Today, in Thomas More Law Center v. Obama, the Sixth Circuit upheld the constitutionality of the individual mandate in the Affordable Care Act. It is the latest court to weigh in on this issue, but everyone agrees that the fate of the law will ultimately be decided the U.S. Supreme Court.

- For more on the constitutional arguments for and against the individual mandate, click here for my earlier post The Constitutionality of the Individual Mandate.

-To track all of the pending legal challenges to health reform, go to the Health Law & Litigation website.

Last month, I wrote a blog post about why Ryan's plan to turn Medicaid into a block grant program would harm Medicaid consumers and states. Last week, two professors at the School of Public Health & Health Services at George Washington University authored a report titled Medicaid Works: A Review of How Public Insurance Protects the Health and Finances of Children and Other Vulnerable Populations, which provides further evidence that the Ryan plan is not the right solution to rising health care costs. The Medicaid Works Executive Summary lists some of the report's key findings:

- Medicaid and CHIP (the Children's Health Insurance Program) provide an essential source of coverage for children with serious health conditions, like asthma, autism, dental and vision problems, ADHD, developmental delays, depression, and seizure disorders. Adults and the elderly with serious health conditions also benefit greatly from Medicaid.

- Medicaid and CHIP are cost-effective because they increase access to preventive health care (including well-child care and vaccinations) at a per-person cost of 20 to 27 percent less than private health insurance: "While Medicaid spending has risen due to the growing number of people who are in need of coverage, Medicaid per-capita expenditures have grown much less than private health insurance premiums and more slowly than oveall healthcare cost growth.

- Medicaid and CHIP already give states enormous flexibility in how they design their programs to meet their populations' needs. As a result, "state Medicaid programs have served as innovators to test a variety of cost-containment and quality care initiatives including payment reform, managed care, patient-centered medical homes, quality measurement, and home and community based care."

- Medicaid and CHIP protect families' finances during times when they are already struggling: "the data is clear that economic downturns take a much greater toll on Medicaid enrollees." For these enrollees, the Ryan plan could be devastating because it would remove a critical source of financial protection, as well as health care. The Medicaid Works report predicts that the Ryan plan will force states to make drastic cuts in Medicaid and that "about 31 to 44 million fewer people would be covered by Medicaid a decade from now than under current law."

Despite the Medicaid program's success, a common complaint by Medicaid consumers is the inability to find a doctor or other provider willing to treat them. According to a recent poll by the Kaiser Family Foundation, 32% of people who had been covered by Medicaid at some point in their lives reported having difficulty finding a provider willing to accept Medicaid, compared to only 13% of those with private insurance. I've discussed this Medicaid access problem in prior posts. It is clear that declining reimbursement and drastic cuts are one cause of this access crisis. The other cause is a lack of clear legal standards and accountability when states violate federal law and impose arbitrary cuts that threaten health care access. The Ryan plan would exacerbate both of these problems.

The Medicaid Works report was commissioned by First Focus, which describes itself as a bipartisan advocacy organization dedicated to making children and families a priority in federal policy.

The National Health Law Program (NHeLP) and the O'neill Institute for National and Global Health Law recently launched a website designed to track the various legal and state legislative challenges to health reform. The new Health Law & Litigation website is a great practical resource for policymakers, practitioners, scholars, and anyone else interested in tracking health reform developments.

Kaiser Family Foundation also provides a web resource to track health reform implementation that is particularly helpful for consumers, as well as patient advocates. It provides information about evolving rules and guidance for expanding private and public insurance. It also discusses the impact of health reform on employment-based insurance and Medicaid access.

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Policy Briefs, Reports & Statistics on Access

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