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ObamaCare Challenge Exposes Conservative Hypocrisy On Federal Power
Next year policy wonks, politics junkies, and legal experts will wait with bated breath for the Supreme Court to determine the constitutionality of a key section of President Obama’s health care law: the mandate that uninsured individuals purchase health care coverage.
“When it has suited social conservatives, they’re all for coercion,” says Sara Rosenbaum, a law professor at George Washington University, where she’s also the chair of the Department of Health Policy. But the court will also review another major piece of the law — the requirement that states expand Medicaid eligibility to people with incomes of up to 133 percent of the federal poverty line. This is no small expansion. Of all the millions of people expected to become insured under the law, about half will be covered through Medicaid.
For the first several years, the federal government will pay the states for the full cost of the expansion. After 2020, the federal contribution will drop to 90 percent. States with conservative governors don’t like this one bit. But Medicaid is a voluntary program — if states don’t like the terms and conditions the government sets for the program, they’re free to drop out of it.
So 26 conservative state governors and attorneys general are seeking to get the coverage expansion tossed on the grounds that it’s too coercive — an unconstitutional application of the Constitution’s Spending Clause.
Most legal experts say this is a long-shot. But however the court rules, the challenge in itself exposes the inconvenient fact that the conservative movement has been opportunistically on differing sides of federalism for a long time now. And a favorable court ruling for the plaintiffs would have severe and adverse implications for a number of right wing causes which rely heavily on federal government coercion.
“When it has suited social conservatives, they’re all for coercion,” says Sara Rosenbaum, a law professor at George Washington University, where she’s also the chair of the Department of Health Policy.
The plaintiffs will ask the Supreme Court to rule narrowly that the Medicaid expansion is an unconstitutional use of Congress powers to tax and spend. If the court follows suit, though, it will invite a flood of challenges to other statutes, many of which conservatives adore, but all of which rely on Congress’ power to impose conditions on money they provide to states.
“It opens a tremendous Pandora’s box of other spending clause statutes that might be considered coercive with no clear limiting principles,” Rosenbaum said. “At what point does something become a coercion.”
Timothy Jost, a law professor at Washington and Lee University who has been monitoring the health care lawsuits very closely runs through some of these: “Title IX of the Civil Rights Act and national security programs and No Child Left Behind and all kinds of other programs.”
The list is long. It includes requirements that universities receiving federal funds allow the military to recruit on their campuses. And, both Jost and Rosenbaum note, if conservatives get their way, it will also include a stronger version of the so-called Hyde Amendment, which severely restricts the use of federal funds to provide abortions.
“The House of Representatives has been fashioning a very different kind of Hyde amendment … restrictions say that no federal funds go to the insurance program if that coverage offers more than the [federal] minimum for abortions,” Rosenbaum said.
What are the implications here? Several states that help provide abortion coverage with their own funds would have to pare back that funding or drop out of Medicaid. That’s a federal power conservatives are happy to exercise — but one they’d stand to lose if they get their way in the Supreme Court next year.
“If the states were to prevail on the issue of expansion, then the [abortion] mandate would presumably fall,” Rosenbaum said.
In other words, be careful what you wish for.
“The thing is that Medicaid is already conditioned on all kinds of thing,” Jost said. “And some of them are things that people who are trying to strike the mandate think are pretty good ideas.”
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13 Comments so far
Show AllAs far as the Obama-care mandate to buy health insurance goes, my educated guess is the conservative members will meet with the health insurance, drug companies etc, (If it hasn't happened already) and they will ask them what ruling they want. They'll then find some case law to point to as to why they ruled that way.
IMHO, we got the best damned supreme court that money can buy...
Yes, Tom.........And the best Congress money can buy!
Actually the worst damn congress corporate bribery could inflict upon us.
Living in the U$A is dangerous to your health. Why can't we just be like Costa Rica, Denmark, Cuba, Sweden...
The banksters are buying politicians in those nations as fast as they can so they can export the US model around the globe.
The GOP loves Obamacare's individual mandate, loves coercive legislation, and they know that SCOTUS will uphold the mandate and coercion.
Just like they did with the TARP, however, the GOP did not need to vote in favor of Obamacare since enough Democrats voted in favor, took the political heat, thereby giving the GOP cover to appear that they are siding with the majority of Americans who do not favor the TARP, Obamacare and other massive corporate welfare programs.
Why are we one of the only countries in the World without any National Health Plans for its citizens? Even Cuba has National Health. That is where the President of Venezuela went for Cancer Treatment.
This whole debacle is really unbelievable and extremely sad.
What I suggest is not so much National Health but a Catastrophic Health Care to protect individuals and their families from going broke from one of the many life threatening diseases.
If it were not voluntary at the state level, and if it were federally funded, the expansion of Medicaid would be a great thing. Right now levels for Medicaid eligibility are ridiculously low. Many low income working people are frozen out. 133% of the poverty level would be an improvement.
Column 1 is family size, column 2 is current NYS Medicaid income limit, and column 3 is the new level at 133% of poverty.
1 $8,487 $14,484
2 $10,595 $19,564
3 $12,606 $24,645
4 $14,637 $29,726
5 $16,736 $34,806
6 $18,271 $39,887
7 $19,889 $44,967
8 $21,965 $50,048
Of course the way this would work under current labor laws is that many low-paying, no benefit companies will get a subsidy in the form of medical insurance for their employees. Other low income workers or two income families will be just above the threshold and unable to afford the mandated insurance policies. Our whole system is so convoluted, it is almost impossible to reform it. (By the way, a family of 8 with an income of $22,000 should be getting free condoms or Planned Parenthood services, no?)
The current medical insurance reform is really a cruel hoax and a waste of time and effort. It is so flawed that the right wing will have a field day challenging every halfway decent aspect
Medcare for all is the way to go. Eliminate the useless layer of private insurance, the nightmare of complyng with so many different rules. Fund the system. I think there are some pallets in Iraq that could be used. Or was it Afghanistan? Who can keep track.
Is Huckabee really a Christian? I got a phone call from the Huckabee office wanting money to help stop Obama care, my Medicare just dropped twenty dollars a month due to the affordable health care law. Why isn't this on TV, I can understand why it is not on Fox but why not local stations? Probably because they are all owned by republicans. No health care for the 99 percent no matter how many surfs die.
Great, and after Obama and the Democrats, joined with Republicans are done raising the eligibility age of Medicare, then many might DIE before they can use it!
That sorry bill, referred to as Obamacare, is an insurance policy for insurance companies, whose said insurance, ensures their profitable existence for generations to come. And that's not all! Soon, it will be ILLEGAL to not buy from these blood sucking, money worshipping, greedy sadist companies!!!!
DONT dress up this piece of garbage legislation with utterances that somehow it looks after the 99 percent. Bullshit.
Don't tar the message of OWS, that knows better. OWS is for single payer.
Article I Section 8 of the US Constitution spells out the powers delegated to Congress. It's a short list that has nothing about the government forcing people to buy something, anything, from anyone, much less a for-profit corporation.
No tortured interpretation of the commerce clause could ever result in the ability of the federal government to tell people they have to buy something, especially something they haven't purchased because they couldn't afford to.
Telling insurance companies they can't deny coverage based on prior conditions is the right thing to do. That part should stand (though single-payer would be much better). Telling insurance companies they can't drop an insured just because they've actually needed the insurance is a good thing and should be kept.
Holding a legal gun to people's heads and forcing them to buy something in a mafia-style "deal they cannot refuse" is not constitutional no matter what inane "logic" is applied and must not remain.
The issue of constitutionality is an irrelevant side-show in my opinion. When President Obama began his quest for this legislation he was correct when he stated, in essence, that our insurance/care system was on its way to a "heart attack" and death because the costs would rise out of the pan. So what did "Doctor Obama" and his nurses in Congress prescribe? A pain-reducer that leaves "market-driven for profit" insurance/care in place. There is little doubt that the new system will eventually go down in flames too regardless of what the Supreme Court rules and regardless of what future tinkering at the margins of the system will be done. It will fail, if we are not already at that point, because of the huge and ever increasing number of persons in the USA that must be served.
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Throughout human history the systems of production/distribution/consumption have undergone revolutionary change whenever the population density surpassed some critical value. That is why we no longer "hunter-gather". That is also the reason why we no longer rely on shamans to cure our diseases. And that is also the reason why I am convinced that the Obama-system will inevitably fail. It may already be inadequate. Adequacy is a political and not a judiciary issue and that is the reason why I think that the ruling of the Supreme Court will be irrelevant. For that very reason I aver that bringing this suit to the Supreme Court was a supremely immoral act.
My Medicare-Advantage co-payment for specialists for 2012 has been raised from $15 to $35. So much for the hot-air promise that this law would make health care cheaper. The defenders of the law never tell us how many persons lost their insurance, what percentage of the uninsured got insured, and by what percentage the cost of insurance/care increased or decreased since its passage. My hunch is that these numbers are so devastating for Obama in the 2012 election that they are kept hidden under the table.