A study from the Commonwealth Fund found that adults receiving health care through Medicare receive higher quality care than those who have insurance through their employers or purchase their own coverage.

The report concluded that Medicare beneficiaries are both the most satisfied with their insurance, and also the least likely to have problems paying medical bills. Fifty-eight percent of adults with individual insurance report spending 10 percent or more of their income on medical costs, compared to only 29 percent of adults with medicaid. Similarly, the study found that “only 13 percent of Medicare beneficiaries were unable to pay for basic necessities such as food or rent or used up all their savings to cover medical bills, compared to 27 percent of adults with employer-based insurance and 33 percent with individual insurance.”

The findings of the study are especially pertinent as Republicans attempt to repeal the Affordable Care Act. As ThinkProgress noted earlier this month, the repeal of the Affordable Care Act would put the Medicare system in disarray and would make it impossible for Medicare to pay doctors. The authors of the Commonwealth study noted the political turmoil surrounding Medicare:

Given the evidence that people covered by Medicare tend to feel more satisfied with their insurance plan, particularly compared to those covered by nongroup insurance plans, offering traditional Medicare coverage to the nonelderly population not on Medicare through state insurance exchanges may be an option to consider. In addition, offering a choice of traditional Medicare and Medicare Advantage plans to the nonelderly population would build on Medicare’s wide provider network and experience in making care available to more Americans at lower costs.

In the midst of trying to decrease deficits and reform the health care system, the Commonwealth’s study highlights the potential for the expansion of public health care programs. The positive experiences of Medicare beneficiaries only further substantiate the benefits of such programs.

– Nina Liss-Schultz

Some Republican governors continue to resist implementing health insurance exchanges in their state as required under the Affordable Care Act, but former Senate Majority Leader Bill Frist (R-TN) is urging Republicans to embrace health reform. In an editorial for The Week, Frist argues that both parties should accept the exchanges, which originated as a “Republican idea”:

State exchanges are the solution. They represent the federalist ideal of states as “laboratories for democracy.” We are seeing 50 states each designing a model that is right for them, empowered to take into account their individual cultures, politics, economies, and demographics. While much planning has yet to be done, we are already seeing a huge range in state models. I love the diversity and the innovation.

States have until November to turn in their exchange plans, but governors in states like Florida, Wisconsin, and South Carolina are refusing to act on the law until after the November election if Mitt Romney is elected and tries to repeal the law. After the Supreme Court ruled on Obamacare, Sen. Jim DeMint (R-SC) called on the governors to ignore the ruling and stop implementing the state-level programs. But as Frist correctly notes, inaction would only lead the federal government to establish the new insurance marketplaces.

Yesterday, House Republicans unveiled their proposed budget for the Departments of Labor, Health, and Human Services. One of its provisions “terminates” the Agency for Healthcare Research and Quality (AHRQ), which was created under President Reagan to research which health care treatments are actually effective and hence which ones can be used to save the most lives, research that:

• Reduces life threatening medical errors: According to Mary Woolley, President and CEO of Research!America, “[AHRQ] is addressing medical errors that kill more than 100,000 people a year” by funding research into how doctors can treat illnesses without risking serious mistakes.
• Lowers rates of Pneumonia: AHRQ funded research developed a technique for reducing rates of ventilator-associated pneumonia, a “common cause of increased rates of patient illness and death,” by 70%. Pneumonia more broadly killed about 55,000 Americans in 2006 and kills about 1.4 million children per year worldwide.
• Provides doctors with medical research: Kenny Lim, who directs Primary Care Health Policy Fellowship at Georgetown University School of Medicine, argues that AHRQ research on research effectiveness helps “a doctor like me make good choices about which treatment to give each patient” given that “there’s often little or no reliable information about whether a new drug is actually an improvement over existing therapies.”

AHRQ is also critical to addressing our health care spending crisis. The increasing cost of treatment is driving rising health care costs, which makes understanding what treatments can be used most effectively and cheaply in any given case critical to reigning in rising costs. Researching precisely that question is AHRQ’s bread-and-butter, which is why Lisa Simpson, President and CEO of AcademyHealth, calls the House bill “a devastating attack on health research funding at a time when this work is most critically needed” as AHRQ is “the very agency tasked with generating the evidence necessary to build a higher-quality, higher-value health care system for the American people.”

Ironically, the House celebrated the draft budget as a measure aimed at “protecting life.”

A Nebraska federal judge has dismissed a lawsuit in which Republican attorneys general in seven states tried to block the Obamacare provision requiring contraceptive coverage in employer-provided insurance plans.

The seven state officials, along with three Nebraska-based Catholic institutions, filed their lawsuit on false grounds that the ACA’s contraceptive provision violates the Constitution’s guarantee of religious liberty by forcing Catholics to pay for contraception against their beliefs. However, churches and other places of worship are already exempt, and the regulation also includes a work-around for Catholic-affiliated institutions who object to birth control so they can refer employees to an outside insurer for contraception coverage.

U.S. District Judge Warren Urbom ruled that the lawsuit is without merit, just as it appeared on the surface. Urbom pointed out that there is no evidence that religious groups are being forced to violate their conscience, especially since the provision will not go into effect until 2013:

URBOM: Although the rule that lies at the heart of the plaintiffs’ complaint establishes a definitive, final definition of ‘religious employer,’ the ACA’s contraceptive coverage requirements are not being enforced against non-exempted religious organizations, and the rule is currently undergoing a process of amendment to accommodate these organizations.

The plaintiffs face no direct and immediate harm, and one can only speculate whether the plaintiffs will ever feel any effects from the rule when the temporary enforcement safe harbor terminates. This case clearly involves ‘contingent future events that may not occur as anticipated, or indeed may not occur at all’…and therefore it is not ripe for review. None of the plaintiffs have established that they have standing to challenge the rule, and even if I were to assume that they did have standing, their claims are not ripe.

Obama has defended his contraception regulation, pointing out that “it’s not fair” for Catholic institutions to deny their employees birth control when there is already a compromise in place to prevent Catholic institutions from having to pay for the coverage directly. In fact, many large Catholic institutions like Georgetown University provided contraception coverage even before the ACA required them to do so.

Furthermore, the birth control regulation remains popular among the American public. An overwhelming majority of Americans — including Catholics — support coverage for contraceptive services. This ruling is only the most recent example of the fact that the Catholic case against the contraception mandate is easily dismantled.

In House Republicans’ latest attack on women, Rep. Denny Rehberg (R-MT) released a labor, health, and education spending bill on Tuesday that would allow employers to deny contraception coverage for “moral reasons.”

And the bill goes further. It would stop Planned Parenthood clinics from receiving federal funding until the health organization certifies that it no longer offers abortions, despite the fact that Planned Parenthood does not use federal funds on abortion services, and it attempts to halt Obamacare funding:

The legislation also states that none of its funds can be used to carry out the Title X family planning program or be used to “implement, administer, enforce, or further the provisions” of the Affordable Care Act.

The bill scraps the provision in Obamacare that requires insurance plans to cover birth control and other preventative health services, allowing any issuer or sponsor of a group health insurance plan to refuse to cover any health care service “on the basis of religious beliefs or moral convictions.” It also increases restrictions on educating abortion physicians beyond current law and allocates $20 million for “competitive grants to provide abstinence education to adolescents.”

House Appropriations Chairman Hal Rogers (R-KY) said the bill “reflects our strong commitment to reduce over-regulation and unnecessary, ineffective spending that feeds the nation’s deficits and hampers economic growth.” It is scheduled to be marked up in Appropriations Subcommittee on Labor and Health this morning, but it is unlikely to become law. House Democratic aides told the Huffington Post that Republicans will likely use the massive cuts to women’s health programs as a starting point in budget negotiations.

But as Planned Parenthood President Cecile Richards put it, the Republican-backed budget proposal is “badly out of touch with the needs of American women and families” because it eliminates a vital family planning program and would harm women’s health services.

House Republicans have already pushed a controversial ban on sex-selective abortions, and the Senate stopped Republican Sen. Roy Blunt’s (MO) amendment that would have empowered employers to deny coverage of health services to their employees on the basis of personal moral objections. And at the state level, Republican-dominated states have enacted 39 abortion restrictions so far this year. Rehberg’s budget proposal is only the continuation in an ongoing war on reproductive health.