Tag: affordable care act

Might the Washington Post Be Partial to ObamaCare?

Here’s a poor, unsuccessful letter I sent to the editor of the Washington Post:

Thirty-two states have issued a stunning vote of no confidence in President Obama’s health care law by refusing to finance and operate the new regulatory bureaucracies (“exchanges”) at its core. This development threatens to delay implementation of the law, at the very least.

Post readers learned of this once-unimaginable rebuke in an article that gave top billing to those states’ critics [“Critics Slam GOP States over Health Exchanges,” Dec. 14, A1]. The article further claimed, “there’s no question that federal officials will wield substantially more power” in those states, when in fact that highly disputed opinion is at the center of the entire debate.

This followed an article hailing an Obama administration decision to abandon a measure designed to reduce federal Medicaid spending as a “silver lining” [“A Supreme Court Silver Lining?: How Medicaid Dodged the Deficit Debate,” Dec. 12]. The article quoted six sources who supported the administration’s move, but none of the administration’s critics.

Post readers would be better served by less partial health policy coverage.

I’m Still Not Over the Obamacare Ruling

That’s the title of an op-ed I had in the Daily Caller last week.  Here’s how it begins:

Four months have passed since Chief Justice John Roberts made Obamacare’s individual mandate a tax and thereby let stand one of the two laws most responsible for our sluggish economy (the other being the Dodd-Frank financial “reform”). I was in the courtroom that fateful June day and my emotions quickly cycled through shock, denial, anger, and later depression — why had I dedicated myself to the law when the most important case of my lifetime turned out in this illegitimate way? — before settling into the “bargaining” stage of grieving.

I’m still there. I just cannot get over that blow against not only sound jurisprudence and the rule of law — bad enough — but against the legitimacy of our government altogether. By recognizing that Obamacare was unconstitutional but shying away from striking it down, John Roberts fundamentally shook my faith in our system of justice.

Read the whole thing and also consider the words of Randy Barnett – who more than anyone is responsible for the Obamacare litigation – from the first panel of Cato’s Constitution Day conference in September:

Now we will have an election to decide the ultimate fate of Obamacare. But this election will also be about who gets selected to serve on the Supreme Court. Should Republican presidents continue to nominate judicial conservatives who are enthralled with New Dealers’ mantra of judicial restraint, or should Republican presidents nominate constitutional conservatives who believe that it is not activism for judges to be engaged in enforcing the whole Constitution. All future nominees should be vetted not only for their views on the meaning of the Constitution, but for their willingness to enforce that meaning. For over two years, our nation was given a great lesson on constitutional law — that the enumerated powers are limits Congress cannot exceed. In June, the electorate was given a different lesson in judicial philosophy: Judicial restraint in enforcing those limits is no virtue. In November and beyond, we will see just how well those lessons were learned.

Obamacare delenda est.

Replacing Obamacare: Cato Offers a Positive Solution

Now that the Supreme Court has ruled on Obamacare—the first of many challenges to reach it because, to paraphrase Nancy Pelosi, the more we learn about it, the more constitutional defects we find—the focus of public debate has returned to the policy arena. I’ve stepped to the side here because, as I said all along, I’m a simple constitutional lawyer, not a health care expert.

My colleagues Michael Cannon and Michael Tanner, however, have been doing yeoman’s work in describing what states should and shouldn’t do until we get federal officials willing to excise the Obamacare tumor from the body politic—and what Congress should then do to actually reform our health care system. They’ve collected their (and a few others’) work into a really cool e-book, Replacing Obamacare: The Cato Institute on Health Care Reform.

I’ll let the Mikes expound on their various policy analyses and prescriptions elsewhere, but just wanted to highlight the legal parts:

Chapter 25 - Bill ‘Reforms’ Constitution - Robert A. Levy and Michael F. Cannon

Chapter 26 - The Case against President Obama’s Health Care Reform: A Primer for Nonlawyers - Robert A. Levy

Chapter 27 - Elena’s Nanny State - Michael D. Tanner

Chapter 28 - Obamacare Is Unconstitutional - Roger Vinson

Chapter 29 - HHS v. Florida - Cato’s individual mandate brief before the Supreme Court

Chapter 30 -  Baking Some Humble Pie for Congress - Trevor Burrus

Chapter 31 - The Supreme Obamacare Question - Michael D. Tanner

Chapter 32 - That’s Not a Limiting Principle, Noah Feldman Edition - Michael F. Cannon

Chapter 33 - In Opposing Obamacare, We Were Serious the Whole Time - Ilya Shapiro

Chapter 76 - It Now Falls to Congress - Roger Pilon

Chapter 77 - We Won Everything but the Case - Ilya Shapiro

Chapter 78 - John Roberts, Judicial Pacifist - Ilya Shapiro

Chapter 79 - Health Law a Loser despite Court Victory - Michael F. Cannon

Chapter 80 - Chief Justice Roberts Sold Out the Constitution for Less Than Wales - Ilya Shapiro

Chapter 81 - ObamaCare’s Now a Bigger Mess - Michael D. Tanner

Chapter 82 - If ObamaCare Survives, Legal Battle Has Just Begun - Jonathan H. Adler and Michael F. Cannon

These are white papers, essays, op-eds, blog posts, and even a brief that you may have come across already (and can Google separately), but now you can get them all—along with all the great policy stuff —in one convenient e-book (whose table of contents you can see here).

Roberts Was Against Treating the Mandate as a Tax Before He Was For It

On March 27, during the part of the Obamacare oral argument devoted to the individual mandate, Solicitor General Verrilli said that the Court has an “obligation to construe it as an exercise of the tax power, if it can be upheld on that  basis.”  To that, Chief Justice Roberts responded quite critically, interrupting the solicitor general and asking why then didn’t Congress call it a tax.  The Chief does not seem particularly convinced on this issue, with the SG having a nonsensical answer of “there is nothing I know of that illuminates that.”

Yet, that is the exact issue he later accepted.

Here is the full exchange (from pages 49–50 of the transcript), including the preceding relevant exchange between Justice Kagan and the SG:

JUSTICE KAGAN: I suppose, though, General, one question is whether the determined efforts of Congress not to refer to this as a tax make a difference. I mean, you’re suggesting we should just look to the practical operation. We shouldn’t look at labels. And that seems right, except that here we have a case in which Congress determinedly said this is not a tax, and the question is why should that be irrelevant?

GENERAL VERRILLI: I don’t think that that’s a fair characterization of the actions of Congress here, Justice Kagan. On the—December 23rd, a point of constitutional order was called to, in fact, with respect to this law. The floor sponsor, Senator Baucus, defended it as an exercise of the taxing power. In his response to the point of order, the Senate voted 60 to 39 on that proposition.  The legislative history is replete with members of Congress explaining that this law is constitutional as an exercise of the taxing power. It was attacked as a tax by its opponents. So I don’t think this is a situation where you can say that Congress was avoiding any mention of the tax power.  It would be one thing if Congress explicitly disavowed an exercise of the tax power. But given that it hasn’t done so, it seems to me that it’s—not only is it fair to read this as an exercise of the tax power, but this Court has got an obligation to construe it as an exercise of the tax power, if it can be upheld on that basis.

CHIEF JUSTICE ROBERTS: Why didn’t Congress call it a tax, then?

GENERAL VERRILLI: Well—

CHIEF JUSTICE ROBERTS: You’re telling me they thought of it as a tax, they defended it on the tax power. Why didn’t they say it was a tax?

GENERAL VERRILLI: They might have thought, Your Honor, that calling it a penalty as they did would make it more effective in accomplishing its objective. But it is—in the Internal Revenue Code it is collected by the IRS on April 15th. I don’t think this is a situation in which you can say—

CHIEF JUSTICE ROBERTS: Well, that’s the reason. They thought it might be more effective if they called it a penalty.

GENERAL VERRILLI: Well, I—you know, I don’t—there is nothing that I know of that illuminates that, but certainly…

What a difference a few weeks make.

H/t to a frequent co-author who must remain nameless due to his current occupation.

Obamacare Rethink Maybe

Right before leaving town for the summer, the Supreme Court ruled 8-1 that “Rethink Maybe” was the pop hit of the summer, overtaking last year’s remake of “Every Breath You Take”:

Rethink Maybe

I filed a brief with the Court,
Don’t worry, it’s rather short
Constitution and not tort,
But now you’re in my way

I’d trade my soul for a wish,
Limited powers it is
Nobody expected this,
But now you’re in my way

Blue-eyed stare was holdin’,
Black-robed, balls-strikes callin’
Then you started cavin’
Where you think you’re goin’, CJ?

Hey, John Roberts,
This is crazy,
Mandates aren’t taxes,
So rethink, maybe?

It’s hard to look right,
At you CJ,
Your op makes no sense,
So rethink, maybe?

I just read you,
The ruling’s crazy,
Read Article I,
And rethink, maybe?

The other justices,
Ruled on the law,
But you played politics,
So rethink, maybe?

You thought Congress was remiss,
But changed your mind after this
You gave me the Commerce Clause,
But still, you’re in my way

I beg, and argue and plead
Had foresight, reason indeed
I didn’t know how I’d feel,
But now it’s in my way

Blue-eyed stare was holdin’,
Black-robed, balls-strikes callin’
Then you started cavin’
Where you think you’re goin’, CJ?

It’s hard to look right,
At you CJ,
Your op makes no sense,
So rethink, maybe?

Hey, John Roberts,
This is crazy,
Mandates aren’t taxes,
So rethink, maybe?

It’s hard to look right,
At you CJ,
Your op makes no sense,
So rethink, maybe?

All other justices,
Ruled on the law,
Mandates aren’t taxes,
So rethink, maybe?

When you came onto the Court
I thought you so rad
My man-crush so bad
My man-crush so, so bad

Now thanks to you I’ll pay this tax
It made me so mad
But now I’m just sad
It makes me so, so sad

It’s hard to look right,
At you CJ,
Mandates aren’t taxes,
So rethink, maybe?

I just read you,
The ruling’s crazy,
Read Article I,
And rethink, maybe?

The other justices,
Ruled on the law,
But you played politics,
So rethink, maybe?

When you came onto the Court
I thought you so rad
My man-crush so bad
My man-crush so, so bad

Now thanks to you I’ll pay this tax
It makes me so sad
And you should know that

So rethink, maybe?

Obamacare’s Constitutional Defects, First Amendment Division

On May 11, the Department of Health & Human Services finalized rules requiring insurers to tell any of their customers who get premium rebates this summer that the windfall comes courtesy of Obamacare.  Here’s the official required language:  “This letter is to inform you that you will receive a rebate of a portion of your health insurance premiums. This rebate is required by the Affordable Care Act-the health reform law.”

Given that Obamacare is already increasing costs for most patients – insured or otherwise – I wonder who the lucky few will be who get a chance to read the government’s prose.  Moreover, it’s a bit rich to create this “language mandate” when HHS Secretary Kathleen Sebelius had earlier advised insurance companies not to speak against Obamacare’s cost-increasing features.  As the Competitive Enterprise Institute’s Hans Bader put it:

Obama’s HHS secretary sought to gag insurers that disclosed how Obamacare’s mandates are increasing the cost of health insurance, even though such speech is clearly protected by the First Amendment, telling them if they did so, they could be excluded from health insurance exchanges. Prior to that, the Obama administration attempted to gag insurers from disclosing how Obamacare harms Medicare Advantage participants, drawing criticism from First Amendment experts like UCLA law professor Eugene Volokh, the author of two First Amendment textbooks.

Beyond the unseemliness of it all, however, there’s also a constitutional problem:  The government can’t require people to make politicized statements, whether that’s “Live Free or Die” on license plate or the labeling of consumer products where the labels aren’t justified on fraud-prevention or public health grounds.  See some other examples and legal analysis in Bader’s post at CEI’s blog.

The bottom line is that just like the First Amendment stops the government from censoring speech, it stops it from forcing speech.  And just like there’s no “health care is unique” exception to the Commerce Clause, there isn’t one to the First Amendment.

Obamacare Argument Post-Mortem

Now that I’ve woken from the first full night’s sleep since the Supreme Court’s three-day Obamacare marathon began, I can share my thoughts on how the argument went, in case you haven’t seen my first and second days’ reports for the Daily Caller:

  1. The Anti-Injunction Act: On an argument day that can best be described as the calm before the storm, it quickly became clear that the Supreme Court would reach the constitutional issues everyone cares about. That is, regardless of how the justices resolve the hyper-technical issue of whether the Anti-Injunction Act is “jurisdictional,” this law – which prevents people from challenging taxes before they’re assessed or collected – does not apply to the Obamacare litigation. There were also hints that the Court was skeptical of the government’s backup merits argument that the individual mandate was justified under the Constitution’s taxing power. Perhaps the only surprising aspect of the hearing was how “cold” the bench was; it’s rare for the justices to allow advocates to speak at length without interruption, but that’s what they generally did today. That’s yet another indication that the Court will get past the AIA appetizer to the constitutional entree.
  2. The individual mandate: From Justice Kennedy’s noting that the government is fundamentally transforming the relationship of the individual to the government, to Chief Justice Roberts’s concern that “all bets are off” if Congress can enact economic mandates, to Justice Alito’s invocation of a hypothetical burial-insurance mandate, to Justice Scalia’s focusing on the “proper” prong of the Necessary and Proper Clause – and grimacing throughout the solicitor general’s argument – it was a good day for those challenging the individual mandate.  Paul Clement and Mike Carvin, who argued for the plaintiffs, did a masterful job on that score, showing again and again the unprecedented and limitless nature of the government’s assertion of federal power.  The solicitor general meanwhile, had a shaky opening and never could quite articulate the limiting principle to the government’s theory that at least four justices (and presumably the silent Justice Thomas) were seeking.  While trying to predict Supreme Court decisions is a fool’s game, the wise should take note that if Tuesday’s argument is any indication, Obamacare is in constitutional trouble.
  3. Severability: The most likely ruling on severability is that all of Obamacare will fall along with its fatally flawed individual mandate.  While such a result would be legally correct, it would still be stunning.  Perhaps even more remarkable is that the severability argument proceeded under the general assumption that the mandate would indeed be struck down.  This was not a mere hypothetical situation about which the justices speculated, but rather a very real, even probable, event.  There’s still a possibility that a “third way” will develop between the government’s position (mandate plus “guaranteed issue” and “community rating”) and that of the challengers (the whole law) – perhaps Titles I and II, as Justices Breyer and Alito mused (and as Cato’s brief detailed) – but the only untenable position would be to sever the mandate completely from a national regulatory scheme that obviously wouldn’t work without it.
  4. Medicaid expansion/coercion: The justices don’t want to reach the factually complicated and legally thorny Medicaid issue.  That may be another marginal factor pushing one or more of them to strike down all of Obamacare under a straightforward severability analysis and leave the “spending clause coercion” issue for another day.  This was perhaps the most difficult of the four issues to predict, and having heard argument doesn’t really make that task easier.  A majority of the Court was troubled by the government’s “your money or your life” stance, but it’s not clear what standard can be applied to distinguish coercion from mere inducements.  Then again, if this isn’t federal coercion of the states, I’m not sure what is.

General post-argument reaction: All of my pre-argument intuitions were confirmed, and then some:  The Court will easily get past the AIA, probably strike down the individual mandate, more likely than not taking with it all or most of the rest of the law (including the Medicaid expansion).  Still, it was breathtaking to be in the courtroom to see the Chief Justice and Justices Scalia, Kennedy, and Alito all on the same page.  (For example, when Justice Kennedy’s first question during yesterday’s hearing was, “Can you create commerce in order to regulate it?” – a question hostile to the government – my heart began racing.)  Much as I’d love to think that my briefs helped get them there even a little bit, ultimately it’s the strength of the constitutional claims and the weakness of the government’s positions that prevailed – or will prevail if the opinions that come down in three months follow along the lines set by this week’s arguments.  They may not of course – trying to predict the Supreme Court isn’t a science—but I’m coming out of this week feeling very good.

Finally, for links to all of Cato’s briefs and my last series of op-eds on the Obamacare litigation, see Monday’s blog post.