Viewpoints: Court's 'baffling' decision; opposing views on Medicaid alternatives; fixing the VA with earmarks

Los Angeles Times: At Supreme Court, Baffling Decision Follows Awful Hobby Lobby Ruling
Over the weekend, without a pressing deadline at hand, I sat down to read more closely the Supreme Court's Hobby Lobby decision, and Justice Ruth Bader Ginsburg's strong dissent. Maybe, in the heat of deadline, I had missed something important when I first judged the decision deeply offensive to women. I had not. If anything, the Hobby Lobby decision -- and the court's subsequent ruling three days later in a thematically similar matter involving Wheaton College -- is even more offensive and troubling than I first thought (Robin Abcarian, 7/7). 

The Wall Street Journal: Without Reason Or Empathy
There's a good lesson in Justice Sonia Sotomayor's heated dissent from a Thursday order in the case of Wheaton College v. Burwell: When making an argument, you should be cautious about imputing bad faith to your adversaries--not only because civility has intrinsic value but also because such aggression magnifies the embarrassment if you turn out to be mistaken. That's just what Sotomayor, joined by Justices Ruth Bader Ginsburg and Elena Kagan, did in this dissent. "Those who are bound by our decisions usually believe they can take us at our word," she declared, using the first-person plural to refer to the court. "Not so today." In making that assertion, Sotomayor committed an elementary error of logic (James Taranto, 7/7).

Bloomberg: Who's The Real Hobby Lobby Bully?
[C]onsider an argument I have now heard hundreds of times -- on Facebook, in my e-mail, in comment threads here and elsewhere: "Hobby Lobby's owners have a right to their own religious views, but they don't have a right to impose them on others." As I wrote the day the decision came out, the statement itself is laudable, yet it rings strange when it's applied to this particular circumstance. How is not buying you something equivalent to "imposing" on you? (Megan McArdle, 7/7).

The Boston Globe: The Supreme Court's Subterfuge
Alito's reassurances that the ruling would not prevent women from receiving contraceptives also ring hollow. He explains that Obamacare already contains exceptions allowing religious groups to file a form to avoid the contraceptive requirement, which in turn triggers an obligation for insurance companies to provide contraceptives on their own tab. Religious corporations could use the same mechanism, he says. But late last week -; after the term had ended -; the court issued a preliminary ruling in favor of an employer asserting a conscientious objection to filing the form (Kent Greenfield, 7/8).

The Washington Post: Health-Care Sign-Up Mistakes Pose A New Challenge For Obamacare, Not A Disaster
Are hundreds of thousands of Americans getting government money they aren't entitled to because of Obamacare? Illegal immigrants, too? Is it all further evidence that the Obama administration is incompetent and the system unworkable? For critics of health-care reform, these are tempting conclusions to draw from reports that the Obama administration found nearly 3 million discrepancies between what enrollees reported when they signed up for Affordable Care Act insurance and what federal records show about them. Tempting but overblown (7/7).

USA Today: States' Obamacare Alternatives Worth Trying: Our View 
Some Republican governors have been cutting deals with the Obama administration to expand Medicaid -; on the condition that it be done through private insurance. At first, that sounds like a bad deal. For all its flaws, Medicaid has very low overhead and low reimbursement rates, so it can cover more people for less money than private insurers. ... This alternative approach is worth trying. Not only will people who would otherwise have no health insurance get coverage, the new programs also might improve on traditional Medicaid (7/7). 

USA Today: 'Private Option' Won't Help Poor: Opposing View
Medicaid is far from perfect, but the private option won't be an improvement. Medicaid patients, for instance, often have trouble finding doctors. But private option Medicaid plans, like many plans on the health exchanges, have very narrow doctor and hospital networks. "Churning" is another problem: Families must often change providers as they move in and out of Medicaid eligibility. But churning will persist under the private option as people change jobs or plans change provider networks (Adam Gaffney, 7/7). 

Fox News: Don't Be Fooled, Republicans Have Lots Of Ideas About How To Fix ObamaCare
Conservatives have no ideas to help "[bring] care to the uninsured, or those with pre-existing conditions." Heard this before? It's the New York Times editorial board's favorite meme. It's certainly true that Republicans haven't collectively endorsed a "replace" plan to go with their "repeal" strategy. Part of the reason is tactical-;while polls find ObamaCare consistently unpopular, Republicans hesitate to put forth their own comprehensive plan that would (undoubtedly) attract its own critics (Paul Howard and Yevgeniy Feyman, 7/7).

On other health care topics -

The New York Times: The Long Wait To See A Doctor
Americans are already experiencing long waits to get doctor's appointments, and experts say the delays are bound to get worse when millions of previously uninsured Americans get health coverage under the Affordable Care Act. That is the sobering news from a new survey of wait times conducted by Merritt Hawkins, a physician staffing firm, which polled some 1,400 medical offices in 15 large metropolitan areas across the country (7/7). 

Los Angeles Times: There's Family Value In Paid Parental Leave
A week ago, President Obama announced his support for paid maternity leave at the federal level. "Many women can't even get a paid day off to give birth -; now that's a pretty low bar," he told the audience at the White House Summit on Working Families. "That, we should be able to take care of." He was right to voice his support. After all, only 12% of workers have access to paid leave through state programs or more generous employers. A quarter of mothers who work during pregnancy either quit their jobs or are let go when a new child arrives, and those who receive only partial pay or no pay at all face financial hardship. The inadequate policies take a toll on family health as well as wealth, because maternity leave lowers infant mortality rates, illness and hospitalization for mother and child alike (7/7). 

Politico: Earmarks Can Fix The VA
One reason for this scandalous neglect is that the U.S. House and Senate were unable to provide the resources the VA needed because there is something missing from Congress' toolbox. And that missing governmental good-wrench is the power to direct federal spending to solve specific problems, large and small. With that authority, Congress could have pointed funding for understaffed and overburdened VA hospitals toward workable solutions for reducing the wait times for medical appointments, diagnostic tests and much-needed procedures (Jim Dyer, 7/7).

Raleigh News & Observer: NC Medicaid Makes An Important Difference For Those With No Alternatives
One overall lesson from The News & Observer's recent two-part report on the Medicaid health care system is that the system in North Carolina is in many ways working well. Costs per person have gone down at a time when spending nationally has gone up. More providers in the state, compared with the national rate, are willing to participate in services, percentage-wise. And there is better preventive care under N.C. Medicaid than in other states. ... But there is a threat that Republicans, having cut taxes excessively and seeming confused by the challenge of putting together a budget, will look to cut Medicaid services as an "easy" savings. ... It is always important, therefore, to remember who pays the price for cuts in those services and what type of pain changes in Medicaid inflict on vulnerable people (7/7).

Charlotte Observer: DHHS, Medicaid Fixes Start At Top
The sad thing in reading the (Raleigh) News & Observer's important two-part series on the state's Medicaid woes and the dysfunctional management of the Department of Health and Human Services is that the revelations no longer have the power to amaze. Problems beset DHHS and Medicaid long before Pat McCrory was elected governor nearly two years ago. But McCrory and the current legislature haven't made things any better, and in one key way they seem to have made things worse. McCrory's hiring of Aldona Wos as secretary of health and human services was a huge blunder, one that he refuses to rectify by letting her go (7/7).