On Tuesday, President Obama urged congressional action to prevent automatic spending cuts scheduled to begin on March 1. Photo : courtesy of Jim Lo Scalzo/EPA/Landov

By JULIE ROVNER | NPR

It’s looking increasingly likely that $85 billion of automatic federal budget cuts known as a sequester will come to pass if Congress doesn’t act by March 1.

Congress and President Obama agreed on the cuts, which will be divided evenly between defense and domestic programs, including health care, back in the summer of 2011 as part of a last-ditch effort to force a deficit-reduction deal and avert a debt limit default.

Daniel Werfel of the Office of Management and Budget explained last week in testimony before the Senate Appropriations Committee: “Agencies would be required to implement the cuts over the remaining seven months of the fiscal year, meaning that in many programs the effective cuts would be closer to 9 percent for nondefense programs and 13 percent for defense programs when compared to what agencies would spend during this period under normal circumstances.”

The Obama administration has been arguing for months that such cuts would have, if not devastating, at least highly painful effects on programs that affect real people.

According to a letter to the Senate Appropriations Committee from Department of Health and Human Services Secretary Kathleen Sebelius, the required cuts “would result in about 3,000 fewer inpatient admissions and 804,000 fewer outpatient visits provided in [Indian Health Service] and tribal hospitals and clinics.”

Sebelius said the reduced funding would also result in 424,000 fewer HIV tests conducted by grantees of the Centers for Disease Control and Prevention and “2,100 fewer domestic and foreign facility inspections of firms that manufacture food products to verify that domestic and imported foods meet safety standards” by the Food and Drug Administration.

Medicaid and the Children’s Health Insurance Program are exempt from the automatic cuts, as are many other safety-net programs and Social Security. But Medicare is not. Well, not completely.

Under a specially negotiated provision, Medicare beneficiaries will not be subject to benefit cuts. But Medicare providers can be docked up to 2 percent.

That has prompted a loud outcry from the health care industry. A joint study funded last year by the American Hospital Association, American Nurses Association and American Medical Association estimated that should the cuts take effect, nearly a half a million health care jobs could be lost in just the first year.

Also not exempt from the cuts is most of the funding for the Affordable Care Act, despite the last-minute efforts of states and the federal government to prepare for next year’s rollout of most of the law’s big benefits.

A program that will not be cut, however, is the one providing insurance for people with pre-existing conditions. Last Friday the administration announced it would not accept any new applications for the program, to preserve the program’s remaining funds until the end of the year. That’s when those currently enrolled can transition into new health insurance coverage under the law.

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The U.S. Supreme Court justices (first row, from left) Clarence Thomas, Antonin Scalia, Chief Justice John Roberts, Anthony Kennedy, Ruth Bader Ginsburg, (back row) Sonia Sotomayor, Stephen Breyer, Samuel Alito and Elena Kagan -- pose at the Supreme Court in 2010. Photo: Chip Somodevilla/Getty Images

By Dave Davies
An eventful term of the U.S. Supreme Court ended Thursday with the landmark 5-4 ruling affirming the legality of the Affordable Care Act. Much attention has focused on the pivotal role of Chief Justice John Roberts in the case — and whether some elements of his opinion in the health care ruling will have a conservative influence on future cases.

But the health care case wasn’t the only important decision rendered by the court during its recent term. On Monday’s Fresh Air, Adam Liptak, Supreme Court reporter for The New York Times, provides a roundup of the past year’s most important Supreme Court decisions — including ones addressing health care reform, immigration law, campaign finance rules, the access of Guantanamo detainees to the courts, and the rights of criminal defendants while plea bargaining.

Liptak tells Dave Davies that the court voted unanimously in 44 percent of its cases this term, which is not unusual. What was unusual is that the court voted unanimously in major decisions — and not just trivial matters.

Last week’s Supreme Court decision upholding the Affordable Care Act has brought the 2010 law back into the news. If you’ve forgotten all the things that are in the massive measure, never fear. Morning Edition has this refresher course.

Photo: flicker.com | afagen

Photo: Saul Loeb/AFP/Getty Images

Photo: Saul Loeb/AFP/Getty Images

By SCOTT HENSLEY | NPR

There were winners and losers in the journalistic race to get out the news of the Supreme Court’s momentous ruling upholding the administration’s health care law Thursday.

If this had been the Olympics, CNN and Fox News would have been called for false starts, or worse, after initially reporting that the high court had struck down the law. Public radio talk show host Diane Rehm got it wrong, too, during her Thursday show, although the NPR network’s newscasts were correct, NPR’s David Folkenflik reported.

The gold would have gone to Bloomberg News, at least according to the organization’s PR people, who trumpeted a 24-second advantage over the Associated Press. Folkenflik tweeted that Bloomberg “got it first (and right)” followed seconds later by Reuters, AP and then Dow Jones.

But for my money, the real winners were the journalists who raced, literally, to get the decision out of the court as fast as humanly possible. Check out the slideshow for proof of their athletic prowess.

NPR’s David Folkenflik reported

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Chief Justice John Roberts pivoted from considering the Commerce Clause to reviewing the ACA as a tax. Photo: supremecourt.gov

NPR | By Nina Totenberg

By a vote of 5-4, the Supreme Court upheld almost all of the 2010 health care law. Chief Justice John Roberts joined the court’s four more liberal members in saying it is constitutional under Congress’ right to levy taxes.

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Protesters and supporters of President Obama's health care law await the Supreme Court's ruling Thursday. The court ruled to uphold the law. The focus now shifts to the states, which are responsible for the lion's share of getting people without insurance covered. Photo: NPR | Kevin Dietsch/UPI /Landov

From NPR’s Julie Rovner

The Supreme Court’s decision to uphold nearly all of the Affordable Care Act may move the debate to the presidential campaign trail. But it shifts much of the burden of implementing the law to the states.

States are actually responsible for the lion’s share of getting people without insurance covered under the health law.

First, they get to decide whether or not to set up and run a marketplace called a health insurance exchange. That’s where individuals without insurance and small businesses will go to compare plans and buy coverage. The court’s action is what many state leaders have been waiting for.

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California is well on the way to setting up it’s own exchange 

The California Report’s Mina Kim says development is ongoing on the online service for shopping and buying health insurance.

Peter Lee, in charge of crating the state’s health insurance exchange: “We look forward to making the purchase of insurance through California’s exchange as easy as buying a book on Amazon.”

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Photo: USACE Europe District U.S. Army Corps of Engineers Europe District

KUSP Reports | By J.D. Hillard

A signature goal of the Affordable Care Act is reducing the ranks of the uninsured. the core of the law does this by requiring you to get health insurance and requiring insurance companies to issue it to you. But for people who are poor enough that they can’t afford insurance even with a subsidy the law expands eligibility for Medicaid – in California known as Medi-Cal.

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A bulletin board in New York's Jamaica Hospital offers advice for uninsured patients. Photo: Seth Wenig/AP

NPR | by MARY AGNES CAREY AND PADMANANDA RAMA

Now that the Supreme Court has decided that the Affordable Care Act can stand, it’s time to think about what the law actually means for your medical coverage. The requirement that everyone buy health insurance (the individual mandate) has gotten all the attention, but there’s a lot more to the health law. So let’s review the changes the law has already wrought and those that still lie ahead:

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Marketplace's scorecard of key ACA elements before the court. Source: marketplace.org

MARKETPLACE | by Matt Berger

The U.S. Supreme Court is scheduled to deliver its much-anticipated ruling on the constitutionality of the Affordable Care Act Thursday, leaving many to speculate the future of President Barack Obama’s landmark health care law. Most of that analysis has focused on three key questions that are expected to be answered by the court.

View post to print out scorecard

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By ERICA RYAN and MATT STILES

Go to the interactive decision.