Affordable Care Act

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May 17, 2012 | 11:20 AM | By

Bridge to Health Reform “Undoable” in San Luis Obsipo

By John Gonzales, Center for Health Reporting

San Luis Obispo County. (Steve Wilson: Flickr)

San Luis Obispo County. (Steve Wilson: Flickr)

California’s “Bridge to Reform” program is intended to do exactly that: provide a bridge to the 2014 roll-out of the Affordable Care Act. Right now, 47 of California’s 58 counties have already provided health care to more than 335,000 people. San Luis Obispo is a case study in one county that is not participating.

We have reported on the Bridge to Reform, also known as the Low Income Health Program, since its early phases. I was the reporter on our first piece, which looked at Kern County’s efforts to build the bridge. A follow-up examined the challenges of implementing the program in the far corners of Humboldt and Del Norte counties.

In San Luis Obispo, Health Agency Director Jeff Hamm said he made the decision to withdraw from participation reluctantly. For years, the county has slashed its health budget and outsourced its medical safety net.

It reached the point, Hamm said, of not having the start-up funds, or medical infrastructure, needed to implement the Bridge to Reform.

“We understood it would be good for a lot of people. We didn’t have the money,” said Hamm, whose county joins Fresno as a non-participant. “It was a big paradigm shift, a really big shift in terms of infrastructure, requirements for data collection, and processing. … We’re talking a 150-page contract with the State of California. … It became undoable for us.” Continue reading →

FILED UNDER: Policy, Reform, Affordable Care Act, Bridge to Reform
March 29, 2012 | 10:26 AM | By

Full Audio & Transcripts: Supreme Court’s Oral Arguments on the Health Law

(Jessica Marcy: KHN)

(Jessica Marcy: KHN)

The Supreme Court’s historic hearings of the Affordable Care Act have wrapped up. The Court addressed four issues over the last three days and held a total of six hours of oral arguments.

Below is complete audio and transcripts from each set of arguments.

First, the court heard arguments about whether it can even consider the case now. Under the new law, the first penalties would be assessed in 2015 for those who do not purchase health insurance. An arcane 1867 law says people can’t sue over a tax until they pay a tax. Must the court wait until 2015 to decide whether the health law is constitutional?

You can listen to the 90 minutes of oral arguments here:

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Or read on for the complete transcript as well as audio and transcripts from the other arguments:
Continue reading →

FILED UNDER: Reform, Affordable Care Act, Health Care and the Supreme Court
March 28, 2012 | 3:56 PM | By

Legal Levity: Moments of Humor During Historic Hearings

Supreme Court Justice Antonin Scalia was one of the justices making the occasional joke today. (Courtesy: U.S. Supreme Court)

Supreme Court Justice Antonin Scalia was one of the justices making the occasional joke today. (Courtesy: U.S. Supreme Court)

It was the hottest ticket inside the Beltway–the Supreme Court’s hearings on the federal health care law. Kaiser Health News reporter Phil Galewitz was determined to get in, but didn’t have a press pass (and no member of Congress gave him one, either). Instead–just by standing in line–he got in.

There were two sets of arguments today. For the earlier arguments, Galewitz only snagged a “three-minute pass” then parlayed it into a full six minutes. But for the second hearing about the Medicaid expansion, he got a special “gray” ticket for the full, one-hour session.

Galewitz picks up his story from there–and it turns out the Justices can be funny: Continue reading →

FILED UNDER: Reform, Affordable Care Act, Health Care and the Supreme Court
March 27, 2012 | 10:19 AM | By

Audio/Transcript of Tuesday’s Supreme Court Hearings on the Individual Mandate

The Question: Is the individual mandate constitutional?

Of the four questions the Supreme Court is considering, this is the big one. The Affordable Care Act requires all Americans to purchase health insurance or pay a penalty. If your annual income is below a certain level–about $92,000 for a family of four– the government will provide subsidies or tax credits to help you. The primary legal question is this: does Congress have the authority under the Commerce Clause of the U.S. Constitution to require Americans to purchase a product, in this case health insurance? Those in favor say yes–Congress can both regulate interstate commerce and legislate taxes. Those opposed say this is the first time Congress has required Americans to purchase a product and it’s unconstitutional.

As she left the hearings, NPR’s Nina Totenberg tweeted, ”The government had a hard time. And if they win, they win narrowly. I don’t think you can call this.”

You can listen to the complete oral arguments here:

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Or read on for the complete transcript:
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FILED UNDER: Reform, Affordable Care Act, Health Care and the Supreme Court
March 27, 2012 | 7:13 AM | By

Justices Tackle The Big Question: Can Congress Force You To Buy Insurance?

Protesters demonstrate in front of the Supreme Court on the second day of hearings about the constitutionality of the federal health care law. (Mark Wilson: Getty Images)

Protesters demonstrate in front of the Supreme Court on the second day of hearings about the constitutionality of the federal health care law. (Mark Wilson: Getty Images)

WASHINGTON (AP) — The Supreme Court is taking up the key question in the challenge to President Barack Obama’s historic health care overhaul: Can the government force people to carry insurance or pay a penalty?

The justices hear extended arguments on that topic this morning. It’s the linchpin of the law’s aim to get medical insurance to an additional 30 million people, at a reasonable cost to private insurers and state governments.

Virtually every American will be affected by the outcome, due this summer in the heat of the presidential and congressional election campaigns. Continue reading →

FILED UNDER: Reform, Affordable Care Act, Health Care and the Supreme Court
March 26, 2012 | 1:40 PM | By

Justices Seem Determined to Get to Heart of Health Care Law

By Scott Hensley, NPR

(Courtesy: U.S. Supreme Court)

(Courtesy: U.S. Supreme Court)

Does a federal law stretching back to 1867 bar the Supreme Court from deciding on the merits of the administration’s health law right now?

The court on Monday heard the first arguments in a historic three-day session that could decide the fate of the Obama administration’s signature domestic achievement.

The administration and the challengers to the overhaul law don’t agree on much. But both sides agreed that the Anti-Injunction Act, which says people can’t challenge a tax in court before they pay it, should not prevent the Supreme Court from deciding the constitutionality of the law.

After arguments ended shortly before noon, NPR’s Nina Totenberg gave a brief recap outside the court. “It was packed, and everybody was very excited to be there,” she told Ari Shapiro. She said the arguments were dense and difficult to penetrate. Continue reading →

FILED UNDER: Reform, Affordable Care Act, Health Care and the Supreme Court
March 26, 2012 | 9:14 AM | By

Day One: Oral Arguments on Health Care Law Have Wrapped

Justices react skeptically to delaying ruling due to arcane “Tax Anti-Injunction Act“

(Mike Renlund: Flickr)

(Mike Renlund: Flickr)

WASHINGTON (AP) — The Supreme Court plunged into debate Monday on the fate of the Obama administration’s overhaul of the nation’s health care system, starting with pointed questions about a legal issue that could derail the case.

Eight of the nine justices fired two dozen questions in less than half hour at Washington attorney Robert Long. He had been appointed by the justices to argue that the case has been brought prematurely because a law bars tax disputes from being heard in the courts before the taxes have been paid.

Under the new law, taxpayers who don’t purchase health insurance will have to report that omission on tax returns for 2014 and will pay a penalty along with federal income tax. At issue is whether that penalty is a tax. Continue reading →

FILED UNDER: Reform, Affordable Care Act, Health Care and the Supreme Court
March 26, 2012 | 8:11 AM | By

Supreme Court Health Care Law Arguments Have Begun

(OZinOH: Flickr)

(OZinOH: Flickr)

WASHINGTON (AP) — With demonstrators chanting outside, the Supreme Court began hearing arguments Monday on the fate of President Barack Obama’s historic health care overhaul, no less controversial two years after Democrats pushed it to passage in Congress. Twenty-six states are leading the legal challenge, while Republican presidential candidates are vowing to repeal it after throwing Obama out of office.

The law, much of which has still to take effect, would require almost all Americans to obtain health insurance and would extend coverage to more than 30 million people who now lack it. The law would be the largest expansion in the nation’s social safety net in more than four decades.

The nine justices began hearing arguments a little after 7 a.m. PT. Continue reading →

FILED UNDER: Reform, Affordable Care Act, Health Care and the Supreme Court, Heath Care Overhaul
March 1, 2012 | 6:00 AM | By

How Big a Barrier is Language to Enrolling in Health Exchange?

Most health care terms are not as easily understandable as this sign. (Elliott Brown: Flickr)

For people who don't speak English well, most health care terms are not as easily understandable as this sign. (Elliott Brown: Flickr)

As policy makers work toward setting up the California Health Benefit Exchange–the marketplace where individuals and small businesses will be able to buy health insurance–they’re grappling with questions on two fronts: what benefits the policies will offer and how to ensure that people enroll. According to a new report, 2.6 million adults under age 65 will be eligible for federal tax credits to buy insurance in this new marketplace. Of those people, 67 percent will be people of color, and 40 percent (or just over one million adults) will speak English less than very well. This lack of English proficiency could be a barrier to these people enrolling in the exchange, according to the report [PDF].

Ellen Wu is Executive Director of the California Pan-Ethnic Health Network, one of the sponsors of the report. “Language poses a barrier when people try to enroll in coverage programs,” she said in an interview. “We know that it’s just confusing for those of us who DO speak English well, and for those who have a different language other than English, it’s even more difficult to first find the materials in their language and second to understand the terminology.” Continue reading →

FILED UNDER: Money, Reform, Affordable Care Act, communities of color, Health Benefit Exchange
January 26, 2012 | 12:21 PM | By

Without Individual Mandate, Fewer Californians with Health Insurance

(s_falkow: Flickr)

(s_falkow: Flickr)

In March, the U.S. Supreme Court will consider the constitutionality of several aspects of health care reform, including the “individual mandate,” the requirement that all Americans have health insurance.

In a new study, [PDF] researchers at the UCLA Center for Health Policy Research and UC Berkeley crunched the numbers and determined that without the individual mandate, more than one million Californians would put off buying health insurance.

The individual mandate is part of The Affordable Care Act, set to roll out in 2014. The mandate requires people to purchase health insurance or pay a tax penalty up to $2085 per household. Continue reading →

FILED UNDER: Reform, Affordable Care Act, Health Care and the Supreme Court, Individual Mandate, U.S. Supreme Court