Bill de Blasio, whose fiery populism propelled his rise from obscure neighborhood official to the 109th mayor of New York, was sworn into office on Wednesday, pledging that his ambition for a more humane and equal metropolis would remain undimmed.NY Times on contraception and ACA:
To understand the context of Justice Sotomayor’s decision, it helps to look at the details of the Affordable Care Act. The law distinguishes among three kinds of organizations: religious employers, for-profit corporations and nonprofit groups affiliated with religious organizations but not owned or controlled by them.Given that the lower courts have mixed results on review, it's hard to see the Supremes staing out of this. We look forward to settling the questions.
Under the law, religious employers like churches are exempt from the contraceptive requirement. For-profit corporations fall on the other end of the spectrum and are not exempt. Nonprofit groups affiliated with, but not owned or controlled by religious organizations, like the Little Sisters of the Poor, fall in the middle. Although such groups need not provide coverage themselves, they must sign a certification allowing insurance companies to do so.
The dispute in the new case is whether that certification itself amounts to conduct that violates the groups’ religious faith.
More policy and politics below the fold.
Here are some more good Ocare articles I hope you did not miss:
A crucial GOP line of attack against the Affordable Care Act (ACA) is that millions of people will supposedly lose coverage thanks to shifting requirements on the health insurance exchanges — a flagrant violation of President Obama’s infamous “if you like your plan, you can keep it” proclamation. The truth has always been more complicated, of course. Republicans are constantly blurring the line between people who lose a plan and people who lose coverage. That is, many people might lose a particular insurance plan but immediately be presented with other options.Ryan Cooper:
Now, a new report from the minority staff of the House Committee on Energy and Commerce has destroyed the foundation of that particular GOP claim. It projects that only 10,000 people will lose coverage because of the ACA and be unable to regain it — or in other words, 0.2 percent of the oft-cited 5 million cancellations statistic.[my bold]
Because of the decision on Obamacare by the Supreme Court, which left the decision to expand Medicaid (a key part of Obamacare) up to the individual states, most Republican-controlled states refused said expansion, leaving substantial portions of the citizenry in the lurch.John McDonough:
Ed Kilgore has been calling this the “wingnut hole,” and many have been speculating about its size. How many Americans will go without health insurance simply because the GOP dislikes the president? Well, happy 2014, dear readers: initial estimates are in, and we have 5 million lucky winners!
Before that, let's consider January 1 2014. In the midst of constant turmoil over websites, enrollment snafus, policy cancellations, political attack ads, and more, we are missing something important. January 1 2014 may well be the most transformational day in the history of United States health care policy, ever, and nobody seems to notice. What's so big about 1/1/2014?Here's a blast from the past (Feb 2013) from Kaiser:
First, this is the first day of fundamental reform of the business and regulation of health insurance in all 50 states:
• Banning the practice of "medical underwriting" by which insurance companies rate enrollees based on their health status and medical history,
• Banning pre-existing condition exclusions from US health insurance everywhere,
• Establishing "guaranteed issue" as the new operating paradigm for individual health insurance,
• Completely eliminating lifetime limits on all health insurance, and
• Establishing "minimum essential benefits" that must be included in nearly all licensed health insurance policies everywhere.
Why Premiums Will Change for People Who Now Have Nongroup InsuranceIt's a good primer, but it's also a reminder that
Before reform, the nongroup market was widely acknowledged to be broken, with restricted access, limited benefits, high administrative costs, and frequent and large premium increases subject to inadequate oversight.Fixing that market is inevitably going to be disruptive (see the Ryan Cooper piece above, see Jonathan Cohn), but don't ever lose sight of how awful it was (Consumer Reports, 2009):
individual insurance is a nightmare for consumers: more costly than the equivalent job-based coverage, and for those in less-than-perfect health, unaffordable at best and unavailable at worst. Moreover, the lack of effective consumer protections in most states allows insurers to sell plans with ‘affordable’ premiums whose skimpy coverage can leave people who get very sick with the added burden of ruinous medical debt.Meanwhile (NY Times):
Millions of Americans will begin receiving health insurance coverage under the Affordable Care Act on Wednesday after years of contention and a rollout hobbled by delays and technical problems. The decisively new moment in the effort to overhaul the country’s health care system will test the law’s central premise: that extending coverage to far more Americans will improve the nation’s health and help many avoid crippling medical bills.Meanwhile (Wonkblog):
Everything you need to know about life under ObamacareMeanwhile: (Sarah Kliff):
It's impossible to know how many people are gaining insurance today. There is no national clearing house for which Americans get their health insurance where, which makes it all but impossible to know who has insurance on Jan. 1 who didn't on Dec. 1. Here's what we know for sure: At least 6 million people have signed up for Obamacare's coverage expansion, either through private insurance or the public Medicaid program.And meanwhile the way health insurance is delivered will never be the same.
We don't know how many of those people had insurance before Jan. 1 and are transitioning into a new, Obamacare-compliant plan. We also don't know how many of the people signed up for coverage have paid their first month's premium -- and they have to do that by Jan. 10 in order to be covered by their new health plan. The Wall Street Journal estimates that about half of those who have picked a private plan have so far made this payment.