According to just-released Centers for Disease Control and Prevention data, 2 million high school students and almost half a million middle school students used e-cigarettes in 2014. E-cigarettes have taken over as the most commonly used tobacco product among high school and middle school students. Youth use of traditional cigarettes continues to decline – only 9.2 percent of high school students reported smoking cigarettes in 2014 compared to 16 percent in 2011.  

Increasing health care expenditures are a source of great worry to public officials. Perhaps new data that show that public programs – Medicare and Medicaid – seem to hold down per capita spending growth more than private insurance will provide some reassurance to officials as they consider expanding public programs in their states.

Today the federal government announced that it would be taking grant applications for $67 million for navigators to link consumers to federally-facilitated and state-based health insurance exchanges. 

The speakers on the conference call characterized the announcement and posting as part of the "regular grant process" but one has to wonder if this is a sign of the administration's confidence that the Supreme Court will find in their favor in the King v. Burwell case.

The Cleveland Clinic, one of the nation’s largest hospitals, reported a 40 percent drop in charity care and credited the good news to Ohio’s Medicaid expansion, according to Kaiser Health News. Free care costs fell from $171 million in 2013 to $101 million in 2014.

In Armstrong v. Exceptional Child Center the Supreme Court held 5-4 that Medicaid providers cannot rely on the Supremacy Clause or equity to sue states to enforce a Medicaid reimbursement statute. 

The Court’s rejection of a private cause of action under the Supremacy Clause has implications well beyond this case.  Had the Supreme Court ruled otherwise, the Supremacy Clause would have provided a cause of action for every federal statute that arguably conflicts with state law.  

Approximately 7.7 million people living in states with a federally run health insurance exchange purchased health insurance and qualified for monthly premium tax subsidies during the 2014-15 open enrollment period, according to newly released data. The estimated annual value of those tax subsidies tops $24 billion, according to calculations by The Council of State Governments. These premium subsidies are at risk in the King v. Burwell case currently before the U.S. Supreme Court.

I learned a few things last week when I was visiting with Indiana Rep. Ed Clere, one of the new co-chairs of CSG’s Health Public Policy Committee.

  • That week, the state announced the 100,000th person enrolled in the Medicaid expansion waiver, called HIP 2.0 in Indiana, after the program opened less than a month before. Indiana had three Medicaid managed care organizations already engaged in the state and the state Medicaid office and the
  • ...

States that previously were reluctant to expand Medicaid eligibility as allowed under the Affordable Care Act are considering waivers for expansion designed with their state politics and health care system in mind. Several governors met with President Obama in January to advocate for their proposals. This eCademy session addresses how much flexibility states have under Section 1115 waivers and provides an overview of state waiver proposals.

 

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For Justice Kennedy it was his questions, for Chief Justice Roberts it was his silence…

Today the Supreme Court heard oral argument in King v. Burwell, where it will decide whether federal health insurance exchanges, operating in 34 states, can offer subsidies to middle and low income purchasers of insurance under the Affordable Care Act (ACA). 

Simply put, the Court must decide whether it agrees with the Internal Revenue Service (IRS) that the following statutory language, “established by the State,” can include federal exchanges too.

March 4 is an important date for anyone who cares about health policy. The Supreme Court justices will hear oral arguments in the case King v. Burwell, challenging tax subsidies for health insurance purchase in states that are not running their own health insurance exchanges.

The potential impact of the case is clear. Approximately 7.5 million Americans in 34 states receive subsidies to offset the cost of health insurance purchased through the federally-run exchange.

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