In July, two Republican judges on the United States Court of Appeals for the District of Columbia Circuit handed down a decision defunding much of the Affordable Care Act (ACA). This effort to implement Sen. Ted Cruz’s (R-TX) top policy priority from the bench was withdrawn on Thursday by the DC Circuit, and the case will be reheard by the full court — a panel that will most likely include 13 judges. In practical terms, this means that July’s judgment cutting off subsidies to consumers who buy insurance plans in federally-operated health exchanges is no more. It has ceased to be. It is, in fact, an ex-judgment.
The reason why this matters is because the plaintiffs in this lawsuit, known as Halbig v. Burwell, are hustling to try to convince the GOP-dominated Supreme Court to hear this case, where they no doubt believe that they have a greater chance of succeeding than in the DC Circuit, as a majority of the active judges in the DC Circuit are Democrats. The Supreme Court takes only a tiny fraction of the cases brought to their attention by parties who lost in a lower court — a study of the Court’s 2005 term, for example, found that the justices granted a full argument to only 78 of the 8,517 petitions seeking the high Court’s review that term. The justices, however, are particularly likely to hear cases where two federal appeals courts disagree about the same question of law.
Two hours after the divided DC Circuit panel released its opinion attempted to defund Obamacare, a unanimous panel of the Fourth Circuit upheld the health subsidies that are at issue in Halbig. Thus, so long as both decisions remained in effect, Supreme Court review was very likely. Now that the full DC Circuit has vacated the two Republican judges’ July judgement, Supreme Court review is much less likely.
Although it is possible that the full DC Circuit could agree with the two judges who voted to cut off health subsidies to millions of Americans, this outcome is unlikely. The plaintiffs’ arguments in this case are weak and are unlikely to move judges who do not have a partisan stake in undermining the Affordable Care Act.
The litigants seeking to undermine Obamacare through this lawsuit — Oklahoma Attorney General Scott Pruitt (R), who filed a brief supporting the plaintiffs in this case, admitted in a Wall Street Journal op-ed that the purpose of this lawsuit is to cause “the structure of the ACA” to “crumble” — waged a two front effort trying to convince the full DC Circuit not to vacate their two GOP colleagues’ decision. The first half of this effort was a brief the plaintiffs filed with in the DC Circuit urging the full court to give the case a miss — although the argument raised in this brief is rather unusual. In essence, it broke down to three claims:
- This case is really important. And potentially very disruptive. According to the Halbig plaintiffs, “continued uncertainty” over whether Obamacare will be defunded “is simply not tenable, given its enormous consequences for millions of Americans, hundreds of thousands of businesses, dozens of states, and billions of dollars in monthly federal spending.”
- If the full DC Circuit agreed to hear the case, however, that “would cause delay without providing any certainty,” because the Supreme Court may ultimately decide to take the case.
- Thus, the DC Circuit must not near this case, and it must “proceed immediately” to a “final resolution by the Supreme Court.”
On the surface, this argument may have some appeal, but it collapses upon a fairly minimal amount of scrutiny. It would indeed be disruptive if much of the Affordable Care Act were defunded, and the existence of this lawsuit does raise some uncertainty over whether or not that will happen. It would be even more disruptive, however, if President Obama were deposed because the Supreme Court held that he was born in Kenya, or if the federal tax code were held unconstitutional, or if people could immunize themselves from the law by declaring themselves “sovereign citizens.” If the mere fact that a plaintiff raises a potentially disruptive legal argument were grounds for removing all obstacles to immediate Supreme Court review, then the Court’s docket would be clogged with cases brought by birthers, tax protesters and sovereign citizens.
The reason why this doesn’t happen is that the justices typically use the lower courts as a mechanism to screen the few cases raising issues that are difficult enough to warrant Supreme Court review from the vast bulk of cases that do not. This is one reason why the justices tend to hear cases where two courts of appeals disagree — because that disagreement is a sign that the case is sufficiently challenging that it requires a definitive ruling from the nation’s highest Court. When the full DC Circuit announced they would rehear the case, by contrast, that was an indication that the two Republicans who blocked the subsidies may be outliers who reached an idiosyncratic result in an easy case. The fact that all six of the other judges who have considered the Obamacare subsidies have also upheld them also lends credence to this view.
Perhaps recognizing that their legal arguments against further DC Circuit review were not likely to carry the day, Obamacare’s opponents turned to the conservative press to litigate their case in the media. A full hearing by a federal appeals court, what is known as an “en banc” hearing, is an unusual proceeding. But the Federal Rules of Appellate Procedure provide for en banc review when a case “involves a question of exceptional importance.” The plaintiffs in this case admit that “[t]here is no doubt that this case is of great national importance” in their most recent brief to the court — so they actually admit that this case warrantsen banc review.
Additionally, the official commentary on the federal rule dealing with en banc hearings explains that “[i]ntercircuit conflict is cited as one reason for asserting that a proceeding involves a question of ‘exceptional importance,’” so that is a second reason why this case was a prime candidate for en banc review.
Yet you would never guess these facts if you read the conservative Wall Street Journal’s opinion page, which claims that “if the D.C. Circuit rehears the case en banc, it would be a sharp break from history.” Nor would you learn it from the National Review, which suggests that “the recent D.C. Circuit panel decision on Obamacare exchange subsidies in Halbig v. Burwell doesn’t meet the D.C. Circuit’s very high standard for en banc review.” Or if you read the Volokh Conspiracy, a popular libertarian legal blog read by many judges and their law clerks, which claims that “the bar on en banc rehearing in the D.C. Circuit has been higher than the bar for certiorari in the Supreme Court.”
The subject of how a federal appeals court should handle the purely discretionary question of whether or not they wish to rehear a particular case rarely makes national headlines. Nor do opinion writers of any kind normally dive into arcane rules of federal appellate procedure. It is difficult to read the conservative media’s protests regarding en banc review as anything other than an attempt to paint the court’s decision to rehear the case as a partisan decision — rather than what it is, a decision that is clearly consistent with the federal rules governing these circumstances. Indeed, the Wall Street Journal op-ed quoted above it quite explicit in its claim that a decision to grant an en banc rehearing would be a partisan decision — “Those who claim that the D.C. Circuit will rehear the case en banc do no service to the court’s judges, who know the threat that overtly politicized en banc rehearings pose to the court’s collegiality.”
Now that the DC Circuit has ignored these attempts to scare them off with accusations of partisanship, this case no longer meets the usual criteria for Supreme Court review.
The “ice bucket challenge” has taken the internet by storm over the past several weeks, and participants have raised over $22 million dollars to combat ALS (amyotrophic lateral sclerosis), a rare neurodegenerative condition that has no cure. But some anti-abortion groups are instructing their members to stop participating.
Abortion opponents are raising concerns over the fact that the ALS Association may use the flood of recent donations to help fund embryonic stem cell research, which is often part of the search for new therapies. Catholics and conservative evangelicals contend that using embryonic stem cells in research is comparable to abortion because the cells end up being destroyed.
This was a huge culture war issue during the Bush administration, but has largely faded into the background in recent years now that it doesn’t fall as clearly across party lines. Still, though, the GOP took an official stance against embryonic stem cells in the party’s 2012 platform, and scientists warned that a Mitt Romney win could end up rolling back important innovation in new treatments for diseases.
Even if Republican lawmakers aren’t as outspoken against embryonic stem cells anymore, right-wing abortion opponents remain vocal on the issue. As Religion News Services reports, two blog posts on Patheos last week first suggested that the ice bucket challenge might not be pro-life. Soon, other groups started weighing in. “It’s such a shame that the ALS Association…chooses to support research that thrives from experimenting on and killing tiny, innocent human beings,” Lila Rose, the president of Live Action, said in a statement on Wednesday.
A Roman Catholic diocese in Ohio took it a step further, releasing a letter encouraging the 113 Catholic schools in its jurisdiction to “immediately cease” any plans to raise funds for the ALS Association. The Archdiocese of Cincinnati is asking people to donate to the John Paul II Medical Research Institute in Iowa City, which supports “research that is pro-life driven,” instead. “We appreciate the compassion that has caused so many people to engage in this,” Dan Andriacco, the spokesman for the Archdiocese, said. “But it’s a well established moral principle that a good end is not enough. The means to that ends must be morally licit.”
The U.S. Conference of Catholic Bishops has not yet issued any similar directives on a larger scale, telling the Associated Press that the Cincinnati diocese’s actions are considered to be “a local matter.”
In response to a inquiry about the growing controversy, a spokesperson for the ALS Association provided a statement to ThinkProgress clarifying that the organization primarily funds adult stem cell research. “Currently, The Association is funding one study using embryonic stem cells (ESC), and the stem cell line was established many years ago under ethical guidelines set by the National Institute of Neurological Disorders and Stroke (NINDS),” the statement explains. “This research is funded by one specific donor, who is committed to this area of research. In fact, donors may stipulate that their funds not be invested in this study or any stem cell project.”
Other experts in the field agree that, despite the recent concerns, ALS research does not necessarily require the use of embryonic stem cells.
“Embryonic stem cells certainly always bring up ethical and political issues for all research, not just for ALS,” Dr. Steve Perrin, the CEO of the ALS Therapy Development Institute, which does not conduct embryonic stem cell research, told ThinkProgress. “But the bottom line, specifically for ALS, is that there’s no real reason for organizations to be funding that type of research anymore with the advent of new advances in technology.”
Most researchers agree that adult stem cells — located in the adult brain and spinal cord — can’t totally replace the need for embryonic stem cells. But scientists are largely optimistic about other recent discoveries in this area. Induced pluripotent stem (iPS) cells, or regular adult cells that can be genetically altered to change their form, may be able to bolster research efforts without the need for using as many embryonic stem cells. And some researchers are working on developing a way to make embryonic stem cells without using an actual embryo.
Perrin also pointed out that the money being raised by the ice bucket challenge isn’t earmarked for any particular studies yet, so it’s not necessarily dedicated to research involving embryos. “A clear plan on how to disperse the funds to ongoing research projects is the biggest outstanding question,” he said.
Outside of stem cells, the anti-abortion community has recently been accused of staying silent on other current issues in the news that may relate to their issue space. In a piece published at the Nation this week, Michelle Goldberg pointed out that abortion opponents haven’t spoken out on the use of tear gas against protesters in Ferguson, despite the fact that those chemicals are scientifically considered to be “abortifacients” because they’ve been proven to harm fetuses and induce miscarriages.
WASHINGTON — The Senate passed a compromise bill allowing veterans to seek private care and adding $17 billion to the Department of Veterans Affairs to hire doctors to address long wait lists. The final vote in favor was 91-3.
The bill, which was rushed through before the August recess so it could be sent to President Obama, would require VA to make up $5 billion by taking it from other programs.
The House passed the compromise bill earlier this week.
Veterans enrolled in emergency care as of Aug. 1 who face long wait times, or live more than 40 miles from a VA facility could seek private care. It also gives VA $1.3 billion to open 27 new outpatient clinics, allows the VA secretary to fire top officials, allows veterans to qualify for in-state status for tuition at public colleges, and provides care for veterans who were sexually assaulted during their service.
It also cuts funding for VA employee bonuses by $40 million less than last year.
"The veterans of this country are entitled to quality and timely health care," Sen. Bernie Sanders, I-Vt., said in a statement. "This legislation will take us a long way toward making good on that promise."
Republican Leader Mitch McConnell said in a statement, “When veterans are denied care, it’s a priority deserving of bipartisan attention, and this legislation will help ensure the VA lives up to the promises that we made to our veterans. We owe them no less.”
The three senators who voted against the bill were Tom Coburn, R-Okla., Bob Corker, R-Tenn., and Jeff Sessions, R-Ala.
Holly Fisher, aka 'Holly Hobby Lobby', Busted In Another Lie: Son's 'Award-Winning' Cardiologist Isn’t Even Certified
Holly Hobby Lobby Caught in More Lies, Her Son’s “Award-Winning” Cardiologist Isn’t Even Certified
A federal appeals court might be on the verge of blowing a massive hole in the foundation of Obamacare.
The U.S. Court of Appeals for the D.C. Circuit is expected to rule any day now in a lawsuit that aims to block the law’s insurance subsidies in more than half the country. If the challengers ultimately prevail, the Affordable Care Act’s complex framework could begin to unravel as millions of people lose financial assistance.
For now, the stakes are a lot higher than the odds of success—challenges to the insurance subsidies have a 0-2 record in federal courts. But the pending D.C. Circuit ruling may be the one to break that streak, according to legal experts on both sides of the issue.
A three-judge panel heard oral arguments in the case, Halbig v. Sebelius, in March. Two judges appeared to split along partisan lines, leaving Judge Thomas Griffith, a George W. Bush appointee, as the likely swing vote. Griffith seemed during oral arguments to at least be open to the challengers’ arguments, and perhaps leaning in their direction.
A ruling against the Obama administration wouldn’t immediately damage the Affordable Care Act, and it wouldn’t mean that the administration will ultimately lose. But it would give the challengers their first victory and ensure that the issue keeps moving through the courts.
"I … think it’s going to get far more attention than it deserves," said Timothy Jost, a law professor at Washington & Lee University and a supporter of the Affordable Care Act.
Halbig aims to cut off the law’s insurance subsidies in federally run insurance exchanges—subsidies that nearly 7 million people are already receiving.
Obamacare set up an insurance marketplace in each state and authorized the federal government to operate the exchanges in states that wouldn’t set up their own. The exchanges were designed primarily for people who buy insurance on their own, rather than getting it through their employer, and the law provides tax subsidies to help most of those consumers cover the cost of their premiums.
The Halbig challenge argues that the Obama administration—specifically the IRS—is breaking the law by offering those tax subsidies in all 50 states. It relies mainly on the text of the statute, which authorizes subsidies in “an exchange established by the State.”
That phrasing clearly restricts subsidies to state-run exchanges and does not authorize them to flow through the federally run fallback exchange, the lawsuit claims.
But the Justice Department says that reading is too narrow, and the challengers have had a hard time convincing judges that Congress intended to set up a two-tiered system.
"The plain text of the statute, the statutory structure, and the statutory purpose make clear that Congress intended to make premium tax credits available on both state-run and federally facilitated Exchanges," D.C. District Court Judge Paul Friedman wrote in his ruling on the subsidies.
Even taking the “established by the State” language into account, the Justice Department and lower courts said, the statute as a whole indicates that Congress intended to treat all exchanges equally. The federal government “stands in the shoes” of states, the Obama administration argues.
"Congress is clearly indicating that it wants a system of exchanges, nationwide, to provide affordable health care for all Americans. States have the first opportunity to establish those exchanges under this framework, but if they don’t, that same exchange is created by the [Health and Human Services] secretary," Justice Department lawyer Stuart Delery said during the Halbig arguments in March.
The challengers in Halbig and its companion lawsuits say Congress wanted to use the subsidies as an incentive for states to set up their own exchanges. Friedman, though, said “there is no evidence in the legislative record that the House, the Senate, any relevant committee of either House, or any legislator ever entertained this idea.”
The challengers appealed Friedman’s Halbig ruling to the D.C. Circuit on an expedited timeline, which is why a decision is expected soon. Jost said the fact that the court hasn’t ruled yet might be a sign that Griffith, the swing vote, wasn’t ready to quickly sign on to a ruling axing the subsidies.
A district court in Virginia dismissed a nearly identical lawsuit, also saying there was no evidence that Congress intended to make subsides available only through state-run exchanges. That case, King v. Sebelius, was appealed to the 4th Circuit Court of Appeals, which could also issue its ruling soon.
Any day now, a three-judge panel on the D.C. Circuit Court of Appeals is expected to rule in Halbig v. Burwell, an expansive challenge that goes directly after federal insurance subsidies. An unfavorable outcome stands to cripple a core component of Obamacare, without which the law may not be able to survive. Two of the judges, both Republican appointees, expressed varying degrees of sympathy for the challengers’ case.
"Of all the challenges since the individual mandate, this is the one that presents the most mortal threat to the act," Jonathan Turley, a professor at George Washington University Law School, told TPM.
At issue is whether the statute permits the federal exchange (which serves residents of 34 states which opted not to build their own) to dole out premium tax credits. Without the subsidies, which are benefiting millions of lower-income Americans, the individual mandate is unworkable because many people won’t be able to afford insurance. And without the mandate, the coverage guarantee for preexisting conditions threatens to send costs soaring and destabilize the health care market.
The challenge was initially written off by some as a fool’s errand because there’s a lack of evidence that the Democrats who crafted and passed the Affordable Care Act intended to block subsidies on the federal exchange, which was designed as a backstop on behalf of the states. (They’ve signed a brief saying as much.) But the challengers seized on an ambiguity in the language of the statute which says the subsidies are to be provided by “an Exchange established by the State.”
"If the legislation is just stupid, I don’t see that it’s up to the court to save it," Judge A. Raymond Randolph said during oral arguments in March.
Randolph, a George H.W. Bush appointee, said the text of the statute “seems perfectly clear on its face” that the subsidies are confined to state-run exchanges. Carter-appointed Judge Harry T. Edwards slammed the challengers’ claims as “preposterous.” So the deciding vote appears to be with George W. Bush-appointed Judge Thomas B. Griffith, who wasn’t resolute but sounded unconvinced of the Obama administration’s defense, saying it had a “special burden” to show that the language “doesn’t mean what it appears to mean.”
Turley said, “If this case were decided on the basis of the statutory language, the advantage goes to the challengers. If the court is willing to broaden its interpretation then the administration may have an edge. It depends entirely on how the panel structures its analysis.”
If the three-judge panel rules against federal Obamacare subsidies, sources close to the case say the administration is very likely to request an en banc ruling — a re-vote taken by the full D.C. Circuit. The math of the overall bench is friendlier to the White House: 7 judges are Democratic appointees and 4 are Republican appointees. Four of the judges were placed by President Barack Obama himself, all during his second term.
The legal basis for the lawsuit was crafted by Cato’s Michael Cannon and Case Western law professor Jonathan Adler. The challengers lost the case in the D.C. district court. Cannon said on Wednesday he’s “hopeful” about winning at the appeals court.
The White House declined to comment on the pending litigation and administration officials wouldn’t weigh in on potential contingency plans if the D.C. Circuit court’s final judgment is against the Obamacare subsidies.
"The text of the statute makes clear that the state establishment of an Exchange was never viewed as a condition for the availability of tax credits," read the brief signed by Senate Majority Leader Harry Reid (D-NV), then-House Speaker Nancy Pelosi (D-CA) and other legislative architects of Obamacare.
h/t: Sahil Kapur at TPM
Image via Daily Kos’ FB Page.
Virginia Gov. Terry McAuliffe (D) plans to move forward with Medicaid expansion even without lawmakers’ support, the governor announced on Friday. The battle over Medicaid expansion has been particularly contentious in Virginia over the past several months, as McAuliffe been unable to convince the GOP-controlled legislature to move forward with implementing the policy even though it has bipartisan support in the state.
The governor announced his decision to expand Medicaid unilaterally during a press conference on Friday. He said he will use his executive power to expand Medicaid administratively, and asked the Secretary of Health and Human Resources to draw up plans for that project by the beginning of September. “I am moving forward,” he said, noting that lawmakers’ continued refusal to extend health care to an estimated 400,000 of the state’s poorest residents sends him “to bed every night with a pit in my stomach.” He called the GOP’s decision to block Medicaid expansion “unconscionable.”
Earlier this week, the Richmond Times-Dispatch’s Jeff Schapiro laid out what an administrative expansion might look like. Essentially, McAuliffe could enlist private businesses to execute the public program, a so-called “public-private partnership.” It’s a method the state has used before to finance a highway.
Although the governor wasn’t explicit about the specifics of his plan, he did say that he’s been consulting with the attorney general every step of the way, and “whatever we do will be in full compliance with the attorney general’s office.”
After the GOP took control of the state Senate earlier this month — in a dramatic turn of events that may have involved an illegal bribe to get a Democrat to step down — Virginia lawmakers rushed to pass a budget that explicitly bans the state from expanding Medicaid. Republicans say that the expansion is too expensive and that it’s irresponsible to pour more money into a broken government program.
But McAuliffe announced on Friday that he plans to veto that provision, along with several other line items in the budget that he doesn’t want to approve. The political fight over the state’s budget has been threatening a government shutdown, so McAuliffe opted for line vetoes rather than rejecting the entire proposal outright.
Across the country, GOP-led resistance to Medicaid expansion is leaving an estimated 5.8 million impoverished Americans without any access to affordable health care whatsoever. Meanwhile, the states that have agreed to expand the public program are seeing dramatic drops in their uninsurance rates and significant boosts to their budgets.
When Fox News shrugged off poor military medical care.
Of course, this was under another president…
In 2007, key talkers such as Sean Hannity and Charles Krauthammer were all amazingly silent on Fox, for weeks at a time, about the wounded soldiers scandal. During that time, Hannity failed on camera to condemn the deplorable Army hospital environment, or hold the administration accountable. The same lack of interest was shared by Krauthammer: Not once did he discuss Walter Reed on the air during his more than one dozen primetime Fox News appearances in the months of February and March in 2007.
Fox’s discrepancies in coverage when it comes to mistreatment in military medical facilities reveal the opportunism that is at the core of how they approach stories about Americans who are suffering.
What’s “classic” is how Fox and friends determine their level of outrage about failed military care based on who occupies the White House.
The Obama outrage engines are revving up at Fox News and across the conservative media landscape as conservatives shift, temporarily at least, from Obamacare and Benghazi and set their sights on the unfolding scandal involving backlog waiting lists at Veterans Affairs (VA) hospitals. The serious allegations that dozens of veterans died while awaiting treatment from Phoenix Veterans Affairs Health Care system, and that VA managers there created a secret waiting list to hide how long men and women had to wait to see a doctor, sparked a resignation and Congressional hearings.
The Fox condemnations have been especially loud, and sweeping. And yes, they’ve been mostly directed at the president.
"If only Barack Obama’s team treated our veterans as well as they treat the mega-donors to the Democrat [sic] party," lamented Laura Ingraham on Fox & Friends. For days, a parade of Fox talkers have condemned Obama for the story. One even accused the administration of “criminally negligent homicide.”
The heated right-wing response stands in stark contrast to the muted coverage Fox News provided for the last major controversy involving failed medical care for returning soldiers. In February 2007, the Washington Post, following up on original reporting done by Salon, exposed shockingly poor conditions inside the Walter Reed Army Medical Center. Those revelations also sparked resignations and Congressional hearings.
But back then, of course, George W. Bush was president and back then Fox News wasn’t as interested in the story. (It took Bill O’Reilly six weeks following the publication of the first Post expose to conclude that the Bush administration had badly bungled veterans care at Walter Reed.) And Fox worried journalists were paying too much attention to the scandal.
Numbers highlight the striking disparity in coverage.
Over a six-week period during early 2007, as the Walter Reed story continued to generate headlines, Fox aired a total of 28 reports and discussions on the topic, according to a search of programs archived by Nexis. By contrast, in just the last seven days Fox has aired more than 30 segments on the VA story. (According to TVEyes.com, “VA” was mentioned more than 250 times on Fox between May 14-20; 100 more mentions than on CNN and MSNBC.)
In 2007, key talkers such as Sean Hannity and Charles Krauthammer were all amazingly silent on Fox, for weeks at a time, about the wounded veterans scandal. During that time, Hannity failed on camera to condemn the deplorable Army hospital environment, or hold the administration accountable. The same lack of interest was shared by Krauthammer: Not once did he discuss Walter Reed on the air during his more than one dozen primetime Fox News appearances in the months of February and March in 2007.
"At some point, you’ve gotta ask, ‘Where has he been, and where is the competence, the elementary competence, he promised when he ran in 2008?’"
Betraying our Veterans: A new whistleblower blames VA department for vet suicides next #Hannity— Sean Hannity (@seanhannity) May 20, 2014
Meanwhile, in 2007 Think Progress noted that on March 2, as the veterans scandal escalated, and one day after the secretary of the Army resigned, the story was of little interest at Fox. That day, Fox mentioned “Anna Nicole Smith,” who had generated tabloid headlines when she died three weeks earlier, 121 times. But “Walter Reed” was referenced just ten times on March 2, 2007. By contrast, MSNBC and CNN mentioned the veterans hospital 84 and 53 times on that day, respectively.
While Fox shied away from the Walter Reed story seven years, it simultaneously wondered if the rest of the news media were paying too much attention to the scandal. During a March 10, 2007 discussion on Fox News Watch, host E.D. Hill noted, “The media first brought the scandal to light. But now, are they also in danger of overdoing it?” She later pressed a guest: “Is all of this just slightly overdone?”
Note that the disturbing Walter Reed story has been unraveling for years. Steve Robinson, director of Veterans Affairs at Veterans for America, had told Salon, “What we are talking about is a systemic problem where soldiers are left unattended in the barracks. They are sharing medications. They are drinking like alcoholics,” and waiting for treatment.
Indeed, Salon’s Mark Benjamin spent years prior to 2007 diligently detailing the troubling and widespread shortcomings for Americans veterans who returned to Walter Reed from wars in Iraq and Afghanistan.
Fox’s look-away coverage from Walter Reed mirrored how the conservative press ignored the growing veterans scandal for years. “If the right-wing media had broadcast the story, hidden in plain sight,” Steve Young wrote in the Philadelphia Inquirer, “the right’s water-carriers could have helped avert years of misery for many of our veterans.”
More from Young, a U.S. veteran, in March 2007:
But you heard nary a peep of indignation from O’Reilly against the Republican Congress, which, for the last six years, not only stood by and allowed Walter Reed to happen but actually conspired in the abomination.
The one constant in the VA and Walter Reed coverage from Fox has been that in both instances, pundits erroneously suggested the deep flaws in veterans care represented the failings of “government-run" health care. That knee-jerk partisan response was widespread within the conservative media in 2007.
From Rush Limbaugh:
If you want government-run health care, if you want to see what it’s going to be like, take a look at the mess that supposedly exists at Walter Reed and some of these other hospitals. It’s classic.
What’s “classic” is how Fox and friends determine their level of outrage about failed veteran care based on who occupies the White House.
Kentucky sets the golden standard of the success of universal health care, as anti-Obamacare Sen. Mitch McConnell faces a tough race. Ed Schultz and Mark Binelli discuss.
WASHINGTON — Kathleen Sebelius, the health and human services secretary, is resigning, ending a stormy five-year tenure marred by the disastrous rollout of President Obama’s signature legislative achievement, the Affordable Care Act.
Mr. Obama accepted Ms. Sebelius’s resignation this week, and on Friday morning he will nominate Sylvia Mathews Burwell, the director of the Office of Management and Budget, to replace her, officials said.
The departure comes as the Obama administration tries to move beyond its early stumbles in carrying out the law, persuade a still-skeptical public of its lasting benefits, and help Democratic incumbents, who face blistering attack ads after supporting the legislation, survive the midterm elections this fall.
Officials said Ms. Sebelius, 65, made the decision to resign and was not forced out. But the frustration at the White House over her performance had become increasingly clear, as administration aides worried that the crippling problems at HealthCare.gov, the website set up to enroll Americans in insurance exchanges, would result in lasting damage to the president’s legacy.
Even last week, as Mr. Obama triumphantly announced that enrollments in the exchanges had exceeded seven million, she did not appear next to him for the news conference in the Rose Garden.
The president is hoping that Ms. Burwell, 48, a Harvard- and Oxford-educated West Virginia native with a background in economic policy, will bring an intense focus and management acumen to the department. The budget office, which she has overseen since April of last year, is deeply involved in developing and carrying out health care policy.
“The president wants to make sure we have a proven manager and relentless implementer in the job over there, which is why he is going to nominate Sylvia,” said Denis R. McDonough, the White House chief of staff.
Last month, Ms. Sebelius approached Mr. Obama and began a series of conversations about her future, Mr. McDonough said. The secretary told the president that the March 31 deadline for sign-ups under the health care law — and rising enrollment numbers — provided an opportunity for change, and that he would be best served by someone who was not the target of so much political ire, Mr. McDonough said.
“What was clear is that she thought that it was time to transition the leadership to somebody else,” he said. “She’s made clear in other comments publicly that she recognizes that she takes a lot of the incoming. She does hope — all of us hope — that we can get beyond the partisan sniping.”
The resignation is a low point in what had been a remarkable career for Ms. Sebelius, who as governor of Kansas was named by Time magazine as one of the five best governors in the country and was even mentioned as a possible running mate for Mr. Obama in 2008. The two had bonded when Ms. Sebelius endorsed his presidential bid early in 2008, becoming one of the highest-profile Democratic women to back him over Hillary Rodham Clinton, and helping him deliver a big win in the Kansas caucus.
White House officials were quick to point out the many successes during Ms. Sebelius’s tenure: the end to pre-existing conditions as a bar to insurance, the ability for young people to stay on their parents’ insurance, and the reduction in the growth of health care costs. In addition, Ms. Sebelius helped push through mental health parity in insurance plans and worked with the Department of Education to promote early childhood education.
Ms. Sebelius said in an interview Thursday that she always knew that she would not “be here to turn out the lights in 2017.”
“My balance has always been, when do you make that decision?” she added.
The president had been under pressure for months to fire Ms. Sebelius. But he had resisted, in part because he did not want the Department of Health and Human Services to undergo more upheaval amid all the problems plaguing HealthCare.gov, and in part because of his general reluctance to publicly rebuke top officials.
In November, Mr. Obama defended the secretary, saying in an interview with NBC News that she “doesn’t write code; yeah, she wasn’t our I.T. person.” As recently as last week, Jay Carney, the White House press secretary, rejected any suggestion that Ms. Sebelius would be fired.
Mr. McDonough on Thursday praised Ms. Sebelius as “a fierce advocate,” and said she had been “tenacious in her belief” in the president’s health care law. “She’s fearless in her defense of this idea at the heart of the Affordable Care Act,” he said. “The president has commented to me countless times how much he admires that.”
But the Affordable Care Act faces a range of obstacles, political and otherwise, in the months ahead, and Mr. Obama is hoping that Ms. Burwell can smoothly steer the department and bring stability to its operations. In addition to the midterm elections, in which the health care law is the target of a flood of negative ads, the administration is grappling with policy questions: how it will levy the penalty on individuals who lack insurance, how much premiums will increase in the coming year, and how ultimately to administer the requirement that employers provide insurance.
Ms. Sebelius was not Mr. Obama’s first choice to lead the department; he wanted former Senator Tom Daschle in the job, but Mr. Daschle withdrew after acknowledging that he had underpaid his taxes for several years. She was hailed as a gifted political leader in Kansas who could work with legislators of both parties, but those skills were less evident in Washington, and she became a more distant figure within the administration.
In addition to the political battles over the passage and carrying out of the Affordable Care Act, she clashed with conservatives over contraception, and faced frequent calls for her political head by Republicans after the health care website failed to function properly last year.
In hearings on Capitol Hill, Ms. Sebelius sometimes grew rattled under grillings by lawmakers. In one hearing at the end of October, Ms. Sebelius declared that HealthCare.gov “has never crashed.”
“It is functional,” she added, “but at a very slow speed and very low reliability, and has continued to function.”
She made that statement even as large screens in the hearing room showed a live shot of the website with a page that said: “The system is down at the moment. We are experiencing technical difficulties and hope to have them resolved soon.”
An appearance on “The Daily Show With Jon Stewart” last October went even worse. Mr. Stewart challenged her to “sign up for Obamacare” before he could download every movie ever made. “We’ll see which happens first,” he joked. She struggled to defend the website and the health care law.
The television appearance prompted headlines like “Kathleen Sebelius’s Daily Show Disaster” and accusations from Republicans that she was being misleading. Democrats squirmed at her stiff and halting performance, which did little to inspire confidence in the website’s performance — or her own.
But Ms. Sebelius has not been at the center of public attention in recent weeks. After the poor public performances, her national television exposure has been limited, but she has continued to make small appearances and has been active on Twitter to press for people to sign up for insurance. She submitted to another grilling before a Senate committee Thursday and later acknowledged that the idea of not doing “a hearing every three weeks sounds pretty good to me.”
The president’s choice of Ms. Burwell to lead the Department of Health and Human Services places a relative outsider at the helm of one of the government’s largest bureaucracies. Ms. Burwell has led the president’s budget office since taking over for Jacob J. Lew, who is now the Treasury secretary.
Ms. Sebelius said she hoped — but did not expect — that her departure would represent the beginning of a more cooperative period in Washington to make health care better.
“If I could take something along with me,” she said, it would be “all the animosity. If that could just leave with me, and we could get to a new chapter, that would be terrific.”
Ted Cruz, Who Said Uninsured Should Just Get Health Care From ERs, Backs Group That Wants ERs To Turn Away Uninsured People
When he was running for office two years ago, Sen. Ted Cruz of Texas insisted that rather than expanding Medicaid, Texas should just let the uninsured get all their health care from emergency rooms. The argument that emergency rooms are an acceptable backup for the uninsured has also been used by Mitt Romney, Heritage Foundation president Jim DeMint and many other prominent Republicans.
But now, some members of the GOP are trying to keep the uninsured from using emergency rooms at all. Georgia Gov. Nathan Deal is pushing Congress to allow hospitals to turn people away from emergency rooms, and Georgia congressman and US Senate candidate Paul Broun – who previously cited ERs to claim that “everyone has access” to health care – has introduced a bill that would allow ERs to treat only patients who they determine have an “emergency medical condition.”
Now, the Madison Project, a Tea Party group that has earned the high-profile backing of Sen. Cruz in its effort to defeat three sitting GOP senators in primaries this year, is also advocating for allowing emergency rooms to turn away anybody not deemed to need immediate emergency care.
In a blog post on the group’s website yesterday, Madison Project policy director Daniel Horowitz writes of taking his son to the emergency room only to encounter a waiting room “full of illegals” (although he doesn’t specify how he knew the citizenship status of his fellow patients), including “adults who, let’s just say, did not look like they were about to keel over.”
My wife and I were entreated to the chaos of emergency room care last night after our two-year-old son slipped while climbing onto a high kitchen counter and banged his head on the floor. He had a massive lump on his forehead and we were concerned about internal bleeding. When we drove to the closest hospital, the waiting room was full of illegals. Most of them were adults who, let’s just say, did not look like they were about to keel over. Opting not to wait all night simply for a decision whether to put our son through a CT scan, we drove for a half hour in the rain to a hospital that was less likely to be full of those who use ERs for regular care.
Thank God our son recovered and there was no internal bleeding, but in a different situation that extra time could have been critical. Also, if you ever wonder why you get hosed with outrageous bills simply for stepping foot in a hospital, look no farther than the “undocumented” costs of illegal aliens.
The solution for this, Horowitz concludes, is to allow hospitals “to turn away people from ERs if they do not have an immediate need for emergency care” thereby “solv[ing] the problem of illegal immigrants using ERs for primary care.”
The problems with illegal immigrants and emergency hospital care also provide us with an opportunity to examine true free market healthcare reform. Any GOP healthcare proposal must be predicated not on “replacing” Obamacare, but on fixing even some of the anti-market federal policies that existed before passage of the monstrosity.
One of those policies is the mandate on hospitals to treat everyone who comes to an ER – including illegal immigrants – irrespective of whether they are suffering from a real emergency. In 1986, Congress passed The Emergency Medical Treatment and Active Labor Act (EMTALA) as part of the Consolidated Omnibus Budget Reconciliation Act (COBRA), which was ostensibly the first act in universal healthcare mandates.
If we ever plan to curb skyrocketing hospital costs and improve access to emergency care, we must address this massive unfunded federal mandate of EMTALA. Among the provisions of Rep. Paul Broun’s Patient Option Act, which is one of the best healthcare reform proposals, are some good reforms of emergency and indigent care. Under Broun’s proposal, hospitals would be allowed to turn away people from ERs if they do not have an immediate need for emergency care. This would solve the problem of illegal immigrants using ERs for primary care.
Could it be that Tea Party leaders like Sen. Cruz never actually thought that emergency rooms were suitable alternatives for the uninsured and were instead just looking for any excuse not to expand insurance coverage?
h/t: Brian Tashman at RWW
The two programs are now a staple of American political culture. But a backward glance at the political environment during their inception reveals equally fierce, ugly antipathy from conservatives — including screaming warnings that they’d be ruinous to freedom.
During the 1935 debate over Social Security, Republicans likened it to slavery and dictatorship.
"Never in the history of the world has any measure been brought here so insidiously designed as to prevent business recovery, to enslave workers and to prevent any possibility of the employers providing work for the people," said Rep. John Taber (R-NY).
"The lash of the dictator will be felt," said Rep. Daniel Reed (R-NY), "and 25 million free American citizens will for the first time submit themselves to a fingerprint test."
Rep. James W. Wadsworth (R-NY) cautioned that passage of Social Security would open the door to a government power “so vast, so powerful as to threaten the integrity of our institutions and to pull the pillars of the temple down upon the heads of our descendants.”
Three decades later, when Medicare was first conceived in the early 1960s, the public was deeply divided, and similar warnings were voiced. Embodying the conservative movement’s sentiments at the time was Ronald Reagan, who taped a recording on behalf of the American Medical Association warning that the program would, quite simply, lead to the destruction of freedom.
"If Medicare passes into law, the consequences will be dire beyond imagining," Reagan said. If opponents failed to scuttle it, he warned, "One of these days you and I are going to spend our sunset years telling our children, and our children’s children, what it once was like in America when men were free."
Republican presidential nominee Barry Goldwater, in 1964, likened Medicare to free vacations and beer. “Having given our pensioners their medical care in kind,” he said, “why not food baskets, why not public housing accommodations, why not vacation resorts, why not a ration of cigarettes for those who smoke and of beer for those who drink?”
Half a century later, Republicans loudly and proudly proclaim their support for both programs, and are loathe to admit their party ever opposed them.
But history repeats itself. In 2010, Democrats passed the Affordable Care Act — the largest expansion of the safety net since Medicare — following a similarly intense debate. Democrats heralded it as a step toward a more humane society, and Republican opponents warned it would pose a grave threat to economic freedom. Unlikely Social Security and Medicare, Obamacare failed to win over even a fraction of Republicans, who were reduced a small, deeply ideological rump in both chambers of Congress after two landslide elections for Democrats.
This week, Obamacare took a leap toward sustainability as it crossed the milestone of 7 million insurance sign-ups. Even as conservative wonks concede that the program is probably here to stay, the residue from the hyper-partisan and polarizing debate lingers, and Republicans remain committed to dismantling it. But if past is prologue, over time as the coverage expansion and benefits fully take effect, the fatalistic warnings will fizzle and Republicans will come to terms with the new health care program.
"In politics, losses always worry people more than abstract future gains entice them. Now, every vote to repeal or eviscerate Obamacare risks offending millions – and the potential to arouse pushback will only grow," argued Theda Skocpol, a Harvard professor, sociologist and liberal author. “This story isn’t like Social Security, where most potential beneficiaries saw few gains for two decades. Affordable Care is already a massive presence in U.S. health care. It cannot be rolled back and those who keep championing that Lost Cause will do so at rising political peril.”
h/t: Sahil Kapur at TPM