Health insurers and supporters of the Obama administration’s health-care reform law are currently in the midst of drawing up possible contingency plans in case the Supreme Court overturns the Affordable Care Act’s individual mandate.

The insurance industry argues that premiums are likely to skyrocket without the individual mandate in place to aid in pushing millions of new enrollees into the marketplace, as healthy people will be less likely to buy insurance, while insurers will still be required to sell policies to all applicants. In fact, a repeal of the individual mandate would increase insurance premiums by 25 percent, according to a study released by the Robert Wood Johnson Foundation.

“The insurance reforms would have to change if the mandate were struck,” said Justine Handelman, vice president of legislative and regulatory policy for the Blue Cross and Blue Shield Association trade group.

Health-insurance officials say that if the mandate is repealed, “their first priority would be persuading members of Congress to repeal two of the law’s major insurance changes: a requirement to cover everyone regardless of his or her medical history, and limits on how much insurers can vary premiums based on age.” Their next step would be to “set rewards for people who purchase insurance voluntarily and sanction those who don’t.”

Other possible alternatives to the individual mandate that insurers are weighing:

- Penalize those who enroll outside of short annual windows; deny treatment for specific conditions, especially right after a policy is purchased

- Reward certain insurance buyers, such as offering much lower premiums for younger and healthier people

- Expand employers’ role in automatically enrolling employees for health insurance

- Urge credit-rating firms to use health-insurance status as a factor in determining individuals’ ratings

Although the mandate has been upheld in two appeals courts, it was struck down in a third. The Supreme Court hearings are scheduled to begin March 26, and an official ruling is expected to be delivered in June.

– Fatima Najiy

As the Supreme Court prepares to consider the constitutionality of the Affordable Care Act, opponents of the law continue to lie about its consequences.

Just last week, Republicans misrepresented a Congressional Budget Office (CBO) report which said that the Affordable Care Act was expected to cost $50 billion less than they anticipated a year ago while extending coverage to 30 million Americans. In spite of what the report actually found, many Republicans have claimed that the cost of the bill would double. As FactCheck.org points out, Republicans appear to have reached their conclusion by distorting the math:

So, where did Republicans get their $1.76 trillion cost figure? That’s the gross cost for 11 years ending in 2022. Republicans inappropriately compare that figure to the original estimate of $938 billion for the 10-year period ending in 2019.

The 11-year figure is much higher because it includes three additional years of full implementation of the coverage provisions of the law. The federal subsidies and expansion of Medicaid, which are by far the most costly elements of the coverage provisions, don’t go into effect until 2014. So, that 2010-2019 estimate includes four years of very low coverage costs (relatively speaking), and the 11-year estimate only includes two years of very low costs, plus three extra years of full implementation costs.

It is worth noting that Republican attempts to repeal either the whole bill or parts of it are projected to increase the budget deficit, suggesting that Republicans are more interested in delivering a blow to President Obama than lowering the national debt. At least one conservative justice has also noted the potential for “economic chaos” if the law was struck down and health care costs rose as a result.

More to the point, however, this is not the first time that a CBO report on the health care law has been misrepresented by its opponents to make it seem like they reached a different conclusion. Nor is it the first time that claims about the law have turned out to be inaccurate. Even the suggestion that millions of Americans will lose workplace health insurance ignores the reality: While employer coverage will vacillate — as it has before the ACA was enacted — the vast majority of businesses say they will continue to offer coverage to employees when the law’s insurance exchanges start up. In fact, if Massachusetts’ health reform is any indication, employers are highly unlikely to dump employees into the exchanges.

With most legal observers believing the Court will ultimately uphold the Affordable Care Act, and few compelling legal arguments available for its opponents, it appears the only way they see fit to attack the law is to lie about it.

-Zachary Bernstein

Tennessee lawmakers will consider a controversial measure on Wednesday that could intimidate women seeking abortions by requiring that the names of doctors who perform the procedures be published online. The legislation, known as the Life Defense Act of 2012 or House Bill 3808, would restrict access to the procedure in two ways:

The first would require doctors to have admitting privileges at a hospital near where they perform abortions, while the second would require the Department of Health to release more information on abortions, including the name of the doctor who performed the procedure and demographics about the women who receive them.

The measure’s sponsor, Rep. Matthew Hill, R-Jonesborough, said at an initial hearing on the bill earlier this month that the reporting requirement writes into law a form that the Department of Health already asks providers to fill out whenever they perform an abortion.

“The Department of Health already collects all of the data, but they don’t publish it,” he said. “All we’re asking is that the data they already collect be made public.”

But the measure goes beyond existing reporting requirements and could undermine women’s right to privacy by allowing opponents to identify — harass and intimidate — patients who undergo the procedure.

The state’s Department of Health already reports information on the age, race, education, and number of children of women who receive abortions, and aggregates the data by region, “making it impossible for others to figure out who underwent an abortion procedure.” This bill, however, would require the department “to release patient data broken down by county” and could “reveal the identities of some women who receive abortions, particularly in small, rural communities.” “I think in some small communities that woman would be identified,” State Rep. Gary Odom (D) warned when a subcommittee advanced the measure earlier this month. “I think that by publicizing this, it would have serious consequences. … We know what has happened to physicians who perform abortions that there has been violence. … There could be violence against the women. … This is a dangerous piece of legislation. … I think this is full of meanness.”

Abortion providers could also be at risk, as abortion foes would now have a comprehensive list of the names of the doctors who perform the procedure. “In an environment where doctors are victims of violence — and we’ve had physicians who provide abortion care murdered in the past few years — I think this is an attempt to intimidate and allow for providers to be terrorized,” said Jeff Teague, president and CEO of Planned Parenthood of Middle and East Tennessee.