First Edition: July 3,2014

Today's early morning highlights from the major news organizations, including more analysis of the Supreme Court's Hobby Lobby decision and concerns in New York about significant insurance rate increases for 2015: 

Kaiser Health News: Did The Supreme Court Tip Its Hand On Contraception Cases Yet To Come?
Kaiser Health News staff writer Julie Rovner reports: "The Supreme Court's opinion Monday holding that some for-profit firms do not have to provide women the contraceptive coverage required under the Affordable Care Act if they have religious objections addressed only half of the ongoing legal battle over the birth control mandate. But those on both sides of the issue think the court's majority may have telegraphed which way it could rule when one of those other cases reaches the justices" (Rovner, 7/2).

Kaiser Health News: The Latest In Medical Convenience: ER Appointments
Kaiser Health News staff writer Anna Gorman and The San Francisco Chronicle's Victoria Colliver report: "Scott Paul knew he needed to head to the emergency room on a recent Sunday after his foot became so painful he couldn't walk. The one thing that gave him pause was the thought of having to wait several hours next to a bunch of sick people. But his wife, Jeannette, remembered she'd seen Dignity Health television commercials featuring a woman sitting in a hospital waiting room and then cutting to the same woman sitting on her living room couch as words come up on the screen: "Wait for the ER from home" (Gorman and Colliver, 7/3).

The Wall Street Journal: Administration Points To Hobby Lobby Ruling In Wheaton College Case
In the latest battle over the Affordable Care Act, the Obama administration Wednesday cited the Supreme Court's Hobby Lobby ruling to buttress the claim it has offered religious nonprofits an acceptable compromise to opt out of contraceptive coverage in employee health plans. U.S. Solicitor General Donald Verrilli made the arguments in a Wednesday filing involving Wheaton College, a Christian institution in Illinois, that is seeking to avoid complying with the contraceptive-coverage alternative while litigation over its challenge continues in lower courts (Bravin, 7/2).

Politico: Hobby Lobby Decision: 5 Takeaways
The Supreme Court waited until the very end to deliver its most hotly anticipated decision of the term: declaring in a 5-4 ruling that for-profit companies can use religious objections to avoid paying for contraception coverage required under Obamacare. The sharply divided result in Burwell v. Hobby Lobby immediately touched off a wave of analysis and speculation about how large a hole the court put in the side of President Barack Obama's signature health care law -; just two years after Chief Justice John Roberts sided with liberals to save the measure's individual mandate from legal oblivion (Gerstein and Nather, 7/1).

The Washington Post: Sebelius's Claim That Obamacare Has Brought 'Affordable Coverage' To 22 Million People
This number -; 22 million -; is an interesting figure from the recently departed HHS secretary, given that she had once famously defined "success" for the Affordable Care Act as having signed up 7 million people by the end of March. How did the number suddenly balloon to 22 million? Brad Kemp, an aide to Sebelius, provided the following breakdown: "8 million in market; 3 million young adults; 5 million in ACA-compliant off-market plans, and 6 million (and counting) additional Medicaid folks." That adds up to 22 million, but he did not respond to follow-up e-mails or provide any sources for the numbers. So let's dissect these figures ourselves (Kessler, 7/2).

The New York Times: Insurers On New York State's Health Exchange Seek Significant Rate Increases
Some New Yorkers are in sticker shock after receiving notices from their insurance companies saying that they have asked for significant rate increases through the state's health exchange next year. The exchange, which has prided itself on being affordable, is now facing requests for increases as high as 28 percent for some customers of MetroPlus, a new entry to the individual insurance market and one of the least costly -; and most popular -; plans on the exchange this year. ... Over all, including plans inside or outside the exchange, insurance companies asked for average rate increases of 13 percent in 2015, the state's Financial Services Department said Wednesday (Hartocollis, 7/2).

Los Angeles Times: Obamacare: Legal Aid Groups Demand Answers On Medi-Cal Backlog
With low-income Californians continuing to face months-long delays in getting state healthcare coverage, health advocates are calling on the state to explain within 10 days how it will address lingering Obamacare application delays. In a letter to Gov. Jerry Brown and other officials Wednesday afternoon, the advocates demanded that California's healthcare agency lay out specific plans for eliminating a huge backlog in applications for Medi-Cal, the state healthcare program for the poor (Brown, 7/2).

Los Angeles Times: Los Angeles Times: Need For Ballot Measure On Health Insurance Rate Regulation Debated
Kicking off a major ballot fight this year, California lawmakers pressed the state's insurance commissioner to defend a proposal that would grant his agency sweeping new authority over health insurance rates. At a legislative hearing Wednesday, backers and opponents of the statewide ballot measure on health insurance rate regulation called Proposition 45 squared off for the first time in a public debate. Before the hearing, supporters of Proposition 45 rallied in Sacramento and accused health insurers of putting profits ahead of patient care (Terhune, 7/2).

The New York Times: The Price Of Prevention: Vaccine Costs Are Soaring
Vaccination prices have gone from single digits to sometimes triple digits in the last two decades, creating dilemmas for doctors and their patients as well as straining public health budgets. Here in San Antonio and elsewhere, some doctors have stopped offering immunizations because they say they cannot afford to buy these potentially lifesaving preventive treatments that insurers often reimburse poorly, sometimes even at a loss (Rosenthal, 7/2).

The New York Times: After Criticism, Investigator Steps Down From The V.A.
The head of the Department of Veterans Affairs' medical investigation unit has stepped down, the department announced Wednesday, just days after a federal watchdog sharply criticized the department for failing to adequately investigate allegations of poor care within its sprawling hospital system. The official, Dr. John R. Pierce, who had been director of the department's office of medical inspector, is the fifth senior V.A. official to depart in the past six weeks (Oppel, 7/2).

Politico: Reforming The VA One Step At A Time
Congress is poised to pass the most significant reforms to the Department of Veterans Affairs in nearly two decades -; but don't expect quick fixes to the layers of rot at the agency. The House and Senate have passed bills responding to revelations that veterans died after the VA delayed providing medical care. But the measures don't change the VA employees' habit of gaming the system, covering up problems and punishing whistleblowers who try to sound the alarm -; the "corrosive culture" that White House deputy chief of staff Rob Nabors warned about in a report to President Barack Obama last week (Nather, 7/2).

Los Angeles Times: Medical Sleuths Seek Patients With Mystery Diseases, Offer New Tools
Everyone loves a medical mystery, except the afflicted patient and his or her family who shuffle from doctor to doctor in search of an explanation for a disorder whose name, origin, prognosis and cure are all unknown. Now, the National Institutes of Health have underwritten a nationwide "whodunnit" campaign, with a $43 million-initiative to fund the diagnosis and exploration of undiagnosed, unrecognized and misunderstood diseases (Healy, 7/2).

Politico: Massachusetts Readies New Abortion Clinic Protections
Massachusetts leaders, still smarting from a unanimous Supreme Court rebuke, are preparing to take another shot at keeping protesters away from women entering abortion clinics in the state. The high court last week ruled that Massachusetts' 35-foot "buffer zone" outside the facilities is unconstitutional. A majority of justices said such a large area is overly restrictive of free speech (Cheney, 7/2).

Los Angeles Times: Abortion Foes Get Up Close And Personal After Court Erases Buffer Zones 
Though the Supreme Court decision applied only to the Massachusetts law, advocates on both sides of the debate say it eventually could apply to a variety of ordinances across the country that are aimed at minimizing conflicts in some of the nation's most contentious terrains. New Hampshire last month approved a 25-foot buffer zone around its clinics, and cities including Sacramento, San Francisco, Santa Barbara and Portland, Maine, also have fixed-distance buffer zone laws in place. Many other municipalities, including Los Angeles, require protesters to stay 8 feet away from patients who are within 100 feet of a clinic. Those laws also could be the next targeted by the antiabortion movement after last week's decision (Semuels, 7/2).

The Associated Press: Missouri Governor Vetoes 72-Hour Abortion Wait
Missouri Gov. Jay Nixon vetoed legislation Wednesday that would have required a 72-hour wait for women seeking abortions, asserting that legislators showed a "callous disregard for women" by granting no exception for rape and incest victims. Republican legislators quickly vowed to override the Democratic governor's decision, and they may have the numbers to do so (Lieb, 7/2).