“Succumbing To A Right Wing Project”: Will We Love The Health-Care Law If It Dies?
Any day now, the U.S. Supreme Court may make possible something that has yet to happen: an honest and complete discussion of the Patient Protection and Affordable Care Act (ACA).
And if it throws out all or part of the law now popularly known as “Obamacare,” we will need a fearless conversation about how a conservative majority of the court has become a cog in a larger right-wing project to make progressive political and legislative victories impossible.
I still harbor the perhaps naïve hope that some conservative justices — Anthony Kennedy? John Roberts? — will pull back from judicial activism and allow the voters to decide the fate of the health-care law in this fall’s elections. And here is where the court’s reintroduction of the health-care issue into the political debate could be turned into a blessing by allies of reform, provided they take advantage of the opportunity to do what they have never done adequately up to now. They need, finally, to describe and defend the law and what it does.
The ACA is the victim of a vicious cycle: Obamacare polls badly. Therefore, Democrats avoid Obamacare, preferring to talk about almost anything else, while Republicans and conservatives attack it regularly. This makes Obamacare’s poll ratings even worse, which only reinforces the avoidance on the liberal side.
The media have abetted the problem, but this is partly a response to the impact of the vicious cycle on how the issue has been framed. As a study by the Project for Excellence in Journalism has shown, terms used by opponents of the law, such as “government-run,” were much more common in the coverage than terms such as “pre-existing conditions.”
Maybe now, supporters of the ACA will find their voices and point to the 30 million people the law would help to buy health insurance, how much assistance it gives businesses, how it creates a more rational health insurance market, how it helps those 26 and under stay on their parents’ health plans, how it protects those with pre-existing conditions. “Obamacare” isn’t about President Obama. It’s about beginning to bring an end to the scandal of a very rich nation leaving so many of its citizens without basic health coverage. However the court rules, we need to remember why this whole fight started in the first place.
If the court does strike down the law, those concerned that criticisms of its ruling might undermine the “legitimacy” of the judiciary should put their worries aside. Conservative justices long ago shattered the court’s standing as a nonpartisan, non-ideological actor in our governing system. That’s why recent surveys have found its approval rating on the decline.
As retired Supreme Court Justice John Paul Stevens noted 12 years ago in a powerful dissent, the court’s Bush v. Gore decision threatened “the nation’s confidence in the judge as an impartial guardian of the rule of law.” It’s gotten worse since. The 2010 Citizens United decision stands as another ruling that plainly strengthens conservative monied interests in the electoral arena. Please don’t tell me that these justices are entirely without a political agenda.
But friends of the health-care law need to acknowledge upfront that no matter how effectively they criticize the court, a ruling against it would be a real defeat — for the president, for the cause of expanding insurance coverage, and for progressives generally. Neither Obama nor his congressional allies would have wasted the time and political capital entailed in passing health-care reform if they had known that their efforts would be struck down by the judiciary even before the law came fully into force.
Enacting any sort of health-care reform is, as we have seen repeatedly since Harry Truman called for universal coverage, a gargantuan task. Balancing the many interests involved (and, ironically, the individual health-insurance mandate was a concession to conservative interest groups) is exceedingly difficult. For unelected judges to give the back of their hands to legislators whose job is to solve problems while accounting for competing priorities would be the height of arrogance and a flight from democracy. But all the liberal anger in the world will not make up for the size of the setback.
Were the health-care law to be eviscerated, those who battled so hard on its behalf might draw at least bittersweet comfort from what could be called the Joni Mitchell Rule, named after the folk singer who instructed us that “you don’t know what you’ve got till it’s gone.”
By: E. J. Dionne, Jr., Opinion Writer, The Washington Post, June 24, 2012
Memo To Congress: “You’re In The Hot Seat If Obamacare Is Overturned”
In oral arguments before the Supreme Court in March, lawyer Paul Clement made the case that the simplest way to dispense with the 2010 health-care-reform law would be to overturn it entirely: If the Court finds that the individual mandate is unconstitutional, it should strike down the whole thing. “The better answer might be to say, ‘We’ve struck the heart of this act; let’s just give Congress a clean slate,'” said Clement, representing the National Federation of Independent Business and the 26 states that oppose the law.
On its face, Clement’s logic seems simple: If you’re going to monkey with a giant piece of legislation that restructures nearly one-fifth of the U.S. economy, it’s best not to get into the weeds. Just let Congress start from scratch. But this argument misunderstands what would happen if the sprawling law is suddenly moot. Unlike partial revocations, which would give Congress time to fix potential glitches, a complete invalidation would start several policy fires that would require immediate congressional action. And members of Congress have not spent much time planning for this scenario.
First up: Medicare. The Affordable Care Act changed the formulas that Medicare uses to pay providers from top to bottom. It shifted growth rates, boosted some providers’ pay, and baked in financial incentives for doctors and hospitals that achieve quality benchmarks. It also codified many of the Medicare payment adjustments that it passes every year. (After all, when you have one big health bill moving, why not throw in everything?) Since 2010, regulators have acted on those changes, and the Centers for Medicare and Medicaid Services pays out 100 million medical bills each month according to the new pay scale.
If the law is overturned, no one is sure what figures the system would use. Should CMS continue to pay providers at the rates set by the law? Or should it go back to 2009 levels? Both Donald Berwick, who ran CMS under President Obama before he joined the Center for American Progress last year, and Gail Wilensky, who held a similar post during the presidency of George H.W. Bush and is now at Project HOPE, said they don’t know the answer. The House Ways and Means and Senate Finance committees would need to move fast to establish a clear legal authority for CMS to pay providers.
Furthermore, CMS operates using an antique IT system that makes it difficult to enact quick changes. Last year, when Congress looked like it might not pass routine legislation to forestall a big cut to physician pay rates, CMS Deputy Administrator Jonathan Blum told reporters that the system could hold claims for only 10 days before the computers crashed. Congressional staffers say they would probably need to freeze the current rates for weeks or months to give CMS time to switch back to the old pay scale.
Sen. Tom Coburn, R-Okla., a physician and a member of the Senate Finance Committee, which has jurisdiction over Medicare, opposes the law. But, he says, “there’s going to be a lot of chaos.” Although “there are discussions going on all the time,” Coburn says, few decisions have been made. On the House side, a Republican aide says that staffers are making preparations, but members are not concerned about a real emergency if the law is struck down. “I don’t think, overnight, there’s going to be this immediate panic,” the aide said.
The health-care law also reauthorized several long-standing federal programs, including the Indian Health Service, the principal care provider for nearly 2 million American Indians and Alaska natives. And it dedicates billions of dollars to expand community health centers and the health care workforce. If it disappears, the legal authority for those programs or their funding would disappear with it. If Congress doesn’t want these programs to shut their doors and shed workers, it will need to reauthorize them quickly. Many of these programs have enjoyed broad bipartisan support for decades, and it’s unlikely that even Republicans clamoring for repeal of the health care law would want to see them eradicated.
A complete erasure of the health care law could also spell trouble for the Centers for Disease Control and Prevention. The law’s Public Health and Prevention Fund, despite recent reductions, is set to dole out about $10 billion for community health ventures over 10 years. But because of recent appropriations cuts, the agency is using $825 million of that sum to pay for bioterrorism response-planning, lead-poisoning prevention, immunization programs, and many other core functions this year. Without new appropriations, these public-health programs will face instant, dramatic cuts. Sen. Robert Casey, D-Pa., a member of the Health, Education, Labor, and Pensions Committee, says he has not talked to his Democratic colleagues about contingency plans, and he is not optimistic that much would pass in this Congress. “The last time we did this, it took 30 years,” he says.
Since the Court is not especially likely to overturn the entire law, few lawmakers — including party leaders — have planned for it. “You asked whether there have been discussions,” said Senate Minority Whip Jon Kyl, R-Ariz., who is a member of the Finance Committee. “The answer is yes. But there have been no conclusions reached yet.” In this Congress, though, even if both chambers ready blueprints in time, it’s hardly clear that anything could become law.
By: Margo Sanger-Katz and Meghan McCarthy, The Atlantic, June 25, 2012
“Horribly Misguided”: Supreme Court Again Smacks Down Campaign-Finance Reformers
The Supreme Court’s rejection of a long-shot legal challenge to let states bar corporate and union political contributions in their own elections underscores the legal quandary in which many left-of-center campaign finance reformers find themselves.
The court, in a 5-to-4 vote split along ideological lines, refused on Monday to strike down a Montana ban on corporate political spending. The decision effectively upholds its landmark 2010 decision Citizens United v. Federal Election Commission, which held that corporations and unions were entitled to the same free speech protections as citizens, or at least allow state law to supersede it.
Because the Supreme Court decided Citizens United only two years ago and its conservative majority remains intact, few legal experts expected it to rule in favor of the challenge.
The current case, American Tradition Partnership v. Bullock, stemmed from a century-old Montana law that prohibits corporations from spending money on political campaigns. The effort, joined by more than 20 states, stipulated states should be allowed to carve out their own rules to regulate political fundraising and spending, an argument backed by the Montana Supreme Court when it ruled in favor of the state law last year.
But the Supreme Court, in a one-page per curiam opinion that shut the door on the possibility of oral arguments, curtly dismissed the notion that federal law didn’t apply.
The Citizens United decision, combined with other court cases and FEC rulings, has dramatically loosened fundraising and spending regulations for independent political organizations, which have proliferated since 2010 and become a major force in campaigns. Effort to curb the spending through the judiciary have thus far proven fruitless; Paul Ryan, senior counsel to the Campaign Legal Center, a left-of-center interest group, called the ruling “disappointing but predictable.”
“Unfortunately the only surprise would have been if the Supreme Court had taken the opportunity to revisit its horribly misguided decision in Citizens United,” Ryan said. “Clearly, the Supreme Court has decided to wash its hands of the disastrous results of its earlier decision. Apparently the same five Justices who gave us Citizens United are not troubled by the fact that special interests are picking the winners and losers in our federal and state elections.”
In a dissent, Justice Stephen Breyer agreed. He reiterated his existing objection to the Citizens United decision, arguing that the proliferation of political spending amounted to a quid pro arrangement between politicians and political spenders. He also backed the state’s right to decide on its own whether corporate spending constituted to a corrupting influence, the threshold conservative justices have argued laws must pass to be constitutional.
“Thus, Montana’s experience, like considerable experience elsewhere since the Court’s decision in Citizens United, casts grave doubt on the Court’s supposition that independent expenditures do not corrupt or appear to do so,” Breyer wrote.
But even as the liberal justice signaled he would like to reconsider Citizens United, he acknowledged the court’s unchanging conservative majority means he doubts there is a “significant possibility” the court will reverse itself — something that left conservatives pleased.
“This closes the door on the argument that unique facts in a certain state can be employed to overturn [Citizens United],” said Jim Bopp, an Indiana campaign finance attorney who has spearheaded an array of challenges to campaign finance laws across the country. “Further, it means that independent expenditures are never corrupting as a matter of federal constitutional law.”
Senate Minority Leader Mitch McConnell, a longtime advocate for loosening campaign finance regulations, hailed it as “another important victory for freedom of speech.”
“Clearly, the much predicted corporate tsunami that critics of Citizens United warned about simply did not occur,” he said in a statement.
By: Alex Roarty, The Atlantic, June 25, 2012
“Blame The Supreme Court”: Acting As An Arm Of The Republican Party
Liberals will be tempted to point the finger at themselves if the Affordable Care Act is overturned. They shouldn’t.
It’s a virtual certainty that, if the Supreme Court overturns the individual mandate or the Affordable Care Act wholesale, liberals will find a way to blame each other—or the administration—for its failure to anticipate the constitutional challenge. Yesterday, both The Washington Post and The New York Times ran stories in which critics and observers laid blame on the administration for its tactical strategy, and the bill’s authors for using the mandate to achieve near-universal health-care coverage. Here’s the Times:
With the benefit of hindsight, some advocates said they would have been better off framing the law more explicitly as a tax, although doing so would have been politically explosive. Short of that, some said, strategy alternatives like slowing down the case still might not have made a difference.
This strikes me as misguided. Underlying the assumption that the Court will strike down the individual mandate—or the Affordable Care Act as a whole—is the idea that the current Supreme Court is partisan in a way that’s never been true before. It’s one thing to stack the Court with Justices who are ideologically favorable; it’s something else entirely to stack the Court with fellow partisans, who are primarily loyal to the Republican Party and not any discernible legal principle.
Whether this has happened is an open question, but if it has—as James Fallows argued yesterday—then it’s silly to think that liberals could have avoided disaster by framing the law as a tax, or changing the structure of the mandate. Remember, when the law was being crafted in 2009, or when it was signed in 2010, the spurious distinction between “activity” and “inactivity” hadn’t been devised yet, and no one was concerned the the mandate would violate the Constitution. But eventually, movement conservatives developed a legal principle that would allow them to argue the case.
Likewise, if the mandate were framed as a tax—or even if the Affordable Care Act were shaped as “Medicare-for-all”—movement conservatives would have devised a legal doctrine that challenged its constitutionality.
Because of this, if the Court strikes down the Affordable Care Act, liberals should refrain from turning their guns on each other. Instead, they should take aim at the Supreme Court. A Court that acts as another arm of the Republican Party is one that doesn’t deserve the standing it claims or the respect it demands. Partisan institutions should be treated as such, and liberals should do as much as possible to challenge the legitimacy of the Court.
By: Jamelle Bouie, The American Prospect, June 25, 2012
“Up Popped The Devil”: Darrell Issa’s Cheap Political Opportunism
The historic significance of the day was not lost on the congregation that packed St. Mary’s Episcopal Church in Foggy Bottom two Sundays ago.
People from across the region gathered to celebrate the anniversary of a church founded 145 years ago.
They also had come to hear the morning’s prized speaker: the 82nd attorney general of the United States, and the first African American, Eric H. Holder Jr.
St. Mary’s, the church my wife, Gwen, and I attend, was the vision of 28 free African American men and women, many of whom had been slaves themselves. What a sweep of history: from bondage to the top suite in America’s Justice Department, in the space of a few lifetimes.
It was a time of celebration, a moment to reflect on how far the church, and the nation, had come since 1867.
No more separate pews in corners of the church for “people of color.” No more whites first, colored second when Holy Communion is served. No more separate Sunday school classes for white and black children. No more Washington as a bastion of segregation.
June 10, 2012, was the day to take stock of the church’s rich history, to come hear the attorney general speak of the critical role, as he told the congregation, “that houses of worship and faith-based organizations always have played in strengthening this nation — and bringing us closer to fulfilling America’s founding promise of liberty, opportunity and justice for all.”
It was a day to listen as Holder held up for praise the redeeming power of God’s grace and the values of tolerance, nonviolence, compassion, love and — above all — justice.
He used the occasion to call for a renewed faith in the power of those values “not only to heal fresh wounds and bridge long-standing divisions but also to fuel tomorrow’s progress.” “Seize the opportunity,” Holder said, “to look upon our nation as the founders of this church once did: seeing both its history — however imperfect — and its future of limitless promise; understanding both its weaknesses and its strengths, appreciating both the challenges we face and the infinite opportunities that lie ahead.”
It was a good day.
But then, as the elders like to say, “up popped the devil.”
In fact, 23 devils.
Actually, they aren’t devils. They are the 23-member Republican majority of the House Committee on Oversight and Government Reform, who like to do devilish things such as recommending that the attorney general be held in contempt of Congress simply because they have the power and lust to do so.
Their pack is led by Rep. Darrell Issa (R-Calif.), a headline-chasing publicity hound who never met an accusation too loopy to hurl. Issa got the Republican members to believe — or at least to say they believe — that Holder is withholding critical information from the panel. The committee’s 17 Democrats believe otherwise and voted against the contempt citation, noting that Holder’s Justice Department has turned over 7,600 documents relating to the issue that’s got Issa in a faux snit.
The issue is called “Operation Fast and Furious,” a venture of the Bureau of Alcohol, Tobacco, Firearms and Explosives that allowed illegal gun buyers to take weapons to Mexico in the hopes that federal agents could track the weapons to a drug cartel.
Committee arithmetic being what it is, Issa got his way, and Speaker John Boehner (R-Ohio) has promised a vote on the House floor next week if Holder doesn’t turn over all of the internal documents that Issa seeks. With the Obama administration citing executive privilege to withhold some documents, a nasty, partisan floor fight is likely.
Score one for cheap political opportunism.
Neither Fast and Furious nor Issa’s fake fury justifies the looming crisis between the House of Representatives and the Obama administration. This politically inspired dispute diverts attention from issues of real consequence. That’s the shame of it all.
Two weeks ago, the talk at St. Mary’s was about the urgent priority of fulfilling the promise of security, liberty, opportunity and justice for everyone in this country. It was all about progress and the ability to come together to realize the dream that Martin Luther King Jr. entrusted to us.
There was optimism in the congregation that Sunday morning. People in the pews seemed to share Holder’s view that the record of progress passed to them can be extended, and that, as he said, they should “keep faith — in the Divine, in one another, and in the great nation it is our honor to help lead — and our solemn responsibility to serve.”
It was all about shared purpose and common cause, collective efforts, individual actions and marching toward progress.
Alas, that was before this week, Darrell Issa and his devilish ways.
By: Colbert I. King, Opinion Writer, The Washington Post, June 22, 2012
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