Viewpoints: Lawmaker’s Obamacare Surprise; Conn.’s Stiff Medicaid Cuts; Fla. Budget Debate

The Washington Post's Plum Line: Leading GOP Critic Of Obamacare Accidentally Shows Why Anti-ACA Lawsuit Could Be Disaster For GOP, Too
As you may have heard, GOP Rep. Cathy McMorris Rodgers tried to celebrate Obamacare’s fifth anniversary by calling on constituents to share their horror stories about the law — whereupon many people responded by talking about how much the law has helped them. The story drew national attention. Now McMorris Rodgers has responded to all the praise for the ACA by dismissing its significance: She now suggests people were only praising the parts of the law Republicans also support. But in the process, she has inadvertently demonstrated why Republicans should be hoping the King lawsuit against the ACA — currently the GOP’s best shot at doing the law serious damage — fails. (Greg Sargent, 3/31)

Bloomberg: Catch Of The Day: GOP Retreat On Obamacare
McMorris Rodgers's explanation, according to the Spokesman-Review, was that most of the praise was for provisions with “broad, bipartisan support” such as coverage for those with “pre-existing conditions and those that are getting health insurance up to age 26.” In other words: We're going to vote to repeal every single word of Obamacare. Except for the stuff people like. The problem for Republicans is that all the benefits of Obamacare are popular. It’s the costs that people don't like -- the taxes and Medicare cuts to pay for those benefits, and the individual mandate to make the system work. The more the Republicans reinforce the idea that the goals of the health-care law are worthwhile, the more they are trapped into supporting it no matter how many times they vote to repeal it or promise a replacement. (Jonathan Bernstein, 3/31)

The Wall Street Journal: Close Encounters Of The Medicaid Kind
Medicaid enrollment has surged 19% nationally since ObamaCare’s expansion—50% in New Mexico, 65% in Oregon, 81% in Kentucky—and spending is exploding. So taxpayers ought to be grateful that the Supreme Court declined 5-4 on Tuesday to convert this entitlement—and all the others—into a private right. Medicaid, the joint state-federal program originally meant for the poor and disabled, sets price controls for all health-care services. And in the law that created the program, Congress instructed the states to “assure that payments are consistent with efficiency, economy, and quality of care and are sufficient to enlist enough providers” equal to those available to the general population. In Armstrong v. Exceptional Child Center, a group of in-home care companies sued Idaho for setting reimbursement rates too low, thus purportedly violating this amorphous standard. (3/31)

Bloomberg: What Do You Mean, I Can't Sue My State?
When your state breaks federal law in a way that affects you, can you sue in federal court to make it do the right thing? On Tuesday, the U.S. Supreme Court made doing so substantially harder. In a case involving private health-care providers in Idaho, the justices held that the health workers can’t sue Idaho -- even though the state was paying them less than required under federal Medicaid law. If this sounds weird to you, the fault isn’t yours. The problem lies with the version of federalism that underlies the 5-4 decision. (Noah Feldman, 3/31)

Hartford Courant: State Medicaid Cuts For Births Leave Providers Stunned
Everyone at Women's Health Connecticut was expecting the state to enact Medicaid cuts in the range of 5 percent this summer, a tough but workable hit for the Avon firm that manages 50 obstetrics-gynecology groups in the state. But the hammer that's falling suddenly on ob-gyns, nurse-midwives and their low-income patients across the state on Wednesday is something else altogether. Many of them learned just last week that the state will slash Medicaid payments by as much as 40 percent for ob-gyn services — as of April 1. (Dan Haar, 3/31)

The Wall Street Journal's Washington Wire: Americans Don’t Feel The Slowdown In Health Costs
National spending on health care and insurance premiums has risen at historically low rates in recent years. But ... even when spending and premiums experienced record-low growth in 2013, only 3% of Americans said health costs had been rising slower than usual, and 52% said they had been growing faster than usual. The American people are not out to lunch; their view of the problem of health costs is very different from that of experts. (Drew Altman, 3/31)

The New York Times: The False Hope Of A Smaller Government, Built On Tax Breaks
In the early years of the Reagan Revolution, Senator Robert Packwood, then the powerful Republican chairman of the Senate Finance Committee, offered a robust — if unusual — defense of the tax exclusion for employer-provided health insurance: It prevented the government from getting bigger. “The one reason we do not have any significant demand for national health insurance in this country among those who are employed is because their employers are paying for their benefits,” he argued. “I hate to see us nibble at it for fear you are going to have the demand that the federal government take over and provide the benefits that would otherwise be lost.” This reasoning drives American policy making to this day. (Eduardo Porter, 3/31)

The Miami Herald: Tale Of Two Budgets
At the core of the [state budget] debate is a philosophical difference on how to spend most of the money. And healthcare — specifically, how we pay for the medical needs of millions of low income Floridians — is shaping up to be the battle royal. The heftiness of the Senate’s budget is mainly because it includes federal dollars to cover the uninsured at Florida hospitals through the Low Income Pool, or LIP. ... An alternative to Medicaid expansion, now called the Florida Health Insurance Affordability Exchange or FHIX, is also on the table and also merits approval. ... But the gauntlet has been thrown down. House Speaker Steve Crisafulli, R-Merritt Island, has said the House is not for any expansion, whatever it’s called. (3/31)

The Washington Post: The Pelosi-Boehner Compromise On Medicare Is A Rare Bird
The John Boehner-Nancy Pelosi agreement on Medicare doctors’ payments — permanently easing up on scheduled cuts, funded (partially) by means testing — has been praised as an incremental gain and criticized as a small backward step. In either case, it is a rare bird: the result of a March 4 meeting between leaders in a metaphorical smoke-filled room (and, given Boehner’s smoking habit, perhaps an actual one). (Michael Gerson, 3/31)

The Washington Post's Volokh Conspiracy: The Supreme Court’s Next Obamacare Case(s)
On Monday, the Supreme Court denied certiorari in Coons v. Lew, a constitutional challenge to provisions in the Affordable Care Act (ACA) creating the Independent Payment Advisory Board (IPAB), an independent federal agency charged with responsibility for controlling the growth of health-care costs by constraining the growth of Medicare. ... The Court’s denial of certiorari in the Coons case does not mean the justices won’t revisit the ACA next term. Another cert petition is pending in Mayhew v. Burwell, Maine’s challenge to the constitutionality of the ACA’s maintenance of eligibility requirements for Medicaid. ( Jonathan H. Adler, 3/31)