The question of whether the Affordable Care Act (ACA) can proceed without the mandate that all US individuals purchase health insurance or pay a penalty if they don’t is just one of several questions the Supreme Court will have to decide by June or whenever it issues its opinion. It depends in part on how the Court looks at the issues that have been brought before it. It is the mandate that is being challenged as being unconstitutional, not the other portions of the bill, as well as whether the ACA’s provision for Medicaid expansion is coercive. Continue reading
This week, we were treated to the spectacle of the US Supreme Court debating economics. They called it a discussion about the Affordable Care Act (ACA), but it was more economic than legal. They spent an enormous amount of time on markets for health insurance and food (broccoli, to be specific); they spent little time analyzing precedent. Between the 9 justices and the 7 lawyers, there were 16 people who took part in the debate. As best as I can tell, not one of them had any training in economics. Continue reading
The finding, presented yesterday at a meeting of the American Chemical Society, showed that the standard enzyme-linked immunosorbent assay (ELISA) used by the food industry can’t always pick out milk proteins that have aggregated or changed shape during thermal and non-thermal food processing. Continue reading
When insurance companies pass a larger share of the costs of asthma medications along to families, children aged 5 years or older use slightly less medication and are hospitalized more frequently, report researchers in this week’s JAMA. But such cost sharing had no significant effect on medication use or hospitalization among children younger than this age threshold.
Few studies have probed the effects of cost sharing on medication use in children. To investigate this issue, Anupam B. Jena, MD, PhD, of Massachusetts General Hospital and Harvard Medical School, and his colleagues conducted a retrospective cohort study of 8834 US children with asthma to analyze the effects of out-of-pocket costs on medication adherence, hospitalization, and emergency department use. They found that the average out-of-pocket cost of a year of asthma medication was about $150. An increase in the out-of-pocket cost for a medication led to reduced medication use among children 5 years old or older but not younger children. The authors noted that this age-related difference might be because younger children are more likely to have more severe asthma or their parents may more tightly control their medication use. Older children whose medications costs were higher also had more hospitalizations but did not make more emergency department visits. Dr Jena discussed the findings with news@JAMA. Continue reading
“The revolution will not be televised,” poet-musician Gil Scott Heron famously said, and apparently neither will the US Supreme Court case reviewing whether the Affordable Care Act (ACA) is constitutional.
About a week before the historic proceedings got under way at the Court, Chief Justice John Roberts reported that the Court had rejected requests from members of Congress and news organizations for live, televised coverage of the arguments on the ACA. However, the Court did agree to release audio recordings of the proceedings on the same day. Somewhat unimpressed by this offer, Democratic Senator Richard Durbin of Illinois said that “For that gesture, I guess we can congratulate the United States Supreme Court for entering the radio age.” Continue reading
So much attention has been paid to the individual mandate that relatively few have bothered to focus on the other questions that will be debated tomorrow in front of the Supreme Court. One involves the expansion of Medicaid, and it is absolutely worth some time. Continue reading
Dinner conversation about the Affordable Care Act (ACA) can turn an otherwise lovely evening with friends into eye-glazing tedium. I feared I had been the catalyst for such a transformation a couple of weeks ago when my husband and I had dinner with a friend, whom I’ll call John. Continue reading