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Health Reform Headlines: Legal, Messaging Battles

Health Reform Goes to Atlanta

The health reform law was back in court  Wednesday as 26 states attempted to convince a three-judge panel that the president’s signature domestic policy achievement is unconstitutional.

26 StatesIn arguments before the 11th Circuit Court of Appeals, the Obama administration defended the right of the government to require most individuals to buy health insurance or pay a penalty.

Judge C. Roger Vinson of the U.S. District Court for the Northern District of Florida overturned the new law in its entirety in January. He argued the individual mandate is unconstitutional — and that the provision requiring the mandate is so central to the rest of the law that it could not be severed.

The consortium of 26 states is asking that the appeals court uphold that decision. They wrote in a legal brief that upholding the law “would eliminate any meaningful limit on Congress’s enumerated powers and effectively destroy the Constitution’s careful balance.”

The judges asked repeated questions about how the law might fare if the individual mandate was deemed unconstitutional, but they ultimately gave little indication of how they would rule.

Regardless, the matter will likely end up at the Supreme Court, possibly as early as its next term.

Democrats Join the Fight

Seven House Democrats and a pro-reform advocacy group have added their voices to the growing chorus demanding a repeal of the health care law’s Independent Payment Advisory Board.

Viewed by the president as a key method for getting Medicare costs under control, opponents say the panel will have too much power and its decisions will be too hard for Congress to reverse.

The board will be made up of 15 appointed health experts – doctors, nurses, medical experts and consumers – and charged with finding savings in the Medicare system if prices shoot up too quickly. Rep. Paul Ryan calls it “15 unelected bureaucrats who will ration Medicare.”

Max Richtman, executive vice president and acting CEO of the National Committee to Preserve Social Security and Medicare told Politico his group was willing to put up with IPAB – until now – for the greater good of the law. This week, his words sounded a bit more like Ryan’s: “IPAB turns Medicare into a scapegoat,” Richtman said “Medicare will be forced to make reductions without addressing the rest of the health care costs.”

If You Like Your Care, Can You Keep it?

Nearly a third of employers will “definitely or probably” stop offering health coverage to their workers when the bulk of the health care overhaul takes effect in 2014, according to a new study by McKinsey & Co. And more than 50 percent with a “high awareness of reform” would seek alternatives to offering coverage.

McKinsey’s survey of 1,300 employers found that a full 30 percent claimed they would gain economically from dropping coverage – even if they are forced to pay a penalty of $2,000 per worker. As the Obama administration was quick to point out, the results are much steeper than similar studies by The Rand Corporation, The Urban Institute, and Mercer.

On the White House blog Wednesday morning, Deputy Chief of Staff Nancy Ann-DeParle called the McKinsey study “an outlier” that’s “at odds with history” and should be “taken with a grain of salt.”

Still, Republicans didn’t miss the opportunity to label one of the basic pillars of the reform ineffective. Via Twitter, GOP candidate Newt Gingrich wrote: “30%+ employers could eliminate coverage b/c Obamacare … So much for ‘if you like your coverage you can keep it.'”

Democrats Tout Medicare Poll Results

Democrats did a little poll-touting of their own this week. A message from the Democratic Policy and Communications Center rounded up the latest polls showing their current advantage in the Medicare debate. Their headline: “9 Days, Four Different Polls, All Showing The Same Thing: The American Public Strongly Opposes the GOP Plan to End Medicare.”

Washington Post/ABC News Poll: “Republicans Appear to Have Handed Obama an Opening on Medicare in the Budget Blueprint They Adopted This Spring.”

CNN Poll: “Majority Gives Thumbs Down to Ryan Plan.”

Reuters Poll: “More Oppose Than Support Republican Medicare Plan.”

Pew Poll: “Opposition to Ryan Medicare Plan from Older, Attentive Americans.”

What About Medicaid?

Even as Democrats continue to fuel the firestorm over the Republican Medicare plan, Politico brought up a largely overshadowed point Monday: the GOP budget actually makes more immediate and deeper cuts to Medicaid.

“Democrats haven’t been blasting the GOP Medicaid plan with nearly the same fervor, even though Republicans would cut about $750 billion from the program over the next decade and end the guaranteed federal match for states,” Politico reported. “With intense budget negotiations happening on the debt limit, health care insiders think Democrats won’t budge much on Medicare now that they have a significant campaign chip in their pockets — with Kathy Hochul’s upset win in N.Y. 26 as Exhibit A of the power of Medicare. And that makes advocates worry that Medicaid cuts are more likely to come out of budget negotiations led by Vice President Biden.”

On Thursday, 41 Senate Democrats wrote letters to President Obama urging him to fight back against the GOP proposal. Sen. Jay Rockefeller – one of Medicaid’s most vocal defenders – said the program should not become “a sacrificial lamb” in budget negotiations. “Since 1965, the federal government has helped states pay for the basic health care and long-term services low-income Americans need,” the West Virginia Democrat’s letter states. “A cap on federal funding or block grant would undermine this federal commitment.”

A recent Kaiser Health tracking poll found that popular support for Medicaid may be much stronger than long believed in Washington. Sixty percent of Americans support the program as-is, the study shows, and more than half oppose changing it.

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