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Home > Blog > All > Affordable Care Act

Affordable Care Act

  • March 21, 2012

    Health Care Reform Coercion: Unique Until It Isn't

    Guest Post

    By Sergio Eduardo Muñoz, Senior Policy Analyst, Health Policy Project, Office of Research, Advocacy, and Legislation, National Council of La Raza. This piece is cross-posted at NCLR Blog.

    Earlier this month, a curious thing happened in Texas. Despite repeated federal warnings, Texas enacted state rules that gutted its Women’s Health Program (WHP), a successful state program for low-income health care. Because this state action defunds almost half of the program’s health clinics solely due to their affiliation with Planned Parenthood, the Obama administration advised Texas that the move violated patient choice under federal law. Texas went ahead anyway, despite the ensuing loss of federal dollars as a consequence for noncompliance, and now over 130,000 low-income Texans will be without vital preventive services.

    What didn’t happen?  Texas didn’t drop its vendetta against essential women’s health providers, choosing instead to come between some of the state’s most vulnerable people and preventive care. What else didn’t happen?  Texas, currently arguing before the Supreme Court that it is a victim of Medicaid coercion under the Affordable Care Act (ACA), was not coerced to maintain its WHP. A program that is—you guessed it—funded by Medicaid.

    Last week’s final reply brief filed by the states in the ACA cases has a quick explanation for the contradiction. According to the states, the Medicaid expansion under the ACA is unique, the coercion is unique, the challenge is unique, and the ultimate Supreme Court decision will accordingly be unique as well. Nothing to see over there in uncoerced Texas, and don’t worry about setting bad precedent either. A convenient assurance about a case that clearly could have sweeping consequences for many more federal laws enacted under spending powers, but one of cold comfort in light of the boldness of the actual challenge and the ineffectiveness of similar attempts at damage control. Furthermore, it’s curious that these state litigants, who were previously so concerned about the lack of a limiting principle on the federal government’s powers to regulate commerce and spend in the general welfare, now introduce an argument challenging the Medicaid expansion that itself has no limiting principle.

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    Tags:
    Commerce clause, Constitutional Interpretation and Change, Economic, Workplace and Environment Regulation, Affordable Care Act, Guest Post, Medicaid, Texas
  • March 16, 2012

    SCOTUS Rejects Live Broadcast of Health Care Arguments, But Will Release Audio Each Day

    by Nicole Flatow

    The U.S. Supreme Court today said today it will not allow live, televised coverage of oral arguments on the constitutionality of the Affordable Care Act.

    The court will, however, post audio and transcripts on each of the three days of arguments, within two hours after the day's arguments are complete, The Associated Press reports. Typically, the Supreme Court posts audio files on Fridays.

    The announcement is likely to heighten the “mad dash” to get one of a few coveted spots inside the courtroom.

    "It's like the most important ticket of the decade," Ezekiel Emanuel, a former white house advisor, told The Wall Street Journal. 

    Tags:
    Supreme Court, Affordable Care Act, Health Care Reform
  • March 16, 2012

    Majority of Legal Experts Predict Supreme Court Will Uphold Health Care Law

    by Nicole Flatow

    Eighty-five percent of "a select group of academics, journalists and lawyers who regularly follow and/or comment on the Supreme Court" believe the U.S. Supreme Court will uphold the Affordable Care Act, according to a new American Bar Association poll.

    The widespread belief among legal experts that the health care reform law is constitutional is nothing new. As Reuters’ Joan Biskupic writes in a story tracing the history of the health care litigation, legal challenges to the law were initially regarded among many law professors as “implausible” and “frivolous.”

    She explains:

    As the suits proliferated, many professors, including conservatives, declared the challenges meritless. Charles Fried, a U.S. solicitor general under Reagan and now a Harvard law professor, told Greta Van Susteren of Fox News that he was so confident the individual mandate was valid that he would eat his hat - "bought in Australia ... made of kangaroo skin" - if the law was struck down.

    Public buy-in of the concept that the individual coverage provision is unconstitutional increased when the challengers recruited seasoned Supreme Court litigator Paul Clement. Clement shifted the argument away from directly relevant Commerce Clause precedent and toward the slippery-slope message that there are no discernible limits on the government’s commerce power, and that the law is “unprecedented.”

    The “It’s unprecedented!” rhetoric has been a rallying cry throughout history for those pushing back against progress, writes UCLA law professor Adam Winkler in a column for the San Jose Mercury News. But it hardly ever succeeds. He explains:

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    Tags:
    Economic inequality, Commerce clause, Supreme Court, Constitutional Interpretation and Change, Economic, Workplace and Environment Regulation, Affordable Care Act, Health Care Reform, individual coverage provision, Patient Protection and Affordable Care Act
  • March 15, 2012

    Health Care Reform: The Centrality of the Individual Mandate

    BookTalk
    Health Care Reform
    What It Is, Why It's Necessary, How It Works
    By: 
    Jonathan Gruber
    Available Here

    By Jonathan Gruber, a professor of economics at the Massachusetts Institute of Technology

    The Affordable Care Act (ACA) represents the most fundamental reform of the U.S. health care system of the past 50 years. Such an important social policy change should be widely understood by our citizens so that it can be most effectively implemented. Yet the ACA is sufficiently ambitious and complicated that understanding of the law is quite poor. This is one of the reasons I chose a graphic format for my book, Health Care Reform: What It Is, Why It's Necessary, How It Works.

    You can’t understand the need for, and the accomplishments of, health care reform without appreciating the fundamental failure in health insurance markets today. Unless you are offered insurance by your employer, or by the government, there is effectively no meaningful insurance in America. Individuals subject to the harsh “non-group” market face exclusions from pre-existing illness or can be dropped as soon as they become ill. And the key to solving this problem is the individual mandate, which can end insurance market discrimination by promoting broad insurance participation.

    At the heart of this reform is what I like to think of as a “three legged stool” designed to solve this problem and, as a byproduct, cover most of our nation’s uninsured. The first leg is insurance market reform which will end the ability of insurance companies to discriminate against the sick; no longer will we be one bad gene or one bad traffic accident away from bankruptcy. The second is the individual mandate, which requires insurance coverage so long as that coverage is affordable (costs less than 8% of income). This mandate is critical; without it, insurers will react to insurance market reform by raising prices because they are afraid only the sick will buy insurance. But you can’t mandate insurance coverage unless it is affordable, which it is not for low income Americans.  That’s why we need the third leg of the stool: extensive subsidies that will make health insurance affordable for those living below median income.

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    Tags:
    Economic inequality, Commerce clause, Supreme Court, Constitutional Interpretation and Change, Economic, Workplace and Environment Regulation, Equality and Liberty, Affordable Care Act, BookTalk, Health Care Reform, Patient Protection and Affordable Care Act
  • March 14, 2012

    The Constitution at a Crossroads: The Ideological Battle over the Meaning of the Constitution

    Guest Post

    By Doug Kendall, President, Constitutional Accountability Center

    Lyle Denniston recently described “the tendency of the ‘Roberts Court’ to take on the broadest kind of controversy in cases brought to it.” From Citizens United v. FEC, in which the Court expanded the case on its own motion, scheduled a second argument, and then issued a sweeping ruling discarding prior case law, to the Affordable Care Act (ACA) cases about to be argued, in which the Court decided to hear just about every claim presented to it -- including claims unanimously rejected by the lower courts -- and scheduled six hours of argument time over three days, the Court under Chief Justice John Roberts has put itself at the center of some of the most important political controversies of our day.

    Decisions like the Court’s 5-4 ruling in Citizens United illustrate that the Roberts Court is not only taking big cases and issuing sweeping rulings, it is also splitting sharply along ideological lines on important questions about the meaning of our founding document. That is the focus of The Constitution at a Crossroads: The Ideological Battle over the Meaning of the Constitution, an attempt by Constitutional Accountability Center (CAC) to map and describe the ideological battlegrounds on the Roberts Court. We began to rollout the Crossroads project today with a media teleconference featuring Tom Perriello (former Member of Congress and current head of Center for American Progress Action Fund) and myself (you can listen to our remarks here).

    CAC will be releasing Crossroads chapter-by-chapter over the next several months, beginning today with the release of three chapters on the powers of the federal government, which helps set the stage for the ACA argument later this month. Our plan is to release a dozen or so more chapters over the course of the spring, as the Court races toward the end of its October 2011 Term. After the Court completes its work, we will spend the summer editing, revising and compiling Crossroads into a single document for release in the early fall, timed to coincide with the celebration of the 225th Anniversary of the ratification of the Constitution and  the opening of the Court’s October 2012 Term. Because Crossroads will be released over time and then revised and edited after the Court ends its Term in June, we very much welcome comments and criticisms from ACS members as we shape the final product.

    Crossroads is not the first attempt to map the ideological divisions on the Supreme Court. In 1988, in the wake of the decisive defeat of the nomination of Robert Bork to the Supreme Court and in the run-up to an election that seemed destined to determine the direction of the Court for a generation to come, the Reagan Justice Department released a series of reports that highlighted “substantial differences of opinion over the judicial role in contemporary society.” The most famous of these reports, entitled The Constitution in the Year 2000, highlighted fifteen areas of constitutional law likely to be decided by the Supreme Court over the intervening years, and the “alternative roads down which the Court might travel over this time.”

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    Tags:
    Fidelity to the Constitution, Methods of interpretation, Constitutional Interpretation and Change, ACA, Affordable Care Act, CAC, Citizens United v. FEC, Constitutional Accountability Center, Doug Kendall, Guest Post, Robert Bork, Roberts Court, Supreme Court, The Constitution at a Crossroads: The Ideological Battle over the Meaning of the Constitution, The Constitution in the Year 2000
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