States offer test kitchen for health law theme of coverage expansion

Some state programs will continue, regardless of the high court's finding. Still, the various Supreme Court scenarios that could play out would cause some rethinking of state-level reform approaches.

Stateline:  What Happens To Health Law Money Already In State Coffers?
If the U.S. Supreme Court declares all or parts of the national health law unconstitutional this week, legal experts say it is unclear what will happen to billions in federal money provided by the law that has already been sent to state and local governments, and private organizations.  To date, Washington has written checks for $13.7 billion, according to a federal funds tracker created by the Kaiser Family Foundation. Of that, 31 percent, or about $4.2 billion, has gone directly to state and local governments.  Even if the Affordable Care Act survives the high court review, Congress could attempt to repeal all or parts of the law, putting the billions already spent and billions more to come in question (Vestal, 6/25).

St. Louis Beacon:  Pilot Medicaid Program Begins July 1 Regardless Of Supreme Court Ruling
Ordinarily, able-bodied adults are excluded from Medicaid in Missouri. But the pilot plan offers basic health care to anyone whose income is no more than 133 percent of the federal poverty level -- roughly $14,000 for a single person living alone.  The local program will last 18 months, until 2014, when the needy were scheduled to receive similar health benefits as part of ACA. Whether that happens depends on how the U.S. Supreme Court rules on arguments that the federal government is overstepping its bounds by, among other reforms, expanding Medicaid to cover millions more uninsured Americans (Joiner, 6/22).

The New York Times: Oregon Study Shows Benefits, And Price, For Newly Insured
But in 2008, Oregon opened its Medicaid rolls to some working-age adults living in poverty, like Ms. Parris. Lacking the money to cover everyone, the state established a lottery, and Ms. Parris was one of the 89,824 residents who entered in the hope of winning insurance. With that lottery, Oregon became a laboratory for studying the effects of extending health insurance to people who previously did not have it. Health economists say the state has become the single best place to study a question at the center of debate in Washington as the Supreme Court prepares to rule, likely next week, on the constitutionality of President Obama's health care law: What are the costs and benefits of coverage (Lowrey, 6/22)? 

CHCF Center For Health Reporting/San Jose Mercury News: State's Ahead On Care Reform
As the U.S. Supreme Court nears a decision on health reform, more than 360,000 Californians already receive medical coverage under a state-administered precursor to the landmark legislation. But they could find their coverage fleeting if the so-called Affordable Care Act has no future. The effort, dubbed "The Bridge to Reform," is part of a sweeping Medicaid expansion unfolding in California. … California Department of Health Care Services spokesman Norman Williams said even if the Supreme Court renders the Bridge to Reform a bridge to nowhere, just building it has been of value to the state's health care apparatus. "Health care delivery infrastructure at the local level is being improved as a result," he said (Gonzales, 6/23).

CHCF Center For Health Reporting/San Jose Mercury News: Court Ruling Could Force California To 'Rethink Everything'
Each possibility carries different implications for California, a state that took an early and aggressive approach to implementing the federal law. "We will have to rethink everything" if the federal law is overturned in part or whole, said Hernandez, a Democrat from West Covina and chair of the Senate Health Committee. "We have to reassess all of these measures. Some of them are actually contingent upon the implementation of the Affordable Care Act," he said (Bazar, 6/23).

Sacramento Bee: Health Care Safety Net At Turning Point
Just as it's beginning to look like parts of the federal health care law may be struck down, new research shows exactly how many people in the Sacramento region may be affected by two prominent pieces of the vast legislation. At the high end, with vigorous outreach, up to 330,000 people in the four-county region would be enrolled in expanded Medi-Cal, California's version of Medicaid. The expansion extends assistance to people earning up to $14,856 a year, or 138 percent of the federal poverty level. Another 100,000 in the region are predicted to be enrolled in the tax-subsidy program for people buying insurance in the state exchange established to help implement the health care reform law. Again, this assumes ambitious outreach to the segment of the affected population, people making up to 400 percent of the poverty level – or an individual earning $44,680 annually. Conducted by UC Berkeley and UCLA researchers, the study offers the first glimpse at how many people are expected to be enrolled by 2019 in Sacramento, Yolo, Placer and El Dorado counties (Craft, 6/24).