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The Candidates Weren’t The Only Ones On Display In Tampa

The point of presidential candidate debates is to offer the public a chance to scrutinize and evaluate those seeking national office. Occasionally, though, voters get the chance to scrutinize and evaluate those in the audience, which is nearly as interesting.

The candidates seeking the Republican presidential nomination are a pretty scary bunch — remember, one of them stands a reasonably good chance of becoming the leader of the free world in about 17 months — and the two-hour display on CNN last night was a depressing reminder of what’s become of the GOP in the 21st century. That said, maybe it’s just me, but I’m starting to find the audiences for these debates even more disconcerting.

Wolf Blitzer posed a hypothetical scenario to Ron Paul, asking about a young man who makes a good living, but decides to forgo health insurance. Then, tragedy strikes and he needs care. Paul stuck to the libertarian line. “But congressman,” the moderator said, “are you saying that society should just let him die?”

And at that point, some in the audience shouted, “Yeah,” and applauded.

Earlier in the debate, Blitzer asked Rick Perry about his attacks on Federal Reserve Chairman Ben Bernanke. “I said that, if you are allowing the Federal Reserve to be used for political purposes, that it would be almost treasonous,” Perry said. “I think that is a very clear statement of fact.”

The audience loved this, too.

What’s more, note that in last week’s debate, the mere observation that Perry has signed off on the executions of 234 people in Texas, more than any other governor in modern times, was enough to generate applause from a different GOP audience.

Taken together, over the last five days, we’ve learned that the way to impress Republican voters, at least the ones who show up for events like these, is to support letting the uninsured die, accusing the Fed of treason for trying to improve the economy, and executing lots of people.

There’s a deep strain of madness running through Republican politics in 2011, and it appears to be getting worse. Those wondering why the GOP presidential field appears weak, insipid, and shallow need look no further than the voters they choose to pander to.

 

By: Steve Benen, Contributing Writer, Washington Monthly Political Animal, September 13, 2011

September 13, 2011 Posted by | Affordable Care Act, Class Warfare, Congress, Conservatives, Democracy, Economic Recovery, Economy, Education, Elections, Freedom, GOP, Government, Health Care, Ideologues, Ideology, Individual Mandate, Lawmakers, Middle Class, Politics, Public, Public Opinion, Republicans, Right Wing, States, Tea Party, Uninsured | , , , , , , , , , , | Leave a comment

The Deeply Crazy In Virginia’s Obamacare Lawsuit

As  my Philadelphia Phillies idled through a two-hour rain delay Thursday night, I  curled up with some light reading: a Texas  Review of Law & Politics article by the legal team, led by Virginia  Attorney General Ken Cuccinelli, that’s challenging the new healthcare individual mandate in the U.S. Court of Appeals for the Fourth Circuit.

It’s  fascinating stuff.

Cuccinelli  and co. follow a long trail from the 18th century British jurist  William Blackstone to the Dred Scott  case to the New Deal to the present  day. The conservative team, at  first, makes a tight, prudential case against  the Obamacare mandate  that I, in my nonprofessional capacity, happen to favor.

In  their words:

No  existing case needs to be overruled and no existing  doctrine needs to be  curtailed or expanded for Virginia to prevail on  the merits. Nor does Virginia  remotely suggest that the United States  lacks the power to erect a system of  national healthcare. Virginia  expressly pled that Congress has the authority to  act under the taxing  and spending powers as it did with respect to Social Security and  Medicare, but that Congress in this instance lacked the political   capital and will to do so. No challenge has been mounted by Virginia to  the  vast sweep and scope of the Patient Protection and Affordable Care Act (PPACA).  Instead, only the mandate and penalty were challenged  because the claimed power  is tantamount to a national police power  inasmuch as it lacks principled  limits.

In  plainer, get-to-the-point English: We grant you the social safety  net  established under the “Roosevelt Settlement.” We recognize  Congress’s power to  regulate interstate commerce. We even grant that  this power could conceivably  deliver universal healthcare. But for  Pete’s sake, don’t try to include  “inactivity”—that is, not buying a  health insurance plan on the private  market—under its purview.

Because,  once you regulate the act of doing nothing, what’s left to regulate?

Er,  nothing.

Thus,  does the state’s power to tax and police become theoretically unlimited?

But,  later in the body of the piece, Team Cuccinelli begins to play  other, more  presently familiar cards. Glenn Beck fans will recognize  the faces in the rogue’s  gallery: Justice Oliver Wendell Holmes,  progressive philosopher John Dewey, and  others who, this argument goes,  created the post-New Deal legal and  philosophical edifice.

Wouldn’t  you know it, this welfare-state stuff constitutes a violation of natural law—which, ipso facto,  means economic laissez-faire—and a lurch into moral chaos.  Echoing the  newly popular Hayek, Cuccinelli’s article asserts the primacy of   economic rights while characterizing as relativistic the   not-exclusively-liberal jurisprudential argument that personhood and  dignity  precede the marketplace. (Last I checked, I’ve never seen an  unborn baby sign a  contract.)

Come  conclusion time, the piece sounds eerily like it’s not merely  advocating the  curtailment of an otherwise defensible attempt to  advance the national  interest, but rather like a full-throated  libertarian manifesto:

The  Progressive Meliorists had argued that they should  be accorded constitutional  space in which to make a social experiment,  agreeing in turn to be judged by  the results. The New Dealers carried  the experiment forward. Seventy years  later, results are in suggesting  that the experiment is living beyond its  means. The statist heirs to  the experiment say that it cannot and must not be  curtailed, so now  they claim this new power.

Social  Security and Medicare—an experiment! Just a temporary, 70-year blip on the  radar!

So,  in 46 pages, we proceed from modest and reasonable to deeply crazy.

It  behooves us to ask, what’s Cuccinelli’s endgame?

I  think we’ve seen this movie before.

 

By: Scott Galupo, U. S. News and World Report, August 18, 2011

August 19, 2011 Posted by | Affordable Care Act, Congress, Conservatives, Constitution, Consumers, Democrats, GOP, Government, Health Care, Health Reform, Human Rights, Ideologues, Ideology, Individual Mandate, Medicare, Politics, President Obama, Public, Regulations, Republicans, Right Wing, Social Security, States, Taxes, Teaparty | , , , , , , , , , , , , , | Leave a comment

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

How The Budget Deal Affects The Affordable Care Act

So how does this mammoth budget-cutting deal, with its congressional “supercommittee” affect health reform?

Good question, because lots of people in Washington are asking it too.

More specific answers will become clearer in the next few weeks, but here’s a first version of the road map to both the policy and the politics.

First, understand there are two different processes – and each, separately, aims at cutting more than $1 trillion over the next decade.

The one that you’ve probably heard most about is the “supercommittee” of 12 members of Congress. They are supposed to identify savings by Thanksgiving. Entitlements – Medicare, Medicaid, Social Security and aspects of the Affordable Care Act – are part of their turf. So are taxes and revenue – at least in theory. It’s not so clear that the Republicans see it that way given the public statements of Congressional leaders.

If they agree on some kind of grand deal by Thanksgiving, Congress has to take it or leave it by the end of December, eliminating the usual congressional dilly-dallying. (It looks like dilly-dallying to the casual observer or much of the public, but remember that all that arcane, tedious process IS policy in Congress. If you slow something down, make it go through hoops, amend it, hold it up, etc., it doesn’t become law. That may be good or, depending on your point of view, bad politics.)

If Congress takes any recommendations that the supercommittee agrees on, that’s the law. If the committee fails, or Congress rejects it, then the “trigger” gets pulled. The official name is “sequestration.” That’s a fancy name for automatic cuts – 2 percent across-the-board cuts in Medicare, for instance, affecting all health care providers, doctors, hospitals, etc. It won’t affect beneficiaries – at least not directly.

Medicaid is not subject to the trigger. Neither, according to the preliminary interpretations I’ve received from analysts and congressional staff, are the big, key subsidies in the health care reform law – the Medicaid expansion and the subsidies that will help low-income and middle-income people afford health care in the new state exchanges.

Other parts of the health reform law are, however, subject to automatic cuts. Among them: Cost-sharing subsidies for low-income people. This isn’t the help paying the premium; this is the help with the co-pays when people do get care. But the payments are made to health plans, not directly to beneficiaries so it won’t have the direct impact of discouraging care. It may affect how health plans make decisions about what markets to participate in. Gary Claxton and Larry Levitt at Kaiser Family Foundation explain here.

Also, the supercommittee could have a partial deal – meaning there’s still a trigger, but a smaller one. Maybe they won’t reach agreement on $1.2 trillion to $1.5 trillion in savings, which would avoid the trigger. But maybe they could agree on, say, $500 billion. That means a trigger wouldn’t have to go as deep because some of the savings would already be identified.

To recap – before we go on to the second stage of this process: The “super-committee” can do whatever it wants to health care, Medicare, Medicaid, Social Security, etc. – if it can agree, if it can get the rest of Congress to agree and if the president doesn’t veto it.

Will the Democratic Senate and the Obama White House agree to cuts that eviscerate health reform? Not likely. In fact, the Democrats “won” on very few aspects of the budget/debt deal. Walling off Medicaid and key parts of the health coverage expansion were two of the “wins.” That’s a bright line worth paying attention to as this moves forward.

Does that mean other health-reform related spending will be untouched? Given how many moving parts there are to any spending deal, and the fact that defense and tax policy are also part of the mix, chances are it will be affected. But expect to see that bright line remain visible – maybe not quite as bright, but visible. (The CLASS Act, the voluntary long-term care program created under health reform, is a different story; it’s quite vulnerable.)

The second part is the annual appropriations process. The budget deal provides for cuts – real cuts in spending, not just slowing the rate of growth. Health programs (aspects of the health reform legislation touching on exchange creation, prevention, community clinics, etc., and just about everything else at the Department of Health and Human Services – the FDA, NIH, CDC, etc. – will be subject to these cuts. But this isn’t an across the board process, it’s a line-by-line, or at least category/agency-by-category/agency, process. And there is some horse trading.

It’s safe to say that the Republicans will try to cut discretionary portions of the new health law. That’s not a new political dynamic, it doesn’t arise out of the debt ceiling or the Wall Street woes. It’s what we’ve seen since last fall’s elections and the repeal/defund fights of the past few months. And House Budget Chairman Paul Ryan has publicly tried to insert health care into any potential deal. So expect to see more Republican push to cut, and continued Democratic push back. Will health spending emerge unscathed? It’s too soon to know but, given the amount of savings Congress needs to find –both in this budget deal and in the perennial quest to fund the “doc fix” payments – some cuts are clearly possible. Some of it may affect aspects of exchange establishment, regulation, prevention, public health, etc. But it’s hard to see the Democrats allowing cuts so deep that they basically constitute a side door to repeal.

One further twist – some Republicans are calling for a delay in health reform implementation to save money.”Delay” may sound better to an ambivalent public worried about spending than “repeal.” What’s delayed (if anything), how it’s delayed, how long it’s delayed, and what stopgaps are created in the meantime could have an impact on how many people get covered in 2014.

Assorted committees and government agencies are still examining the new budget law and how it will affect … everything. So the perspective I’ve outlined here – and I’m writing amid all the market turbulence – may change as the economic and political climates change. But the lines in the sand around the trigger – health reform, Medicaid and Social Security – tell us something about where the White House will come down.

By: Joanne Kenen, Association of Health Care Journalists, August 10, 2011

August 11, 2011 Posted by | Affordable Care Act, Budget, Congress, Conservatives, Debt Ceiling, Debt Crisis, Deficits, Democrats, Economy, GOP, Government, Health Care, Health Reform, Ideologues, Ideology, Individual Mandate, Insurance Companies, Journalists, Lawmakers, Medicaid, Medicare, Politics, Public Health, Republicans, Right Wing, Social Security, Tax Increases, Tax Loopholes, Taxes, Teaparty | , , , , , , , , , , , , , , , , , , | 1 Comment

Debt Ceiling: What Killed The Deal And What Might Make One Happen This Week

There are a lot of good articles running through what happened between Thursday night, when a deal seemed likely, and Friday evening, when the talks fell apart. New reports suggest that Boehner is trying to prepare a deal by tomorrow evening, to prevent the markets from dropping Monday. So here’s the short version of what just happened, and where we’re likely to be going:

On Tuesday, the Gang of Six proposed a deal that would raise tax revenues by $2 trillion — which showed there was support among Senate Republicans for a deal that raised taxes by about $2 trillion. On Thursday, congressional Democrats rebelled over reports that the deal Boehner and Obama were negotiating had only $800 billion in new revenue, and it wasn’t even clear how those would be achieved. That night, Obama called Boehner looking for about $400 billion more in revenue to have something he could sell to Democrats. That would have brought the deal from $800 billion in revenue to $1.2 trillion in revenue. He didn’t get a call back until the next day at 5:30 p.m. — by which point the call was unnecessary. Boehner had already told the media that he was leaving the talks.

Republicans are emphasizing that the White House went from asking for $800 billion in revenue to $1.2 trillion. The word you’re hearing from them is “reneged,” but the White House emphasizes that negotiations were ongoing, and both sides were asking for more as they tried to figure out what they could both agree on and pass through Congress. Boehner, for instance, wanted further cuts to Medicaid, a trigger that would repeal the individual mandate and the Independent Payment Advisory Board if the entitlement cuts didn’t come through, and a tighter cap on discretionary spending. “They make it seem like the president made some ultimatum on $1.2 trillion in revenue,” says a senior administration official. “He didn’t. He said, ‘If you can’t do this, let’s figure out what we can do.’ ”

The “what we can do” would probably have been to ratchet back the entitlement cuts. Or maybe another solution would have been found. It’s hard to say because Boehner didn’t come back with a counteroffer. He simply left the negotiations.

But let’s zoom out on where the negotiations left off. Spending cuts would have totaled about $3 trillion, with a bit less than a trillion dollars of that coming from entitlements and other forms of mandatory spending. Revenue increases — none of which would have come from raising marginal tax rates — would have been between $800 billion and $1.2 trillion. The package would have extended the unemployment insurance and payroll tax cut provisions passed in the 2010 tax deal. All in all, that’s about a trillion dollars less in revenues than the Simpson-Bowles/Gang of Six deals advocated, and about $2.6 trillion less in revenue than simply letting the Bush tax cuts expire in 2012.

There’s a question as to whether this was the very best deal Republicans could get or simply close to it. But it’s hard to believe that it was so bad that it ended the talks. What seems likelier is that Boehner spent some time between Thursday and Friday talking to his members and found that his party simply didn’t support a deal with the White House. For one thing, a deal would include some amount of revenue, and that was a hard sell under any circumstances. For another, letting the president look like a dealmaker would potentially dim the GOP’s chances of retaking the White House in 2012. As my colleague George Will put it Thursday, a deal “would enable President Obama to run away from his record and run as a debt-reducing centrist.”

And so Boehner walked. Fundamentally, this looks like the same calculation that ended the last round of talks over a 4 trillion deal. What’s different this time is Boehner’s plan B: The Speaker of the House appears to believe that a deal struck between congressional leadership would perhaps be easier to sell to his members. Since it’s hard to see Nancy Pelosi and Harry Reid making deeper concessions than Obama did, it’s hard to see why that would be true, save that the deal might not look like such a victory for the White House.

Perhaps taking the benefit for Obama off the table will be enough. I’m doubtful. It’s more likely that what we’re really doing now is wasting time until the markets plummet and Boehner’s members decide that a deal is better than no deal. And there’s a very good chance that the first major show of market concern could come tomorrow night, when the Asian markets open. Boehner is hoping to present a plan by then, but a plan is very different from a deal. A plan is something politicians can come up with. A deal, we’re increasingly finding, is something that we need the markets to force.

By: Ezra Klein, Columnist, The Washington Post, July 23, 2011

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July 24, 2011 Posted by | Congress, Conservatives, Consumers, Debt Ceiling, Deficits, Democrats, Economic Recovery, Economy, Elections, Federal Budget, GOP, Government, Government Shut Down, Ideologues, Ideology, Individual Mandate, Lawmakers, Media, Medicaid, Politics, President Obama, Press, Public, Pundits, Republicans, Right Wing, Tax Increases, Taxes, Voters | , , , , , , , , , , , , , , , , , | Leave a comment

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