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  Health Care - Legal News


Uncertainty over the future of health care for millions grew deeper Monday as insurers released a blueprint for stabilizing wobbly markets and the Trump administration left in limbo billions of dollars in federal payments.

At the federal courthouse, the administration and House Republicans asked appeals judges for a 90-day extension in a case that involves federal payments to reduce deductibles and copayments for people with modest incomes who buy their own policies. The fate of $7 billion in “cost-sharing subsidies” remains under a cloud as insurers finalize their premium requests for next year.

The court case is known as House v. Price. In requesting the extension, lawyers for the Trump administration and the House said the parties are continuing to work on measures, “including potential legislative action,” to resolve the issue. Requests for extensions are usually granted routinely.

Hours before the filing, a major insurer group released a framework for market stability that relies in part on a continuation of such subsidies.

The BlueCross BlueShield Association represents plans that are the backbone of insurance markets under the Affordable Care Act, or ACA, and would also be the mainstay with a Republican approach.

As the GOP-led Congress works on rolling back major parts of the Obama law, the BlueCross BlueShield plan called for:

Continued protections for people with pre-existing medical conditions and sustained federal funding to offset the cost of care for the sickest patients.

More leeway for states to experiment with health insurance benefits, with a basic floor of federal standards.

Preserving ACA consumer safeguards including no lifetime caps on benefits, no higher premium for women based on gender, and a requirement that insurers spend a minimum of 80 cents of every premium dollar on medical care.


A media advocacy group and the American Civil Liberties Union are asking Missouri's highest court to settle whether the state's prison system must reveal the closely guarded source of the drug it uses in executions.

The nonprofit Reporters Committee for Freedom of the Press, the American Civil Liberties Union and other plaintiffs asked the Missouri Supreme Court on Wednesday to review the matter, saying the issue has led to conflicting lower-court rulings.

The Missouri Department of Corrections has refused to disclose who supplies it with pentobarbital, saying suppliers' identities are shielded as part of its "execution team."

But the sources of the drugs in Missouri and other death-penalty states are widely believed to be compounding pharmacies, which make drugs tailored to a client's specific needs. Those pharmacies do not face the same approval process or testing standards of larger pharmaceutical companies, spawning lawsuits by watchdogs pressing for them to be publicly known and properly scrutinized.

Wednesday's filing insisted that "any resolution of this question directly affects the ability of the public to exercise effective oversight."

"Transparency is critical for the public to maintain trust in the manner in which executions are carried out in this state," the filing added. "Given this court's special, constitutionally enshrined role in monitoring executions in Missouri, it is in the best position to resolve this issue of immense public interest."

The Missouri Department of Corrections has not returned calls left Thursday morning seeking comment.

The Missouri Court of Appeals' Western District ruled in February that prison administrators aren't obligated to divulge who supplies the execution drugs, overturning a 2016 trial court ruling that found the state wrongly withheld documents that would identify pharmaceutical suppliers.



Neighbors' efforts to block the reopening of a mine in a historic Nevada mining town have unearthed a legal question about whether emails kept by elected officials on their personal devices are public records.

The Comstock Residents Association wants the Nevada Supreme Court to order Lyon County to release communications between county commissioners and Comstock Mining Inc. ahead of a January 2014 decision to allow mining again at Silver City.

The question focuses on whether the public has a right to government information contained on personal electronic devices and in personal email accounts.

Senior Washoe County District Court Judge Steven Kosach rejected the request earlier this year, ruling records on personal devices and accounts are outside the public agency's control and aren't covered under the Nevada Public Records Act.

The judge also found the communications were not official actions. But he acknowledged his ruling "may cause public employees to skirt the provision of the (public records law) by conducting business on their personal devices," the Las Vegas Review-Journal reported.

Barry Smith, director of the Nevada Press Association, said the lower court ruling allows the "electronic version of the old backroom deal."

"Officials could avoid the open-records law by conducting public business through their private phones and email accounts," Smith said.

In a brief filed Nov. 7 with the state high court, association attorney Luke Busby said the court's decision would provide "critical guidance" to public officials about access to public records.

In court filings, Busby noted that then-Commissioner Vida Keller said at the January 2014 commission meeting that she had contacted her colleagues outside the public meeting regarding the land-use change.

"As it turned out, Commissioner Keller and other members of the Lyon County Commissioners used their personal devices or email accounts to conduct official business," Busby said. "An otherwise public record does not lose public status simply because it was created, received or stored on a personal device or personal account."



A Lexington abortion clinic has asked the Kentucky Supreme Court to overturn an appellate court ruling that closed the clinic.

The Lexington Herald-Leader reports the Kentucky Court of Appeals on June 15 reversed a Fayette Circuit Court ruling and granted the Bevin administration's request to close the EMW Women's Clinic of Lexington until it receives a license from the Cabinet for Health and Family Services or until a final judgment is rendered in the case.

The clinic, represented by attorney Scott White, asked the highest court for a reversal Tuesday. White says the clinic is basically "shut down."

At issue is whether the clinic may operate as an unlicensed doctor's office that performs abortions, as it has for years, or whether it is a full abortion clinic that requires state licensing.

Kentucky's only licensed abortion clinic is in Louisville.



The Supreme Court has rejected another challenge to President Barack Obama's health care overhaul.

The justices on Tuesday left in place lower court rulings that dismissed a lawsuit against the national health care law. The suit argues that the law violates the provision of the Constitution that requires tax-raising bills to originate in the House of Representatives.

The court has twice turned back major challenges to the law, in opinions written by Chief Justice John Roberts in 2012 and in June. The court also has allowed family-owned businesses with religious objections to opt out of paying for contraceptives for women covered under their health plans. The Pacific Legal Foundation backed the latest lawsuit, filed on behalf of small-business owner Matt Sissel.


The federal health care law doesn't infringe on the religious freedom of faith-based nonprofit organizations that object to covering birth control in employee health plans, a federal appeals court in Denver ruled Tuesday.

The case involves a group of Colorado nuns and four Christian colleges in Oklahoma.

Religious groups are already exempt from covering contraceptives. But the plaintiffs argued that the exemption doesn't go far enough because they must sign away the coverage to another party, making them feel complicit in providing the contraceptives.

The 10th Circuit Court of Appeals disagreed. The judges wrote that the law with the exemption does not burden the exercise of religion.

"Although we recognize and respect the sincerity of plaintiffs' beliefs and arguments, we conclude the accommodation scheme ... does not substantially burden their religious exercise," the three-judge panel wrote.

The same court ruled in 2013 that for-profit companies can join the exempted religious organizations and not provide the contraceptives. The U.S. Supreme Court later agreed with the 10th Circuit in the case brought by the Hobby Lobby arts-and-crafts chain.



The Iowa Supreme Court has struck down a restriction that would have prevented doctors from administering abortion-inducing pills remotely via video teleconferencing, saying it would have placed an undue burden on a woman's right to get an abortion.

Iowa is one of only two states that offers so-called telemedicine abortions — Minnesota offers them on a smaller scale — and doctors at Iowa's urban clinics that perform abortions had been allowed to continue offering the remotely-administered abortions while the ruling was pending.

Planned Parenthood's local affiliate, Planned Parenthood of the Heartland, had sued the Iowa Board of Medicine over its 2013 decision that would have required a doctor to be in the room with a patient when dispensing abortion-inducing medication.

The board cited safety concerns when it passed the rule requiring a physical examination, but Planned Parenthood and other critics said it was just another attempt by abortion rights opponents to make it harder for women to get abortions. They said the Iowa board's restriction particularly would have made it harder for women in more rural areas who don't live near the few urban clinics where doctors who perform abortions are based.


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