Viewpoints: Target has the right idea for part-timers; health law 'beyond rescue;' fighting back to secure the right to abortion

Jan 24 2014

Los Angeles Times: Is Target Right To Send Its Part-Timers To Obamacare? Probably.
The big noise on the health insurance front today was sounded by Target, which announced via a corporate blog that it's ending health insurance for its part-time workers. Instead of signing up for a company plan, they're encouraged to use the health care exchanges set up through the Affordable Care Act. ... Target is suggesting that most of the affected workers will do better under the exchange system than they were with company-sponsored insurance. Target is probably right (Michael Hiltzik, 1/22). 

The Washington Post: Obamacare's Contingency Plan Isn't A Bailout
It was unrealistic to expect the system to work flawlessly immediately upon implementation. In fact, the law's authors anticipated that and put safeguards in place. One spreads risk among insurance companies by transferring money from those that see relatively low claims costs to those that see relatively high costs. Another helps pay very high medical bills from individual patients. ... Critics, though, are describing the possibility that these stabilizers will have to kick in as a bailout. Some have even called to repeal them. ... Spreading risk is insurance, not a bailout. Smart contingency planning is not a bailout (1/22). 

Bloomberg: Do Conservatives Want To Bail Out Obamacare?
In my Bloomberg View column this week, I argued that Republicans should work to pass a law to prevent the abuse of Obamacare's "risk corridors." Designed properly, risk corridors can be a useful way to spread risk among the insurers who participate in an exchange: The ones who have relatively healthy customers, and thus profits, can subsidize the ones with relatively sick customers, and losses. If almost all the participants are losing money, though, the exchange as a whole isn't working, and taxpayers generally shouldn't have to cover the insurers' losses (Ramesh Ponnuru, 1/22).

The Wall Street Journal: Obamacare's Missing Uninsured
The Affordable Care Act would right a great social wrong. Or so we were told. But reality is again intruding on the Obama administration's narrative. This newspaper reported Saturday that between 65 percent and 80 percent of those who have signed up for health insurance through the federal or state Obamacare exchanges previously had coverage, according to insurers. A survey by McKinsey & Co. suggested that only 11 percent of those who purchased plans through the exchanges were previously uninsured (Karl Rove, 1/22). 

Bloomberg: Resolved: Obamacare Is Now Beyond Rescue
In a nutshell, Obamacare has so far fallen dramatically short of what was expected -- technically, and in almost every other way. Enrollment is below expectations: According to the data we have so far, more than half of the much-touted Medicaid expansion came from people who were already eligible before the health-care law passed, and this weekend, the Wall Street Journal reported that the overwhelming majority of people buying insurance through the exchanges seem to be folks who already had insurance. Coverage is less generous than many people expected, with narrower provider networks and higher deductibles. The promised $2,500 that the average family was told they could save on premiums has predictably failed to materialize. And of course, we now know that if you like your doctor and plan, there is no reason to think you can keep them. Which is one reason the law has not gotten any more popular since it passed (Megan McArdle, 1/21).

The New York Times: The Luck Of The Pontiff
The president's visit, which is scheduled for March, comes at an interesting intersection in the two men's careers. Pope Francis can currently do no wrong, and Barack Obama can do no right. Recently, his administration decided to move its Vatican Embassy into a more secure building, and the outcry was so intense that you'd think Obama had ordered a re-creation of the Sack of Rome. "A slap in the face to the 78 million Catholics in the United States," one congressman screeched. "Why would our president close our Embassy to the Vatican?" twittered Jeb Bush. "Hopefully, it is not retribution for Catholic organizations opposing Obamacare." As political tweets go, this is a keeper on two counts. First, we can once again marvel at Republican politicians' ability to insert the Affordable Care Act into everything (Gail Collins, 1/22).

The New York Times: The First Amendment Protects Abortion Providers, Too
On Friday a district court judge in North Carolina issued a ruling that blocked the state's ultrasound law from going into effect -- a move worth celebrating on the 41st anniversary of Roe v. Wade, and at a time when Republican-led states are rushing to enact aggressive new abortion restrictions. Enacted in 2011 over the veto of then-Gov. Beverly Perdue, a Democrat, and similar to other restrictions lately enacted around the country, this atrocious provision sought to force women seeking an abortion to undergo a "narrated" ultrasound. Judge Catherine Eagles said that the law, which requires abortion-providers to display the ultrasound while describing the images in detail, violates the physician's free speech rights (Dorothy J. Samuels, 1/22). 

Politico: 2014: The Year The Pro-Choice Crowd Fights Back
Sure, 2013 was not a great year for reproductive freedom -- 53 anti-choice measures were adopted at the state level, and we narrowly averted a federal government shutdown when House Republicans demanded that bosses have control over their employees' birth control coverage (though we later had a shutdown, anyway). But 2013 also showed record-high public support for the rights enshrined in Roe v. Wade: Twice as many pro-choice measures as the prior year were enacted at the state level, and voters turned out to vote into office a pro-choice governor in Virginia and soundly defeat the first municipal ballot measure to ban abortion after 20 weeks. In 2013, we saw a movement starting to embody the old adage that the best defense is a good offense (Ilyse Hogue, 1/21).

The Washington Post: Antiabortion Movement Faces A Cold Reality
James Dobson's Focus on the Family asked Christians to pray for rain to fall on Barack Obama in 2008 when he accepted the presidential nomination. Various religious conservatives have said that hurricanes, earthquakes and other meteorological phenomena were divine punishment of wayward humans. So what are we to make of Wednesday's March for Life on the Mall in Washington? The temperature was 12 degrees at the start of the annual antiabortion event, the wind chill below zero, and participants were trudging about in snow and ice from the previous day's storm (Dana Milbank, 1/22). 

JAMA: The Public Health Challenge Of Drug Overdose
The surge in prescription opioid overdoses is a leading national public health crisis, says the U.S. Centers for Disease Control and Prevention, one with a toll of more than 15 000 deaths in the United States each year. Since 1999, deaths from overdose of prescription opioids have increased 4-fold among US women and by 265 percent among US men. As in the fable of the blind men and an elephant, there are many different ways to look at this epidemic -- and just as many ideas on how to address it (Dr. Joshua Sharfstein, 1/22).

The New England Journal of Medicine: Choosing Wisely -- The Politics and Economics Of Labeling Low-Value Services
With its Choosing Wisely campaign, the American Board of Internal Medicine (ABIM) Foundation boldly invited professional societies to own their role as "stewards of finite health care resources." ... On the surface, the creation of low-value–service lists suggests that physicians are willing to make recommendations to improve health care value even against their own financial interests. The services included on the lists, however, vary widely in terms of their potential impact on care and spending. ... Strikingly, no major procedures -- the source of orthopedic surgeons' revenue -- appear on the list, though documented wide variation in elective knee replacement and arthroscopy among Medicare beneficiaries suggests that some surgeries might have been appropriate for inclusion. Other societies' lists similarly include low-impact items (Dr. Nancy E. Morden, Carrie H. Colla, Dr. Thomas D. Sequist and Meredith B. Rosenthal, 1/22).