This is the most important week of President Obamas bid for a second term in November.

Consider:

The Supreme Court will rule not only on the constitutionality of Obamas landmark health-care law, but the highest court in the country also will hand down judgment on Arizonas stringent illegal immigration law.

Congress will be forced into action (or inaction) on federal student loans and highway projects both of which will expire within the next week.

The House will vote on whether to hold Attorney General Eric Holder in contempt of Congress due to his refusal to turn over some documents related to the Fast and Furious gunrunning operation.

Any one of those issues in isolation would be a major political event with resultant consequences on the presidential race. Combined them all in the space of a week and we may well look back at this coming seven days as where/when Obamas second term bid was made/broken.

We are in a short period right now where the candidates and the terms of the presidential debate will be defined, with several critical issues coming to a head and voters perceptions of the economy, and who will best deal with it, clarifying, said Steve Rosenthal, a longtime Democratic strategist.

First among equals when it comes to its impact on the dialogue of the presidential race is the Supreme Courts ruling on the Affordable Care Act, which is set to be handed down either Monday or Thursday.

The administration and Democrats spent the better part of a year wrestling the bill through Congress amid unified Republican opposition and worries within their party that they were doing too much too fast. When he signed the legislation into law, Obama touted it as a historic moment insisting he had done something that seven presidents had tried and failed to do and telling ABCs Charlie Gibson in December 2009 that this will be the single most important piece of domestic legislation passed since Social Security.

Given that proclamation, if the Court rules against the law its hard not to see it as a repudiation of a major part of Obamas first term in office.

Link:

Health-care ruling will cap a consequential week for Obama

By Mary E. OLeary, Topics Editor moleary@nhregister.com / Twitter: @nhrmoleary

There is a lot at stake.

Connecticut officials, like the rest of the country, are anxiously awaiting the Supreme Courts decision on health care reform, which could be announced as early as Monday.

It is generally conceded that the Obama administration has lost the public relations war over the Patient Protection and Affordable Care Act, and the reforms will remain controversial no matter what is upheld or struck down by the high court as the country heads to a presidential election in November.

Much of the discussion has centered on whether the individual mandate to buy insurance is constitutional, but changes to the wide-ranging market reforms that are rolling out, the establishment of insurance exchanges and a vote against increasing the Medicaid population could prove to be more problematic for the states.

It is estimated the Affordable Care Act would add coverage for some 30 million uninsured Americans, a total of 17 million through expanding Medicaid.

In Connecticut, estimates by the Rand Corporation are that 130,000 additional people would be on Medicaid, with 100 percent of the cost of the new enrollees picked up by the federal government for three years from 2014-16, slowly declining to 90 percent by 2020.

Rand estimated 10 percent of Connecticuts nonelderly population, or 310,000, will participate in the insurance exchange now being worked on, while the number of uninsured by 2016 will be about half of what it would be, or 170,000, rather than 340,000, if the ACA wasnt in effect.

Its hard to find a person who will not be touched by this decision, said Vicki Veltri, Connecticuts health care advocate. Everyone with coverage and those who need coverage will be affected in some way.

The court will look at the division of power between the states and the federal government and the ability of Congress to regulate commerce. It will decide if sections of the law can stand alone and whether this is the right time to rule on the constitutionality of the ACA or if it has to wait until 2014 tax returns are filed in 2015.

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Health care reform: Connecticut officials anxiously await Supreme Court decision

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Health Care Law: Supreme Court Decision Looming

WASHINGTON -- With the Supreme Court days away from ruling on the constitutionality of President Barack Obama's 2010 health care overhaul legislation, members of Congress are preparing to respond. One of the first out of the gate is Rep. Bill Cassidy, R-Baton Rouge, a doctor. Cassidy has introduced a bill that would change funding for Medicaid, the joint federal/state health program for the poor and disabled, that would give states more flexibility in spending scarce health resources.

Under the legislation, a state's share of funding would be limited to what is currently the lowest matching amount for the 50 states: the 24 percent share paid by Mississippi. Louisiana's matching share under the bill would drop from 27.2 percent to 24 percent.

Savings to the states would be offset, though, because Cassidy's bill would bar the use of other federal funds, or interagency transfers -- what the congressman calls "funny money" -- to pay the state matching shares.

As part of the plan, which Cassidy describes as a work in progress, states would be free to design health programs for their Medicaid recipients, and would be able to use savings from better preventative care, and elimination of fraud and abuse, to finance other Medicaid related programs.

"By modernizing the way Medicaid is financed and incentivizing better care, we can improve Medicaid's bottom line and patient outcomes," Cassidy said. "If nothing is done, the status quo will eventually bankrupt Medicaid and America. I hope this legislation encourages more debate and discussion on this critical topic."

The federal funding would be based on the number of Medicaid recipients in each state in four broad categories: elderly; blind or disabled; children; and adults. In that way, it differs from a block grant program that designates federal funds on a per-capita basis. Cassidy said funding should be based on Medicaid populations and the degree of care different groups of patients require.

For instance, he said, Louisiana has high levels of intense poverty, which carry high levels of diabetes, hypertension and kidney dialysis.

Louisiana Health and Hospitals Secretary Bruce Greenstein praised the Cassidy proposal, saying it would enable the state to develop innovative programs that will both lower costs and improve health. Greenstein talked about implementing an "outcome-based" reimbursement formula for Medicaid health providers, rather than the traditional pay per procedure.

The state has faced major cuts in Medicaid reimbursement, but Sen. Mary Landrieu, D-La., has helped pass a legislative fix that averted a major financial crisis.

Cassidy, who is thought to be a likely 2014 opponent to Landrieu's expected re-election bid, said he hopes his proposal can be crafted with input from members of both parties in a way that can get it through the House and Senate next year.

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Health care proposal gives Louisiana more Medicaid spending flexibility

Washington - With the U.S. Supreme Court set to rule as early as Monday on the fate of the 2010 health care reform bill, politicians say Congress will need to address the issue again.

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Health care reform debate to rage, regardless of high court ruling

By CONNIE CASS Associated Press

WASHINGTON (AP) - The Supreme Court's upcoming ruling on President Barack Obama's health care overhaul law comes after a century of debate over what role the government should play in helping people in the United States afford medical care. A look at the issue through the years:

1912: Former President Theodore Roosevelt champions national health insurance as he unsuccessfully tries to ride his progressive Bull Moose Party back to the White House.

1929: Baylor Hospital in Texas originates group health insurance. Dallas teachers pay 50 cents a month to cover up to 21 days of hospital care per year.

1935: President Franklin D. Roosevelt favors creating national health insurance amid the Great Depression but decides to push for Social Security first.

1942: Roosevelt establishes wage and price controls during World War II. Businesses can't attract workers with higher pay so they compete through added benefits, including health insurance, which grows into a workplace perk.

1945: President Harry Truman calls on Congress to create a national insurance program for those who pay voluntary fees. The American Medical Association denounces the idea as "socialized medicine" and it goes nowhere.

1960: John F. Kennedy makes health care a major campaign issue but as president can't get a plan for the elderly through Congress.

1965: President Lyndon B. Johnson's legendary arm-twisting and a Congress dominated by his fellow Democrats lead to creation of two landmark government health programs: Medicare for the elderly and Medicaid for the poor.

1974: President Richard Nixon wants to require employers to cover their workers and create federal subsidies to help everyone else buy private insurance. The Watergate scandal intervenes.

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US health care reform efforts through history

The Supreme Court will rule as soon as Monday on Obama's health care reform bill, and everyone agrees that it's the most important case since Bush vs. Gore in 2000.

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With fate of Affordable Care Act in the balance, all sides prepare

WASHINGTON The Supreme Court's upcoming ruling on President Barack Obama's health care overhaul law comes after a century of debate over what role the government should play in helping people in the United States afford medical care. A look at the issue through the years:

1912: Former President Theodore Roosevelt champions national health insurance as he unsuccessfully tries to ride his progressive Bull Moose Party back to the White House.

1929: Baylor Hospital in Texas originates group health insurance. Dallas teachers pay 50 cents a month to cover up to 21 days of hospital care per year.

1935: President Franklin D. Roosevelt favors creating national health insurance amid the Great Depression but decides to push for Social Security first.

1942: Roosevelt establishes wage and price controls during World War II. Businesses can't attract workers with higher pay so they compete through added benefits, including health insurance, which grows into a workplace perk.

1945: President Harry Truman calls on Congress to create a national insurance program for those who pay voluntary fees. The American Medical Association denounces the idea as "socialized medicine" and it goes nowhere.

1960: John F. Kennedy makes health care a major campaign issue but as president can't get a plan for the elderly through Congress.

1965: President Lyndon B. Johnson's legendary arm-twisting and a Congress dominated by his fellow Democrats lead to creation of two landmark government health programs: Medicare for the elderly and Medicaid for the poor.

1974: President Richard Nixon wants to require employers to cover their workers and create federal subsidies to help everyone else buy private insurance. The Watergate scandal intervenes.

1976: President Jimmy Carter pushes a mandatory national health plan, but economic recession helps push it aside.

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Supreme Court ruling caps a century of American debate over how to get medical care for all

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Health Care Reform 2012: A History Of U.S. Efforts (SLIDESHOW)

Whatever the U.S. Supreme Court does to health-care reform, it's unlikely that Congress will act quickly. Insurance companies also will need time to adjust.

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Health-care impact is uncertain

Markets are bracing for the Supreme Court ruling on health care in the week ahead and it could be a positive catalyst for stocks if the new law is overturned.

But any pop is likely to be brief and the focus will return to Europe as the European Union leadership gathers to discuss a banking union at the end of the week. Early in the week, the focus will be on Greece's efforts to restructure its bailout and Spain's expected request Monday for funds to recapitalize its banks. There is also a stream of U.S. economic data, including durable goods, weekly jobless claims and consumer confidence readings.

The Supreme Court decision on President Obama's health-care reforms could possibly come Monday but certainly by the end of the week. Some analysts say if the law is overturned, stocks could instantly spring into rally mode, though that could be short-lived since uncertainties remain. Health-care stocks have been moving higher ahead of the ruling on the Affordable Care Act, and were the best-performing sector in the past week, gaining 0.8 percent.

"The initial reaction (if overturned) will be that this is positive because it had a dampening effect on small business hiring and small business confidence," said Barry Knapp, head of equity portfolio strategy at Barclays Capital. But he said any rally will be unsustainable. "It still leaves a block of uncertainty and that uncertainty also relates to the election results Is it positive for Romney? Is it positive for Obama? Both cases could be made. In the short term, it's not going to move the market that much."

Knapp said if health-care reform is not overturned, or just partially overturned, stocks could react negatively. "It' not so clear what happens to the health-care sector stocks. I think the first reaction will be up, but you have to wonder about HMOs. There was a view they could have a much bigger customer base," he said.

The justices are deciding whether Congress exceeded its authority by passing the law, which mandates individual health-care insurance. They could decide to throw out all of the law, part of it or keep it intact.

Analysts have said the market could read a ruling against the Affordable Care Act as a negative for Obama because he has invested so much personal capital in a law that could be deemed unconstitutional and the process has been disruptive across the economy. On the other hand, there is a sense a rejection could galvanize his supporters, a negative for GOP candidate Mitt Romney.

Euro Driven

But the bigger driver of markets remains Europe's debt crisis and expectations for the EU leaders' summit are relatively low.

"We think what is likely is another half-hearted set of solutions to the problem," said Pimco strategist Tony Crescenzi. He said one problem is there's "bailout fatigue" on the part of creditors, and "austerity fatigue" on the part of countries that have to make tough choices to curb spending.

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Health-Care Ruling May Be a Catalyst for Stocks

Editorial: Health care court ruling opinions

The U.S. Supreme Court is expected to announce its ruling on the federal health care law widely known as Obamacare any time now. Here are some views on the law and the upcoming ruling.

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Editorial: Health care court ruling opinions

Most people believe that the future of health reform rests in the hands of the nine Supreme Court justices currently deliberating over constitutionality of the Affordable Care Act. While their decision could be a game changer, it should not be misconstrued as the last word in health reform.

That will come from those of us in the state legislatures who will have the courage to stand up and continue the march toward providing accessible and affordable care for all New Mexicans.

The Affordable Care Act finally acknowledges that access to high-quality health care was hampered by an insurance market that left millions with coverage that had gaps as wide as a hospital gown that is, if you even had a hospital gown. The law brings fairness and equality that should have been provided all along, but far too often was not.

For example, more than 23,000 university students in New Mexico like Kelli Grady, 23, are now able to remain on their parents insurance plan until they reach 26.

Regardless of what the Supreme Court rules, we wont go back to the old broken system that put so many in New Mexico at risk. The ACA helped people with pre-existing conditions, many of them children, finally access the care they need after being denied for years. More than 850 people are now getting care through the federal high-risk pool established here, and training for the health care workforce we have needed for so long is now under way at colleges and universities around the state, thanks to the act.

It finally makes health plans work for consumers by requiring that lifesaving preventive services such as cancer screenings, immunizations and well-visits for children are included on every plan without co-pays. For seniors, the Affordable Care Act strengthens Medicare and provides seniors in the prescription-drug doughnut hole assistance to provide the medication they need already saving New Mexico seniors around $10 million.

The Affordable Care Act was modeled after policies that had already been successfully implemented in states like Massachusetts and New Mexico. More important, it created momentum to start implementing real change on an issue that has plagued our country for decades. Regardless of the Supreme Court decision, state legislators will continue to be the leaders implementing creative solutions to the unique health needs of our state, and will continue to strive for affordability, security and quality of care for all residents.

We have done it before in New Mexico through hard-fought battles in the Legislature to provide transparency in insurance rate hike requests, prohibitions on rolling back coverage after a subscriber gets sick and limits on insurance company profit and administration charges. We have enabled parents to add their children onto their policies until they reach age 25, and expanded our Medicaid program to include a private-public partnership for low-income employees just above the eligibility level.

We know this is only a start: Continued innovation is needed to improve the affordability, security and quality of care for everyone in the Land of Enchantment.

As state legislators, we refuse to allow New Mexico to revert to a system in which big insurance makes all the decisions for our residents health care needs. Its a matter of basic fairness to those who are ill which will ultimately include all of us. We hope you will hold us and other state lawmakers accountable for protecting the gains we have made and going further to serve all New Mexicans.

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Health Care’s Future In State Legislatures

WASHINGTON, D.C. -- The Patient Protection and Affordable Care Act, which became law in 2010, affects most major components of the U.S. health care system. Here's a look at Ohio's role in the health insurance debate and the impact of the law on Buckeye residents.

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How health care reform affects Ohioans

(CNN) - President Barack Obama advocated for his jobs package while Rep. Bill Cassidy argued against the health reform law as they stood by their parties' positions Saturday during their weekly addresses.

Obama called on Congress to pass a transportation bill, expand access to college and fund infrastructure projects. Cassidy, a Maryland Republican, argued that the health reform law signed by Obama in 2010 had an effect of "driving up health care costs, making it harder for small businesses to hire workers."

"The law, as an example, is going to cost nearly twice as much as we were told, people are already paying more for their health care than they were before, and because of health insurance expenses, employers are canceling plans to expand their businesses, which is to say they will not be hiring new workers," he said.

Cassidy did not say he supported the Supreme Court overturning the law, but said a "majority of Americans want the Supreme Court to overturn all or part of Obamacare."

A CNN/ORC International poll released in early June showed 43% of Americans supported the law while 34% believed it was too liberal and 13% opposed it because it did not go far enough.

An additional 10% said they had no opinion on the law.

Cassidy said his experience as a doctor informed his views on quality care.

"Families should be able to make their own health care choices, visit the doctor of their choosing and receive the health care they and their physician feel is best," he said, arguing the health law does not do that.

In his address, Obama focused on several measures, including funding for a transportation law.

"Bridges are deteriorating after years of neglect. Highways are choked with congestion. Transportation delays cost Americans and businesses billions of dollars every year," he said. "And there are hundreds of thousands of construction workers who have never been more eager to get back on the job."

Excerpt from:

Republicans talk health care, Obama economy in weekly address

No matter how the Supreme Court rules on the constitutionality of the Affordable Care Act (ACA), the debate will continue. If it’s upheld, ACA will become even more of an issue in the presidential campaign.

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Health care changes leave many gaps

Their positions are clear.

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Obama, Romney seek advantage on health care ruling

21-06-2012 09:22 It isn't just large employers, medical businesses and constitutional scholars invested in the Supreme Court's decision on President Barack Obama's health overhaul, as Janet Adamy explains on The News Hub. Photo: Bryan Derballa for The Wall Street Journal. Subscribe to WSJ Live HERE: WSJ Live brings you original programming from The Wall Street Journal. Get news directly from The Wall Street Journal's 2000 reporters across the globe. With exclusive video and daily live programming, you can stay on top of the latest in news, elections, markets, tech, opinion and lifestyle.

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Supreme Court Health Care Ruling - More than Insurance at Stake - Video

PHOENIX--(BUSINESS WIRE)--

Viridian Health Management, a national leader committed to lowering health-care costs through outcomes-based worksite health programs and services, today announced the release of its new MAESTRO modular data platform that integrates multiple data sources and applies research-support analytics to document the performance of employers worksite health programs.

MAESTRO allows employers to integrate data from multiple sources to track program performance and administer client-specific incentive programs. MAESTRO features proprietary algorithms that stratify individual and population health risks and allows for customization of risk metrics to establish a health baseline for employers worksite health programs and identify priority focus areas. With its superior performance and flexibility, MAESTRO makes ongoing comparisons to statistical averages associated with unmanaged health conditions to determine your worksite health programs performance and projected savings over time. MAESTRO can regularly track the success of your worksite health program based on criteria you select, including employer-specific biometrics, health assessments, medical conditions, program participation and completion, referrals, third-party outcomes and incentive options that are fully scalable to your organization. MAESTRO also allows Viridian to calculate a return on investment that is fully supported by industry data based on employers actual health-care costs.

Viridian is on the cutting-edge of worksite health performance management by giving employers the actionable information they need to improve employee health, lower health-care costs and improve productivity, said Brenda Schmidt, president and CEO of Viridian Health Management. Viridians sophisticated data station supports importing data from multiple sources and provides integrated client-specific reporting capabilities that can monitor and validate the effectiveness of worksite health programs and document ROI based on actual cost savings.

The MAESTRO data platform includes several integrated modules to support lifestyle and clinical care management, data integration and reporting, and incentive tracking and fulfillment. With its versatility and customization features, MAESTRO brings together multiple data sources to calculate individual risk areas and then places individuals into category stratifications based on those risks.

Currently available systems do not effectively support employer-specific health improvement and incentive strategies that integrate multiple third-party data sources, added Schmidt. By developing an enterprise system for documenting and evaluating program effectiveness, Viridian can determine which program interventions and financial incentives are the most cost-effective and can provide employers with credible, objective and meaningful evaluations.

The MAESTRO Rewards incentive module is designed to fully manage complex, participation- or outcomes-based incentive strategies based on employer-specific criteria and incentive design. With an intuitive user interface and seamless operational integration, MAESTRO allows Viridian to support multiyear incentive strategies, track the success of each employers incentive program, and provide incentive reporting based on client-specific file format and frequency. Employers can customize incentive award criteria, including biometric measurements, accumulated points, activity participation/program completion and third-party programs. MAESTRO Rewards tracks individual incentives online and provides automated reporting to each client.

The MAESTRO Coach module supports a patient-centered medical home model and provides health coaches and clinicians with the system to track employee participation in client-specific program interventions, as well as document improvements in health behaviors and reductions in chronic disease risk factors. The system is highly customizable to support multiyear worksite health improvement and incentive strategies.

Viridian Health Management will be exhibiting at the SHRM 2012 Annual Conference & Exposition at the Georgia World Congress Center in Atlanta, Ga., at Booth #3712 on June 2427, 2012. Viridian will showcase its extensive experience in worksite wellness and discuss how worksite health programs can help employees to adopt healthier lifestyles, lower the risk of developing costly chronic diseases, and reduce health-care costs. Viridian leaders have recently been invited to provide their expertise in worksite health at several national forums, including leading the Worksite Wellness Group at the Clinton Global Initiative and the NIOSH Total Worker Health Experts Colloquium. Schmidt will also lead an innovator workshop at the Health Enhancement Research Organization (HERO) Forum in October 2012.

Further positioning Viridian as an industry leader in worksite health, the Centers for Disease Control and Prevention (CDC) awarded Viridian a national implementation contract in September 2011 to establish comprehensive worksite health programs based on Viridians proven ability to deliver evidence-based programs that enhance employee health, reduce chronic disease and lower health-care costs. The National Healthy Worksite Program (NHWP) will focus on employer and employee outcomes in the areas of implementing evidence-based interventions, improving nutritional status, increasing physical activity and reducing tobacco use through individual health coaching, environmental supports and workplace policies. As the NHWPs implementation contractor, Viridian will provide operational management of the program, conduct individual and organizational assessments, provide implementation support and data collection, and provide training to program participants.

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Viridian Health Management Launches New MAESTROTM Data Analytics Platform that Converts Worksite Wellness Data into ...

Next week, the Supreme Court will issue its opinion on the Affordable Health Care Act (forgive me for forgoing the silly and uneducated "Obamacare"). Those of us who practiced law but don't today -- we "recovering lawyers" -- watch the Court as ex-athletes watch their sports; somehow feeling we're still in the game. We're not. But that doesn't mean we're humble. We Monday morning quarterback with the best and worst! So here's a lawyer and analyst quarterbacking for investors, with two great stocks to name.

One: It's impossible to predict next week's result. Two: The result may well be more muddy than clear. And three, big deal. The uncertainty has given us marvelous investment opportunities -- two in particular -- with margins of safety, just as all decisions face an inherently uncertain future.

Prediction is fun but impossibleWe ex-athlete lawyers love to opine from the seats, but it's absolutely impossible to predict any decision of the court from oral arguments. From 76-year-old Justice Scalia's just-plain-nuts belittling of the case volume, to the media debate over the solicitor general's performance on behalf of the administration, it's mostly theater.

The oral arguments rarely mean anything about the decision. The judges and their clerks had long before dissected the written briefs and governing law and the justices knew where they were going long before the formality of oral arguments. Oral arguments are holdovers from the 19th century when the briefs were shorter and law less developed. The judges issued opinions orally, sometimes one after the other, and often on the spot. But they do offer the public a fig leaf.

Five fingers -- and not the new running shoesI like to think that the University of Chicago Law School exposed me and my peers to the best of both sides that will consider this case. At the time, my professors included now-legendary progressive thinkers such as Cass Sunstein, whose books have influenced not only the course of legal thought but policymakers; he is now the administration's administrator of the Office of Regulatory Affairs. And on the other side, the conservative law and economics school of judges Posner and Easterbrook, the former and current chief judges of the Seven Circuit Court of Appeals.

If I learned anything about what these sides agreed on, it was that Justice Brennan's rule prevails. He held up five fingers as the rule of the Court. It's all about getting five votes out of nine. Politics, law, economics, theory, whatever. Five fingers.

(My favorite Easterbrook story from law school days: A favorite student in our class, we'll call him Mr. Jones, arrives haggard. When called upon Paper Chase style, Jones declares that he's unprepared. Easterbrook, fond of striking fear into the hearts of students, bellows, "And why is that?" Jones replies, "My wife had a baby last night." No beat missed, ol' Frank rejoins, "Well, Mr. Jones, that would be an excuse if you had had the baby!")

And then those five fingers are fuzzyThe Court also muddies the waters left and right when it can't reach a clear consensus. Take, for example, affirmative action. It's OK to take race into account, but you can't have quotas. Oh, wow, that is easy for a school to figure out in the real world. Is it about playing a game, doing one thing and saying another?

Uncertainty equals inefficient pricing and stock dealsYet the view that the court's decision -- coming next week for sure -- makes a difference, is, to use an investing cliche, overblown. I'll leave the debates over whether the Court will strike down the mandate and leave the rest intact, the so-called severability argument. If you cut off the arm (the individual mandate), does the patient (health reform) live? What if the mandate is actually the head? Does the court have the authority to do so? Who knows?

In terms of stocks, the valuations discount negative effects at a range of health-care companies such as UnitedHealth Group (NYSE: UNH) , WellPoint (NYSE: WLP) , WellCare Health Plans (NYSE: WCG) , Humana (NYSE: HUM) , and Coventry Health Care (NYSE: CVH) . The astute investor can invest with a margin of safety, especially in UnitedHealth Group and WellPoint, not cheapest but with the bets businesses and fundamentals. I consider all numbers below super cheap, unless noted.

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A Recovering Lawyer on Health Care, the Supreme Court, and 2 Great Stocks