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NEWS FLASH

Obama May Allow Some Insurers To Opt Out Of Covering Birth Control | “The Obama administration is debating the inclusion of a conscience clause that would allow some insurers not to cover contraception on religious grounds, POLITICO’s Lester Feder is now reporting. “Internal disagreements over the issue have caused an announcement of the administration’s position to be delayed more than once this week” and a final announcement is expected Monday at 2 p.m. In a report released earlier this month, the Institute of Medicine (IOM) recommended that insurers provide coverage for contraception without additional cost sharing.

Economy

Judge Deals Final Blow To Milwaukee’s Paid Sick Days Law: ‘It’s Over’

In 2008, Milwaukee, Wisconsin became the third U.S. city — after San Francisco and Washington, DC — to require paid sick leave for workers, thanks to a referendum overwhelmingly approved by the city’s voters. However, back in May, Wisconsin’s Republican legislature passed, and notoriously anti-worker Gov. Scott Walker (R-WI) signed, a bill that took away the ability of cities to decide for themselves whether they want to mandate paid sick leave.

The sick days law has been tied up in the courts ever since, but yesterday, the Milwaukee County Circuit Court officially said that the state is within its rights to nullify Milwaukee’s law:

After three years of legal and political wrangling over the Milwaukee paid sick-day law that voters approved but business groups denounced, Milwaukee County Circuit Court Judge Thomas Cooper declared Thursday afternoon: “It’s over.”

In doing so he found the city law, passed by 69% of voters in November 2008 and upheld by the state Court of Appeals in March, was moot because of state legislation approved in April that voided it.

“I don’t feel real good about how this happened politically,” he said in announcing his ruling.

Judge Cooper said the bill was perfectly targeted to negate Milwaukee’s paid sick days law. “You put a bull’s-eye on paid sick days,” he said. The ruling comes on the heels of a few wins by proponents of paid sick days, as Connecticut became the first state to require them and residents of Denver got the issue onto November’s ballot. Philadelphia’s city council also approved a sick days bill recently, only to see it vetoed by Mayor Michael Nutter.

At the moment, the U.S. is all alone in the industrialized world in not mandating some form of paid time off for workers, and the U.S. economy as a whole loses $180 billion in productivity annually due to sick employees attending work and infecting other workers. Lack of sick days is a particularly acute problem in the food services industry (where sick workers attending work is obviously even more problematic). It’s a shame that the anti-worker fervor of Wisconsin’s Republicans goes so far as to nullify a law that the people of Milwaukee clearly wanted.

The Consequences Of Default For Health Care Providers

Kaiser Health News looks into the consequences of a possible default for the health care sector and finds that while providers wouldn’t feel an impact over several days, given their dependence on Medicare and Medicaid payments, a prolonged crisis could be “apocalyptic“:

But the worst case scenario here would be more apocalyptic, he says. That’s because health care providers would lose revenues from Medicare and Medicaid at the same time. Plus, a debt default could also unnerve the capital markets, making it difficult or impossible for providers to borrow money to stay afloat. And states are having so many financial problems that they’re not in a position to fill in the gaps.

Matt Salo, executive director of the National Association of Medicaid Directors, says that in the “worst-case scenario, Aug. 2 comes around with no deal, Medicaid is not going to shut down.” But if the bond markets melt down, states could face higher interest rates on money they’ve already borrowed from investors, making it even harder for states to pay their share of Medicaid, which is generally about half, he says. The federal government on average pays about 56 percent of Medicaid costs.

The administration will also be in a tough spot, having to figure out “which checks to issue and when after Aug. 2, since it will be missing about 40 percent of the cash required to pay its bills.” Experts expect for that order to look something like this: 1) pay interest on the debt, 2) send Social Security checks. Medicare payments could be held back, since a short delay is not expected to “jeopardize access as long as the crisis did not drag out too long and they were paid after the crisis ended.”

Economy

Hundreds Of Thousands Of Boehner’s Constitutents Would Be Hurt By His Debt Ceiling Plan

House Republicans met today in an attempt to scrape together votes to pass House Speaker John Boehner’s (R-OH) plan for raising the debt ceiling. Boehner pulled the bill from the floor last night when it became apparent that he didn’t have to votes to proceed, and has made it even more right-wing today in an attempt to drum up support.

As we’ve been noting, Boehner’s plan would batter the social safety net, forcing trillions of dollars in entitlement cuts and the passage of a balanced budget amendment, in order to raise the debt ceiling again when such a move becomes necessary in six months. As the New York Times put it, “Because the first round of cuts [in Boehner's plan] would eviscerate discretionary programs…the second round of cuts would need to come from Medicare, Medicaid, Social Security and other safety-net programs. To get cuts that deep in 10 years would require cutting the benefits of current retirees and beneficiaries or gutting health care reform, or savaging the safety net for low-income Americans, or some combination of the three.”

According to the Center on Budget and Policy Priorities, Boehner’s plan could cause one of the most dramatic increases in poverty and hardship of any law in history. Boehner’s bill actually eliminates a 26-year-old measure protecting the poor from budget cuts. This would have an adverse effect all across the country, including in Boehner’s district where, as Half in Ten’s Melissa Boteach and Jessica Liu found, hundreds of thousands of people rely on the social safety net that Boehner wants to eviscerate:

180,000 people are on Medicare or Medicaid, comprising 27 percent of his district.

4,000 households access some form of public housing assistance.

90,000 or 13.9 percent of the district lives below the poverty line.

– Approximately 70,000 households receive Social Security benefits.

– Over 30,000 households are eligible for the SNAP (food stamp) program and 20,000 low-income children are eligible for food and nutrition services.

“The House plan would result in an enormous increase in poverty and hardship while keeping Congress mired in a never-ending debate over default crises instead of a focus on jobs,” Boteach and Liu wrote. And Boehner’s constituents would certainly not be spared the pain.

Lawmakers Try To Repeal Long-Term Insurance Program As Baby Boomers Worry About Long-Term Medical Costs

The debt ceiling negotiations highlighted the great disconnect between public opinion and political reality, as lawmakers from both parties went after the very programs — Medicare, Medicaid, Social Security — that an overwhelming majority of voters are hoping to preserve. And no program was more easily discarded than the Affordable Care Act’s long-term health insurance program (CLASS). Lawmakers, government officials, and some advocates have all but given up defending the initiative, conceding that its somewhat problematic financial structure will eventually lead to its repeal. The Senate’s bipartisan Gang of Six (or seven) proposed eliminating the program in their debt ceiling package, as did the president’s Bipartisan Fiscal Commission.

This attitude persists despite seniors’ anxieties about growing old and being unable to pay their medical bills:

Many of the nation’s 77 million boomers are worried about being able to pay their medical bills as they get older, a new poll finds. The concern is so deep that it outpaces worries about facing a major illness or disease, dying, or losing the ability to do favorite activities.

Another major concern among the boomers: losing their financial independence.

The struggling economy, a longer life expectancy, ever-increasing health care costs and challenges facing Social Security are putting added pressure on the boomers, those born between 1946 and 1964.

According to the Associated Press-LifeGoesStrong.com poll, 43 percent of boomers polled said they were “very” or “extremely” worried about being able to pay for their medical costs, including long-term care. Almost the same number, 41 percent, said losing their financial independence was a big concern.

One wonders if CLASS would still be traded so nonchalantly in negotiations if members of Congress were of the same economic class as their constituents, were stripped of the government-sponsored long term insurance they currently enjoy, or knew of how desperately they needed its benefits.

NEWS FLASH

World Population Will Hit 7 Billion In 2011 Putting Pressure On Developing Nations | The world population will reach 7 billion by the end of 2011, according to a new study released by the Harvard School of Public Health. Accompanying the population growth is a shift in the “demographic center of gravity” toward poor nations. Wealthier countries will see their populations age, but their numbers will remain relatively stable. The less-developed world, however, will cope with 97 percent of population growth over the next 40 years — almost half of which will fall to Africa. –Sarah Bufkin

Senators Demand To Know Why Government Is Trying To Limit Marketing Of Unhealthy Foods

Julian Pecquet reports that 19 senators from rural states have written a letter to the heads of four federal agencies demanding that they “justify their call for stringent voluntary restrictions on marketing food marketing to children”:

The letter to the agency heads, spearheaded by Sen. Mike Johanns (R-NE), requests the agencies to explain how they linked marketing to obesity. It also questions their nutritional recommendations and inquires about the economic impact to certain food sectors such as cereals, meats and cheese.

And it raises concerns with possible restrictions on the food industry’s support for “school and community philanthropic activities, including sports teams, literacy programs, and other health-promoting youth activities” and the “economic impact to schools and communities.”

A good place to look for answers about the links between advertising and obesity may be the White House’s obesity report, which found that food and beverage companies rely on a “full range” of marketing techniques to attract young consumers and that some — like the use of licensed characters — are particularly “effective and pervasive”:

Research conducted by the Sesame Street Workshop in 2005 found a strong influence of popular licensed characters on preschoolers’ food preferences. When preschoolers were asked if they would rather eat broccoli or a Hershey’s chocolate bar, 78% of the children chose the chocolate bar and only 22% chose broccoli. When an Elmo sticker was placed on the broccoli, however, 50% of the children chose broccoli. Not surprisingly, food marketers’ use of licensed characters in cross promotions targeting children has increased in recent years. At the same time, the nutritional quality of the products promoted by these characters has decreased.

Undoubtedly, the the Elmo sticker is more frequently appended to the Hershey’s bar than the broccoli. A recent study found that some of the nation’s’ largest food companies have “nearly doubled the use of licensed characters over the past four years, increasing from use in 8.8% of advertisements in 2005 to 15.2% in 2009. Roughly half of all advertisements with these characters are for foods in the lowest nutritional category,” it concluded.

The increases occurred despite the food industry’s voluntary pledge to advertise healthier foods, suggesting the senators may right in raising concerns about the restrictions. Only, they’re asking the wrong questions to the wrong crowd — their inquiry should focus on how the industry can “justify” the advertising increases, not why the government is demanding tougher — but still voluntary — advertising rules.

NEWS FLASH

Real Word Experience: IOM’s Preventive Services Recommendations Could Save Billions | California has already experienced the “health and fiscal benefits of increasing access to and coverage of the services” outlined in the Institute of Medicine’s recent recommendations that insurers offer preventative services for women at no additional cost sharing, California Family Health Council CEO Julie Rabinovitz notes. California’s Family Planning, Access, Care and Treatment, or Family PACT, cited as one of the nation’s most effective models in the Institute of Medicine’s report, has (along with Title X funding) “dramatically decreased the rates of adult and teen unintended pregnancies statewide and has resulted in tremendous savings to the public sector.” Over five years, Family PACT “saved an average of $14,111 public sector costs per averted pregnancy for a total of nearly $4.05 billion.” HHS is expected to decide if it is to accept the IOM’s recommendations by Aug. 1.

NEWS FLASH

Rep. Steve King: If One Person Dies Without Using Medical Care, Health Reform Is Unconstitutional | “Rep. Steve King used his time at the House Small Business health subcommittee yesterday to again question the constitutionality of the health care law,” Politico’s Pulse reports. King argued that if just one person declines any medical attention throughout his or her lifetime, then the 2010 law should be ruled unconstitutional. “If an individual is born and dies in a state, and doesn’t cross his state line and doesn’t use medical care of any kind — and that happens — how is it they are engaging de facto in interstate commerce?” he asked. But this directly contradicts what Judge Jeffrey Sutton — a former clerk to conservative Justice Antonin Scalia — concluded. In his ruling upholding the Affordable Care Act, he found that the law is only unconstitutional if it is found so in every instance.

Abortion Rights Group: Many 2012 Republicans Oppose Funding Contraception, Access To Abortion

Yesterday, NARAL Pro-Choice America released the first of what would be several reports analyzing how the potential GOP presidential candidates threaten women’s access to reproductive services. As Julie Rovner notes, “For the first time, many, if not most of the candidates have come out not just for the defunding of Planned Parenthood (which is at least arguably about abortion). Some have also voted against — and spoken out against — any kind of federal funding for contraception,” which the overwhelming majority of women support (and many) rely on. Below is a small compilation of their records:

– MICHELE BACHMANN: Bachmann has cast 12 “anti-choice” votes during her time in Congress: the No Taxpayer Funding for Abortion Act, prohibiting the District of Columbia from using local revenue to provide abortion services for low income women, and blocked the Food and Drug Administration from using funds for testing, approving or regulating the abortion-inducing drug mifepristone. In the Minnesota state Senate in 2001, she co-sponsored a constitutional amendment to block public funding of any organization associated with an organization that provides, counsels or refers for abortion.

– RICK SANTORUM: As a member of the House of Representatives, Santorum cast 27 “anti-choice” votes on reproductive-rights related issues; in the Senate he cast 72 out of 74 “anti-choice” votes. “He has voted for ‘personhood’ rights of an embryo, in favor of the Federal Abortion Ban and in favor of two Supreme Court and six lower court justice nominees with outspoken anti-abortion rights positions.”

– MITT ROMNEY: Romney’s record is mixed, as the former Massachusetts governor has shifted to his current anti-aboriton position. “In 2005 he vetoed a measure that would have increased access to emergency contraception by allowing pharmacists to dispense the pill without a prescription. From 1998 to 2006, the state used ‘abstinence-only’ funds for public service announcements, not classroom courses.”

– TIM PAWLENTY: While in Congress, “Pawlenty co-sponsored a bill that criminalized some abortion services and carried a 15-year prison sentence for doctors. As governor, he signed into law a measure that prohibits organizations receiving state funds from referring women for abortion services.” He has also signed several pro-choice measures, including “a bill ensuring access to emergency contraception for rape victims, a bill improving access to family-planning services for low-income women and a bill expanding Medicaid to cover more pregnant low-income women in Minnesota.”

– JON HUNTSMAN: As governor, “Huntsman signed into law measures that established a state fund to defend abortion restrictions in court, criminalized some abortion services and required minors seeking abortions to notify their parents even if they come from purportedly ‘violent, abusive, or neglectful homes.’” Huntsman also enacted pro-choice reforms: “a bill that promotes sexually transmitted disease prevention by establishing a public education campaign and a bill that ensures that sexual assault victims receive information on and access to emergency contraception.”

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Morning CheckUp: July 29, 2011

Vote delayed on Boehner plan: “House Republican leaders will try to regroup Friday after being forced to pull the plug on a vote to raise the debt limit and trim deficits when a core of conservative members refused to back the plan, with some of them demanding fundamental changes in its approach.” Some conservative members wish to include “a stricter requirement for a balanced budget amendment to the Constitution” and the House will hold votes “on two different versions of a balanced-budget amendment to the Constitution” today. [CQ]

High risk pools causing people to stay uninsured: “HuffPost first reported on this phenomenon in February, when an Arizona couple canceled their expensive health insurance policy so they could wait six months for the government’s more affordable deal. They said their monthly premiums had jumped from $1,700 to nearly $2,500 in just one year and that they couldn’t keep up.” [Arthur Delaney]

Building support for Part D rebates: “Reps. Henry Waxman (D-CA) and and Pete Stark (D-CA) on Thursday (July 28) issued a Dear Colleague letter in an effort to garner more support for their legislation that would expand Medicaid rebates into the Medicare Part D low-income subsidy program, and cut the deficit by $120 billion.” [Amy Lotven]

No new grandfather regs: “CMS Center Consumer Information and Insurance Oversight Director Steve Larsen appeared to signal Thursday that it is unlikely there will be additional guidance relating to the health reform law’s grandfathering of health plans, telling lawmakers he could not speak to whether there would be new guidance.” [Rachana Dixit]

HHS to fix subsidy glitch: “Federal regulators plan to soon address a glitch in the healthcare law’s subsidies that could stick families with high health insurance costs, insurance reform chief Steve Larsen testified Thursday during a hearing on the law’s impact on small-business coverage.” [The Hill]

Kansas PP defunding part of national trend: “A law stripping the Kansas Planned Parenthood chapter of its funding is part of a national campaign to cut off the entity’s federal family planning money because of its advocacy of abortion rights, lawyers for Planned Parenthood of Kansas and Mid-Missouri argued in a court filing.” [AP]

Court upholds bubble law: “A federal appeals court upheld Oakland’s so-called “bubble” law prohibiting protestors from coming within eight feet of abortion clinics or anyone entering abortion clinics…The court said the city erred when it let supporters offer words of encouragement to women entering a clinic but banned opponents trying to dissuade patients from having abortions.” [KSBW]

Senators question advertising-obesity connection: “Nineteen senators from rural states demanded Thursday that federal agencies justify their call for stringent voluntary restrictions on marketing food marketing to children.” [The Hill]

Convenient health: “House calls, workplace clinics and free-standing emergency rooms. And, most of the time, insurers will cover the visit.” [Kaiser Health News]

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