First Edition: June 14, 2013

Today's headlines includes reports about how, after months of battle, Arizona lawmakers endorsed a Medicaid expansion plan backed by Gov. Jan Brewer. 

Kaiser Health News: Capsules: California Insurance Chief Wants To Bar Anthem From Selling Small Business Coverage; Preparing For Flood Of Consumer Questions On Insurance Exchanges
Now on Kaiser Health News' blog, Julie Appleby reports on developments in California related to the small business insurance market: "Citing a pattern of 'unreasonable rate increases' for small business customers by Anthem Blue Cross, California Insurance Commissioner Dave Jones said Thursday he will recommend that the state's new online insurance marketplace exclude the firm from selling small business coverage" (Appleby, 6/13).

Also on the blog, Peggy Girshman looks at state-based coverage regarding how Minnesota is preparing for consumer questions about the health law's online insurance marketplaces: "On Oct. 1, individual consumers and small businesses will be able to enroll in the online health insurance marketplaces known as exchanges. Minnesota, where the state is running the exchange, and Florida, where the federal government will be in charge, are preparing in different ways. Under the Affordable Care Act,  most Americans who don't already have health insurance through employers, Medicare or some other source are required to get it as of Jan. 1 or pay a fine. Subsidies will be available for people who earn up to 400 percent of the federal poverty level to buy insurance" (Girshman, 6/13). Check out what else is on the blog.

The Associated Press/Washington Post: Employers With 50 Or More Full-Time Workers Required To Offer 'Affordable' Coverage
Requirements that medium-sized and large employers offer insurance coverage or face fines are one of the most complicated parts of President Barack Obama's health care law. While most of the estimated 160 million Americans with job-based coverage will not see not see major changes when the law takes full effect next year, the so-called employer mandate will be important to millions of workers, particularly in low-wage industries (6/13).

The Associated Press/Washington Post: Affordability Glitch: Low-Wage Workers In Some Big Firms Could Get Left Out In Health Overhaul
It's called the Affordable Care Act, but President Barack Obama's health care law may turn out to be unaffordable for many low-wage workers, including employees at big chain restaurants, retail stores and hotels. That might seem strange since the law requires medium-sized and large employers to offer "affordable" coverage or face fines. But what's reasonable? Because of a wrinkle in the law, companies can meet their legal obligations by offering policies that would be too expensive for many low-wage workers. For the employee, it's like a mirage -; attractive but out of reach (6/13).

The Associated Press/Washington Post: Arizona Gov. Brewer Secures Medicaid Expansion After Months-Long Fight With Legislature
Ending a six-month legislative session, Arizona lawmakers endorsed a key element of President Barack Obama's health care law in a huge political victory for Republican Gov. Jan Brewer, after a lengthy fight over Medicaid expansion that divided the state's Republican leadership. The expansion that will extend health care to 300,000 more low-income Arizonans came after months of stalled negotiations, tense debates and political maneuvering as Brewer pushed the Medicaid proposal through a hostile Legislature (6/14).

The Wall Street Journal's Washington Wire: Arizona Expands Medicaid In Win For Gov. Brewer
Ms. Brewer had held rallies across the state since January to persuade Republican legislators to go along with her decision to adopt a key part of the federal health-care law, the growth of the Medicaid health program  to include millions more low-income adults, after the Supreme Court decision a year ago effectively allowed states to choose whether to participate. … As we've reported before, many states have wrestled over what to do with their Medicaid programs, which are funded jointly by states and the federal government. In Arizona, Ms. Brewer faced an unusual situation because the state had already been covering most adults up to the poverty line, and accepting federal dollars for the program expansion in 2014 would have allowed it to continue to do so with more generous funding (Radnofsky, 6/13).

Politico: Jan Brewer Wins Medicaid Expansion In Arizona
The vote is the end of a chapter, though not the book, on Obamacare in Republican-led Arizona, where Brewer defied -; and sometimes confounded -; her base. She not only supported the Medicaid expansion but took extraordinary measures to push for its passage. Other GOP governors who backed Medicaid were not nearly so emphatic in fighting against balky legislatures (Millman and Cheney, 6/13).

The Washington Post's Wonk Blog: How Mississippi Could End Up Killing Medicaid
The fight over expanding Medicaid has gotten ugly, and the latest state to grab the spotlight is Mississippi, where a standoff in the legislature is pushing the state toward a cliff. Without a last-minute agreement, Medicaid may cease altogether there on July 1. Most people think it won't come to that, but given the unpredictable nature of the fight over Obamacare, advocates and hospitals there are growing understandably concerned. Some 700,000 people are on the Medicaid rolls in Mississippi, and the program represents about 16 percent of the state's hospital revenue (Somashekhar, 6/13).

Los Angeles Times: Regulator Wants To Bar Anthem From Small-Business Health Exchange
California Insurance Commissioner Dave Jones wants industry giant Anthem Blue Cross barred from the state's new health exchange for small businesses because he says the company imposes excessive rate hikes. Jones said the state's largest for-profit health insurer should be denied access to the state-run market where thousands of small employers will purchase health coverage for their workers (Terhune, 6/13).

Los Angeles Times: Boxer To Push For Health Costs Of Uninsured Immigrants
Sen. Barbara Boxer plans to push for Washington to provide $250 million and perhaps more to help local and state governments pay the cost of healthcare to uninsured immigrants who seek legal status under legislation now before the Senate. Officials from Los Angeles County--home to an estimated 1.1 million people in the country illegally, one-tenth of the nation's total--have expressed concern that local taxpayers will be "left holding the bag" to pay for the healthcare costs (Simon, 6/13).

The Washington Post's Post Politics: House Democrat Says GOP 'Having A Relapse' On Immigration Reform
Gutierrez is part of a bipartisan House group that has been working privately on a comprehensive immigration reform bill, but the group has suffered delays and setbacks for months. Most recently, one of the original eight members, Rep. Raul Labrador (R-Idaho), dropped out of the coalition, citing a standoff over requirements related to health care for illegal immigrants (Nakamura, 6/13).

The  Texas Tribune/New York Times: Lack of Local Revenue Limits Federal Money For Health Projects
Texas received federal approval in May to begin 1,100 experimental projects that could transform the way health care is delivered to the state's poor and uninsured. But there is a catch: to receive billions of dollars in federal financing, health care providers across 20 Texas regions must start the projects using local financing and meet some performance benchmarks. This presents a particular challenge for the poorest regions, which have higher rates of people who are uninsured or receiving Medicaid benefits, yet have been unable to put up enough local money to draw a representative share of the available federal dollars (Aaronson, 6/13).

The Wall Street Journal: Justices Strike Down Gene Patents
The Supreme Court unanimously held Thursday that human genes cannot be patented, even when isolated from the body, a ruling expected to quickly expand access to genetic testing while potentially allowing inventors to retain rights to artificially created DNA. The decision marked the latest step in the court's decade long march to toughen the requirements for patents. The justices repeatedly have declared that 21st-century innovation depends less on locking up intellectual-property rights than on expanding access to discoveries in order to spur further progress (Bravin and Kendall, 6/13).

The New York Times: Justices, 9-0, Bar Patenting Human Genes
Human genes may not be patented, the Supreme Court ruled unanimously on Thursday. The decision is likely to reduce the cost of genetic testing for some health risks, and it may discourage investment in some forms of genetic research (Liptak, 6/13).

Los Angeles Times: Supreme Court Rejects Gene Patents
The Supreme Court ruled that human genes are a product of nature and cannot be patented and held for profit, a decision that medical experts said will lead to more genetic testing for cancers and other diseases and to lower costs for patients. In a unanimous ruling Thursday, the nine justices declared that human genes are not an invention, so they cannot be claimed as a type of private property (Savage, 6 14).

Politico: Supreme Court Rules Genes Can't Be Patented
The court did uphold patents for a type of synthetic DNA called complementary or cDNA, which is widely used in commercial biotechnology. Francis Collins, director of the National Institutes of Health, praised the opinion (Norman, 6/13).

The New York Times: After Patent Ruling, Availability Of Gene Tests Could Broaden
Almost immediately after the Supreme Court ruled that human genes could not be patented, several laboratories announced they, too, would begin offering genetic testing for breast cancer risk, making it likely that that test and others could become more affordable and more widely available. The ruling in effect ends a nearly two-decade monopoly by Myriad Genetics, the company at the center of the case (Pollack, 6/13).

Los Angeles Times: Supreme Court Ruling A Game Changer For Patients? Doctors Weigh In
The court's 9-0 decision in the case involving the Utah-based Myriad Genetics was welcome news to Grody as well as other doctors and genetic counselors concerned about future research and genetic counselors who said they've had their hands tied by the company's high prices and tough patent enforcement. "I'm very happy," said Raluca Kurz, a certified genetic counselor with Cedars-Sinai Medical Center. "I think we've all been waiting for this to happen for a long time" (Khan, 6/13).

NPR: Judge Reluctantly Approves Government Plan For Morning-After Pill
An obviously unhappy Judge Edward Korman has approved the Obama administration's proposal to make just one formulation of the morning-after birth control pill available over the counter without age restrictions. But in a testily worded six-page memorandum, the federal district judge made it clear he is not particularly pleased with the outcome. He has been overseeing the case in one way or another for more than eight years  (Rovner, 6/13).