Health Care Reform

  • July 18, 2016
    Guest Post

    by Simon Lazarus, Senior Counsel, Constitutional Accountability Center

    *This post originally appeared on the Constitutional Accountability Center's Text & History Blog.

    Republicans in the U.S. House of Representatives – undaunted despite having come up short for six years with ceaseless efforts to kill or maim the Affordable Care Act – struck again, on Thursday, July 7, and Friday, July 8, with back-to-back hearings in two separate committees. As touted in the headline of their joint press release, the two committees – Ways & Means and Energy & Commerce – sought to “Highlight Obama Admin’s Unprecedented Obstruction to Withhold Facts On Billions In Illegal Obamacare Payments.” 

    The purported occasion for the redundant hearings was the release of a 158 page “investigative report” amplifying House Republicans’ claim that the Administration has funded the ACA “Cost-Sharing Reduction” program without a “constitutionally required appropriation from Congress.”  The cost-sharing reduction (CSR) program currently helps 6.4 million lower income individuals to afford deductibles, co-pays, and co-insurance prerequisites for purchasing health care services and products. Many of these individuals could not afford health care, and therefore might forego buying buy health insurance without it, antithetical to the outcome the ACA was designed to produce.

    The CSR subsidies work in tandem with the ACA tax credit program subsidizing insurance premiums, which the Supreme Court held applicable nationwide one year ago in King v. Burwell, rejecting a high-profile lawsuit by anti-ACA activists. If successful, that lawsuit would have barred the premium assistance tax credits in the 30+ states with exchange marketplaces managed by the federal government, rather than by the state on its own.  

    Much like that failed legal challenge, the committees’ attack on the complementary CSR program, itself the subject of an unprecedented lawsuit by the House Republican majority now pending in the D.C. Circuit Court of Appeals, promotes two persistent partisan objectives: to render the ACA dysfunctional, and to reiterate Republicans’ chestnut that President Obama constantly breaches his legal authority, violating his constitutional obligation to “take care that the laws be faithfully executed.” 

  • January 13, 2016

    by Jim Thompson

    On Tuesday, the Supreme Court struck down Florida’s death sentencing system as unconstitutional. In an 8-1 decision, the court ruled that a system which places a judge rather than a jury as the final arbiter violates the Sixth Amendment, writes Nina Totenberg at NPR.   

    At The Atlantic, Teresa Ghilarducci says Social Security is underfunded because policymakers did not predict “how rich today’s rich would be,”  explaining that the method for funding Social Security was calibrated to an America with less income inequality.

    Elsewhere in The Atlantic, Garrett Epps notes that one of the most important cases of the term – Friedrichs v. California Teachers Association – “will be decided on the basis of no facts at all,” and he criticizes members of the Supreme Court’s conservative bloc for routinely making decisions without considering the practical implications of their votes.

    In an effort to counter the nation’s elder care crisis, Hawaii may soon become the first state in the union to offer universal long-term healthcare for seniors, reports Rachel M. Cohen at The American Prospect

  • July 26, 2013
    Guest Post
    by Leslie C. Griffin, William S. Boyd Professor of Law, UNLV Boyd School of Law 
     
    Liberty University v. Lew, the Fourth Circuit’s recent decision about the Affordable Care Act [ACA], should please no one. The opinion demonstrates the dangers of exempting religious organizations and individuals from the law. Take your pick. The court either exempted too many, or too few. Its middle ground unsatisfactorily addresses the First Amendment challenges to the Act.
     
    Individual plaintiffs and Liberty University opposed the individual and employer mandates of the ACA. The individual mandate requires individuals to obtain minimum essential health care coverage or pay a penalty in their taxes. The employer mandate requires employers to provide affordable minimal essential health care coverage to full-time employees or face a tax penalty.
     
    All plaintiffs are Christians morally opposed to abortion except to save the life of the mother. The most straightforward of their complaints alleged that their mandated insurance payments would wind up paying for abortions in violation of their constitutional and statutory rights. This is the simplest exemption argument in the case: plaintiffs think they should be exempt from the ACA because it burdens their religion.
     
    The court quickly dismissed that argument. Under the Free Exercise Clause, it ruled, the ACA is a neutral law of general applicability that applies to everyone without singling out religions for disfavor. Moreover, the court decided, plaintiffs’ religion was not burdened by the mandates. Although plaintiffs alleged that their money would be used for abortion, other provisions of the ACA required that a plan without abortion coverage would always be available as a choice for consumers. Without a substantial burden on religion, neither the Free Exercise Clause nor the Religious Freedom Restoration Act (which prohibits the federal government from substantially burdening religion without a compelling government interest) was violated.
     
  • July 11, 2012

    by Jeremy Leaming

    The right continues to wage a tiresome campaign against even modest efforts to repair the nation’s tattered social safety net.

    Although only symbolic, since it won’t go anywhere in the Senate, the House of Representatives passed a measure to repeal the landmark health care reform law, the Affordable Care Act (ACA).  

    It was not the first time the House has voted on such a measure. In fact the chamber has voted more than 30 times to repeal the ACA. The right-wing controlled House wants to remind everyone that it cares little about the tens of millions of uninsured Americans.

    House Democratic Whip Steny H. Hoyer (D-Md.) took to the floor during today’s vote to blast the House leadership’s continued obsession with destroying health care reform.

    “If this bill were to pass, insurance companies could once again discriminate against 17 million children with pre-existing conditions. If it were to pass, 30 million Americans would lose their health insurance coverage. It would take away $651 each from 5.3 million seniors in the Medicare ‘donut hole,’ making their prescription drugs more expensive,” Hoyer (pictured) said.

    He also noted that “6.6 million young adults under 26 would be forced off their parents’ plans, left to face a tough job market with the added pressure of being uninsured.”

    All of the Republican’s repeal bills, as Hoyer highlighted, contained no measures to help the uninsured.

  • June 29, 2012

    by Jeremy Leaming

    Reading from the bench during the announcement of the Supreme Court’s decision on the Obama administration’s landmark health care reform law, Justice Ruth Bader Ginsburg declared, “In the end, the Affordable Care Act survives largely unscathed.”

    Yes, the Obama administration’s signature legislative achievement and the strongest effort in many decades to repair the nation’s tattered social safety did survive Supreme Court scrutiny.

    But as noted here yesterday, it did so barely, and not in the manner that many constitutional law experts and the high court’s four moderate to left-of-center justices had thought it would. And the opinion also included a shrill dissent that envisions a vastly ineffective federal government. As former U.S. Solicitor General Walter Dellinger said during yesterday’s ACS press briefing if the dissent had carried the day it would have marked and “extraordinary revolution” in constitutional law jurisprudence.

    Although the federal government argued that the law’s integral measure, the minimum coverage provision, was constitutional on two major fronts, it was largely thought that it would be upheld as a valid regulation of commerce. The activity of the health care market represents nearly 18 percent of the nation’s economy.  

    But that did not happen. And some constitutional law scholars say that fact should not be ignored.

    Chief Justice John Roberts’ majority opinion provides some language suggesting the high court was not radically re-reading precedent on the commerce clause. But a careful reading of his opinion reveals that the libertarian argument for a vastly cramped interpretation of the commerce power carried the day.

    As The New York Times’ Adam Liptak put it, “Five justices accepted the argument that had been at the heart of the challenge brought by the 26 states and other plaintiffs: that the federal government is not permitted to force individuals not engaged in commercial activities to buy services they do not want. That was a stunning victory for a theory pressed by a small band of conservatives and libertarian lawyers. Most members of the legal academy view the theory as misguided, if not frivolous.”

    Justice Ruth Bader Ginsburg in her concurring opinion also took the chief justice to task for a “rigid reading” of the commerce clause that “makes scant sense and is stunningly retrogressive.”