Tag: missouri

Missouri Lawmakers Override Veto to Enact Good Samaritan Law

In January, Missouri legislators introduced the “Volunteer Health Services Act.” The bill expands health care access for low-income residents by eliminating the regulatory barriers Missouri previously imposed on out-of-state doctors and other clinicians who want to provide free charitable care to Missouri’s poor. Yes, every state government prevents some doctors from giving away free medical care to the poor. As I wrote in “50 Vetoes:” 

Volunteer groups like Remote Area Medical engage doctors and other clinicians from around the country to treat indigent patients in rural and inner-city areas. States often prevent these clinicians from providing free medical care to the poor because, while they are licensed to practice medicine in their own states, they are not licensed to practice medicine where Remote Area Medical is holding its clinics.

Remote Area Medical has had to turn away patients or scrap clinics in California, Florida, and Georgia…After a tornado devastated Joplin, Missouri, Remote Area Medical arrived with a mobile eyeglass lab, yet state officials prohibited the visiting optometrists from giving away free glasses.

It appears that Missouri legislators, if not the governor, have learned their lesson. The legislature approved the Volunteer Health Services Act in May, and sent it to Gov. Jay Nixon (D), who vetoed it. But yesterday, both the Missouri House and Senate voted to override the governor’s vetoMissouri now joins states like Tennessee, Illinois, and Connecticut that have enacted similar Good Samaritan laws. 

The Missouri law also shields clinicians from liability for simple negligence in malpractice actions. I’m not a really a fan of letting legislatures shield doctors from liability for their own negligence. In my view, doctors and patients should choose and adopt their own med-mal rules via contract. But this part of the law may have little effect. Missouri’s Volunteer Health Services Act still leaves clinicians liable for injuries resulting from gross negligence, and judges and juries may weaken this shield by stretching the definition of “gross” negligence.  

Rather than enact massive and unaffordable new entitlement programs like ObamaCare’s Medicaid expansion, states should follow Missouri’s lead and eliminate this and other barriers that government puts in the way of getting health care to the poor.

(HT: Patrick Ishmael of the Show-Me Institute.)

Ohio’s 2-1 Vote against the Individual Mandate Is a Wholesale Rejection of ObamaCare

Yesterday, Ohio voters approved by 66-34 percent an amendment to the state constitution blocking any sort of individual mandate in the state.  The Cleveland Plain Dealer reported that this “strike at President Barack Obama’s health care plan…was ahead by a wide margin even in Cuyahoga County – a traditional Democratic stronghold.” A little over a year ago, Missouri voters likewise rejected ObamaCare’s individual mandate by 71-29 percent.

Supporters typically dismiss such setbacks, including two years of solid public hostility to ObamaCare, by claiming that voters don’t hate the entire law.  In fact, they actually like specific provisions.  A year ago this month, The Washington Post’s Greg Sargent quoted approvingly a McClatchy-Marist poll:

Almost six in ten voters – 59% – report the part of the health care law that prevents insurance companies from denying coverage due to pre-existing conditions should remain law while 36% want it repealed.

Supporters are in serious denial if they still cling to this theory. These overwhelming rejections of the individual mandate are indeed a rejection of the entire law.

Asking people whether they support the law’s pre-existing conditions provisions is like asking whether they want sick people to pay less for medical care.  Of course they will say yes.  If anything, it’s amazing that as many as 36 percent of the public are so economically literate as to know that these government price controls will actually harm people with pre-existing conditions.  Also amazing is that among people with pre-existing conditions, equal numbers believe these provisions will be useless or harmful as think they will help.

But as the collapse of the CLASS Act and private markets for child-only health insurance have shown, and as the Obama administration has argued in federal court, the pre-existing conditions provisions cannot exist without the wildly unpopular individual mandate because on their own, the pre-existing conditions provisions would cause the entire health insurance market to implode.

If the pre-existing conditions provisions are a (supposed) benefit of the law, then the individual mandate is the cost of those provisions. If voters don’t like the individual mandate–if they aren’t willing to pay the cost of the law’s purported benefits–then the “popular” provisions aren’t popular, either.

Or, as Firedoglake’s Jon Walker puts it, ObamaCare is about as popular as pepperoni and broken glass pizza.

Is It ‘Weird’ for Congress to Consider the Constitutionality of Legislation Before Voting on It?

Slate columnist Dahlia Lithwick seems to think so (h/t David Bernstein).  So I’m not accused of taking Lithwick’s words out of context, here’s the relevant passage, discussing Senate nominee Christine O’Donnell (R-DE):

O’Donnell explained that “when I go to Washington, D.C., the litmus test by which I cast my vote for every piece of legislation that comes across my desk will be whether or not it is constitutional.” How weird is that, I thought. Isn’t it a court’s job to determine whether or not something is, in fact, constitutional? And isn’t that sort of provided for in, well, the Constitution? In 2003, O’Donnell said of the Supreme Court that “it’s kind of like we have the nine people sitting there in Washington who have a constitutional monarchy and that is an abuse of the system.” So I do wonder a little whether she’s claiming that her view of what’s constitutional trumps theirs. Not a lot of space for checks and balances in that reading.

Apparently Lithwick doesn’t know that senators and congressmen (and a whole host of other officials – including federal law clerks of the kind both she and I were at some point) swear an oath to uphold the Constitution.  It seems that it would be hard to fulfill that oath if you don’t in good faith and to the best of your ability consider the constitutional dimension of whatever you’re voting on.  Yes of course not all congressmen are lawyers – though it’s unclear whether being one and even chairing the judiciary committee helps one think through constitutional issues – but you shouldn’t have to be a constitutional scholar to see that, for example, Congress cannot force everyone to eat three servings of fruits and vegetables daily.  (Though now-Justice Elena Kagan refused to say that.)

Indeed, the Constitution is silent as to which branch of government is to review the constitutionality of legislation.  Moreover, as we know from the foundational case of Marbury v. Madison, the judiciary’s role in doing so is merely (but rightly) implied, not explicit, in constitutional text.  There is no “weirdness” in courts exercising their constitutional powers by ruling on constitutional issues brought before them in lawsuits even as the other branches make constitutionality determinations in carrying out their own duties.  After all, isn’t a president who does something he consciously knows is beyond his lawfully vested Article II authority violating his own oath of office and potentially subjecting himself to impeachment for that very reason?

Yes, long gone, unfortunately, are the days when congressional debates focused on the constitutionality of proposed bills rather than their desirability, but shouldn’t Congress at least pay lip service to the idea that it needs a constitutional warrant for everything it does?

In any event, I’ll be on a panel with Dahlia this Thursday at the Missouri Bar Association’s annual meeting and will raise this issue to her.  (May also take on her bizarre accusation that Iowa Senator Chuck Grassley was appealing sub rosa to “Christian Reconstructionists” in asking at Kagan’s confirmation hearings whether the right to keep and bear arms pre-existed the Constitution – see David Bernstein’s simple rebuttal at the Volokh Conspiracy.)

A Rough Week for ObamaCare

Half way through the work week, and the White House has had an unusually difficult week concerning the progress of their signature piece of legislation.  Let’s recap:

On Monday, a federal judge cleared a lawsuit brought forth by Virginia Attorney General Ken Cuccinelli regarding the Constitutionality of the recent health care legislation—specifically the individual mandate.  This case will almost certainly be decided by the Supreme Court, but this was an important first step in that process.

Later that day, reports came out that Secretary of HHS Kathleen Sebelius had caught heat regarding misleading statements that claimed ObamaCare would simultaneously pay for the coverage of an additional 30 million Americans and extend the life of the Medicare Trust Fund.  The $575 billion that CMS claims the Medicare program will save as a result of the legislation can be used for one purpose or the other, but not both.

Yesterday, a Congressional Research Service Study announced that it is impossible to estimate the number of new agencies created as a result of ObamaCare.  Most estimates have the number at around 100, but CRS claims that the final tally is “unknowable” because of the uncertainty surrounding some of the language.

Meanwhile, throughout the course of the day yesterday, voters in Missouri were busy voting in favor of Proposition C, a law that would exempt the citizens of Missouri from the requirement to purchase health insurance, the centerpiece of ObamaCare.  The referendum passed by a 3-to-1 margin, but the breakdown of votes is even more telling.

Nearly 670,000 people voted in favor of the proposition, approximately 85,000 votes more than the number of Republican and third-party primary votes.  Even if the 40,000 or so voters who apparently cast a vote for Proposition C but not for a primary candidate all voted in favor of proposition, as well as every single Republican and third-party voter, that still leaves nearly 45,000 Democrats who must have also voted with their Republican constituents in upholding their right to obtain health insurance on a voluntary basis.

Keep in mind that these are not just ordinary, uninterested voters.  These are the base of the Democratic Party, the most politically active citizens, and yet somewhere between 12-25% of them decided to oppose the individual mandate, notably in a state that is often the bellwether of national election campaigns.

If things continue this way, repeal should be on its way by next week.

Obamacare Lawsuits Gain Steam

David Boaz already noted Missourians’ overwhelming rejection of the individual mandate yesterday.  That, combined with Monday’s decision in Virginia’s lawsuit – where the judge denied the government’s motion to dismiss, ruling that Virginia had standing to make its claims and that those claims had sufficient merit to proceed – should embolden Missouri’s Lieutenant Governor Peter Kinder.  Kinder, in his personal capacity and joined by several other individuals, filed an Obamacare lawsuit last month.

I mention the Kinder suit to remind everyone that there are more challenges out there than just Virginia’s and the Florida-led 20-state suit.  I have personal knowledge of groups and individuals who have sued in Michigan, Ohio, and D.C. – and there are plenty of others, I’m sure (for example, the Goldwater Institute will be filing in Arizona soon).  As Michael Cannon has noted, the D.C. suit, filed by our friends at the Pacific Legal Foundation, has as its plaintiff a 29-year-old artist and former National Guardsman who served two tours in Iraq.  PLF will host a liveblog to discuss their case starting at 3 p.m. today.  You can read the complaint here.

Finally, PLF principal attorney and Cato adjunct scholar Tim Sandefur has a nice refutation of the argument that “well, gee, George Washington required able-bodied men to buy muskets and prepare for militia service under the Militia Act of 1792.”  The upshot: sure, but 1) the Militia Act was passed under the Constitution’s militia clauses (not under the Commerce Clause, taxing power, or anything else being claimed as authority by Obamacare proponents); and 2) to say that the Constitution does not protect “a freedom from government-mandated purchases” is to read the Constitution backwards because the burden is on the government to prove that it has the constitutional authority to force people to do things they don’t want to do.

Repeal now.

Get Back to Me When They’ve Got Something to Launch

Over the past few days, it seems like every major state newspaper ran a story on the state’s governor signing onto the Common Core State Standards Initiative, an effort to establish national standards in mathematics and reading curricula. The only holdouts are Alaska, Texas, Missouri, and South Carolina.

I should probably be more worried, because national standards are a terrible idea.

First, there is nothing inherently better about having a single standard agreed to by numerous states than having individual states set standards for themselves. Either way, politicians – people inherently most responsive to mobilized, highly motivated public school employees who want as little meaningful accountability as possible – will be setting the standards, and the standards will therefore either start low or end up there pretty fast.

Second, the notion that national standards adopted by even just a few states will remain both voluntary for all states and non-federal is pure fantasy, like unicorns, or selfless bureaucrats. Once some version of national standards exist, Washington will tie money to adopting them, which is how the feds force states to “volunteer” for all kinds of odious stuff.

“Oh, sure, feel free to turn down the money, Mr. Arizona” Uncle Sam says. “But your citizens? Well, I don’t think we’ll be taking any volunteers on paying federal taxes…”

The Obama Administration has already got this in the works, suggesting that adopting some sort of national standard could make a state eligible for a piece of the Secretary of Education’s so-called “Race to the Top Fund,” a $5 billion “stimulus” pot of gold controlled by the secretary.

Of course, the ultimate threat is that once standards go federal they never go back, and we’ll be stuck with one-size-fits-all standards for every state, district, and child in America, standards controlled by the National Education Association, Council of Chief State School Officers, and every other card-carrying member of the self-serving education establishment. And even though we’ll finally live in a utopia in which “the child in Mississippi is held to the same standards as the child in New York,” we won’t suddenly see test scores skyrocket or heretofore untapped genius spring forth across the land. We’ll just see an even worse version of the hopelessly moribund, socialist education system we have today.

So why, in light of all these dreadful threats, am I not too worried? Because what governors have agreed to so far is just to draft national standards, not to adopt them, and as I wrote last month, while the national standards crowd seems unanimously exuberant about having a single set of standards for every kid in America, they can’t even come close to agreeing on what those standards should be. And if they can’t agree on what the national standards should be, what are the odds that millions of other people will simply assent to having someone else’s standards foisted upon them?

Not very high. Indeed, when establishing national standards was attempted in the 1990s the real fireworks didn’t begin until proposed standards were published. Then, it seemed that everyone had a different reason they were outraged – outraged! – by the standards.  At best, there was only one point of broad consensus: that the wannabe national standards simply had to go.

So are national standards a serious threat? They sure are: Were they to be enacted, the educationally deadly government-schooling monopoly would be complete, with even the ability to escape to better districts or states cut off. But the news of states agreeing to develop shared standards doesn’t raise the threat level to DEFCON 1. It’s only if they complete the task – if they can somehow agree on how many fins to put on their missile, what range to shoot for, what color to paint it, where to target it, whose names to put on it, what fuel to use, and so on – that we should really become concerned. And making those decisions is, of course, the really tough part.

One Small Step for Private Airports

The New York Times reports that the nation’s only privately financed commercial airport is set to open in Branson, Missouri.

Unlike government transportation projects such as the Big Dig, this private project has gone well so far: “ ‘I think it’s some kind of record,’ Jeff Bourk, executive director of the airport, said of the speed of the construction. ‘On other projects I’ve been involved in, there’s a lot more red tape.’”

On the broader issue of America’s airports, the Times notes:

Every one of the 552 airports providing commercial air service in the United States receives some kind of federal money, according to the Federal Aviation Administration, and these airports are owned by public entities, municipalities, transportation districts or airport authorities.

In airports, America embraces socialism, while free enterprise has taken hold abroad. Many major cities around the world have privatized their airports in recent decades, as I discuss here.

The growth in private airports faces a number of hurdles in America. One problem is that government airports receive federal, state, and local subsidies, which makes it hard for private companies to compete. Another problem is the tax-deductibility of state/local (“muni”) bonds, which gives government facilities a financing advantage over private projects.

Thus, two reforms are obvious: end all federal subsidies for state/local infrastructure and repeal the tax deductibility of muni bonds. (Note that the Branson airport found an interesting way around the second problem).

Over time, these two steps would likely create a giant leap forward for privatized infrastructure in America.

Hat tip: Harrison Moar.