Overnight Healthcare

Overnight Health Care: Supreme Court sets Friday deadline for ObamaCare responses | Democrats worry as court fight over health law drags on | Trump officials to appeal ruling striking down ‘conscience’ rule

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A patient is shown signing up for ObamaCare insurance in this Nov. 22, 2017, file photo.

Happy 2020! Welcome to the first Overnight Health Care of the new year.

An analysis shows the stability of the ObamaCare marketplace, but the law’s defenders are worried if a recent court case stretches into a possible Trump second term. The Supreme Court is also asking parties to respond quickly as it weighs whether to jump into the legal fight. And in other news, public health groups are outraged over Trump’s partial vaping ban.

But we’ll start with ObamaCare:


Supreme Court sets Friday deadline for responses in ObamaCare case

The Supreme Court on Monday told the Trump administration and a group of states to respond by the end of the week to an effort by Democrats to expedite a challenge to a lower court ruling that struck down a key tenet of ObamaCare.

Democrats are challenging the Fifth Circuit Court of Appeals decision that ruled the Affordable Care Act’s individual mandate unconstitutional. They asked the Supreme Court last week to expedite a briefing schedule and to hear the case before the current term ends in June.

Now the justices want the administration and red states fighting to strike down the health law to respond by Friday afternoon. Monday’s briefing order sets an accelerated timeline for a process that normally takes months.

High stakes: The Supreme Court has not decided yet whether it would hear the ObamaCare case in an election-year term already loaded up with controversial cases. The court’s decision on taking up the case will also affect whether or not it is decided before the 2020 election.

Read more here.


And more on the politics of the ObamaCare court fight…


Democrats’ worries grow as ObamaCare court fight drags on

The level of worry among ObamaCare supporters is starting to grow about a lawsuit that was initially widely viewed as making far-fetched arguments. 

Most observers in both parties assume the current makeup of the Supreme Court would uphold the Affordable Care Act, given the skepticism over the arguments in the lawsuit challenging the law.

But two courts have now invalidated either all or part of the law in this case, a conservative district judge in Texas and two GOP-appointees on the Fifth Circuit.

And if the fight in the lower courts drags on and Trump is reelected with the chance to replace one of the liberal justices, it would throw the future of ObamaCare into more doubt.

“Whether Trump is reelected may a have a lot do with how the courts rule in this case,” said Nicholas Bagley, a law professor at the University of Michigan. 

Read more here.


Analysis: ObamaCare market profitable despite loss of individual mandate

Remember when Democrats and many experts warned of chaos in the markets if the individual mandate were repealed? It turns out repeal of the mandate did not damage the law that much, according to a new Kaiser Family Foundation analysis. 

“Results from the first nine months of 2019 suggest that the individual market remains profitable and stable despite the effective repeal of the individual mandate,” the analysis finds. 

A key measure of insurers’ financial strength, the percentage of premiums insurers collect that they pay back out in spending on health claims, remained relatively strong in 2019 despite the repeal of the mandate, the analysis finds. 

Some policy experts, especially right-leaning ones, have long said that the effect of the mandate was overrated and that what was really keeping people enrolled was the carrot of ObamaCare’s financial assistance, not the stick of the mandate.

Read more here.


Trump administration to appeal ‘conscience’ rule 

The Department of Justice (DOJ) will appeal a federal court’s decision to strike down a Trump rule that would make it easier for health professionals to refuse to provide care for religious reasons. 

The DOJ filed its notice of appeal Friday afternoon in the southern district of New York. 

U.S. District Judge Paul Engelmayer, an Obama appointee, ruled against the administration in November, writing that the rule violated federal law. 

The rule is touted by the administration as a way to protect the “conscience rights” of health care workers who oppose procedures or services because of their religious or moral beliefs.

Under the rule, entities that violate the rights of its employees could lose federal funding. 

But the judge wrote in his ruling that only 6 percent of the complaints given to the court dealt with moral or religious objections. Eighty percent of complaints were about vaccinations.


Public health advocates outraged by Trump’s limited vaping ban

Public health groups are outraged by President Trump’s limited vaping ban, arguing the new policy is short-sighted and will not stop a surge in youth vaping.

Health advocates are also accusing the president of bowing to political interests in an election year. The policy was intended to be a compromise between warring factions in the White House, but public health groups and anti-tobacco advocates greeted the announcement with anger and dismay.

The politics: White House officials tried to find a balance between advisers pushing for a comprehensive ban and campaign officials warning that any type of ban would have negative political consequences. But in trying to please both camps, experts said Trump has at best kept the status quo. At worst, they said, he has given tobacco companies a green light to target kids.

Public health concerns: The American Academy of Pediatrics, along with representatives of groups like the American Lung Association, the American Cancer Society and the Campaign for Tobacco-Free Kids, all noted that teens who vape mint or fruit flavors will soon shift to menthol pods if they are available.

Read more here.


CMS names former Anthem executive to key post 

Brad Smith, a former Anthem executive, will lead the Center for Medicare & Medicaid Innovation at CMS, the agency announced Monday. 

CMMI largely tests new payment models for Medicare and Medicaid. Smith will also serve as a senior adviser to Department of Health and Human Services Secretary Alex Azar on value-based transformation.

Smith most recently was chief operating officer of Anthem’s Diversified Business Group. He also co-founded Aspire Health, which provided palliative care for patients facing serious illnesses. 

“Brad will help HHS and CMS continue and accelerate the value-based transformation work that we have begun under President Trump,” Azar said in a statement. 


What we’re reading

Trump touted a new antidepressant as a solution for veterans. Only 15 have been treated (Stat)

Effort to control opioids in an ER leaves some sickle cell patients in pain (Kaiser Health News)

GAO: VA spent $4 billion on new facilities with little oversight (Modern Healthcare)


State by state

Louisiana Health Department head who spearheaded Medicaid expansion stepping down (WWLTV)

Abortion reversal laws in Idaho, Utah could endanger women, study finds (KUER

Hundreds have died from lethal drugs since death with dignity became law in California (East Bay Times)


From The Hill’s Opinion Page

Marijuana policies: A call to shift from a criminal justice approach to a public health approach

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