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Thom Tillis 2As was explained at some length in this post earlier this year, there are several reasons that the support voiced during the 2014 campaign by Senator-elect Thom Tillis and other conservative candidates for access to “over-the-counter” contraceptives was a disingenuous batch of baloney cooked up by GOP campaign consultants.

…the trick lies in the conservative politicians’ deceptive use of a term (“over the counter contraceptives”) that really has no practical meaning.

Currently, the main and most effective contraceptives available to women are not available without a prescription (i.e. “over the counter”). Moreover, as Planned Parenthood Vice President and occasional N.C. Policy Watch contributor Melissa Reed pointed out in a statement last week,

“…while leading women’s health experts agree that some forms of birth control should be made available OTC, there is not a single manufacturer that has submitted an application to the FDA to do so.”

In other words, to be “for” OTC contraceptives without providing any genuine specifics about how and when the government would go about effecting such a momentous change is meaningless and a downright deceptive and empty gesture.

Nonetheless, one might have thought that the GOP would at least pay lip service to the idea after the election in order to cover their tracks for a while. As this article featuring Thom Tillis  (in yesterday’s Washington Times, of all places) makes clear, however, that ain’t gonna’ happen. The article says that expanding OTC access in the upcoming session of Congress is (surprise!!) “markedly absent” from the plans of GOP leaders.

And somewhere, Karl Rove is smiling.

Commentary

As we report below the US Supreme Court has decided to hear another legal challenge to the Affordable Care Act.

You can read the details of the lawsuit in our earlier post, but some context is important. This new fight focuses on subsidies extended to individuals and families earning less than 400 percent of the federal poverty level who purchase private insurance. For these families subsidies are available to make insurance plans more affordable. In North Carolina about 91 percent of people purchasing Affordable Care Act plans received subsidies. Of those, the average cost of insurance is $81 per month.

News coverage of the Supreme Court’s move, coming just before open enrollment is set to start, is sure to cause confusion. In the short term it is critical to remember that the subsidies are still in place and everyone should proceed to shop for insurance without worrying about the political winds.

In the long term it is difficult to know what this case will mean for the law. The challenge is absurd, but that doesn’t give us any hint at how the Supreme Court Justices will vote. Read More

News

The U.S. Supreme Court stepped back into the ring in the ongoing challenge to the viability of the Affordable Care Act today, agreeing to review the availability of tax credits under its provisions.

The justices will review a decision out of the Fourth Circuit, King v. Burwell,  holding that such subsidies are available to health insurance purchasers on both state exchanges and the federal exchange.

In North Carolina, which did not set up a state exchange, more than 350,000 residents purchased health insurance on the federal exchange — and more than 90 percent did so with the assistance of subsidies. Millions more across the country did the same.

Plaintiffs who brought the case contended that the language of the statute only authorized those credits for purchasers on state-run exchanges, but the Fourth Circuit unanimously rejected that position.

That ruling came just hours after a three-judge panel of the federal appeals court in Washington issued a contrary decision in a separate case pending there. Several weeks later, though, the full D.C. Circuit Court of Appeals reversed that panel and agreed to have the entire court consider the issue.

Rather than wait for a decision there, the justices today agreed to take the Fourth Circuit case up this term.

The Supreme Court’s order is here.

 

Commentary

The conservatives in Congress are already queuing up to offer proposals that would gut amend Obamacare. For instance, leaders McConnell and Boehner are already proposing to raise the threshold number of hours that employees must work per week from 30 to 40 in order to trigger the mandate that their employer provide coverage.

As Paul Van de Water of the Center on Budget and Policy Priorities explains on the blog Off the Charts, this will be a destructive idea that will actually lead to less full-time employment:

ACA work thresholdCritics of health reform claim that employers are shifting some employees to part-time work to avoid offering them health insurance.  But the data provide scant evidence of such a shift.

Moreover, raising the threshold for mandating coverage from 30 to 40 hours would make a shift toward part-time employment much more likely — not less so.

Only about 7 percent of employees work 30 to 34 hours (that is, at or modestly above health reform’s 30-hour threshold), but 44 percent of employees work 40 hours a week and thus would be vulnerable to cuts in their hours if the threshold rose to 40 hours.  Under the Boehner-McConnell proposal, employers could easily cut back large numbers of employees from 40 to 39 hours so they wouldn’t have to offer them health coverage.

The bottom line according to Van de Water:

There’s little evidence to date that health reform has caused a shift to part-time work.  There’s every reason to expect the impact to be small as a share of total employment, as we have explained.  And raising the cutoff for the employer mandate from 30 to 40 hours a week would be a step in the wrong direction.

Commentary

Medicaid expansionIn case you missed it over the weekend Ned Barnett of Raleigh’s News & Observer had an on-the-money column about the latest  bizarre claim from the McCrory administration that we can now expand Medicaid under the Affordable Care Act because they have “fixed” what was a “broken” system. As Barnett notes:

“It’s good news that the governor is now open to doing the right thing about Medicaid expansion. Even Tillis now says he might favor it. Refusing to do it could cost the state $51 billion in lost federal money over the next decade, according to a report from the Robert Wood Johnson Foundation.

But this change of position shouldn’t pass without a look at the rationale for not doing it in the first place. Wos’ reign at DHHS has been marked by massive provider payment problems, an exodus of staff, plummeting morale and expensive consultants hired to fill in the gaps. Now she’s saying that the administration of Medicaid has been fixed and it’s ready to take on a half-million new recipients.

If that turnaround is true, Wos has accomplished an amazing feat of introducing efficiency and accountability. Yet there’s nothing to suggest that is the case. DHHS under Wos remains an agency riddled by vacancies and burdened by a reputation for administrative dysfunction that has discouraged top applicants. But the Medicaid program itself was never “broken”. It has operated in North Carolina for decades and in recent years has successfully held down administrative costs compared with the national average. Medicaid’s “out-of-control costs,” which Republican legislators say busted the state budget, reflect wishful budgeting. Simply putting a number in the budget won’t hold down costs. People need treatment, and when there’s a recession Medicaid rolls grow. With the economy now improving, Medicaid costs are coming in under budget.”

In other words: It’s great that McCrory and Wos want to expand Medicaid and even fine if they want to delude themselves about the reasoning, but anyone who’s been paying attention knows their claims and rationales are bogus.