Asked if there was anything at all insurance companies should be mandated to cover during tonight’s Nevada Senate debate, Sharron Angle doubled down on her now infamous opposition to coverage mandates and suggested that they shouldn’t. “What we have here is a choice between the free markets and Americanism,” she said. “America is about choices. The free market will weed out those companies that do not offer as many choices and do not have a cost-effective system”:

ANGLE: What we want is a basic policy where we can have the coverages that we need. I taught autistic children. I know this is a biomedical disorder, and it needs to have its own insurance code so that families can get the right treatment and also be covered…we need to stop making band-aid applications and look at real solutions when we talk about health care, and really, forcing someone to buy something they do not need is not the way to solve a problem.

Watch it:

During an earlier Republican primary debate, Angle went a step further, saying that she had “introduced three bills” in the state legislator to eliminate coverage mandates — a claim she did not make tonight, because it’s not true. According to an exhaustive search of Angle’s record in the State legislator by the Las Vegas Sun, rather than trying to eliminate mandates, Angle co-sponsored legislation expanding them. “Angle proposed no fewer than five laws that would have expanded state insurance mandates,” the paper reported. “She co-sponsored a bill to require insurance companies to cover mammograms and another bill, which she later voted against, to cover osteoporosis treatment. She co-sponsored legislation that would have required an insurance company to continue covering the treatment of a patient if the company’s contract with the provider was canceled before the treatment was completed.”

Thus, despite her comments tonight, Angle’s record suggests that even she once believed that the government should set basic standards for insurance coverage to ensure that individuals receive adequate coverage when they need it most.

The Los Angeles Times is reporting that “prosecutors Wednesday accused the parent company of insurance giant Anthem Blue Cross of California of falsely stating that it had changed its procedures for canceling the policies of patients after they become sick.” Wellpoint’s denials, issued earlier this year, were in response to charges that the company used a computer algorithm to rescind the insurance policies of women who were diagnosed with breast cancer:

In an amended civil complaint filed Wednesday in Los Angeles County Superior Court, prosecutors said WellPoint issued three “false and misleading” press releases in April and May to burnish its corporate image as it fended off assertions about its cancellation practices in a news story and criticism from the Obama administration that followed.

The prosecutor’s office contended that WellPoint continued to target women with breast cancer. It said the company also falsely stated that it had changed its procedures this year before the new federal healthcare law took effect. The law bars rescissions nationwide except in cases in which policyholders lie on applications.

Prosecutors acknowledged that WellPoint’s rescissions in California had slowed to a “trickle” but said the Indianapolis company continued to misrepresent itself.

“This is a company that seems willing to say anything — true or not — in order to maintain their profit level,” said Chief Asst. City Atty. Jeffrey Isaacs.

The allegations first came to light in April after a report by Reuters’ Murray Waas revealed that “tens of thousands of Americans lost their health insurance shortly after being diagnosed with life-threatening, expensive medical conditions.” WellPoint “specifically targeted women with breast cancer for aggressive investigation with the intent to cancel their policies.”

Interestingly, today’s prosecutor’s findings come just days after a Congressional report found that health insurers regularly rescinded policies of sicker patients to bolster profits.

Earlier today, Judge Roger Vinson, a federal trial judge in Florida, issued a mostly procedural opinion ruling on the Department of Justice’s motion to dismiss a group of right-wing state officials’ lawsuit challenging the Affordable Care Act.  His opinion dismisses three of the state officials claims outright, while allowing their challenge to the law’s minimum coverage provision and its amendments to the Medicaid program to move forward.

Among the three dismissed claims is a challenge to the law’s “employer mandate,” which requires most employers to provide their employees with health insurance.  Judge Vinson notes, correctly, that a law requiring employers to provide employee benefits is no different from a law requiring them to provide a minimum wage — and since the minimum wage is unquestionably permitted, the employer mandate also survives muster.  Vinson also dismissed two completely implausible claims that the law imposes on state sovereignty and that it violates a radical doctrine that was once used to declare virtually all state labor protections unconstitutional.

Although Vinson allowed the plaintiffs’ Medicaid claim to move forward, he also hinted that this claim is unlikely to prevail in the end.  As the Wonk Room previously explained, this claim rests on the absurd theory that Medicaid is unconstitutional because it is too generous to the states.  Vinson notes that every single court to consider a similar claim has rejected it.

Sadly, however, Judge Vinson also engages in some highly implausible reasoning to escape dismissing the entire lawsuit outright.  For starters, he  cites favorably to a completely discredited decision holding a child labor law unconstitutional on the third page of his opinion.

The most troubling aspect of his opinion, however, is his conclusion that the law’s minimum coverage provision, which requires almost all Americans to either carry health insurance or pay slightly higher income taxes, was not properly enacted under Congress’ power to levy taxes.  Judge Vinson does not claim that there is anything substantively wrong with the law.  Rather, he relies on a Supreme Court decision from more than 100 years ago to claim that Congress’ taxing power does not apply largely because Congress called the minimum coverage provision something other than a “tax.”

There are all kinds of things wrong with this analysis.  For one thing, the anachronistic Supreme Court decision that Vinson relies on comes from a wholly discredited era in constitutional law when the minimum wage and child labor laws were considered unconstitutional and the justices would routinely jump through hoops to prevent Congress from levying taxes that would encourage employers to treat their workers like human beings.  This discredited theory of Congress’ taxing power has been firmly rejected by modern era justices, and should not be relied on by any judge living in the present century.

Just as importantly, Vinson’s theory makes no sense.  If Vinson is right, than the constitutionality of federal laws depends not on what those laws actually do, but on whether Congress used the right magic words when they enacted the law.

Nevertheless, Vinson may still uphold the law as falling within Congress’ sweeping power to regulate the national economy.  If he fails to do so, there is little doubt that he will be reversed on appeal.

On Friday, The Department of Health and Human Services announced “awards of $727 million to 143 community health centers (CHC) across the country to address pressing construction and renovation needs and expand access to quality health care.” “The funds are the first in a series of awards that will be made available to community health centers under the Affordable Care Act,” the agency said in a press release, noting that CHCs “serve nearly 19 million patients” and “deliver preventive and primary care services at more than 7,900 service delivery sites around the country to patients regardless of their ability to pay.”

CHCs enjoy strong bipartisan support. President George W. Bush committed to double the number of patients seen by these centers during his presidency and succeeded, and President Barack Obama included an additional $2 billion in the American Recovery and Reinvestment Act of 2009 and $9.5 billion in operating costs and $1.5 billion for new construction in the Affordable Care Act. With this additional funding, community health centers will be able to double the number of patients they serve to up to 40 million annually by 2015.

But if Republicans follow through on their promise to completely defund or repeal the health law, they would undermine the planned expansion, drastically reducing the services of institutions that their constituents have come to depend on. A Wonk Room analysis of the 143 community health centers that have received the first series of grants finds that 36 are located in Republican district and have already benefited from the extra ACA funding. Below is a sampling:

- Open Door/BMH Health Center, Inc: $6,078,544.00 — Mike Pence (R- IN)

- Perry County Medical Center, Inc: $1,455,603.00 — Marsha Blackburn (R-TN)

- Kenosha Community Health Center, Inc: $2,851,204.00 — Paul Ryan (R-WI)

An Energy and Commerce Committee report found that there are 14 community health centers in Pence’s district and estimated that the law, once fully implemented, would provide them with approximately “$18.2 million in new assistance.” Blackburn’s 12 CHCs would receive “$15.6 million in new assistance” and Ryan’s 4 would get $5.2 million.

The full list of community health centers in GOP districts that received the first series of CHC grants (Riley Waggaman assisted in researching this report): Read more

Adam Serwer points out that during last night’s discussion about paying for uncompensated health care, Christine O’Donnell suggested that hospitals shouldn’t provide care to “illegal immigrants.” Here is the exchange again:

ODONNELL: They could afford to buy a catastrophic only policy from across state lines.

BLITZER: But what if that person doesn’t want to buy it?

ODONNELL: Well, then we have to address that. We have to address that.

BLITZER: Would all of us taxpayers have to pay for that?

ODONNELL: No, anything that they do when they have another bill they can’t pay, make them pay that, hold them accountable for that.

KARIBJANIAN: Before or after they get care?

ODONNELL: Well, that’s up to the hospital. But right now, we’re forcing them to, we’re forcing them that they have to give care to illegal aliens.

Watch it at around 1:19:

As Serwer notes, the requirement for hospitals to provide uncompensated care to anyone who comes through the doors is the result of the Emergency Medical Treatment and Active Labor Act, signed by President Ronald Reagan in 1986. “The idea that hospitals shouldn’t be required to give care to illegal immigrants is unbelievably callous–what you’re basically saying is that, for someone unfortunate enough to be dealing with a life-threatening health-related emergency, illegal immigration is a capital crime that should be punishable by death,” he wites.

I would just add one thing. Throughout the health care reform debate, conservatives tried to downplay the extent of the health care crisis by claiming that everyone has access to care in the nation’s emergency rooms. “Well, no one is going to go without health care, because everyone can just show up at the hospital, but that’s just not the most efficient way to do it,” Sen. Jim DeMInt said in November of 2009. Now, some candidates are apparently even moving further to the right by suggesting that this law should also be repealed.