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January 01, 2016 12:00 AM

Abortion, contraception cases are on Supreme Court docket in 2016

Lisa Schencker
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    Some had thought 2016 would be a quiet legal year for healthcare after last year's frenzy over the premium subsidies case in the U.S. Supreme Court. Not likely.

    Legal Cases to Watch

  • Gobeille v. Liberty Mutual Insurance Co.: The Supreme Court likely will issue a decision in the spring. The issue is whether the federal ERISA law shields an employer with a self-funded employee health plan from having to share healthcare data with a state all-payer database designed to aid healthcare reform.

  • Zubik v. Burwell: The Supreme Court will decide whether religious not-for-profit groups that object to the ACA's contraception coverage mandate can be required to notify their third-party administrators or HHS that they want to opt out so the government can arrange such coverage.

  • Whole Woman's Health v. Cole: The Supreme Court will consider whether a Texas law that imposes conditions on abortion providers such as requiring the doctors to have admitting privileges at local hospitals places an undue burden on women's constitutional right to get an abortion.

  • U.S. House of Representatives v. Burwell: A federal district judge will decide whether it was lawful for the Obama administration to fund the ACA's program for reducing exchange plan members' out-of-pocket costs without Congress appropriating money for that purpose.
  • This year, the Supreme Court will tackle abortion, contraceptive coverage, and a battle between states and self-insured employers over healthcare data. In addition, there's a pending challenge to the Affordable Care Act in a lower court that worries ACA supporters.

    The high court will decide Gobeille v. Liberty Mutual Insurance Co., a case involving whether an insurance company with a self-funded employee health plan must share data such as medical claims with the state of Vermont for its all-payer healthcare database. The case is being closely watched because it has implications for more than a dozen states with similar databases.

    The insurance company in Gobeille argues that the federal Employee Retirement Income Security Act protects it from having to share that information, sparing it and other self-insured employers from being subject to different state laws. The state, however, says it needs the information for healthcare reform efforts. If the insurer wins, “these all-payer claims databases will be hollowed out,” said Nicholas Bagley, a University of Michigan law professor.

    The high court also will decide major cases on abortion and contraceptive coverage. In Whole Woman's Health v. Cole, abortion providers allege that a Texas law makes it too difficult for women to get abortions, abridging their constitutional rights. The law requires, among other things, that doctors at abortion clinics have admitting privileges at local hospitals.

    The contraception cases involve challenges brought by religious not-for-profit groups that oppose having to play any part in providing birth control to employees. Those groups are challenging an Obama administration policy that says if they want to opt out of the ACA's contraception coverage mandate, they must notify their third-party administrators or HHS so the government can arrange coverage. A decision likely will come near the end of the court's term in June.

    More issues to watch

    Election uncertainty clouds business climate

    High drug prices will be a big political issue in 2016

    Insurer mergers, ACA exchanges' sustainability will be issues to watch in 2016

    Medicaid expansion fights in GOP states will continue

    Healthcare merger and acquisition activity likely to stay strong in 2016

    Hospitals can expect slower patient growth, higher wages, more expensive drugs

    Telemedicine, data security expected to grow in 2016

    Meanwhile, in U.S. House of Representatives v. Burwell, House Republicans allege that the Obama administration illegally funded the ACA's cost-sharing subsidies for lower-income exchange plan members. Those subsidies, which are received by a large percentage of exchange plan members, make it more affordable for them to use their plans to obtain medical services.

    It's possible that U.S. District Judge Rosemary Collyer, a George W. Bush appointee who sounded sympathetic to the plaintiffs' arguments in an earlier hearing, will decide the case soon. If she rules against the administration, “it will throw a wrench in the works,” Bagley said.

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