KHN Morning Briefing

Summaries of health policy coverage from major news organizations

First Edition: Tuesday, July 1, 2014

Today's early morning highlights from the major news organizations, including numerous reports about the Supreme Court's decision on the health law's contraception mandate and its effect for coverage and on national politics.

Kaiser Health News: Hobby Lobby Decision May Not Be The Last Word On Birth Control Coverage
Kaiser Health News staff writer Julie Rovner reports: "The Supreme Court’s decision Monday saying that 'closely held corporations' do not have to abide by the contraceptive coverage mandate in the Affordable Care Act may not give those firms the ability to stop providing that coverage after all. More than half the states have 'contraceptive equity' laws on the books that require most employers whose health insurance covers prescription drugs to also cover FDA-approved contraceptives as part of that package. Unlike the ACA, those laws do not require that coverage to be available without deductibles or co-pays" (Rovner, 6/30). 

Kaiser Health News: Supreme Court Limits Contraceptive Mandate For Certain Employers
Kaiser Health News staff writer Julie Rovner reports: "A sharply divided Supreme Court ruled Monday that at least some for-profit corporations may not be required to provide contraceptives if doing so violates the owners’ religious beliefs. But the five-justice majority writing in Burwell v Hobby Lobby, et al., took pains to try to limit their ruling only to the contraceptive mandate in the health law and only to 'closely held' corporations like the family-owned businesses represented by the plaintiffs in the case" (Rovner, 6/30).  

Kaiser Health News: FAQ: High Court's Hobby Lobby Ruling Cuts Into Contraceptive Mandate
Kaiser Health News staff writer Mary Agnes Carey reports: "In a 5-4 decision Monday, the Supreme Court allowed a key exemption to the health law’s contraception coverage requirements when it ruled that closely held, for-profit businesses could assert a religious objection to the Obama administration’s regulations. Here are some frequently asked questions and answers about the case" (Carey, 6/30). 

Kaiser Health News: Court Suggests Narrow Application Of Birth Control Case, But Others See Broader Impact
Kaiser Health News staff writer Jay Hancock reports: "The Supreme Court’s decision on contraceptives and employer health plans could affect companies and workers far beyond Hobby Lobby and the other plaintiffs. But nobody seems to know how far. The ruling applies to “closely held for-profit corporations,” a small subset of employers, Justice Samuel A. Alito Jr. wrote for the majority. But in a dissenting opinion, Justice Ruth Bader Ginsburg suggests the impact will be far broader (Hancock, 6/30). 

Kaiser Health News: What The Hobby Lobby Decision Means For Employers
Kaiser Health News staff writer Mary Agnes Carey and legal analyst Stuart Taylor discuss Monday's ruling on the health law's contraception mandate, examining what the decision could mean for future challenges to the law.  

Kaiser Health News: Proposal To Add Skimpier ‘Copper’ Plans To Marketplace Raises Concerns
Kaiser Health News consumer columnist Michelle Andrews reports: "If you offer it, will they come? Insurers and some U.S. senators have proposed offering cheaper, skimpier 'copper' plans on the health insurance marketplaces to encourage uninsured stragglers to buy. But consumer advocates and some policy experts say that focusing on reducing costs on the front end exposes consumers to unacceptably high out-of-pocket costs if they get sick. The trade-off, they say, may not be worth it" (Andrews, 7/1).  

Kaiser Health News: Capsules: Poll: Americans Bristle At Penalties In Wellness Programs; New Hampshire Medicaid Expansion Starts Tuesday
Now on Kaiser Health News' blog, Phil Galewitz looks at another state expanding Medicaid: "New Hampshire on Tuesday became the latest state to begin enrolling low-income residents in an expanded Medicaid program, a step toward moving many into plans sold on the online federal marketplace (Galewitz, 7/1). 

Also, Jordan Rau reports on employees' views of workplace wellness programs: "Workers believe employer wellness programs should be all gain but no pain, according to a poll released Tuesday. The poll from the Kaiser Family Foundation found employees approve of corporate wellness programs when they offer perks, but recoil if the plans have punitive incentives such as higher premiums for those who do not take part (Rau, 7/1).   

The Washington Post: Supreme Court Sides With Employers Over Birth Control Mandate
The Supreme Court struck down a key part of President Obama’s health-care law Monday, ruling that family-owned businesses do not have to offer their employees contraceptive coverage that conflicts with the owners’ religious beliefs. The decision deeply split the court, not only on its holding that the federal Religious Freedom Restoration Act (RFRA) protects some businesses from offering contraceptive coverage but also on how broadly the ruling will apply to other challenges in which businesses say laws impose on their religious beliefs (Barnes, 6/30). 

The New York Times: Supreme Court Rejects Contraceptives Mandate For Some Corporations
The Supreme Court ruled on Monday that requiring family-owned corporations to pay for insurance coverage for contraception under the Affordable Care Act violated a federal law protecting religious freedom. It was, a dissent said, “a decision of startling breadth.” The 5-to-4 ruling, which applied to two companies owned by Christian families, opened the door to many challenges from corporations over laws that they claim violate their religious liberty (Liptak, 6/30).

The New York Times: Between The Lines Of The Contraception Decision
Justice Samuel A. Alito Jr., writing for the court, declared that family-owned corporations like Hobby Lobby cannot be forced to pay for insurance coverage for contraception for employees over their religious objections. The ruling means that the Religious Freedom Restoration Act of 1993 applies to corporations, that the contraception requirement placed a substantial burden on companies like Hobby Lobby, and that the government has not chosen the least restrictive means to further a compelling governmental interest — the most demanding test in constitutional law (Schwartz, 6/30). 

The Wall Street Journal: Supreme Court Makes Religious Exception To Health-Care Law
The Supreme Court ruled Monday that "closely held" companies can invoke religious objections to avoid covering contraception in workers' health plans, carving out another piece of the Affordable Care Act. Breaking 5-4 along the justices' conservative-liberal divide, the final decision of the court's term extended the religious protections enjoyed by people and churches to certain employers, in one of the most important rulings on religion in years (Bravin, 6/30). 

The Wall Street Journal: Hobby Lobby Ruling Raises Question: What Does 'Closely Held' Mean?
The three firms in the lawsuit—Hobby Lobby Stores Inc., Conestoga Wood Specialties Corp. and Mardel—all have the same business structure: they are owned and controlled by members of a single family. But closely held firms can take other ownership forms (Armour and Feintzeig, 6/30). 

NPR: High Court Allows Some Companies To Opt Out Of Contraceptives Mandate
For the first time, the U.S. Supreme Court has ruled that a for-profit corporation can refuse to comply with a general government mandate because doing so would violate the corporation's asserted religious beliefs. By a 5-4 vote, the court struck an important part of President Obama's health care law — the requirement that all insurance plans cover birth control — because it conflicted with a corporation owners' religious beliefs (Totenberg, 6/30). 

USA Today: Justices Rule For Hobby Lobby On Contraception Mandate
The Supreme Court put freedom of religion above reproductive freedom Monday in the most closely watched case of its term, ruling that companies cannot be forced to offer insurance coverage for certain birth control methods they equate with abortion (Wolf, 6/30). 

Los Angeles Times: Supreme Court, Citing Religious Liberty, Limits Contraceptive Coverage In Obamacare
The Supreme Court ruled for the first time Monday that private companies had a religious right to be exempted from federal law, saying a business owned by devout Christians may refuse to pay for insurance covering contraceptives for female employees. The 5-4 ruling was a victory for social conservatives and the high court’s most significant statement on religious liberty in years (Savage, 6/30). 

Politico: SCOTUS Sides With Hobby Lobby On Birth Control
The ruling deals directly with only a small provision of Obamacare and will not take down the entire law but it amounts to a huge black eye for Obamacare, the administration and its backers. The justices have given Obamacare opponents their most significant political victory against the health care law, reinforcing their argument that the law and President Barack Obama are encroaching on Americans’ freedoms (Haberkorn and Gerstein, 6/30). 

The New York Times: More Cases On Religion Await, With Eye On Opinion By Alito
Battles over health care and religious rights are sure to continue, even after the Supreme Court ruled Monday that family-owned for-profit corporations like Hobby Lobby are not required to provide insurance coverage of contraceptives to their employees if the companies object on religious grounds. About 50 cases involving nonprofit organizations and a similar number involving for-profit companies are pending in federal courts around the country, and many of those plaintiffs intend to push forward with the argument that they should be able to opt out of providing or authorizing coverage that conflicts with their religious beliefs (Pear, 6/30). 

The Wall Street Journal: Obama, Congress Likely Face Tough Decision On Contraceptive Coverage
The Obama administration could face another thorny decision on contraception-coverage rules in the wake of Monday's Supreme Court ruling in favor of religious owners of for-profit companies. ... Dozens of universities and charities are challenging the accommodation in a wave of separate lawsuits. ... Now all eyes will be on the administration to see what rules it crafts to exempt employers with objections and allow workers affected by the ruling to obtain contraception by another means (Radnofsky, 6/30).

The Wall Street Journal: Some Companies To Halt Contraception Coverage After High-Court Ruling
Some employers that had argued their religious beliefs prevented them from complying with federal health-law regulations said they are planning to stop covering certain contraceptives following Monday's Supreme Court decision (Feintzeig, 6/30). 

The Washington Post: Contraception Ruling Is A Symbolic Blow To The Health-Care Law
Two years ago, the court, while upholding the constitutionality of the Affordable Care Act, also gutted the law’s mandatory Medicaid expansion, severely limiting the law’s reach. By contrast, the effect of Monday’s decision is peripheral. The contraception provision was not part of the main law but was laid out in regulatory language issued by the Obama administration. Millions of women who receive birth control at no cost through their company health plans are likely to keep it (Somashekhar, 6/30). 

Politico: Practical And Legal Hurdles Remain In Contraception Fight
The Obama administration and Senate Democrats promised to fight the Supreme Court rebuke of Obamacare’s contraception coverage requirement on Monday, even as a second round of legal fights over birth control head to the court. ... The court devoted several pages of its opinion Monday explaining that the government could choose to provide birth control to women directly, without involving employers (Haberkorn, 6/30). 

USA Today: Dems Discuss Response To Contraception Ruling
The White House and congressional Democratic leaders said Monday they will seek legislation to reverse a Supreme Court decision that corporations can opt out of providing contraception coverage if they claim religious objections. It is unlikely a divided Congress could pass any bill on the issue. "President Obama believes that women should make personal health care decisions for themselves rather than their bosses deciding for them," said White House spokesman Josh Earnest. "Congress needs to take action to solve this problem that's been created, and the administration stands ready to work with them to do so" (Davis, 6/30). 

NPR: How Many Companies Will Be Touched By Court's Contraception Ruling?
When the Supreme Court ruled Monday that "closely held" corporations don't have to pay for workers' contraception, you may have assumed the decision applied only to family-owned businesses. Wrong. An estimated 9 out of 10 businesses are "closely held." However, some benefits experts question just how many of those companies would want to assert religious views (Geewax, 6/30). 

Politico: SCOTUS Decision Ignites Obamacare, Contraception Fight
The contraception coverage mandate isn’t central to the law, the way the individual mandate is. By letting some closely held employers — like family-owned businesses — opt out of the coverage if they have religious objections, the justices haven’t blown a hole in the law that unravels its ability to cover millions of Americans. They didn’t even overturn the contraception coverage rule itself. They just carved out an exemption for some employers from one benefit, one that wasn’t even spelled out when the law was passed. But politically, that doesn’t matter (Nather and Haberkorn, 6/30). 

The New York Times: A Ruling That Both Sides Can Run With
The Supreme Court’s ruling on Monday that the government cannot force certain employers to pay for birth control was more than a rebuke to President Obama. It was vindication of the conservative movement’s efforts to chip away at laws it finds objectionable by raising questions of freedom of expression. ... leaders predicted Monday’s decision would infuse Republicans with energy as they fight to take control of the Senate this year and reclaim the White House in 2016. ... Yet even as conservatives celebrated coming out on the winning side of a divisive social issue, their court victory may have also handed Democrats an issue that will turn out liberal voters in the fall. Democrats have spent hundreds of millions of dollars in the last several years to cast Republicans as callous and extreme on women’s health issues (Peters and Shear, 6/30).

The Wall Street Journal: Hobby Lobby Ruling Galvanizes GOP And Democrats
The latest Supreme Court ruling on the Affordable Care Act reinforces the lines of attack both parties are using to mobilize their political bases for the 2014 midterm, while potential presidential candidates signaled the case would resonate into 2016. ... Republicans seeking to make the election a referendum on the administration cast the decision as a sweeping repudiation of Mr. Obama, his signature domestic-policy achievement and his more expansive view of the role of the federal government. "Obamacare defeated," declared a fundraising appeal from the Republican National Committee, though the court on Monday ripped out only a page of the health-care law. ... Democrats said the ruling also would mobilize their core voters, particularly women, framing the decision as an infringement on their right to use birth control (Reinhard, 6/30). 

USA Today: Clinton: Supreme Court Contraception Ruling 'Deeply Disturbing'
Hillary Rodham Clinton blasted the Supreme Court’s 5-4 decision saying some privately held companies with religious objections cannot be forced to offer insurance coverage for certain kinds of birth control. ... She said the ruling in the so-called Hobby Lobby case could mean companies “can impose their religious beliefs on their employees” and end up “denying women contraception as part of their health care plan” (Camia, 6/30). 

Politico: Hillary Clinton Blasts Hobby Lobby Ruling
Hillary Clinton on Monday called the Supreme Court’s ruling in the contraception-related Hobby Lobby case “deeply disturbing.” The former secretary of state and possible Democratic front-runner skewered the decision during an appearance at the Aspen Ideas Festival in Colorado, hours after the Supreme Court ruled that for-profit employers don’t have to provide contraception coverage, mandated under Obamacare, if they have religious objections (Glueck, 6/30). 

Politico: Democrats: Hobby Lobby Ruling Could Boost 2014 Hopes
Democrats may be decrying the Supreme Court’s Hobby Lobby ruling, but the party’s campaign strategists believe they can use it to their benefit in this year’s midterm elections. Despite the legal setback for Obamacare, the strategists hope the ruling will boost Democrats’ efforts to keep the Senate by persuading some Republican-leaning women to defect in states with competitive races while galvanizing younger women who typically don’t vote in midterms (Hohmann, 6/30). 

Politico: White House: Hobby Lobby Ruling ‘Jeopardizes’ Women’s Health
President Barack Obama believes that the Supreme Court’s ruling in the Hobby Lobby case on contraceptives “jeopardizes” women’s health and will press Congress to respond, White House press secretary Josh Earnest said Monday. “Today’s decision jeopardizes the health of women employed by these companies,” Earnest told reporters (Epstein, 6/30). 

The Washington Post: Faith Groups Divided In Their Reaction To Court’s Decision Affirming Religious Rights
U.S. faith groups were starkly divided in their reaction Monday to the Supreme Court’s decision affirming the religious rights of corporations, with some seeing a narrow decision protecting the religious liberty of business owners and others seeing a profane intrusion into the beliefs of employees. Traditional Christians and Jews in particular celebrated Monday’s decision, which comes at a time when many feel conservative religious beliefs — especially around sexuality and marriage — are slipping in official status. ... Some faith groups saw a dangerous, broadly worded decision. They pointed to the dissent written by Justice Ruth Bader Ginsberg (Boorstein, 6/30).

The New York Times: Ruling Against Union Fees Contains Damage To Labor
The Supreme Court dealt a limited blow to organized labor on Monday by ruling that some government employees did not have to pay any fees to the unions representing them. But the court declined to strike down a decades-old precedent that required many public sector workers to pay union fees. ... Justice Alito wrote that home-care aides who typically work for an ill or disabled person, with Medicaid paying their wages, should be classified as partial public employees and should not be treated the same way as public schoolteachers or police officers who work directly for the government (Greenhouse, 6/30).

The Wall Street Journal: Justices Rule Certain Workers Can't Be Forced To Pay Union Fees
Home-based care workers in Illinois aren't full-fledged public employees so they can't be forced to pay dues to a union they don't want to join, a divided Supreme Court said. But the limited ruling stopped short of barring organized labor from collecting fees from government workers who object to union representation (Kendall and Trottman, 6/30). 

The Washington Post: Supreme Court: Home Health-Care Workers Can’t Be Required To Pay Union Fee
Thousands of home health-care workers cannot be forced to pay union fees if they are not in a union, the Supreme Court ruled Monday, dealing a defeat to organized labor and foreshadowing a potentially far more serious blow to come. ... The case had prompted widespread concern among public-sector unions because Illinois had deemed the aides, who are paid by the state, to be public employees. But the court said the aides are only quasi-public because their real employers are their patients (Markon and Barnes, 6/30). 

Los Angeles Times: Supreme Court Ruling On Home Healthcare Workers A Setback For Unions
In a 5-4 opinion written by Justice Samuel A. Alito Jr., the court said the home healthcare assistants, some of whom care for their own loved ones, had a constitutional right not to support a union they opposed. The decision will make it more difficult in some states for unions to continue organizing home healthcare assistants, a rapidly growing segment of the workforce that is expected to double in the next decade thanks to the aging U.S. population (Phelps and Savage, 6/30). 

The Wall Street Journal: Former Procter & Gamble CEO Tapped As New VA Secretary
In turning to Robert McDonald to fix the Department of Veterans Affairs, President Barack Obama is banking that a longtime corporate executive has the skills to revamp the beleaguered veterans' health system. Mr.  McDonald's 33-year tenure at consumer-products giant  Procter & Gamble Co. offers a glimpse at the skills he would bring to the job. He was known as a straight shooter with a tireless work ethic. ... At the same time, during his years as CEO from 2009 to mid-2013, P&G stumbled with weak financial results and some delayed or poorly executed product launches (McCain Nelson and Ng, 6/30). 

The New York Times: V.A. Nominee McDonald Faced Criticism At Procter & Gamble
On Monday, Mr. McDonald, a 61-year-old former Army captain and West Point graduate, became President Obama’s pick to unscramble the Department of Veterans Affairs, a $154-billion-a-year agency of 300,000 employees that has become an enterprise of dysfunction and has lost the trust of many of the nine million people it serves. ... Mr. McDonald had critics at Procter & Gamble, but on Monday some analysts, including one who was a harsh judge of his tenure there, said that trying to turn around a government bureaucracy might be more suited to Mr. McDonald’s skills (Oppel, 6/30). 

The Washington Post: Obama Taps Robert A. McDonald To Lead VA, Tackle Troubled Agency’s Many Challenges
Speaking at the department’s headquarters, Obama said McDonald was well-suited to fix what an administration report has found to be “significant and chronic system failures,” a “corrosive culture” and major dysfunction at the Veterans Health Administration, which has faced scandal over long waits encountered by veterans seeking care (Goldfarb and Eilperin, 6/30). 

Politico: Barack Obama Announces VA Pick
President Barack Obama announced his intention Monday to nominate former Procter & Gamble executive Robert McDonald to lead the Department of Veterans Affairs, as he vowed to continue to push to reform the troubled agency. ... Leading efforts to improve the agency — and the Veterans Health Administration, which is part of the department — “is not going to be an easy assignment,” the president said, but he believes that McDonald is well-suited for the task. The ex-P&G CEO “has a reputation for being ready, for jumping into tough situations and going all the way” (Epstein, 6/30). 

The New York Times: Official Seeks Restored Trust In Military Care
The Pentagon’s senior health-affairs official said Monday that the armed forces’ global network of hospitals and clinics must work to restore trust in the caliber of health care following disclosures of shortcomings in maternity and surgical care and a pattern of avoidable errors that have led to injuries and contributed to some deaths (LaFraniere, 6/30). 

Cincinnati Enquirer/USA Today: Businesses Tackle The Obamacare Equation
David Tramontana is still crunching the numbers. His firm has spent thousands of dollars hiring consultants to walk him through the ins and outs of complying with new rules on the horizon under health reform. ... Across the country, large employers like Black Stone are hustling to comply with requirements of the Patient Protection and Affordable Care Act that are set to move into full swing in 2015 (Bernard-Kuhn, 6/30). 

The New York Times: UnitedHealth, An Insurer Switching Roles, Helps Hospitals On Medicare Billing
To hospitals, billions of dollars depend on how they define a patient’s stay. Even though a patient may be in the hospital for a simple surgery, Medicare might classify the procedure as outpatient care and pay a lower fee to the hospital. ... UnitedHealth also owns a little-known consultant that is flourishing by helping hospitals exploit what they describe as a gray area in Medicare payments for hospital stays, fighting to get what can amount to thousands of dollars more per patient. The consultant, Executive Health Resources, is often at the center of battles between hospitals and Medicare over how the facilities bill (Abelson, 6/30).

Check out all of Kaiser Health News' e-mail options including First Edition and Breaking News alerts on our Subscriptions page.

This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.