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Justice

Health Care And The SCOTUS Day 2: A Bad Beginning And A Better Ending

The Constitution’s words enabling Congress to “regulate commerce…among the several states” gives the United States broad authority over economic matters — although non-economic regulation is far more suspect. Early in today’s argument, however, several of the justices appeared poised to impose an entirely novel limit on Congress’ authority — suggesting that laws which require, in Justice Kennedy’s words, an “affirmative duty to act to go into commerce” is somehow constitutionally suspect. So there were no shortages of pointed questions about the Affordable Care Act’s requirement that everyone either carry health insurance or pay slightly more income taxes.

There are two reasons why this requirement is necessary. The first is that, because the law prohibits insurers from denying coverage to patients with preexisting conditions, it must also ensure that healthy people enter the insurance market before they become sick. 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. The second reason relates to a problem with our health system that long predates the Affordable Care Act. Because emergency rooms must provide at least some degree of care free of charge to people who cannot afford it, these costs wind up being transferred to persons with insurance — driving up annual premiums as much as $1,100 on the average patient.

Initially, the Court’s conservatives appeared highly credulous of the plaintiffs’ false claim that upholding the health reform would necessarily enable the federal government to do absolutely anything. Solicitor General Don Verrilli addressed this question by explaining that the health care market is unique in that it is the only market that everyone inevitably participates in — we all get sick at some point — and that, because of health care’s sudden and unexpected costs, people typically pay their health bills through insurance. Thus, he explained, because everyone is already caught up in the health care market, the Affordable Care Act does not impose any kind of “duty…to go into commerce” — it merely tells people who are already in the health care market to make sure they pay for their health costs through insurance.

While Verrilli was still at the podium, the Court’s conservatives did not seem to buy this claim. A ray of hope emerged at the end of the oral argument, however, when Justice Kennedy expressed a somewhat nuanced view:

[T]he government tells us that’s because the insurance market is unique. And in the next case, it’ll say the next market is unique. But I think it is true that if most questions in life are matters of degree, in the insurance and health care world, both markets — stipulate two markets — the young person who is uninsured is uniquely proximately very close to affecting the rates of insurance and the costs of providing medical care in a way that is not true in other industries. That’s my concern in the case.

There’s a lot going on in this statement. On the one hand, Kennedy is clearly skeptical that, if the Court says this market is unique, the government won’t simply argue that the next market is also unique in the next case. On the other hand, Kennedy also appears sympathetic to the second reason why the mandate is essential — that the problem of uninsurance leads to billions in health care costs being transferred to other health care consumers. A young person who forgoes health insurance is “uniquely proximately very close” to affecting the health care costs of others, and that may be enough to get Kennedy’s vote to uphold the law.

The big loser in all of this debate, however, is the Constitution itself. The Constitution says nothing about unique markets. Or about the need to impose artificial Congress authority to regulate the nation’s economy. It simply says that Congress can “regulate commerce.” The idea that a law which regulates 1/6 of the nation’s economy is not regulating commerce is, frankly, absurd. Nor was there ever any risk that a decision upholding health reform would lead to all things being permissible. There are many things that are not commercial — federal murder laws, assault laws, child neglect laws or sexual morality laws, for example. A law regulating our entire national health care market, however, is clearly and obviously constitutional.

Justice Kennedy may inevitably vote to uphold the law — he may even bring Chief Justice Roberts along with him — but, whatever the Court does this term, it appears increasingly likely that we live under the constitution of Anthony Kennedy, and that we no longer live under the Constitution of the United States.

NEWS FLASH

Gohmert: Republican Presidential Candidate Should ‘Absolutely’ Repeal Romneycare | Rep. Louie Gohmert (R-TX) said that the GOP presidential candidate should repeal Mitt Romney’s signature health care reform plan in Massachusetts just moments after he addressed a Tea Party crowd on the steps of the Supreme Court. During a brief interview with ThinkProgress, Gohmert explained that he was “embarrassed that [Romney] felt like even a state can do a mandate like that.” Asked if the party’s challenger to Barack Obama should work to repeal it, the Congressman added, “[I] absolutely do, I absolutely do.” Watch it:

NEWS FLASH

Romneycare Mentioned In Today’s Supreme Court Debate Over Individual Mandate | After today’s two-hour long argument over the individual mandate before the Supreme Court, a few Democratic Senators who witnessed the events spoke with the media. Senate Judiciary Committee Chairman Patrick Leahy (D-VT) revealed that, in his final argument defending Obamacare, the Solicitor General of the United States referenced Romneycare in Massachusetts as a reason for uploading the federal law. Watch it:

Update

During the conference, Sens. Chuck Schumer (D-NY) and Jack Reed (D-RI) also reiterated that the individual mandate originated as a Republican idea and Sen. Patrick Leahy (D-VT) warned that invalidating the minimum coverage provision could place other popular safety net programs at risk. Watch it:

Special Topic

As Supreme Court Hearings Kick Off, Faith Leaders Rally Around Obamacare As A ‘Step In The Right Direction’

Our guest bloggers are Emily Farnell and Alexandra Scheeler, interns for the Center for American Progress’ faith and progressive policy initiative.

As the Supreme Court began the first of three days of hearings on the constitutionality of the Affordable Care Act (ACA), people of faith and other supporters gathered outside the Supreme Court yesterday morning in defense of the health care reform law.

The rally served as a statement of solidarity among the faithful progressive community in response to the religious rhetoric often employed by opponents to affordable health care. Leaders from Protestant, Catholic, and Jewish traditions spoke about the scriptural mandates of taking care of the less fortunate. “Quite simply, we believe the Supreme Court and the decision it makes is a reflection of the moral and ethical character of our people,” said James Winkler, general secretary of the General Board of the Church and Society of the United Methodist Church. “Providing comprehensive health insurance reform ensures every single person in the United States has access to needed care without regard in their ability to pay. To do otherwise is to elevate private insurance interests above the need of human beings.”

Here’s a clip of the Monday demonstration:

The supporters outside of the Supreme Court put forth an alternative faith-based narrative to push back against religious conservatives who oppose the health care reform law. The progressive faith leaders argue that affordable health care is consistent with scriptural injunctions to provide basic human rights for all and that the ACA furthers this spiritual goal. “In the Gospel story of the Good Samaritan, Jesus challenges us to reach out and care for the vulnerable, respond to the needs of the victim, and bind up their wounds,” said Sister Simone Campbell of the Catholic economic and social justice group Network Lobby. “This is exactly what the ACA does.”

Faith leaders added that Obamacare also addresses the moral issue of economic inequality in America. Reverend Cynthia Abrams, health care program director for the General Board of Church and Society of the United Methodist Church, highlighted the practical and deeply personal benefits of the ACA allowance for youth to stay under their parents’ coverage until the age of 26. She talked about her nephew, a 25-year-old man who was hit by a drunk driver and required prohibitively expensive treatments to stay alive. Because he was still covered under his parents’ insurance, he received care and survived the wreck. Had he not been covered, his family would be $90,000 in debt.
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Health

Georgia Senate Passes Watered Down ‘Fetal Pain’ Bill

Women protest against anti-abortion bills in Georgia. (Source: AP)

State legislators across the country have been debating several bills to limit women’s access to abortion, from cutting off funding to putting more barriers in their way. Lawmakers in Georgia have been considering one of those bills — a measure that would prevent women from receiving abortions 20 weeks after fertilization — and the Senate passed an amended version of the legislation. A bipartisan group of senators agreed to an amended version of the controversial GOP-backed House Bill 954. The amended bill passed on a 36-19 vote, though it’s unclear whether Republicans in the state House will accept the changes.

The original legislation, sponsored by Republican Rep. Doug McKillip, would have effectively outlawed abortion 20 weeks, the point where the lawmaker said fetuses can feel pain — a concept that has been widely disputed by many doctors. Although exceptions were allowed in cases where a pregnancy threatened the life or health of the women, no exemption would be granted in cases of rape or incest. The law, once enacted, would have “cut by about six weeks the time women in Georgia may have an elective abortion.”

At the last minute, members of the Senate adopted a key change that “would allow women to get an abortion even after the five-month mark if a doctor determined a fetus has a fatal congenital or chromosomal defect.” Under current Georgia law, women are permitted to get abortions for any reason during the first six months of a pregnancy. Abortions are also legal during the last three months of pregnancy, but “only to protect a woman’s life or her physical or mental health.” Opponents of the 20 week ban argue that most late-term abortions are sought out by parents “who learn their unborn child will not survive outside the womb.”

“I think we need to give doctors and their patients that opportunity,” said Republican Sen. John Bulloch. He added that lawmakers should “not punish a pregnant woman.”

The passage of HB 954 would make Georgia the seventh state to ban abortions after 20 weeks:

Six states — Nebraska, Idaho, Indiana, Kansas, Oklahoma, and Alabama — have similar “fetal pain” restrictions; a seventh, North Carolina, restricts abortion at 20 weeks. Passing the bill now throws Georgia into a stormy debate in this national election year over abortion limits. Most notably, Virginia Gov. Bob McDonnell signed into law this month a controversial bill requiring Virginia women to undergo an ultrasound procedure prior to having an abortion, although he backed off a mandate to require a trans-vaginal ultrasound.

The bill now heads back to the House, where the proposal could fail if an agreement is not reached by Thursday, when the General Assembly adjourns for the year.

To see more about the anti-abortion bills legislators in Georgia and several other states have been debating, check out our interactive map HERE.

– Fatima Najiy

NEWS FLASH

Watch: Two Gay Siblings Come Out To Their Catholic Latino Family | The Brave New Foundation’s Cuéntame presents the latest in its collection called “An Honest Conversation,” stories about LGBT Latino youth and their friends, families, and communities. This video features the Morenos, a fervently Catholic Latino family in Arizona in which both brother and sister faced the struggle of coming out as gay to their parents. In the end, they agree that despite its challenges, their coming out strengthened the family’s union, because “this is all we have, the family.” Watch it:

(HT: Towleroad.)

Special Topic

Gohmert: Americans Will ‘Die’ If The Affordable Care Act Remains In Place

As the Supreme Court considers the constitutionality of the Affordable Care Act’s individual mandate, Texas Rep. Louie Gohmert (R) addressed a Tea Party rally calling for its repeal. In a short interview following his remarks, Gohmert told ThinkProgress that Americans will “die early” if the law remains in place and the Court finds it constitutional:

VOLSKY: Congressman, do you think because of health care that people will live shorter lives — that it will shorten the lives of Americans?

GOHMERT: Those are the indications. [...] [This law] would make us like England and Canada where they try to come to America to get the treatment because they don’t want to die.

Watch it:

Gohmert’s rhetoric closely resembles the “sky is falling” hysteria surrounding the measure as it made its way through Congress in 2009 and 2010. Gohmert himself warned, “I would hate to think that among five women, one of ‘em is gonna die because we go to socialized care.” But in the two years since its enactment, none of the GOP’s dire predictions have come to pass.

NEWS FLASH

Tea Party Nation To Uninsured Americans: ‘Pay For It Yourself’ | A dozen of Obamacare opponents associated with the group Tea Party Nation chanted “pay for it yourself” in front of the Supreme Court early Tuesday morning, implying that uninsured Americans should finance their own health care needs. The chant — which could be alternatively interpreted as a defense of personal responsibility — comes on the day that the justices hear arguments on the constitutionality of the Affordable Care Act’s individual health care mandate. When ThinkProgress asked a protester if she believed the uninsured should pay out of pocket for such expenses as cancer care or hospitalization, she suggested that they could enroll in the government-sponsored Medicaid program. Watch it:

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