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CHRT Blog

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Contraception Coverage and the Constitution

In the midst of all the election coverage—the daily hoopla and scoring of who is up and who is down—it would be very possible to miss an extremely important court decision on the Affordable Care Act, regarding the contraceptive coverage mandate included in the law’s implementation rules. On September 28, 2012, in a case brought by a Missouri mining company, …

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It’s the Math: The Medicaid Expansion in Michigan

In many respects, the Affordable Care Act is a law about health care coverage. It is designed to expand coverage, mostly by using two tools: (1) the requirement for individuals to have/purchase health coverage or face tax penalties (known as the individual mandate), and (2) the expansion of Medicaid eligibility to all with incomes at or below 138 percent of …

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Asking the right question about “two-tiered” care

When we think of two-tiered care in America, we most often think of the “haves” and “have nots”: those who are covered by health insurance and those who are not. But there is a different way to look at this question, and it may take being outside the U.S. to see it that way. Going back through old issues of …

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Funding Priorities in the ACA

Much of the discussion and press coverage of the Affordable Care Act (ACA) has been focused on provisions related to the expansion of coverage: the individual mandate, the Medicaid expansion, and to a lesser degree, health insurance exchanges. These provisions don’t go into effect until 2014. Other important parts of the ACA are already in place, and already making a …

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A Caveat on the Cheesecake Factory and Health Care

Atul Gawande’s latest article in the New Yorker magazine is a hot trending story in health care. It even spawned an editorial in the Wall Street Journal that seemed oddly confused about what Gawande was advocating. In his article, Gawande talks about lessons learned from quality and cost control processes at a restaurant chain called The Cheesecake Factory, and argues …

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The Lesser Known Parts of the ACA and Medicaid

Since the Supreme Court ruling on the Affordable Care Act (ACA), the discussion about Medicaid has largely focused on a choice states now have: whether or not to expand coverage to those at or below 138 percent of poverty. This issue is extremely important because of the impact it could have on those who are uninsured today. However, there is …

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Health Reform on the Ground: The Case of Cheboygan Memorial

Debates about the Affordable Care Act continue—especially in this election year—but health reform is already happening all around us. All we need to do is look. Case in point: Cheboygan, Michigan, where the local hospital was closed suddenly at the beginning of April, and then resurrected—in a different form—in mid-May. Initial press reports about the closure left the impression that …

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A Failure to Communicate: How Washington Drops the Ball

Earlier this year, on April 3, the Cheboygan News reported that Cheboygan Memorial Hospital was closing unexpectedly. The hospital had been in a purchase agreement with McLaren Health Care, based in Flint; the closure came as an unwelcome surprise to many in the community. Here’s what was in the press as it became clear the hospital would close in early …

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After the Ruling on the Affordable Care Act: Can We Just Give it a Chance?

It is hard for me to understand why opponents of the Affordable Care Act (ACA) react so negatively to the law and use such vitriolic language in describing their views. There is a legitimate public policy debate about this law, but the policy debates have not been much in evidence in the aftermath of the June 28 Supreme Court ruling. …

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A Remarkable Day in Healthcare

It is a remarkable day in healthcare in America. The Affordable Care Act is largely upheld and millions of people can stop holding their breath. Whether you were in support of the law or opposed to it, you now know where things stand in the legal system. And, it is good. Millions of people who have not been able to …

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