Supreme Court considers cases on abortion and contraception … another challenge to the ACA … state all-payer databases
Some had thought 2016 would be a quiet legal year for healthcare after last year’s frenzy over the premium subsidies case in the U.S. Supreme Court. Not likely.
This year, the Supreme Court will tackle abortion, contraceptive coverage, and a battle between states and self-insured employers over healthcare data. In addition, there’s a pending challenge to the Affordable Care Act in a lower court that worries ACA supporters.
The high court will decide Gobeille v. Liberty Mutual Insurance Co., a case involving whether an insurance company with a self-funded employee health plan must share data such as medical claims with the state of Vermont for its all-payer healthcare database. The case is being closely watched because it has implications for more than a dozen states with similar databases.
The insurance company in Gobeille argues that the federal Employee Retirement Income Security Act protects it from having to share that information, sparing it and other self-insured employers from being subject to different state laws. The state, however, says it needs the information for healthcare reform efforts. If the insurer wins, “these all-payer claims databases will be hollowed out,” said Nicholas Bagley, a University of Michigan law professor.
The high court also will decide major cases on abortion and contraceptive coverage. In Whole Woman’s Health v. Cole, abortion providers allege that a Texas law makes it too difficult for women to get abortions, abridging their constitutional rights. The law requires, among other things, that doctors at abortion clinics have admitting privileges at local hospitals.
The contraception cases involve challenges brought by religious not-for-profit groups that oppose having to play any part in providing birth control to employees. Those groups are challenging an Obama administration policy that says if they want to opt out of the ACA’s contraception coverage mandate, they must notify their third-party administrators or HHS so the government can arrange coverage. A decision likely will come near the end of the court’s term in June.
Meanwhile, in U.S. House of Representatives v.
Burwell, House Republicans allege that the Obama administration illegally funded the ACA’s cost-sharing subsidies for lower-income exchange plan members. Those subsidies, which are received by a large percentage of exchange plan members, make it more affordable for them to use their plans to obtain medical services.
It’s possible that U.S. District Judge Rosemary Collyer, a George W. Bush appointee who sounded sympathetic to the plaintiffs’ arguments in an earlier hearing, will decide the case soon. If she rules against the administration, “it will throw a wrench in the works,” Bagley said.