Showing posts with label skinny repeal. Show all posts
Showing posts with label skinny repeal. Show all posts

Monday, December 17, 2018

Radical Right Wing TX Judge Tries To Smite Obamacare - Will He Succeed?


By now,  most citizens are aware of the news that a radical right wing nut masquerading as a federal judge -  Reed O’Connor -   has issued a ruling to strike down all aspects of the ACA, otherwise known as Obamacare.   Well, we already knew Texas was the home of right wing assassins who plotted (and succeeded)  in taking out JFK in Big D, but who would have reckoned that some 55 years later a  right wing Texas judicial assassin would try to take out 133 million Americans?  Because effectively, all those millions will be left without a medical pot to piss in if this travesty is upheld.

Let's reference that in historical memory the Right's zealots have always bitched about the Left's "activist judges" who they somehow believe constantly interject themselves to settle political disputes best left to congress.   But I warrant not one of the Right's wackos will so much as whisper criticism of this rogue judge who - in the words of two law professors writing in the NY Times-  has conducted "an exercise of raw judicial power, unmoored from the relevant doctrines concerning when judges may strike down a whole law because of a single alleged legal infirmity buried within."

Yet this asshole, another of the extremist mutants  (along with Brett Kavanaugh) inserted into the federal bench by Gee Dumbya Bush, did it.  To grasp what's going on we need to take a stroll down memory lane as regards the ACA, especially in the past year and a half. As readers may recall, the Reeptards were hell bent - following Traitor Dotard's lead - to repeal the entire law. They wanted it more than anything on God's green earth, and actually came within one vote of succeeding in the Senate.

This was by way of what came to be known as "the skinny repeal".  This would have eliminated the individual mandate, the least popular provision of the ACA that requires all Americans to have health insurance or face a fine. It would also remove the employer mandate, requiring certain businesses to provide health insurance to employees, as well as a tax on medical device manufacturers. But, more importantly, it would not touch the Medicaid program for the poor (hence the 'skinny' aspect) .  Bear in mind here that one of the key bases of the ACA was Medicaid expansion in dozens of states.

If this measure had passed the Senate with a simple majority, it would then have entered a conference committee with the House, where Republicans could have reconciled the differences and produced a larger repeal-and-replace measure . (Most likely including Medicaid.)  They could immediately claim 'victory' and that they succeeded in what they set out to do: repeal Obamacare (at least minimally).

This did not happen because Sen. John McCain entered the Senate chamber at the last minute and cast the deciding 'no' vote, killing the cynical skinny repeal effort. The Repukes never forgave or forgot this betrayal, and most regarded McCain as a latter day Benedict Arnold.

Long story short, unable to get the votes to repeal the entire law, the Reeptard Congress just zeroed in on  the tax  penalty, aiming to eliminate it. Again, recall that in 2012 the Supreme Court upheld this penalty as an exercise of Congress’s taxing power.   Justice Roberts, in fact, wrote the decision for the five justices in favor.

Backed into a corner like rats, the Repukes did the only other thing they could, fabricate a specious lawsuit to kill the tax penalty.  Given the traitor Trump administration refused to stand up for any part of the law - even cutting back funding for advertising the ACA-  all that was needed to upend it was one renegade  judge to rule against it.  In such an event the whole thing would come crashing down, including the popular parts, i.e. youngsters able to stay on their parents' plan until age 26, and protection for those with preexisting conditions.

Well, the Repukes got their wishes fulfilled when loose cannon judge Reed O'Connor ruled the ACA was "unconstitutional"  and hence the whole law needed to come down.  Right wing screwballs salivating to take down yet another Obama legacy point had endless wet dreams.

 The rest as they say is history, with Texas and and 19 other Reep- dominated states arguing in their junk lawsuit that with zero penalty, the mandate lacked a constitutional basis because it could no longer be enforced via a tax.   The little element they appeared to forget is that under the ninth amendment, health care is a right, one of what we call unenumerated rights of the Bill of the Rights. They forgot that tax penalty or no tax penalty, mandate or not,  you cannot repeal a right using a subterfuge such as invoked by this idiot judge.

But compounding their hubris and disrespect for the ninth amendment-    the  20 rogue states (and the Texas renegade judge O’Connor )   argued  -  that the rest of Obamacare must fall, too. They claimed that the mandate was so central to the A.C.A. that nothing else in it could operate without it.  Of course this is nonsense, because the whole edifice is predicated on health care being an unenumerated right under the ninth amendment. So merely dispatching the tax penalty from the law is immaterial to the centrality of the right.  The right still stands, even if there is no tax penalty.  Indeed, the inference is that the optimal way to validate the right is to maximize health care for all, which would be a single payer system.

Further, the U.S. is a signatory to a 1994 UN Declaration that health care is indeed a right.  But there is a more technical legal basis on which the judge's ruling can also be rejected. It was articulated by two law professors- Jonathan Adler and Abbie Gluck- writing in the NY Times three days ago.   According to the pair:

"That’s not how the relevant law works. An established legal principle called “severability” is triggered when a court must consider what happens to a statute when one part of it is struck down. The principle presumes that, out of respect for the separation of powers, courts will leave the rest of the statute standing unless Congress makes clear it did not intend for the law to exist without the challenged provision. This is not a liberal principle or a conservative principle. It is an uncontroversial rule that every Supreme Court justice in modern history has applied.

Sometimes severability cases are difficult because it is hard to guess how much importance Congress attributed to one provision, especially in a lengthy law like the Affordable Care Act. But this is an easy case: It was Congress, not a court, that eliminated the mandate penalty and left the rest of the statute in place. How can a court conclude that Congress never intended the rest of the statute to exist without an operational mandate, when it was the 2017 Congress itself that decided it was fine to eliminate the penalty and leave the rest of the law intact?"

The pair went on to note that in his vapid  55-page opinion  O’Connor claimed that we  "cannot divine the intent of the 2017 Congress because Congress didn’t have the votes to repeal the entire law but wished it could".   But as they retort:

"That’s ridiculous. Congressional intent is all about the votes. One would not say Congress wished it could repeal the Civil Rights Act if only a minority of Congress supported such a move. It is conservative judicial doctrine 101, as repeatedly emphasized by Justice Antonin Scalia, that the best way to understand congressional intent is to look at the text Congress was able to get through the legislative process."


Profs. Adler and Gluck then ruminate on what happens next, asserting that,  despite this reckless ruling,  the ACA is likely to continue in place while the case moves to the higher courts.   They predict that  the appeal will almost certainly end up in the Fifth Circuit — the federal appellate court that presides over Texas-  with California and other states defending it.   The Dem-controlled  House of Representatives will also likely join the lawsuit, and I would not exclude the possibility of Reed O'Connor being subpoenaed  before the House Judiciary Committee to answer questions on his decision.  It's possible!

If the Fifth Circuit reverses Renegade Reed O’Connor, the authors think it unlikely the Supreme Court will take the case.  Why would they when the Supremes already supported the law (including the mandate)  back in 2012?  If the Fifth Circuit upholds the ruling, possible with two new activist justices (Gorsuch and Kavanagh) the authors are skeptical a majority of the  highest court would sustain this weak analysis.  Besides, it would roil the insurance markets and whole health care system as 20 million Americans would lose their health care, while premiums could rise as much as 25 percent for others, according to the analysis on CBS Early Show this a.m. by financial specialist Jill Schlesinger.

On the other hand, as Ms. Schlesinger pointed out, this ruling doesn't change anything for your coverage during 2019 IF you already enrolled.  She also added, for those who haven't decided whether or not to enroll yet:

"If you are considering this, don't listen to this and say 'oh, I shouldn't enroll'. You absolutely should enroll, and again, your coverage will be intact for 2019."
Let's also note, as the  law profs have, that Chief Justice John Roberts is sensitive to allowing the court to be an instrument of politics, particularly when doing so violates separation of powers. Justice Brett Kavanaugh is an expert on statutory interpretation who has previously said that courts should “sever an offending provision from the statute to the narrowest extent possible unless Congress has indicated otherwise in the text of the statute.”

Hell, even the least qualified supreme, Clarence Thomas,  has opined that the kind of hypothesizing on which O’Connor relied is inappropriate:.  Congress’s intentions “do not count,” he wrote earlier this year, unless they are “enshrined” in a text that made it through the “constitutional processes of bicameralism and presentment”.

Even the reactionary WSJ editorial writers agree that O'Connor blew it ('Texas ObamaCare Blunder', p. A16, today) noting  "this judge's ruling will be overturned and could backfire on Republicans" adding:

"When judging congressional intent, a  judge must account for the amending congress as well the original congress..... In any case, the Supreme Court's severability doctrine calls for restraint in declaring an entire law illegal merely because one part of it is"  

Whatever the outcome, this issue has already become a political nightmare for the 'pukes, -even forcing them to go on the campaign trail before the midterms and posture and lie about keeping the best parts of the ACA.  Of course, they were disingenuous to the core given most of these hypocrites had signed onto the lawsuit attacking the ACA even as they vowed to keep the most important provisions, such as allowing preexisting conditions.

And the Kaiser Family Foundation has since found in its latest poll that fully 65 percent of Americans believe "it's very important"  that insurers don't deny Americans coverage based on their health.

Another little aspect neglected: Repukes have yet to come up with a viable replacement for the ACA.  A key aspect they omit is that a mandate is needed for any feasible insurance plan, given that costs can only be controlled if the young and healthy are pooled with the old, sick and unhealthy..  But with no mandate and no penalty there is no reason for the young and healthy to comply.   Then insurers are stuck with a vastly sicker and more expensive consumer base.

In the end the Reeptards and this Reeptardo renegade judge are hoist on their own petards.  So is Dotard Donnie who bragged while lollygagging at Mar-a-lago how "great" this judge's decision is, and oh "we will now have a great health care system".   Sorry, fool, those are two contradictory notions. Given the country's skittishness concerning "socialized" single payer health care, Obamacare is the next best option and every manjack with an IQ over room temperature digits knows it.  Well, except Trump and his lackey judge in Texas.  As the WSJ editorial writers put it (ibid.): "Trump hailed the ruling in a tweet, but he has never understood the Affordable Care Act."

Begging the question: Does this fungal mutt fouling the Oval Office really understand anything?  I doubt it!

See also:


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by P.M. Carpenter | December 16, 2018 - 7:14am | permalink


Thursday, August 17, 2017

John McCain's Anti- Skinny Repeal Vote Has The Right Squealing

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In most of the Right media the caterwauling and whining can still be heard concerning Sen. John McCain's dramatic late night vote against the Senate's "skinny repeal". Most people at the time failed to recognize the skinny repeal was actually a Trojan horse to turn the bill over to the GOP House where Medicaid could be eliminated by 2020,   see e.g.

Republicans admit it: 'Skinny repeal' is a Trojan horse to turn Trumpcare over to the House

This although the lingo in the bill voted on by the Senate affirmed Medicaid would not be touched.

The main charge against McCain's vote has been one of "betrayal" but linked to "voting against the bill to spite Trump".  The reason given that this was payback for Drumcpf's campaign slur that John McCain was not a genuine war hero.  Most recently Trump railed against McCain during his tirade to defend to Ku Kluxers and Nazis who terrified Charlottesville last weekend. See e.g. the excellent Vice documentary:

https://www.youtube.com/watch?v=RIrcB1sAN8I

In response to a reporter's question Trump huffed; "Oh yeah, John McCain,  who killed the plan for Americans to get better health care."

In fact, John McCain saved their bacon by torpedoing the Trojan horse so it could never find its way to the House and see Medicaid eviscerated for over 75 million who depend on it.  This includes many lower middle class Americans suffering from pre--existing conditions, as well as oldsters who've exhausted their saving for nursing home care and need Medicaid monies to continue. (Unless the Repukes want relatives to shoot them and put them in backyard graves.)

Anyway, the latest bellyache has been in a WSJ editorial ('John McCain's Defense Cut', Aug. 11, p. 12) which equated McCain's vote to a "defense cut". As the editorial put it:

"his vote to kill health reform means that entitlements like Medicaid will continue to squeeze the Pentagon like an ever tightening vise long after he has retired......spending on Medicare and other entitlement programs - is up from 25 percent in the 1960s - and 42 percent in the mid- 1980s. That leaves much less for the military - which has dropped to about 15 percent of the federal fisc from more than 25 percent in the 1980s."

Several points in rebuttal:

- Medicare is NOT an "entitlement". Citizens had to pay in via their payroll (FICA) taxes to get it and also it does not cover everything (dental, eye glasses, only 80 % of costs of  procedures etc.)  In the past two weeks alone I've had to shell out more than $1700 for a new crown and filling. This is why seniors are advised to have at least $250,000 on hand in savings to cover what Medicare doesn't.

- Of course spending on Medicare is up from the 1960s, the population of the country has DOUBLED since then! WTF does the WSJ want anyway, spending to remain constant while the population (including elderly) grows?

- The military spending at 15 % of the federal budget in the 1980s was largely due to Reagan' overspending on defense - including the idiotic Strategic Defense Initiative (SDI) which literally altered the nation's fiscal destiny to emerge as a debtor - after $2.1 trillion was spent.

Since 9/11 the anomalous defense spending has continued  the assault on domestic needs spending. Specifically, the Bushies ramped up defense spending to 2.4% of GDP as opposed to 1.2%, Former Defense analyst Chuck Spinney predicted it would incept a “war on Social Security and Medicare”. He predicted the total costs of military spending, including in Iraq, and Afghanistan and a de facto perpetual ‘war on terror’ (as well as a burgeoning national security state) would become so great that the major social programs would be slashed to pay for the deficits engendered. How large is the military money pit?  What sort of monster must it ‘feed’?

The United States currently maintains 702 military 'installations' in 63 foreign countries (it has 4,471 bases altogether), according to the Defense Department's annual budget statement. These figures don't include bases in Iraq and Afghanistan. We also spend more on military weaponry than the next 13  nations combined. No wonder seniors’ and disabled vets are now on the chopping block .  (See the proposed Trump budget for details).

The graphic provided by the WSJ (top) actually - in the light of the preceding - shows a rational slowing of defense spending when energy inflation and cost overruns (such as with the F35) are factored in.  The growth of Medicaid merely represents how it has increased as a result of being incorporated into Obamacare to serve the needs of more citizens who need it. Many of these people - such as disabled who live at home - would have to be warehoused in large, impersonal institutions if Medicaid cuts were allowed.

The WSJ ends with this piss and moan:

"When Senator McCain cast his vote on the Senate floor he was greeted by hugs and huzzahs from Democrats, and no wonder. They understood that the Senator had preserved their entitlement state priorities at the expense of military buildup:."

In fact, whether he intended it or not, John McCain preserved medical support for millions of citizens who need it, while not enabling further growth in the already out of control military industrial complex which only encourages adventurism  The WSJ would do well to consider the words of former President Dwight D. Eisenhower:

"The cost of one modern heavy bomber is this: a modern brick school for more than 30 cities, …two finely equipped hospitals, or 50 miles of concrete highway. We pay for a single fighter with a half million barrels of wheat. We pay for a new destroyer with new homes that could have housed 8,000 people…Under a cloud of threatening war it is humanity hanging from a cross of iron.”-  President Dwight D. Eisenhower in an April, 1953 address

Thursday, July 27, 2017

GOP "Skinny Repeal": A 'Trojan Horse' To Screw 16 Million Out Of Their HealthCare

McConnell
"Yeah, we gonna sneak this skinny plan through when folks least suspect it!"

As Mitch McConnell's  ACA Repeal "Vote A- Rama" continues, assorted lone voices in the wilderness have tried to warn sane citizens not to mark victory too early. They point to McConnell and the GOOPs pushing a series of "mini-bill" votes through until a conference with the House can get the final job done - likely by 51 votes to 50 (Pence casting the tie breaker then relatively fast reconciliation with an earlier House bill). An end game that will emerge as a classic Trojan Horse move, as even the GOOPs now admit (see link at bottom).

Yes. it is true that yesterday a vote to "repeal and delay"  failed by 55-45 with 7 Republicans joining with Dems to reject the bill. This is the same ill-advised plan that had been favored by small-government conservatives, such as Rand Paul from Kentucky, who have been clamoring to repeal the law for years. The CBO estimated that 32 million people would lose health insurance over the next decade under this plan compared to current law.

So no wonder seven Republicans found their sanity long enough to reject it. But the $64 question is whether they can continue to do so as McConnell pushes the iterations toward "skinny repeal".

To set the legislative scene again: one  day after the Senate narrowly voted to open debate on repealing the Affordable Care Act (ACA) despite not knowing where it would lead, the so-called “skinny repeal” seemed the most probable of a number of options for the repeal or replacement of the ACA to succeed.

How or why is the skinny repeal a Trojan horse?

The “skinny repeal” would eliminate the individual mandate, the least popular provision of the ACA that requires all Americans to have health insurance or face a fine. It would also remove the employer mandate, requiring certain businesses to provide health insurance to employees, as well as a tax on medical device manufacturers. But, importantly, it would not touch the Medicaid program for the poor.  The danger here ought to be automatically evident to everyone as we note these aspects:

i) This cowardly mutant would barely meet the definition for "repealing Obamacare" and hence is most likely to get most small -c conservatives on board to vote for it.

ii) The Republican moderates - like Susan Collins and Lisa Murkoswki - would probably come on board because Medicaid would be left alone.

This means the "skinny repeal" has a damned good chance of being pushed through at the last minute.

Let's pursue this further.   If this measure passes the Senate with a simple majority, it would likely then enter a conference committee with the House, where Republicans could reconcile the differences and produce a larger repeal-and-replace measure later.  They could immediately claim 'victory' and that they succeeded in what they set out to do: repeal Obamacare (at least minimally).

Let's further observe that the Democrats are largely unable to stop this bill from moving forward. Saddled with only 48 votes (two of them - Angus King of Maine, Bernie Sanders of Vermont, independents) the party has remained united in opposition to any measure that would repeal the law, but has enjoined Republicans to work with them on solutions that would stabilize the insurance markets and lower premiums.

But as Republicans continued to work their way through a planned 20 hours of debate and prepared to vote for a series of amendments in the so-called “vote-a-rama”, it is still  unclear whether anything would be passed by the deadline of the end of this week set by the Senate majority leader, Mitch McConnell.  But what I am saying is don't put anything past McConnell to pull out all the stops to get it done.

This is exactly why Democrats have urged  ACA activists to continue putting pressure on lawmakers as the Senate enters the final, frenetic push toward repeal. For months, voters and activists have inundated the telephone lines of Republican lawmakers and protested at their offices and even some of their homes.  Up to now it has worked, but the key issue now is whether it will be sustained into the most critical '4th quarter'.

At a Planned Parenthood protest on the Capitol lawn Wednesday evening, Democratic lawmakers laid out the stakes.   Senator Kamala Harris, a Democrat from California, told the crowd:

"Keep doing your thing!. Keep being you. Keep doing what you’ve been doing because it’s working and it matters and it counts.”

"Thirty-six hours,” she added, referring to the amount of time left before the repeal vote.

“So let’s keep calling. Let’s keep tweeting. Let’s keep writing. Let’s keep marching. Let’s keep shouting and we will win."

And what happens if "we" don't win and McConnell sneaks this revolting bill through? Well the consequences will be too horrific to contemplate.

The insurance markets would be roiled beyond belief, namely for people in the ACA exchanges.  Basically, minus the mandates, health care hell breaks loose. First, faced with a 20- 25 % spike in premiums even from next year, many will simply bail out.  These will likely be people who want insurance but feel they can't afford the increases. Their only option if seriously ill will be to visit ERs - jacking up even more expanses on the system.

Then, with no mandate or penalties hanging over their heads, the younger, healthier people will simply opt out of insurance altogether.  They will believe they don't need it, so why pay hundreds a month especially when they have college loans to pay off. This, logically, will leave the remaining insurance pool (again in the exchanges) older and sicker.

Such a trend - and it is expected to become a trend - will clearly  freak out insurers.  Facing the loss of the relatively healthy - who ordinarily would have helped pay for sicker citizens - the insurers will simply do what they did before the ACA and jack up premiums for everyone in the "sick" pool.  The federal government would then spend more providing subsidies to people who buy health insurance on their own - but save money by not providing subsidies to those who bailed. In other words the proponents of the bill - like Ted Cruz - are betting on the healthier folks bailing to save money to provide subsidies for those who buy their own.

Other adverse consequences are also projected. For example, with far more people uninsured, hospitals would be on the hook to provide  more care that they don't get paid for. Again, this would be mostly via ER visits by those with no insurance.   This will definitely threaten many hospitals' ability to stay open.

All in all, the "skinny" repeal, if pushed through and passed via a conference gambit, would be just about the worst calamity to happen to this nation's health care.

See also:

Republicans admit it: 'Skinny repeal' is a Trojan horse to turn Trumpcare over to the House

Update:

Thanks to Sen. John McCain (recall he was insulted during the '16 campaign by Trump as not being a 'real' war hero) the skinny bill has been sunk into oblivion. Along with Senators Lisa Murkowski (who Trump tried to blackmail into voting for the bill) and Susan Collins, McCain provided the needed 3rd opposition vote to deny the Reeps the 'skinny' majority (of 51) to pass it.  You can read more here:

http://www.bbc.com/news/world-us-canada-40750071