Some small businesses brace for health law hardships

The Wall Street Journal reports on the impact the health law could have on restaurants and retailers, while other news outlets explore reverberations of the Supreme Court decision making the expansion of Medicaid effectively optional.

The Wall Street Journal: Small Firms See Pain In Health Law
Restaurants and retailers face some of the toughest changes now that the Supreme Court has kept the overhaul in place. These industries historically are among the least likely to provide insurance to workers. Many franchisees of big chains hover around the threshold at which they will be required to start insuring workers or pay the penalty. With high turnover and a large percentage of part-time and seasonal workers, restaurant and retail operators must juggle several variables in figuring out whether they will cross the threshold (Radnofsky, 8/1).

Medscape:  Medicaid Expansion?  Expand Pay Too, Physicians Say
In the wake of last month's Supreme Court decision on the Affordable Care Act, some governors have announced that their states will opt out of a dramatic expansion of Medicaid and the massive influx of federal dollars that comes with it.  That negative stance has provoked opposition, guarded agreement, and, more than anything, mixed feelings among leaders of affected state medical societies. Even physician supporters of Medicaid expansion acknowledge the dilemma that it poses - more people will gain coverage, but not necessarily a clinician who is willing to treat them, given the program's notoriously stingy rates (Lowes, 8/1).

Stateline:  Health Care Ruling Casts Doubts On Billions In State-Federal Funding
In striking down the federal health care law's mandatory Medicaid expansion, the U.S. Supreme Court's ruling last month limited a key component of the federal government's power over the states for the first time in decades, unsettling state-federal relations for years to come.  With the new limit in place, worries that countless other programs, regulations and mandates that impose federal requirements on states could face a similar fate are now beginning to reverberate around the country (Grovum, 8/1).