Health Care

Can We Take John Roberts's Word at Face Value?

Flickr/Donkey Hotey
For years, conservatives have articulated a clear legal philosophy to guide their beliefs about the proper role of the courts and the way judges should arrive at their decisions, much clearer than the philosophy liberals espouse. They said they supported "originalism," whereby judges would simply examine the Constitution as the Founders understood it to guide its interpretation today. They said they opposed "judicial activism," wanting judges to simply interpret the law instead of making their own laws. Liberals always replied that these ideas were a disingenuous cover for something much simpler: conservatives just want judicial decisions that support their policy preferences. They see whatever they want in the Constitution and define "judicial activism" as nothing more than decisions whose outcomes they don't like. The reaction to Chief Justice John Roberts joining the Supreme Court's four liberals to uphold the Affordable Care Act shows something revealing about the conservative...

Not the Issue?

If you don't think Republicans are monomaniacs, may I suggest watching Mitch McConnell's performance on Fox News Sunday. Three times host Chris Wallace asked McConnell what would become of the 30 million Americans who'd be able to obtain health coverage under the Obama administration's newly upheld health-care law if the Republicans repealed the law, and three times McConnell said that such temporal concerns were beside the point. The third time Wallace asked about the 30 million Americans, McConnell responded, "That is not the issue. The question is how you can go step by step to improve the American health-care system." An incredulous Wallace followed up with, "You don't think 30 million people who are uninsured is an issue?" To which McConnell responded, "Let me tell you what we're not going to do. We're not going to turn the American health-care system into a Western European system." Ideology—maybe it's closer to theology—trumps reality. Thirty thousand, thirty million, thirty...

Our Strange Ideological Divide

When Democrats pursue centrist solutions to problems, Republicans react as though we were all just herded onto collective farms.

Yes, they actually believe this. (Flickr/Peter Vidrine)
If you knew nothing about the Affordable Care Act (ACA), the picture you saw last Thursday of liberals celebrating and conservatives lamenting the end of American liberty would have convinced you that a monumental shift to the left had just taken place. Was the military budget cut by two-thirds or higher education made free for all Americans, you might have asked? At the very least, a universal, public health-insurance program must have been established. But no, the greatest ideological battle in decades was fought over a law that solidifies the position of private health-insurance companies. That isn't to ignore that those companies will be subject to greater regulation, outlawing their cruelest abuses of their customers, and millions will be added to the insurance program for the poor. The ACA is a very, very good thing, but after its full implementation we will still have the least socialized health-care system of any advanced country in the world. Yet to hear the ACA's opponents...

Failures of Spin

Flickr/Gage Skidmore
Republican Senate leader Mitch McConnell is ordinarily a spinner of unusual skill. He's relentlessly focused on his message and doesn't let any interviewer frame a question in a way he (McConnell) doesn't like. Which is why it was a little odd to see Fox News' Chris Wallace catch him without a handy talking point when it came to covering the uninsured. This excerpt is a little long, but you have to see the whole thing: WALLACE: All right, let's move on. If voters elect a Republican president and a Republican Senate, your top priority will be, you say, to repeal and replace "Obama-care." And I want to drill down into that with you. One of the keys to "Obama-care" is that it will extend insurance access to 30 million people who are now uninsured. In your replacement, how would you provide universal coverage? MCCONNELL: Well, first, let me say the single the best thing we could do for the American health care system is to get rid of "Obama- care," get rid of that half a trillion dollars...

Roberts's Switch in Time

WikiMedia Commons
Jan Crawford has a blockbuster story in which two sources confirm what many people inferred from the structure of the opinions—that Chief Justice John Roberts initially voted to strike down at least some parts of the Affordable Care Act before switching his vote. The story reveals some interesting things about Roberts and the Supreme Court, although we should also be careful about taking all the claims at face value given that they clearly reflect the positions of justices and/or clerks with an ax to grind. The most obvious takeaway from the Crawford piece is that there was a fairly substantial rift created on the Court by Roberts's eventual decision to uphold the bill. While some details about the internal deliberations of the Court generally leak out eventually—as clerks have less to fear in terms of reprisals or as court papers are released by retired justices—for these details to emerge less than a week after a decision is handed down is extraordinary. Clearly, some of the...

Maggie Gallagher and I Agree to Agree

So my three-part series last week on whether or not marriage equality is radical (in brief: who cares ?; yes ; and no ) drew the attention of Maggie Gallagher, longtime opponent of same-sex marriage. It was kinda fun to be called "always interesting and honest." I've known for a long time that she and I agree about the symbolism of allowing two people of one sex into marriage—it's why we were paired several times in debate. As she says, quoting me whole : Graff also acknowledges that Blankenhorn’s (and mine!) core concern is not irrational. Gay marriage furthers the disconnection of marriage from procreation; it helps in an ongoing way to sever the link between sex and diapers. I just think the change is a good idea, while she thinks it's a bad one. I have long wondered, though, why she's fighting this particular rearguard action. Our 1.5 percent of the population is hardly a very important symbol. Why doesn't she focus on the real source of this disconnection—same-sex couples are...

Reading the Tea Leaves in the Supreme Court Opinions

Jaime Fuller
Two features of the scene in the courtroom at the Supreme Court Thursday flow together to spark curiosity. For one, the justices appeared unusually agitated. Justice Sonia Sotomayor looked as if she’d been up all night, for example, while (as Tony Mauro also noted) Justice Antonin Scalia was downcast and tight-lipped. Had something happened in the days or hours before the opinion to spark this emotional response? In his bench dissent, Justice Anthony Kennedy stressed that the act had been so mutilated by the Court’s decision that it should be struck down in its entirety. That struck me at the time as odd. The Medicaid expansion, as I explained yesterday, is an important part of the act. Even so, it’s not the heart of it—that was the individual mandate. The government had argued that, if the Court struck the mandate, it should also strike the provisions guaranteeing that the people with “preexisting conditions” can’t be turned down for insurance and barring insurers from discriminating...

Court Stays Clear of Tinkering with the First Amendment

(Flickr / mr_mayer)
Xavier Alvarez got twin pieces of good news Thursday. First, thanks to the Court’s decision in the Health Care Cases, Medicaid in California may soon be funded to supply mental-health services to crazed compulsive liars like him. Second, and of more immediate interest to him, he won’t be doing a year in the federal slam for falsely claiming to have won the Congressional Medal of Honor. United States v. Alvarez was second banana on the Supreme Court stage Thursday, blasted out of the headlines by the stunning decision upholding the Affordable Care Act. But the case had been closely watched in the First Amendment community. That’s because it represented an attempt by the government to find a brand-new, gaping hole in free-speech protection—a First Amendment exception for liars like Alvarez. Alvarez, as has been reported earlier , is a half-crazed poseur who likes to claim, among other things, to have played for the Red Wings, to be the ex-husband of a Mexican movie star—and to hold the...

Peggy Noonan Feels the News

She's feeling something. (Flickr/kylebogucki)
When he began his still-brilliant show a few years ago, Stephen Colbert said, "Anyone can read the news to you. I promise to feel the news at you." And there's nobody who feels the news quite like Peggy Noonan, America's most unintentionally hilarious columnist. Pretty much every time she writes a column or goes on television, Noonan can be counted on to tell us about a feeling out there in the land. It's seldom a powerful feeling; instead, it's more often a stirring, an inchoate emotion still in the process of crystallizing. It might be a yearning, or an unease, or a doubt or a fear, but it lingers just out of our perception until Peggy Noonan comes along and perceives it for us. Did you think the impact of yesterday's Supreme Court ruling was that millions of uninsured Americans will now be able to get health insurance, and after 2014 none of us will ever need to fear the words "pre-existing condition" again? Nay , good-hearted Americans: The ruling strikes me as very bad for the...

Supreme Surprise

(AP Photo)
The verdict of the Supreme Court upholding nearly all of the Affordable Care Act is a victory to be savored in the full knowledge that it may be only temporary and includes potentially damaging changes in constitutional interpretation. It is a victory, first of all, for the millions of people excluded from health insurance who stand to gain protection despite their medical history or low incomes. It is a victory for the rule of law in the face of a group of partisan conservative justices who want to immobilize federal power in social policy. It is a victory for the millions of people who have struggled for decades to achieve equal access to health care. And, not least, it is a victory for President Barack Obama and the Democrats in a critical election year. In fact, the outcome of the election will determine the ultimate significance of the Court’s decision. If Mitt Romney and the Republicans win in November, not only will they repeal the main provisions of the Affordable Care Act;...

If Texas Doesn't Expand Medicaid, Two Million Will Be Without Options

(Flickr/ José Goulão)
It's no secret there's a health-care crisis in Texas. The state has the biggest uninsured population in the country with around 6.2 million—or a quarter of all residents—lacking insurance. As a Kaiser Health News report highlighted , poor and uninsured Texans must sometimes wait more than 24 hours in emergency rooms, where treatment is most expensive, while more cost-effective health-care options, like preventative care, are out of reach. The Affordable Care Act was supposed to change all that. It offered new avenues for health-care coverage to people at all income levels by expanding Medicaid. But yesterday's Supreme Court decision made it optional for states to expand their Medicaid coverage. "There's going to be a donut hole in the middle if a state doesn't proceed," says Edwin Park, vice president for health policy at the D.C.-based Center on Budget and Policy Priorities. In Texas, if the state chooses not to expand its services, almost two million people may be stuck in limbo—...

On Medicaid, Republicans Explore New Moral Depths

Florida governor and aspiring Bond villain Rick Scott, looking forward to denying poor Floridians health insurance. (Flickr/Gage Skidmore)
As the lawsuits challenging the Affordable Care Act worked their way up to the Supreme Court, I always found the challenge to the expansion of Medicaid to be the strangest part. Quick context: the program provides insurance for poor people, splitting the cost between the federal government and the states. But the current rules say that each state gets to set its own eligibility standards, which meant that if you live in a state run by Democrats and you're poor, you can get Medicaid, but if you live in a state run by Republicans, you have to be desperately poor to get Medicaid. For instance, in Mississippi, a family of four has to have a yearly gross income below a princely $9,828 to qualify. Because if a family is living high on the hog with their $10,000 a year, they aren't really poor, right? Fortunately, the Affordable Care Act fixed this, by changing Medicaid so that everyone with up to 133 percent of the federal poverty level ($30,657 for a family of four) would qualify. And to...

Sometimes a Loss Is Just a Loss

WikiMedia commons
Given the very strong likelihood that the centerpiece legislation of the Obama administration would be struck down in its entirety, yesterday's decision upholding the Affordable Care Act seems to most progressives like both a relief and a major political victory. But was it actually a legal victory when you examine the opinions closely? Tom Scocca says no : Roberts' genius was in pushing this health care decision through without attaching it to the coattails of an ugly, narrow partisan victory. Obama wins on policy, this time. And Roberts rewrites Congress' power to regulate, opening the door for countless future challenges. In the long term, supporters of curtailing the federal government should be glad to have made that trade. According to Scocca, Roberts engineered a big win for conservatives by fundamentally changing the law but doing so in a way that his opponents couldn't respond—a trick pioneered by Chief Justice John Marshall in Marbury v. Madison . If Roberts planted a time...

Give Me Broccoli or Give Me Death!

Scenes from the Supreme Court

Jaime Fuller
It’s only a bit after 8 a.m. and Russell Mokhiber is shouting at a belly dancer in front of the Supreme Court of the United States. Granted, it’s out of concern—it’s the kind of Washington, D.C., summer morning when it feels like the air is one giant dog’s tongue licking your body, and the lady in question, Angela Petry—a middle-aged sandy blonde with the abdominal muscles of an 18-year-old pageant queen—is his wife. She’s been dancing up a storm, a whirl of skin, red and blue silk scarves, and beads dripping from her bosom. “We need to pace ourselves, we’ve got three hours,” Mokhiber says, and he’s right, because the belly dancing is quickly becoming the media darling of the protesters gathered at the steps of the Supreme Court on Thursday morning to hear the ruling by the justices on President Barack Obama’s landmark health-care legislation. Mokhiber, of Berkley Springs, West Virginia, has come as part of Single Payer Action, a group that advocates for striking down the individual-...

What CNN Could Have Done

Oops!
If you were watching cable news when the Supreme Court handed down its ruling, you were probably confused at first. Initially, both CNN and Fox News announced that the individual mandate had been struck down, only to come back a few minutes later and correct themselves, after their screaming chyrons and web site headlines had already gone up announcing the administration's defeat. Let's forget about Fox, since they're just a bunch of nincompoops anyway. The more interesting question concerns CNN. The most common explanation for this screwup is that they have come to value being first over being right, which is true enough. But I think it also suggests that they don't really understand their audience. And by trying to be just as fast as MSNBC or Fox, they lost an opportunity to differentiate themselves. My guess is that the people who work at CNN have in their heads an imagined audience made up of people like them, people who think it matters if a particular piece of news is delivered...

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