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Harry and Louise Now Support Sanders’ Medicare-for-All Plan. With Good Reason.

In the Comments thread today to my post yesterday titled “Clinton Announces When She Will Disclose Her Healthcare Insurance Improvement Plan: She’ll announce it just as soon as the Republican presidential candidates tell us theirs,” reader Urban Legend wrote, as part of a several-paragraph comment:

While a single payer plan is superior in theory — and has been proven in practice — thought should be given to the extreme political danger of offering a program at this time that can and will be painted by Republicans as one that will destroy half a million jobs in many different states. There was more than spite in Joe Lieberman’s objection to the public option. Think Hartford, Connecticut, insurance capital of the country. We would see “Harry and Louise” in spades. (Look it up if you’re too young to remember, and see what happened to Congress in the following election in 1994.)

I responded:

Guys, I’ve pretty much given up on trying to convince Dem baby boomers and silent generationers that it’s no longer the ’80s and ’90s and that the Bernie-is-a-SOCIALIST thing would mean a George McGovern-like trouncing and a Repub sweep in congressional elections. Finally, that argument is no longer being made by the punditry; instead it’s now the reverse: Can Clinton beat Trump, given the public’s now-obvious anti-Koch-brothers-Republican-platform mood.

But I do want to respond to Amateur Socialist’s concerns about Harry and Louise, whom I remember quite well.

The reason for the success of the insurance industry’s anti-Hillarycare ad featuring the young couple Harry and Louise was that the essence of Hillarycare was that it would all-but-force people who had choose-any-doctors-and-hospitals-you-want insurance into HMOs or PPOs that limit the choice of doctors and hospitals to those in a network, sometimes a small network, especially back then, and that sometimes required a referral by a primary care doctor for access to a specialist.

Most people back then had employer-provided insurance that did not have those limitations.  Their insurance was like Medicare—usually like Medicare with a supplemental plan is now.  The problem back then was that there still were tens of millions of people who had no access to insurance, many of them because of preexisting medical conditions, and also that premiums had been skyrocketing. And suddenly many employers were no longer paying the entire premiums.

But of course now, very few employers provide insurance that does not involve healthcare networks.  And very few now pay the full premiums.  And most policies have much larger copayments and much larger deductibles.

These are the really big problems with the ACA’s marketplace plans, too.

And these are the problems that Sanders’ Medicare-for-all proposal would eliminate.  No provider networks, no large copayments, no large deductibles, and affordable premiums.

In other words, Harry and Louise would support the Sanders plan now.

Enough said on that, I would think.

The two paragraphs in Urban Legend’s comment that precede the one I quoted read:

I agree that the Thorpe alleged take-down of Sanders’ single payer proposal is ridiculous. As you say, you can’t expect a candidate to dot every i and cross every t in a broad campaign proposal. The experience of other countries indicates almost certainty that in the long run, everyone would come out ahead with a “Medicare for All” system.

And:

I disagree completely that Clinton has no proposals for healthcare. She has quite specific proposals, including tax credits up to $5000 to reduce co-pays and deductibles (which she says are excessive), efforts to reach 16 million people who are eligible for Medicaid (a single payer plan) but haven’t signed up, and revival of the public option, the primary purpose of which was to make a genuine non-profit, efficient insurance offering available and force insurance costs further downward through direct competition. Whether they are adequate or not is a matter of opinion, but it should not be said that she has no proposals. They are there for everyone with a finger and two seconds to see.

The first of those paragraphs refers to the main point of my post: the sheer silliness of Emory University healthcare economist Kenneth Thorpe’s most recent attempt at a takedown of the Sanders proposal. The second of the paragraphs—well, it’s meaning needs no background.

But it does raise this question: Why has there been no study by mainstream progressive economists about the costs of these proposals of Clintons’, and an explanation of why this would be better than a plan that would, among other things, significantly reduce what are now the very high premiums that employers now pay to private insurers and that employees themselves pay in contributions to the premiums costs and also in copayments and deductibles?

Paul Krugman, maybe?  Nah.

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Clinton Announces When She Will Disclose Her Healthcare Insurance Improvement Plan: She’ll announce it just as soon as the Republican presidential candidates tell us theirs. [Typo in sentence referencing Max Ehrenfreund’s Wonkblog post corrected 3/2 at 2:28 p.m.]

Paul Krugman has been incessantly complaining about some Sanders supporters who accuse him and other high-profile Sanders critics, especially academics, of conflict of interest. The Sanders supporters allege all manner of self-interested reasons for the Sanders animus, much of it (including Krugman’s) expressed with vitriol.

I’m not among the Sanders supporters who subscribe to the academics-who-want-a-position-in-the-Clinton-White-House general theory.  And making that charge against Krugman is ridiculous.  But there is one virulently anti-Sanders healthcare economist who I’m betting is motivated exactly by personal ambition: Emory University’s Kenneth Thorpe.*

Thorpe, a Clinton administration healthcare official, gets his Sanders’-single-payer-critique cred because he worked on the failed Vermont single-payer plan.  Just before it was about to begin being implemented last year, the governor, a supporter of the plan, agreed to kill it because it became clear that its costs would significantly exceed former projections.

Weirdly, the failure of the Vermont plan is used, by Thorpe and others, as evidence that single-payer could not be cost-effective nationally.  As if the tiny state of Vermont has the same contractual bargaining power, regulatory power, medical training funding power, and any other relevant power as the federal government has.

Thorpe recently made big news with a report that deconstructed the Sanders plan as little more than witchcraft in its cost savings and costs overall and in its costs to this or that entity—the federal government, the states, etc.  But in a January 29 response published at Huffington Post, two healthcare economists, David Himmelstein and Steffie Woolhandler—both with credentials at least as impressive as Thorpe’s—deconstructed the Thorpe deconstruction as, well, odd in light of certain facts.  Including several that Thorpe earlier had used.

Not to worry.  Thorpe last week came up with a new headline grabber, this one likely intended to respond to us Sanders supporters who think Sanders would do better in November against Trump than Clinton would.  (Or, it now seems likely, courtesy largely of elderly and middle-aged Southern African-Americans, will.)  It is an issue that this week has become red hot now that Trump is the probable Republican nominee.  And as of this week we Sanders supporters are no longer alone in thinking that Clinton is not quite the perfect candidate to compete against Trump.  According to the NYT, the Clinton campaign itself now shares our concern.

The Washington Post Wonkblog writer Max Ehrenfreund on February 25 summarized Thorpe’s headline grabber thusly:**

Sanders estimates a middle-class family of four would pay an annual premium of $466 under his plan, with no deductible or co-pays. Less affluent households would pay less than that, or nothing at all.

But for at least 72 percent of households enrolled in Medicaid — in which someone is working — the costs of Sanders’s plan would exceed the benefits, according to an analysis by Kenneth Thorpe, a public-health expert at Emory University.

That figure includes 5.7 million households, or 14.5 million people — among them, 4.2 million Hispanic recipients and 2.5 million black recipients. The requirements for eligibility for Medicaid vary widely by state, so that group includes some households living in poverty as well as some that are modestly better off.

How? Well:

“The vast majority of low-income Medicaid workers, who are probably predominantly minority, are going to end up paying more in terms of payroll taxes, and aren’t going to receive really any financial benefits,” said Thorpe, a former Clinton administration health official.

Many lower-income people are already insured or eligible for insurance under Medicaid, at least in the states that expanded the program under President Obama’s health-care reform. Many Medicaid beneficiaries also work, and those workers’ wages would likely decline due to the additional 6.2 percent payroll tax the proposal would levy on their employers.

The lengthy blog post is titled “Study: Bernie Sanders’s health plan is actually kind of a train wreck for the poor.”

That, presumably, is because of course Sanders could not, or at least would not, tweak the plan to remove the payroll tax for people who qualify for Medicaid under current federal law.  Because although the ACA is a very complex and very lengthy statute that took a year of drafting and amending to finalize, Sanders surely has thought of every possible issue and when that one came up he simply said, “Too bad.”

Sort of like Hillary Clinton, who regularly professes plans to build on Obamacare and move toward universal coverage for all—$10,000 deductibles?  No prob.—but who never hints at what her building plans are, and, curiously, is never asked.  Not by the likes of Thorpe or Krugman.  And not by the likes of anyone else I know of.

But she’s definitely working on a plan for that move-toward-universal-coverage thing, and, as with the release of the transcripts of her highly-compensated speeches to large finance-industry and other big-corporate players, she’ll give us a hint about how she plans to do that the very minute after the Republican presidential candidates outline their plans to move toward universal healthcare coverage.

Or instead, she could refer us to Thorpe.  Since he will again be a healthcare official in the Clinton administration.

*This entire paragraph was inadvertently deleted before the post was published. So now it’s back.  And the post makes sense!

____

UPDATE:  Reader J.Goodwin and I just exchanged these comments in the Comments thread:

J.Goodwin

March 1, 2016 6:08 pm

Is there a reason we should anticipate that it would be significantly different than the Health Security Act?

I.e. larger federal subsidies and a stronger employer mandate than the ACA?

 

Me

March 1, 2016 6:54 pm

I think it wouldn’t be anything at all, J.Goodwin. I think it’s outrageous of her to keep saying generically that she wants to build on the ACA without saying what she wants to do, yet criticize Sanders for his plan.

And I think it’s outrageous of the Hillary shillary economists brigade–Thorpe, but Krugman too, and probably others–for not mentioning that she has said nothing at all about what she has in mind, yet keeps saying she has, well, something in mind.

Then again, I don’t know why Sanders hasn’t pointed out that she’s taking a page out of the Republican playbook: just keep saying you plan to do something about the uninsured; just don’t say what that is.

Added 3/1 at 6:59 p.m.

_____

**Sentence edited and separated from preceding paragraph, to make sense. 3/2 at 2:19 p.m.

Gotta tell ya, Microsoft updated its Office 365 last week, and since then I’ve had nothing but big problems trying to write anything using Word.  With this post, two main parts were just missing from the post by the time I pasted it into AB’s new-post function. There was the mysteriously deleted paragraph that I reinserted last night, and there was a sentence between this now-edited one and the preceding paragraph, and they were two separate paragraphs, as they are now.

This post is not the only thing that the Word update has made very hard for me to write.  I am not happy about this, and do not look forward to calling Microsoft and having them FIX THE SETTINGS SO THAT I CAN USE WORD AGAIN.

Okay. Rant done.  Now back to trashing pols and economists.

I’m very grateful to Yves Smith for reposting this post at Naked Capitalism this morning, and I’ve now posted the following comment to the repost there:

POST SHOULD READ:

“… Not to worry.  Thorpe last week came up with a new headline grabber, this one likely intended to respond to us Sanders supporters who think Sanders would do better in November against Trump than Clinton would.  (Or, it now seems likely, courtesy largely of elderly and middle-aged Southern African-Americans, will.)  It is an issue that this week has become red hot now that Trump is the probable Republican nominee.  And as of this week we Sanders supporters are no longer alone in thinking that Clinton is not quite the perfect candidate to compete against Trump.  According to the NYT, the Clinton campaign itself now shares our concern.

“The Washington Post Wonkblog writer Max Ehrenfreund on February 25 summarized Thorpe’s headline grabber thusly:”

I just corrected the original post at Angry Bear and added a note at the bottom raging about Microsoft’s update to Office 365 that has caused big, big problems for me in drafting anything in Word.  In this case it mysteriously deleted an entire paragraph, which I reinserted last night, and also a sentence that had prefaced the one mentioning Ehrenfreund’s blog post and making clear that his post was about Thorpe’s latest attempt to take down Sanders’ healthcare plan, not about the Clinton campaign’s concerns about the strength of Trump’s candidacy and problems with her own.

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Horses, Carts, and the Order in Which They Belong

Democrats should take continued GOP opposition to Obamacare very seriously. It has serious real-world consequences. As long as states hold out against the Medicaid expansion, it could slow the law’s efforts to realize its goal of expanding coverage. One thing this means is that Democrats should redouble their efforts to regain electoral ground on the level of the states, where future decisions about the Medicaid expansion will be made.

— Morning Plum: GOP won’t give up fight against Obamacare. Dems should take that seriously., Greg Sargent, Washington Post, today

I should have known by now that neither Democratic politicians, nor their political consultants, nor virtually any progressive pundits will ever consider the possibility that it puts the cart before the horse to try to regain electoral ground on the level of the states through some generic campaign that doesn’t the issue of the Medicaid expansion—so that, once in office, the Dems can enact the Medicaid expansion.

But, no, I had thought that the one plus in the months-long concern about the outcome of King v. Burwell—which indicated the political disaster that a win for their side would cause the Republicans (they were seriously panicking)—was that the Dems and progressive pundits would recognize, finally, that providing access to healthcare for those who otherwise have no access to it is popular.  Especially, it turns out, among the beneficiaries and potential beneficiaries.  And that campaigning on the issue increases the chance of winning.

But I should have recognized that once pols, consultants, and pundits get locked into a mindset about something, nothing will jar them loose from it.  Nothing.  Ever.

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In its ACA opinion today, the Court significantly narrowed its “Chevron-deference” doctrine. I’m glad. Even despite the immediate repercussions for EPA authority.

[T]oday’s victory may have been even more decisive than it looks at first glance.

It isn’t just that the Court ruled six-to-three in favor of the government’s position, with John Roberts and Anthony Kennedy joining the Court’s liberals in support of a single, non-splintered decision, though that’s important.

It’s also that Roberts’ opinion may have precluded any future efforts by a Republican president to use executive discretion to cancel the subsidies for the millions of people on the federal exchange. [Italics in original.] This option might have been left open if the ruling had been written differently.

A decisive win for Obamacare, Greg Sargent, Washington Post, today

Indeed.

The Court issued opinions in two of its seven remaining cases this morning, in this one, King v. Burwell, is in my opinion the lesser-significant of the two.  Texas Department of Housing and Community Affairs v. Inclusive Communities Project, in which the Court, ruling 5-4, upheld as both intended by the Fair Housing Act and within permissible constitutional bounds the right to invoke that Act to challenge government agency and private business actions that, while not overtly racially discriminatory, plainly have a discriminatory effect.  It is a tremendously important opinion, even beyond the housing issue.  And no slouch in the significance department is another 5-4 opinion issued this week, Kingsley v. Hendrickson, that began, finally, the process of limiting what has been the tacitly unfettered authority of prison guards to brutalize both pretrial detainees and post-conviction inmates—although the dissents in that opinion deserve their own post, and soon will get one.

But the far-reaching importance of the King opinion today, authored by Roberts, is in its choice to interpret the statute directly as providing for the subsidies irrespective of whether a state had designed and runs its own insurance exchange or instead defaults to the option by which the federal government created and runs the state’s exchange.  The government had argued both that that was the clear intent of the statute in providing for the default (the backup) option, and, alternatively, that under a Court-created doctrine known as “Chevron deference,” courts are required to give deference to the statutorily designated federal agency—here, HHS—in the agency’s reasonable interpretation of an ambiguous provision in the statute.

The Chevron-deference option would have enabled a later White House administration’s HHS to interpret the statutory language at issue—“an Exchange established by the State”—as the King plaintiffs claimed: Tax credits are available only in states in which the Exchange was set up and is run by the state, not an Exchange set up and run for the state by the federal government.

The Chevron-deference doctrine was created in a 1984 Supreme Court opinion, Chevron U.S.A., Inc. v. Natural Resources Defense Council, Inc., mainly for the purpose of allowing Reagan’s regulatory agency chiefs to orchestrate the industry capture of the respective regulatory agency charged with regulating the capturing industry.  Federal laws that create regulatory agencies provide that the agency itself will design regulations addressing specifics, in order to give effect to the broad design and mandates of the Act that establishes the agency.  The EPA was the original target of the Chevron doctrine, and is still the most common, I believe, but obviously the doctrine comes in handy in undermining regulations regulating the financial industry, the pharmaceutical industry, employee safety, and, well … you get the idea.

The doctrine’s stated premise is a clearly sensible one: that the very purpose of creating a regulatory agency is to have a permanent body of experts in the relevant fields employ their expertise to study the science, the technology, the methodology, and promulgate regulatory mandates and parameters that give effect to Congress’s purpose in enacting the statute and creating the regulatory agency.  But the extreme deference that the Chevron doctrine has appeared to accord to the agencies has, rather than served to effectuate congressional regulatory purposes in enacting the statutes that come within the regulatory jurisdiction of the relevant agency—the Clean Air Act vis-à-vis the EPA, for example—turned control of these agencies into political footballs.

Which was fine with the conservative justices, as long as the White House was in Republican hands.  But nearly seven years into the Obama administration, they’ve had enough, and have begun to make noises indicating a change of heart on Chevron.  They want to rein it in.  Two of them, joined by the four Democratic justices, took the first step toward that today, in King. And tomorrow, it is widely expected, in a case called Michigan v. Environmental Protection Agency, the five Republican justices will take a second, broader, and direct step, in an opinion that will strike down as beyond its authority under the Clean Air Act the current EPA’s interpretation of that statute as permitting it to regulate the release of mercury into the air by power plants.

And as a longstanding critic of the Chevron-deference doctrine, I’m thrilled with the Chevron implications of King.  As someone who’s not fond of the effects of mercury on the health of anyone or anything who breathes, though, I won’t welcome the substantive result in tomorrow’s opinion. But I hope, and think, that the issue of statutory regulation of power plants will become a somewhat potent issue in next year’s national elections.

What won’t be a national issue in next year’s elections, federal and state, are tax credits for subsidies for healthcare premiums under the ACA.  Which is precisely why Roberts and Kennedy decided that King must be decided as it was decided today.  Last March, after the argument in the case, I predicted exactly correctly what would happen, and why—and have never looked back, instead rolling my eyes at all the continued handwringing of liberal pundits so worried about the case’s outcome.

I pointed out back then that Roberts, for all his desire to fully, thoroughly, complete the circa 1980s Conservative Legal Movement’s takeover of American law, point by point by point, wants first and foremost, always—always—to provide every possible assist to Republican candidates for federal and state elective office.  Once it became clear, as it already had by the time King was argued at the Court, that a victory for the plaintiffs would spell electoral disaster for Republicans for federal and state office next year, Roberts’ vote, and the outcome of the case, was clear as well.

Tomorrow, in addition to the predictable ruling in the EPA/mercury-emissions case, and in addition to a declaration of a constitutional right to same-sex marriage—another 5-4 ruling, in Obergefell v. Hodges—the Court will issue an opinion in Arizona State Legislature v. Arizona Independent Redistricting Commission, a case that could directly implicate continued Republican control of the House of Representatives.  So the only question is, which way will Kennedy vote—and most people expect that he will vote Republican.

Which is to say, most people think he’ll make up the fifth vote to strike down as unconstitutional an amendment to Arizona’s state constitution, passed by the state’s voters in 2000, that removed the legislature’s authority to draw boundaries for federal congressional districts away and placed that authority with an independent redistricting commission.  The legislature is challenging the amendment’s constitutionality under the Elections Clause, which states: “Times, Places and Manner of holding Elections for . . . Representatives, shall be prescribed in each State by the Legislature thereof.”  (Scotusblog notes that California has a similar setup.)

Obviously, since state legislative gross gerrymandering is largely responsible for Republican control of the House, presumably until after the next census in 2020, the Republican justices don’t want to invite, say, Pennsylvania voters to push through something similar in a voter referendum, reversing the extreme gerrymandering there by the Republican-controlled legislature in 2011. That includes Kennedy.  But Kennedy authored Citizens United and reportedly was the one who encouraged his cohorts to take on issues that had not been raised in the case, in order to destroy the McCain-Feingold law, and he’s been on the extreme defense about it ever since.  He could see this as some sort opportunity to regain some semblance of credibility on the nonpartisan front.  I mean, you never know.

Okay, you probably do know.  It won’t happen. The CW will prove right.

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Dear Greg Sargent: YOU may not know what Scalia and Alito were up to yesterday. But I do.*

The chief justice said almost nothing.

Supreme Court Appears Sharply Split in Case on Health Law, Adam Liptak, New York Times

Okay, so how well did my predictions from three days ago hold up at the argument yesterday* in King v. Burwell?

Well, I got the outcome right, but not the particulars of how it will occur.  By saying almost nothing, Roberts said everything you need to know: The ACA will remain undisturbed.  He will join with the four Dem justices in an opinion that simply invokes standard statutory-interpretation methods that the Court employs when, say, it’s the Tea Party whose interests that long-established mechanism serves. In, y’know, garbage statutes. There’s no way—seriously; there really is no way—that Roberts would sit through 80 minutes of argument, in this of all cases, almost completely silently, if he intended to vote to interpret the four-word phrase at issue as the statute’s challengers ask.

Roberts will leave Kennedy to his federalism obsession—his bizarre the-Civil-War-and-the-Reconstruction-amendments-are-figments-of-the-political-left’s-imagination claims. (Roberts shares this view, but only as a means to specific Conservative Legal Movement ends, such as nullifying the Voting Rights Acts.)  Sure, the majority opinion will invoke the fancy the-federal-government-can’t-coerce-the-states-not-even-by-subterfuge federalism ground tailored specially for Kennedy.  But it will do so only to undermine the challengers’ belated switch argument: that Congress intended that the subsidies be available only in states that had set up and run their own websites, and that the purpose of the provision in the ACA that provided that the federal government would set up and run websites for individual state healthcare markets in states that do not set up and run their own was to mislead the states about the effect of a failure by the state to set up and operate its own website. (Congress knows better than to try that kind of thing and think it could get away with it! Unless, of course, it knew it wouldn’t get away with it.)  Originally, the challengers had argued that the four-word phrase at issue was an inadvertent error.

Congress’s clever ruse was predictably effective, since, as Kagan, Sotomayor, Ginsburg and Breyer noted, the federally run websites would have no products available and no customers, so the state legislators who bought the head fake weren’t really all that gullible in not catching on.

Then again, as Dahlia Lithwick reported, Scalia commented to Solicitor General Donald Verrilli: “How can the federal government establish a state exchange. That is gobbledygook.”  Which surely it is, since although each state has its own separate insurance market under the ACA, available only to residents of the respective state, the ones set up and run by the federal government were intended to have no actual insurance policies available, or customers to buy policies even if one or two policies should happen to pop up on one of those non-state exchanges.  And Scalia—no fool, he—does now recognize that that could undermine the challenger’s Plan B argument that Congress gamed this all out and decided to lull the states into a false sense that they could default to the federal government the setup and operation of the exchanges, with no ill effects.  Pun intended.  So Scalia needed a Plan B to save Plan B as something he could assert in his dissent.

But Scalia’s pointing this out wasn’t really the main gist of what he was up to yesterday. What he really was up to was having his cake and eating it too. He apparently waited until it was becoming clear that Roberts and Kennedy would do the heavy lifting for him and Thomas and Alito, and then largely reverted to his November 2014 garbage-statutes position—that is, to his pre-January 21, pre-Fair Housing Act case argument comments about how the Court normally interprets complex, multi-section federal statutes that intend to establish a coherent policy.

Well, inadvertent garbage, or instead advertent garbage; whatever. Either scenario works in this silly save-us-from-ourselves-please-while-we-protest-too-much kabuki act.  Just as Sens. Orrin Hatch, Lamar Alexander, and John Barrasso indicated in a Washington Post op-ed published last Sunday that was unabashedly directed to Roberts, Kennedy and Scalia.

Specifically, this trio opened its message with:

Wednesday, the Supreme Court will hear oral arguments about whether the Obama administration used the IRS to deliver health insurance subsidies to Americans in violation of the law. Millions of Americans may lose these subsidies if the court finds that the administration acted illegally. If that occurs, Republicans have a plan to protect Americans harmed by the administration’s actions.

Oh, okay. Republicans have a plan to protect Americans harmed by the administration’s actions that for the last year are providing them with healthcare, by enabling them to continue to have the healthcare insurance that is harming them.  In other words: Please, Supreme Court, save our party’s election chances in 2016, just as we quietly asked you a couple of months back, Antonin Scalia, to do.  But since it takes only one of you to do this for us, the rest of you don’t have to participate.  One sacrificial lamb is all that’s necessary.  The rest of you, write a dissent along the lines of … well, I’ll let Greg Sargent explain:

At oral arguments before the Supreme Court yesterday, two of the conservative justices — Samuel Alito and Antonin Scalia — both floated versions of the idea that, if the Court does strike down Obamacare subsidies in three dozen states, it might not be that big a deal, because surely lawmakers would then fix the problem and avert disruptions for millions.

This had more significance than it first appeared.

Here are the key quotes. After Solicitor General Donald Verrilli claimed that a Court decision against the law would cut off subsidies “immediately,” producing “very significant, very adverse effects” for “millions of people,” Alito suggested that the Court could side with the challengers but delay the ruling “until the end of this tax year.”

That would mean people would not abruptly lose their subsidies; the suggestion was that if the Court did this, the disruptions might not be immediate, and perhaps somehow contingency plans could come together to soften the blow for those millions of people. Verrilli suggested the Court might have this authority, but disputed whether doing this would actually make much of a difference in practice, because many of the states would be unable to set up exchanges — keeping the subsidies flowing — by the end of the year.

Whereupon this happened:

JUSTICE SCALIA: What about Congress? You really think Congress is just going to sit there while all of these disastrous consequences ensue. I mean, how often have we come out with a decision such as the — you know, the bankruptcy court decision? Congress adjusts, enacts a statute that takes care of the problem. It happens all the time. Why is that not going to happen here?

GENERAL VERRILLI: Well, this Congress, Your Honor, I — I –

[Laughter.]

That was indeed a richly comic moment! But it was also very significant. The conservative Justices implicitly suggested that the consequences of ruling with the challengers — which Scalia himself termed “disastrous,” though there may have been a hint of sarcasm there — are in fact weighing on the Court, and they themselves floated the idea that a legislative fix might mitigate those consequences.

Sargent goes on to say:

I don’t pretend to know for certain what motivated the conservative justices to say this stuff. But here’s a guess: The idea that a legislative solution might soften the disruptions could make it easier for Anthony Kennedy (who appeared torn over federalism concerns, particularly in light of the punishment that might be inflicted on states) and/or John Roberts (who seemed at least open to the idea that Chevron deference should be accorded to the government) to rule with the challengers.

Okay, well, unlike Sargent, I do pretend to know for certain what motivated the conservative justices to say this stuff.  Or at least what motivated Scalia.  He just enjoys cake.  It’s his favorite dessert.  Despite all those calories.  Especially when he has the cake and eats it too.

Kennedy will join the majority’s ruling only in its bottom line: the ACA survives in its current interpretation.  He’ll write a concurring opinion explaining that this is a necessary outcome, in order to avoid so offending the sovereign dignity of 36 states that, in self-defense, they would enter into a military treaty with Russia and attack Washington using an allied force comprised of the Armed Forces of the Russian Federation and the states’ national guard units.  Which itself would violate the Constitution’s design because it obviously would have the effect of coercing the states into increasing their own military budgets significantly.

But Kennedy’s concurrence will be a sideshow.

Laughter.  Applause.  Curtain.

—-

*Typo-corrected to reflect the day that the post was posted (Thursday), rather than the day when I began writing it, which was Wednesday, the day of the argument. The post also has been edited slightly (and typo-corrected elsewhere) for clarity.

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How the Supreme Court’s King v. Burwell Debacle Will End [Addendum added]

I have known for the last five weeks—since January 27, to be exact—that the Supreme Court will uphold the Administration’s interpretation of the federal-subsidies provisions in the ACA when it issues its decision in the infamous King v. Burwell case whose argument date at the Court is Wednesday.  I also have known since then that the opinion will be unanimous, or nearly so, and that Antonin Scalia is likely to write it but if not will join it.

I considered revealing this to AB readers earlier, but feared an F.B.I. inquiry into suspicions that I hacked into the computer system in Scalia’s chambers, so I hesitated.  But it’s now or never—Scalia will make his position clear at the argument, and then I will have lost my one chance, ever, for a career as a Vegas oddsmaker—and I think I can persuade the F.B.I. that I received my information not illegally but instead from a report recounting extensive, pointed comments Scalia made in open court on January 21, in a case that is not about the ACA but is, like King, about the methods the Court uses to interpret lengthy, highly complex federal statutes with multiple interconnecting sections and subsections whose purpose is to establish a cohesive policy.

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Cynthia Lummis’s (Stunningly) Glib Fraud: A Follow-Up

Cynthia Lummis, a wealthy Republican House member from Wyoming, claims her husband passed away, thanks in part to Obamacare. Lummis cited the law as a major contributing factor to her husband’s demise. Instead of blaming her husband, who could easily have afforded the test (who elected to skip the necessary diagnostic), she blames the best thing to happen to millions of low income Americans, Obamacare.

From Addicting Info:

Cynthia Lummis is actually among one of the richest members of Congress. In 2007-2008, Representative Lummis’ financial disclosure forms reported a net worth between $20 million and $75 million… Obamacare wasn’t designed for people who have $20-$75 million. It was passed so the rest of us, who are either self-employed or have no access to insurance, can afford health care. It’s not the fault of the law that Lummis’s husband chose not to get a potentially life saving test – if he chose not to get the test.

Steve Doocy was desperately trying to dramatize her ‘poignant’ moment during these ridiculous hearings based on a pompous MIT economics professor speaking candidly. Lummis would not take the bait and blame her husband’s death entirely on the healthcare law. But she was willing to attribute a likely mistake in coverage to the passing of her husband. She believes men in general are easily dissuaded from seeking medical care, so any little glitch or problem will convince them to discount medical advice.

It’s truly disingenuous to blame a death on a law which is reliant on the insurance marketplace, as we all know insurance companies aren’t exactly cooperative and committed to the well-being of their customers. They are, like Republicans, only interested in financial gain and not human lives. Her husband’s choices and consequences should not deny insurance to the millions of poor people who finally have access to medical care. But they sure as hell will try their best to perpetuate the Republican Cult of Death and take away as much as they can from poor and needy Americans.

Cynthia Lummis Lies And Blames Obamacare For Her Husband’s Death, Crooks and Liars, yesterday

 

I can’t figure out which is worse. That this woman dragged her dead husband into this witch hunt to make a political point, or that she is so stupid to not realize that her story makes no sense.

And [Washington Post political blogger Nia-Malika] Henderson really needs to get a clue.

— EMichael, comment this morning to my post yesterday titled “Cynthia Lummis’s (Stunningly) Glib Fraud

The one thing I wish Crooks and Liars had added to that post was that Lummis mentioned that her husband was 65 years old.  He therefore was on Medicare–although Lummis failed to say that.* 

Indeed, that may well have been what caused the confusion when he sent in his claim to “Obamacare”; he turned 65 last January, and this might have been his first use of Medicare, and that might have someow complicated the matter.  But in any event the cost at issue would have been the difference between what Medicare paid for the various tests he had, and would have paid for the test he did not have, and the portion of the remainder of the charges that the “Obamacare” plan that Lummis and her husband purchased was supposed to pay for as Medicare supplement coverage.

Lummis is trying to get away with murder here—the murder of others.  I really, really would like to see one of the high-profile fact-checker blogs inquire into why Lummis was effectively claiming that “Obamacare” negated her husband’s access to Medicare coverage.  Nor was her husband even required under the ACA to have insurance beyond just Medicare, although of course the additional coverage was free, courtesy of his wife’s employment with the federal government.

Might the Washington Post’s own Fact Checker, Glenn Kessler, be interested in pointing this out?

But the Cooks and Liars highlights a critical point: that the ACA is reliant on the insurance marketplace, and, as we all know, insurance companies aren’t exactly cooperative and committed to the well-being of their customers.  Thus the problems—of the sort that Lummis complained of and of the sort that virtually everyone else who complains about it, complains about.

Such as Catherine Keefe, whose op-ed published yesterday in the Washington Post, is titled “I’m an Obama supporter. But Obamacare has hurt my family.” The subtitle is “Obamacare has been far more frustrating than I’d ever dreamed.”  Chances are, I’d say, excellent that Keefe wrote the subtitle but not the title, since the subtitle accurately summarizes her piece but the title does not.

What Keefe’s complaint, like most other accurately stated complaints about the ACA are really complaints about this country’s for-profit, market-based healthcare insurance industry.  So were Lummis’s.  Keefe’s only actual harm from the ACA itself, as opposed to harm from the obnoxious insurance-industry-created provider-networks system—a factor now in most employer-based insurance coverage, although that’s rarely mentioned in the media—is that as a 56-year-old woman (her husband is 59), she should not have to purchase a plan that includes children’s dental coverage and maternity care.  Point taken, but that would be an easy fix.  (Missing from her article is mention of two benefits from the ACA that may matter to her husband: no annual nor lifetime coverage cap.  She does, though, note her gratitude for the ACA’s having ended the pre-existing-conditions thing, a big factor for husband, especially, but also for her.)

As for Lummis, what she’s really complaining about is that, thanks to an amendment offered by Sen. Charles Grassley (R. IA) to the original ACA bill as it was being debated in Congress, members of Congress and their staffs no longer are covered by the federal government’s famously generous and user-friendly healthcare coverage. They now must, like regular folk, deal with the for-profit, market-based healthcare insurance industry that she and her ideological cohorts claim to hold in such high esteem.

As I read Keefe’s op-ed yesterday, what struck me is how very ready huge swaths of the public are for Medicare-for-all. And how thoroughly clueless most politicians, political operatives and pundits are that this is so.  Lummis’s husband needed simply to schedule that final test and present his Medicare card when he arrived at the medical facility.  And that’s how simple and direct such things should be for everyone. Including the spouses of people whose financial assets don’t range between $20 million and $75 million.

—-

*Post edited slightly to clarify that while Lummis mentioned her husband’s age, she failed to note that he had Medicare coverage–a key point I made in my earlier post.  12/11 at 1:07 p.m.

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Cynthia Lummis’s (Stunningly) Glib Fraud

The big news story of the last 24 hours, of course, is the Senate Intelligence Committee’s sickening torture report.  But you might also have heard about Wyo. Rep. Cynthia Lummis’s dramatic statement yesterday as a member of Darrell Issa’s Committee on Oversight and Government Reform’s Jonathan Gruber/Marilyn Tavenner Obamacare hearing.

The purpose of the hearing was, naturally … well, you know.  But something surprising did happen at the hearing.  In short, Lummis, the chairwoman of the Republican Study Committee’s Obamacare-repeal subcommittee, claimed that her 65-year-old Medicare-eligible husband failed to get a physician-recommended medical test to diagnose the cause of his chest pains because he was told incorrectly that he and his wife “were not covered by Obamacare”.

Even if you did hear about this, you might have missed Washington Post political blogger Nia-Malika Henderson’s precious take on it as “the most moving moment of the Gruber hearing.”:

Jonathan Gruber, the MIT economist who said that the stupidity of the American public played a major role in the passage of the  Affordable Care Act, came to Capitol Hill on Tuesday to be verbally flogged by members of Congress. Amid the predictable litany of “stupid” references, Wyoming Republican Rep. Cynthia Lummis (R-Wyo.) provided a poignant moment. Here’s what she said:

“On October 24, the week before election, my husband went to sleep and never woke up. He had a massive heart attack in his sleep at age 65.  A perfectly, by all accounts, healthy man. Come to find out, in a conversation with his physician after he died, he chose not to have one of the tests, the last tests, his doctor told him to have. This happened to coincide with the time that we were told that we were not covered by Obamacare. I’m not telling you that my husband died because of Obamacare.  He died because he had a massive heart attack in his sleep.

Lummis’s husband was Alvin Wiederspahn, a former Democratic state legislator and a lawyer and rancher. They married in 1983. When he died, Lummis released this statement, which mentions the couple’s only child: ‘Last night, my husband, Al, passed away peacefully in his sleep in our home in Cheyenne. Annaliese and I know that God has taken Al home to heaven, but right now our hearts are broken.’

“Her statement about her husband in the Gruber hearing wasn’t so much a question as much as it was a raw accusation about the Affordable Care Act, a statement she ended by asking for some compassion. ‘I want to suggest that regardless of what happened to me personally, that there have been so many glitches in the passage and implementation of Obamacare that have real-life consequences on peoples’ lives,’ she said, almost choking up. ‘The so-called glibness that has been referenced today has direct consequences for real American people. So get over your damn glibness.’”

“Centers for Medicare and Medicaid Services Administrator Marilyn Tavenner tried to offer Lummis some sympathy, but was cut off by outgoing chairman Darrell Issa (R-Calif.)”

Hearings like this are always political.  But they don’t usually offer such deeply-felt personal stories from lawmakers.

Apparently, it didn’t occur to Henderson, nor for that matter to Tavenner, to mention that Lummis’ husband surely was covered by Medicare.  For the record, Mr. Wiederspahn, according to his own Wikipedia page, was born on January 18, 1949, so he turned 65 a full 10 months before his death.

Also for the record, Lummis and her husband had a net worth of between $20 million and $75 million, including three Wyoming ranches.  Although Mr. Wiederspahn himself came from a prominent Cheyenne family and was a successful lawyer, the couple, who met when they were young across-the-political-aisle colleagues in the state legislature, inherited most of their extensive wealth from Lummis’s family.

Lummis said at that hearing that her husband had had several routine heart-health tests, presumably months or at least weeks before he died, and had submitted payment claims to “Obamacare,” but was told, erroneously, by “Obamacare” that the two of them were not were not covered, even though they had purchased a plan through the DC exchange website.  She said he resubmitted the bills and was told again that he and his wife weren’t covered.  But he was covered primarily by Medicare. And of course he knew that. Lummis didn’t mention that, but she did say that he had been having chest pains yet declined to have that final diagnostic test.

Lummis ran unsuccessfully in September to chair the Republican Study Committee, and she heads its legislative-repeal subcommittee. Her story was not a deeply-felt personal one but instead a deeply-felt ideological one.  The chance is nil that her husband delayed getting that final diagnostic test for fear that he might have to pay out-of-pocket some relatively small portion of the cost for the test–the portion that Medicare would not pay. Or that he thought the insurance error would not be corrected.

Her claim is a fraud.  Call her the “‘Jackie’, the-University-of-Virginia-fraternity-gang-rape-victim” of the Obamacare-horror-story crowd.  By which I mean that, theoretically at least, her fabrication in order to try to serve her cause may prove to have the opposite effect.  But only if the news media reports the credibility issues.  And because this is not about sex but instead about Obamacare, the news media probably won’t.

And, no, I’m not being glib.  Lives indeed are at stake.

And while it may be unfair to analogize Henderson to Rolling Stone journalist Sabrina Rubin Erdely, the author of the infamous UVa-fraternity-gang-rape article—Henderson, after all, was just extemporaneously reacting to what she had just seen on CSPAN, not writing an ostensibly extensively-investigated in-depth news article—I’ll draw the analogy anyway, albeit while noting that important distinction.

But Henderson certainly is correct on her last point: Congressional hearings don’t usually offer such deeply-felt personal stories—real ones or fake ones—from lawmakers. Nor, of course, was this lawmaker actually testifying.  Not under oath, anyway.

But to Henderson’s observation, I’ll add one of my own: There has, at least to my knowledge, never been a House or Senate hearing at which, say, a surviving spouse of someone who died because of lack of access to diagnostic tests or to treatment because of the family could not afford healthcare insurance on the private market on the pair’s minimum-wage jobs, or because the spouse had a pre-existing condition detailed this.  Nor, to my knowledge, has there been testimony by a witness who alone or along with a spouse filed for bankruptcy, or completed lifelong savings and retirement accounts, because of huge and possibly ongoing medical bills that far exceeded the pre-Obamacare annual benefit cap on the family’s Blue Cross plan.

For that matter, there has been no Congressional-hearing testimony by people who will lose access to healthcare insurance if Antonin Scalia brings along with him next spring the votes of four other justices to interpret the ACA as containing an antidisestablishmentarian clause that bars insurance-premium subsidies under that statute in states that have allowed the federal government to set up and run their state’s insurance exchange website, as per the ACA, rather than set one up and run it itself.  During a little-publicized private speech to the Appellate Judges Education Institute Summit last month, Scalia decided to tamp down public speculation that in the ACA cases, King v. Burwell and Halbig v. Burwell, he might adhere to the rule of statutory construction that he announced for the Court last June in a ruling favoring a who’s-who cadre of anti-environmental-regulations Republican campaign finance benefactors, and against the EPA.  Scalia reportedly told his audience that judges don’t have the power to interpret “garbage” statutes enacted by Congress to avoid an undesired outcome. (Scalia and four of his colleagues do believe, however, as they demonstrate regularly these days, that they have the power to interpret non-garbage statutes and statutory procedural rules as garbage statutes, but apparently he didn’t mention that in his speech.)

And there has been no Congressional testimony by anyone who, notwithstanding a very moderate annual income ($11,670 to $29,175 a year for an individual), this year has enjoyed excellent healthcare insurance through an ACA provision that has remained almost secret because it requires a separate budget appropriation that the Republicans have blocked. HHS has used funds appropriated for the tax subsidies to fund the program this year, but the professional-anti-Obamacare-litigation industrial complex is challenging the legality of this in the courts.  New York Times healthcare reporter Robert Pear explained on November 29:

In mounting the latest court challenge to the Affordable Care Act, House Republicans are focusing on a little­-noticed provision of the law that offers financial assistance to low­ and moderate­ income people.

Under this part of the law, insurance companies must reduce copayments, deductibles and other out-­of­pocket costs for some people in health plans purchased through the new public insurance exchanges. The federal government reimburses insurers for the “cost-­sharing reductions.”

Nor has there been Congressional testimony by anyone who is deeply grateful for the dramatic slowing of the decades-long virulently-rising annual increase in healthcare insurance costs for private-employer-based insurance, although surely there are many, many millions who are.

I want to suggest that regardless of what happened to Lummis personally, that although there have been so many glitches in the passage and implementation of Obamacare, the actual real-life consequences of Obamacare on peoples’ lives are that it mitigates to some extent but by no means fully the profoundly harsh and quite-often deadly American healthcare-access/healthcare-coverage system, and that Lummis is fraudulently invoking her husband’s untimely death in the service of trying to strip millions of spouses, parents, and children of their newfound, very-long-in-coming access to diagnostic tests, treatments, and preventative medical care.  That—unlike her false indictment of the ACA in her husband’s death—is a fact.

Lummis’s husband, whether or not he remained a Democrat throughout his life, did remain someone whose heart was in the right place.  He reportedly played a large role in obtaining financial support for Cheyenne’s largest homeless shelter.  His widow should have let him rest in peace, rather than glibly invoking his death in a cause whose purpose is to deny access to healthcare insurance to massive numbers of people.  His widow’s glibness was intended to have direct consequences for real American people, of exactly the sort that her husband (who surely knew that at the least he was covered by Medicare) did not face.  It is not Gruber, but Lummis, whose glibness will kill, as is its intention.

Yes, Henderson really did title her blog post “This was the most moving moment of the Gruber hearing.”  Once Obamacare has been repealed root-and branch, as Mitch McConnell has vowed, or just branch-but-not root, by the Supreme Court, as Scalia is hinting, there will be many possible moving moments, superficially similar but substantively different than Lummis’s, although of course not by lawmakers.  There still is a difference between staged theater and real life; at least I think so.  So I suppose we’ve seen the last of the moving moments, at Congressional hearings, concerning spousal deaths due to lack of health insurance coverage.

Lummis surely mourns her husband.  Deeply.  But she also made him her unwitting stage prop yesterday.

 

 

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Not quite EVERY national indicator, Ms. Grimes

“He thinks that another six years on top of the 30 he’s already had constitutes change, well we don’t buy that,” Grimes said. “He thinks that we can’t live without his seniority, well has he seen that we’re at the bottom of every national indicator that’s out there? Henderson, are ya’ll better off after having Mitch McConnell for the last 30 years?”

“No!” roared the crowd of more than 150.

Kentucky Democrat Tears Up on Campaign Trail, Jay Newton-Small, Time.com, reporting yesterday from Henderson, Ky

Actually, there’s one important national indicator that Kentucky is no longer at the bottom of: the percentage of residents who have no healthcare insurance. That’s because of Kynect and the Medicaid expansion, under the ACA.  Y’know, under Obamacare. Paid for 100% by the federal government.

Shhhhh.

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