Following the ACA Lawsuits

If you’re interested in following the lawsuits surrounding the Affordable Care Act (ACA, “ObamaCare,” etc.), you could do worse than take a look at the ACA litigation blog. It has legal briefs and motions from various challenges to the law. This week, it features commentaries about the arguments made before the Supreme Court.

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Follow State House Call on Twitter

I was hoping to write on this site every day–there’s certainly enough to write about–but there’s no way that’s going to happen anytime soon.

But you should follow me on Twitter: http://twitter.com/#!/StateHouseCall. I am attempting to write at least one tweet a day that points to an interesting or important commentary on health care policy, from a free-market perspective.

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Gov. Martinez: Say “No” to Exchanges!

Legislation has passed both houses of the Legislature that would set up so-called “insurance exchanges” that are a component of ObamaCare. Originally found in Mitt Romney’s Massachusetts state takeover of health care, the “exchange” is, according to Pete Sunderman of Reason: a highly regulated, government-run marketplace where individuals can shop for health insurance, by 2014. Each state is required to either show progress on building an exchange by 2013 or make way for the federal government to build and manage one directly.

Sunderman goes on to explain that “These exchanges are the chief method by which the federal government will exert control over the insurance marketplace… The Department of Health and Human Services will have the authority to determine minimum health insurance requirements for most medical services and providers as well as cost-sharing details for plans offered through the exchanges.”

As John Graham and I write today over at NMPolitics.net, New Mexico should not assist the Obama Administration in their hostile takeover of American healthcare.

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Basic Health Care Freedom MIA in New Mexico

I sat through a lengthy hearing of the House Business and Industry Committee on Thursday, March 10th. Floor session ran late, so the hearing did not get going until after 7pm. No problem.

I was there to testify on separate legislation, but during the hearing HB 99 sponsored by Rep. Nora Espinoza came up for discussion. The bill is very simple. It would have allowed “anesthesiologist assistants” to work at hospitals outside of UNM Hospital here in Albuquerque. Currently,anesthesiologist assistants (AA’s) are limited to working at one hospital while Certified Registered Nurse Anesthetists (CRNA’s) can work anywhere. Needless to say, the CRNA’s were out in force to testify against the bill — in order to protect their market monopoly — while the AA’s also were out in force to gain more employment opportunities. The testimony and questions were emotional on both sides.

The issue is about economic freedom plain and simple. Hospitals would not be forced to hire AA’s if they don’t want to. If you are concerned about rising health care costs, it only makes sense to expand the number of people who can work in a particular field.

But, in what I can only describe as a shocking but not entirely surprising vote, all six Republicans on the committee supported the effort while all six Democrats opposed it. Thus, the bill died. Simply put, the Republicans supported economic freedom while the Democrats seemed to believe that unless the AA’s could “prove” that their services were absolutely necessary, they should not have the right to work in the specific field. This is backwards thinking and is a major problem for New Mexico. Voters need to understand that this attitude keeps business and economic activity from coming here and causes New Mexicans to remain dependent on government….unfortunately, that may be the very reason these legislators oppose economic freedom.

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Unintended consequences and health care reform

Albuquerque Journal Business journalist Winthrop Quigley recently wrote about American health care. The theme of the article is basically that there are often unintended consequences when it comes to changing health care laws.

Quigley also relied on a GAO report that attacked health savings accounts for being targeted at the wealthy when this study was flawed and other studies have shown that health savings accounts are attractive for everyone, not just the rich.

I responded with a letter to the editor that appeared in the paper on Monday and is found below:

Winthrop Quigley is absolutely right that policy decisions – even ostensibly pro-market ones – made in Washington, DC, often have unintended consequences. Nowhere is this clearer than in the area of health care where policies are adopted on top of policies, often with contradictory results.

Unraveling this mess of policies will take political will and humility, two things that are in very short supply in Washington, but things will move in a better direction if certain principles are followed including:

• Not all wisdom comes from Washington. Let the 50 “laboratories of democracy” tackle the health care issue their own way;
• Spending on health care programs – including Medicare and Medicaid — should be managed at the state level. The block grant model worked in the 1990s with welfare reform, it could work again;
• Better decisions and greater efficiency will result from putting health care dollars back in the hands of patients and consumers, not governments and insurance companies.

The aforementioned principles have been ignored by Democrats and Republicans alike, leading to our current mess. President Obama’s health care law, like Bush’s massive Medicare prescription drug bill, centralized decision-making and has led (or will lead) to massive deficits and inefficient delivery of health care services.

We can and must do better in health care for our own health and for the fiscal health of the nation.

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Stopping the tyranny of ObamaCare

Federal Judge Robert Vinson declared the entirety of ObamaCare to be void.  Judge Vinson said that it is unconstitutional for the Federal government to force individuals to purchase health care insurance.

It is an act of tyranny for a government to mandate people to make specific purchases for themselves and for their families.  It is unjust and evil to force poor people to purchase health insurance that has been made extremely expensive by the illogical and dictatorial actions of a repressive government.

On October 14, 2010, U.S. District Judge Robert Vinson ruled that the case brought originally by 20 state Attorney Generals could go forward.  Judge Vinson ruled that the Commerce Clause of The Constitution of the United States gives no authority to Congress or the President to mandate the purchase of health insurance.

http://www.healthcarebs.com/2010/10/14/federal-judge-rules-that-anti-obamacare-suit-can-go-forward/

At this stage in the litigation, this is not even a close call. . . This case law is instructive, but ultimately inconclusive because the Commerce Clause and Necessary and Proper Clause have never been applied in such a manner before.  The power that the individual mandate seeks to harness is simply without prior precedent.

Judge Vinson differentiated between the ability to mandate the purchase of certain automobile liability insurance and preventing people from engaging in nonactivity, such as the decision to not purchase health insurance.

[In the latter] case we are dealing with something very different. The individual mandate applies across the board. People have no choice and there is no way to avoid it. Those who fall under the individual mandate either comply with it, or they are penalized. It is not based on an activity that they make the choice to undertake. Rather, it is based solely on citizenship and on being alive.

Judge Vinson also criticized the Obama Administration for claiming ObamaCare was not mandating a tax and then claiming the opposite in the defense of this legal case.

Congress should not be permitted to secure and cast politically difficult votes on controversial legislation by deliberately calling something one thing, after which the defenders of that legislation take an ‘Alice-in-Wonderland’ tack and argue in court that Congress really meant something else entirely …

Judge Vinson clarified that the insurance mandate inherent in ObamaCare was indeed not a tax.

Congress did not intend to impose a tax when it imposed the penalty. To hold otherwise would require me to look beyond the plain words of the statute. I would have to ignore that Congress: (i) specifically changed the term in previous incarnations of the statute from “tax” to “penalty;” (ii) used the term “tax” in describing the several other exactions provided for in the Act; (iii) specifically relied on and identified its Commerce Clause power and not its taxing power; (iv) eliminated traditional IRS enforcement methods for the failure to pay the “tax;” and (v) failed to identify in the legislation any revenue that would be raised from it, notwithstanding that at least seventeen other revenue-generating provisions were specifically so identified.

On Monday January 31, 2011, Judge Robert Vinson declared that the “mandate is unconstitutional” and the entirely of ObamaCare is “void”.  Judge Vinson sided with the 26 states that had sued to block the implementation of ObamaCare.

The Los
Angeles Times considered Judge Vinson’s ruling so very important that it
published his decision in its entirety. 
The following from the CONCLUSION of Judge Vinson’s SUMMARY JUDGEMENT are
of interest.

http://latimesblogs.latimes.com/washington/2011/01/obamacare-unconstitutional-federal-judge-roger-vinson-florida-1.html

The existing problems in our national health care system are recognized by everyone in this case. There is widespread sentiment for positive improvements that will reduce costs, improve the quality of care, and expand availability in a way
that the nation can afford. This is obviously a very difficult task. Regardless of how laudable its attempts may have been to accomplish these goals in passing the Act, Congress must operate within the bounds established by the Constitution.

“Again, this case is not about whether the Act is wise or unwise legislation. It is about the Constitutional role of the federal government.

“For the reasons stated, I must reluctantly conclude that Congress exceeded the bounds of its authority in passing the Act with the individual mandate. That is not to say, of course, that Congress is without power to address the problems and
inequities in our health care system. The health care market is more than one sixth of the national economy, and without doubt Congress has the power to reform and regulate this market. That has not been disputed in this case. The principal dispute has been about how Congress chose to exercise that power here.30

“Because the individual mandate is unconstitutional and not severable, the entire Act must be declared void.

“This has been a difficult decision to reach, and I am aware that it will have indeterminable implications. At a time when there is virtually unanimous agreement that health care reform is needed in this country, it is hard to invalidate and strike down a statute titled “The Patient Protection and Affordable Care Act.” As Judge Luttig wrote for an en banc Fourth Circuit in 30 On this point, it should be emphasized that while the individual mandate was clearly “necessary and essential” to the Act as drafted, it is not “necessary and essential” to health care reform in general. It is undisputed that there are various other (Constitutional) ways to accomplish what Congress wanted to do.

“Indeed, I note that in 2008, then-Senator Obama supported a health care reform proposal that did not include an individual mandate because he was at that time strongly opposed to the idea, stating that “if a mandate was the solution, we can try that to solve homelessness by mandating everybody to buy a house.”

Our Supreme Court will ultimately decide this case.  The Court will quite possibly hear this case in an expedited manner.

Our Supreme Court will decide if our Federal government can forcibly cause a person to spend money on a product they do not wish to purchase, not allow a person to purchase a more logical and much less expensive competitive product, mandate how one shall receive the services of the product, diminish the quality of the services rendered by the product with excessive rules and regulations, and ultimately ration and even deny the services of the product to the purchaser.

What is at stake here is whether or not our Federal government can choose to govern We the People in a tyrannical manner.

http://lubbockonline.com/interact/blog-post/may/2011-02-01/stopping-obamacare-tyranny-0

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Dr. Deane Waldman Explains the Health Care Law’s “Death Panels”

With the House of Representatives poised to pass a repeal of health care (the effort is likely to die in the Senate, but it is still a worthy exercise), Dr. Deane Waldman explains in this new article where the much-discussed “death panels” really are to be found in the new health care law.

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Repealing ObamaCare, State by State

What can state legislatures do to repeal ObamaCare? Plenty, says Christie Herrera of the American Legislative Exchange Council (ALEC).

ALEC has just released The State Legislators Guide to Repealing ObamaCare, which offers legislators plenty of options for defunding ObamaCare, drawing attention to its harmful effects, and otherwise working to undo the increasing rate of “governmentizing” health care.

For states, ObamaCare has several harmful effects, including:

  • Increased financial demands on already stressed Medicaid programs
  • Higher taxes
  • A federal takeover of health insurance regulation.

What can state legislators do? They can take several steps, including:

  • Refrain from building the ObamaCare edifice
  • Hold public hearings to draw attention to the harmful effects of the law
  • Pursue market-based reforms.

In other words, the action isn’t just at the national level. For those of us who appreciate federalism, that’s a good thing.

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Repeal legislation

If you’d like to see the legislation that has been introduced to repeal ObamaCare, it’s H.R. 2. H.4. 9, which I can’t find at the moment, is a companion measure that instructs House committees to pursue alternative reforms to health care policy.

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Putting Medicaid on the Table in New Mexico

With a $400 million deficit (revised upwards from $286 million during the campaign), Tom Molitor explains that Medicaid in New Mexico should be on the table for some reforms. Leaders of other states, facing far worse deficits, are making more dramatic cuts. Governor Martinez can and should take on Medicaid.

Of course, as Molitor writes, Congressional action to give states more responsibility for, and control over, Medicaid spending, is absolutely essential to the long-term viability of both federal and state budgets.

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