Jun 25

That’s how the Wall Street Journal described the second Supreme Court ruling to uphold the Affordable Care Act, as written.

Which is precisely what was at the heart of the case before the justices yet again, what the AFA said. Here’s the later version of the WSJ story, though the news alert that dropped into my inbox said this in opening summary:

The U.S. Supreme Court ruled the Obama administration can continue to subsidize health-insurance purchases by lower-income Americans across the country, a decision that preserves a centerpiece of the Affordable Care Act.

The ruling marks the second time President Barack Obama’s signature domestic policy achievement has survived a near-death experience in the courts, and leaves the law on a firmer footing for the remainder of his time in office.

And thus

rescuing for the second time the most ambitious social program in nearly 50 years and ensuring that the law’s ultimate fate will be in the hands of the political process.

Which nearly everything is, these days. In the hands of the political process, that is. Except for those matters  in the hands of the judiciary, though that wing has long been bending in the direction of the prevailing political winds.

As usual, there’s a lot of coverage out there, something to fit any viewpoint. Though I’m a legal and policy wonk, my angle is of a purist, how carefully we adhere to the truth and meaning of language of law, policy, and everything else from political promises to social realities, scientific statements to biomedical facts, faith claims to gospel teachings, and all things as they uphold human dignity.

So the key issue for me is how words were so central to this case and final ruling. Leaving aside the specifics of the AFA, otherwise known as Obamacare, I believe everyone deserves health care. How that is best delivered is debatable. Interestingly, two allegedly conservative justices, Chief Justice John Roberts and Justice Antonin Scalia, differed widely (and wildly) in their views of how to handle the Obamacare wording and challenge to it. And the wording of the opinion and dissent.

The WSJ reports:

The 6-3 ruling, written by Chief Justice John Roberts, upheld a signature achievement of President Barack Obama’s tenure. In buttressing the health law’s legal foundation it raised the odds that it may become as entrenched as Social Security, Medicare and Medicaid.

The case turned on wording, as the WSJ and any other responsible media reported, no matter how else they reported it. In particular, four words: “established by the State”.

Carrie Severino explains at NRO:

On the Chief’s appeal to context, Scalia points out that context “is a tool for understanding the terms of the law, not an excuse for rewriting them.” But, as Scalia explains, the Chief’s opinion does not merely redefine the words “established by the State,” it effectively deletes them from the statute because the majority’s position is that they add precisely no meaning to the law. Yet Congress used this apparently meaningless phrase over and over. “It is bad enough for a court to cross out ‘by the State’ once. But seven times?”

To which dissenting Justice Scalia went to great lengths by delivering his lively and blistering dissent from the bench, which is unusual.

To mention just the highlights, the Court’s interpretation clashes with a statutory definition, renders words inoperative in at least seven separate provisions of the Act, overlooks the con­trast between provisions that say “Exchange” and those that say “Exchange established by the State,” gives the same phrase one meaning for purposes of tax credits but an entirely different meaning for other purposes, and (let us not forget) contradicts the ordinary meaning of the words Congress used. On the other side of the ledger, the Court has come up with nothing more than a general provision that turns out to be controlled by a specific one, a handful of clauses that are consistent with either under­standing of establishment by the State, and a resemblance between the tax-credit provision and the rest of the Tax Code. If that is all it takes to make something ambiguous, everything is ambiguous. (emphasis added)

There was a lot of buzz about judicial activism on this ruling. NRO’s Peter Augustine Lawler posted this in response.

I’m sympathetic with Roberts’s statesmanlike view that the judiciary is not the branch of government equipped, all alone, to save us from Obamacare. So he refuses an opportunity for “judicial activism.” But, from another view, he turns out to be quite the activist, telling Congress what it really meant by its incompetently drafted, screwed-up law. And so if judicial activism is a synonym for judicial legislation, that’s what we have here. Someone might say that Scalia was uncharacteristically the activist for wanting to strike part of the law down. But he claims to be doing the least activist thing by sending the law back to Congress. It should figure out what it really meant and then say that…

All in all, there are some interesting separation-of-powers issues here, as well as the one about the extent to which the Court should scope out the political environment before deciding whether or not to strike a law down.

Yes. Which is precisely the point. It was the point when the Blackmun court wrote abortion into law and cited the Constitution as grounding for it, making that up as it went. It was the point going back to the Dred Scott decision on slavery. Both issues involve classes of human beings denied human rights by the high court.

With this ruling, Justice Scalia said in his dissent, “words no longer have meaning”.

How that atmosphere impacted the decision on how the definition of marriage was deliberated and decided is about to become clear. The task of restoring the meaning of language in communicating human truths is as vital as ever. The merits of Justice Roberts majority opinion may be understandable to many people. But Justice Scalia’s clarifying blast is a valuable call for truth in justice.

Tagged with:
Mar 31

It’s not really news anymore that signup for healthcare as promised and touted by the president has hit another glitch. But that it did on deadline day generated at least some headlines.

Like Politico’s. The bottom line is more the story than the body of the story.

Public opinion polls have shown many Americans are still opposed to the law. A new Washington Post-ABC poll released Monday showed approval rising slightly, with 49 in favor and 48 opposed, but many other surveys have found more skepticism.

So, fair assessment is that we’re about evenly split over Obamacare. Allegedly.

The issues I have with it relate to life, true healthcare coverage and accessibility, and conscience rights, as regular readers here know. Those have been highlighted in the HHS mandate lawsuits over the past two years.

Here’s another detailed rundown of what’s wrong with the Affordable Care Act, which few people have actually read.

Once the Affordable Care Act became law in March 2010, the two chambers of Congress have held diametrically opposed views. The House, under Republican control since 2011, has voted many times to repeal the entire act; the Democratic-controlled Senate has resisted changes.

The Catholic bishops’ conference has not joined in either agenda. Supporters of national efforts to achieve universal health coverage for almost a century, the bishops have urged specific reforms in accord with the moral principles they articulated during consideration of the A.C.A. The bishops support basic, life-affirming health coverage for everyone, including immigrants; compliance with longstanding federal policies on abortion funding; and respect for rights of conscience.

The A.C.A. remains deficient in these areas. The bishops have urged Congress to pursue comprehensive immigration reform, including reform of the way our health laws treat immigrant families. On abortion issues—both federal funding and conscience rights—the implementation of the A.C.A. over four years has brought its defects into sharper focus.

One barrier to progress on the act’s problems regarding abortion is that many, including some Catholics, are confused about those problems or deny that they exist. Here, then, are the abortion-related problems the bishops’ conference finds in the A.C.A.

Click on that link.  Read the article. Rich Doerflinger counts the ways.

1) Under existing federal jurisprudence, federal funds appropriated by the A.C.A. are available for elective abortions.

He doesn’t just make the claim, he backs it up. Do read on, especially about the protections put in place and upheld for decades under the Hyde Amendment. It’s very instructive.

2) The act violates the policy of all other federal health programs by using federal funds for health plans covering elective abortions.

Here’s just a snip from that section:

The A.C.A. forbids insurers to inform consumers about their abortion coverage except as part of the long list of benefits provided to those already enrolling. It also forbids them to reveal how much of the enrollee’s premium will go into the separate account for abortions. Thus a common impression that enrollees will write a “separate check” for abortion, which pro-life dissenters might try refusing to sign, is apparently false—the funds are separated at the insurer’s end. Some states have said that every health plan on their exchange will cover elective abortions.

This is troubling in light of polling commissioned by the bishops’ conference during consideration of the A.C.A. Most survey respondents opposed measures that require Americans to support abortion with their tax dollars or their premiums; 68 percent said that if the choice were theirs they would not want abortion in their health coverage. On each question, women gave stronger pro-life responses than men. The majority of American women who oppose abortion coverage will now often face a sad dilemma: Either pay for abortions anyway or have greatly reduced options when looking for a health plan to meet their families’ needs.

Next:

3) The A.C.A. lacks important conscience protections.

Most of this is contained within the HHS mandate, a ‘birth control delivery scheme’ objected to by a great number of Americans for many reasons, most enumerated in those lawsuits linked above. But note this, which isn’t well known (along with most everything else in Doerflinger’s article):

More broadly, the final version of the A.C.A. deleted an important conscience provision from the original House-passed bill, which incorporated the Hyde/Weldon Amendment that has been part of Labor/H.H.S. appropriations bills since 2004. That law withholds Labor/H.H.S. funds from a federal agency or program or a state or local government that discriminates against health care entities that refuse to provide, refer for, pay for or provide coverage of abortion. Like the Hyde Amendment on funding, the Hyde/Weldon policy on conscience does not govern funds appropriated by the A.C.A.

And then:

4) Finally, it has been said that federal judges in Virginia and Ohio have ruled there is no abortion funding in the A.C.A. That is not quite true.

He explains. And then, the bottom line:

The great majority of American men and women do not want to support abortion with their taxes or health premiums. A recent poll of obstetrician-gynecologists showed that only 14 percent perform abortions, and the latest abortion statistics show abortion rates and the number of abortion providers at their lowest since 1973. To all but the most committed enthusiasts for abortion, that tipping point cannot arrive too soon.

Tagged with:
Mar 24

Or put bluntly, the government mandate to violate your conscience.

It’s as simple as that. No matter how much spin has been spun, and there has been much, it comes down to this.

Do Americans enjoy religious-liberty protections when they are at church, or do Americans enjoy religious-liberty protections when they are Americans?

That’s it. The Supreme Court hears oral arguments this week on that question.

Hobby Lobby is owned by a trust controlled by the Green family, observant Christians who make a point of carrying their faith into the marketplace, stocking Christian products and closing their stores on Sundays. They refuse to comply with parts of the Affordable Care Act’s contraception mandate, specifically the provision of products that they regard as actual or potential abortifacients, including intrauterine devices and the so-called morning-after pill, both of which can function to prevent an embryo from implanting in the uterus and thus surviving. Whether these products are properly regarded as abortifacients is a matter of some controversy, but the relevant question is not a technical one about the mechanisms by which these drugs and devices prevent pregnancy. Federal law protects religious liberty with no proviso that matters of conscience must be argued to the satisfaction of the American College of Obstetricians and Gynecologists before legal protections kick in.

Now here’s the money paragraph, the important explanation of the whole thing that helps understand what’s at stake in the claims to protection against government encroachment of religious freedom and conscience rights. Those claims are grounded in the Constitution and RFRA, the Religious Freedom Restoration Act.

While the issue is at heart a constitutional one, Hobby Lobby is not in this instance appealing to the First Amendment but rather to the Religious Freedom Restoration Act, which was passed by a unanimous House, a near-unanimous Senate, signed into law by President Bill Clinton, and certified as constitutional as applied to the federal government in a 2006 Supreme Court decision. The act sets a high standard that the federal government must meet when it burdens the free exercise of religion and was enacted in response to court decisions that had narrowed First Amendment protections. It is intended to reinstate the “Sherbert test,” which holds that in a case in which the involved parties hold a sincere religious belief and the federal government places a substantial burden on the exercise of that belief, then the federal government must both prove a “compelling state interest” in burdening religious exercise and — perhaps most important in this case — demonstrate that it has sought to secure that compelling interest in the least restrictive fashion.

That’s a two-pronged test the government cannot possibly pass in imposing the HHS mandate.

While it is hardly obvious that there is a compelling state interest in subsidizing access to contraception, which is widely available and inexpensive (a woman who required an emergency dose of Plan B once a quarter would still spend more annually on toothpaste), it is entirely implausible that the least restrictive way of achieving that subsidy is a nationwide legal mandate for coverage of those products at no out-of-pocket expense by every employer in the country offering health insurance — and the federal government will penalize them if they don’t offer it.

So…

Whatever the federal government might have done differently, the express purpose of the Religious Freedom Restoration Act is to prevent it from doing what it has done in the Affordable Care Act: ride roughshod over the free exercise of religion whenever doing so proves politically convenient.

The case is about more than the Green family and Hobby Lobby. There are in fact 94 related cases involving 300 plaintiffs representing nearly half the states, from Southern Baptists such as the Greens to Catholic nonprofits and Amish cabinetmakers. The objections to the ACA mandate are neither narrow nor sectarian.

Split decisions from the appellate courts all but guaranteed a Supreme Court hearing of the issue, which will begin tomorrow. The decision will be only incidentally about what kind of health insurance we have — it will be about what kind of country we have.

So here we go.

Whatever the federal government might have done differently, the express purpose of the Religious Freedom Restoration Act is to prevent it from doing what it has done in the Affordable Care Act: ride roughshod over the free exercise of religion whenever doing so proves politically convenient.

The case is about more than the Green family and Hobby Lobby. There are in fact 94 related cases involving 300 plaintiffs representing nearly half the states, from Southern Baptists such as the Greens to Catholic nonprofits and Amish cabinetmakers. The objections to the ACA mandate are neither narrow nor sectarian.

Split decisions from the appellate courts all but guaranteed a Supreme Court hearing of the issue, which will begin tomorrow. The decision will be only incidentally about what kind of health insurance we have — it will be about what kind of country we have.

This is about that, and more.

The United States is one of the most religiously diverse nations on earth. People of a vast array of traditions of faith live here in a harmony that would have been unthinkable in most of the world for most of human history.

One of the ways America has fostered and protected this diversity is by nurturing a robust understanding of religious liberty that includes granting certain exemptions to people who need them in order to be true to their religious faith. Religious exemptions protect people in situations where legislative or executive acts might otherwise unnecessarily force them to violate their consciences…

The United States is one of the most religiously diverse nations on earth. People of a vast array of traditions of faith live here in a harmony that would have been unthinkable in most of the world for most of human history.

One of the ways America has fostered and protected this diversity is by nurturing a robust understanding of religious liberty that includes granting certain exemptions to people who need them in order to be true to their religious faith. Religious exemptions protect people in situations where legislative or executive acts might otherwise unnecessarily force them to violate their consciences.

In a free, representative republic, it’s hard to imagine why or how government acts would possibly force citizens to violate their consciences. Surely, that cannot stand.

The reason that government is likely to lose in the Hobby Lobby case, however, is that there are so many ways for the government to distribute these drugs—on its own exchanges, through the Title X family-planning program and by cooperating with willing distributors—that do not require the forced participation of conscientious objectors. That presumably is why an effort is now being made to cut back on the robust conception of religious freedom that once united Americans of all faiths and even unbelievers.

The Establishment Clause argument should also fail. That provision exists to prevent the establishment of a national religion or the granting of superior standing to a religion that happens to have the support of most citizens. It would be perverse for a court to use it to punish the laudable practice—dating all the way back to George Washington’s decision to excuse Quakers from his army—of accommodating the free exercise of religion by protecting people whose religious beliefs or practices are not shared by the majority from being compelled even in the absence of a compelling reason to violate their consciences.

The two-pronged test of proving a compelling government interest in pursuing an edict that requires citizens to violate their religious beliefs, and then proving that the means of doing so constitute the least restrictive means possible to do so, is a test the government cannot pass with the HHS mandate, without the help of an activist court.

Oral arguments begin. The court ruling will come later. Stay tuned.

Tagged with:
Nov 12

No one knows yet just how much worse this is going to get.

But the people the healthcare overhaul was supposed to help are mostly not being helped, and the people who were supposedly safe in the system they preferred have mostly lost that safe haven. President Obama was not able to deliver what he promised, and even when he was warned to stop promising it, he persisted.

He was the one who made it sharply and divisively political from the start, giving leadership of the Republican party  no voice at the table to negotiate necessary healthcare reform. Something as major as the redesign of health care in America should have been a joint effort, but alternative plans never got a hearing.

Wall Street Journal columnist Peggy Noonan summarizes it, to this point, here. She makes very good and important points, and particularly one I’ve focused on while so much attention in the early unraveling of Obamacare centered on the stunning website failures. That was misdirected focus, though that crash definitely occurred, definitely cost a ton of money and most definitely didn’t have to happen, with technology experts able to handle something like this with far less lead time and at far less cost with vastly more ease of use. That’s all true. But Noonan focuses on what I’ve wanted to see addressed, which is the main point.

So the program debuts and it’s a resounding, famous, fantastical flop. The first weeks of the news coverage are about how the websites don’t work, can you believe we paid for this, do you believe they had more than three years and produced this public joke of a program, this embarrassment?

But now it’s much more serious. No one’s thinking about the websites. They wish you were thinking about the websites! I bet America hopes the websites never work so they never have to enroll.

The problem now is not the delivery system of the program, it’s the program itself. Not the computer screen but what’s inside the program. This is something you can’t get the IT guy in to fix.

Yes, it’s the program itself. It was always that.

They said if you liked your insurance you could keep your insurance—but that’s not true. It was never true! They said if you liked your doctor you could keep your doctor—but that’s not true. It was never true! They said they would cover everyone who needed it, and instead people who had coverage are losing it—millions of them! They said they would make insurance less expensive—but it’s more expensive! Premium shock, deductible shock. They said don’t worry, your health information will be secure, but instead the whole setup looks like a hacker’s holiday. Bad guys are apparently already going for your private information.

Many people may have missed that, but HHS Secretary Kathleen Sebelius had to admit under oath in her testimony before a Senate Finance Committee hearing that healthcare ‘navigators’ hired by the federal government to help people sign up for healthcare online and thus take sensitive personal information from them just may be felons.

Sen. John Cornyn asked if federal background checks were a prerequisite for the hiring of the individuals tasked with walking people through ObamaCare enrollment.

“The president is in Dallas, Texas today touting the navigator program, which as you know are people who are hired to navigate the [Affordable Care Act], but I would just like to ask you this question,” Cornyn said to Sebelius. “Isn’t it true that there is no federal requirement for a navigator to undergo a criminal background check, even though they will receive sensitive personal information for people they help sign up for the Affordable Care Act?”

“That is true,” Sebelius responded. “States can add an additional background check and other features, but that is not part of the federal requirement.”

“So a convicted felon could be a navigator and could acquire sensitive personal information?” Cornyn asked.

“That is possible,” Sebelius said. “We have contracts with the organizations, and they have taken the responsibility to screen their navigators and make sure that they are sufficiently trained for the job, and there’s a self attestation, but it is possible.”

Noonan has a suggestion.

Maybe [oversight committees] could even call in some people from the White House and Congress, the ones who helped write and interpret this famous law that you had to pass before you could know what was in it, and ask: “Did you ever meet a normal human? Did you understand what you were doing when you produced this thing?”

Maybe they could even ask the president: “In your entire life, from community organizer to lawyer to politician, did you ever buy an insurance policy? Were you always on your wife’s plan, or immediately put on a plush government plan? Did you ever have to do anything like what you’re telling the people of your country to do?”

What are the odds those questions will be asked? Though the media are now, finally, asking questions and turning up information about pressure politics to avoid transparency on the healthcare overhaul.

We deserve transparency, the president and all elected officials deserve scrutiny by an informed electorate, because we’re all affected by it.

The idea that “only” 3 percent of Americans will end up on the short end of a 2,700-page law remaking the nation’s health care system seems as fanciful as the President’s pledge that anyone who likes their current plan could keep it.

The facts are clear: Obamacare isn’t just unfair for a small percentage of Americans; it’s unfair for the entire country.

There were alternatives. Here are some that didn’t require policy wonks.

It didn’t have to be this way. The Affordable Care Act may have been designed to be a socialized monstrosity of health care displacement and governmental control, but it need not have been. Creating a means whereby people who wanted health insurance could purchase it (and younger people in good health could choose limited, catastrophic coverage, or none at all) needed only two things: a willingness to put common sense over politicization, and a genuine respect for the notion that people understand their individual needs better than anyone else.

Common sense, and respect for the people they have ostensibly been elected to serve, are currently in short supply in our nation’s capital. The Affordable Care Act was passed by one political party while it was in control of two branches of government and feeling disinclined toward discussing (or even acknowledging) design alternatives.

That’s a shame because creatively exploring and expanding upon just a few of these framework ideas might have solved the problems of the uninsured without severely disrupting much of anything:

A) Begin where you are: Why should all roads lead to Washington DC when local communities are best able to identify those in need and to reach out? In 2000, then-Mayor Rudy Giuliani, went to the New York City Council with the simplest of plans: Take a pro-active approach and reach out to the uninsured who are not even aware of what programs already exist, which helped to insure several hundred thousand in New York City alone. Before upending anyone, get the right people enrolled into the appropriate, existing programs.

B) Invite-in can still avoid federal intervention: Healthcare infrastructure is all about managing risk by spreading it. If the most economically efficient plan is the one covering as many people as possible, then why not create extensions that offer the uninsured the opportunity to buy into the very same insurance plans offered to any state’s government employees, which are usually excellent?

C) Open the markets: Perhaps because it is both the simplest and the most commercial of ideas, and the least political, there appears to have been no discussion of allowing insurance to be sold across state lines, which would have immediately broadened the market competition and thereby lowered costs for everyone, across the board. Rather than opening coverage availability, the ACA appears to narrow it.

Read the account there of cancer patient Edie Littlefield Sundby:

Before the Affordable Care Act, health-insurance policies could not be sold across state lines; now policies sold on the Affordable Care Act exchanges may not be offered across county lines. It would seem the ACA would have the effect of geographically trapping people, effectively keeping them from pursuing new in-state opportunities and adventures for fear of again losing insurance and having to re-start the research and purchasing process. It is another narrowing, rather than enlarging, effect of Obamacare.

The column concludes with a presumption that perhaps something may still be done, by people of common sense, before this gets much worse. Maybe that’s not possible, maybe it is. But there’s no telling right now.

As this unpopular policy we call Obamacare begins to crumble from the weight of its own incompetent over-reach and mendacity, the opportunity may soon arise for policy reform, but if other voices do not have alternative plans already designed, thought through and set for discussion when an urgent solution is called for, there will be no option left in the political imagination but a single-payer program—managed by these same incompetents—and a nation full of frightened, uninsured people willing to turn to it.

The latest political class punditry holds that there’s no turning back now from the inevitable impact of such a massive federal program already in place. We’ll see.

Tagged with:
Oct 09

Like ‘How is this going to work when it gets implemented?’

In the crush of media coverage of the politics of the government shutdown, and political jockeying in government itself, a bit of common sense stands out.

Like this little snip about CNN’s Wolf Blitzer saying maybe we could benefit from a little delay on Obamacare. First, CNN correspondent Brian Todd reported on the problems with the healthcare law rollout:

“We’re also hearing now that the administration was warned about these potential problems months in advance,” Todd continued. “We spoke to a health care consultant who has clients who are insurers. He says his insurers, who dealt with the administration in the months ahead of time, had contentious meetings with people at [Health and Human Services] and other health care officials who were in charge of this, warning them, ‘This isn’t working, it’s not going to be smooth, don’t do it.’ He says those warnings were ignored, they went full speed ahead, and said we’ll work these problems out. There’s been a bit of pushback from the White House, we’ll hope to get more later from them.”

Right now, that’s just protocol for network correspondents to say, because they know they’re not going to get more from them later.

Here’s Slate with a little more specificity about what the pre-launch warnings were likely about. I can’t remember right now where I read it, but one techie was quoted in a news story a few days ago as saying that using two different contractors to build the “front end” and “back end” of the site is sort of like trying to build a bridge by starting on opposite shorelines and trying/hoping to meet in the middle:

“So we had (at least) two sets of contracted developers, apparently in isolation from each other, working on two pieces of a system that had to run together perfectly. Anyone in software engineering will tell you that cross-group coordination is one of the hardest things to get right, and also one of the most crucial, because while programmers are great at testing their own code, testing that their code works with everybody else’s code is much more difficult.

“Look at it another way: Even if scale testing is done, that involves seeing what happens when a site is overrun. The poor, confusing error handling indicates that there was no ownership of the end-to-end experience—no one tasked with making sure everything worked together and at full capacity, not just in isolated tests. (I can’t even figure out who was supposed to own it.) No end-to-end ownership means that questions like “What is the user experience if the back-end gets overloaded or has such-and-such an error?” are never asked, because they cannot be answered by either group in isolation.”

This is a good, grabbable, concise message. So is HotAir.com‘s conclusion.

Blitzer’s offhand endorsement of a one-year delay is an intriguing bit of anecdotal evidence that Glitchapalooza might be nudging public opinion towards supporting a postponement of the law for a few months or a year while the bugs are worked out. But then that raises the question — why isn’t “delay” the GOP’s core message right now? Boehner’s holding one or two press conferences a day to complain that Obama won’t talk to him when he should be using that free media to hammer the point that O-Care isn’t ready for primetime. Frankly, unless I missed it, this has been a minor point from Ted Cruz and Mike Lee lately too. Whenever I’ve seen them on the news the past few days, they’re more likely to be talking about using small funding bills to restart parts of the government than the many, many catastrophic technical problems with the exchanges.

This all needs attention. Because while everyone is on talking points, the right questions aren’t being asked, answered, covered, or explained to the American public.

As Ed Morrissey so well points out here.

Tagged with:
Oct 07

This whole government shutdown and funding stalemate is sheer politics and lack of reason.

As noted here before, the House of Representatives’ effort to settle on a funding agreement that adds conscience protection to the ‘Affordable Care Act’ actually funds necessary government services, tried to avoid the now days old shutdown and asks for a delay in the implementation of Obamacare as the president has already granted, by executive order, to selective institutions, bodies and organizations.

Thomas Sowell points this out in National Review Online.

There is really nothing complicated about the facts. The Republican-controlled House of Representatives voted all the money required to keep all government activities going — except for Obamacare.

But on the idea that Obamacare is “settled law”, there’s considerable dispute. This WaPo opinion piece explains:

The Affordable Care Act was passed by Congress, signed by President Obama, upheld by the Supreme Court and reconfirmed by the president’s reelection. Many of its provisions have gone into effect. As Democrats have taken to saying, it is the law of the land.

But contrary to what the president suggested in the Rose Garden this past week, that does not mean Obamacare is “settled, and it is here to stay.” And it is not illegitimate for Republicans to use every lawful means at their disposal to stand in its way.

Lawyers use the term “settled law” to describe court decisions that clearly establish a rule or a doctrine. Yet settled law also refers to legal actions that are accepted by society. Consider two of the most famous Supreme Court decisions: Brown v. Board of Education, which desegregated public schools, and Roe v. Wade, which created the constitutional right to have an abortion. Both of these cases are “the law of the land.” They are binding on all courts in the United States. Only one of them, though, is settled in the broader sense of that phrase. It is perfectly acceptable for politicians, judges and ordinary citizens to attack Roe and call on the Supreme Court to overturn it. It is totally unacceptable to criticize Brown in 2013.

A statute or court opinion becomes settled law when there is a broad consensus that it is just. But a more practical rule of thumb is that both political parties must agree on its legitimacy. Roe remains unsettled after 40 years primarily because Republicans refuse to accept it…

The Affordable Care Act is not settled law because the public remains deeply divided over it: More than half of Americans are opposed. But even more critically, congressional Republicans have withheld their stamp of approval. Many Republican lawmakers refuse even to call it a law; they keep referring to it as a “bill.”

Republicans offer several explanations for their rejection of the act’s validity. Most often, they note that the law was passed entirely with Democratic votes. This is in contrast to other major legislation, including the Civil Rights Act of 1964, which was enacted with overwhelming bipartisan support and thus became settled much more quickly.

Republicans also cite the unusual procedures used to pass the health-care act — most notably, the budget reconciliation process that avoided a filibuster while moving the final legislation through the Senate. This tactic left many Senate Republicans feeling cheated.

Republican suspicions about the legitimacy of the act were exacerbated by a report that Chief Justice John Roberts switched his position on the constitutionality of the individual mandate — the provision at the heart of Obamacare — late in the Supreme Court’s deliberations. According to unnamed sources who spoke to CBS News, Roberts initially sided with the conservative justices and started to draft an opinion striking down the mandate, but at some point he became “wobbly” and decided to join the liberal justices and uphold the bulk of the law.

Ethics and Public Policy Center scholar George Weigel offered his opinion on why Roberts’ did that. It’s provocative. Take this snip of it posted by one of his colleagues:

The deepest of the “deeper truths” that one might find in Chief Justice Roberts’s opinion is that America’s success in forming a more perfect union, providing for the general welfare, and ensuring the blessings of liberty to our posterity ultimately rests on the strength of American political culture. And here, the sensus plenior of the Roberts opinion intersects with the social doctrine of Pope John Paul II, especially in the 1991 encyclical Centesimus Annus. Democracy, the Polish pontiff taught, is not a machine that can run by itself. It requires a critical mass of…men and women who have internalized the habits of mind and heart that make responsible self-governance possible…to make democracy work. Beneath the functions of democratic government lies the character of a people. And if the machinery has become dysfunctional, then it is time for the people to examine their conscience about the ways in which they are living their freedom: nobly or basely, selfishly or philanthropically, responsibly or dependently?

This was written before the last election, by the way.

And to note, a sensus plenior (the key to trying to understand Roberts’ decision) is “a fuller or deeper meaning, than can be apparent at first glance,” as Weigel explains in the original piece.

The chief justice thereby suggests that if “we, the people of the United States,” do not like the way the Congress taxes and spends, it is not only our prerogative but our responsibility to do something about it by electing new representatives who will tax and spend differently…

The second of the deeper truths implied by the Roberts opinion is that the Congress as presently constituted and currently functioning has too often been derelict in its constitutional duties. Thus at several points in his opinion, Chief Justice Roberts suggests, in some instances sharply, that the Congress should get serious.

No sign of that at the moment. But they’re facing the debt ceiling deadline next week, and anything could happen by then. Except, it appears, any fundamental agreement.

The mid-term elections are just over a year away. But you can still contact your congressional representatives, in the House and the Senate, whether anyone answers the phones or not. Emails, letters, visits to district offices, notes slipped under their doors if necessary, all convey the spirit of the electorate. We’re proving the adage…we get the government we deserve.

Tagged with:
Oct 02

There may be a lot of people and issues causing the deep divide in government, but this is one few are talking about.

At least, few in the House, almost no one in the Senate or White House, and ditto that in what’s still called the mainstream media.

But some bold voices are speaking up about H.R. 940, the Health Care Conscience Rights Act that proved too major a sticking point in the government spending agreement that didn’t happen. The bill that took some House members a lot of work and effort to pressure Speaker John Boehner into standing up for it, in spite of opposite pressure to give in on it. All within the GOP. Democratic members of Congress are almost uniformly against it.

So what is ‘it’? This piece in the lead up to the showdown explains.

H.R. 940 advances a proposition you might expect any decent person to embrace — and it does so by making a small amendment to the Patient Protection and Affordable Care Act, aka Obamacare.

The key language in that amendment says nothing in the Obamacare law “shall require an individual to purchase individual health insurance coverage that includes coverage of an abortion or other item or service to which such individual has a moral or religious objection, or prevent an issuer from offering or issuing, to such individual, individual health insurance coverage that excludes such item or service.”

Similar language in H.R. 940 also protects employers and health-insurance issuers from being forced to buy or provide coverage for items or services to which they have a “moral or religious objection.”

H.R. 940 mirrors the first words in the Bill of Rights, which say: “Congress shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof.”

To object to H.R. 940, a person must argue that the federal government has the moral and constitutional authority to force Americans to act against the teachings of their religion and the dictates of their conscience.

To defend H.R. 940, a person need only argue it is wrong for the government to force Americans to act against their religion or the conscience.

Yet, President Barack Obama and his bureaucratic subordinates are effectively doing just that by pushing forward with a regulation that will require all health care plans (except those bought directly by actual churches and their immediate auxiliaries) to cover sterilizations, contraceptives and abortion-inducing drugs.

A week later, as the deadline loomed for a government shutdown if a spending agreement wasn’t reached, U.S. bishops again implored members of both houses of Congress to stand for fundamental conscience rights, a small amendment in a massive law overhauling the healthcare system in America.

We have already urged you to enact the Health Care Conscience Rights Act(H.R. 940/S. 1204). As Congress considers a Continuing Resolution and debt ceiling bill in the days to come, we reaffirm the vital importance of incorporating the policy of this bill into such “must-pass” legislation.

Protection for conscience rights in health care is of especially great importance to the Catholic Church, which daily contributes to the welfare of U.S. society through schools, social services, hospitals and assisted living facilities. These institutions, which have been part of the Church’s ministry since the earliest days of ourcountry, arose from religious convictions. They should not be told by government to abandon or compromise those convictions in order to continue serving their own employees or the neediest Americans. Nor should individual Catholics or others be told they cannot legally purchase or provide health coverage unless they violate their conscience.

A particular threat is the Administration’s mandate for covering contraception, sterilization and related education and counseling as “preventive services” for enrollees and their minor daughters. The mandate includes drugs and devices that can act against a human life after fertilization, implicating our moral teaching on abortion as well as contraception. The more than six dozen lawsuits filed against this mandate by hundreds of for-profit and nonprofit organizations led by people of faith highlight the need to reassert Americans’ right to live and serve in accord with their deepest convictions about the sanctity of life…

We make our plea as religious leaders who strongly support universal access to health care. Such access is threatened by Congress’s continued failure to protect the right of conscience. Those who help provide health care, and those who need such care for themselves and their families, should not be forced to choose between preserving their religious and moral integrity and participating in our health care system. Please act on this matter without delay.

A coalition of House Representatives also urged Speaker Boehner to stand for the conscience rights provision as part of the spending resolution.

Under the terms of the Affordable Care Act’s HHS mandate, employers must provide all employees with insurance plans that include abortion-inducing drugs, sterilization, and contraception with no co-pay, or pay a fine of $100 per employee per day.

Business owners who are evangelical, Catholic, or otherwise hold to traditional values have sought relief from ObamaCare’s crushing provisions in the courts.

The Health Care Conscience Rights Act, introduced in March, would exempt all employers from that requirement, as well as strengthening the conscience rights of health care providers.

Its author, Congressman Jeff Fortenberry, came on my radio show Monday just before another House vote to send another proposal to the Senate, where each proposal got rejected and kicked back demanding a “clean CR”, or a continuing resolution with no strings attached. As some put it, ‘my way or the highway’. I asked the congressman whether there weren’t some senators willing to form even a small coalition to support such fundamental protection for basic conscience rights. “No,” he said, bluntly and frankly, startlingly. Partisan, strong arm politics had come to that.

Fortenberry called on everyone who heard his voice to contact their elected representatives and thank them if they supported conscience protection legislation, or encourage them to support it if they hadn’t done so yet. “This is Bigger than who it covers and other details, this is so much bigger than that,” he said. “It’s about human dignity.”

And human lives. Following Fortenberry that evening of high drama on Capitol Hill, my radio guest was Chuck Donovan, who caught my attention with this article about Obamacare subsidizing abortions, based on his studies and report detailing them. “Tens of thousands of publicly subsidized abortions.” Read it. It’s very thorough. And though it may seem wonkish, that old cliche ‘the devil is in the details’ seems to apply.

The report is summarized here:

“The issue of whether the Affordable Care Act creates streams of taxpayer funding for abortion has been hotly debated,” Chuck Donovan, president of the Charlotte Lozier Institute, said Sept. 26. “Research done by the Lozier Institute makes clear that, through the Multi-State Plans alone, Americans will be complicit in the deaths of thousands of unborn children each year through their tax dollars.”

How many Americans know that? Media haven’t mentioned it. Politicians haven’t mentioned it, beyond those working to pass the Health Care Conscience Rights Act, and they’re trying to get legislation through that protects basic provisions of the Bill of Rights. They’re not getting into the tall weeds of the ACA the way Chuck Donovan and other researchers are.

Consider their findings:

The institute estimates federal taxpayers will heavily subsidize between 71,000 and 111,500 abortions per year through federal premium tax credits and Medicaid expansion for subscribers to plans that permit abortion.

Twenty-seven states and the District of Columbia do not bar health plans with elective abortion coverage from the health insurance exchanges created by the 2010 law. Seventeen states permit state funds to be used for elective abortion coverage in their Medicaid programs.

These laws mean that about 5.57 million girls and women could gain abortion coverage under the Affordable Care Act through either the Medicaid expansion or the insurance exchanges created by the act.

During debate over whether to pass the health care legislation, President Obama secured the support of several pro-life Democrats by signing an executive order that confirmed the application of long-standing restrictions on elective abortion funding to the health insurance exchanges.

However, critics of the executive order said at the time that it would not prevent federal subsidies from going to insurance plans that pay for abortion and are allowed on the health exchanges.

Donovan, the report’s author, said that the current multi-state plans’ rules would allow the administration to push for the creation of health plans that cover elective abortions in states where they are not explicitly banned.

And he told me this is only part of the profoundly complex layers of problems the ACA is fraught with, confusing as it is to most people, including those who passed it without reading it. This thing that’s called a ‘train wreck’ is so much worse than that. The collateral damage of a machine so out of control as this is potentially beyond calculation.

After people contact their elected representatives on the Health Care Conscience Rights Act, they ought to follow up quickly to contact the media and urge them to do their job as well.

Tagged with:
Feb 11

The basic mandate that employers with religious objections to the HHS contraceptive coverage still have to comply or pay punitive fines still stands. The latest fig leaf changes little, but it took a few days to wade through the dense and convoluted legalese the government issued to essentially say ‘we’re not willing to budge, more than an inch.’

There is nothing new about the administration deciding who gets exemptions and who doesn’t, and that’s the main point.

After nearly a year, the Obama administration released, on February 1, its latest version of a “compromise” with the employers who object, on religious grounds, to the Health and Human Services (HHS) mandate that their health plans cover no-cost access to sterilization services and contraceptives, including those that can act as abortifacients, destroying the early-stage embryo.

As many observers have already remarked, there is nothing substantively new in the administration’s proposal, which only formalizes and fills in details of a proposal it first floated last March, and continues to be based on the same dubious science.

Now facing more than forty lawsuits initiated by colleges, charities, and other religious nonprofits, as well as by for-profit companies whose owners have religiously informed moral objections, the Obama administration may hope that its latest gambit will persuade some credulous judges to toss some of the litigants’ cases.

But in truth, it has only revealed its own blinkered and tyrannical understanding of religious freedom, which it would sacrifice to a goal of “gender equality” that is at best only tenuously related to its free-contraception-for-all policy. And, if the judges attend closely to its arguments, it may even have severely weakened its case.

Well that’s interesting.

Matt Franck makes a good presentation there at Public Discourse on what this alleged compromise actually does. And he wraps it up with a challenge to the reader to do this thought exercise:

Given its stated hostility to any serious understanding of our first freedom, the right not just to worship but to live one’s faith in all one’s daily work, on what understanding of our remaining constitutional freedoms can the administration assure us that any of these other liberties still stands on a firm foundation?

Good question.

Also at Public Discourse was this well-reasoned and extraordinarily well presented analysis.

With last Friday’s rules, the government is claiming that after a year of a mostly losing record of religious freedom lawsuits, it has struck the perfect balance between two urgent goals: getting contraception into the hands of as many American women and girls as possible, and protecting Americans’ religious freedom.

The truth of the matter is quite different.

There are myriad problems inherent in the new rules. They still fail to protect the legally guaranteed religious freedom of religious institutions, for-profit employers, insurers, non-religious non-profit organizations, and individuals. Religious liberty is protected not only by the First Amendment of our Constitution, but also by the Religious Freedom Restoration Act.

They fail to understand the full nature of the free exercise of religion—that religion, whether practiced individually or by a group, requires being able to integrate one’s actions with one’s religious beliefs, especially when these don’t attack but advance the common good—here, the health and well-being of women and girls.

They trample on parents’ constitutionally-protected right to direct the upbringing of their daughters. And they reveal, still, an irrational zeal for a narrow category of drugs and devices, thus evincing a narrow and harmful understanding of women’s freedom as coincident with sexual expression.

Moreover, while the government tries to make us think that the new rules are hospitable to religious freedom, we shouldn’t overlook its continued failure to admit the bankruptcy of the mandate’s grounding “medical” claim: that unintended pregnancy is a kind of health crisis properly resolved with free contraception and early abortions.

Thank you, Helen Alvare, for such a sound argument.

Cardinal Timothy Dolan, president of the US bishops conference, said this latest attempt for cover is still unacceptable.

The Administration’s proposal maintains its inaccurate distinction among religious ministries. It appears to offer second-class status to our first-class institutions in Catholic health care, Catholic education, and Catholic charities. HHS offers what it calls an “accommodation,” rather than accepting the fact that these ministries are integral to our Church and worthy of the same exemption as our Catholic churches. And finally, it seems to take away something that we had previously—the ability of an exempt employer (such as a diocese) to extend its coverage to the employees of a ministry outside the exemption.

(The bishops’ document) United for Religious Freedom explained that the religious ministries not deemed “religious employers” would suffer the severe consequence of “be[ing] forced by government to violate their own teachings within their very own institutions.”After Friday, it appears that the government would require all employees in our “accommodated” ministries to have the illicit coverage—they may not opt out, nor even opt out for their children—under a separate policy.In part because of gaps in the proposed regulations, it is still unclear how directly these separate policies would be funded by objecting ministries, and what precise role those ministries would have in arranging for these separate policies.Thus, there remains the possibility that ministries may yet be forced to fund and facilitate such morally illicit activities…

 the bishops explained that the “HHS mandate creates still a third class, those with no conscience protection at all:individuals who, in their daily lives, strive constantly to act in accordance with their faith and moral values.”This includes employers sponsoring and subsidizing the coverage, insurers writing it, and beneficiaries paying individual premiums for it.Friday’s action confirms that HHS has no intention to provide any exemption or accommodation at all to this “third class.”In obedience to our Judeo-Christian heritage, we have consistently taught our people to live their lives during the week to reflect the same beliefs that they proclaim on the Sabbath.We cannot now abandon them to be forced to violate their morally well-informed consciences.

Because the stakes are so high, we will not cease from our effort to assure that healthcare for all does not mean freedom for few.Throughout the past year, we have been assured by the Administration that we will not have to refer, pay for, or negotiate for the mandated coverage.We remain eager for the Administration to fulfill that pledge and to find acceptable solutions—we will affirm any genuine progress that is made, and we will redouble our efforts to overcome obstacles or setbacks.Thus, we welcome and will take seriously the Administration’s invitation to submit our concerns through formal comments, and we will do so in the hope that an acceptable solution can be found that respects the consciences of all.At the same time, we will continue to stand united with brother bishops, religious institutions, and individual citizens who seek redress in the courts for as long as this is necessary.

For now, this remains necessary.

The cases proceed through the courts, and the latest HHS proposal is likely a response to a DC Circuit Court judge who required the government to report back on what ‘accommodations’ it was making that it had promised would be forthcoming. This does not suffice, say Becket Fund attorneys representing the most cases against the federal mandate.

Today’s announcement of the Notice of Proposed Rulemaking on the HHS mandate leaves the religious liberty of millions of Americans unprotected.

“Today’s proposed rule does nothing to protect the religious freedom of millions of Americans. For instance, it does nothing to protect the rights of family businesses like Hobby Lobby,” said Kyle Duncan, General Counsel for the Becket Fund for Religious Liberty.  “The administration obviously realizes that the HHS mandate puts constitutional rights at risk.  There would have been an easy way to resolve this—expanding the exemption—but the proposed rule expressly rejects that option.”

Becket Fund Executive Director Kristina Arriaga sent out this press release:

We’re all still reeling from the Administration’s announcement on the HHS Mandate last Friday, which, as it turns out, is 80 pages of nothing new.
 
The Administration’s proposal is murky on the details – in fact, it’s not at all clear how this would work, if it could work at all; but it’s clear that it still fails to protect our nation’s 237-year guarantee of religious liberty for millions of Americans.
 
As I mentioned in my email to you last Friday when the Obama Administration released this proposal “respecting the concerns of some religious organizations,” – their words, my emphasis – the millions of American entrepreneurs who want to live their lives and run their businesses with their faith intact are not covered even a stitch by this proposal.
 
They are still forced to choose between their conscience and their livelihood.  These entrepreneurs are winning big in court – 11 wins for businesspeople of faith to just 3 for the government –  yet the Administration still refuses to accept that religious liberty is even at issue in these cases.
 
So, as far as the Becket Fund is concerned, the fight against the HHS Mandate is far from over…

The government seems to have been so intent on defining religious liberty as narrowly as possible that they’ve drafted a convoluted 80-page proposal riddled with half-baked ideas and vague accounting schemes.

And, finally, says Helen Alvare

…these proposed regulations show the government’s standing obsession with this narrow piece of the Affordable Care Act. From August 2011 to today, the White House and HHS have expended enormous amounts of time, written hundreds of pages of rules and amended rules and “safe harbor” provisions, occupied press conference time, re-election campaign ads, and delivered speeches—all to promote the notion that free contraception and early abortifacients are the near sum of women’s freedom.

It’s as clear, and offensive, as that.

Tagged with:
Nov 27

Had President Obama lost the election, it would have been eliminated and replaced by new healthcare reform. But his win doesn’t assure that his signature legislation will survive intact.

For days, I’ve been hearing dizzying roundtable discussions with analysts focusing on different aspects of Obamacare and predicting the impact of the still unfolding law, especially as its component parts go into effect in 2013 and continue to roll out into 2014.

But then it got more immediate Monday, when the Supreme Court got involved. Again.

The Supreme Court has ordered a federal appeals court to take another look at whether a key requirement in the health care reform law violates religious freedoms.

A pending lawsuit from the private Liberty University had claimed, among other things, that the law would lead to taxpayer dollars funding abortions and contraception, a claim the Obama administration rejects. The justices issued their order Monday.

The high court in June had upheld the overall law championed by President Obama, but left room for continued legal challenges to certain aspects of the law’s application.

Justice Roberts was key to the individual mandate withstanding the constitutional challenge, to nearly everyone’s surprise at the time. But he left it in place by calling it what it was, a tax. And now that it is, and is about to be enforced, the door is open to rehear challenges to that tax – and penalty for not paying it – as a violation in itself.

So here we go again.

ObamaCare returns to federal appeals court to resume its battle against religious liberty, thanks to a Monday directive from the Supreme Court that revives the lawsuit brought by Liberty University, a Christian school in Virginia.  The Liberty suit has essentially been put on ice while the Supreme Court dealt with the constitutionality of ObamaCare’s individual mandate.  With that landmark 5-4 ruling behind us, and the entirely new concept of a shape-shifting “tax/penalty” added to Constitutional lore, it’s time for the courts to revisit some of the other places where the federal health-insurance takeover conflicts with our dwindling inventory of inalienable rights.

Liberty University’s suit ran afoul of the Anti-Injunction Act, which says that taxes cannot be legally challenged until they have been assessed.  The tax/penalty pulled some of its remarkable shape-changing tricks to get ObamaCare itself around the Anti-Injunction Act, while allowing the dishonest proponents of the law (prominently including President Obama) to claim that it wasn’t really a tax.  Those pretenses are no longer necessary, and the gigantic ObamaCare taxes are now being assessed, so Liberty University re-filed its suit, without objection from the Obama Administration.

It’s going to be very interesting following these court cases for all the charges being filed against this healthcare law.

But the main attraction will be the university’s First Amendment challenge to ObamaCare’s contraception mandates, which raise a very thorny issue.

(Several, actually.)

The law grants conscience waivers to explicitly religious institutions, such as houses of worship, but not to business enterprises run by devoutly religious people.  In other words, Congress is making laws respecting the establishment of religion and prohibiting the free exercise thereof, which the First Amendment says is a bad thing, even before it gets around to saying that abridging the freedom of speech is bad.

And freedom of speech violation is buried in the law and therefore some of these legal challenges as well. Former Speaker Nancy Pelosi famously said ‘we have to pass the bill to find out what’s in it.’ We’re still discovering, but you have to wonder how little they knew.

Tagged with:
Nov 26

So now that President Obama has won another four years to fundamentally transform America as he promised in 2008, running to retain that office on the simple premise that he wanted to go forward, the question which should have been answered in the campaign but wasn’t even asked, now looms: To where and what are we headed?

To some knowledgeable analysts, it looks a whole lot like backwards.

Will 2013 be 1937? This is the question many analysts are posing as the stock market has dropped after the U.S. election. On Nov. 16, they noted that industrial production, a crucial figure, dropped as well.

In this case, “1937” means a market drop similar to the one after the re-election of another Democratic president, Franklin D. Roosevelt, in 1936.

The drop wasn’t immediate in that case; it came in the first full year after the election. Industrial production plummeted by 34.5 percent. The Dow Jones Industrial Average dropped by half, from almost 200 in early 1937 to less than 100 at the end of March 1938.

It’s hard to imagine stock indexes dropping by half today, or unemployment rising past 15 percent, as they did in the “depression within the Depression.” But the parallels are visible enough to be worth tracing. They have to do with the danger of big government, and can be captured in a few categories.

Amity Shlaes neatly lines them up:

– Pre-election spree that sets records. In the old days, federal spending amounted to about 19 percent or 19.5 percent of gross domestic product. That ratio was so reliable that economists took it as a given, the American normal, from which divergence was unnatural and temporary. By the old 19 percent rule, federal spending would have dropped back once the worst of the 2008 economic crisis passed.

That didn’t happen. Instead the federal government continued to spend. Most important, even in 2012, when the crisis was long past, the government went on a spree, spending the equivalent of 24.3 percent of the economy, more than the 24.1 percent for the year earlier…

– Bath of cold water afterward. After this year’s election, President Barack Obama made it clear that budgeting was his priority: “I’m ready and willing to make big commitments to make sure that we’re locking in the kind of deficit reductions that stabilize our deficit, start bringing it down, start bringing down our debt. I’m confident we can do it.”

Roosevelt too opened his second term on a sober budget- cutting note. The president, wrote journalist Anne O’Hare McCormick in 1937, was like “the Dutch householder who carefully totes up his accounts every month and who is really annoyed now that he is bent on balancing the budget, that Congress can’t stop spending.”

– Fearsome attack on the status quo. In his first news conference on Nov. 14, Obama went out of his way to make clear his tax increases would fall on the rich: “What I’m concerned about is not finding ourselves in a situation where the wealthy aren’t paying more or aren’t paying as much as they should.”

Roosevelt was also ferocious, telling the old guard: “I should like to have it said of my first administration that in it the forces of selfishness and of lust for power met their match. I should like to have it said of my second administration that in it these forces met their master.”

When Roosevelt followed through in 1937, both with high taxes and his effort to pack the Supreme Court with more progressives, markets shivered.

– Fallout from first-term legislation. Obama signed his health-care act in 2010, postponing much of its enforcement until 2013, after the election. Now that the effects of the act are so proximate, markets are wondering whether they or investors can handle the changes demanded.

That’s looking doubtful, as WaPo captures pretty well here.

After surviving a Supreme Court decision and a presidential election, the Obama administration’s health-care law faces another challenge: a public largely unaware of major changes that will roll out in the coming months.

States are rushing to decide whether to build their own health exchanges and the administration is readying final regulations, but a growing body of research suggests that most low-income Americans who will become eligible for subsidized insurance have no idea what’s coming.

Part of the problem, experts say, is that people who will be affected don’t realize the urgency because the subsidies won’t begin for another year. But policy decisions are being made now that will affect tens of millions of Americans, and the lack of public awareness could jeopardize a system that depends on having many people involved. Low enrollment could lead to higher premiums, health policy experts say. Hospitals worry that, without widespread participation, they will continue getting stuck with patients’ unpaid medical bills. And advocates say the major purpose of the Affordable Care Act – extending health insurance to more Americans – will go unmet if large numbers of vulnerable people don’t take advantage of it.

It’s a mess, actually.

Even though the subsidies for currently uninsured people won’t go out until Jan. 1, 2014, the state exchanges that will offer health plans are being set up now, and participants will need to start signing up next Oct. 1. Supporters of the health-care law say the plan won’t be a success without a massive public relations campaign to build awareness.

“That part is a going to be a real challenge,” said Rich Umbdenstock, president of the American Hospital Association, one of Enroll America’s funders. “If we want to see high enrollment achieved, we have to figure out how to get the word out.”

Work with the Obama re-election team. They managed to convince a slight majority of voters that he cared about them and would provide for their needs. Time to deliver, because a whole lot of people don’t really know what lies ahead.

Tagged with:
preload preload preload