�������ýҕ�l

Even as Democratic presidential candidacies implode over Medicare for All, Republican state attorneys general and the Trump Administration are handing the left a political lifeline with an overbroad attack on ObamaCare in the courts. On Wednesday the Fifth Circuit Court of Appeals ensured this will drag on as it struck down the individual mandate and asked a district-court judge to determine if other parts of the law have to go too. The finding that the mandate is unconstitutional is straightforward though it should have little impact. Chief Justice John Roberts in 2012 upheld the Affordable Care Act’s (ACA) command that everyone purchase insurance on grounds that it was a “tax” on failing to buy insurance. In 2017 the GOP Congress set the penalty for failing to buy insurance at $0. If it doesn’t collect revenue, the Fifth Circuit now says, it can’t be a tax. (12/20)

Gov. Gavin Newsom, who praised the “Medicare for All” concept last year on the campaign trail, is thankfully offering a more nuanced view now. In announcing the creation of the Healthy California For All Commission, Newsom shrewdly said it would look at ways to expand health care that includes a single-payer government model but also the “hybrid” health systems used around the world. It’s not a given that single-payer is best, yet at Thursday night’s Democratic presidential debate, it was the center of attention. (12/20)

Health care is stuck in a bad place. It’s complicated, expensive, and fraught with disparities. Built to deliver acute care in a different era, health care services doesn’t work well enough at addressing the chronic diseases that account for more than 70 percent of US health care spending. This isn’t an indictment of the millions of dedicated professionals who provide care. It’s an indictment of a broken system that urgently needs transformation. Health care needs a new normal. (Elizabeth Teisberg and Scott Wallace, 12/23)

For all of the talk about our healthy economy, reflected in booming job creation numbers and a surge in new construction, one metric suggests a sickliness under the surface: the growing number of young children without basic health care coverage. A distressing report this month showed Texas has nearly 200,000 children under age 6 who lack health insurance, with a rate of uninsured youngsters (8.3%) that’s nearly twice the national average. Worse, the ranks of uninsured kids under age 6, once on the decline, have been growing over the past couple of years. In 2016, 1 in 14 young children in Texas didn’t have health insurance.Last year, it was 1 in 12, according to a report by Georgetown University’s Health Policy Institute. The report’s authors note this is a particularly troubling trend “during a time of economic growth when more children should be gaining health care coverage” (emphasis added). In our view, these numbers are the entirely predictable outcome of Texas’ stubborn refusal to expand Medicaid, the state’s harmful practice of kicking some kids off Medicaid midyear, and the cuts in federal grants and state outreach efforts that previously helped families obtain coverage. (12/22)