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The 11th Circuit’s Affordable Care Act Decision Cannot Be Squared With The Constitution

The key passage in today’s opinion striking down part of the Affordable Care Act appears on page 113, where the two judge majority explains how they will determine whether this law is constitutional:

In answering whether the federal government may exercise this asserted power to issue a mandate for Americans to purchase health insurance from private companies, we next examine a number of issues: (1) the unprecedented nature of the individual mandate; (2) whether Congress’s exercise of its commerce authority affords sufficient and meaningful limiting principles; and (3) the far-reaching implications for our federalist structure.

This is one way to evaluate whether a law is constitutional, but a better way is to ask whether the law can be squared with text of the Constitution. The Constitution provides that Congress may “regulate Commerce…among the several states,” and the very first Supreme Court decision interpreting this language made clear that this power is “plenary,” meaning that Congress may choose whatever means it wishes to regulate interstate marketplaces such as the national health care market, so long as it does not violate another textual provision of the Constitution.

A law requiring most Americans to either carry insurance or pay slightly more taxes clearly regulates the national market for health care. It determines how people will finance health care purchases. It lowers the cost of health insurance. And it protects that market from something known as an “adverse selection death spiral.” So that should have been the end of the case. The Court cites no provision of the Constitution limiting Congress’ authority to pass this law because no such provision exists.

Instead, it imposes two extra-textual limits on national leaders’ ability to solve national problems. If the law is somehow “unprecedented,” and if a decision upholding the law lacks vague and undetermined “meaningful limit[s]” on Congress’ authority that somehow upset the balance between federal and state power, then the law must be struck down even if the Constitution’s text says otherwise.

Yet even if these two novel limits are taken seriously, the court’s analysis still makes no sense. For one thing, the law is only “unprecedented” in the sense that it preferred a market-driven solution to the problem of widespread uninsurance over more government driven solutions such as Medicare. The truth is that Congress already requires nearly all Americans to purchase health insurance — and they have done so for many years. Every year the federal government collects taxes which are in no way optional. A portion of these taxes are then spent to buy health insurance for the elderly (Medicare) for the poor (Medicaid) and for children (SCHIP).

So the only real question in this case is whether the government is required to first take your money and then buy health coverage for you, or whether the Constitution allows Congress to cut out the middle man.

The Court is also simply wrong to claim that a decision upholding the ACA would necessarily mean that there are no limits on federal power. The Constitution does not simply allow Congress to regulate commercial markets. It establishes that, in Justice Scalia’s words, “where Congress has the authority to enact a regulation of interstate commerce, it possesses every power needed to make that regulation effective.”

Scalia’s rule is important because the ACA doesn’t just require people to carry insurance, it also eliminates one of the insurance industry’s most abusive practices — denying coverage to patients with pre-existing conditions. This ban cannot function if patients are free to enter and exit the insurance market at will. If patients can wait until they get sick to buy insurance, they will drain all the money out of an insurance plan that they have not previously paid into, leaving nothing left for the rest of the plan’s consumers.

Because the ACA’s regulation of the national insurance market cannot function without a requirement that nearly every American carry insurance. this requirement is clearly constitutional under Justice Scalia’s statement that Congress possess “every power needed” to make it’s economic regulations effective. Moreover, upholding the Affordable Care Act under Justice Scalia’s rule would require a court to do nothing more than hold that the Affordable Care Act is constitutional. There is no federal law which depends upon mandatory broccoli purchases, for example, in order to function properly in the same way that the ACA’s preexisting conditions provision can only function properly in the presence of an insurance coverage requirement. Accordingly, the court’s concern that upholding the law would destroy any limits on federal power is unwarranted.

As a final note, it is likely that conservatives will tout the fact that Judge Hull was appointed by President Clinton in the same way that progressives touted Bush-appointed Judge Sutton’s decision rejecting an ACA challenge. The two judges are not comparable, however. Judge Sutton is a former Scalia clerk who stood on the vanguard of the conservative legal movement for many years. Judge Hull, by contrast, is a compromise nominee Clinton selected in order to overcome obstruction from the Republican-controlled Senate.

Hull has a long record of conservative criminal and individual rights decisions. We now know that she is also very far to the right questions of federal power. That is unfortunate, but it also places her well to the right of some of the Supreme Court’s most conservative members.

 

By: Ian Millhiser, U. S. News and World Report, August 12, 2011

August 12, 2011 Posted by | Affordable Care Act, Commerce Clause, Congress, Conservatives, Constitution, Consumers, Democracy, Democrats, GOP, Health Care, Health Care Costs, Health Reform, Ideologues, Ideology, Individual Mandate, Insurance Companies, Medicaid, Medicare, Politics, Pre-Existing Conditions, President Obama, Republicans, SCOTUS, Supreme Court, Under Insured, Uninsured | , , , , , , , , , , , , , , | Leave a comment

Are You Smarter Than A Fifth Grader?: Bert and Ernie Getting Married Is a Dumb, Destructive Idea

Some people see politics everywhere,  even where they don’t belong.

Case in point a Chicago-area man who,  according to Washington, D.C. radio station WMAL, has  started an online petition at a website called Change.org seeking to pressure  the people behind the landmark children’s program Sesame Street to “let Ernie & Bert get married.”

As a child—and as a parent—I  watched a lot of Sesame Street.  I’m a big fan of Bert & Ernie and their antics. I can still sing most of  the lyrics to “Rubber Duckie” and “Doin’ the Pigeon” from  memory. They are  funny, engaging characters who demonstrate to children  that people—no matter  how different they might be in temperament,  likes, dislikes and personalities—can still be the best of friends. But  they are also, as apparently has been  lost on some people, Muppets—a  combination marionette and foam rubber puppet  invented decades ago—by the legendary Jim Henson and his wife  Jane.  Muppets are not people, and while they are in many cases gender  specific they,  as the Sesame Workshop felt compelled to point out  Thursday, “Do not have a  sexual orientation.” Nonetheless someone out  there thinks they would be useful  to further a point about sexual  identity.

It’s an idea that’s foolish, and  moreover, culturally destructive  because, if enacted, it would further the end  of childhood innocence in  America. Children are already bombarded, in and out  of school, with  messages and meanings that, in my judgment, are far too  sophisticated  for them to comprehend. Instead, they just confuse and, in some  cases,  scare them—as was the case when, as the Boston Globe reported back in   2009, “an anxious, depressed 17-year-old boy was admitted to the  psychiatric  unit at the Royal Children’s Hospital in Melbourne.”

“He was refusing to drink water.  Worried about drought related to  climate change, the young man was convinced  that if he drank, millions  of people would die. The Australian doctors wrote  the case up as the  first known instance of climate change delusion,'” the  paper reported.

A 17-year-old man is far more mature  than the average viewer of Sesame    Street.  We have an obligation to protect innocents  and innocence and, in a  sense, childhood itself. Children are treasures,  precious gems that  are our future and should be treated as such, not as targets  for  indoctrination.

By: Peter Roff, U. S. News and World Report, August 12, 2011

August 12, 2011 Posted by | Ideologues, Ideology, Politics | , , , , , , , , , , , , , | Leave a comment

Gov Rick Perry’s Abysmal Record On Women’s Health

If you’re a woman from Texas—or indeed, any  woman—there’s a lot to dislike about Gov. Rick Perry.

The vanity.  The boorishness.  The belief you’re too  stupid to make your own medical decisions. The weird resemblance to Animal House’s Niedermeyer in his college  photo.

Perry reminds me of the scene in Thelma and Louise in which  Thelma (Geena Davis) says of her  n’er-do-well husband, “He kind of  prides himself on being infantile.” Louise (Susan  Sarandon) responds,  “He’s got a lot to be proud of.”

So as we all prepare for the media barrage surrounding  Perry’s  presidential announcement on Saturday, and in tradition of my idol   Molly Ivins, I’m going to start a new group, Texas Women Enraged by Rick  Perry—TWERP for short.

As TWERP’s organizer, I feel  obliged to point out that on a  practical level, Rick Perry has made it pretty  lousy for women in  Texas, especially for women at the bottom of the economic  ladder. He’s  also made it pretty lousy for anybody who doesn’t look like him.  As  Eileen Smith wrote  in the Texas Observer, “In  just one session, Republicans managed to  screw children, women, gays,  immigrants, teachers, the elderly,  Hispanics, the unemployed and the uninsured.  The only people who got off easy were white guys. Can’t imagine why.”

The numbers tell the tale. Texas is dead last in the number  of  non-elderly women without health insurance, and 6th nationally in  the  percentage of women in poverty, according to the Texas  Legislative Study Group.  One in  five Texas children lack health insurance, the highest rate in  the nation. And  if that weren’t bad enough, Perry tried to opt out of  Medicaid, which provides  healthcare to the most vulnerable Texas populations, including pregnant women  and children.

When it comes to reproductive healthcare, the state budget guts  family planning, leaving 284,000 Texas women without birth control or access  to basic reproductive healthcare. This will also likely increase the abortion  rate, sonograms or no sonograms. And of course there’s the standard right wing assault on  Planned Parenthood. Women needing prenatal care fare no better.

As reported in the Texas  Tribune, “Texas has the worst rate  of pregnant women receiving prenatal care in the  first trimester,  according to the report commissioned by the Legislative Study  Group…And  though Texas has the highest percent of its population without  health  insurance, the state is 49th in per capita spending on Medicaid, and   dead last in per capita spending on mental health, according to the   report.”

So if you’re a working class Texas woman, Rick Perry doesn’t  want  you to have access to birth control or reproductive healthcare to  prevent  unintended pregnancy, but once you’re pregnant the state  mandates a sonogram  and a lecture to convince you of the error of your  ways. After that sonogram  and lecture, if you need prenatal care,  you’re SOL. And once the baby is born,  Texas is 47th in monthly benefit payments under the Women, Infants, & Children program, which  provides nutrition assistance.

This is Rick Perry’s vision for women in the United States. Limited  healthcare, little birth control, low  income women and kids left to  fend for themselves, a bunch of bureaucrats  telling you what to do—and  the very real human suffering that goes along with  it. TWERP might be  an understatement.

By: Laura Chapin, U. S. News and World Report, August 11, 2011

August 12, 2011 Posted by | Abortion, Class Warfare, Conservatives, Democracy, Economy, Education, Elections, Equal Rights, GOP, Governors, Health Care, Human Rights, Ideologues, Ideology, Immigrants, Income Gap, Lawmakers, Media, Medicaid, Middle Class, Planned Parenthood, Politics, Press, Pro-Choice, Racism, Republicans, Right Wing, States, Teaparty, Unemployed, Uninsured, Voters, Women, Women's Health, Womens Rights | , , , , , , , , , , , , , , , , , , | 1 Comment

   

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