Viewpoints: GOP Pressure Point; Cut Coverage Costs For Young Adults; Insurance Merger Talks

Bloomberg: The Next Step If Obamacare Loses In Court
But the real question about King (if the challengers win) isn’t about which party gets the blame for chaos in Republican-state insurance markets. It’s whether important groups in those states pressure their politicians to do something about it. If sufficient pressure is applied, the likely outcome is that subsidies are restored, full stop. ... All in all, if the King plaintiffs win in the Supreme Court, don’t pay attention to Democratic or Republican spin. The whole ballgame will be whether people whom Republican politicians care about demand action if subsidies dry up. (Jonathan Bernstein, 6/22)

Politico: Why The GOP Can't Win On Health Care
Regardless of how the Supreme Court decides this month on King v. Burwell, which challenges the legality of the administration’s decision to allow private insurance subsidies in federally run exchanges, what the episode reveals, yet again, is the Republican party’s historic failure to truly engage with the difficult realities and trade-offs of health policy—and how that failure has crippled the party’s ability to respond even when faced with events like big Supreme Court decisions that should force them to come up with an actual plan. (Peter Suderman, 6/22)

The Wall Street Journal's Washington Wire: A Gender Gap In Economic Security For Seniors
The gender gap in retirement income security happens because women are marrying less and working more but still being paid less than men. In 2013, the most recent year for which these data are available, women earned 82% of the median earnings of full-time male workers. Lower earnings lead, on average, to lower Social Security payments, retirement savings, and pensions. Lower savings are a particular concern for older women, who tend to live longer than men and need to stretch savings further to cover expenses as they age. Social Security, Medicare, and often Medicaid are fundamental to their retirement security. Issues like Social Security and Medicare are seldom regarded as “women’s issues,” and they are not women’s issues alone. But they are central to the economic security of a growing population of economically disadvantaged older women. (Drew Altman, 6/23)

Forbes: Shrink Obamacare's Costs By Removing Rule Driving Up Young People's Premiums
The Supreme Court will soon decide King v. Burwell, the case that will determine whether tax credits being paid in at least 34 states without their own exchanges are legal. If the Supreme Court makes the administration follow the letter of the law, billions of dollars of federal tax credits will continue to flow to 16 states, but not the rest. This will result in a political crisis giving Congress and President Obama the opportunity to fix the worst aspects of Obamacare. Here is one suggestion: Remove Obamacare’s rule forbidding accurate premiums by age. ... instead of reducing premiums for older applicants, the rule dramatically increases premiums for younger ones. (John Graham, 6/22)

The New York Times' The Upshot: Medical Insurance Is Good For Financial Health, Too
People who have health insurance have less health-related financial stress. That’s a not-so surprising finding from a recent survey from the Centers for Disease Control and Prevention. There’s good reason to expect the Affordable Care Act to reduce financial strain. Exposure to health care costs fell for those who gained coverage, as it has for those whose coverage became more generous, too. (Austin Frakt, 6/22)

Forbes: CBO Obamacare Report Shows Deficit And Debt Are Phony Issues
The report, which was prepared at the request of Senate Budget Committee Chairman Mike Enzi (R-WY), concluded that eliminating Obamacare would definitely, unambiguously and undeniably (Get the picture?) increase the deficit. This is directly contrary to what Republicans have been saying since the law was enacted and should be a body blow to their insistence the law was a mistake and should be repealed. ... It’s difficult to find a silver lining in the report for congressional Republicans. They’ve tried. (Stan Collender, 6/22)

The Philadelphia Inquirer: To Solve Our Health Care Spending Problem, We Must First Understand It
Our nation’s spending on health care is 17 percent of the gross domestic product, while other developed countries typically spend only 9-10 percent and achieve similar patient outcomes. We spend an estimated $2,600 more per capita on healthcare than the next most expensive nation, Norway. Despite our higher spending, Norway has more doctors and beds per 1,000 and a higher life expectancy. Adjusting for population size, the U.S. spends roughly $835 billion more on health care than Norway per year. (Howard Peterson, 6/22)

The New York Times' Dealbook: Health Care Law Spurs Merger Talks For Insurers
President Obama signed the Affordable Care Act more than five years ago. At the time, members of the health care industry — hospitals, doctors and insurers — were anxious about what it would do to the business. Everyone had an opinion, but nobody knew for sure. We’re now beginning to see the answer: consolidation on a huge scale. Just in the last couple of weeks, the nation’s five largest health insurers began a round robin of merger talks — some still semiprivate, others now out in the open — that could whittle their number to three. Anthem made a bid for Cigna; Aetna approached Humana; and the UnitedHealth Group made overtures to Aetna. (Andrew Ross Sorkin, 6/22)

The Philadelphia Inquirer: The Future Of Health Care For America's Seniors
Efforts to improve quality while reducing cost in health care are changing the way we pay doctors and provide care for our seniors. After decades of "fee-for-service" payments -- meaning payments for individual visits and tests -- there is now a determined effort to reward "value-based care." The idea is that we should be rewarding quality care that improves health -- not just episodes of service. After years of debate, Congress and the Obama administration have taken important action to drive this positive change for seniors and for all Americans. And Medicare, the nation's largest health-care program, is at the center of this transformation. (Allyson Y. Schwartz, 6/22)

The Washington Post's Monkey Cage: Here Are The 5 Reasons Republicans Are Trying To Cut Research On Evidence-Based Medicine
The United States spends $3 trillion annually on health care — much of it funded by taxpayers through programs such as Medicare — yet only a limited amount of information exists about what treatments work best for which patients. ... The good news is that the federal government is now making a significant investment in health services and patient-centered outcomes research to identify waste and improve the safety, effectiveness and quality of care. The bad news is that House Republicans are trying to abolish one of the main agencies carrying out this research, the Agency for Healthcare Research and Quality (AHRQ), and cut the funding of another, the Patient-Centered Outcomes Research Institute (PCORI). The puzzle is why. (Eric Patashnik, 6/22)

The Washington Post: Striking A Benefit Balance In Montgomery County
As the Obama administration’s push to require employers to provide paid sick leave languishes in Congress, a number of states and localities have acted. In most cases, the local measures have sensibly set the bar somewhat higher for big corporations than for small businesses. Montgomery County would be wise to adopt a similar approach. (6/22)

JAMA Internal Medicine: Faster Drug Approvals Are Not Always Better And Can Be Worse
A shared goal of all health professionals is to relieve suffering and prolong life. At times these goals are at odds, particularly in oncology care. Patients with severe disease and low chance of survival may be offered therapies in the hope of buying a few more weeks or even months. However, the treatments themselves are often toxic, with many unpleasant adverse effects .... It is a difficult choice: extend life, or offer higher quality of life at home. Or is it? This choice assumes that the drugs really do extend life. (Rita F. Redberg, 6/22)

JAMA Internal Medicine: Strengthening Medical Device Postmarket Safety Surveillance
The system by which the US Food and Drug Administration engages in medical device postmarket safety surveillance needs strengthening. ... While [current] efforts have successfully detected potential safety issues and contributed to reassessments of the benefits and risks, these systems are likely to identify only a small proportion of the totality of adverse events that occur. (Joseph S. Ross, 6/22)

JAMA: Seven Questions For Personalized Medicine
Personalized or precision medicine maintains that medical care and public health will be radically transformed by prevention and treatment programs more closely targeted to the individual patient. ... Even though personalized medicine will be useful to better understand rare diseases and identify novel therapeutic targets for some conditions, the promise of improved risk prediction, behavior change, lower costs, and gains in public health for common diseases seem unrealistic. Proponents of personalized medicine should consider tempering their narrative of transformative change and instead communicate a more realistic set of expectations to the public. (Michael J. Joyner and Nigel Paneth, 6/22)