KHN Morning Briefing

Summaries of health policy coverage from major news organizations

Viewpoints: Hasty Congressional Response To Hobby Lobby; Medicaid ‘Charade’ In Va.; Brain Science Problems

Los Angeles Times: Some (Considered) Fixes To The Religious Freedom Restoration Act
When the Supreme Court unwisely ruled that some companies can decline on religious grounds to cover contraceptives in their employee health plans, it was interpreting not the 1st Amendment but a federal statute, the Religious Freedom Restoration Act. That means Congress has the authority to revisit and change the 1993 law. It can and should do so, not just to overrule the court's decision as it affects healthcare for women but also to address other possible consequences of the majority's expansive holding that for-profit corporations are "persons" that can raise religious objections to complying with a host of laws. But haste in responding to the decision makes waste, as is evident in the incomplete proposal unveiled last week by Sens. Patty Murray (D-Wash.) and Mark Udall (D-Colo.) (7/13).

Los Angeles Times: The Supreme Court And The Flow Of History
The case that raises the thorniest questions over the court's standing among the public and in the flow of history is the Hobby Lobby case, in which owners of family companies claimed their religious freedom was infringed by a federal law requiring that the health insurance plans they provide to employees include contraception. It's unclear whether the decision places the court truly at odds with public sentiment. In part that's because the breadth of the decision is still unclear, even though Justice Ruth Bader Ginsburg, in her dissent, warned that it would lead the court "into a minefield" of differing religious claims (Michael Hiltzik, 7/12). 

Reuters: What's The 2014 Election Really About? Religious Vs. Women’s Rights
Religious rights versus women’s rights. That’s about as fundamental a clash as you can get in U.S. politics. It’s now at the core of the 2014 election campaign, with both parties girding for battle. What generated the showdown was last week’s U.S. Supreme Court decision in the Hobby Lobby case. The decision instantly became a rallying cry for activists on both the right and left. Congressional Democrats are already proposing a law to nullify the decision (Bill Schneider, 7/10).

Journal of The American Medical Association: The ACA's Contraceptive Mandate
Hobby Lobby does not undermine the core components of the ACA such as affordable access to services. The decision, however, does potentially affect women's reproductive health and could signal a "chipping away" at the margins of this historic health care entitlement. Beyond the ACA, the case solidifies a growing trend in Supreme Court jurisprudence defending corporate personhood, which is becoming a major impediment to public health regulation (Lawrence O. Gostin, 7/11).

The Wall Street Journal: A Republican Victory On The Front Lines Of ObamaCare
The biggest ObamaCare fight in the country is ruffling the politics of Virginia. The issue is whether the state should expand Medicaid to 400,000 more Virginians, as President Obama's health-care law prescribes. Gov. Terry McAuliffe, the pal of the Clintons and a former Democratic National Committee chairman, is committed to expansion; Republican House Speaker Bill Howell is opposed. Though the struggle is far from over, Mr. Howell has the upper hand, and Mr. McAuliffe is increasingly exasperated. He's been outsmarted at every turn by Mr. Howell, whose maneuvers should be a lesson for foes of enlarging Medicaid in other states where it's still an issue (Fred Barnes, 7/11).

The Washington Post: The Virginia GOP's Medicaid Charade
Having handed Gov. Terry McAuliffe (D) a stinging defeat by refusing to extend Medicaid coverage under Obamacare to as many as 400,000 low-income Virginians, Republican leaders in Richmond now say they intend to convene the legislature in September to conduct a "full and fair" discussion of the question — which they have already decided. By transforming the General Assembly into a stage for Kabuki theater, the GOP leaders have called attention to their glaring failure to propose any alternative to expanding Medicaid (7/11).

The Wall Street Journal: Why States Are Hesitating To Expand Medicaid
The Pew Trusts also released a data compilation last week. But that one showed why many states, which had large and growing Medicaid programs even before Obamacare, have not rushed to embrace greater expansion. Pew examined data from 2000 to 2012 and found large increases in state Medicaid spending even after adjusting for inflation. Nationally, Medicaid spending grew an average of 4% more than inflation every year during this period. All but two state Medicaid programs grew at real (inflation-adjusted) rates greater than 2% annually. In addition, programs in eight states and the District of Columbia grew at rates exceeding 5.9% per year–meaning that spending doubled during the 12-year period, even after accounting for inflation (Chris Jacobs, 7/11). 

The Tennessean: Medicaid Expansion Is The Conservative Choice
The Tennessean's Tom Wilemon did a superb job this past week illustrating the human costs that our obstinate legislature and Gov. Bill Haslam force on folks instead of dealing forthrightly with the issues around an expansion of TennCare to include 162,000 uninsured Tennesseans eligible for coverage under the revised Medicaid rules established by the Patient Protection and Affordable Care Act passed by Congress in 2010. Yes, the ACA is flawed legislation, but when repeated Republican efforts to repeal the law failed before its implementation in January, intransigence by state legislators made bad business sense (Frank Daniels III, 7/13).

The Washington Post: The Real Medicaid Problem
The White House recently put out a 40-page report arguing that the 24 states that have not expanded Medicaid coverage under the Affordable Care Act (ACA or "Obamacare") are hurting their poor and themselves. It’s an easy case to make, but it’s incomplete and misleading. The further truth is that Medicaid also threatens to crowd out spending for many traditional state and local functions: schools, police, roads, libraries and more (Robert J. Samuelson, 7/13). 

The New York Times: Obamacare Fails To Fail
How many Americans know how health reform is going? For that matter, how many people in the news media are following the positive developments? I suspect that the answer to the first question is "Not many," while the answer to the second is "Possibly even fewer," for reasons I'll get to later. And if I'm right, it's a remarkable thing — an immense policy success is improving the lives of millions of Americans, but it's largely slipping under the radar (Paul Krugman, 7/13). 

In other health care issues-

The New York Times: An Inadequate Response To Concussions
The National Collegiate Athletic Association, which is currently embroiled in a lawsuit over its ostrichlike response to concussions, released new voluntary guidelines on Monday for concussion safety. But these won't necessarily fix the problem. ... A larger issue is that the guidelines provide no mechanism for oversight or enforcement. Experience has shown that it is dangerous to rely on individual athletic programs to police themselves (7/11). 

The New York Times: The Trouble With Brain Science
[H]undreds of neuroscientists from all over the world issued an indignant open letter to the European Commission, which is funding the Human Brain Project, an approximately $1.6 billion effort that aims to build a complete computer simulation of the human brain. The letter charges that the project is "overly narrow" in approach and not "well conceived." While no neuroscientist doubts that a faithful-to-life brain simulation would ultimately be tremendously useful, some have called the project "radically premature." The controversy serves as a reminder that we scientists are not only far from a comprehensive explanation of how the brain works; we're also not even in agreement about the best way to study it, or what questions we should be asking (Gary Marcus, 7/11).

The Wall Street Journal: The Corruption Of Peer Review Is Harming Scientific Credibility
Academic publishing was rocked by the news on July 8 that a company called Sage Publications is retracting 60 papers from its Journal of Vibration and Control, about the science of acoustics. The company said a researcher in Taiwan and others had exploited peer review so that certain papers were sure to get a positive review for placement in the journal. ... Acoustics is an important field. But in biomedicine faulty research and a dubious peer-review process can have life-or-death consequences. In June, Dr. Francis Collins, director of the National Institutes of Health and responsible for $30 billion in annual government-funded research, held a meeting to discuss ways to ensure that more published scientific studies and results are accurate (Hank Campbell, 7/13). 

The Boston Globe: How Should Lawmakers Decide What Deserves Mandatory Coverage?
Governor Patrick’s move last month to require health insurers to cover gender reassignment surgery revived a perennial flash point: For health insurers and the employers who pay most premiums, opting not to cover some services makes insurance cheaper. But for people with expensive medical conditions, these decisions often seem arbitrary or unjust. Over the years, lawmakers have wrestled with requiring insurers to pay for treatments for a variety of conditions, from infertility to tobacco addiction to gender dysphoria. So which criteria should be used in the decision-making process? (7/13).

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