ThinkProgress Logo

Stories tagged with “Obamacare”

Special Topic

Scalia Says Court Can’t Be Bothered To Read Obamacare: ‘You Really Want Us To Go Through These 2,700 Pages?’

By Amanda Peterson Beadle on Mar 28, 2012 at 4:51 pm

During the last day of Supreme Court hearings about the Affordable Care Act, the justices covered whether or not the entire law could stand if the individual mandate was struck down and the law’s expansion of Medicaid. But Justice Antonin Scalia seemed surprised that someone would have expected the justices to read the text of the health care reform law before the hearings:

JUSTICE SCALIA: Mr. Kneedler, what happened to the Eighth Amendment? You really want us to go through these 2,700 pages? (Laughter.) And do you really expect the Court to do that? Or do you expect us to — to give this function to our law clerks? Is this not totally unrealistic? That we are going to go through this enormous bill item by item and decide each one?

Maybe Scalia should have read the bill before he brought up the Cornhusker kickback during the hearing. As Dave Weigel notes, the plan Scalia brought up — a special deal added that would have funded Nebraska’s Medicaid expansion in perpetuity — was not in the final version of the Affordable Care Act that Congress passed.

To be clear, the Affordable Care Act is a very long bill, and it includes far more than just a provision requiring people to buy insurance. It has expanded insurance coverage for millions of people by allowing young adults to stay on their parents’ insurance plans until 26, and it prevents insurance companies from denying someone coverage because of a pre-existing condition. Scalia is brushing off a bill that could dramatically expand affordable health insurance to the 50 million Americans who are currently uninsured — that is, so long as the Supreme Court does not strike down the entire law.

Justice

Health Care And The SCOTUS Day 3, Part I: The Justices Flirt With Chaos

By Ian Millhiser on Mar 28, 2012 at 2:32 pm

Justice Samuel Alito

Justice Samuel Alito

It is probably not the case that the Supreme Court is poised to strike down the entire Affordable Care Act if it finds just one provision of it unconstitutional. Among other things, after conservative superlawyer Paul Clement spent nearly twenty minutes trying to convince a skeptical panel of judges that the whole law must fall, his conservative ally Justice Alito asked Clement a question no advocate ever wants to hear: “What would your fallback position be if we don’t accept the proposition that if the mandate is declared unconstitutional” the entire statute must fall? Apparently, even the Supreme Court’s right flank was considering other options besides Clement’s overreaching theory.

Unfortunately, however, the justices gave his proposal far more credit than it actually deserves. Under longstanding law, a court may not invalidate any constitutional part of a law unless it is “evident” that Congress would have preferred no law to some law. Yet the justices peppered the law’s defenders with uncertain questions about how they should proceed — with Scalia finally outright saying he would simply eliminate President Obama’s signature accomplishment altogether. Every single one of these questions were inappropriate. Given the exceedingly high presumption in favor of retaining as much of the law as possible, the justices must resolve any of their uncertainties in favor of the Affordable Care Act.

The Court’s conservatives did not get this. Worse, Justice Kennedy at one point seemed to suggest the Court’s duty was to resolve any uncertainties in favor of the insurance industry:

When you say judicial restraint, you are echoing the earlier premise that it increases the judicial power if the judiciary strikes down other provisions of the Act. I suggest to you it might be quite the opposite. We would be exercising the judicial power if one Act was — one provision was stricken and the others remained to impose a risk on insurance companies that Congress had never intended.

To be fair, it is not entirely clear how Kennedy’s fears cut, and as Lyle Denniston suggests, they could ultimately wind up saving the law. If Kennedy is genuinely concerned that any decision striking down the individual mandate will risk nuking the insurance industry, he could ultimately conclude that the least worst outcome is simply to uphold the entire law. Indeed, the problems created by trying to remove just one provision from a comprehensive economic regulatory scheme demonstrate the wisdom of a decision Kennedy previously joined saying that the justices should not generally be in the business of doing so.

If they ultimately decide to throw out the entire law, however, the result will be bedlam. Much of the Affordable Care Act has already taken effect, and cannot simply be stopped on a dime tomorrow:

  • Stripping Young People of Care: At least 2.5 million young people now have insurance because of the Affordable Care Act. All of them would be cast back into the wilderness if the whole law were struck down.
  • Blowing Up Medicare: Approximately 100 million Medicare claims are processed each month using a formula that was altered by the Affordable Care Act. If the entire law were struck down, new rates could not be calculated under the old, pre-ACA formula until after a rulemaking process that can take months before is completed. The result would be massive delays in payments to health providers throughout the country.
  • Pulling The Rug Out On Retirees: The Affordable Care Act also provides thousands of Americans the opportunity to retire early and still remain insured until they become eligible for Medicare. Striking down the entire law could yank insurance away from many near-elderly Americans who retired solely because of the promise that the Affordable Care Act would be there for them.
  • Ungrateful States: Many of the states that are currently challenging the law have nonetheless accepted millions of dollars worth of grants under the Affordable Care Act. If the law is struck down, it’s likely that this money would need to be returned immediately, further stressing already tight state budgets.

Simply put, today should have taught the justices a lesson. There is a reason why the Constitution leaves difficult questions of economic policy to elected officials and not to unelected judges. These choices are difficult, they are not easily unwound and they should be made by someone who actually has a mandate from the people to make them.

Special Topic

Pray-In Asks Supreme Court To Strike Down Health Law That Subsidizes ‘The Killing Of Innocents’

By Igor Volsky on Mar 28, 2012 at 11:30 am

Opponents of the Affordable Care Act held a small prayer-in on the steps of the Supreme Court as the justices began the third and final day of hearings examining the constitutionality of the law on Wednesday.

The ceremony was timed to coincide with the opening prayer heard in the Court and included a shout-out to all nine justices. Anthony Kennedy — largely considered the key swing vote between the Court’s liberal and conservative factions — received special mention. The participants also asked God to provide the Justices with “clarity” and dissuade them from upholding legislation that subsidizes “the killing of innocents”:

God we pray for the nine justices. We pray oh God that they would have clarity on this case. We pray oh God that they would rule for any health care legislation that would respect religious freedom, not subsidize the killing of innocents and honor the Constitution… We cry to you oh Lord.

Watch it:

The sentiment echoed the rhetoric adopted by some Republicans who argue that Americans will “die” if the Court upholds the constitutionality law.

Special Topic

Sen. DeMint: People With Pre-Existing Conditions Actually Got Better Health Care Before Obamacare

By Annie-Rose Strasser and Scott Keyes on Mar 28, 2012 at 10:13 am

WASHINGTON, DC — Though one of the key successes — and most popular aspects — of the Affordable Care Act is the provision banning insurance companies from denying coverage to people with pre-existing conditions, Sen. Jim DeMint (R-SC) thinks they were better off before the law passed.

ThinkProgress spoke with DeMint outside a tea party rally nearby where the Supreme Court heard oral arguments on the constitutionality of the individual mandate. The second-term South Carolina senator called the pre-existing condition clause simply an “excuse for government to run health care.” We asked whether people with such conditions would get less health care under Obamacare than they did prior to its enactment. “They probably will,” declared DeMint.

DEMINT: I can guarantee you people with pre-existing conditions are going to get less health care—lower quality health care—under Obamacare than they would under a state-run plan.

KEYES: Do you think they get less health care under Obamacare than they did before Obamacare was enacted?

DEMINT: They probably will. It will definitely cost more for everyone and it will be inefficient and it won’t be as patient-focused. And so we need to make sure that we do the thing the right way and there are ways that everyone can have insurance, and that’s our goal.

Watch it:

While DeMint may think care will be worse for those with pre-existing conditions, this is simply not true. Nearly 50,000 people previously turned down because of a pre-existing condition have already been able to receive health care because of the ACA and the new Pre-Existing Condition Insurance Plan that the law created. Already, health care reform has stopped discrimination against children with pre-existing conditions. By 2014, that same law will apply to all adults, ensuring that everyone with an existing medical problem is able to get the care they need.

Republicans are currently pushing for the repeal of the ACA as the Supreme Court hears a case on the constitutionality of the individual mandate section of the law. If the mandate were to be repealed, health insurers would likely have to once again deny coverage to those with pre-existing conditions, because it would be unsustainable to have an insurance pool made up of only “high risk” people.

Yet for DeMint, that world where insurance companies could deny health insurance to people with pre-existing conditions is not only preferable, but somehow better for such people. If Republicans get their wish, DeMint’s vision may soon be realized at the expense of health care for millions of Americans with existing medical problems.

Health

Romney Justifies Denying Health Care To People With Pre-Existing Conditions: ‘We Can’t Play The Game Like That’

By Alex Seitz-Wald on Mar 28, 2012 at 9:28 am

As Mitt Romney tries to distance himself from Obamacare, he ran into some trouble last night when he got stumped by comedian Jay Leno. Leno asked Romney what he would do to help people with preexisting medical conditions, who are often denied coverage today by insurance companies worried about increased costs.

Romney’s answer was essentially nothing. Someone who has forgone insurance doesn’t deserve to get medical coverage, Romney suggested, because, “we can’t play the game like that.” Asked what he would do to help people with pre-existing conditions, Romney replied:

ROMNEY: People with pre-existing conditions, as long as they have been insured before, they are going to be able to continue to have insurance.

LENO: Suppose they haven’t been insured before?

ROMNEY: Well, if they are 45 years old and they show up and say I want insurance because I have heart disease, it’s like, ‘Hey guys. We can’t play the game like that. You’ve got to get insurance when you are well and then if you get ill, you are going to be covered. [...]

We’ll look at a circumstance where someone is ill and hasn’t been insured so far, but people who have the chance to be insured –- if you are working in the auto business for instance, the companies carry insurance, they insure their employees, you look at the circumstances that exist –- but people who have done their best to get insured are going to be able to be covered. But you don’t want everyone saying, ‘I am going to sit back until I get sick and then go buy insurance.’ That doesn’t make sense. But you get defined rules and get people in who are playing by the rules.

Watch it (beginning 2:15):

Barring insurance companies from denying coverage to people with pre-existing conditions is one of the Affordable Care Act’s most popular and important provisions. The problem, for Romney, is that this can only function when coupled with an individual mandate (as he well knows), the constitutionality of which the Supreme Court considered yesterday.

Without the mandate, healthy people could forego buying insurance until they became sick, thus driving up costs for everyone and potentially collapsing the system as there may not be enough people paying into the system to cover the costs of all the sick people. Moreover, there are people who, from a young age or even birth, have pre-existing conditions due to congenital diseases.

Under Romney’s current plan, since they have no existing history of coverage, it’s conceivable people born with pre-existing conditions would be completely unable to ever get insurance. Insurance companies have already said that without the mandate, they’d go back to denying coverage to people with pre-existing conditions.

Romney himself seems to understand this, telling Leno, “you have to find rules that get people in” to the insurance market so they don’t freeride. A former governor of Massachusetts named Romney came up with just a such a rule — it’s called the individual mandate. But now that Romney is running for president for Pete’s sake, he hates mandates, and so he has literally nothing to offer people with pre-existing conditions expect for a scolding about how they should have purchased insurance earlier.

Switch to Mobile
ThinkProgress Signup Overlay Skip and Continue to ThinkProgress Skip and Continue to ThinkProgress

Sign Up