July 22, 2014

Court rulings prompt confusion on ObamaCare subsidies

A pair of federal court rulings on Tuesday are causing some uncertainty over whether those buying insurance through federal health exchange will continue to qualify for subsidies.

In one case, an appeals court in the District of Columbia Circuit ruled the residents of 36 states that rely on the federal exchange do not qualify for subsidies. However, in a ruling in the 4th Circuit Court of Appeals just hours later, judge said subsidies are available to all residents who qualify for them, regardless of whether an exchange is state-based or run by the federal government. Wisconsin is one of the three dozen states that uses the federal exchange.

A spokesperson for Governor Scott Walker called the D.C. ruling an example of “how irresponsible it is to pass a law without knowing what is in it and what its impact will be on hard-working Americans. The federal government’s one size fits all approach is unsustainable.”

While both cases are likely to face more appeals and the District of Columbia ruling did not include an injunction, Robert Kraig with Citizen Action of Wisconsin says now may be a good time for states like Wisconsin, which relies on the federal exchange, to revisit their decision. He says “a lot of people are depending on the subsides to make health care affordable,” and any decision to uphold the D.C. ruling could make it difficult for about 4.5 million people nationwide to continue paying for coverage. Kraig says Wisconsin already had a prototype for a state-based exchange developed, and it would “really behoove state officials to start looking at that, just in case.”

About 130,000 Wisconsin residents signed up for coverage through the federal exchange. Of those, Kraig says “many” are receiving some form of subsidy to help pay for their insurance, based on their incomes.

Federal judge dimisses Johnson lawsuit

U.S. Senator Ron Johnson (R-WI)

U.S. Senator Ron Johnson (R-WI)

A federal judge in Green Bay is throwing out a lawsuit against provisions of the Affordable Care Act, which was filed by U.S. Senator Ron Johnson (R-WI).

Johnson, a Wisconsin Republican, argued that an ObamaCare rule forced him to treat his staff differently. Judge William Griesbach ruled Monday that Johnson and his aide Brooke Ericson did not have legal grounds to file the lawsuit, because they did not prove they were hurt personally.

Johnson was challenging a requirement that lawmakers and their official staff members use the ObamaCare exchanges to get their tax-subsidized health insurance. Those who are not official office staff still get their previous employee health benefits.

Johnson argued the rule forced him to choose which staff members are official and which are not. He also claimed that he was being forced to take part in a program he believes is illegal, and he would look bad to voters because his staff would get tax subsidies the general public does not receive.

Griesbach says Johnson’s beliefs about the legality of ObamaCare are not enough to win his lawsuit; and neither was the claim that voters would see him in a negative light.

Johnson said it was unfortunate that the judge dropped his lawsuit on a technicality, without going into the legal merits of it. His office says Johnson is consulting with lawyers before deciding whether to appeal.

Court clarifies state law on abortion pills

A judge is providing more clarity on a 2012 state law that deals with prescribing medications that can cause an abortion.

Planned Parenthood of Wisconsin challenged the law that requires doctors to meet in-person with a patient when prescribing drugs designed to terminate a pregnancy. CEO Teri Huyck says they were worried it also required doctors to be present when women took the medication, which is a problem because they usually require two doses. Hyuck says “the law was so vague, we weren’t sure how to comply with it.” She says the group worried that could result in criminal penalties or fines for their doctors.

The law is aimed at preventing so-called webcam abortions, a practice where doctors prescribe the drugs from another location. Those were not being used in Wisconsin prior to the bill’s passage, but Republicans and pro-life groups worried the method of consultation could make its way here in the future.

A Dane County judge issued a decision Thursday clarifying the law only applies to when an abortion-inducing drug is prescribed, and that doctors do not have to be present when the medications are taken. Hyuck applauded the decision, saying “we now know that our physicians don’t have to worry about being sent to jail.”

Attorney General J.B. Van Hollen was critical of Planned Parenthood for taking the issue to court, saying the judge’s decision affirmed what his office has said all along. In a statement, Van Hollen said “The decision is in accord with what the law is and what this office has always said the law is. No one ever tried to enforce the law differently. Planned Parenthood’s case was a frivolous action from the beginning, first in their dismissed federal case and now this case. Courts of law shouldn’t be stages for political theater funded by taxpayer dollars, but that’s the bill that Planned Parenthood has rung up.”

Coverage gap may exist for 38,000 Wisconsin residents

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Wisconsin Department of Health Services

Many of the Wisconsin residents dropped from the state’s BadgerCare Plus program earlier this year may be having a hard time obtaining coverage from somewhere else. New figures released by the state Wednesday show that, of the 63,000 people who lost coverage because of new income eligibility requirements, nearly 60 percent did not obtain new health insurance plans through the federal exchange system.

Majority Republicans in the state Legislature rejected federal funding to expand the state’s Medicaid program to cover all residents living at or below 133 percent of the Federal Poverty Level (FPL). Instead, they opted for a plan from Governor Scott Walker that called for covering all residents living at or below the FPL, which is about $23,850 for a family of four.

Figures released by the state Wednesday show that enrollment in BadgerCare under the changes has grown by 97,509 people, as of the end of June. Department of Health Services Deputy Secretary Kevin Moore says they “are very encouraged by the enrollment numbers.”

For those living above the FPL, backers of the plan argued they could purchase coverage through the federal exchange system. However, the state says nearly 60 percent of those who lost BadgerCare coverage did not purchase a plan through the exchange. Moore contends that some of those individuals may have purchased insurance through a non-exchange vendor or obtained it through their employer, but critics argue the state may be overstating that possibility.

Kevin Kane with Citizen Action of Wisconsin says it’s more likely that those who lost their BadgerCare and are living just above the poverty line simply can’t afford to buy coverage through an exchange, even with the federal subsidies that are being offered. He adds that only a small amount have jobs where employer-offered health insurance is even an option. Kane says studies have shown “less than even a fourth of them have access to employer coverage…and many of them are not going to be able to buy private health insurance without the tax credits that are available for low-income individuals.” He says it’s more likely those roughly 38,000 people are just going without coverage for the time being and paying the federal penalties.

Kane says the numbers released by the state are yet another sign Republicans should reconsider the decision to reject federal funding, which would allow the state to expand its Medicaid programs and cover more low-income residents.

Wisconsin woman featured in anti-smoking ad (VIDEO)

A Wisconsin woman’s story of smoking while pregnant is featured in a new ad aimed at helping others to quit. Amanda Brenden of Eau Claire was a 24-year old college student and a smoker when she gave birth prematurely to a baby girl who weighed only three pounds. She hopes her failure to quit her addiction will serve as a lesson to other moms.

“I think that women don’t think that something bad is going to happen to them, and I wanted to share my story to let pregnant women know that it can happen to you,” Brenden said during a press event Monday at the Capitol in Madison. Quitting smoking can be a challenge for anyone, but it can be even tougher for pregnant women. Brendon admitted that she smoked as way of dealing with stress, so it was hard to give up when dealing with the added stress of pregnancy.

Dr. Kathy Stewart, a UW physician who specializes in high-risk pregnancy, said women may not get a lot of support. “If everyone else is smoking, if dad is smoking, if grandparents are smoking and you’re in a community where smoking is acceptable, you’re asking one person to change when it’s a really stressful time in their life,” she said. Wisconsin has a culture of substance abuse that can also work against quitting. “We have a very high drinking and pregnancy rate, and I think some of that goes hand in hand,” said Tommi Thompson of the Wisconsin Women’s Health Foundation. According to research from UW-Milwaukee, 13 percent of pregnant women in Wisconsin smoke, compared to a national average of 10 percent.

Now seven, Brenden’s daughter suffers from asthma. “When I decided to be a part of this Tips campaign, I had to tell my daughter why she was born early, and get her permission to share this story,” she said. She credits the CDC campaign with inspiring her to finally quit smoking two years ago, with help through the WWHF First Breath program.