Since the Affordable Care Act (ACA) passed in early 2010, there have been a lot of legal challenges that have come to the forefront of the healthcare reform debate, including the individual mandate, Medicaid expansion, and federal regulation of state commerce to name just a few. In an issue brief released by the Kaiser Family Foundation on December 9, 2013, the authors reviewed the most recent challenge taken up by the U.S. Supreme Court. In late November 2013, the Court accepted two separate cases to decide on the constitutionality of whether the contraceptive mandate, a requirement of the ACA, infringes on protections of religious freedom under the First Amendment and the Religious Freedom Restoration Act of 1993 (RFRA).
The brief outlines the two cases, Sebelius v. Hobby Lobby Stores and Conestoga Wood Specialties v. Sebelius, and discusses the potential ramifications if the Court does not uphold the mandate. Currently, nonprofit, religiously affiliated organizations (i.e., houses of worship) are exempted from the mandate that requires all new private insurance plans to provide access to all FDA approved contraceptive methods. However, “insurance companies are required to cover the cost of contraceptives for employees of religiously affiliated organizations that have requested… [a religious]… accommodation at no cost to the employees or the employers.” To qualify for the accommodation the organization must have religious objections to providing some or all contraceptive coverage, file as a nonprofit, advertise as a religious organization in the public domain, and self-certify that they meet the first three criteria.
The Court’s decision, expected by June 2014, will try to lay to rest whether for-profit, private businesses should be afforded the same protection of rights as individuals and religious organizations under the First Amendment and the RFRA, which could have broad reaching policy implications for both equality for women in the workplace and religious freedom.
To read the entire issue brief, click HERE
A new guide helps Navigators answer questions from consumers and employers about how insurance reforms under the Affordable Care Act (ACA)will affect their coverage options. This comprehensive resource addresses more than 230 enrollment questions about everything from tax credits and cost standards to enrollment periods, and more. The guide is intended to supplement the Navigator training available from HHS and help answer questions about the private insurance reforms in the Affordable Care Act.
You can access the resource here.
Don Taylor wrote an interesting analysis of the state decisions on Medicaid expansion. His analysis indicated that about $30 billion in federal funds would go to the 24 states expanding Medicaid and that $35 billion is being left on the table by states that are not expanding Medicaid. He arrived at an interesting conclusion. “The bottom line is that if the current State Medicaid expansion decisions persist, the unintended story of the ACA will turn out to be the redistribution of money from poorer States, to richer ones, an outcome imposed by the poorer states, upon themselves.”
You can read his full blog post and access the supporting resources here.
The deadline to sign up for health insurance on the federal marketplace has been extended to March 31. This gives people an extra 6 weeks to sign up and avoid the tax penalties.
You can read more here.
The Institute of Medicine (IOM) just released the report, Population Health Implications of the Affordable Care Act summarizing the June 2013 workshop, which examined the impact of the Affordable Care Act on population health improvement. The workshop brought together stakeholders from the public and private sectors involved with health and health care delivery. In an effort to move outside of status quo understanding of population health, this report discusses three core issues:
- Supporting fruitful interaction between primary care and public health
- Strengthening governmental public health
- Exploring community action in transforming the conditions that influence the public’s health.
Other IOM reports can be found here.
This article in the New York Post does a great job of summarizing the impact on businesses of the ACA. There is an enormous amount of passion and misinformation surrounding this issue. The impact on business and particularly how businesses respond to the ACA provisions will be a very interesting question for policy researchers over the next several years.
The launch of the federally run marketplace in states that chose not to run their own marketplace was fraught with technical difficulties. In contrast, most states that opted to operate their own marketplace had few problems and claim to be successful. Given the contrast, many have been asking why the federally run marketplace struggled. At least part of the reason is that the original intention of the law was for every state to run their own exchange and so it was not anticipated that the federal government would run the marketplace in so many states. However, another criticism has been about the design of the site, which has been detailed in a recent new story, which you can access here. The main criticism is that the federal government required people to set up an account rather than being allowed to browse options before setting up an account. Washington state had issues launching their site, but have fixed those issues and now has been running successfully, which was detailed in a great news story here. It may be a lesson for the federal government. This shouldn’t be surprising because states are often described as policy laboratories where innovations happen that are then diffused to other states and sometimes, eventually, to the federal level.