Viewpoints: GOP’s Legal ‘Plot’ Against Health Law; Extending Enrollment Will Lead To Problems

The New York Times: The Plot To Kill Health Care
Republicans hate activist judges — those black-robed elites who are willing to upset the lives of millions of people just to further a political cause. Ditto trial lawyers trolling for clients, the ambulance-chasing, “Better Call Saul” guys. They hate them, until they need them. And in the raw power play that is behind the attempt to kick millions of people off health care gained through the Affordable Care Act, Republicans are attempting one of the most brazen manipulations of the legal system in modern times. To pull it off, they’re relying on a toxically politicized judiciary to make law, and to make a mockery of everything that conservative legal scholars profess to believe. (Timothy Egan, 2/20)

Forbes: Contra White House, Obamacare Exchanges Enroll Roughly 5 Million Uninsured, Not 11.4 Million
Last night, the White House tweeted that “about 11.4 million Americans are signed up for private health coverage” through Obamacare’s insurance exchanges. President Obama claims that this figure proves that his health law is working. But once you unravel the spin, what the latest numbers show is that the pace of enrollment in Obamacare’s exchanges has slowed down by more than half. If previous trends hold, Obamacare exchanges have enrolled roughly 5 million previously uninsured individuals: a far cry from 11.4 million. (Avik Roy, 2/18)

The Wall Street Journal: The ACA Enrollment Story Is In The States
The Obama administration announced this week that 8.6 million people had signed up for coverage in the 37 states using HealthCare.gov and estimated that an additional 2.8 million had signed up in states operating their own exchanges during the Affordable Care Act open-enrollment season that closed Sunday. ... Beneath these numbers lies significant variation in the enrollment experiences in the states using HealthCare.gov. The aggregate national enrollment figures get a lot of attention in Washington and in the media amid the ongoing debate about the health-care law–but the state numbers can be more revealing. (Drew Altman, 2/19)

The New York Times: Cranking Up For 2016
Across the board, the modern American right seems to have abandoned the idea that there is an objective reality out there, even if it’s not what your prejudices say should be happening. What are you going to believe, right-wing doctrine or your own lying eyes? These days, the doctrine wins. Look at another issue, health reform. Before the Affordable Care Act went into effect, conservatives predicted disaster: health costs would soar, the deficit would explode, more people would lose insurance than gain it. They were wrong on all counts. But, in their rhetoric ... they simply ignore this reality. (Paul Krugman, 2/20)

USA Today: Affordable Care Act Is Working
Over the past three months, millions of Americans sent a powerful message: The Affordable Care Act is working, and the quality health coverage offered on its Health Insurance Marketplace is a product that consumers need, want and like. ... Health insurers sent a message as well. Twenty-five percent more of them offered coverage in the Marketplace compared to the last open enrollment. ... Given this progress, it's time to move beyond efforts to repeal the Affordable Care Act. (Health and Human Services Secretary Sylvia M. Burwell, 2/19)

The Wall Street Journal: Three Ways To Create Smarter Health-Care Consumers
Even Americans with health insurance are paying more out of pocket for their care as medical costs increase and insurance coverage gets leaner, with higher deductibles and copays. This means that more people are making tough choices about whether to forgo recommended treatments. The key to making those choices is good information on both the benefits and costs of care. (David Blumenthal, 2/19)

The Washington Post: A Historic, Bipartisan Medicaid Proposal For Virginia
[Virginia Gov. Terry] McAuliffe tried for months to get about 400,000 people added to Medicaid. The General Assembly said no. Now he is aiming to add about 20,000. But, adopting the right mix of incentives — and enforcement — to spur those already covered to use Medicaid would produce a far greater expansion in usage, the supposed goal, than the General Assembly will pass this year. (Norman Leahy and Paul Goldman, 2/19)

The Wall Street Journal: How Much Of Your Taxes Go To Health Care? Do The Math.
Between state, federal and Medicare taxes, and insurance premium growth potentially displacing wage increases, you paid a high price for health care in 2014—even if you were healthy and never used the system once. Health care is very important to all of us, which is why we are willing to pay so dearly for it. But at this high a cost, we ought to expect better than the rampant waste, errors and quality problems that plague the system. No voter with a W-2 should elect a politician who won’t fight for the best care at the best price. (Leah Binder, 2/19)

The New England Journal of Medicine: #BlackLivesMatter — A Challenge To The Medical And Public Health Communities
Ongoing exclusion of and discrimination against people of African descent throughout their life course, along with the legacy of bad past policies, continue to shape patterns of disease distribution and mortality. There is great injustice in the daily violence experienced by young black men. But the tragedy of lives cut short is not accounted for entirely, or even mostly, by violence. ... Physicians, nurses, and public health professionals witness such inequities daily: certain groups consistently have much higher rates of premature, preventable death and poorer health throughout their lives. Yet even as research on health disparities has helped to document persistent gaps in morbidity and mortality between racial and ethnic groups, there is often a reluctance to address the role of racism in driving these gaps. (Dr. Mary T. Bassett, 2/18)

The New England Journal of Medicine: Bias, Black Lives, And Academic Medicine
What are the systemic biases within academic medical centers, and what do they have to do with black lives? Two observations about health care disparities may be relevant. First, there is evidence that doctors hold stereotypes based on patients' race that can influence their clinical decisions. ... Second, despite physicians' and medical centers' best intentions of being equitable, black–white disparities persist in patient outcomes, medical education, and faculty recruitment. (Drs. David A. Ansell and Edwin K. McDonald, 2/18)

news@JAMA: Is The Patient CARE Act Heir Apparent To The Affordable Care Act?
The first week of February was an eventful one on Capitol Hill. First, on February 3, 2015, the House of Representatives passed HR 596, its 56th attempt to repeal the Affordable Care Act (ACA). Two days later, a news release from the Senate Committee on Finance announced that Republican Senators Richard Burr (NC), Orrin Hatch (Utah), and Fred Upton (Mich) unveiled the Patient Choice, Affordability, Responsibility, and Empowerment (CARE) Act, described as a “legislative plan that repeals Obamacare and replaces it with common-sense, patient-focused reforms that reduce health care costs and increase access to affordable, high-quality care.” (Adashi, 2/18)

The New England Journal of Medicine: Healthcare.Gov 3.0 — Behavioral Economics And Insurance Exchanges
[I]t will soon be time to tackle the much more challenging job of designing exchange websites in ways that maximize the chances that consumers will choose plans best suited to their needs and preferences. If the first round of open enrollment was primarily about avoiding catastrophe and the second round was about ironing out wrinkles in the underlying programming code, then version 3.0, in our view, should focus on redesigning the way exchanges present their insurance choices, to avoid features known to bias people's decisions. (Peter A. Ubel, David A. Comerford and Eric Johnson, 2/18)