After all the contentious debate, the U.S. Supreme Court has finally settled it: The federal health care law is constitutional, including the individual mandate. But the politics of the law are far from settled, as it will be a campaign issue in the coming presidential and congressional elections, and Congress is sure to continue fighting about it. Though some may have been stunned by the court’s ruling, it wasn’t a huge surprise. Two federal appeals courts had upheld the law, and past court rulings set precedents that would be difficult to ignore. What perhaps was most surprising was that the deciding vote in the court’s 5-4 decision came from Chief Justice John Roberts. Also of note: The court based its decision on Congress’ authority to tax, not on the commerce clause.
Though most Republicans oppose the federal health care law, they support many of its key provisions, according to a new Reuters-Ipsos survey. For example, 80 percent of Republicans favor creating an insurance marketplace for small businesses and individuals (yet Gov. Sam Brownback sent back federal grant money last year to help Kansas set this up). Also, 57 percent of Republicans support providing subsidies on a sliding scale to help people buy insurance, 54 percent favor requiring companies with more than 50 employees to provide insurance, and 78 percent support banning insurance companies from denying coverage based on pre-existing conditions (which necessitates the individual mandate to purchase insurance). How is it that people hate the law but like what it does? “It’s another sign of the conservative messaging triumph in this fight and the failure of Dems to make the case for the law,” wrote Greg Sargent of the Washington Post. But if the Supreme Court strikes down the law, Sargent said, there might be opportunities to refocus on some of these individual reforms.
In defending its plan to turn Medicaid into a managed-care program, the Brownback administration has cited the thousands of Kansans who were consulted and gave input at public forums last year. But that was misleading, because administration officials never said at those forums that they were planning to have private insurance companies manage Medicaid, so it wasn’t discussed. Now that the administration is being forced by federal rules to hold real public hearings, it is getting an earful. At a hearing Monday in Wichita, all of the public speakers opposed the plan. “I wish the state would look at it through our eyes,” said one woman. But the administration is pressing on with the reform, regardless of what the public wants or thinks.
Mayor Michael Bloomberg’s pioneering proposal to limit serving sizes of sugary drinks is the boldest effort yet to prevent obesity, which is not only painful for millions of Americans but is costing our nation upwards of $150 billion in higher health costs annually. New York City’s health department deserves tremendous credit for recognizing the harm that sugary soft drinks cause in the form of obesity, diabetes and heart disease – and for doing something about it. We hope other city and state public health officials adopt similar curbs on serving sizes and reducing Americans’ exposure to these nutritionally worthless products. – Michael F. Jacobson, Center for Science in the Public Interest
Mayor Michael Bloomberg has done a lot to help improve the health of New York City residents. Smoking is outlawed in workplaces, restaurants and bars. Trans fat is banned in restaurants. Chain restaurants are required to post calorie counts, allowing customers to make informed choices. Bloomberg, however, is overreaching with his new plan to ban the sale of sugary drinks larger than 16 ounces. He argues that prohibiting big drinks at restaurants, movie theaters, stadiums and other food sellers can help combat obesity. But as he admits, customers can get around the ban by purchasing two drinks. The administration should be focusing its energies on programs that educate and encourage people to make sound choices. In the case of sugary drinks, a regular reminder that a 64-ounce cola has 780 calories should help. But too much nannying with a ban might well cause people to tune out. – New York Times
Congratulations to Hunter Health Clinic for receiving a $4.6 million federal grant last week that will help it build a new facility. The clinic has been operating for the past 35 years out of a former shopping center at Central and Grove. Dramatic increases in patients the past few years have caused it to run out of room. It converted closets into exam rooms and has had to put off care to some patients. The grant, which is part of the federal health care reform law, will help it construct a new facility next to its current clinic.
The state’s political leaders were quick to reaffirm the safety of beef after the announcement this week that mad cow disease was discovered in a dead dairy cow in California. No meat from the cow was ever headed for the food supply, and the disease isn’t transmitted through milk, experts say. Sen. Pat Roberts, R-Kan., issued a joint statement with Senate Agriculture Committee Chairwoman Debbie Stabenow, D-Mich., saying the fact “that we’re hearing about this discovery and that there was never any threat to consumers in this case shows that the mechanisms in place for protecting our food supply worked as intended.” Sen. Jerry Moran, R-Kan., and the state’s four U.S. representatives also said in a statement that the announcement “reaffirms the fact that our food-safety system works.” Gov. Sam Brownback said Tuesday that consumers should remain confident that beef and milk in Kansas are safe, adding that he “had beef for lunch.”
Given how the oral arguments on the Affordable Care Act seemed to go, shouldn’t the Obama administration have a backup plan ready in case the U.S. Supreme Court declares the law unconstitutional? “Probably so,” Health and Human Services Secretary Kathleen Sebelius said last week. But it doesn’t. “That isn’t where conversations are headed right now, and I’m confident that it is constitutional,” the former Kansas governor added.
Untreated mental illness costs Kansas about $1.17 billion annually, according to a study released last week by the Health Care Foundation of Greater Kansas City. Most of these costs are related to higher unemployment rates, lost productive time at work, and permanent disability or premature death. About 1 in 10 adults in Kansas has a serious mental illness – such as major depression, schizophrenia and bipolar disorder – and about 40 percent of those cases go untreated. Meanwhile, state spending on mental health services has dropped by more than $14 million, or 16.4 percent, in the past three years, according to the National Alliance on Mental Illness. Also, a new inspection report found that in the past five years, the Larned State Hospital “lost more than two-thirds of its medical staff due to budget cuts, turnover related to poor working conditions and other factors,” the Kansas Health Institute News Service reported. As a result, it is now having trouble hiring doctors and nurses.
Sedgwick County ranked 72nd in health outcomes out of 100 Kansas counties reviewed in a study released this week by the University of Wisconsin Population Health Institute and the Robert Wood Johnson Foundation. That’s not good. Sedgwick County ranked 94th for social and economic factors, such as child poverty, unemployment and violent crime rates. The only category in which the county scored relatively high was clinical care, including the availability of primary care physicians and number of preventable hospital stays. Riley County has the healthiest residents in Kansas, according to the study.
For months, Kansans with developmental disabilities have protested the inclusion of their long-term care in the Brownback administration’s plan to privatize Medicaid. They’ve begged lawmakers to help stop this. So they were profoundly disappointed last week when the House blocked an amendment by Rep. Jim Ward (in photo), D-Wichita, to “carve out” such care from the reform. Rep. Brenda Landwehr, R-Wichita, and others kept Ward’s amendment from coming to a floor vote by getting the underlying bill sent back to committee. Ward was flabbergasted. “Incredible,” he said on the House floor. “This bill was introduced in January. I spent 60 days cajoling, arguing, persuading, begging the chairman of Health and Human Services (Landwehr) to have a hearing on the bill.” Ward added later, “Now they come and say, ‘Oh my gosh, we need to send it back to committee.’”
In the past, slaughterhouse waste – fatty scraps and bits of connective tissue left over from beef processing – was used only for pet food or rendering into cooking oil. But in 2001, a South Dakota company called Beef Products Inc. received U.S. Department of Agriculture approval for a new process that extracts fat from the scraps and treats the remaining tissue with ammonium hydroxide to inhibit pathogens such as E. coli and salmonella. The resulting gelatinous pink mass, nicknamed “pink slime” by a horrified government microbiologist, is mixed into ground beef as cheap filler (up to 15 percent in school lunches), reportedly shaving 3 cents off every pound that contains it. These trimmings are also in much of the ground beef sold in this country (as much as 70 percent, according to ABC News). But many consumers have no idea they’re eating “pink slime” because it is not disclosed on labeling. The USDA recently announced that starting in the fall, schools will be able to opt out of pink slime. This is a good first step. We also need to insist that pink slime is labeled in grocery-store ground beef. Consumers have a right to know what’s in their burgers. – Bettina Siegel, Houston Chronicle
More than 200 local plant workers are paying the price for a burning controversy over what they produced. Beef Products Inc. closed its Holcomb plant because of backlash over production of lean, finely textured beef used in hamburger, sausage, ground beef and other foods. Critics who dubbed the product “pink slime” waged a campaign of misinformation powered by television shows and social media. The unfortunate developments stemmed from controversy over BPI’s use of ammonium hydroxide to kill harmful bacteria, including E. coli and salmonella. The process was wrongly depicted, leaving consumers understandably confused and concerned. As a result, fast-food chains and grocers dropped food items with textured beef. Plus, the U.S. Department of Agriculture gave school districts an out regarding the purchase of the beef, instead of defending the safety of a product that received a governmental stamp of approval. Stepped-up efforts to help consumers better understand a process in place to keep them safe should help undo enough damage, hopefully, to allow the Holcomb facility and BPI as a whole to resume putting out a beef product long considered safe to eat. – Garden City Telegram
Leon Rodriguez, director of the Office for Civil Rights within the U.S. Department of Health and Human Services, is scheduled to meet today with Gov. Sam Brownback about the state’s long waiting lists for services for the disabled, the Kansas Health Institute News Service reported. HHS and U.S. Attorney Barry Grissom have been concerned that the waiting lists violate disabled individuals’ right to live in the “least restrictive environment.” The Brownback administration (like past administrations) has shown little interest in reducing the waiting lists, preferring to focus on tax cuts. But the federal government appears to be tired of waiting. Those on the waiting lists certainly are.
Oral arguments began today before the U.S. Supreme Court in the challenge to the federal health care law. Kansas is one of the states opposing the law. Attorney General Derek Schmidt wrote a commentary in the Sunday Eagle that summarized the states’ case. “We are challenging the authority of the federal government to commandeer American citizens (through the individual mandate) and to commandeer state taxpayers (through the required Medicaid expansion) in pursuit of Washington’s objectives,” Schmidt wrote. “No matter the nobility of its purpose, Congress may not use extra-constitutional powers that it simply does not possess.”
Two years ago, Congress passed and President Barack Obama signed the Patient Protection and Affordable Care Act, a landmark, once-in-a-generation legislation that was decades in the making.
Having lost that argument through the democratic process, the Republicans and their allies are now seeking to have the Supreme Court overturn the ACA by judicial fiat.
That’s right – the same people who complain endlessly about the overreach of “activist judges” now want to use the highest court in the land to reverse the will of the people as expressed through their elected representatives.
The Affordable Care Act is not even fully implemented, yet it’s already making a powerful difference in the lives of the American people.
Today, already 2.5 million young adults have gained health coverage, thanks to the ACA provision that allows them to stay on their parents’ plans until age 26. And last year, 3.6 million seniors saved a total of $2.1 billion on pharmaceutical costs, with the closing of the “donut hole” coverage gap written into the 2003 Medicare Part D prescription drug bill.
And there are more benefits to come, if the Supreme Court upholds the law and allows the bill to take full effect. By 2014, at long last, your insurance company will no longer be able to discriminate against you because you have a pre-existing health condition.
It is wrong-minded to dismantle or undermine a plan that will work.
Rep. Lynn Woolsey, D-Calif.
The Patient Protection and Affordable Care Act is unconstitutional down to its very DNA. The Supreme Court can save itself and the country years of litigation by striking down the entire law when it issues its decision this summer.
The individual mandate should be struck down because it isn’t protected under the Commerce Clause.
The law also requires states to expand their Medicaid programs to cover families earning up to $30,000 a year. Lawyers for the 26 states that are challenging the law will tell the court during oral arguments this violates the Tenth Amendment’s protection of states’ rights.
The Affordable Care Act bashes into the Constitution at every turn because it is fundamentally in conflict to the essential founding principles of this country – freedom and the sovereignty of states and citizens. It turns control over one-sixth of our economy to the federal government, ceding life and death decisions to the state.
The law is wrong for America, and the sooner the Supreme Court overturns it, the sooner we can get on the path to patient-centered reform that fits our economy – and our Constitution.
Grace-Marie Turner, Galen Institute
The five private insurance companies hoping to oversee Kansas’ Medicaid system have until March 30 to show that they have assembled at least half of the statewide provider network needed in order to secure a contract, the Kansas Health Institute News Service reported. As a result, the companies are pressing service providers to sign contracts or letters of intent. Many providers are holding off, not wanting to commit to a company that might not be chosen. Krista Postai, who runs the Community Health Center of Southeast Kansas in Pittsburg, likened the companies and their sales pitches to “the cute guys with the blue eyes who sell computer software.” She said that “you want to believe them, but it never works the way they said it would.”
Though surveys showed that the public opposed a GOP proposal last year to privatize Medicare, the author of the plan, Rep. Paul Ryan, R-Wis., isn’t backing down. He released a new budget plan today that would require those who retire a decade from now to purchase either traditional Medicare or private insurance through a government-run exchange. “Forcing health plans to compete against each other is the best way to achieve high-quality coverage at the lowest cost,” Ryan wrote in a Wall Street Journal commentary. Critics noted that the GOP budget plan would cut taxes while reducing health care and social safety net spending on the poor and middle classes.
There was a time when many Kansans thought seat belts were for sissies. But a recent SurveyUSA poll, sponsored by KWCH, Channel 12, found 88 percent of Kansans surveyed claiming to use their seat belts all the time. Only 6 percent said they never buckle up, including 10 percent of men and 18- to 34-year-olds. As for the state’s wimpy $10 fine for not wearing a seat belt: 46 percent said it was too lenient, but 39 percent considered it about right.
How did there come to be such a disconnect between the Catholic Church’s official policy against contraception and the lives of average parishioners? Elaine Tyler May, a professor at the University of Minnesota and author of the book “America and the Pill,” recounted how the pope convened a special commission in the 1960s to evaluate whether the church should change its stance on contraception. “A significant majority of its members favored lifting the ban, including 60 of 64 theologians and nine of the 15 cardinals,” May wrote in the Washington Post. When the pope sided with the minority and reaffirmed the ban in 1968, many church leaders and leading Catholic theologians, as well as many parish priests, publicly criticized the decision, arguing that Catholic women and men should follow their own consciences. Two years after the decree, two-thirds of Catholic women were using contraception,” May wrote. “Quickly, the gap between Catholic and non-Catholic women disappeared.” Today, according to research by the Guttmacher Institute, about “98 percent of sexually active Catholic women have used contraceptive methods banned by the church.”
Good for the bipartisan coalition of state lawmakers urging the Brownback administration to slow down its push to privatize Medicaid. “Medicaid is a massive and complex issue,” said Sen. Dick Kelsey, R-Goddard. “By rushing through the implementation process, the livelihood of more than 380,000 Kansans who rely on Medicaid services will be threatened.” Already, 22 of the Senate’s 40 members back the resolution seeking a six-month delay in moving Medicaid to a managed-care system. But as happened when parents pleaded that the long-term care of the developmentally disabled not be included in the reform, the administration responded with hubris. “It would be a costly mistake to postpone making these critical improvements to our system,” Lt. Gov. Jeff Colyer said. In other words: Forget what lawmakers, families and service providers think; we know best.
Gov. Sam Brownback was challenged on a call-in show on C-SPAN Monday by a Kansas woman who complained about the trampling of women’s rights. “We can pay for vasectomies, we can pay for Viagra, but we cannot pay for birth control for women?” the woman said. “I think it’s a shame.” Brownback said the contraception issue was about respecting the beliefs of religious institutions and not about denying women their rights. His solution for women who work at those institutions and want birth control: “Go work somewhere else.” That’s a flippant attitude about an important health concern of women. Switching jobs is also much easier said than done during this down economy – especially when religiously affiliated institutions, such as hospitals or universities, can be among the largest employers in a community.
About 529,000 Kansans were able to receive at least one new free preventive service through their private insurance plans in 2011 as part of the federal health care law, according to the U.S. Department of Health and Human Services. An additional 313,000 Kansans qualified for free preventive services through Medicare. These free services range from annual wellness visits to mammograms. “With more people taking advantage of these benefits,” HHS Secretary Kathleen Sebelius said, “more lives can be saved, and costly, and often burdensome, diseases can be prevented or caught earlier.”
Columnist Matt Miller argued that what the contraception controversy really exposed is why the U.S. needs to move beyond a system in which most people get their insurance through their employers. “If individuals were able to buy group coverage outside the employment setting – without risk of being denied coverage or priced out of the market due to pre-existing conditions – this entire blowup would never have happened, because the idea of requiring employers to offer specific kinds of coverage would be irrelevant,” he wrote.
A senior citizens advocacy group is opposing an executive reorganization order by Gov. Sam Brownback to move disability and mental health programs and services from the Kansas Department of Social and Rehabilitation Services to the Department on Aging. Mitzi McFatrich, executive director of Kansas Advocates for Better Care, fears the focus on the needs of older Kansans will become diluted, the Kansas Health Institute News Service reported. That was the case in the 1970s before the Department on Aging was carved out of SRS, she said. Supporters of the Juvenile Justice Authority raised a similar concern last fall when Brownback proposed moving that agency to SRS. They noted that juvenile justice was removed from SRS in 1997 in order to give it special focus. Brownback backed off that reorganization.
The Kansas Department of Social and Rehabilitation Services contends that the food-stamp eligibility change it made – which has resulted in more than 1,000 U.S. children being dropped from the federally funded program – was its only option to change what it considered to be an unfair system. But a leader of El Centro, an anti-poverty program in Kansas City, Kan., said the group contacted the U.S. Department of Agriculture to see if capping benefits would be a possible alternative, the Kansas Health Institute News Service reported. According to El Centro, USDA indicated that it would be open to considering such an alternative if Kansas submitted a request for a waiver, which takes six to eight weeks to review. If so, why didn’t SRS attempt that first before kicking U.S. kids off food stamps?
Nearly 39,000 Kansas residents with Medicare saved more than $23 million on their prescription drugs in 2011 because of reforms in the Affordable Care Act, according to data released by the U.S. Department of Health and Human Services. The savings came from discounts on prescription drugs and some closing of the benefits “doughnut hole.” By 2021, when the gap is closed completely, the average person with Medicare is expected to save nearly $4,200, according to HHS.
After all the contentious debate, the U.S. Supreme Court has finally settled it: The federal health care law is constitutional, including the individual mandate. But the politics of the law are far from settled, as it will be a campaign issue in the coming presidential and congressional elections, and Congress is sure to continue fighting about it. Though some may have been stunned by the court’s ruling, it wasn’t a huge surprise. Two federal appeals courts had upheld the law, and past court rulings set precedents that would be difficult to ignore. What perhaps was most surprising was that the deciding vote in the court’s 5-4 decision came from Chief Justice John Roberts. Also of note: The court based its decision on Congress’ authority to tax, not on the commerce clause.
