudy Lieberman reported this month in Harper’s, the ACA made a decent stab at solving the problem of Americans lacking insurance. Unfortunately, the bargain struck to get the bill to a point where lobbyists for the hospital, insurance, and pharmaceutical industries to sign on, or at least not fight it, did not adequately address the issue of overall medical costs.

And that’s where the consumer comes in. Someone is “it,” the party paying the bill. And that “it” is increasingly you, whether you receive insurance on the exchanges or from an employer.
[Except 85% on the exchange are getting subsidies from taxpayers, which hit those not on the exchange]

According to the Health Research Institute at PricewaterhouseCoopers, the health care spending growth rate was 6.5 percent in 2014. It’s expected to climb slightly to 6.8 percent this year, before dropping back to 6.5 percent in 2016. That’s certainly an improvement from the pre-ACA years, when increases often topped 10 percent, but our overall inflation rate is lower too. At the moment, it’s all but nonexistent, with the consumer price index registering annual gains in the low single digits.

Moreover, that doesn’t mean your overall rate of medical inflation is 6.5 percent or in the single digits at all. It might well be much higher than that. “Much of the slowing growth can be attributed to cost shifting,” the writeup accompanying the report helpfully announces.

Someone is “it,” the party paying the bill. And that “it” is you, whether you receive insurance on the exchanges or from an employer.

And how does that play out? Higher premiums are one way. Another is high-deductible plans that leave consumers responsible for, say, $6,750 in out-of-pocket costs for individuals or $12,900 for a family before payments kick in.

If you’re wondering, the number of employers only offering high-deductible plans surged this year, from 18 percent in 2014 to 25 percent this year. Altogether use of these plans has grown by almost 300 percent since 2009.

Another way to lower medical care spending is to simply stop it, something that high-deductible, tiny-network plans are great at. In phraseology that could come straight from the pen of George Orwell, PricewaterhouseCoopers noted that “cost-shifting pushes consumers to be more conscientious about their health care choices” before going on to explain that 24 percent of those surveyed either did not take or took less than the recommended amount of medication and another 16 percent delayed or skipped a recommended treatment. These are people like Jennifer Ross, who USA Today reports can’t take a medication that will possibly get her out of her wheelchair. Why? Her family lacks the money to pay the $600 monthly copay for the treatment.

True, more than 80 percent of those purchasing insurance on the exchanges are eligible for subsidies for their premiums. But that’s not a solution, in either the short-term or the long-term. First, there are still deductibles, and although subsidies covering parts of the deductible and other approved costs are available to those meeting certain income limits who sign up for particular plans on the exchanges, it’s a complicated, difficult-to-understand process.* Second, subsidies don’t mean freebie. The taxpayer pays the money to the insurance industry, leaving less funding for other priorities. Third, of course, it leaves the people who are not eligible for subsidies feeling like chumps, stuck paying the bill for a health insurance expansion that, no matter how necessary, many of them don’t see as offering them enough in return for their own personal increased costs. It’s highly unlikely they will give the reforms a pass simply because premiums were also increasing before the ACA became law. Obamacare, after all, was supposed to put a stop to this sort of thing.

It’s possible that deals that consolidate insurers, like Aetna’s $37 billion planned purchase of rival insurer Humana, will bring down prices by giving them increased leverage over the hospitals. But it’s also possible they won’t, or won’t bring them down in any way that helps consumers all that much. Insurers facing less competition for their offerings—a combined Aetna and Humana, for example, will control just under 90 percent of the entire insurance market in Kansas—could ask state regulatory authorities for ever greater price increases. Hospitals faced with more powerful insurance companies could attempt to dump even more costs onto consumers through the practice known as balance billing, which means making them pay for the charges their insurance won’t cover. Nor do these mergers do anything about the surging price for pharmaceuticals, which is also a driving force in our medical budgets, both personal and corporate. In sum, it’s a problem so pressing that even Ezekiel Emanuel, one of the major players behind Obama’s health care reforms, took to the Wall Street Journal this week to declare, “If Mr. Obama doesn’t act soon to control costs, escalating costs may ultimately threaten the sustainability of his coverage expansion.”

In the meantime, you shouldn’t need a political consultant to tell you why consumers paying hundreds of dollars—or even more than $1,000 a month—for health insurance they are required to buy and often can’t afford to use might well get angry. Once you name something the Affordable Care Act, people oddly expect the product on offer to be affordable. Who’d have thunk it?

Correction, July 9, 2015: The article originally stated that subsidies are not available for health plan deductibles. Subsidies are available to some customers on some plans on the health care exchanges.

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http://www.wsj.com/articles/kentucky-is-new-test-case-of-health-laws-politics-1436737174

Kentucky Is New Test Case of Health Law’s Politics

For a Southern state where President Barack Obama is deeply unpopular and Republicans dominate federal elections, Kentucky stands out for having created a well-regarded health exchange and having expanded Medicaid coverage under the Affordable Care Act. That dynamic will be put to the test in November’s gubernatorial election....

Quasimodo

Jul 13 2015, 03:06 PM

"I just won a Nigerian lottery according to an email from a Nigerian prince!.

"He holds the sum of ONE MILLION DOLLARS in my name and he wants to send it to me FREE!

"All I have to do is give him my bank account number, and send him $500.00 US dollars cash, to show my good faith, so he can transfer the money!

"And then I got ANOTHER email!!!

"Could lightening strike twice in one day? Well, goody for me, it did!

"This one if from a KENYAN prince who wants to give me FREE healthcare for life!

"All I have to do is give him MY BANK ACCOUNT NUMBER, MY SOCIAL SECURITY NUMBER, MY CONFIDENTIAL HEALTH INFORMATION and pay $700 per month for a policy with only a $10,000 deductible. Then he can make it happen!

"Am I on a roll or what!"

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http://www.wsj.com/articles/christian-employers-dealt-setback-on-birth-control-cases-1436908738

Christian Employers Dealt Setback On Birth-Control Cases

Christian employers challenging the Obama administration’s revised system for providing contraception as part of the 2010 health law lost a round in the U.S. 10th Circuit Court of Appeals on Tuesday. The ruling added another victory for the federal government in a series of lawsuits working their way through the courts.

The opinion covered cases including one brought by the Little Sisters of the Poor, a Catholic religious order that operates nursing homes. The Obama administration’s rules that most health plans cover contraception have spurred dozens of legal challenges from Christian groups with moral objections to birth control.

Under alternative arrangements finalized by the Obama administration last week, employers who have such objections must tell their insurance company or the federal government. The insurance company then takes over responsibility for providing the coverage to employees who want it.

The Little Sisters of the Poor and other religiously affiliated employers such as Christian universities say those steps are inadequate because they still require the insurance plan the employers set up to provide contraception, which they believe to be wrong. Some plaintiffs are opposed to most forms of birth control; others object specifically to forms such as the so-called morning-after pill, which they consider tantamount to abortion.

A three-judge panel of the Denver-based U.S. Court of Appeals for the 10th Circuit, in a two-to-one ruling,” concluded Tuesday that the government’s system “relieves them from complicity.”

“Shifting responsibility to provide coverage away from the plaintiffs relieves rather than burdens their religious exercise,” wrote judges Scott Matheson and Monroe McKay, appointed by Presidents Barack Obama and Jimmy Carter, respectively.[...]

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http://blogs.wsj.com/law/2015/07/14/wal-mart-faces-potential-class-action-for-prior-denial-of-same-sex-benefits/

Wal-Mart Faces Potential Class Action for Prior Denial of Same-Sex Benefits

Two civil rights groups are trying to build a class action against Wal-Mart Stores Inc.WMT -0.26% over the retailer’s former policy of denying health-insurance benefits to the same-sex spouses of gay employees.

In January 2014 Wal-Mart started offering benefits to domestic partners of U.S. employees regardless of their sexual orientation. But a lawsuit filed in federal court on Tuesday says the company should be held liable for refusing to extend employee benefits to same-sex partners in the past.

The complaint, which seeks class action status, claims Wal-Mart’s old policy is a form of sex discrimination under Title VII — the federal law that prohibits employment discrimination based on sex, religion, race and national origin.[...]

LTC8K6

Jul 15 2015, 02:18 PM

Then why weren't they sued over it earlier?