Tag Archives: SCOTUS

Facing increased scrutiny, PBMs will press case before High Court

Joseph Burns

About Joseph Burns

Joseph Burns (@jburns18), a Massachusetts-based independent journalist, is AHCJ’s topic leader on health insurance. He welcomes questions and suggestions on insurance resources and tip sheets at joseph@healthjournalism.org.

pharmacy benefit managers

Photo: FunGi_ (Trading) via Flickr

The U.S. Supreme Court recently agreed to hear a case that pits two groups on opposite sides of the debate over prescription drug costs: community pharmacists and pharmacy benefit managers.

In the case, Rutledge v. Pharmaceutical Care Management Association, the court will consider whether the federal Employee Retirement Income Security Act (ERISA) of 1974 pre-empts an Arkansas law regulating PBMs’ drug-reimbursement rates.

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Older same-sex couples gain financial protection in SCOTUS decision

Bob Rosenblatt

About Bob Rosenblatt

Bob Rosenblatt has been a journalist in Washington, D.C., for more than 30 years, with much of his career focused on aging. At the Los Angeles Times, he started the paper’s first beat on aging and launched a popular advice column on Medicare and health insurance.

Photo: Matt Popovich via Flickr

Photo: Matt Popovich via Flickr

In the wake of last month’s Supreme Court ruling on marriage, same-sex married couples in all 50 states should now qualify for financial protection against impoverishment under Medicaid if one of them goes into a nursing home.

Before the high court’s decision, spousal financial protection rules were unavailable to same-sex couples if their state of residence did not recognize their marriage. With a semi-private room in a nursing home costing $80,000 a year, many couples can easily wipe out all their assets without such protection. Continue reading

Could the other SCOTUS ruling improve health for the LGBT community?

Susan Heavey

About Susan Heavey

Susan Heavey, (@susanheavey) a Washington, D.C.-based journalist, is AHCJ’s topic leader on social determinants of health and curates related material at healthjournalism.org. She welcomes questions and suggestions on resources and tip sheets at determinants@healthjournalism.org.

Photo: Matt Popovich via Flickr

Photo: Matt Popovich via Flickr

All eyes were on the U.S. Supreme Court last week as it handed down its highly anticipated decision in King v. Burwell, affirming subsidies in the Affordable Care Act. The justices upheld the financial assistance, saying Congress saw it as critical to a functioning health insurance market. But could the court’s other big ruling have an equally profound impact on another group?

On Friday, the court ruled 5-4 in support of same-sex marriage, saying the Fourteenth Amendment gave such couples the right to marry and legalizing marriage in all 50 U.S. states. While an affirmation of LGBT rights, the decision could also be the first step in improving the health of same-sex couples, according to several health provider organizations that released statements soon after the landmark ruling. Continue reading

Things to keep in mind about the King v. Burwell SCOTUS ruling

Joanne Kenen

About Joanne Kenen

Joanne Kenen, (@JoanneKenen) the health editor at Politico, is AHCJ’s topic leader on health reform and curates related material at healthjournalism.org. She welcomes questions and suggestions on health reform resources and tip sheets at joanne@healthjournalism.org. Follow her on Facebook.

  • The court ruled that the subsidies were integral to the functioning of insurance markets under the ACA, and that Congress constructed the law with that in mind. The Court did not use an alternative legal argument to uphold the subsidies – saying that the law was ambiguous but the executive branch (in this case the IRS) had the right to interpret it so that subsidies are available in both state and federal exchanges. This is not a minor distinction – that latter interpretation (used by one of the lower courts) would have meant that a future administration could come in and change the subsidy policy. The 6-3 court ruling bars a future administration from doing so. (A future Congress could still change the law regarding subsidies but a future administration couldn’t just flip a switch and stop them.) Continue reading

Notes and quotes from King v. Burwell decision

Pia Christensen

About Pia Christensen

Pia Christensen (@AHCJ_Pia) is the managing editor/online services for AHCJ. She manages the content and development of healthjournalism.org, coordinates AHCJ's social media efforts and edits and manages production of association guides, programs and newsletters.

By Steve Petteway, Collection of the Supreme Court of the United States (Roberts Court (2010-) - The Oyez Project) (Public domain), via Wikimedia Commons

By Steve Petteway, Collection of the Supreme Court of the United States (Roberts Court (2010-) – The Oyez Project) (Public domain), via Wikimedia Commons

Here are just a few notes, key quotes and links to coverage of the Supreme Court’s decision to uphold the subsidies in the Affordable Care Act.

The decision is here.

The phrase “death spiral” appears three times in the majority opinion. Also from the majority opinion: Continue reading

Things to keep in mind as we anticipate the King v. Burwell ruling

Joanne Kenen

About Joanne Kenen

Joanne Kenen, (@JoanneKenen) the health editor at Politico, is AHCJ’s topic leader on health reform and curates related material at healthjournalism.org. She welcomes questions and suggestions on health reform resources and tip sheets at joanne@healthjournalism.org. Follow her on Facebook.

Photo by dbking via Flickr

Photo by dbking via Flickr

We’ve put up a tip sheet and written about the King v. Burwell case, but now that the ruling is imminent, we wanted to bring one more good one-stop-shopping resource to your attention and share a few tips.

The Alliance for Health Reform has issued a very good four-page tool kit – links to background articles, think tank papers, issue briefs and lots of sources. One caveat – it says that 7.5 million are subsidized in the affected states but the most recent government numbers are 6.4 million.

Other things to remember

There are 37 states using HealthCare.gov (with Hawaii, soon 38). But the reason you keep reading that 34 states are affected is that 34 are federal exchanges. Continue reading