TEA PARTY PATRIOTS:
GOP Praises Court Halting Amnesty: ‘Impatient Presidents Don’t Get to Change the Law’
“…Jenny Beth Martin, co-founder of the Tea Party Patriots, declared, “on to the Supreme Court.” “The U.S. Constitution vests the Congress with authority over immigration and naturalization. And as U.S. District Judge Hanen pointed out, President Obama simply treated Congress — and Article 2 — as if they didn’t exist. “We are a Constitutional Republic, not a banana republic,” Martin added. “Our Constitution, with its three co-equal branches, is the roadmap for the governing process. “As much as this would-be imperial president wishes it were otherwise, we are a nation of laws, not of his arbitrary whims,” Martin said…”
http://www.newsmax.com/Newsfront/GOP-supports-court-ruling/2015/05/26/id/646874/
HEALTHCARE:
‘ObamaCare is penalizing me for pursuing my dreams!’
“In a Midtown specialist’s office, I confessed the secret that’s been weighing on my mind.
“My health insurance expires at the end of May,” I told the doctor. I had a lot of questions for him: How much does an uninsured visit cost? What is the fewest number of follow-ups we can do this year? Do you have payment plans available to patients paying cash? I’ve been down the uninsured path before, having spent my post-college years waiting tables and freelance writing. I know the risks involved, but I also know what information I need to make sure I’m relatively safe and mostly healthy. My doctor looked confused. “Well, you’re required to have it now, right? So you’ll be covered?” If only it were that simple. ObamaCare has hit people like me the hardest. I left a desk job at The Post to dedicate my time to teaching yoga and developing a career in health and wellness (the irony of sacrificing my health insurance for this is not lost on me). I’m teaching on a freelance basis. My husband is also a full-time freelancer, or a “perma-lance,” if you will. Our household income puts us just barely in the lower-middle-class bracket.
And we will end up paying top dollar to have any type of insurance. So we’ve decided we’re just going to pay the Affordable Care Act’s individual-mandate penalty: 2 percent of household income or $325 per person, whichever is more (of course)…”
http://nypost.com/2015/05/25/obamacare-is-penalizing-me-for-pursuing-my-dreams/
Sticker Shock for Some Obamacare Customers
“So the proposed 2016 Obamacare rates have been filed in many states, and in many states, the numbers are eye-popping. Market leaders are requesting double-digit increases in a lot of places. Some of the biggest are really double-digit: 51 percent in New Mexico, 36 percent in Tennessee, 30 percent in Maryland, 25 percent in Oregon. The reason? They say that with a full year of claims data under their belt for the first time since Obamacare went into effect, they’re finding the insurance pool was considerably older and sicker than expected. Don’t panic, says Kevin Drum. This is just the opening bid in a regulatory dance that will end up somewhere very different: “A few months from now, the real rate increases — the ones approved by state and federal authorities — will begin to trickle out. They’ll mostly be in single digits, with a few in the low teens. The average for the entire country will end up being something like 4-8 percent.”
He’s right, of course, that the proposed rates will not end up being the final rate. Regulators are going to push back on these rates as hard as they can, with some success. But in the case of the companies cited by the Wall Street Journal, I’d bet they’re not going to go down to 4-8 percent. As it turns out, the insurer filings are public information, available on state websites. And in the three cases where I could see supporting data about premium revenue and losses, those losses appear to be large. Moda of Oregon says that its claims were 139 percent of revenue, making for a margin of -61 percent. If I am reading their somewhat confusing table right, Health Service Corporation of New Mexico says it lost $23 million on revenue of $121 million. CareFirst of Maryland says that claims were 120 percent of revenue, which if we add in some money to pay for overhead, amounts to … less than or equal to what they’re asking from regulators. I can’t find claims experience data for Tennessee, but that state told the Wall Street Journal that it lost $141 million on exchange plans last year. Now, this is not the whole story. These are only the biggest insurers in some states. Smaller insurers may price lower in an attempt to grow their business (though if their claims experience matches the biggest insurers, that’s going to be a recipe for a quick bankruptcy). And the median request on a list of the biggest insurers in 12 states was more on the order of 10-15 percent, and three states — Maine, Connecticut and Indiana — had insurers ask for increases in the low single digits. That’s only 12 states, of course, and none of the biggest-population ones. But even if we assume that the regulators cut the increases in half, that’s a median increase of 5-6 percent, with a mean considerably higher than that. Even if you weight by population — well, actually population-weighting makes that worse, not better, because the states with the lowest rate requests are disproportionately sparse. Moreover, significant rate increases are what I would broadly expect, because these rates are the first ones set with a full year of claims data, and what we know about the pool is that it is poorer and older — which would also mean sicker — than was projected. Initially, HHS was saying that it needed about 40 percent of the exchange policies to be purchased by people age 18-35 to keep the exchanges financially stable. It was 28 percent in both 2014 and 2015, according to HHS data. The CBO had projected about 85 percent of exchange enrollees to be subsidized, falling toward 80 percent as enrollment grew; instead, that number is 87 percent and actually rose slightly from 2014. It would be pretty surprising if rates weren’t increasing faster than inflation, or even than general health care cost inflation…”
http://www.bloombergview.com/articles/2015-05-25/sticker-shock-for-some-obamacare-customers
Bad news for Obamacare?
http://www.msnbc.com/msnbc/bad-news-obamacare
OBAMACARE INSURANCE PREMIUMS TO JUMP, UP TO 51%
“Major insurers in some states are proposing up to 51 percent premium increases for health plans sold under the Affordable Healthcare and Patient Protection Act, commonly referred to as Obamacare. Despite single digit increases for 2015, insurance companies are seeing their costs jump and are demanding to be compensated with dramatically higher rates. When Insurance plans proposed 2015 rates last summer, they had only a little information about the health of the new customers they expected to sign up during the fall Obamacare expansion. Big insurers tended to ask for increases of less than 10%, while some smaller insurers tried to under-cut pricing by the major’s to take market share, according to the Wall Street Journal. Under Obamacare, insurers must file proposed premium rates with their local state regulator and the federal government by June. But some states have already started publicly disclosing the premium requests. Due to the high utilization costs from people newly enrolled under Obamacare, the 2016 insurance premiums are about to skyrocket. According to states that have released rate requests, New Mexico’s market leader Health Care Service Corp. is asking for an average premium spike of 51.6 percent; Tennessee’s top insurer BlueCross BlueShield of Tennessee wants an average spike of 36.3%; Maryland’s market leader CareFirst BlueCross BlueShield is requesting an average spike of 30.4%; and Oregon’s top insurer, Moda Health, is seeking a 25% spike. The Obama Administration’s only legal power regarding healthcare premiums is the right to ask insurers seeking increases of 10% or more to explain themselves. There is no federal power to force rate cuts. State insurance regulators can force carriers to scale back requests they believe are not justified, but the carriers can drop coverage and cause a crisis. Obamacare supposedly sought to fix two problems: coverage and cost. To extend coverage, the law made it compulsory for Americans to have health insurance, or pay a fine. It also offered subsidies for those who could not afford it and barred insurance firms from charging people more if they have “pre-existing conditions.” Before the exchanges arrived in 2013, some 41.3 million Americans lacked health insurance. That number fell to 30 million, but only because 48% of Obamacare subscribers received “premium assistance.”…”
http://www.breitbart.com/big-government/2015/05/25/obamacare-insurance-premiums-to-jump-up-to-51/
Employers say 2016 will be costliest year yet for Obamacare compliance: Survey
“The majority of employers in the United States believe the largest cost increases related to the Affordable Care Act are yet to come, according to a recent survey by the Brookfield-based International Foundation of Employee Benefit Plans. One-third of employers surveyed expect the greatest cost increase from ACA implementation will happen in 2016. Twenty percent believe the biggest increases will hit in 2018 when the so-called ACA “Cadillac tax” is scheduled to take effect. Most employers — 71 percent — think the costliest years are yet to come, but that doesn’t mean they aren’t already feeling a financial impact. The impact of the law this year is adding 1 percent to 6 percent to cost increases, according to most survey respondents.
The International Foundation of Employee Benefit Plans said it conducted the survey in March on how single-employer plans are being affected by the Affordable Care Act. The foundation received responses from 598 human resources and benefits professionals who represent employers from nearly 20 industries that range in size from fewer than 50 employees to more than 10,000. “Interestingly, we have seen a trend of employers continually anticipating the worst, where each upcoming year looms with the largest costs,” said Julie Stich, research director at the International Foundation. “In 2014, the majority felt 2015 would bring the largest costs. In 2015, 2016 seems to be the worst.”…”
http://www.bizjournals.com/milwaukee/news/2015/05/26/employers-say-2016-will-be-costliest-year-yet-for.html
Ignoring the Penalty for Not Buying Health Insurance
“Obamacare’s big stick doesn’t seem to be scaring many people into buying health insurance. The health law includes many inducements for people to obtain health insurance — including free Medicaid coverage for many low-income Americans and subsidies for those with moderate incomes. But it also includes the notorious “individual mandate,” a fine for those who can afford insurance but don’t buy it. Because the law, and the fine, are new, many policy experts expected that some people would decline to sign up for insurance until they were hit with a penalty at tax time. Forecasters have estimated a big bump in marketplace enrollment next year, the first sign-up period after people have been fined. The Congressional Budget Office, for example, estimates 10 million more people will have Obamacare plans next year. The law’s structure relies on even healthy and otherwise disinclined consumers to enter insurance markets to help stabilize prices. Certainly, some people who might otherwise go uninsured have been persuaded by the penalty. Polls have shown that it is a well-known provision of the law. And studies of the uninsured have shown that mentioning the penalty changes some people’s thinking about health insurance. At the end of the normal enrollment period in February, about 11.7 million people had selected marketplace health plans or renewed their plans from 2014, according to the federal government….”
http://www.nytimes.com/2015/05/21/upshot/penalty-for-not-buying-health-insurance-might-be-too-light.html?ref=todayspaper&abt=0002&abg=1
Obamacare’s Big Gamble on Hospital Productivity
“Can hospitals provide better care for less money? The assumption that they can is baked into the Affordable Care Act. Historically, hospital productivity has grown much more slowly than the overall economy, if at all. That’s true of health care in general. Productivity — in this case the provision of care per dollar and the improvements in health to which it leads — has never grown as quickly as would be required for hospitals to keep pace with scheduled cuts to reimbursements from Medicare. But to finance coverage expansion, the Affordable Care Act made a big bet that hospitals could provide better care for less money from Medicare. Hospitals that cannot become more productive quickly enough will be forced to cut back. If the past is any guide, they may do so in ways that harm patients. The Obamacare gamble that hospitals can become much more productive conflicts with a famous theory of why health care costs rise. William Baumol, a New York University economist, called it the “cost disease.” (He wrote a book about it by that title; I blogged on it as I read it if you’d like to quickly get the gist.) This theory asserts that productivity growth in health care is inherently low for the same reason it is in education: Productivity-enhancing technologies cannot easily replace human doctors or teachers. In contrast with, say, manufacturing — a sector in which machines have rapidly taken over functions that workers used to do, and have done them better and more cheaply — there are, at least for the time being, far fewer machines that can step in and outperform doctors, nurses or other health sector jobs. But a new study casts doubt on that theory and suggests Obamacare’s bet may indeed pay off. The study, published in Health Affairs by John Romley, Dana Goldman and Neeraj Sood, found that hospitals’ productivity has grown more rapidly in recent years than in prior ones. Hospitals are providing better care at a faster rate than growth in the payments they receive from Medicare, according to the study….”
http://www.nytimes.com/2015/05/26/upshot/obamacares-big-gamble-on-hospital-productivity.html?abt=0002&abg=0
States Band Together To Keep Obamacare Afloat
“A handful of states struggling to finance their Obamacare health exchanges are considering teaming up with other states to keep their insurance portals sustainable as federal funds run out this year. Under the Affordable Care Act, the federal government gave states a collective $4.8 billion to set up and customize their own exchanges for their own state residents. The idea was that the federal government would help prop up the exchanges, and then states would have to make them self-sustainable by this year. However, a number of states including California and Oregon are having trouble financing their exchanges now that federal funding is drying up. Covered California, for example, is running a deficit of $80 million. To save on costs, California is reportedly in talks with Oregon, another state struggling to afford its exchange, to merge their exchanges, The Hill first reported. They’re not alone. Other states are contemplating building similar multi-state exchanges. New York and Connecticut are also discussing the plan, though both are in the very preliminary stages. Though it’s unclear what a merge would entail, it’s likely that states would be able to share call centers and websites to keep expenses low. Of course, there are plenty of issues that would need to be hammered out, like how insurance markets would be regulated between the two (or more states)…”
http://www.thefiscaltimes.com/2015/05/26/States-Band-Together-Keep-Obamacare-Afloat
TROUBLED COVERED CALIFORNIA TO CAP PRESCRIPTION DRUG PRICES
“Covered California, the Golden State’s exchange for Obamacare, has announced that it will cap the price of prescription drugs for the 2.2 million Californians who have bought individual insurance plans. “Starting in 2016, most people will only have to pay a maximum of $150 or $250 per prescription, per month. These caps are for Covered California’s so-called silver and platinum plans. Bronze plans will have caps of $500,” NPR reports. But the effect on premium prices is unclear. The California exchange, so frequently held up by Obamacare’s advocates as a model, has run into budget and enrollment problems. The enrollment numbers for 2015 have been disappointing, and Covered California is slashing its own budget 15% as a result, while repairing its balance sheet with $100 million in federal funds, which critics charge is illegal. The program also faces charges of cronyism after $184 million in no-bid contracts were awarded to well-connected companies. Most California media outlets reported the proposed caps in glowing terms, noting that the state legislature is considering similar caps for those with insurance through their employers. But these outlets also tend to ignore the effect on premiums, as well as the problem with lowering prices for drugs that require heavy investments to produce. Major pharmaceutical companies had been among Obamacare’s major proponents, largely because drug prices remained unaffected by the law…”
http://www.breitbart.com/california/2015/05/26/troubled-covered-california-to-cap-prescription-drug-prices/
Obamacare advocates seek to fix problem they made worse
“Back in 2009, when Congress was debating the Affordable Care Act, many liberal Democrats felt it did not go far enough — that it should be even more sweeping, even more expansive, even more costly. Tom Harkin, D-Iowa, one of the Senate’s most liberal Democrats and a veteran of many legislative battles, urged his colleagues on the Left to go ahead and pass the bill. “The key to this is that this modest home, we can put additions onto it in the future,” Harkin told MSNBC’s Rachel Maddow in December 2009. “But if we don’t have the starter home, we’re never going to be able to put those additions on.” Harkin’s view prevailed, and many Democrats came to view Obamacare as a starter home. Now, even though the Affordable Care Act still faces an uncertain future in the courts, they want to start building the additions. The first addition is the result of a problem Obamacare itself made worse….”
http://www.washingtonexaminer.com/obamacare-advocates-seek-to-fix-problem-they-made-worse/article/2565016?custom_click=rss
Senate GOP prepared to replace Obamacare subsidies
If the Supreme Court strikes down current subsidies, some Republicans are wary of booting millions off healthcare rolls.
“Preparing for a Supreme Court decision that could strike down Obamacare’s subsidies for nearly 7.5 million people this summer, Senate Republicans are coalescing around a plan to resurrect them — at a steep price for the White House. With several Senate Republicans facing tough reelections, and control of the chamber up for grabs, 31 senators have signed on to a bill written by Sen. Ron Johnson (R-Wis.) that would restore the subsidies for current Obamacare enrollees through September 2017. But the administration would have to pay a heavy price — the bill would also repeal Obamacare’s individual and employer mandates and insurance coverage requirements. “In that moment of what could be political chaos, we’re offering such a reasonable proposal that solves a mess,” Johnson said. “It fixes a mess caused by a sloppily written law, unlawfully implemented. All we’re asking for is a little bit of freedom back, which would be, I think. pretty popular,” Johnson said. Even Majority Leader Mitch McConnell (R-Ky.) is backing Johnson’s measure, along with the rest of the chamber’s GOP leaders. Johnson, who’s got a tight race in 2016, says the legislation would be a bridge to ensure that consumers can keep the insurance they have — a promise that President Barack Obama was widely criticized for breaking in 2014. But even if Johnson could somehow persuade Obama and Senate Democrats to accept his plan — a herculean task — the bigger problem will be his Republican colleagues in the House. The growing divide between the two chambers leaves the GOP in an awkward spot. The court could gut Obamacare in June, handing Republicans a long-sought victory they couldn’t achieve legislatively. But without a backup plan that the whole party supports, the GOP has no way to blunt the political damage if millions of Americans lose the ability to pay for their health insurance. When asked about Johnson’s bill, Rep. Matt Salmon (R-Ariz.), said only “Eerrrrrrntt!” in imitation of a game show buzzer, and gave a thumbs down…”
http://www.politico.com/story/2015/05/republicans-still-groping-for-obamacare-replacement-118272.html
Texas Torn Apart by Storms; Will SCOTUS Tear Apart Obamacare?
http://www.foxnews.com/us/2015/05/26/texas-torn-apart-by-storms-will-scotus-tear-apart-obamacare/
ObamaCare fallout? Supreme Court ruling sets up potential Obama, GOP battle
“The upcoming Supreme Court decision on the Affordable Care Act could wipe out insurance for millions of people covered by the president’s health care plan, leaving states that didn’t set up their own health care markets scrambling to subsidize coverage for those left uninsured. Twenty-six of the 34 states that would be hardest hit by the ruling have GOP governors. Twenty-two of the 24 Senate seats that are up for re-election in 2016 are currently held by Republicans. What that means is that it’s the GOP – and not the White House –that’s working on damage control. President Obama’s landmark legislation offers subsidized private insurance to those without access to it on the job. In the Supreme Court case, opponents of the law argue that its literal wording allows the government to subsidize coverage only in states that set up their own health insurance markets. The justices will determine whether the law makes people in all 50 states eligible for federal tax subsidies — or just those who live in states that created their own health insurance marketplaces. The question matters because about three dozen states opted against their own marketplace, or exchange, and instead rely on the U.S. Health and Human Services Department’s Healthcare.gov. If the court rules against the Obama administration, insurance subsidies for people in those states would be in jeopardy. If the court invalidates the subsidies in those states, the results would be “ugly,” former Kansas insurance commissioner Sandy Praeger told The Associated Press. “People who are reasonably healthy would just drop coverage,” she said. “Only the unhealthy would keep buying health care. It would really exacerbate the problem of the cost of health insurance.” Praeger, a Republican who retired this year, called it “a classic death spiral,” using a term for market collapse. In March, the Supreme Court appeared divided along ideological lines after hearing the challenge that, if struck down, could affect up to 8 million policy holders. If the subsidies survive, the ACA will look like settled law to all but a few passionate opponents. However, if they are overturned, the shock could carry into next year’s elections…”
http://www.foxnews.com/politics/2015/05/25/ugly-potential-fallout-from-supreme-court-health-care-case/
Fallout from Supreme Court case on Obamacare could be ‘ugly’
“A Supreme Court ruling due in a few weeks could wipe out health insurance for millions of people covered by President Barack Obama’s health care law. But it’s Republicans — not White House officials — who have been talking about damage control. A likely reason: Twenty-six of the 34 states that would be most affected by the ruling have Republican governors, and 22 of the 24 GOP Senate seats up in 2016 are in those states. Obama’s law offers subsidized private insurance to people without access to it on the job. In the court case, opponents of the law argue that its literal wording allows the federal government to subsidize coverage only in states that set up their own health insurance markets. Most states have not done so, because of the intense partisanship over “Obamacare” and in some cases because of technical problems. Instead, they rely on the federal HealthCare.gov website. If the court invalidates the subsidies in those states, an estimated 8 million people could lose coverage. The results would be “ugly,” said Sandy Praeger, a former Kansas insurance commissioner…”
http://www.ibj.com/articles/53322-fallout-from-supreme-court-case-on-obamacare-could-be-ugly
Four Words That Imperil Health Care Law Were All a Mistake, Writers Now Say
“They are only four words in a 900-page law: “established by the state.” But it is in the ambiguity of those four words in the Affordable Care Act that opponents found a path to challenge the law, all the way to the Supreme Court. How those words became the most contentious part of President Obama’s signature domestic accomplishment has been a mystery. Who wrote them, and why? Were they really intended, as the plaintiffs in King v. Burwell claim, to make the tax subsidies in the law available only in states that established their own health insurance marketplaces, and not in the three dozen states with federal exchanges? The answer, from interviews with more than two dozen Democrats and Republicans involved in writing the law, is that the words were a product of shifting politics and a sloppy merging of different versions. Some described the words as “inadvertent,” “inartful” or “a drafting error.” But none supported the contention of the plaintiffs, who are from Virginia. “I don’t ever recall any distinction between federal and state exchanges in terms of the availability of subsidies,” said Olympia J. Snowe, a former Republican senator from Maine who helped write the Finance Committee version of the bill. “It was never part of our conversations at any point,” said Ms. Snowe, who voted against the final version of the Senate bill. “Why would we have wanted to deny people subsidies? It was not their fault if their state did not set up an exchange.” The four words, she said, were perhaps “inadvertent language,” adding, “I don’t know how else to explain it.” Former Senator Jeff Bingaman, Democrat of New Mexico, said there may have been “some sloppiness in the drafting” of the bill. Mr. Bingaman, who was a member of both committees that developed the measure, said he was surprised that the lawsuit had reached the Supreme Court because the words in dispute appeared to be a “drafting error.” “As far as I know, it escaped everyone’s attention, or it would have been deleted, because it clearly contradicted the main purpose of the legislation,” Mr. Bingaman said. He added, “In all the discussion in the committees and on the floor, I didn’t ever hear anybody suggest that this kind of distinction between federal and state exchanges was in the bill.” When the Supreme Court offers its judgment, it could affect more than 7.5 million people now receiving subsidies through the federal exchange and a health care industry that accounts for 17 percent of the nation’s gross domestic product….”
http://www.nytimes.com/2015/05/26/us/politics/contested-words-in-affordable-care-act-may-have-been-left-by-mistake.html?ref=todayspaper&_r=0
Lawmakers: We didn’t interpret Obamacare as lawsuit claims
“In the coming weeks, the Supreme Court could rule that only customers in state-run Obamacare marketplaces are eligible for federal subsidies. If the court does agree with the plaintiffs in King v. Burwell, it could make the health care coverage unaffordable for millions. The ruling could effectively upend the entire health care law, creating an even bigger rift between the mostly-blue states that have embraced aspects of Obamacare and the red states that haven’t. However, more than two dozen Democrats and Republicans told the New York Times that this is never what they intended. “It was never part of our conversations at any point,” said former Sen. Olympia Snowe, a Maine Republican who helped draft the law as part of the Senate Finance Committee. “Why would we have wanted to deny people subsidies?” The King v. Burwell case rests on the interpretation of one sentence in the Affordable Care Act: Section 1311 of the law says the federal government will give subsidies to eligible consumers who buy insurance from an exchange “established by the State.” The conservative plaintiffs argue that Congress explicitly denied subsidies to any customers who buy insurance on the federally-run marketplace. If that’s case, as many as 7.5 million Americans could lose access to subsidies…”
http://www.cbsnews.com/news/lawmakers-we-didnt-interpret-obamacare-as-lawsuit-claims/
ObamaCare drafters: We never intended to limit federal subsidies to state exchanges
http://hotair.com/archives/2015/05/26/obamacare-drafters-we-never-intended-to-limit-federal-subsidies-to-state-exchanges/
Crucial Omission in NYT Obamacare Story
“So, the New York Times has a big front-page story today about how nobody believed that subsidies would be unavailable to people in states without their own exchanges. And they run the story without even mentioning that Obamacare “architect” Jonathan Gruber once said the opposite and has been backpedaling furiously ever since. Any story claiming that the wording of the law was all just an unfortunate mistake has to at least deal with the Gruber embarrassment. Pretending he isn’t there won’t make him go away. How can we trust the New York Times’ stories when they so often leave out crucial facts that run contra to the desired narrative? Short answer: We can’t.”
http://www.nationalreview.com/corner/418863/crucial-omission-nyt-obamacare-story-wesley-j-smith
Jonathan Gruber Glaringly Absent From NYT Article on Obamacare Wording ‘Mistake’
“New York Times writer Robert Pear knows his name but he didn’t say it in his article about how four words in the Obamacare law was simply a mistake. Pear quotes a number of people involved in the law’s writing process but fails to mention the one who was acknowledged as the architect of Obamacare…until it became politically inconvenient to do so—Jonathan Gruber. And the reason why Gruber’s name went unmentioned in the article is because of his claim, recorded for all eternity on video, that only state established health exchanges would be eligible for subsidies…”
http://newsbusters.org/blogs/pj-gladnick/2015/05/26/jonathan-gruber-glaringly-absent-nyt-article-obamacare-wording-mistake
Obamacare’s Assumptions
“As Wesley Smith notes below, the New York Times is flagging a story about the drafting of Obamacare that supposedly undermines the plaintiffs in King v. Burwell and related cases. Author Robert Pear sees it that way, too, noting that nobody with whom he spoke intended to restrict subsidies to state-established exchanges as a way to make the states establish them. But the story he tells seems broadly consistent with the plaintiffs’ case. Here’s the crucial passage from Pear: At the Finance Committee, which thrashed out its version of the bill in September and October 2009, senators initially assumed that all states would set up exchanges, so they added a section to the Internal Revenue Code to provide subsidies, in the form of tax credits, for insurance purchased through an exchange. But senators and staff lawyers came to believe that some states — “five or 10 at the most” — would choose not to set up exchanges, said Christopher E. Condeluci, who was a staff lawyer for Republicans on the Finance Committee. At that point, senators authorized a backup plan to allow the federal government to establish an exchange in any state that did not have its own, but they failed to include that language in the section of the tax code providing subsidies. “We failed to include a cross-reference to the federal exchange,” Mr. Condeluci said. “In my opinion, due to a drafting error, we overlooked it. It was an oversight. Congress, in my experience, always intended for the federal exchange to deliver subsidies.” Russ Sullivan, the staff director for Democrats on the Finance Committee, gave a similar account. The language in the law providing tax credits through state exchanges was “a holdover from what we had in the Finance Committee,” which originally assumed that “every state was going to set up an exchange,” Mr. Sullivan said. The idea of a federal backstop came later, he said, when people started asking what would happen if some states did not set up an exchange. . . . It appears that the four words now being challenged were based on the initial premise and were carelessly left in place as the legislation evolved…”
http://www.nationalreview.com/corner/418874/obamacares-assumptions-ramesh-ponnuru
The New York Times Inadvertently Makes a Strict Constructionist Case for Halbig/King
“In today’s New York Times, Robert Pear has a piece on the impending King v. Burwell decision. And, as Ramesh notes below, it is inadvertently far more supportive of the challengers’ position than of the Obama administration’s. At first blush, the Times appears to be following the government’s line of argument: They are only four words in a 900-page law: “established by the state.” But it is in the ambiguity of those four words in the Affordable Care Act that opponents found a path to challenge the law, all the way to the Supreme Court. This idea — that the text of the statute is “ambiguous,” and that it should thus be resolved in favor of the federal government and not of the plaintiffs — is the one that the government’s lawyers have taken before the Supreme Court. Why? Well, because convincing a judge that a piece of plain text is the product of a good old-fashioned screw-up is extremely difficult in America — especially when the legislative history shows that the contested phrase was changed between drafts. Not being stupid, the Obama administration knows that it has a shot at winning an ambiguity-based case but that it has pretty much no chance of winning a this-was-a-typo case. So, smartly, it has elected to try the former. For two paragraphs at least, so did the New York Times. But then it didn’t. Indeed, when you dig into the legislative history, the Times concluded, you will see no textual “ambiguity” at all. Rather, the problem at hand is that the statute is not what the drafters had hoped for. Per Pear, the drafting error went down like this: The idea of denying subsidies to people who bought insurance through the federal exchange “was never discussed,” said Charles M. Clapton, a lawyer who worked on both committees for Senator Michael B. Enzi, Republican of Wyoming. Mr. Clapton said he had difficulty accepting the argument advanced by the plaintiffs because it was “so contrary to the intent” of those who had written the legislation. At the Finance Committee, which thrashed out its version of the bill in September and October 2009, senators initially assumed that all states would set up exchanges, so they added a section to the Internal Revenue Code to provide subsidies, in the form of tax credits, for insurance purchased through an exchange….”
http://www.nationalreview.com/corner/418894/new-york-times-inadvertently-makes-strict-constructionist-case-halbigking-charles-c-w
NYT Shows No One Buys Government’s ‘Term of Art’ Argument in King v. Burwell
“The Supreme Court is likely to rule on King v. Burwell by the end of June. The King plaintiffs are four Virginia taxpayers. They claim the Patient Protection and Affordable Care Act (ACA) does not authorize the Internal Revenue Service to issue certain subsidies or impose certain taxes in states like Virginia, whose health-insurance “Exchanges” were established by the federal government rather than the state itself. The challengers argue Congress intentionally authorized those taxes and subsidies only—as the ACA says—“through an Exchange established by the State.” A win for the challengers means: more than 57 million Americans in up to 38 states will be freed from the ACA’s individual and employer mandates, with considerable economic benefits; and perhaps 8 million consumers will see the full cost of their ACA plans. The Obama administration, on behalf of the IRS, argued before the Supreme Court that the statutory phrase “through an Exchange established by the State” is actually “a term of art that includes an Exchange established for the State by HHS.”…”
http://www.nationalreview.com/bench-memos/418893/nyt-shows-no-one-buys-governments-term-art-argument-king-v-burwell-michael-f
On the origins of ‘established by the State’ in the Affordable Care Act
http://www.washingtonpost.com/news/volokh-conspiracy/wp/2015/05/26/on-the-origins-of-established-by-the-state-in-the-affordable-care-act/?wprss=rss_national
President Obama’s legacy is increasingly in legal jeopardy
“President Obama’s second-term agenda, it seems, is in the hands of the courts. Same-sex marriage. Obamacare. Climate change. And now immigration. And in many cases, there is significant doubt about whether his signature initiatives will stand legal scrutiny. The latest blow to Obama’s second-term plans came Tuesday when a federal appeals court in New Orleans denied the administration’s request to move forward with implementing his expanded executive action on immigration to defer deportation for millions of undocumented immigrants….”
http://www.washingtonpost.com/blogs/the-fix/wp/2015/05/26/obama-courts/?wprss=rss_national
Charles Krauthammer Breaks Down Why Court’s Immigration Ruling Might Be a ‘Problem’ for Republicans
“Conservative pundit Charles Krauthammer on Tuesday explained why he thinks a court ruling that upheld an injunction against parts of President Barack Obama’s executive immigration action might be a “problem” for Republicans. The syndicated-columnist contended that if the measure “goes up the chain” to the Supreme Court, it will ultimately be defeated. “For the Republicans it’s a problem,” he said. “It’s like the case going forward on ObamaCare and the thing about the exchanges and the subsidies. The problem is what happens if you win? Because if you win then the issue gets thrown back into the political arena.”…”
http://www.theblaze.com/stories/2015/05/26/charles-krauthammer-breaks-down-why-courts-immigration-ruling-might-be-a-problem-for-republicans/
Feds unveil long-awaited overhaul of Medicaid managed care
“The federal government on Tuesday unveiled a long-awaited regulatory package intended to modernize contracts under Medicaid that contains the biggest changes to the program in more than a decade. The nearly 700-page rule, which has been described by some groups as an “uber rule,” contains long-awaited instructions about contracts between state Medicaid programs and managed care groups, which are hired to handle long-term care for the elderly and disabled. Managed care organizations — known for their sometimes-controversial pay-for-performance structure — have exploded in popularity since the 1970s. Thirty-nine states, representing 90 percent of Medicaid beneficiaries, now have contracts with managed care groups. More than $120 billion in Medicaid premium payments were paid to managed care organizations in fiscal year 2013 alone, according to the Kaiser Family Foundation. Under the managed care model, states pay the managed care groups a fixed monthly premium – also known as a “capitation rate” for each patient – instead of the more traditional fee-for-service model. Doctors are offered incentives to limit costs, which often means that individuals are kept in their homes rather than in more expensive nursing home facilities. The federal government has not released rules on managed care since 2003. Nearly 30 million people are now enrolled through managed care, which amounts to about two-thirds of people with Medicaid. That’s up from just 2.7 million people with managed care in 1991…”
http://thehill.com/policy/healthcare/243135-feds-release-long-awaited-uber-rule-for-state-medicaid-contracts
Medicare Part D saves money and lives
“Federal officials recently set off budgetary alarm bells with new data on Medicare prescription drug spending. The Centers for Medicare and Medicaid Services pegged Medicare Part D’s 2013 price tag at $103 billion. That’s a large number — and largely misleading. A closer look at Part D reveals a program that is working very well at delivering essential services while keeping costs down. The key to the success of Part D has been its ability to harness market forces for the benefit of participants and taxpayers alike. Implemented in 2006, Part D gives seniors and the disabled access to prescription drugs, which Medicare previously didn’t cover. Today, 36 million Americans can afford essential medications thanks to this program. Part D has cost less than expected year after year, making it nearly unique among government programs. From 2004 to 2013 Part D cost $349 billion — 45 percent less than originally predicted. In 2014, the Congressional Budget Office lowered its projection for total Part D spending by $56 billion….”
http://www.washingtonexaminer.com/medicare-part-d-saves-money-and-lives/article/2564958
What Veterans Affairs won’t pay for: Chance for the wounded to have kids
“After Army Staff Sgt. Alex Dillmann was paralyzed from the abdomen down in a bomb blast in Afghanistan, the Department of Veterans Affairs paid to retrofit his Chevrolet Silverado truck so he could drive it and bought him a handcycle so he could exercise. But the agency that cares for former troops won’t pay for what the onetime squad leader and his wife, Holly, ache for most: a chance to have children. VA will not pick up the bill for in vitro fertilization, which fertility experts say offers those with spinal cord and genital injuries the best hope for a biological child. Under a 23-year-old law, VA is prohibited from covering IVF. Congress adopted the ban as the result of conservative opposition to assisted reproduction and concern that some fertilized embryos might be discarded. Now, however, veterans and lawmakers from both parties are pushing to overturn the ban. They argue that it is outdated and that IVF is widely accepted and performed worldwide…”
http://www.washingtonpost.com/politics/for-combat-veterans-va-ban-on-ivf-coverage-adds-insult-to-injury/2015/05/25/a5ae2940-fd8b-11e4-833c-a2de05b6b2a4_story.html?wprss=rss_homepage
IMMIGRATION:
Obama amnesty helps guest-workers and their spouses over laid-off tech workers
Court rules no direct competition with immigration policy
“Technology workers who say they lost their jobs to immigrant workers lost their bid to halt President Obama’s latest guest-worker program after a court ruled Sunday evening that they couldn’t prove the new workers would specifically compete with them. Federal District Judge Tanya S. Chutkan’s ruling means Mr. Obama’s controversial program can go into effect Tuesday as planned. Under the program, legal guest-workers’ spouses, who now are generally barred from working, will be allowed to apply for work permits, giving them the chance to win jobs. Judge Chutkan wrote in the 12-page ruling that the damage to the technology workers, organized as Save Jobs USA, was “highly speculative.” “Save Jobs does not explain how many IT jobs may be taken by H-4 visa holders, how many of those jobs its members may have sought themselves, what pay or benefits its members risk losing while the case is pending, or what other harm its members may face,” the judge wrote. “The court is left to speculate as to the magnitude of the injury, and speculation is not enough to turn economic loss into irreparable harm.” The H-4 visa is given to dependents of H-1B visa holders, who are sought-after high-skilled workers…”
http://www.washingtontimes.com/news/2015/may/25/obama-amnesty-helps-guest-workers-and-their-spouse/?utm_source=RSS_Feed&utm_medium=RSS
SPOUSES OF GUEST WORKERS NOW ELIGIBLE FOR WORK PERMITS UNDER OBAMA ACTIONS
“The Department of Homeland Security is now accepting employment authorization applications for certain H-4 dependent spouses of H-1B visa holders. In February, U.S. Citizenship and Immigration Services (USCIS) Director León Rodríguez announced that, come May, the Obama administration would be extending employment authorization eligibility to a category of immigrant previously ineligible to work in the U.S. — dependent spouses of H-1B immigrants. DHS began accepting applications under the new H-4 employment rule — which was part of the executive actions on immigration President Obama put in motion on November 20 — Tuesday. When the Obama administration announced the expansion in February, it anticipated that the number of individuals eligible to apply for work permits under the rule could be 179,600 in the first year and 55,000 for each subsequent year. Last month, a group of former Southern California Edison employees — displaced by H-1B visa holders — sued the administration over the new H-4 rule, arguing that it negatively impacts their job prospects. “DHS’s H-4 Rule, which grants work authorization to H-4 visa holders, injures Save Jobs USA’s members by (1) depriving them of statutory protections from foreign labor…(2) by increasing the number of economic competitors; and (3) by conferring benefits to their economic competitors on H-1B visas,” the lawsuit read…”
http://www.breitbart.com/big-government/2015/05/26/spouses-of-guest-workers-now-eligible-for-work-permits-under-obama-actions/
Court won’t lift hold on Obama immigration action
“A federal appeals court refused Tuesday to lift a temporary hold on President Barack Obama’s executive action that could shield as many as 5 million immigrants illegally living in the U.S. from deportation. The U.S. Justice Department had asked the 5th U.S. Circuit Court of Appeals to reverse a Texas judge who agreed to temporarily block the president’s plan in February, after 26 states filed a lawsuit alleging Obama’s action was unconstitutional. But two out of three judges on a court panel voted to deny the government’s request. It wasn’t immediately clear if the government would appeal, either to the full appeals court in New Orleans or to the U.S. Supreme Court. The states suing to block the plan, led by Texas, argue that Obama acted outside his authority and that the changes would force them to invest more in law enforcement, health care and education. But the White House has said the president acted within his powers to fix a “broken immigration system.” U.S. District Judge Andrew Hanen sided with the states and, from his court in Brownsville, Texas, issued a temporary injunction on Feb. 16 to block the plan from taking effect while the lawsuit works its way through the courts. Justice Department lawyers sought a stay while they appealed the injunction. They argued that keeping the temporary hold interfered with the Homeland Security Department’s ability to protect the U.S. and secure the nation’s borders. They also said immigration policy is a domain of the federal government, not the states…”
http://www.washingtontimes.com/news/2015/may/26/court-wont-lift-hold-on-obama-immigration-action/?utm_source=RSS_Feed&utm_medium=RSS
Appeals court refuses to lift hold on Obama immigration action
“A federal appeals court refused Tuesday to allow the implementation, for now, of President Obama’s executive action that could shield from deportation as many as 5 million illegal immigrants. The U.S. Justice Department had asked the 5th U.S. Circuit Court of Appeals to reverse U.S. District Judge Andrew Hanen’s earlier decision temporarily halting the administration’s plan. Hanen issued the temporary hold in February, after 26 states filed a lawsuit alleging Obama’s action was unconstitutional. Two out of the three judges on a court panel, though, voted Tuesday to deny the government’s request, as the underlying case is argued. The majority opinion reasoned that lifting the temporary hold — known in judicial parlance as issuing a “stay” — could cause serious problems for states should they ultimately win their challenge. It said the states have shown that “issuance of the stay will substantially injure” them. It continued: “A stay would enable DAPA beneficiaries to apply for driver’s licenses and other benefits, and it would be difficult for the states to retract those benefits or recoup their costs even if they won on the merits. That is particularly true in light of the district court’s findings regarding the large number of potential beneficiaries, including at least 500,000 in Texas alone.” Texas Attorney General Ken Paxton praised Tuesday’s decision. “The separation of powers and check and balances remain the law of the land, and this decision is a victory for those committed to preserving the rule of law in America,” he said in a written statement. The White House has said the program is intended to primarily help immigrants brought to the U.S. as children and those with children who are U.S. citizens. It wasn’t immediately clear if the government would appeal, either to the full appeals court in New Orleans or to the U.S. Supreme Court. The states suing to block the plan, led by Texas, argue that Obama acted outside his authority and that the changes would force them to invest more in law enforcement, health care and education…”
http://www.foxnews.com/politics/2015/05/26/appeals-court-refuses-to-lift-hold-on-obama-immigration-action/
Appeals Court Keeps Block of Obama Immigration Plan
Decision preserves lower-court hold on White House plan to shield millions from deportation
“A federal appellate court on Tuesday sided with states challenging the Obama administration’s plan to defer deportations for millions of undocumented immigrants. The administration had appealed a February ruling by U.S. District Judge Andrew Hanen, which temporarily blocked it from proceeding with the president’s plan, announced in November, to allow millions of undocumented immigrants to apply to stay in the U.S. Judge Hanen, based in Brownsville, Texas, sided with officials from 26 largely Republican states who contend that President Obama overstepped his authority when he unilaterally implemented a program that would allow more than four million people in the country illegally to apply for deferred deportation and work authorizations, among other benefits. Under the president’s plan, immigrants would have to meet certain criteria, including not posing a security threat and having a child who is a U.S. citizen or lawful permanent resident. The Fifth U.S. Circuit Court of Appeals in New Orleans declined the administration’s request to stay the lower-court injunction and to begin implementing the immigration action while the two sides battle it out in court. “Because the government is unlikely to succeed on the merits of its appeal of the injunction, we deny the motion for stay,” the court ruled. The Justice Department, which defends suits against the administration, didn’t immediately return a call for comment. In a brief filed earlier with the Fifth Circuit, the Obama administration said Judge Hanen’s injunction had undermined the federal government’s authority to prioritize which undocumented immigrants to deport. “The Constitution does not entitle states to intrude into the uniquely federal domain of immigration enforcement,” the administration said. Texas Attorney General Ken Paxton, who is leading the suit by the states, commended the ruling on Tuesday…”
http://www.wsj.com/articles/appeals-court-keeps-block-of-obama-immigration-plan-1432665888
Obama Loses Second Bid to Implement Overhaul of Immigration
“President Barack Obama’s bid to make overhauling immigration policy a second-term victory was dealt a serious blow as federal judges ruled the effort must remain on hold while 26 states sue to overturn it. Obama’s executive action, which would allow 5 million undocumented immigrants to remain in the country, must be delayed until the lawsuit is resolved, the U.S. Court of Appeals in New Orleans ruled. The case has drawn sometimes furious opposition from members of Congress, and more than a few presidential contenders. For years, Congress has been unable to agree on a revised law to address an estimated 11 million undocumented immigrants in the U.S. Obama said he acted because the House has refused to take up a bipartisan measure passed by the Senate in 2013 that would create a path to citizenship for many of those immigrants. To qualify under his deferral program, undocumented immigrants must have been in the U.S. for at least five years and have a child who is a citizen, or have been brought here as children themselves. They must also pass a criminal background check.
2-1 Decision – The appeals court ruled Tuesday in a 2-1 decision that the federal government isn’t likely to win the appeal. It refused to lift a federal judge’s injunction banning the changes from taking effect before the litigation is resolved. The Obama administration had no immediate comment on the ruling. The majority of the court disagreed with the administration’s argument that the states didn’t have a legal right to challenge the policy. Texas, in particular, the judges said would be forced to spend millions of dollars providing drivers’ licenses and other permits to undocumented immigrants. By providing the protected immigrants with eligibility for federal and state benefits, the administration commits actions judges can review, wrote Judge Jerry Smith, an appointee of President Ronald Reagan, a Republican. Judge Jennifer Elrod, an appointee of Republican President George W. Bush agreed with Smith. The issue should be left to political branches, not courts, to decide, Judge Stephen Higginson, an Obama appointee, wrote in a dissent from the majority…”
http://www.bloomberg.com/news/articles/2015-05-26/obama-administration-loses-bid-to-implement-immigration-orders-ia5n71k0
APPEALS COURT REFUSES TO LIFT HOLD ON OBAMA AMNESTY
“A federal appeals court has upheld a district court’s injunction preventing the Obama administration’s executive amnesty programs from moving forward. In February U.S. District Court Judge Andrew Hanen placed a preliminary injunction on Obama’s executive amnesty programs — expanded Deferred Action for Childhood Arrivals (DACA) and Deferred Action for Parents of Americans and Lawful Permanent Residents (DAPA) — keeping the programs from taking effect. Hanen blocked the programs after 26 states led by Texas challenged the executive actions. Justice Department lawyers sought a stay on the injunction from the 5th Circuit Court of Appeals. Tuesday’s ruling from the 5th, refusing to lift the injunction, marks a significant setback for the Obama administration’s executive amnesty effort. According to the Associated Press, the court declined the stay the injunction on a 2-1 vote with 5th Circuit judges Jerry Smith and Jennifer Walker Elrod voting for denial and Judge Stephen Higginson dissenting. Texas is leading the 26 state coalition challenging the executive amnesty. Alabama, Arizona, Arkansas, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Michigan, Mississippi, Montana, Nebraska, Nevada, North Carolina, North Dak