Posts Tagged ‘Obamacare’

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U.S. Supreme Court Is Likely to Decide On the ACA This Term

Tuesday, October 11th, 2011

As of the first Monday of October, the United States Supreme Court is back in session and likely to make what could be a momentous decision on the Patient Protection and Affordable Care Act (ACA).  The nation’s highest court will consider President Barack Obama’s landmark healthcare overhaul, which impacts almost everyone in the country.  The Obama administration’s request last week that the justices resolve whether or not the healthcare law is constitutional makes it more likely than not that they will deliver their verdict by next June, shortly before the president and his Republican opponent move into the fall general election campaign.

Already, the GOP presidential candidates are taking advantage of virtually every debate and speech to attack Obama’s major domestic accomplishment, which extends health insurance to more than 30 million people who now lack coverage.  If, as expected, the justices agree to review the law’s constitutionality, those deliberations would define the court’s coming term.  Their decision could rank as the court’s most momentous since the December, 2000, ruling that sent George W. Bush to the White House.

According to the Med Page Today website, “The Obama administration petitioned the Supreme Court to decide on the constitutionality of the ACA, making it very likely that the high court will hear at least one of the cases challenging the landmark healthcare reform law before next year’s presidential election.  The U.S. Appeals Court for the 11th Circuit ruled in August that the individual mandate provision of the ACA is unconstitutional.  The Justice Department had until November to ask the Supreme Court to hear the case, but filing its petition sets the stage for oral arguments in the spring, and a final decision in June — at the height of Obama’s re-election campaign.  The 11th Circuit case was filed by 26 states that object to the ACA on a number of fronts, but opposition to the individual mandate is the main thrust of their argument.  The individual mandate, considered the linchpin of the law, requires everyone to have health insurance by 2014.  In its petition, lawyers for the Obama administration said the appeals court decision is ‘fundamentally flawed.’”

Supreme Court analysts say it is difficult to predict how the court would rule on the conservative challenge to the health care law.  Miguel Estrada argued several cases before the Supreme Court as an official with the Justice Department in the 1990s.  “The issues are really hard. Every time you ask the Supreme Court to overturn an act of Congress, it is a very difficult thing for the court to do. And Congress comes to the Supreme Court with a presumption of deference (to Congress) and constitutionality,” said Estrada.

Writing on the Big Think website, Robert de Neufville writes that “The administration’s decision strongly suggests that it will ask the Supreme Court to hear the case, since it doesn’t want the 11th Circuit’s decision to stand.  That puts the Supreme Court in the difficult position of having to rule on a politically charged piece of legislation during an election year.  Rick Hasen (of the Election Law Blog) that a Supreme Court decision is win-win for Obama: either the court affirms the constitutionality of the law or it seems to overreach by overturning it.  By the same token, ruling on the law may be a lose-lose proposition from the perspective of the court.  Whatever the court decides it will seem to be taking sides in a political struggle.  As Slate’s Dahlia Lithwick says,  there may not be five justices who want to want to make the court itself an election-year issue.  Lithwick says that “I don’t think Chief Justice John Roberts wants to borrow that kind of partisan trouble again so soon after Citizens United, the campaign-finance case that turned into an Obama talking point.  And I am not certain that the short-term gain of striking down some or part of the ACA (embarrassing President Obama even to the point of affecting the election) is the kind of judicial end-game this court really cares about.  Certainly there are one or two justices who might see striking down the ACA as a historic blow for freedom.  But the long game at the court is measured in decades of slow doctrinal progress — as witnessed in the fight over handguns and the Second Amendment — and not in reviving the stalled federalism revolution just to score a point.” 

The editors of Bloomberg Business Week fear the collateral damage that overturning the ACA might cause.  They note that “Should the Supreme Court take up healthcare reform this year?  So far, only one appeals court has ruled that the ‘individual mandate’ in ObamaCare — the requirement that virtually everybody must buy insurance, with government assistance if needed — overreaches the federal government’s powers under the commerce clause of the Constitution.  It’s not a trivial argument.  But an affirmative ruling would be a huge departure from our understanding of the commerce clause going back to the New Deal.  If the healthcare law’s individual mandate is unconstitutional, so is much of what the government has been doing for 80 years or so, and it will be the duty of the Supreme Court to sort through the ruins of the federal government as we know it and find a few shards to start building again.  We can’t help but suspect that the court will choose to avoid this opportunity, by not taking the case, by finding some other grounds for ruling, or by upholding ObamaCare.

“Ever since it passed in 2010, ObamaCare has been attacked as a costly and possibly unconstitutional intrusion of the federal government into people’s lives.  Almost the central issue in the campaign for the Republican presidential nomination has been the resemblance between ObamaCare and the state healthcare plan enacted in Massachusetts under then-Governor Mitt Romney.  Today, most Democrats feel the less said the better.  But if the new law loses in the Supreme Court, the political ramifications may look very different.  If the Supreme Court kills healthcare reform, it will stay dead a long time.  It took 17 years before anybody felt like scaling that mountain again after Hillary Clinton’s failure two administrations ago.”

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Virginia Appeal Confirms the ACA’s Individual Mandate

Monday, September 19th, 2011

The Obama administration won a round in the legal battle over the Patient Protection and Affordable Care Act (ACA) when a federal appeals court tossed out two lawsuits in Virginia.  The 4th U.S. Circuit Court of Appeals ruled in both lawsuits — one filed by Virginia Attorney General Kenneth Cuccinelli, the second by Liberty University – that the plaintiffs did not have legal standing to sue.  This is a rejection of the first case that ended with a ruling that the healthcare reform law was unconstitutional.  Additional cases remain active, including the lawsuit filed by 26 other states, which means that the issue has by not gone away.

Virginia argued that it had the right to challenge the individual mandate – a key proviso of the law that requires people to buy health insurance by 2014 or pay a tax penalty – because it interferes with a state law that says residents can’t be forced to purchase health insurance.  According to the court, “To permit a state to litigate whenever it enacts a statute declaring its opposition to federal law” would “convert the federal judiciary into a forum for the vindication of a state’s generalized grievances about the conduct of government.”  During oral arguments, a lawyer for the Obama administration said that the case “fails at the outset” because the mandate is applicable to individuals and not the state.  After the decision was handed down, Cuccinelli expressed “disappointment” that the case was thrown out.  According to Cuccinelli, “the Court did not even reach the merits on the key question of Virginia’s lawsuit – whether Congress has a power never before recognized in American history: the power to force one citizen to purchase a good or service from another citizen.”

In the case brought by Liberty University — a private Christian school — the court said in a 2 – 1 ruling that it was blocking the case because a federal tax law stripped it of jurisdiction to decide the issue.  The Court was the first to rule that the individual mandate is essentially a tax.  Because the mandate cannot be enforced until 2014, the Court ruled that the Anti-Injunction Act “strips us of jurisdiction” from hearing a pre-enforcement challenge.  “What the Court said is that the penalty for not complying with the mandate functions as a tax that cannot be challenged until it has been assessed,” said Kevin Walsh, a law professor at the University of Richmond School of Law.

Virginia Governor Bob McDonnell reacted to the ruling, saying “Today, a three judge panel, consisting of two judges appointed by President Barack Obama and one by former President Bill Clinton, found that Virginia lacks standing to challenge the individual mandate provision of the federal healthcare law.  We respectfully disagree with the panel’s reasoning.  To conclude that a state has no standing to challenge an expensive and burdensome federal mandate on its citizens that the state has banned in its law, might cause James Madison and George Mason, Virginia’s principal drafters of our nation’s founding documents, to promptly roll in their graves.  To dismiss a Virginia statute as a basis for standing, declaring it to be ‘quintessentially political,’ and asserting that a state cannot be a ‘constitutional watchdog’ undermines our precious principles of federalism.  This decision must be promptly appealed.

“As federal courts across the country continue to come to differing conclusions on the merits of cases arguing the unconstitutionality of the federal healthcare law, today’s decision further exemplifies why these cases should be expedited to the nation’s highest court.  It is the Supreme Court that will ultimately determine whether the federal mandate on every citizen to purchase health insurance violates the U.S. Constitution.  States and businesses continue to expend time and money and languish in uncertainty as they try to come into compliance with a law that may ultimately be ruled unconstitutional.  It is exasperating that the President and the Justice Department oppose a prompt resolution of this case through an expedited appeal.  America needs finality in this case,” according to McDonnell.

Judge Diana Gribbon Motz, who was appointed to the bench by President Clinton, wrote that the only apparent function of the state law was “to declare Virginia’s opposition to a federal insurance mandate.”  The state law was enacted just days after President Obama signed the ACA into law.

Writing in U.S. News & World Report, Scott Galupo says that “Cuccinelli and co. follow a long trail from the 18th century British jurist William Blackstone to the Dred Scott case to the New Deal to the present day.  The conservative team, at first, makes a tight, prudential case against the Obamacare mandate that I, in my nonprofessional capacity, happen to favor.”  Parsing Cuccinelli’s statement about the decision, Galupo notes that “In plainer, get-to-the-point English: We grant you the social safety net established under the ‘Roosevelt Settlement.’  We recognize Congress’s power to regulate interstate commerce.  We even grant that this power could conceivably deliver universal healthcare.  But for Pete’s sake, don’t try to include ‘inactivity’ — that is, not buying a health insurance plan on the private market — under its purview.  Because, once you regulate the act of doing nothing, what’s left to regulate?  Er, nothing.  Thus, does the state’s power to tax and police become theoretically unlimited?  But, later in the body of the piece, Team Cuccinelli begins to play other, more presently familiar cards.  Glenn Beck fans will recognize the faces in the rogue’s gallery: Justice Oliver Wendell Holmes, progressive philosopher John Dewey, and others who, this argument goes, created the post-New Deal legal and philosophical edifice.  Wouldn’t you know it, this welfare-state stuff constitutes a violation of natural law — which, ipso facto, means economic laissez-faire — and a lurch into moral chaos.  Echoing the newly popular Hayek, Cuccinelli’s article asserts the primacy of economic rights while characterizing as relativistic the not-exclusively-liberal jurisprudential argument that personhood and dignity precede the marketplace.  (Last I checked, I’ve never seen an unborn baby sign a contract.)”

The Obama administration remains optimistic about the ACA.  “When it ends, we are confident we will prevail,” White House adviser Stephanie Cutter said.

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Medicare ACOs Receive Mixed Reviews

Tuesday, August 16th, 2011

A Medicare pilot program started in 2005 chose 10 groups for an experiment in improving quality and controlling costs. This foreshadowed some of the cost-control rules in the Patient Protection and Affordable Care Act (ACA) , with groups given bonuses for meeting approximately 15 quality measures, and for spending at least two percent less than conventional Medicare.  This program is a forerunner to the Accountable Care Organization (ACO) model that is one of the prime means by which the ACA’s supporters expect it to control costs.  Now that the results are in, the quality issues were met, but the issue of cost proved to be far more difficult to achieve.

Writing in The Atlantic, Megan McArdle says that Donald Berwick, the head of the Centers for Medicare and Medicaid Services (CMS), says “he is optimistic about the potential of ACOs to lower costs by coordinating care, although he acknowledged that savings from the experiment ‘were unevenly distributed, and they were modest…if care is correctly coordinated, costs fall and quality rises.  To me, it’s a matter of how fast we will get there, not whether we will get there.’  He may be right; sometimes you just haven’t done a program correctly.  On the other hand, sometimes programs don’t work, were never going to work, and can’t be made to work.  Even in the latter case, you still hear the sort of thing that Berwick is saying from the proponents of said programs: we need more time, more money, more staff, more rules.  People have usually spent years, even decades, investing in their ideas; when contrary evidence comes in, their first instinct is rarely to say, ‘Well, that’s too bad–it sure seemed like it was going to work, but I guess it didn’t!’.  No, what they want to do is double down.”

Started in 2005 by the George W. Bush administration, the experiment offered “performance payments” to participants that met most of 32 measures of quality — half as many as in the proposed rule — and spent at least two percent less for Medicare patients.  Despite their spotty financial progress, all 10 medical groups in the experiment met the quality requirements.  Additionally the program promoted care innovations, according to administration officials, outside health policy experts and leaders of the groups.

The Obama administration recently announced new options for Medicare ACOs.  The new shared savings components complement the proposed rules that will be finalized this year, Dr. Berwick said.  This pioneering model has been in process for months and that the latest announcement was not in response to skepticism about the proposed rules.  “This is responsive to some of the concerns on how to get started faster,” Dr. Berwick said.  “That’s what we’re getting asked about a lot. The criticism is comment we’re welcoming.”

CMS’ announcement represents a step in the right direction, although additional changes to the shared savings program need to be included to assure physician involvement, said American Medical Association’s (AMA) Immediate Past President J. James Rohack, MD.  “The AMA is pleased that (the innovation center) is working to assist physicians at varying stages of readiness who want to participate in Medicare ACOs,” Dr. Rohack said.  “The benefits of this new care delivery model cannot be fully realized unless physicians in all practice sizes can be involved.”

The CEO of the Cleveland Clinic hates proposed federal rules for accountable care organizations, saying they create “significant barriers” and would discourage hospitals from adopting the new model of care.  Toby Cosgrove made the comments in an eight-page letter addressed to Donald Berwick, though Cosgrove stressed that the Clinic supports the concept of accountable care organizations (ACOs).

“Rather than providing a broad framework that focuses on results as the key criteria for success, the proposed rule is replete with (1) prescriptive requirements that have little to do with outcomes; and (2) many detailed governance and reporting requirements that create significant administrative burdens,” according to Cosgrove.

To be considered an ACO, organizations must agree to manage all of the health needs of a minimum of 5,000 Medicare beneficiaries for at least three years.  ACOs are appealing to hospitals because organizations that save Medicare money will be eligible to share in some of that savings themselves.  CMS is accepting public comments on its proposed ACO rules and will issue final rules later this year.  Like the Clinic, other leading hospitals have criticized the rules as being too burdensome and providing too little possibility of financial gain.

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Affordable Care Act Under Siege As It Celebrates Its 1st Birthday

Wednesday, March 30th, 2011

As the Patient Protection and Affordable Care Act (ACA) celebrates its first birthday, the future of the law is still unclear, but its effects have been enormous.  The debate over the law likely created the “tea party” movement.  Last November, Republicans took control of the House of Representatives and strengthened their numbers in the Senate.  Potential contenders for the 2012 Republican presidential nomination need only say one word, “Obamacare,” to get a negative reaction from a crowd.  President Obama at times himself has struggled to ensure that his first term isn’t defined solely by this legislation.

Public opinion over the ACA remains divided, despite the efforts of Democrats to showcase how it will provide healthcare insurance to millions of uninsured Americans.  Additionally, most Americans remain confused about what the healthcare overhaul actually accomplishes.  Republicans considering a 2012 presidential race for the most part stand united in their opposition to the legislation.  Former Minnesota Governor Tim Pawlenty is using his opposition to the law to gain a national following.  “If courts do not do so first, as president, I would support the immediate repeal of Obamacare and replace it with market-based healthcare reforms,” Pawlenty said.  Former Massachusetts Governor Mitt Romney is in a different position because he supported a similar law during his tenure.

Representative Steve King (R-IA), the Iowa Congressman who is in the vanguard to repeal the ACA, says that “America will never become the nation it can be if were saddled with Obamacare“, “I have a deep conviction that this is unconstitutional, that this is unsustainable, and I have a duty.  And that doesn’t mean I sit back and wait for the Supreme Court to save America from itself.  It’s my job to step up and lead.”

Taking a difference stance, Carmela Coyle, president and chief executive of the Maryland Hospital Association, said her group strongly supports the reform law and will work to assure that the effort translates into better and cost-effective care.  “We support healthcare reform because hospitals see every day what happens when patients don’t have the healthcare coverage they need and can’t get their care at the right time and in the right setting.  Expanding coverage was necessary, and it was right.  We must ensure that the health coverage now guaranteed to many Marylanders is meaningful coverage.”

What’s the future of the Affordable Care Act? House Republicans, who say the law gives the federal government too much control and doesn’t cut costs, passed a repeal bill after they became the majority in January.  Full repeal is unlikely unless Republicans successfully take control of the Senate and the presidency in the 2012 presidential elections.  The current Democratic-led Senate will not vote to repeal and President Obama would certainly veto a repeal bill.  Democrats argue the law’s reforms will slow the growth of healthcare costs while improving care and reducing the ranks of the uninsured.  Republican efforts to withhold funds to block the law’s implementation will be DOA in the Senate.  That leaves Republicans the option of picking apart the law regulation by regulation, a strategy that could prove more successful.

In the meantime, implementation is underway.  “As we look forward with implementation of the health reform law, the states really become the focus now,” said Jennifer Tolbert, a principal policy analyst at the Kaiser Family Foundation.  “When thinking about the coverage expansions in particular because it is going to be up to the states to implement the expansion of the Medicaid program for lower-income individuals and to create the new health-insurance exchanges that will provide access to private insurance for moderate and middle income individuals.”

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Judge Rules That Healthcare Law Must Be Implemented as it Heads to the Supreme Court

Tuesday, March 15th, 2011

The same Florida federal judge who declared President Barack Obama’s healthcare reform law unconstitutional ruled that states must continue implementing it as the case goes through the courts. U.S. District Judge Roger Vinson was responding to a request from administration attorneys who sought to ensure that states obey the law until their challenge to it is resolved.  Two other federal judges have upheld the law; one in Virginia has ruled against it.  The law’s ultimate fate is expected to be decided by the Supreme Court. In all, three federal judges have ruled that Congress possesses the authority under the Commerce Clause of the Constitution to enact the Patient Protection and Affordable Care Act (ACA).  The mandate requires that all Americans acquire healthcare coverage.  Two other federal judges have voted that the healthcare reform law is unconstitutional.

“It would be extremely disruptive and cause significant uncertainty” to halt implementation, Vinson wrote.  He added that if the federal government does not appeal within seven days, the states can consider the law invalid.  The Justice Department welcomed the stay and plans to file an appeal within the required time frame.  David Rivkin, a lawyer representing the 26 states challenging the law, said the decision “gets us exactly what we always wanted, which is an expeditious appellate process.”

“The battle lines have been drawn, the relevant case law marshaled and the legal arguments refined,” Vinson wrote.  “It is very important to everyone in this country that this case move forward.”  In some ways, the ruling was a victory for the Obama administration because it ended confusion over whether states should continue working to implement the law. “We appreciate the court’s recognition of the enormous disruption that would have resulted if implementation of the Affordable Care Act was abruptly halted,” Justice Department spokeswoman Tracy Schmaler said in a statement.  “We strongly disagree with the district court’s underlying ruling in this case and continue to believe — as three federal courts have found — that this law is constitutional.”

“It almost seems to be that he’s (Vinson) telling the 11th Circuit what they’re supposed to do,” said Tim Jost, a professor at Washington & Lee University School of Law.  “I’m not sure they’re going to take very kindly to that.”  The case was brought by 26 states and the National Federation of Independent Business NFIB), which hoped for an injunction clearly barring implementation of the reform law.  “The government’s attempts to stymie the judicial process are simply prolonging the uncertainty surrounding the law and do a disservice to the states, small-business owners and individuals who are seeking resolution,” said Karen Harned, executive director of the NFIB Small Business Legal Center.

In her “Right Turn” column in the Washington Post, blogger Jennifer Rubin writes that “When U.S. District Judge Roger Vinson issued his ruling finding ObamaCare unconstitutional, liberals seemed to develop a reading comprehension problem.  He plainly stated that the law is unconstitutional, but defenders of ObamaCare seemed not to grasp that the judge meant the government was supposed to follow that edict.  Can we imagine the howls that would have gone up had the Bush administration acted with such brazen dishonesty and contempt for a court?”

According to Rubin, “In sum, the administration’s feigned lack of understanding of the court’s earlier ruling, a position egged on by the liberal cheerleaders for ObamaCare, has only served to speed up the next level of review of ObamaCare’s constitutionality.  Moreover, for an administration promising to ‘depoliticize’ the administration of justice and to be faithful defenders of the rule of law, this episode shows the chasm between administration rhetoric and behavior.”

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Healthcare Law Repeal DOA in Senate; Likely Headed to the Supreme Court

Monday, February 14th, 2011

The Republican House of Representatives’ attempt to repeal the Patient Protection and Affordable Care Act was DOA — as expected — in the Democratic-controlled Senate.  Voting along strict party lines, all 50 Democratic Senators who were present and one Independent gave the repeal a thumbs down.  All 47 Republican Senators voted in favor of repeal.  Two Senators – one a Democrat and the other an Independent – were not present to vote.

Senator Barbara Mikulski (D-MD) delivered a scornful speech during the heated debate, saying the Republicans are offering “one more hollow, symbolic pander-to-the-masses amendment.  If you want to rewrite the bill, keep your promise, Republican Party, that if you want to repeal, then let’s go replace.  I want to hear their ideas for replacement.  I challenge them right here, right now, today on this amendment.”  Not surprisingly, Republican Senate leaders disagree with Senator Mikulski’s stance. “We think it is just the beginning,” Senate Republican Minority Leader Mitch McConnell (KR-KY) said Wednesday after the Senate voted to reject an amendment he offered to repeal the law.  “This issue is still ahead of us and we will be going back at it in a variety of ways,” McConnell noted.  “We’ll be looking at it in every different way to revisit it.”

The Republicans can claim a small victory as the Senate voted to repeal the 1099 requirement that was a highly unpopular inclusion in the healthcare reform law. Many perceived this as a tax on healthcare consumers and small businesses because it required anyone performing a transaction equaling $600 or more to file a 1099 form with the IRS.  The cost of the requirement had the potential to add up to 40 percent for some small businesses, which could have resulted in closures or layoffs.  The amendment passed the Senate by an 81 – 19 vote and has President Barack Obama’s support. Opponents of the amendment, such as Senator Carl Levin (D-MI), said that Congress, not the White House, should wield the budget-cutting ax.

The Senate’s actions come on the heels of a decision by Florida Federal District Court Judge Roger Vinson that it is unconstitutional for Congress to pass a healthcare law that requires Americans to obtain insurance coverage.  Judge Vinson’s decision created a 2 – 2 tie in lower courts. According to Judge Vinson’s decision, “The act, like a defectively designed watch, needs to be redesigned and reconstructed by the watchmaker.”

Judge Vinson’s decision increases the likelihood that the Affordable Care Act will end up in front of a Republican-dominated Supreme Court. “A year ago, it was a long shot,” said Randy Barnett, a law professor at Georgetown University.  “Now, it’s seen as a 5 to 4 case.  And nobody’s sure which way the 5 – 4 will come down.”  The stakes are enormous for the defining achievement of the Obama presidency.  The decision also has the potential to define the limits of federal power for generations.  “This case could define federalism for the next 100 years,” said Jonathan Turley, a George Washington University constitutional law professor.  “This is a very difficult case for the Supreme Court as an institution.  You have a slight majority of the states opposing it.  You have a national law that’s affecting hundreds of billions of dollars and services.  This is the type of case the justices do not relish.”

Additionally, Virginia Attorney General Ken Cuccinelli has asked the Supreme Court to fast track his state’s challenge to the healthcare law, saying he thinks the legal dispute has become so important that the nation’s highest court should take it up immediately. “We want to eliminate the uncertainty in both our governmental budgets and in the private sector,” he said.  “We want to eliminate at least the uncertainty associated with health care.” The Obama administration opposed the move, saying the case should follow the regular process.  This would put off until 2012 a Supreme Court ruling on the law that aims to provide more than 30 million uninsured Americans with medical coverage and cracks down on unpopular insurance industry practices.

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Lie of the Year: Reform Equals a Government Takeover of Healthcare

Tuesday, December 28th, 2010

The most egregious lie of the year, according to PolitiFact.com, is the suggestion that President Barack Obama’s landmark healthcare reform law is a “government takeover of healthcare.” This is the opinion of PolitiFact.com,  the St. Petersburg Times’ independent fact-checking website.  In early 2009, Republican strategist Frank Luntz urged GOP legislators to call the bill a “government takeover.”  According to Luntz, “Takeovers are like coups.  They both lead to dictators and a loss of freedom.”  PolitiFact’s runner-up lie was Representative Michele Bachmann’s (R-MN) statement that President Obama’s trip to India would cost taxpayer $200 million a day.

Jonathan Oberlander, a health policy professor at the University of North Carolina at Chapel Hill, said “The label ‘government takeover’ has no basis in reality, but instead reflects a political dynamic where conservatives label any increase in government authority in healthcare as a ‘takeover’.”  Although the new law increases government oversight of health insurance companies, it relies on private companies and the free market.

Others are in agreement with PolitiFact’s stance.  The online magazine Slate said “the proposed healthcare reform does not take over the system in any sense.”  Princeton University professor Uwe Reinhardt, a healthcare economics expert, wrote in the New York Times that “Yes, there would be a substantial government-mandated reorganization of this relatively small corner of the private health insurance market (that serves people who have been buying individual policies).  But that hardly constitutes a government takeover of American healthcare.”

When a spokesman for incoming Speaker of the House John Boehner (R-OH) was asked about Republicans’ insistence on using the phrase – even now that it’s been thoroughly debunked – the response was “We believe that the job-killing ObamaCare law will result in a government takeover of healthcare.  That’s why we have pledged to repeal it, and replace it with common-sense reforms that actually lower costs.”

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New Republican Congressman Peeved About His 28-Day Wait for Healthcare Coverage

Tuesday, November 30th, 2010

New Republican Congressman Peeved About His 28-Day Wait for Healthcare CoverageWith millions of Americans poised to get health care coverage when the Patient Protection and Affordable Care Act takes full effect in 2014, pity the plight of Andy Harris (R-MD), an incoming Congressman who will represent Maryland’s Eastern Shore in the 112th Congress.  Harris, an anesthesiologist who ran on a platform supporting the repeal of the healthcare reform law, was shocked when he learned that his taxpayer-funded, government-run healthcare plan won’t take effect until 28 days after he is sworn into office on January 3.

According to a congressional staffer, Harris — while attending an orientation session for newly elected members of Congress — “Stood up and asked the two ladies who were answering questions why it had to take so long, what would he do without 28 days of healthcare.  Harris then asked if he could purchase insurance from the government to close the gap.”  His spokeswoman, Ana Nix, said “This is the only employer I’ve ever worked for where you don’t get coverage the first day you are employed.”  To the contrary, waiting periods for employer-sponsored health benefits are common.  The typical waiting period is 90 days and the average is just over two months, according to the Kaiser Family Foundation’s 2009 survey of employer health benefits.

Speaking about President Obama’s healthcare law, which mandates that the majority of Americans purchase some kind of health insurance coverage, Harris said “If we can’t repeal it we’re going to try to change it in such a way to remove the parts that people don’t like.” Harris defeated Democrat Frank Kratovil, who voted against the healthcare law.

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GOP Vows to Repeal the Affordable Care Act

Monday, November 8th, 2010

Newly empowered GOP sets its sights on rolling back healthcare reformNow that the GOP has retaken control of the House of Representatives, one of their overarching goals – according to Speaker-of-the-House-to-be John Boehner (R-OH) – is to repeal the landmark Affordable Care and Patient Protection Act that would provide healthcare coverage for millions of Americans who now have no insurance.

In Boehner’s own words, “The American people are concerned about the government takeover of healthcare,” he said.  “I think it is important for us to lay the groundwork before we begin to repeal this monstrosity and replace it with common-sense reforms that will bring down the cost of healthcare insurance in America.”  “Republicans will roll back whatever they can on healthcare,” noted Douglas Holtz-Eakin, a former Congressional Budget Office director.

Yet, there’s no hard evidence that the Republicans want to replace the current law with their own version of healthcare reform.  The GOP vision would give states the power to fund programs that extend coverage to some uninsured Americans.  People would also be allowed to carry insurance policies across state lines.  Mandates and government-run insurance pool would be non-existent.  Additionally, Republican legislation would cap court malpractice awards and help people direct more pretax money into healthcare savings accounts.  The Republican plan is anticipated to cut deficits by $68 billion over a decade.  On the downside, it would cover only about three million of the uninsured, leaving 52 million Americans with no healthcare coverage, according to Douglas Elmendorf, who is currently the Congressional Budget Office director.

There’s a significant roadblock in the way of the Republicans’ healthcare plan:  the presidential veto, which can be overturned only by a 2/3 vote in both houses of Congress.  “It would be a symbolic vote – a vote of intention rather than reality,” said Joseph Antos of the conservative think tank American Enterprise Institute.

Complicating the situation is the fact that some aspects of healthcare reform already in effect are quite popular, such as the provisions forcing insurers to cover children with pre-existing conditions and allowing parents to keep kids up to age 26 on their policies.

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Affordable Care Act Passes Its First Court Test

Thursday, October 28th, 2010

Healthcare reform survives its initial court case. Can the government make people buy insurance?  The Affordable Care Act (ACA) has survived its first court test, an attempt in Michigan to overturn the mandatory insurance provision that requires Americans to buy minimum coverage. The ruling by U.S. District Judge George Steeh was in response to a lawsuit filed by the Thomas More Law Center, which had requested an injunction against the ACA on the grounds that it exceeds Congress’ authority and is an unconstitutional tax.

In his 20-page decision, Steeh ruled that Congress has the power to pass the law under the Commerce Clause of the United States Constitution.  According to the decision, “The minimum coverage provision, which addresses economic decisions regarding healthcare services that everyone eventually, and inevitably, will need, is a reasonable means of effectuating Congress’ goal.”

Steeh noted that “Without the minimum coverage provision, there would be an incentive for some individuals to wait to purchase health insurance until they needed care, knowing that insurance would be available at all times.  As a result, the most costly individuals would be in the insurance system and the least costly would be outside it.  In turn, this would aggravate current problems with cost-shifting and lead to even higher premiums.”

The Thomas More Law Center plans to appeal Judge Steeh’s ruling.

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