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The Supremes’ busy healthcare year


Herewith a very useful review of healthcare-sector-related decisions by the U.S. Supreme Court in its just-completed season.

Among the cases: abortion/contraception; data access; patents, the False Claims Act and unions.

To read the Modern Healthcare article, please hit this link.

Supremes deal a blow to healthcare transparency


ProPublica, the nonprofit news organization, reports that  the U.S. Supreme Court has dealt a blow  to  efforts to track the quality and cost of health care, “ruling that a 1974 law precludes states from requiring that every healthcare claim involving their residents be submitted to a massive database”.

“The arguments {in the Vermont case} were arcane, but the effect is clear: We’re a long way off from having a true picture of the country’s healthcare spending, especially differences in the way hospitals treat patients and doctors practice medicine.”

ProPublica also reported that the ruling means “for the time being at least, we’ll remain heavily reliant on data being released by Medicare.”

News organizations have used Medicare data to study differences in medication prescribing, surgeons’ complication rates and use of services by doctors, but it’s still not clear that Medicare is representative of all  U.S. healthcare.

Falling off the rolls


Some 13 percent of people who signed up for health-insurance coverage in 2015 under the Affordable Care Act have fallen off the rolls. The Obama administration attributes much of this decline to many people failing to pay their share of premiums. (Some probably got addicted to the “free”  — for them — care in emergency rooms.)

Things could get more exciting soon if the U.S. Supreme Court rules that the Affordable Care Act only authorizes subsidies to help people pay for health insurance in states that established their own health-insurance exchanges. About 6.4 million could lose their premium subsidies if the Supremes rule against the subsidies.

Execs say the ACA too entrenched to be killed




Top healthcare executives say that the Affordable Care Act is far too entrenched to be killed  by Republicans on Capitol Hill.

Repeal of the ACA “is not a possibility,” George Scangos, chief executive at biotechnology company Biogen Idec Inc., told Reuters . “They {the Republicans} would somehow have to explain to millions of people that they will lose health insurance.”

Aetna Inc. said it is talking to Republicans and Democrats about a possible “grand bargain” to salvage  the ACA if the U.S.  Supreme Court rules against key elements of the law later this year.

“Blowing up the (Affordable Care Act) is like shutting down the government,” Aetna Chief Executive Officer Mark Bertolini told some investors. “So we are having conversations on both sides of the aisle about what … things you change in the ACA, what we could introduce, about how to make a grand bargain should the Supreme Court decide.”



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