Health Care

Supreme Court Justices Struggle With Health Policy And Key 'Obamacare' Facts

Brian Beutler | March 30, 2012, 2:39PM

In weighing the constitutionality of the health care law's individual mandate, and possibly in deciding what to do with the rest of the law if they strike that provision, Supreme Court justices will have to confront key questions of health policy: What purpose does the mandate serve? How connected is it to other measures in the law? If those other measures must fall, too, what's left? And is that new, diminished law the sort of policy that Congress might have passed if the mandate had proved politically infeasible in the first place?

That's a troubling reality for reform supporters.

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HCR/SCOTUS

What's In A Mandate? Why SCOTUS May Take A Pass On 'Obamacare' -- For Now

Brian Beutler | March 20, 2012, 5:23AM

When the Supreme Court convenes next week to hear arguments about the constitutionality of President Obama's health care law, the first issue they will consider is the basic character of one of the law's crucial features: the requirement that uninsured Americans either purchase coverage or pay a fine to the federal government.

Better known as the individual mandate, it's the provision of the health care law at the heart of the GOP's constitutional complaint. The plaintiffs -- the 26 states suing over the law -- contend the individual mandate exceeds Congress' power to regulate interstate commerce, and the court's ruling on that issue could have the most sweeping legal impact, perhaps upending decades of Commerce Clause jurisprudence.

But before they get to the question of whether the individual mandate is an unconstitutional expansion of the Commerce Clause, the justices have agreed to consider whether they even have the power to take up this case, since the mandate does not go into effect for another two years. And that decision will ride on a fine distinction: Is the individual mandate a tax or is it a penalty?

The arguments they will hear, and the decision they ultimately reach, will determine whether the court can proceed to rule on the merits of the law, or whether they must punt on the substance until after the mandate takes effect in 2014. Either decision would place several key actors in awkward political predicaments without any easy escape routes.

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Health Care

Controversial McKinsey Health Care Study Creates Major Dissent At Firm

Brian Beutler | June 10, 2011, 4:40PM

The political damage to President Obama's health care law may already be done. But there's a curious backstory to the report this week from a major consulting firm study that found "ObamaCare" would lead to fairly dramatic unintended consequences.

The consulting firm McKinsey & Company was thrust into the political spotlight Tuesday after it published a study -- at odds with the expert consensus -- finding that, once fully implemented, the health care reform law will drive huge numbers of employers to drop or dramatically restructure their companies' health care benefits.

The predictable fallout led Democrats, and several reporters, to press McKinsey for the survey itself -- a request McKinsey has declined on the grounds that the material is proprietary.

But multiple sources both within and outside the firm tell TPM the survey was not conducted using McKinsey's typical, meticulous methodology. Indeed, the article the firm published was not intended to give the subject matter the same authoritative treatment as more thorough studies on the same topic -- particularly those conducted by numerous think tanks, and the Congressional Budget Office, which came to the opposite conclusion. And that's created a clamor within the firm at high levels to set the record straight.

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Health Care

The Real Death Panel: If 'Obamacare' Repealed, Some Patients Can't Go Back

Brian Beutler | March 24, 2011, 3:00PM

If the health care reform law were to disappear tomorrow, Dallas Wiens would be in trouble.

Earlier this week, in a 15-hour procedure, Boston surgeons grafted a donor's face onto Wiens' skull. Weins is a 25-year-old boom lift operator from Texas who came into contact with a live electrical wire, costing him his lips, nose, and eyes and leaving him severely disfigured.

The Department of Defense covered the cost of the surgery through a grant to Brigham and Women's Hospital, where the surgery was performed -- an investment the military hopes will pay off in new surgical techniques that will benefit wounded soldiers. But all the Pentagon's largesse would have been for naught without the new health care law.

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Health Care

FreedomWorks Gives Health Care Repeal Pointers To House GOP

Brian Beutler | February 16, 2011, 1:22PM

Dick Armey, FreedomWorks chairman

In a sign that the public is tiring of GOP efforts to repeal the health care law, the Tea Party-aligned group FreedomWorks is pressing Republican leaders to go on the offense -- double down on the repeal push while advocating conservative health care policies.

In a memo to House Republicans, the leaders of FreedomWorks, including former House Majority Leader Dick Armey, suggest that the public is souring on repeal because the GOP lacks a coherent set of reforms with which to "replace" the health care law.

"We're sending this memo because we believe your ultimate success depends as much on how you handle the "replace" as the "repeal" side of the strategy. We think it's time to start emphasizing what you're for as much as what you're against," the memo reads.

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Health Care

Yet Another Dem Alternative To The Health Law Mandate Emerges

Brian Beutler | February 3, 2011, 10:12AM

Rep. Peter DeFazio (D-OR)

Here's another change Dems are considering to the individual mandate in the health care law in the wake of Tuesday's federal court decision.

Rep. Peter Defazio (D-OR) proposes that people be allowed to opt out of the insurance mandate altogether -- but if they do, they will not be allowed to free-ride on the new health care system.

Under his plan, a person opting out "must file an 'affidavit of personal responsibility' with the state exchange. Such a filing will waive their rights to: 1) Enroll in a health insurance exchange; 2) Enroll in Medicaid if otherwise made eligible; and 3) Discharge health care related debt under Chapter 7 bankruptcy law," DeFazio wrote in a letter to colleagues Tuesday.

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Health Care

Democrats Explore Alternatives To Health Insurance Mandate

Brian Beutler | February 2, 2011, 2:19PM

Sen. Claire McCaskill (D-MO)

Most Democrats believe, or say they believe, that the courts will uphold the individual insurance mandate as constitutional -- and slice off one prong of the GOP attack on the health care law.

But they're also exploring their options.

One plan is modeled on an existing incentive built into the Medicare prescription drug benefit: Create an open-enrollment period for people who want to buy health insurance, and assess a penalty on anybody who tries to enter the insurance market after that window closes.

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Health Care

Republicans Hide Health Care Law Benefits From Their Constituents

Brian Beutler | February 2, 2011, 10:22AM

House Speaker John Boehner (R-OH) with Senate Minority Leader Mitch McConnell (R-KY)

Two days after a Republican Florida federal court judge voided the entire health care law, the multi-front Republican war against it continues in the Senate, where members will vote today on whether or not to just repeal it, full stop.

Simultaneously, Republican members are trying to sneak grenades into the heart of the law, crafting modifications which they admit are meant to destroy it.

But that presents them with a conundrum when they head back to their states and districts and face constituents who stand to benefit from the law right now -- seniors who are entitled to free checkups, and young adults, who can now stay on their parents' insurance until they turn 26, for example. Republicans can chose to help those constituents navigate the law -- answer their questions constructively, encourage them to seek those benefits -- or they can let their political agendas interfere.

Different strokes for different folks.

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Nancy Pelosi

House Dems Press GOP To Announce Whether They'll Accept Government Health Care

Brian Beutler | January 5, 2011, 5:47PM

Rep. Nancy Pelosi (D-CA)

The minority has almost no power in the House of Representatives, but they usually do have the prerogative to force a single uncomfortable procedural vote. These motions leave the majority to choose between voting against something popular, or voting to scuttle or complicate their own agenda. This is how Republicans managed to wrongfoot Democrats on the 9/11 health bill and other issues in the last couple Congresses.

Democrats just offered their first "motion to commit" the new House rules. The goal? To amend the package to force new members to announce whether or not they'll be taking their government health care.

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Health Care

Major Health Care Reforms Take Effect January 1

Brian Beutler | December 31, 2010, 11:39AM

President Barack Obama

Starting Saturday, two of the new health care law's most significant reforms take effect -- or at least begin to take effect.

The first will dramatically clamp down on insurance industry waste, abuse, and excesses. Starting on New Year's Day, insurance companies will have to spend at least 80 percent of the revenues they receive from premiums on actual health care. Not on salaries or overhead.

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Health Care

GOP Turns To K Street Veterans To Help Unravel Health Care Law

Brian Beutler | December 27, 2010, 2:53PM

House Minority Leader John Boehner (R-OH) with members of the GOP leadership

House Republicans are turning to old friends on K Street to lead their legislative attempts to repeal the new health care law.

Three recently hired Republican aides -- two set to work in senior positions on the powerful Energy and Commerce Committee, and one for soon-to-be Speaker John Boehner -- spent the past years lobbying on behalf of insurance companies, pharmaceutical manufacturers, and other corporate interest groups with a vested interest in weakening or repealing the law.

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Health Care

The Courts Divided: How Health Care Lawsuits Have Exposed A Partisan Judiciary

Brian Beutler | December 6, 2010, 2:07PM

When the health care law passed earlier this year, Democrats and Republicans had already been bickering for months over one of the central provisions of the legislation: the individual mandate. Can Congress, under the Constitution's commerce clause, compel people to purchase health insurance? The fight was just one of many health care-related disagreements that have divided conservatives and liberals since the issue took center stage, but it's the one major aspect of the new policy that gave Republicans an opening to take the Affordable Care Act to court.

Normally, a lawsuit challenging the scope of Congress' power under the commerce clause would be open and shut -- it's been a perennial loser for plaintiffs going back decades. But in that time, the court has moved to the right, and become more partisan. And the early rulings in these health care lawsuits indicate what Republicans knew all too well -- that Republican-appointed judges will be as sympathetic to their arguments as Democrat-appointed judges will be opposed. And that could presage several major victories for conservative foes of the health care law as their challenges make their way toward the Republican-leaning Supreme Court.

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Health Care

State Official Orders Insurance Company To Sell Insurance To Children

Brian Beutler | October 15, 2010, 5:10PM

Washington's insurance commissioner stepped in today to force Regent Blue Shield -- the state's largest provider of insurance to children -- to keep selling children-only health care plans.

"Regence is in clear violation of state law that prohibits insurers from denying insurance to people on the basis of age," reads a statement from Mike Kreidler. "I was shocked and deeply disappointed when Regence announced its decision last week to stop selling insurance to kids."

One of the earliest-implemented -- and most popular -- provisions of the new health care law forbids insurance companies from denying coverage to children with preexisting conditions. Rebelling against the policy, insurance companies have threatened or attempted to stop selling children-only plans. New Hampshire's insurance commissioner likewise stepped in to block the maneuver.

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