First Edition: March 4, 2015

Kaiser Health News: No Medicaid Expansion? No Problem For Many Safety-Net Hospital Profits
Hospitals that treat many poor and uninsured patients were expected to face tough financial times in states that did not expand Medicaid under the federal law known as Obamacare. That’s because they would get less Medicare and Medicaid funding under the Affordable Care Act, while still having to provide high levels of charity care. (Galewitz, 3/4)

The Washington Post: The Supreme Court Is Hearing Oral Arguments Over Obamacare Today. Here’s What That Means.
The Supreme Court on Wednesday will hear oral arguments in King v. Burwell, the most serious challenge to the Affordable Care Act (a.k.a. Obamacare) since the justices upheld it as constitutional almost three years ago. Here’s how this works. (Barnes, 3/4)

The Washington Post: Obamacare Back Before Supreme Court Today
At issue is whether millions of Americans who receive tax subsidies to buy health insurance are doing so illegally. If the justices rule that the payments are not allowed, the entire health-care law could be in jeopardy. The latest showdown between the Obama administration and the conservative legal strategists who have targeted the law since its passage in 2010 focuses on a once obscure phrase in the legislation: “established by the State.” (Barnes, 3/4)

The Associated Press: High Court Takes Up Major Fight Over Health Law Subsidies
Opponents of the Affordable Care Act failed to kill the law in an epic, election-year Supreme Court case in 2012. Chief Justice John Roberts joined with the court’s liberal justices and provided the crucial vote to uphold the law in the midst of Obama’s re-election campaign.Partisan and ideological divisions remain stark for a law that passed Congress in 2010 with no Republican votes. ... Of the judges who have ruled on lawsuits over the subsidies, Democratic appointees have sided with the administration and Republican appointees have been with the challengers. Roberts was the only justice to essentially cross party lines with his vote in 2012. His fellow conservatives on the court voted to strike down Obamacare in its entirety. (3/4)

USA Today: A Case About Four Words, With Mammoth Implications
President Obama's health care law squeaked through the Senate in 2009, the House in 2010 and the Supreme Court in 2012. Wednesday, the high court will consider whether it can survive its infancy. The case is far narrower than the one brought — and nearly won — by opponents three years ago. Opponents of the law claim it allows health insurance premiums to be subsidized only in states that set up exchanges, or online marketplaces. If the court agrees, those subsidies can't continue to flow to residents in at least 34 states that use a federally operated exchange. (Wolf, 3/3)

USA Today: By The Numbers: The Case Against Obamacare
The case, by the numbers: 4: Words in the law that are in dispute ("established by the state"); 34: States using the federal health insurance exchange, where tax credits could be eliminated; 9.3 million: People who would lose tax credits if the court sides with the law's opponents; 8.2 million: People at risk of becoming uninsured. (Wolf, 3/3)

The Wall Street Journal's Law Blog: Health-Care Law Arguments: A Big Battle Over Four Words
The fundamental question facing the justices in the latest challenge to the 2010 Affordable Care Act has nothing to do with health care: how to interpret a tiny snippet – specifically, four words — embedded in the voluminous law. First, some background: Congress in the law authorized the government to provide tax credits for insurance purchases by middle- and low-income people. The credits are vital to the program. (Jones, 3/3)

NPR: Round 2: Health Care Law Faces The Supreme Court Again
Round 2 in the legal battle over Obamacare hits the Supreme Court's intellectual boxing ring Wednesday. In one corner is the Obama administration, backed by the nation's hospitals, insurance companies, physician associations and other groups like Catholic Charities and the American Cancer Society. In the other corner are conservative groups, backed by politicians who fought in Congress to prevent the bill from being adopted. (Totenberg, 3/3)

The New York Times: In Health Law Case, Plaintiffs Dislike Rules On Purchases And Penalties
People sometimes wonder why David M. King would fight health insurance subsidies all the way to the Supreme Court, which is scheduled to hear his case on Wednesday. Even his sister is puzzled. Asked what motivated her brother, who is the lead plaintiff in the latest challenge to the Affordable Care Act, Deborah K. Siebols said: “I don’t have any idea. I am clueless. He’s my brother, but we are so opposite in our beliefs — have been all our lives. We don’t discuss politics.” (Pear, 3/3)

The Wall Street Journal: Voters Want Congress To Take Action If Health-Law Tax Credits Are Voided
A majority of voters wants Congress to take action if the Supreme Court voids the health law’s tax credits in much of the country, a new Wall Street Journal/NBC News survey finds. The court is set to hear arguments Wednesday over whether the Obama administration can issue federal tax credits to offset the cost of health premiums to millions of Americans who live in states that haven't set up their own insurance exchanges. The tax credits are closely tied to other provisions in the law, including requirements that most Americans buy coverage or pay a penalty, and insurers can’t reject people based on their medical history. (Radnofsky, 3/3)

The Wall Street Journal: Chief Justice John Roberts In Hot Seat In Health-Law Case
The most uncomfortable seat at Wednesday’s Supreme Court argument on health-law insurance subsidies might be the one held by Chief Justice John Roberts. Both sides will be trying to sway his vote on the assumption the court is otherwise split 4-4 along ideological lines, as it was three years ago when it heard an earlier challenge to the law. (Bravin, 3/3)

The Washington Post: Two Sides Enter The Ring For Another Supreme Court Battle Over Health Care
Washington lawyer Michael A. Carvin will be back at the Supreme Court on Wednesday for the second great battle over the Affordable Care Act, once again facing off against a familiar adversary in Solicitor General Donald B. Verrilli Jr. With hardly a trace of deadpan, Carvin said it would be wrong to characterize the case as a rare second chance to bring down President Obama’s health-care law. “Me, personally?” he said. “I’m a libertarian. I’d get rid of three-quarters of the U.S. Code if I could.” But he added, “The ACA is the law of the land. We want it to be implemented the way Congress intended for it to be.” (Barnes, 3/3)

Politico: Stark Contrast: The 2 Attorneys Arguing The Obamacare Case
One attorney is known for his measured, authoritative approach, the other for a brash, confrontational style. And when the Affordable Care Act brings both of them back before the Supreme Court on Wednesday, these differences may be on display as much as their legal points. In what’s arguably the most important case of the court’s term, Michael Carvin will argue for plaintiffs seeking to upend a fundamental aspect of Obamacare, and Solicitor General Donald Verrilli Jr. will again defend the government. Both are hailed as brilliant litigators steeped in case law, and their first round in 2012 concluded with each man able to claim a victory of sorts. (Wheaton, 3/3)

The Wall Street Journal: To Kill A Health-Care Law
Attorney Michael Carvin on Wednesday will for the second time argue against the health-care law at the Supreme Court, hoping to do what opponents couldn’t do in 2012: cripple President Barack Obama ’s signature domestic achievement. Challengers to the law fell one vote short three years ago when Chief Justice John Roberts stunned fellow conservatives with a vote to uphold most of the Affordable Care Act. This time, Mr. Carvin says things should go more smoothly. (Bravin, 4/3)

The New York Times: A Supreme Court Rematch For A Lawyer Targeting The Health Care Act
In March 2012, a blunt-talking and rumpled lawyer named Michael A. Carvin told Supreme Court justices that President Obama’s health care law was an unconstitutional attempt to “regulate every activity from cradle to grave.” He lost that case — and has never quite gotten over it. (Stolberg, 3/4)

The New York Times: Solicitor General Will Try, Again, To Keep Health Care Law Alive
Three years ago this month, Solicitor General Donald B. Verrilli Jr. stood before the Supreme Court to defend President Obama’s health care law against a constitutional challenge that threatened to destroy its central provision. His oral argument drew harsh reviews, but in the end he managed to persuade five justices to accept his backup argument, saving the law. Mr. Verrilli will return to the lectern on Wednesday morning to defend the law once again, and he has reason to be nervous. (Liptak, 3/4)

Los Angeles Times: Obamacare Case Began When Conservative Lawyer Saw Possible Flaw In Law
The case that comes before the Supreme Court on Wednesday with the potential to unravel President Obama's landmark healthcare law began in a conference room at the American Enterprise Institute, a few blocks from the White House and the K Street corridor. It was December 2010, and voters had recently elected a new crop of Republicans, many of whom had ridden to victory on their objections to Obamacare. GOP attorneys general in several states, along with a major business group, had headed to court in Florida, arguing the entire law was unconstitutional. (Savage, 3/3)

Politico: Halt To Obamacare Subsidies Could Come Swiftly
Billions of dollars in Obamacare tax subsidies could come to an abrupt end this summer if the Supreme Court rules against the White House in the latest challenge to the president’s health care law. (Haberkorn, 3/4)

The Wall Street Journal: Insurers’ Biggest Fear: A Health-Law Death Spiral
As the Supreme Court hears arguments on Wednesday in the latest challenge to the Affordable Care Act, health insurers are struggling to prepare for a decision that could unravel the marketplaces created by the law. The ruling could come in June—but insurers must make regulatory filings before then about their 2016 plans. Utah’s Arches Health Plan, for one, says it may propose an array of insurance product designs this spring. Then, depending on what the court decides, the insurer would be poised to drop some of them before they’re finalized with regulators and offered to consumers. The insurer may also come up with two different sets of rates for next year, one for each potential court outcome. (Wilde Mathews, 3/3)

NPR: 4 Reasons Both Parties Should Be Sweating Bullets Over King V. Burwell
The Supreme Court will hear arguments on Wednesday in another case that threatens the survival of Obamacare. This one doesn't challenge the constitutionality of the law itself, it merely challenges the legality of one of the most important parts of the system — subsidies so that everyone can afford health care. If the court strikes down the subsidies for people who live in states that chose not to set up their own exchanges, and who get their health coverage from the federal marketplace — healthcare.gov — it would begin to unravel the entire Obamacare project. (Liasson, 4/3)

The Washington Post: U.S. Faces 90,000 Doctor Shortage By 2025, Medical School Association Warns
The United States faces a shortage of as many as 90,000 physicians by 2025, including a critical need for specialists to treat an aging population that will increasingly live with chronic disease, the association that represents medical schools and teaching hospitals reported Tuesday. (Bernstein, 3/3)

The Wall Street Journal: The Next Marketing Frontier: Your Medical Records
Dr. Treadwell isn’t the only one who is pleased with the alerts. So is Merck & Co., which pays for the notifications sent to Dr. Treadwell and 20,000 other health-care providers. Medical-record software startup Practice Fusion Inc., which sells the alerts and displays them through its software, said that during a four-month study period ending in August, it observed a 73% increase in vaccinations—amounting to 25,000 additional treatments—compared with a control group. The company didn’t disclose its fees for delivering sponsored alerts but said it doesn’t take a cut of sales that result. (Elizabeth Dwoskin, 3/3)

The Wall Street Journal's Pharmalot: FDA Warns Testosterone Drugs Can Increase Heart Risks
Following months of deliberation, the FDA is now requiring drug makers to add information on product labeling about the possible increased risk of heart attacks and strokes associated with low testosterone treatments. And the agency is also cautioning these medications have not been shown to help men with low testosterone levels reverse the aging process. The move comes after sustained controversy over the cardiovascular safety and allegations of inappropriate marketing of these widely prescribed drugs, which have attracted sustained regulatory scrutiny as a result. Testosterone treatments have, at times, been widely promoted to help reverse aging, but safety concerns prompted heated debate amid dueling medical studies. (Silverman, 3/3)

NPR: FDA Mandates Tougher Warnings On Testosterone
The Food and Drug Administration said Tuesday that it is requiring drugmakers to warn patients that testosterone products may increase the risk for heart attacks and strokes. Testosterone replacements are approved to treat men with low testosterone related to medical problems, such as genetic deficiencies, chemotherapy or damaged testicles. But the level of the hormone can fall as men grow older. And testosterone is increasingly being prescribed to men to stave off aging, something the agency never approved. Doctors and specialized clinics have jumped on the bandwagon, offering testosterone replacements to treat what some refer to as "Low T." (Stein, 3/3)

The Washington Post's Wonkblog: Why A Big Insurer Is Sharply Limiting One Of Women’s Most Common Health Procedures
UnitedHealth, the country’s largest insurer, will soon require doctors to get permission before performing most types of inpatient hysterectomies, a procedure in which the uterus is removed, often to prevent or treat cancer. The move follows lengthy debate over a surgical device believed by many medical researchers to spread cancer in patients -- and highlights how insurers can also play watchdog. (Panquette, 3/3)

The Washington Post's Wonkblog: Unplanned Pregnancies Cost Taxpayers $21 Billion Each Year
Unintended pregnancies cost American taxpayers $21 billion each year, according to a new analysis released by the Guttmacher Institute. That averages out to a cost of about $366 per every woman of childbearing age in the U.S. Overall, more than half of U.S. pregnancies are unintended, and roughly 1-in-20 American women of reproductive age have an unplanned pregnancy each year. (Ingraham, 3/3)

The Washington Post: Legislative Session A Mixed Bag For McAuliffe
But the session was a mixed bag for McAuliffe, who saw many of the liberal causes he championed, as well as his renewed push for expansion of Medicaid under the federal Affordable Care Act, go nowhere in the Republican-controlled legislature. ... But this year, social issue bills, including those that would have prohibited abortion after 20 weeks or expanded gay rights, died quietly. Two antiabortion measures made it to a vote of the full House, but only because they were attached to the budget. They later died in behind-closed-doors budget negotiations. ... But the budget plan does provide the millions the governor had sought to expand mental-health services and school breakfast programs. (Portnoy and Vozzella, 3/3)