The Supreme Court this week heard arguments for and against the constitutionality of the mandate that nearly everyone get health insurance. The mandate, included in the health reform law, has been described as critical to the economic viability of insurance reforms designed to make health plans more affordable and accessible. You can read a quick summary of that economic argument here.
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The Solicitor General tried today to get in a few words between sharp questions from Supreme Court justices during arguments over the health reform mandate that nearly everyone have health insurance.
Solicitor General Donald Verrilli Jr. had the job of defending the mandate as within Congress' ability to regulate interstate commerce under the Constitution's commerce clause. He did so under frequent questioning by the justices and by arguing that the mandate regulates how people pay for healthcare services they will inevitably need.
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Imagine the job market fully recovered from the economic downturn by next year (purely hypothetical, I know, but I'd be thrilled to be wrong). What would happen to employer-sponsored insurance coverage? Not what many would hope, according to one author of a new analysis of job-based health benefits.
Chapin White, a senior researcher with the Center for Studying Health System Change, who co-authored the analysis with James Reschovsky, a senior fellow for the center, said more hiring would not address the more fundamental erosion of employer-sponsored coverage caused by fast-growing premiums.
A rebound in job-based coverage to pre-recession levels seems unlikely as long as premiums continue to grow faster than the economy and wages, as has been the case, White said.
Or as White and Reschovsky said in their paper on the drop in job-based coverage between 2007 and 2010: “The recent experience with employer-sponsored health insurance could be viewed as an acute illness aggravating a chronic condition. The acute illness—the sluggish economy and weak employment situation—likely will resolve at some point. But the underlying chronic condition—rising healthcare costs—likely will persist.”
Of course, coverage options will change in 2014 if the Patient Protection and Affordable Care Act survives its legal challenges. White said the law offers competing incentives for employer-sponsored coverage that make projections difficult.
The recession took a severe toll on employer-sponsored coverage, largely thanks to the painful job losses during the downturn, according to the center's research. The center conducted the analysis using data from a nationally representative survey for the National Institute for Health Care Reform, a not-for-profit launched by labor, the Chrysler Group, Ford Motor Co., and General Motors.
In 2010, 53.5% of non-elderly individuals had employer-sponsored insurance compared with 63.6% in 2007, the center found. Job losses accounted for most of the decline, according to White and Reschovsky:
Source: Center for Studying Health System Change
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Moody's Investors Service said no rating changes are expected to follow its newly released credit-rating methodology for not-for-profit hospitals.
The rating agency replaced its 2008 rating matrix with a new rating scorecard, according to a newly released report. The switch seeks to more clearly convey certain rating factors for market position, operating performance, balance sheets and capital plans in a grid.
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A health policy expert and an economist ponder the direction of Medicare spending growth in the latest New England Journal of Medicine. It's a topic of considerable interest among hospitals and medical groups. Many have concluded—and braced for—a future in which healthcare providers will receive less from Medicare for the work that they do.
As Chapin White and Paul Ginsburg point out in the medical journal, the Patient Protection and Affordable Care Act clamps down on the rate of growth for Medicare payments “for almost every category of provider other than physicians and makes additional targeted cuts to home health agencies and some other providers.”
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Doctors with electronic access to imaging results ordered more tests, not fewer, a newly published study found, but researchers were stumped as to why.
“Whatever the explanation for our findings,” they wrote in Health Affairs, “they emphasize the importance of establishing the benefits of computerization rather than estimating them in the absence of data, or generalizing from small studies at a few atypical institutions.”
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