First Edition: June 27, 2013

Today's headlines include reports explaining how yesterday's Supreme Court decision on DOMA impacts federal health benefits and the health law's coverage expansion. 

Kaiser Health News: Capsules: Test Driving The Obamacare Software
Now on Kaiser Health News' blog, Jay Hancock reports: "All the outreach in the world won't count for much if the Obamacare ticket counter doesn't work. Behind the campaign to educate the uninsured about the Affordable Care Act is the assumption that software to sell the plans will be ready and user-friendly by Oct. 1, when enrollment is supposed to start. That assumption is not universally shared. Some wonder if systems will be tested and finished on time. Others worry the programs will lead consumers to make dumb insurance choices" (Hancock, 6/27).Check out what else is on the blog.

Politico: Dems To Kathleen Sebelius: Seniors Confused On Obamacare
Congressional Democrats told Health and Human Services Secretary Kathleen Sebelius on Wednesday that Americans are still very confused about the health care law -; including older people who worry that Obamacare will change their Medicare. Sebelius went to the Hill for another update with Democrats on Obamacare rollout. HHS this week overhauled its website, focusing more on the exchange enrollment, which starts Oct. 1 (Cunningham and Haberkorn, 6/27).

Los Angeles Times: Healthcare Law's Renewal Loophole Divides Health Insurers
Ahead of next year's healthcare overhaul, some major insurers and consumer advocates want California lawmakers to bar companies from renewing most individual policies beyond Jan. 1. At issue is a loophole in the federal Affordable Care Act that enables health insurers to extend existing policies for nearly all of 2014, thereby avoiding changes under the healthcare law (Terhune, 6/26).

The Associated Press/Washington Post: Exemption From Health Law's Individual Mandate Broadened For Native Americans
The Obama administration on Wednesday broadened an exemption for American Indians from the new health care law's requirement that virtually every U.S. resident has health insurance starting next year. New rules clarify that people who are eligible to receive medical care through the federal Indian Health Service will be exempt from the requirement to have health insurance or face fines from the Internal Revenue Service. The Indian Health Service, a division of U.S. Health and Human Services, oversees a network of clinics that are required through treaty obligations to serve all patients of Indian ancestry, even if they cannot document their federal tribal status (6/26).

Politico: Obamacare Wants Sports Teams To Play Ball
President Barack Obama's love of the Chicago White Sox is no secret, but he'd probably be an even bigger fan if his hometown baseball team goes to bat for Obamacare. It's not just the Obama administration looking to join forces with professional sports leagues to enroll people in health insurance. Some states are also looking to get a lift from local teams this fall, when millions can start signing up for coverage (Millman, 6/27).

The Washington Post: At Supreme Court, Victories For Gay Marriage
The divided court stopped short of a more sweeping ruling that the fundamental right to marry must be extended to gay couples no matter where they live. But in striking down a key part of the 1996 Defense of Marriage Act (DOMA), the court declared that gay couples married in states where it is legal must receive the same federal health, tax, Social Security and other benefits that heterosexual couples receive (Barnes, 6/26).

The Wall Street Journal: Federal Rules, Taxes To Shift Due To Gay-Marriage Decision
Justice Anthony Kennedy's 5-4 opinion for the court noted a range of burdens gay couples faced under DOMA, "from the mundane to the profound." The invalidated law, he said, prevented married couples from obtaining government health-care benefits and raised their health-care costs by taxing health benefits that employers provide to workers' same-sex spouses. The law also deprived same-sex couples of more favorable consideration for student financial aid and denied them certain bankruptcy protections, Justice Kennedy said (Kendall and Saunders, 6/26).

NPR: How The End Of DOMA Will Affect Obamacare, Federal Employees
The Supreme Court's ruling that the Defense of Marriage Act is unconstitutional will not only make a big difference in health benefits for some federal employees, it could also affect people who will be newly eligible for Obamacare beginning next year (Neel, 6/26).

The New York Times: Federal Court Speaks, But Couples Still Face State Legal Patchwork
Consider two women living at Keesler Air Force Base in Biloxi, Miss., who travel to Maine to get married. When they get back to the base, the military will now recognize their marriage, affording them a variety of benefits that would go to any married couple, like health care and a housing allowance (Peters, 6/26).

The Wall Street Journal: Changes Loom For Employers
Wednesday's ruling now applies only to workers in the 12 states, plus the District of Columbia, that recognize gay marriage. Companies in those states will have to review their employee-benefit packages to make sure they don't discriminate against gay spouses and comply with the law, lawyers and benefits consultants said. … One of the biggest changes for married gay couples will be equal tax treatment of health-insurance premiums. Prior to the ruling, the value of a gay spouse's benefits coverage was treated as taxable income because he or she wasn't considered a spouse or dependent under federal law. By contrast, heterosexual couples paid for spousal benefits from pretax earnings. Now, in affected states, gay workers will enjoy the same tax status, potentially saving them thousands of dollars a year (Weber and Hofschneider, 6/26).

The Washington Post's Wonk Blog: The Feds Now Must Recognize Same-Sex Marriage. That Changes Obamacare.
With the United States recognizing same-sex marriage, a same-sex couple can be counted by the federal government as one family unit. Instead of two separate individuals applying for health benefits, each judged by the federal poverty line for one person, they're now a team. Their federal poverty line is $15,510 (Kliff, 6/26).

The New York Times' Bucks Blog: How Supreme Court Decision Affects Gay Couples
Medicaid. Having a federally recognized marriage can help or hurt an individual when it comes to Medicaid programs, "or perhaps even some of both," said Vickie Henry, a senior staff lawyer at Gay and Lesbian Advocates and Defenders. The fact that both spouses' incomes will be used to determine eligibility may hurt some couples. But if one spouse is in a nursing home or other long-term care institution, the couple may benefit from Medicaid's "spousal impoverishment" provisions. … Medicare. Individuals may be eligible for free Part A coverage, which generally covers hospital services and nursing homes, based on a spouse's earning record, according to the Medicare Rights Center. Married people may also be able to delay enrolling in Part B coverage, which covers things like preventative visits to the doctor, while a spouse is still working and for up to eight months afterward (Siegel Bernard, 6/26).

Politico: Texas Abortion Fight Throws Spotlight On State-Based Regulations
A late-night Lone Star State showdown that stopped an abortion bill in its tracks galvanized people on both sides of the battles that are raging in states -; fights that could eventually land in the Supreme Court (Glueck, 6/26).

Los Angeles Times: Texas Sen. Wendy Davis' Abortion Filibuster Galvanizes Activists
Wendy Davis' filibustered victory, which ricocheted around the world via social media, may prove short-lived. Gov. Rick Perry announced Wednesday he would reconvene the Legislature on Monday in a second and likely successful attempt to pass the measure. But the celebrity Davis garnered and the passions the Fort Worth Democrat ignited -; at one point she generated 6,000 Tweets a minute with the hashtag #StandWithWendy -; may prove longer lasting (Hennessy-Fiske and Barabak, 6/26).

The Washington Post's Wonk Bog: This Georgia Hospital Shows Why Rejecting Medicaid Isn't Easy.
The Affordable Care Act was originally written such that every state would have to accept a Medicaid expansion. But the Supreme Court struck down that part of the law last year. The result is an unexpected bind for safety-net hospitals in states that are refusing Medicaid. How bad of a bind? Just look at the choices facing Atlanta's Grady Memorial Hospital (Blau, 6/26).

The Associated Press/Wall Street Journal: Paid Sick Times Law Passes In NYC, Veto Overridden
New York City is becoming the most populous place in the United States to make businesses provide workers with paid sick time, after lawmakers overrode a mayoral veto early Thursday to pass a law expected to affect more than 1 million workers. With the vote, the city joined Portland, Ore.; San Francisco; Seattle; Washington, D.C.; and the state of Connecticut in requiring the benefit for at least some workers. Similar measures have failed in some other places, including Milwaukee, Denver and Philadelphia (6/27).