Posts Tagged ‘ObamaCare’

Justice Ruth Bader Ginsberg did not mean to, but she appears to have said that the Supreme Court has, at a minimum, ruled that the individual mandate in ObamaCare is unconstitutional.

As reported by POLITICO, the liberal Justice told the American Constitutional Society on Friday, June 15 that the one remaining ObamaCare question the Court must decide is is whether the whole law must fall if the individual mandate is unconstitutional — “or may the mandate be chopped, like a head of broccoli, from the rest of it?”

But they would not need to decide this question if they had already ruled that the individual mandate passes Constitutional muster.

This suggests, at a minimum, that the individual mandate is gone.  But it may well be that the court has ruled that the entire ObamaCare law is, therefore, null and void because there is no severability clause.

A severability clause means that if one part of a piece of large legislation is ruled unconstitutional by a court, that unconstitutional portion is “severed” from the the bill — but the ruling would not stop the rest of the law from being enforced.

The Democrats at one point included a severability clause in ObamaCare. But they consciously took it out — apparently as a tactic to prevent opponents of ObamaCare from taking the law apart piecemeal.

But the Democrats may have been too clever by half — might have outwitted themselves on this one.

The court may well decide that because the severability clause was deliberately removed by Congress, that it wasn’t omitted by mistake, the clear intent of Congress was that the entire law must stand, or none of it. This appears to be the key debate that is happening, or has happened, in the court.

BETSY MCCAUGHEY: Presidential aspirant Mitt Romney may not have intended that the mandatory health insurance law he signed in 2006 would look like the Obama health law. But the Massachusetts law does a lot more than cover the uninsured (a worthy goal). The law broadens the powers of government to dictate treatment decisions and even interferes in where and how patients die. The result will be a breathtaking shift of decision-making from the doctor at bedside to the state.

The Massachusetts law has come under fire for soaring premiums, now the highest in the nation. A 2011 Beacon Hill Institute study concluded that 18,000 fewer people were employed in the state, because employers required to provide coverage left the state or stopped hiring to avoid the cost. But the cost cutting has begun, and the results are alarming.

Chapter 305 of the 2006 law created councils and regulatory bodies charged with cost-cutting, and after several years they have produced a plan. Here are key components:

Mandatory electronic medical records: All physicians must comply by January 2015 as a condition of keeping their medical license.

Comparative effectiveness: A state board — with unions, consumers, employers and other nonphysicians on it — will synthesize medical research into guidelines and ensure that all insurers and doctors follow them. These guidelines will lay out what care is “medically necessary” and include “how to address individual patient cases and circumstances.” Massachusetts says it and its bureaucrats can make better decisions than highly trained physicians at bedside. (Roadmap to Cost Containment pp. 10, 21,36)

Massachusetts’ End of Life Program: Sec. 41 of Chapter 305 of the Massachusetts law creates an expert panel to deal with how and where people die. The state will launch an aggressive public relations campaign to get hospitals and doctors to encourage palliative care, hospice care, and death at home. In Massachusetts, only 24 percent of people die at home. The state says that is too low. (Roadmap, pp.32,33, 41,90,)

Sometimes a patient doesn’t die at home because the doctor doesn’t foresee that death is imminent. A 2006 Emory University study found that doctors treat patients who are expected to die less intensively than patients who are expected to survive, but often doctors can’t predict who is near the end.

The benefits of hospice care are obvious. But physicians also worry that some patients will break down at the mention of hospice care and lose the will to fight their disease. Ultimately, the question is how involved should government be in how we die, especiall when the goal is to cut costs?.

Ending fee-for-service insurance options: Massachusetts will push patients into “medical homes,” to limit access to costly specialists and diagnostic tests, and substitute nurse practitioners and physicians assistants for doctors.

A 2008 Congressional Budget Office report noted that. if cost control is the priority, medical homes are likely to present the same problems as those  HMOs of 20 years ago.

HMOs would withhold physicians’ fees until the end of the year and give it back only to the physicians who met targets for limiting referrals or diagnostic tests. Ultimately, what a doctor prescribed for a patient came out of the doctor’s own pocket at the end of the year, setting up a conflict between you and your doctor. (Roadmap, p. 14)

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Sounds like Death Panels. If ObamaCare can’t even do this, what can it do?

ASSOCIATED PRESS: The Obama administration’s signature health overhaul law has suffered its first major casualty – a long-term care insurance plan.

The program, expected to launch in 2012, had been dogged from the beginning by doubts over its financial solvency.

Proponents, including many groups that fought to pass the health care law, have vowed a vigorous effort to rescue the program, insisting that Congress gave the administration broad authority to make changes. Long-term care includes not only nursing homes, but such services as home health aides for disabled people.

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ASSOCIATED PRESS: The federal government is taking on a crucial new role in the nation’s health care, designing a basic benefits package for millions of privately insured Americans. A framework for the Obama administration was released Friday.

The report by independent experts from the Institute of Medicine lays out guidelines for deciding what to include in the new “essential benefits package,” and how to keep it affordable for small businesses and taxpayers, as well as scientifically up to date.

The advisers recommended that the package be built on mid-tier health plans currently offered by small employers, expanded to include certain services such as mental health, and squeezed into a budget. They did not spell out a list of services to cover, but they did say that treatments should be cost-effective.

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CNS: The percentage of American adults who lack health insurance coverage has not only increased during the presidency of Barack Obama, but it has continued to increase since Obama signed his signature piece of legislation last year mandating that by 2014 every American carry health insurance, according to a Gallup survey released today.

In 2008, when George W. Bush was president, according to Gallup, 14.9 percent of adult residents of the United States lacked health insurance coverage. That increased to 16.2 percent in 2009, the year that Obama was inaugurated, and to 16.4 percent in 2010, the year that Obama signed his law requiring that all Americans have health insurance.

In the first half of this year, according to data released by Gallup today, the percentage of adults in the United States lacking health insurance ticked up to 16.8 percent.

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Tea leaves not looking good for Obama’s crowning achievement surviving the Supremes.

POLITICO: The 11th Circuit Court of Appeals on Friday ruled that the health care reform law’s requirement that nearly all Americans buy insurance is unconstitutional, a striking blow to the legislation that increases the odds the Supreme Court will choose to review the law.

The suit was brought by 26 states — nearly all led by Republican governors and attorneys general — and the National Federation of Independent Business. The Department of Justice is expected to appeal.

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BEN SAYS: Here’s another thing this chart shows. The economic recovery was well under way before any of Obama’s policies took effect. The economic recovery we were having in 2009 was a “Bush Recovery” that was then killed by Obama. More accurately, it was a normal recovery that happens as part of the normal business cycle if politicians don’t get in the way and mess it up. Had Obama done absolutely nothing but play golf, the economy would be booming by now.

 

JAMES SHERK-HERITAGE FOUNDATION: Private-sector job creation initially recovered from the recession at a normal rate, leading to predictions last year of a “Recovery Summer.” Since April 2010, however, net private-sector job creation has stalled. Within two months of the passage of Obamacare, the job market stopped improving. This suggests that businesses are not exaggerating when they tell pollsters that the new health care law is holding back hiring. The law significantly raises business costs and creates considerable uncertainty about the future. To encourage hiring, Congress should repeal Obamacare.

Initially Solid Job Growth

The economy is recovering at an unusually slow pace. Typically, employment grows strongly after a severe recession.[1] In the year and a half following the last comparable recession (1981–1982), the unemployment rate fell by 3.3 percentage points.[2]

Initially the economy appeared on track for a steady recovery. In August 2009, the White House projected the unemployment rate would fall to 8 percent by the end of 2011 and 7.5 percent by the end of 2012.[3] This would represent a recovery roughly one-third slower than after the 1981–1982 recession.[4]

Job creation data supported these forecasts. The economy went from losing 841,000 jobs in January 2009—the recession’s low point—to gaining 229,000 jobs in April 2010.[5] By the spring of 2010, the Administration confidently predicted a “Recovery Summer.”[6]

Obamacare Discourages Hiring

In March 2010, Congress passed President Obama’s health care reform legislation. The bill had appeared in serious jeopardy, and after the upset special election victory of Senator Scott Brown (R–MA), many analysts expected the bill to fail. Instead, it became law.

The law discourages employers from hiring in several ways:

• Businesses with fewer than 50 workers have a strong incentive to maintain this size, which allows them to avoid the mandate to provide government-approved health coverage or face a penalty;
• Businesses with more than 50 workers will see their costs for health coverage rise—they must purchase more expensive government-approved insurance or pay a penalty; and
• Employers face considerable uncertainty about what constitutes qualifying health coverage and what it will cost. They also do not know what the health care market or their health care costs will look like in four years. This makes planning for the future difficult.

Recovery Stalls Post–Obamacare

Within two months of Obamacare’s passing, the recovery stalled. Figure 1 shows net private-sector job creation from January 2009 onward. The red line shows the trend in job creation before and after April 2010. Private-sector job creation improved by an average of 67,600 jobs per month before April 2010.[7]That month, private-sector employers added 229,000 net jobs.

SOURCE: Heritage Foundation >>>

 

MICHELLE MALKIN: Is there a health insurance horror story disseminated by the White House and its allies that ever turned out to be true? Obamacare advocates have exercised more artistic license than a convention of Photoshoppers. Now, a prominent sob story shilled by President Obama himself about his own mother is in doubt. It’s high past time to call their bluffs.

The tall-tale-teller-in-chief cited mom Stanley Ann Dunham’s deathbed fight with her insurer several times over the years to support his successful push to ban pre-existing condition exclusions by insurers. In a typical recounting, Obama shared his personalized trauma during a 2008 debate: “For my mother to die of cancer at the age of 53 and have to spend the last months of her life in the hospital room arguing with insurance companies because they’re saying that this may be a pre-existing condition and they don’t have to pay her treatment, there’s something fundamentally wrong about that.”

But there was something fundamentally wrong with Obama’s story. In a recently published biography of Obama’s mother, author and New York Times reporter Janny Scott discovered that Dunham’s health insurer had in fact reimbursed her medical expenses with nary an objection. The actual coverage dispute centered on a separate disability insurance policy.

Channeling document forger Dan Rather’s “fake, but accurate” defense, a White House spokesman insisted to the Times that the anecdote somehow still “speaks powerfully to the impact of pre-existing condition limits on insurance protection from health care costs” — even though Dunham’s primary health insurer did everything it was supposed to do and met all its contractual obligations.

No matter. Expanding government control over health care means never having to say you’re sorry for impugning private insurers. Democrats have dragged every available human shield into the contentious debate over Obama’s federal takeover of health care. Personal anecdotes of dying family members battling evil insurance execs deflect attention from the cost, constitutionality and liberty-curtailing consequences of the law. The president’s Dunham sham-ecdote is just the latest entry in an ever-expanding catalogue of Obamacare fables:

– Otto Raddatz. In 2009, Obama publicized the plight of this Illinois cancer patient, who supposedly died after he was dropped from his Fortis/Assurant Health insurance plan when his insurer discovered an unreported gallstone the patient hadn’t known about. The truth? He got the treatment he needed in 2005 and lived for nearly four more years.

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Speaker Nancy Pelosi at the health summit: “It’s about jobs. In it’s life, it [the health bill] will create 4 million jobs — 400,000 jobs almost immediately.”

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ILYA SHAPIRO-CATO INSTITUTE: In the most important appeal of the Obamacare constitutional saga, today was the best day yet for individual freedom. The government’s lawyer, Neal Katyal, spent most of the hearing on the ropes, with the judicial panel extremely cautious not to extend federal power beyond its present outer limits of regulating economic activity that has a substantial aggregate effect on interstate commerce.

As the lawyer representing 26 states against the federal government said, “The whole reason we do this is to protect liberty.” With those words, former solicitor general Paul Clement reached the essence of the Obamacare lawsuits. With apologies to Joe Biden, this is a big deal not because we’re dealing with a huge reorganization of the health care industry, but because our most fundamental first principle is at stake: we limit government power so people can live their lives the way they want.

This legal process is not an academic exercise to map the precise contours of the Commerce Clause or Necessary and Proper Clause — or even to vindicate our commitment to federalism or judicial review. No, all of these worthy endeavors are just means to achieve the goal of maximizing human freedom and flourishing. Indeed, that is the very reason the government exists in the first place.

And the 11th Circuit judges saw that. Countless times, Judges Dubina and Marcus demanded that the government articulate constitutional limiting principles to the power it asserted. And countless times they pointed out that never in history has Congress tried to compel people to engage in commerce as a means of regulating commerce. Even Judge Hull, reputed to be the most liberal member of the panel, conducted a withering cross-examination to establish that the individual mandate didn’t help that many people get affordable care, that the majority of people currently without coverage would be exempt from the requirement (presumably due to their income level).

In short, while we should never read too much into an oral argument, I’m more optimistic about this case now than any other.

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