SCOTUS arguments recap - Day two

After initial arguments yesterday, the Supreme Court today slogged headlong into the meat of the arguments for and against the Affordable Care Act mandate (transcript and full audio via NPR).

Nothing new here but specific presentation, and maybe the political optics outside the court.  Politico has a recap of the 7 key points, including the "Brocolli Argument":

SCALIA: “Could you define the market — everybody has to buy food sooner or later, so you define the market as food, therefore, everybody is in the market; therefore, you can make people buy broccoli.”

VERRILLI: “No, that's quite different. That's quite different. The food market, while it shares that trait that everybody's in it, it is not a market in which your participation is often unpredictable and often involuntary. It is not a market in which you often don't know before you go in what you need, and it is not a market in which, if you go in and — and seek to obtain a product or service, you will get it even if you can't pay for it.”

Challengers are already cheering the demise of the mandate, and SCOTUSblog's Lyle Denniston confirms this is going to be Justice Kennedy's case to call.  But where Kennedy is may be up in the air (emphasis mine):

“So,” Breyer said, “I thought the issue here is not whether it’s a violation of some basic right or something to make people buy things they don’t want, bujt simply whether those decisons of that groujp of 40 milliion people substantially affect the interstate commerce that has been set up in part” through a variety of government-sponsored health care delivery systems.  That, Breyer told Carvin, ”the part of your argument I’m not hearing.”

Carvin, of course, disputed the premise, saying that Congress in adopting the mandate as a method to leverage health care coverage for all of the uninsured across the nation.  Kennedy interrupted to that that he agreed “that’s what’s happening here.”  But then he went on, and suggested that he had seen what Breyer had been talking about.   “I think it is true that, if most questions in life are matters of degree,” it could be that in the markets for health insurance and for the health care for which insurance was the method of payment “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.”

More interesting, was yesterday a setup? As David Dayden has pointed out: yesterday every Justice agreeing a mandate was not a tax under Anti-Injunction, today Obama's SG arguing it's just like a tax to Congress.

And the politics around of it all.  Roll Call has 5 races where health care will matter either way, and why Democrats will make this about RyanCare. Senate Republicans are squealing tires in reverse, hoping everyone forgets "Replace" is a word. For Obama, it could be win-win.  Mandate struck down, Republicans lose a major rallying point for the general election, Democrats may gain one (Activist judges!).  Robert Reich sees Obama positioned well for Medicare for All if the Affordable Care Act unravels.  And somewhere, Lil' Ricky and the Newt are firing up the attack ads on Romney.

Tomorrow's arguments: Mandate "what-ifs" and the Medicaid expansion

 

SCOTUS arguments recap - Day two

After initial arguments yesterday, the Supreme Court today slogged headlong into the meat of the arguments for and against the Affordable Care Act mandate (transcript and full audio via NPR).

Nothing new here but specific presentation, and maybe the political optics outside the court.  Politico has a recap of the 7 key points, including the "Brocolli Argument":

SCALIA: “Could you define the market — everybody has to buy food sooner or later, so you define the market as food, therefore, everybody is in the market; therefore, you can make people buy broccoli.”

VERRILLI: “No, that's quite different. That's quite different. The food market, while it shares that trait that everybody's in it, it is not a market in which your participation is often unpredictable and often involuntary. It is not a market in which you often don't know before you go in what you need, and it is not a market in which, if you go in and — and seek to obtain a product or service, you will get it even if you can't pay for it.”

Challengers are already cheering the demise of the mandate, and SCOTUSblog's Lyle Denniston confirms this is going to be Justice Kennedy's case to call.  But where Kennedy is may be up in the air (emphasis mine):

“So,” Breyer said, “I thought the issue here is not whether it’s a violation of some basic right or something to make people buy things they don’t want, bujt simply whether those decisons of that groujp of 40 milliion people substantially affect the interstate commerce that has been set up in part” through a variety of government-sponsored health care delivery systems.  That, Breyer told Carvin, ”the part of your argument I’m not hearing.”

Carvin, of course, disputed the premise, saying that Congress in adopting the mandate as a method to leverage health care coverage for all of the uninsured across the nation.  Kennedy interrupted to that that he agreed “that’s what’s happening here.”  But then he went on, and suggested that he had seen what Breyer had been talking about.   “I think it is true that, if most questions in life are matters of degree,” it could be that in the markets for health insurance and for the health care for which insurance was the method of payment “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.”

More interesting, was yesterday a setup? As David Dayden has pointed out: yesterday every Justice agreeing a mandate was not a tax under Anti-Injunction, today Obama's SG arguing it's just like a tax to Congress.

And the politics around of it all.  Roll Call has 5 races where health care will matter either way, and why Democrats will make this about RyanCare. Senate Republicans are squealing tires in reverse, hoping everyone forgets "Replace" is a word. For Obama, it could be win-win.  Mandate struck down, Republicans lose a major rallying point for the general election, Democrats may gain one (Activist judges!).  Robert Reich sees Obama positioned well for Medicare for All if the Affordable Care Act unravels.  And somewhere, Lil' Ricky and the Newt are firing up the attack ads on Romney.

Tomorrow's arguments: Mandate "what-ifs" and the Medicaid expansion

 

SCOTUS arguments recap - Day two

After initial arguments yesterday, the Supreme Court today slogged headlong into the meat of the arguments for and against the Affordable Care Act mandate (transcript and full audio via NPR).

Nothing new here but specific presentation, and maybe the political optics outside the court.  Politico has a recap of the 7 key points, including the "Brocolli Argument":

SCALIA: “Could you define the market — everybody has to buy food sooner or later, so you define the market as food, therefore, everybody is in the market; therefore, you can make people buy broccoli.”

VERRILLI: “No, that's quite different. That's quite different. The food market, while it shares that trait that everybody's in it, it is not a market in which your participation is often unpredictable and often involuntary. It is not a market in which you often don't know before you go in what you need, and it is not a market in which, if you go in and — and seek to obtain a product or service, you will get it even if you can't pay for it.”

Challengers are already cheering the demise of the mandate, and SCOTUSblog's Lyle Denniston confirms this is going to be Justice Kennedy's case to call.  But where Kennedy is may be up in the air (emphasis mine):

“So,” Breyer said, “I thought the issue here is not whether it’s a violation of some basic right or something to make people buy things they don’t want, bujt simply whether those decisons of that groujp of 40 milliion people substantially affect the interstate commerce that has been set up in part” through a variety of government-sponsored health care delivery systems.  That, Breyer told Carvin, ”the part of your argument I’m not hearing.”

Carvin, of course, disputed the premise, saying that Congress in adopting the mandate as a method to leverage health care coverage for all of the uninsured across the nation.  Kennedy interrupted to that that he agreed “that’s what’s happening here.”  But then he went on, and suggested that he had seen what Breyer had been talking about.   “I think it is true that, if most questions in life are matters of degree,” it could be that in the markets for health insurance and for the health care for which insurance was the method of payment “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.”

More interesting, was yesterday a setup? As David Dayden has pointed out: yesterday every Justice agreeing a mandate was not a tax under Anti-Injunction, today Obama's SG arguing it's just like a tax to Congress.

And the politics around of it all.  Roll Call has 5 races where health care will matter either way, and why Democrats will make this about RyanCare. Senate Republicans are squealing tires in reverse, hoping everyone forgets "Replace" is a word. For Obama, it could be win-win.  Mandate struck down, Republicans lose a major rallying point for the general election, Democrats may gain one (Activist judges!).  Robert Reich sees Obama positioned well for Medicare for All if the Affordable Care Act unravels.  And somewhere, Lil' Ricky and the Newt are firing up the attack ads on Romney.

Tomorrow's arguments: Mandate "what-ifs" and the Medicaid expansion

 

Weekly Pulse: New Anti-Choice Bill Suggests More #DearJohn Letters Needed

By Lindsay Beyerstein, Media Consortium blogger

Health advocate Eesha Pandit and blogger Sady Doyle join GRITtv host Laura Flanders for a discussion of the House GOP’s draconian abortion bill, H.R.3. The bill, which Speaker John Boehner (R-OH) has called a top priority, would permanently restrict federal funding for abortion, even beyond the already stringent guidelines set out in the Hyde Amendment.

Doyle launched the #dearjohn Twitter campaign to channel public outrage over H.R. 3, particularly its clause that changed the existing “rape and incest” exception for Medicaid funding for abortion to an exception for “forcible rape.”The GOP ultimately removed the word “forcible,” but the bill’s other far-reaching restrictions remain in place.

Getting the “forcible” proviso removed from the bill was a small victory, but Doyle notes the fight is far from over. H.R. 3 isn’t the only radical anti-choice bill on the GOP’s legislative agenda. Carol Joffe reports at RH Reality Check that H.R.358 (the so-called “Protect Life Act”) would give hospitals unlimited discretion to turn away women who needed abortions, even to save their lives.

Insure pregnant women

A California state senator is taking on insurance companies for denying pregnancy-related health care coverage, Brie Cadman reports at Change.org. State senator Noreen Evans has introduced a bill that would protect insurance coverage for pregnant women in the individual health insurance market. Unlike group insurers and HMOs, private plans in the state are currently not required to cover maternity care. In 2004, 82% of individual health insurance plans in California covered maternity care; by 2009, only 19% of individual plans did so.

Irony alert

The individual mandate component of health care reform, which will impose a tax on people who don’t buy health insurance, is the bete noire of conservative Republicans, and the target of multiple constitutional challenges working their way through the courts. Ironically, as Simeon Talley explains at Campus Progress, the mandate was originally proposed by a Republican as a bulwark againstsocialized medicine:

Indeed the individual mandate has its genesis on the right. Ezra Klein interviews ‘Father of the Mandate’ Republican Mark Pauly: “We did it because we were concerned about the specter of single-payer insurance, which isn’t market-oriented, and we didn’t think [that] was a good idea. One feature was the individual mandate.”

Medicine and the public good

At truthout, Dr. Andrew Saal remembers what he said when a medical colleague asked him to sign a petition to repeal health care reform:

I centered myself and spoke in calm, measured phrases, with a warm smile. “I believe that the status quo is unsustainable. I believe that caring for those unable to pay is a matter of civic duty and professional honor. And while a pinch of free enterprise may keep the system nimble and foster innovation, at the end of the day, medicine is a social commodity similar to police and fire services.”

Saal’s colleague argues that he should be entitled to charge as much as the market will bear for medical services. After all, he studied hard and went to medical school. Saal sees things differently. He argues that, while doctors are entitled to fair compensation for their skilled services, medical knowledge is social. The doctor who places a cardiac stent didn’t invent the procedure. Saal notes that federal tax dollars fund the basic research that makes medical breakthroughs possible. While the stent itself may have been developed by a private company, the company couldn’t have invented it if the government hadn’t invested untold millions of dollars on basic research.

What’s more, Saal notes, doctors don’t pay the full cost of their schooling. The federal government subsidizes medical education through low interest federal loans, the university system itself, and Medicare reimbursements for interns and residents (doctors in training).

Nail salon hazards

Nail salon workers are exposed to a miasma of formaldehyde, toluene, and other known and suspected chemical hazards. The National Radio Project takes a closer look at the potential health effects of working long hours in poorly ventilated salons.

In California, the issue is of special concern to the Vietnamese community. An astonishing two-thirds of nail salon workers in the state are Vietnamese immigrants, most of them women in their childbearing years. Epidemiologists have yet to definitively prove a link between nail salon exposure and chronic disease, but the suspect chemicals have been shown to cause cancer in laboratory animals.

The bottom line is that safer chemicals are available. Activists say that regulators should mandate healthier alternatives now.

This post features links to the best independent, progressive reporting about health care by membersof The Media Consortium. It is free to reprint. Visit the Pulse for a complete list of articles on health care reform, or follow us on Twitter. And for the best progressive reporting on critical economy, environment, health care and immigration issues, check out The AuditThe Mulch, and The Diaspora. This is a project of The Media Consortium, a network of leading independent media outlets.

 

 

Weekly Pulse: New Anti-Choice Bill Suggests More #DearJohn Letters Needed

By Lindsay Beyerstein, Media Consortium blogger

Health advocate Eesha Pandit and blogger Sady Doyle join GRITtv host Laura Flanders for a discussion of the House GOP’s draconian abortion bill, H.R.3. The bill, which Speaker John Boehner (R-OH) has called a top priority, would permanently restrict federal funding for abortion, even beyond the already stringent guidelines set out in the Hyde Amendment.

Doyle launched the #dearjohn Twitter campaign to channel public outrage over H.R. 3, particularly its clause that changed the existing “rape and incest” exception for Medicaid funding for abortion to an exception for “forcible rape.”The GOP ultimately removed the word “forcible,” but the bill’s other far-reaching restrictions remain in place.

Getting the “forcible” proviso removed from the bill was a small victory, but Doyle notes the fight is far from over. H.R. 3 isn’t the only radical anti-choice bill on the GOP’s legislative agenda. Carol Joffe reports at RH Reality Check that H.R.358 (the so-called “Protect Life Act”) would give hospitals unlimited discretion to turn away women who needed abortions, even to save their lives.

Insure pregnant women

A California state senator is taking on insurance companies for denying pregnancy-related health care coverage, Brie Cadman reports at Change.org. State senator Noreen Evans has introduced a bill that would protect insurance coverage for pregnant women in the individual health insurance market. Unlike group insurers and HMOs, private plans in the state are currently not required to cover maternity care. In 2004, 82% of individual health insurance plans in California covered maternity care; by 2009, only 19% of individual plans did so.

Irony alert

The individual mandate component of health care reform, which will impose a tax on people who don’t buy health insurance, is the bete noire of conservative Republicans, and the target of multiple constitutional challenges working their way through the courts. Ironically, as Simeon Talley explains at Campus Progress, the mandate was originally proposed by a Republican as a bulwark againstsocialized medicine:

Indeed the individual mandate has its genesis on the right. Ezra Klein interviews ‘Father of the Mandate’ Republican Mark Pauly: “We did it because we were concerned about the specter of single-payer insurance, which isn’t market-oriented, and we didn’t think [that] was a good idea. One feature was the individual mandate.”

Medicine and the public good

At truthout, Dr. Andrew Saal remembers what he said when a medical colleague asked him to sign a petition to repeal health care reform:

I centered myself and spoke in calm, measured phrases, with a warm smile. “I believe that the status quo is unsustainable. I believe that caring for those unable to pay is a matter of civic duty and professional honor. And while a pinch of free enterprise may keep the system nimble and foster innovation, at the end of the day, medicine is a social commodity similar to police and fire services.”

Saal’s colleague argues that he should be entitled to charge as much as the market will bear for medical services. After all, he studied hard and went to medical school. Saal sees things differently. He argues that, while doctors are entitled to fair compensation for their skilled services, medical knowledge is social. The doctor who places a cardiac stent didn’t invent the procedure. Saal notes that federal tax dollars fund the basic research that makes medical breakthroughs possible. While the stent itself may have been developed by a private company, the company couldn’t have invented it if the government hadn’t invested untold millions of dollars on basic research.

What’s more, Saal notes, doctors don’t pay the full cost of their schooling. The federal government subsidizes medical education through low interest federal loans, the university system itself, and Medicare reimbursements for interns and residents (doctors in training).

Nail salon hazards

Nail salon workers are exposed to a miasma of formaldehyde, toluene, and other known and suspected chemical hazards. The National Radio Project takes a closer look at the potential health effects of working long hours in poorly ventilated salons.

In California, the issue is of special concern to the Vietnamese community. An astonishing two-thirds of nail salon workers in the state are Vietnamese immigrants, most of them women in their childbearing years. Epidemiologists have yet to definitively prove a link between nail salon exposure and chronic disease, but the suspect chemicals have been shown to cause cancer in laboratory animals.

The bottom line is that safer chemicals are available. Activists say that regulators should mandate healthier alternatives now.

This post features links to the best independent, progressive reporting about health care by membersof The Media Consortium. It is free to reprint. Visit the Pulse for a complete list of articles on health care reform, or follow us on Twitter. And for the best progressive reporting on critical economy, environment, health care and immigration issues, check out The AuditThe Mulch, and The Diaspora. This is a project of The Media Consortium, a network of leading independent media outlets.

 

 

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