KHN Morning Briefing

Summaries of health policy coverage from major news organizations

Viewpoints: Romney’s Mandate Problem; Rage At Roberts; Should Feds Take Over Medicaid?

The New York Times: Mr. Romney Changes His Mind, Again
Massachusetts residents who file a state tax return have to provide proof that they have health insurance. If they can afford insurance but don’t have it, they must “pay a penalty through their tax returns,” according to the state Department of Revenue’s Web site. This is all thanks to former Gov. Mitt Romney, who set up the system -- the best of its kind in the country -- and is now trying to pretend he doesn’t remember how it works (7/5).

The New York Times Taking Note blog: Flip Flopping Away
Last week, the Romney campaign didn’t want to call the fine a “tax,” probably because Mr. Romney himself imposed such a penalty as part of the health care reform he got enacted in Massachusetts. (That reform, of course, is the template for President Obama’s program.) That caused a lot of bother among what’s left of the Republicans to his right. So on Wednesday, Mr. Romney celebrated the nation’s independence by abandoning his (Andrew Rosenthal, 7/5).

The Washington Post: Mitt Romney’s Problem On The Health-Care Mandate Question
Romney has tried to talk his way past his health-care dilemma for more than a year. Faced with the choice between calling his support for an Obama-like health-care plan in Massachusetts a mistake or sticking with it while trying to draw distinctions between the two, Romney chose the latter. Labeling it a mistake would have opened him up to a new charge of flip-flopping for political convenience. But neither course was ideal (Dan Balz, 7/5).

Chicago Tribune: Mr. Romney, Own It
Mr. Romney, just own it. You signed a health care mandate. It looks very much like Obamacare on a state scale. The state and federal laws are built on the same principles. They share many benefits and requirements. Please stop trying to talk your way around that. ... Romney took a political risk to reach a deal with Democrats in Massachusetts to extend health care to thousands of uninsured people. He can't dance around that. He would sound a lot more believable if he spoke about the future of health care from experience. Instead, he's all about political advantage, and that has him twisting (7/5).

Baltimore Sun: Romney Foolishly Flip-Flopped On Health Mandate
Remember in March, when former senator Rick Santorum got a lot of grief for saying that Mitt Romney was the "worst Republican" in the country to challenge President Barack Obama on health care reform? Well, turns out he was right. That was evident Wednesday when former governor Romney decided he couldn't leave well enough alone and, in a CBS television interview, declared Mr. Obama's individual health care insurance mandate was a tax. That directly contradicted what his campaign had been saying on the subject for two days and left the Republican in the uncomfortable position of having to explain why his own version of health care reform in Massachusetts, which also carried a mandate and a similar penalty, was somehow not a tax (7/5).

Baltimore Sun: Romney Courts Confusion
Poor Mitt Romney. Even when he is handed the football with a clear path to the goal line, he seems almost unable not to fumble it along the way. In his majority opinion ruling the Affordable Care Act constitutional, Supreme Court Justice John G. Roberts Jr. surprisingly said the law's mandate was a tax and therefore within Congress' revenue-raising power. In doing so, he presented Mr. Romney a prime argument for accusing President Barack Obama of heaping more billions of dollars in taxes on the middle class. But the likely Republican nominee, instead of instantly seizing the decision to make that case against Mr. Obama, contradicted one of his own political aides who tried to do so. A Romney campaign release contended that mandating the citizenry to shell out to the feds in lieu of buying health insurance was not a tax, just "an unconstitutional penalty" (Jules Witcover, 7/6).

The Des Moines Register: A Tax Or Not A Tax. That Is The Question
We are now in summer silly season for politics. Citizens are jumping into lakes and pools and staying cool in basement rec rooms, door stoops, and under shade trees in parks and back yards. Still the political classes keep churning away. This week we found out that “Romney Now Says Health Mandate by Obama Is a Tax” according to JEREMY W. PETERS of the New York Times. “Days after his spokesman [his top aide Eric Fehrnstrom] said the requirement that people have insurance was not a tax, [he said Romney believed it’s is “an unconstitutional penalty” instead] Mitt Romney said it was [a tax], aligning himself with the conservative voices in his party” (Steffen Schmidt, 7/6).

The Denver Post: Editorial: On Health Care, Tax Vs. Penalty Is The Wrong Debate
Mitt Romney — or at least his campaign — had it right the first time. Just because the Supreme Court has said the Affordable Care Act's individual mandate to buy health insurance is a tax doesn't mean he should adopt the thesis as a campaign theme. Before last week's court ruling, Romney didn't believe the mandate was a tax. Why pretend he believes it now? (7/5)

Boston Globe: For Mitt Romney, Avoiding Risk Means Obscuring His Own Positions
Mitt Romney responded to the Supreme Court’s upholding the health care law last Thursday with a short, blunt declaration: “What the court did not do on its last day in session, I will do on my first day,” he said. “I will act to repeal Obamacare.” Like many other Republicans, Romney has said he wants to “repeal and replace” the health care law. But however much he’s pressed, he offers few specifics about what he would replace it with. On Thursday, he skipped over the issue altogether. This has become a familiar pattern: a ringing affirmation of some major policy difference with President Obama, followed by a lot of vagueness about what he would do instead (Joshua Gree, 7/6).

Chicago Sun-Times: Rage At Roberts Won’t End Soon
Admittedly, it was not standard fare for a Fourth of July party, but time and again the conversation under a sweltering sun drifted back to the U.S. Supreme Court’s health care ruling. This being a mostly conservative crowd, much perplexity and dissatisfaction were expressed about Chief Justice John Roberts finding a way to save the Affordable Care Act from a constitutional challenge. It was another bit of evidence that the firestorm ignited by the controversial ruling won’t go away, likely making ObamaCare a major issue, albeit far behind the economy, for the fall election (Steve Huntley, 7/5).

Kansas City Star: Ruling Put Constitution Before Political Ideology
Conservatives’ fury over Chief Justice John Roberts’ surprising ruling in support of President Barack Obama’s health care law has crystallized into a shocking accusation. He changed his mind. How dare he? Only a week after the court announced its long-awaited decision on the constitutionality of the Affordable Care Act, a scenario first based on speculation has been confirmed by “sources” and emerged as a meme (Barbara Shelley, 7/5).

Philadelphia Inquirer: How The Supreme Court’s Health Care Decision Affects Pharma
The Supreme Court's decision last week to let the Affordable Care Act (ACA) stand will not appreciably affect the escalation of costs or the other fundamental dynamics of health care. While the decision clearly provides fodder for politicians and other blowhards, its effect on most of health care's business sectors appears unlikely to alter the course of events. … The manufacturing sectors such as pharma and devices will sustain both gains and losses, but nothing appears likely to alter industry fundamentals (Dr. Daniel R. Hoffman, 7/5).

The Fiscal Times:  Small Businesses:  Big Losers In Obamacare Decision
Why are small businesses so opposed to the Patient Protection and Affordable Care Act? Sam Graves, chairman of the House Committee on Small Business, who held hearings on the matter, recently sent a letter to President Obama highlighting companies’ concerns. He quoted one restaurant owner who said, "The real irony here is that in the name of expanding health care coverage, Congress and the administration are making it more difficult for workers to enter and eventually be promoted in the workforce at a time when we need job growth" (Liz Peek, 7/6).

The Fiscal Times:  Should The Federal Government Take Over Medicaid?
With over a dozen conservative states leaning against expanding Medicaid to cover poor workers without health insurance, perhaps it is time to resuscitate an idea embraced by President Ronald Reagan. Let the federal government take over Medicaid lock, stock and barrel. In 1982 the president who ushered in the modern conservative era offered to assume federal responsibility for the program that now consumes over 22 percent of state government budgets in exchange for states taking over welfare. His offer built on a series of recommendations going back to 1969 by the U.S. Advisory Commission on Intergovernmental Relations, which called for a federal takeover of all public assistance programs (Merrill Goozner, 7/6).

The New York Times: When It’s the Nurse Who Needs Looking After
Trusted more than almost any other professional, nurses exert a wide-ranging influence on how health care is delivered and defined. But nurses’ work is not easy, particularly in the hospital setting, where they must deal with intense intellectual and significant physical demands over three or more grueling 12-hour shifts each week. Not surprisingly, nursing ranks among the worst occupations in terms of work-related injuries, and studies have shown that in a given year, nearly half of all nurses will have struggled with lower back pain (Dr. Pauline W. Chen, 7/5).

The Arizona Republic:  Arizona Has Hard Choice To Make
Now that the U.S. Supreme Court has made it voluntary, should Arizona participate in "Obamacare's" Medicaid expansion to 133 percent of the federal poverty level?  Well, as the movie title puts it, it's complicated.  In the first place, Arizona is in an awkward position to consider the question. The state is already in violation of an initiative approved by voters to cover everyone up to 100 percent of the poverty level. And it's broke (Robert Robb, 7/6).

Milwaukee Journal Sentinel: Cuts Hurt Care For Disabled
These aren't people needing nursing homes or hospitals. They are individuals who simply can't live on their own, who need assistance at various levels to live normal lives. … But cutting funding for these people will not make them more independent. It will only increase risks (Thomas Zachek, 7/5).

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