Julie Rovner

The newest faculty member at the Uniformed Services University of the Health Sciences has a great smile ― and likes to be scratched behind the ears.

Shetland, not quite 2 years old, is half-golden retriever, half-Labrador retriever. As of this fall, he is also a lieutenant commander in the Navy and a clinical instructor in the Department of Medical and Clinical Psychology at USUHS in Bethesda, Md.

The politics of health care are changing. And one of the most controversial parts of the Affordable Care Act — the so-called "Cadillac tax" — may be about to change with it.

The Cadillac tax is a 40% tax on the most generous employer-provided health insurance plans — those that cost more than $11,200 per year for an individual policy or $30,150 for family coverage. It was a tax on employers and was supposed to take effect in 2018, but Congress has delayed implementation twice.

The headlines about presidential candidate Joe Biden's new health care plan called it "a nod to the past" and "Affordable Care Act 2.0." That mostly refers to the fact that the former vice president has specifically repudiated many of his Democratic rivals' calls for a "Medicare for All" system, and instead sought to build his plan on the ACA's framework.

The fate of the Affordable Care Act is again on the line Tuesday, as a federal appeals court in New Orleans takes up a case in which a lower court judge has already ruled the massive health law unconstitutional.

State attorneys general and women's health advocates who are hoping to block in court new Trump administration rules for Title X, the federal family planning program, face one major obstacle: The Supreme Court upheld very similar rules in 1991.

Those rules were summarily canceled after a change in administrations. But the court is arguably more conservative than it was 28 years ago.

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