Hobby Lobby Wins Partial Victory From Appeals Court In Health Care Challenge

A federal appeals court in Denver sided with Hobby Lobby Stores Inc. on Thursday in its legal battle against part of the Affordable Care Act.

The 10th Circuit Court of Appeals moved to reverse a lower court's decision to deny Hobby Lobby Stores Inc.'s quest for an injunction against part of the Affordable Care Act that requires it to cover the cost of emergency contraceptives for some of its employees.

In a statement, Hobby Lobby founder and CEO David Green said he and his family believe that life begins with conception and paying for their employees to have insurance coverage for emergency contraceptives such as the morning-after pill would force them to violate their religious beliefs.

“We believe that business owners should not have to be forced to choose between following their faith and following the law,” he said in the statement. “We will continue to fight for our religious freedom, and we appreciate the prayers of support we have received.”

In a 168-page ruling issued Thursday, the federal appeals court sent the case back to a lower court for further review.

The panel of eight appellate court judges who heard arguments in May ruled unanimously that Hobby Lobby and its affiliated Christian bookstore chain Mardel have the right to sue over the Affordable Care Act.

“A religious individual may enter the for-profit realm intending to demonstrate to the marketplace that a corporation can succeed financially while adhering to religious values,” the judges said in the ruling.

The ruling is a blow to the federal government's argument that as for-profit corporations, the companies cannot claim that the health care law is a violation of constitutionally protected religious freedoms.

Kyle Duncan, general counsel for the nonprofit Becket Fund for Religious Liberty, which is representing Hobby Lobby, called the appeals court ruling a significant milestone for the company and other businesses that are challenging the health care law.

“It confirms all along the argument that we have been making for the Green family — that they have the right to exercise religion in the running of their business,” Duncan said. “The government has consistently denied that.”

Judges split on temporary injunction

Hobby Lobby is the largest company to sue the federal government over the health care law, according to the Becket Fund. The company is one of 60 legal challenges to the mandate on emergency contraceptives.

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Obamacare Gets New Court Challenge

Opponents of the health-care overhaul have filed a new lawsuit Thursday against the federal government on behalf of four individuals and three employers in the U.S. District Court for the District of Columbia.

The complaint focuses on the law’s distribution of federal subsidies for Americans to purchase insurance, and whether people can get them if they live in one of the 33 states that have refused to set up their own insurance exchanges and have left that task up to the federal government.

The health law was designed around the idea that states would run exchanges where people could compare insurance plans and apply for the subsidies. Some critics say that language in the legislation bars the Obama administration from allowing those subsidies to be distributed in exchanges run by the federal government.

The individual plaintiffs in the new lawsuit, from Tennessee, Texas, Virginia and West Virginia – states that didn’t set up exchanges — say they should not be considered eligible for the subsidies and should not have to pay a fine if they don’t purchase insurance.

The “subsidies actually serve to financially injure and restrict the economic choices of certain individuals,” the new complaint says. “For these people, the Subsidy Expansion Rule, by making insurance less ‘unaffordable,’ subjects them to the individual mandate’s requirement to purchase costly, comprehensive health insurance that they otherwise would forgo.”

The employers from Missouri, Kansas and Texas are arguing that they should not be subject to penalties that they may have to pay if their workers receive tax subsidies through the exchanges.

Oklahoma’s attorney general, Republican Scott Pruitt, filed a similar challenge in federal court for the Eastern District of Oklahoma on behalf of the state. The Obama administration has argued that the case should be thrown out because Oklahoma cannot show it is being harmed.

U.S. Treasury officials have also said that they believe Internal Revenue Service rules applying the law’s provisions to the federally run exchanges are in keeping with the statute. They have criticized opponents for trying to prevent millions of Americans from getting tax credits.

The new plaintiffs are being represented by Michael Carvin, a former Reagan administration lawyer who helped to represent the Bush campaign in the 2000 presidential election cases.

Mr. Carvin, of Jones Day, also represented the National Federation of Independent Business in its unsuccessful case arguing that the Affordable Care Act was unconstitutional because of its requirement that individuals purchase insurance or pay a fee.

A libertarian think-tank, the Competitive Enterprise Institute, said it is coordinating some of the legal work in the case and helping to fund it.

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Hospitals Serving The Uninsured Face Challenge Under Obamacare

Hospitals that treat the most vulnerable patients may have the toughest time weathering spending cuts under President Obama’s health-care law.

Approximately 1,500 hospitals nationwide are known as “safety net” providers because they care for a larger portion of uninsured patients than their competitors.

Under the Affordable Care Act, the safety-net hospitals will gain a new source of revenue when millions of the uninsured gain coverage. At the same time, the law’s spending cuts could prove challenging for hospitals that tend to operate with relatively small profit margins.

“This is a time of uncertainty for them,” said Stu Guterman, vice president of the Commonwealth Fund. “On the one hand, they should be thrilled because a lot of the patients they treat will have payment attached to them. On the other, they’re losing some of the funding they rely on.”

A report released Tuesday by the private consulting firm Alvarez & Marsal warned that the health-care law “may actually worsen the status of many safety net hospitals.”

The Affordable Care Act layers three big spending cuts on top of reductions that states have made during the recession.

First, the law slows the rate of regularly scheduled pay bumps from the federal government, meant to help hospitals keep pace with growing health-care costs.

Safety-net hospitals also will  bear the brunt of cuts in “disproportionate share payments,” money that the federal government sends hospitals that cover a high level of uninsured patients. These payments, which come from the Medicaid and Medicare programs, will fall by more than $30 billion over the next decade.

Health experts initially thought that those funds would become unnecessary as the expanded access to health coverage lessened demand for uncompensated care. After the Supreme Court declared the Medicaid expansion optional, several Republican governors declined to move forward, leaving hospitals worried that they will still see high numbers of uninsured patients.

Last, the health-care law tethers a small portion of hospitals’ Medicare payments to the quality of care they provide and to patient satisfaction rankings. If hospitals don’t hit certain targets, they stand to lose 1 percent of their Medicare income.

Safety-net hospitals, separate research suggests, may have a tough time hitting the goals, because they tend to receive lower patient satisfaction ratings than competitors who treat fewer uninsured people.

“The challenge for a lot of these institutions are that they rely heavily on federal subsidies,” study author David Gruber said. “Now it’s like a tsunami of cuts hitting at the same time.”

Researchers who have studied the safety-net hospitals echo some of the report’s concerns but note that the health law offers many benefits for these providers.

“What the Affordable Care Act really means for the hospitals is going to vary,” said Teresa Coughlin, a health policy researcher at the Urban Institute. “It will depend on whether their states take the Medicaid expansion, how many people are left uninsured, and what happens with state and local funding.”

Coughlin recently published a study looking at how five large safety-net systems were  adapting to the health-care law. Some, she said, are building new facilities and putting a new focus on quality, so they can compete for the patients who do gain coverage under the health law.

“It’s not all doom and gloom,” Coughlin said.

The Obama administration has responded to some of the hospitals’ concerns. In the president’s budget released last week, the White House proposed delaying some of the cuts in disproportionate share payments by one year, as states continue to debate the Medicaid expansion.

Still, safety-net hospitals remain concerned over what lies ahead under the health law.

“It’s a more challenging environment when you have all these issues colliding at once,” said John Haupert, president of Grady Health System.

The Atlanta-based hospital system estimates that 30 percent of its patients lack insurance coverage and an additional 30 percent receive Medicaid, which tends to pay lower rates than private health plans.

When Grady ran the numbers, it found that it would lose $45 million annually under the health law’s Medicaid cuts to disproportionate share payments. That works out to be about 7 percent of the hospital’s $670 million budget. If those cuts go through, Haupert said, he has thought about cutting back on some of the clinical services the hospital system provides. However, many of its uninsured patients will become eligible for coverage next year.

“Clearly we’re faced with lots of decisions,” Haupert said. “We’ve done some brainstorming. None of it will be an easy decision.”

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First Lady Michelle Obama and Epicurious Host Second Recipe Challenge

The White House

Office of the First Lady

FIRST LADY MICHELLE OBAMA AND EPICURIOUS HOST
SECOND RECIPE CHALLENGE
TO PROMOTE HEALTHY EATING NATIONWIDE

“The Healthy Lunchtime Challenge” Welcomes Children and Their Parents to Create 
Healthy Lunch Recipes for an Invite to a Kids’ “State Dinner” at the White House

New York, NY (April 3, 2013) – With the overwhelming success of the inaugural Healthy Lunchtime Challenge & Kids' “State Dinner” in 2012, First Lady Michelle Obama is again teaming up with Epicurious, the U.S. Department of Education, and the Department of Agriculture to host a nationwide recipe challenge to promote healthy eating among America’s youth.

“Last year’s Kids State dinner was one of my favorite events we’ve ever done for Let’s Move! because it perfectly captured how young people, parents, community leaders and businesses can come together for innovative, healthy solutions,” said First Lady Michelle Obama.  “Last year’s young chefs impressed and inspired me with their creativity, and I can’t wait to welcome a whole new group to the White House this summer and taste their creations.  So kids, let’s get cooking!”

The second Healthy Lunchtime Challenge & Kids' “State Dinner” invites parents or guardians and their children, ages 8-12, to create and submit an original lunch recipe that is healthy, affordable, and tasty.  In support of Let’s Move!, launched by the First Lady to solve the issue of childhood obesity, each recipe must adhere to the guidance that supports USDA’s MyPlate (at ChooseMyPlate.gov) to ensure that the criteria of a healthy meal are met.  Entries must represent each of the food groups, either in one dish or as parts of a lunch meal, including fruits, vegetables, whole grains, lean proteins and low-fat dairy foods, with fruits and veggies making up roughly half the plate or recipe.

All U.S. states and territories, including Washington, D.C., Puerto Rico, Guam, American Samoa, the U.S. Virgin Islands, and the Northern Mariana Islands, are invited to participate. Fifty-six children and their parent/guardian (one pair from each of the 50 states, plus the U.S. Territories, D.C., and Puerto Rico) will be flown to the nation’s capital where they will have the opportunity to attend a Kids’ “State Dinner” at the White House this summer, hosted by Mrs. Obama.  A selection of the winning healthy recipes will be served.  

“In order to promote a healthier next generation of Americans, we need to encourage kids to make healthier choices now – which they can carry into adulthood,” said Agriculture Secretary Tom Vilsack.  “USDA is thrilled to be part of the Healthy Lunchtime Challenge again this year because it inspires kids to use USDA’s MyPlate to take a hands-on approach to building healthier meal times.”

“We know healthy kids are healthy students, and healthy students are better able to engage in the classroom and excel academically,” said U.S. Secretary of Education Arne Duncan. “If we can get our children to eat healthier and exercise more, that’s a recipe for success. Kids are the best judges of what looks and tastes good, so we’re challenging them to create lunches that all their peers will enjoy.”

“We are thrilled to once again partner with Mrs. Obama, and to champion her Let’s Move! initiative, in an effort to raise awareness for the importance of healthy eating among kids,” said Tanya Steel, editor-in-chief of Epicurious.  "Through ‘The Healthy Lunchtime Challenge,’ we will, for the second year, create a call to action for kids, highlighting the importance of healthy meals. This initiative will continue to make a positive impact on the way our children eat, and will reinforce that meals, especially school lunches, can be delicious and nutritious.”

The winning recipes will be chosen by a panel of judges, including Tanya Steel, Let’s Move! Executive Director Sam Kass, USDA and U.S. Department of Education representatives, as well as a celebrity chef, to be named.  At the conclusion of the Challenge, a free, downloadable and printable e-cookbook featuring the winning recipes, nutritional analysis, photos and drawings, will be available via LetsMove.gov, USDA.gov, Ed.gov and recipechallenge.epicurious.com.

The White House Kids’ “State Dinner” is currently scheduled to take place in July or August 2013.

Recipes can be submitted April 3 through May 12, online at recipechallenge.epicurious.com, or via mail at “The Healthy Lunchtime Challenge c/o Epicurious.com,” 1166 Avenue of the Americas, 15th Floor, New York, NY 10036. Winners will be notified at the end of June. For more information and contest rules visit recipechallenge.epicurious.com.

President Obama tell the American people about the budget he is sending to Congress, which makes the tough choices required to grow our economy and shrink our deficits

Here’s a quick glimpse at what happened this week on WhiteHouse.gov.

President Obama marks the end of the Easter season with a prayer breakfast at the White House.

view all related blog posts

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BRIEF-Glenmark Generics confirms patent challenge for its generic version of FINACEA

March 14 (Reuters) - Glenmark Pharmaceuticals Ltd :

* Glenmark confirms patent challenge for its generic version of FINACEA

* Intendis,Intraserv and Bayer Healthcare filed suit against Glenmark Generics

seeking to prevent sales of ANDA product

* Source text: * Further company coverage

((Bangalore Newsroom; +91 4135 5800))

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Joss Whedon’s ‘Much Ado About Nothing’ And The Challenge Of Modern Shakespeare Adaptations

One of the reasons William Shakespeare’s work is so enduring is that it’s perceived to be timeless. Romeo and Juliet are stand-ins for every teenage couple that perceives themselves to be or actually is pulled apart by family or other societal forces. Hamlet is every son with a dead father and an uncertain sense of himself. Bands of brothers will continue to charge into battle from this day to the ending of the world, and they and we will need to believe they do so for a greater cause to enable them to keep doing it. But while many of Shakespeare’s psychological insights may feel unmoored from time, in the same way Lizzy Bennet and Mr. Darcy could have met, sparred, and found each other in almost any time period, with adjustments along the way, the means by which Shakespeare delivered those insights vary widely in how tightly they’re tied to particular historical circumstnaces and mores, and in how much structres from the past have reinvented themselves for new eras. This poses enormous challenges for the success of a contemporary Shakespeare adaptation: it’s easy to turn the Capulet and Montagues’ relatively amorphous family fued into a gang rivalry or a spat between business empires, but rather harder to come up with a modern equivalent of the Salic Law that will get audiences juiced.

I say all of this as a roundabout way of approaching Joss Whedon’s adaptation of Much Ado About Nothing, a play that’s a perfect example of a relatively modern relationship that’s brought together under difficult-to-translate circumstances. Beatrice and Benedick, two wits who have each other as their favorite targets, are brought together in a horribly traumatic moment that’s difficult to imagine today: Beatrice’s cousin has her chastity impugned at the altar on her wedding day, is left at the altar, and her family pretends that she’s died of shame in order to build time to restore her reputation. The process by which Hero’s wedding is ruined is essentially a timeless one—she’s framed for cheating with another man on the night before her marriage to Claudio—but the reaction to this news is not. Claudio isn’t just disgusted by the idea that Hero has cheated on him: the fact that she has sexual experience at all is at the root of Claudio’s complaint to Hero’s father at the altar:

Sweet prince, you learn me noble thankfulness.
There, Leonato, take her back again:
Give not this rotten orange to your friend;
She’s but the sign and semblance of her honour.
Behold how like a maid she blushes here!
O, what authority and show of truth
Can cunning sin cover itself withal!
Comes not that blood as modest evidence
To witness simple virtue? Would you not swear,
All you that see her, that she were a maid,
By these exterior shows? But she is none:
She knows the heat of a luxurious bed;
Her blush is guiltiness, not modesty.

I wrote on Friday that this is a scenario that’s exceedingly hard to move into the modern era, and I thought the success of Much Ado About Nothing would depend on the ability of the movie to find a contemporary scenario into which this conflict fit without seeming jarringly anachronistic, making it easier to suspend disbelief about the characters’ reactions. While there’s no question that cheating on your wedding night is a big deal in modern society, we’re—fortunately—not a society where it would be a reasonable test of your lover’s affections to ask him to kill his best friend for besmirching your cousin’s sexual reputation. There are options here, of course. I would have been curious to see a slightly larger social context where Hero and her family are Christian, and the film took seriously the idea that her honor is valuable to her because she’s been taught it’s the most important thing about her. And even more interesting could have been a setup where Claudio’s reaction seems to come more from a sense of anxiety about the revelation that his bride has more sexual experience than he does than from the idea that Don Leonato has offended him by pretending to honor him but offering him “this rotten orange” as a sign of that honor.”

So it’s an interesting choice for Whedon that he does add one significant bit of modern context to Much Ado. But it’s meant to flesh out the relationship between Beatrice and Benedick, the part of the play that transitions most smoothly into a modern setting, rather than to render less jarring the conflict that lets them end the “merry war of words” between them. In the scene that opens the film, it’s revealed that Beatrice (Amy Acker) and Benedick (Alexis Denisof) slept together before he went off to the wars, and for reasons unclear, they’re both embarrassed and angry with each other about the encounter. It’s a decision that works surprisingly well for all its lack of necessity, giving new meaning to Beatrice’s barb that Benedick is “a good soldier to a lady,” or her insistence that “I know you of old” after he slips out of their conversation with “a jade’s trick,” just as he slept out of her bed early in the morning to avoid awkward conversation. When the Prince tells Beatrice at the party that “You have lost the heart of Senor Benedick,” Beatrice’s reply that “He lent it to me for a while” has a new and lovely melancholy.

But the dynamic between Beatrice and Benedick has larger problems. Denisof, a veteran of How I Met Your Mother plays Benedick like womanizer Barney Stinson, rather than as a man who’s hesitant to see the military unit that’s given his life meaning and companionship broken up by marriage—this is bro-hood, not brotherhood. In his readings of lines like “I hope you have no intent to turn husband,” or Benedick’s declaration that the woman he marries must be “Virtuous, or I’ll never cheapen her,” I could almost see MacLaren’s Pub breaking through the background as if conjured for another realm. Acker’s performance as Beatrice is better, a melancholy rather than merry read on the character, which wisely means she’s competing less with Emma Thompson than Denisof is with Kenneth Branagh, even to the extent of stealing his voice concealment schitck during the garden party, and she suffers less by comparison as a result. But the new backstory between her and Benedick would have required slightly more context to explain why an independent woman in a contemproray setting who has repeatedly rejected the idea of marriage would be so wounded by a one-night stand. Explaining that reaction might have provided a set of norms that would have clarified the Claudio-Hero story, and given more context for Beatrice and Benedick’s reactions when Hero is falsely accused, and Benedick takes her side rather than standing with his friends, giving him more reason than simply wanting to impress Beatrice.

The real problem is with what happens after Hero is accused and pretends to have died. Fran Kranz and Jillian Morgese do very nice work with the most fundamentally boring parts in the play, and in particular, someone should really cast Kranz in an indie romantic comedy already. But watching Beatrice demand that Claudio be killed for the sin of falsely accusing Hero, or watching Denisof flash a pistol at Claudio in the tastefully-appointed library in Joss Whedon’s real-life house just feels silly and histrionic. Rather than Shakespeare’s words giving us the gravity we’ve scrambled after in contemporary life, something that worked so well with contemporary war in Ralph Fiennes’ excellent 2011 adaptation of Coriolanus, here, his scenario just feels ludicrous, diminishing everyone involved, and making the challenges of contemporary romance feel histrionic rather than blesssed with a vocabulary that can express their proper gravity. That’s not to say there are no pleasures to be had here, particularly the channeling of Nathan Fillion’s spectacular gift for pomposity into Dogberry, a performance that would do Michael Keaton proud, and the lovely use of Clark Gregg’s decency as Don Leonato in perhaps the most deft and subtle casting in the movie. But Whedon’s interpretation ultimately makes the much ado about nothing in the title seem like a negative reflection on his characters rather than a charming reflection of the inherent nonsense and complication of true love.

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Obamacare Gets New Court Challenge

Opponents of the health-care overhaul have filed a new lawsuit Thursday against the federal government on behalf of four individuals and three employers in the U.S. District Court for the District of Columbia.

The complaint focuses on the law’s distribution of federal subsidies for Americans to purchase insurance, and whether people can get them if they live in one of the 33 states that have refused to set up their own insurance exchanges and have left that task up to the federal government.

The health law was designed around the idea that states would run exchanges where people could compare insurance plans and apply for the subsidies. Some critics say that language in the legislation bars the Obama administration from allowing those subsidies to be distributed in exchanges run by the federal government.

The individual plaintiffs in the new lawsuit, from Tennessee, Texas, Virginia and West Virginia – states that didn’t set up exchanges — say they should not be considered eligible for the subsidies and should not have to pay a fine if they don’t purchase insurance.

The “subsidies actually serve to financially injure and restrict the economic choices of certain individuals,” the new complaint says. “For these people, the Subsidy Expansion Rule, by making insurance less ‘unaffordable,’ subjects them to the individual mandate’s requirement to purchase costly, comprehensive health insurance that they otherwise would forgo.”

The employers from Missouri, Kansas and Texas are arguing that they should not be subject to penalties that they may have to pay if their workers receive tax subsidies through the exchanges.

Oklahoma’s attorney general, Republican Scott Pruitt, filed a similar challenge in federal court for the Eastern District of Oklahoma on behalf of the state. The Obama administration has argued that the case should be thrown out because Oklahoma cannot show it is being harmed.

U.S. Treasury officials have also said that they believe Internal Revenue Service rules applying the law’s provisions to the federally run exchanges are in keeping with the statute. They have criticized opponents for trying to prevent millions of Americans from getting tax credits.

The new plaintiffs are being represented by Michael Carvin, a former Reagan administration lawyer who helped to represent the Bush campaign in the 2000 presidential election cases.

Mr. Carvin, of Jones Day, also represented the National Federation of Independent Business in its unsuccessful case arguing that the Affordable Care Act was unconstitutional because of its requirement that individuals purchase insurance or pay a fee.

A libertarian think-tank, the Competitive Enterprise Institute, said it is coordinating some of the legal work in the case and helping to fund it.

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Sen. Feinstein: Passing gun-control legislation is ‘hardest’ challenge

Sen. Dianne Feinstein (D-Calif.) said Sunday that she will push her assault-weapons ban as an amendment if it doesn’t get into the package that Senate Majority Leader Harry Reid (D-Nev.) allows on the floor.

Reid has said he will allow an open amendment process for gun-control legislation on the Senate floor — which gun-control proponents fear could weaken a final bill — but Feinstein said on CNN’s “State of the Union” Sunday that she would also force a vote on renewing the assault-weapons ban.

She said that’s how it happened in 1993, when the ban was first passed.

“This has always been an uphill fight,” Feinstein said. “This has never been easy — this is the hardest of the hard.”

Feinstein introduced legislation this week to ban assault weapons at a press conference flanked by a group of Democratic senators and the guns they want to ban displayed behind them.

The ban faces a difficult fight in the Senate, as Republicans and a handful of Democrats have said they are opposed to banning assault weapons again.

Feinstein said Sunday that the Newtown, Conn. shootings was an “epiphany” for her, and that the country has reached the point where “enough is enough.”

She accused the National Rifle Association (NRA) of being “an institution of gun manufacturers” and said they their tactics had targeted lawmakers eager for compromise.

“They come after you — they put together large amounts of money to defeat you,” Feinstein said. “They did this in 1993,” when the first assault-weapons ban passed.

The NRA’s CEO Wayne LaPierre will be testifying at Tuesday’s Judiciary Committee hearing on gun control.

Feinstein, who sits on the Judiciary panel, wouldn’t disclose Sunday what she would ask him, only saying: “You can be sure I will have some questions for him.”

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Patent 'Cliff' a Challenge, but We Can Manage: Lilly CEO

Victor J. Blue | Bloomberg | Getty Images

Eli Lilly will be "very challenged" by the loss of exclusivity on several blockbuster drugs, CEO John Lechleiter told CNBC on Tuesday, but added the company is engaged in other ways to revive growth next year.

Lilly is one of many drug manufacturers confronting a wave of patent expirations that imperils its ability to profit from key drugs. The "patent cliff," which it's called by many industry watchers, could shave as much as $25 billion off drug sales this year, according to estimates from Fitch Ratings.

Although Lechleiter said his company would be "very challenged" by the loss of key patents, he told CNBC's "Squawk on the Street" that Lilly was cultivating new lines of medicines and existing markets.

"We saw the patent cliff coming as recently as the middle of the last decade and began to invest in our pipeline," the CEO said, giving management time to respond with new drug trials. He said Lilly has about seven in various stages of testing.

"Unfortunately, the timing of the launch of the first of those products doesn't precisely coincide with the loss of revenue from our patents," Lechleiter said.

In 2011, a federal court ruled that generic drug companies could not sell versions of Eli Lilly's blockbuster Cymbalta until this June, when the patent protection is expected to lapse.

"But the guidance we've given is we expect to resume growth after 2014, when we will feel the brunt of the loss of the Cymbalta patent," he said, speaking of Lilly's anti-depression drug. "We're very confident we can achieve that."

Lechleiter stated that the patent cliff had impacted Lilly's decision to hike its dividend payments.

"We provided guidance in 2009, so roughly three years ago, that as we go through this period, we're going to be very challenged with the loss of several of our patented products," he said, adding that the company's goal "was to maintain the dividend at the current level and, of course, that's what we've done."

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New Hawaii Senator: Climate Change The ‘Most Urgent Challenge Of Our Generation’

Hawaii Lt. Gov. Brian Schatz (D), who was yesterday named to fill the Senate seat vacated by the death of Sen. Daniel Inouye (D), wants to tackle an issue that has largely disappeared from Washington’s political agenda in recent years: climate change.

Speaking briefly after being named to the seat by Gov. Neil Abercrombie (D), Schatz voiced his concern over the threat climate change poses to the world if nothing is done:

“For me, personally, I believe global climate change is real and it is the most urgent challenge of our generation,” Lt. Gov. Brian Schatz (D), whom Hawaii Gov. Neil Abercrombie (D) tapped for the seat, said in brief comments Wednesday.

While climate change poses a threat to everyone, it is particularly dangerous for the Hawaiian Islands. Sea level rises could drown its beaches and the communities around them, and two of the state’s major industries — fishing and tourism — would feel an especially large impact.

Across America, industries and the environment have been devastated by droughts and natural disasters that a changing climate has exacerbated, but little has caught the attention of policymakers. While climate change-related legislation has stalled in the U.S. in recent years, the United Nations climate summit ended earlier this month with only “modest” movement toward a deal to address the problem on a global level.

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Next Challenge for the Health Law: Getting the Public to Buy In

But this focus group, along with nine others held around the country in November, was an important tool for advocates coming up with a campaign to educate Americans about the new health care law. The participants were among millions of uninsured people who stand to benefit from the law. With incomes below 400 percent of the poverty level, or $92,200 for a family of four this year, the focus group members will qualify for federal subsidies to help cover the cost of private insurance starting in 2014.

The sessions confirmed a daunting reality: Many of those the law is supposed to help have no idea what it could do for them. In the Miami focus group, a few participants knew only that they could face a fine if they did not buy coverage.

“It’s another forced bill,” said Christopher Pena, 24, who works in customer service.

There lies the challenge for Enroll America, a nonprofit group formed last year to get the word out to the uninsured and encourage them get coverage, providing help along the way. With the election over and the law almost certain to survive, the group is honing its fund-raising and testing strategies for persuading people to sign up for health insurance — a process that will begin in less than a year.

Starting next October, people will be able to shop for coverage, or find out if they are eligible for Medicaid, through online markets known as insurance exchanges.

“Our job is to convey to them that there is help coming that they didn’t know about,” said Rachel Klein, Enroll America’s executive director.

The group has raised only about $6 million so far — but financial backers include some major players in the medical industry: insurers like Aetna and Blue Cross Blue Shield, associations representing both brand name and generic drug manufacturers, hospitals and the Catholic Health Association. Insurance companies generally opposed the law before its passage in 2010 but now have a stake in its success.

Over the next two years, the group hopes to raise as much as $100 million for advertising, social media and other outreach efforts. “There are so many different groups that can play some role in this: hospitals, community health centers, pharmacies, tax preparers,” said Ron Pollack, chairman of Enroll America’s board. “Our job has got to be to try to galvanize each of those sectors, so there is a wide variety of ways people potentially can hear about this.”

Although the campaign will be national, the group will devote more resources to some states than to others. About half of the nation’s uninsured population lives in six states: California, Florida, Georgia, Illinois, New York and Texas. Of those, states whose leaders remain opposed to the health care law, like Texas, will probably get the most attention, Mr. Pollack said.

At the same time, Enroll America will coordinate with states, many of which are planning their own outreach and enrollment efforts, and with the Obama administration.

The Department of Health and Human Services has already awarded a $3.1 million contract to Weber Shandwick, a public relations firm, to plan a national education campaign for next year. It plans to seek proposals soon for a larger contract with a public relations firm that would help with the actual campaign, officials there said. Although the campaign has yet to take shape, an administration official confirmed that President Obama will play a role as it moves forward.

Republicans in Congress have already criticized the administration for spending taxpayer money to promote the law. Last month, Representative Dave Camp of Michigan, who leads the Ways and Means Committee, subpoenaed Kathleen Sebelius, the secretary of health and human services, seeking information on “public relations campaigns, advertisements, polling, message testing, and similar services.”

In addition to holding focus groups in Miami, Philadelphia, San Antonio and Columbus, Ohio, Enroll America commissioned a nationwide survey to help hone its message. The survey, conducted in September and October by Lake Research Partners, a Democratic polling group, found that the vast majority of uninsured people are unaware of the new coverage options provided by the law.

They are also skeptical. Many who participated in the focus groups or survey reported bad experiences trying to get health insurance, and doubted that the law would provide coverage that was both affordable and comprehensive.

“It’s two major mountains that need to be climbed,” Mr. Pollack said. “People are unaware of the benefits that could be provided to them, and they have to overcome skepticism, based on their past experiences with trying to obtain insurance.”

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