The Doctor Is In

The Supreme Court ruled this past week that the Affordable Care Act can stand without the penalty that the Republicans repealed, as the law as it now reads in not unconstitutional.  

It seems that when Congress got rid of the penalty, it also got rid of its opponents' argument for killing it.  The 7-2 majority (yes, a 7-2 majority!), in an opinion written by Justice Stephen Breyer, found that because there is no penalty, it does not cause harm to those who have a problem with a law making health care affordable and accessible for so many millions of American citizens.  Even Justice Clarence Thomas, who personally dislikes the law, said the suit against it didn't pass muster.  (Justices Neil Gorsuch and Samuel Alito, who made the argument that the Affordable Care Act put too much of a burden on the sates, were the two dissenters.)  There was also likely a political reason for this decision as well - because no one wants to take away people's inexpensive medical insurance in the middle of a pandemic.  

Chief Justice John Roberts, when he was confirmed in 2005, said he saw his role as a judge as someone who called balls and strikes.  Well, the Supreme Court just ruled on the Affordable Care Act for the third time - to its detractors, I say, "Three strikes and you're out!" 😛 

And with that out of the way, we can now celebrate Juneteenth with great relief. 😃 

Supreme Consequence

The Supreme Court began hearing arguments last week on whether or not the Affordable Care Act is constitutional without the individual mandate, which the Republicans repealed in an effort to weaken the law so it could be killed.

But Chief Justice John Roberts took issue with the idea that taking out a part of the law to make it violate the Constitution.  He strenuously opined that the Democratic Congress that passed it never intended to allow such a thing to happen, even as the Republicans never repealed (or replaced) that whole damn law to begin with.   

"I think it's hard for you to argue that Congress intended the entire act to fall if the mandate was struck down when the same Congress that lowered the penalty to zero did not even try to repeal the rest of the act," Roberts told the attorney representing the state of Texas, which is one of several states pursuing the case against the law. "I think, frankly, that they wanted the Court to do that, but that's not our job." 

And whether or not newly appointed Justice Amy Coney Barrett agrees with that, one Trump appointee apparently does - Justice Brett Kavanaugh, who seemed to concur with the Chief Justice over the intentions of the legislative branch.

For obvious reasons, I'm not sure I can trust Justice Kavanaugh, at least not completely, at this moment, but Chief Justice Roberts, despite his ideological leanings, has proven himself to be a decent and fair man, and he holds a lot of sway in prickly issues like regulating health care.  After all, he saved the law in 2012.  Right now, it looks like the law may be upheld, mandate or not.  And President-elect Biden will almost certainly try to restore the mandate and build further on the law . . . even as Mitch McConnell, who is likely to remain Senate Majority Leader, will almost certainly to have a problem with that.  A compromise deal between Biden and McConnell could stave off the case by reinstating the mandate and allowing Congress to set the penalty.  Whatever happens, those who benefit from the Affordable Care Act can probably breathe a little more easily than the could in October.     

The Notorious ACB

 Be very afraid of Amy Coney Barrett.

She has impeccable credentials as a judge and an stellar record for intellectually sound opinions.  And she's a reactionary.  But she is not a Trojan horse for conservatives who wish to politicize the Supreme Court the way Ginsburg was (Douglas Ginsburg, not the former Joan Ruth Bader).  She is a political appointee with her ideas already in place from her own reasoning.

Maybe as a Supreme Court justice, she wouldn't necessarily rule in favor of Trump if he tries to sue his way to a second term.  But she would almost certainly rule against Roe v. Wade, and her originalist views would definitely mean the end of the Affordable Care Act.  And she's all but certain to get on the Court despite majority public opposition just as Trump could be "re-elected" despite majority public opposition.

Be very afraid indeed.  And vote.

Sick Policy

Up until late this past week, Democrats were worried that Donald Trump, having been non-vindicated by William Barr's non-exonerating synopsis of the Mueller report, will build his base into a formidable juggernaut by whipping up anti-Democratic (and anti-democratic) sentiment over his opponents' investigations into his international and financial dealings.  

They can rest easy now. Trump wants to dismantle the remainder of the Affordable Care Act.

Democrats won back the House and were able to prevent huge losses in the Senate while capturing seven governorships - all while emphasizing health care at a time when the Affordable Care Act has actually become quite popular.  Democrats are more than ready to let Trump try to tear the health care law out while defending it.

Of course, the Democrats could easily snatch defeat from the jaws of victory if any of the leading Democratic candidates for the Presidency advocate some form of single-payer health care system - at a time when the politics and the process to get there are non-existent - allowing Trump to bash the Affordable Care Act because some Democrats want to replace it either. At least the Democrats have something to replace it with.  Hopefully, though, they won't overreach and try to give us single-payer when it can't happen just yet.

Of course, a certain politician from Maryland suggested phasing in an all-payer approach as a way of getting to single-payer, but you know how Democrats are, they won't listen to reason within their own ranks.            

Legacy Lost?

Donald Trump appears to have done what he set out to do - completely erase Barack Obama's legacy from the annals of history as sure as the Harding and Coolidge administrations erased that of Woodrow Wilson.

First up: health care!  Insisting that the payment of money to private health insurers to subsidize insurance plans for poor people under the Affordable Care Act is unconstitutional, Trump ended those payments and also allowed health plans to be sold across state lines without being subject to regulation.  The result?  Costs will go up for people who can least afford it, and a lot of people will be screwed.

Also: the Iran nuclear deal!  Trump decertified that Iran is living up to the deal, even though the deal has worked at preventing Iran from getting a bomb.  He wants to tie it with efforts to stop Iran from funding terrorist groups - a different issue - and his attempt to unravel a plan that would keep the Iranians at bay for several years has angered our European ex-allies (you think they'll be with us in solidarity after this?), destroyed American credibility, and pleased the paranoid Israeli right wing - including the prime minister of Israel, Benjamin Netanyahu, who sees any effort at peace in the Middle East as threat to his nation.  Trump has indicated that he wants to fix parts of the deal, such as the part that allows the Iranians to test ballistic missiles, and Secretary of State Rex Tillerson has indicated that the U.S. hopes to use leverage in from decertifying the deal, but the Europeans have made it clear that renegotiation is, well, non-negotiable.  Congress can pass on re-imposing sanctions against Iran that would undermine the deal, but Trump could just as easily pull out altogether.

Why are Americans so hung up about making a deal with Iran, even if it keeps the mullahs from nuking anyone?  Two words - "hostage crisis."  The 1979-81 Iran hostage crisis is something we just can't let go of after thirty-six years.

So Obama's legacy is kaput?  Not entirely.  There's still one remaining piece of his legacy - Donald Trump.  By neglecting the need to build up the Democratic Party and placing at the helm of the Democratic National Committee the insufferable Debbie Wasserman Schultz - who tired to satisfy her lust for power by trying to satisfy the lust of the Clintons to get their power back - he paved the way a Republican comeback and, ultimately, for Trump.

Yes, he was the first black President.  But he may also be the last Democratic President - much like Millard Fillmore was the last Whig President.

Bitter Pill

Okay, in light of the fact that Trump has expanded the ability of employers to deny women contraception coverage through the Affordable Care Act based on religious or moral objections, let me see if I have this straight (bear with me here):

Many Democrats, especially many female Democrats, were so insistent on making Hillary Clinton the first female President that they rigged the system to ensure her the 2016 Democratic presidential nomination.  The party needed to win the 2016 election.  They needed to win to protect the advances in women's rights against misogynistic Republicans.  They wanted to ensure that contraception coverage and other women's health services would remain available to all women.  But at the same time, they were so desirous of getting a woman in the White House that they got behind Hillary Clinton, a lousy candidate whom many people suspected could not win a general election.  There were ten women that the Democrats could have nominated for President in 2016.  The first was Hillary and no one cared who the other nine were.  And they cared even less about any of the cisgendered white males who were Hillary's opponents for the Democratic presidential nomination in 2016.

Moreover, Hillary partisans tried to shame women who dared to support one of said opponents, namely Bernie Sanders and Martin O'Malley.  Remember when Madeleine Albright said there was a special place in hell for women who didn't support Hillary?  And how about Gloria Steinem's comment that female Sanders supporters were only supporting Sanders to meet guys?  The message was clear: Hillary was going to be the Democratic presidential nominee because it was not just a woman's turn, it was this woman's turn - and cisgendered white males need not apply.  Despite everything at stake for women's rights, the Hillbots were hell-bent (Hill-bent?) on making Hillary Clinton the Democratic presidential nominee and counting on her to make history for women in America by getting elected President, even though it turned out that she could not beat Donald Trump, instead of nominating a man - Sanders or O'Malley - who could have beaten Trump and would have protected contraception access and other women's health services.  But Democrats just weren't going to bother with a cisgendered white male nominee.  Now we have a cisgendered white male Republican President taking away contraception coverage for millions of American women . . . all because the Hillbots in the Democratic Party preferred a woman who couldn't win over one of two men who could have won.

You Hillbots didn't think this thing through, did you?

I could have told you that this was too big a risk to take back in 2016, but ahh, who would listen to a cisgendered white male like me anyway?

And you really blew it by choosing not to at least consider Elizabeth Warren.

The Price Is Wrong

Having bilked the taxpayers to the tune of a million dollars for chartered flights on government planes, Health and Human Services Secretary Tom Price is out.  He was forced to resign before Trump had the chance to say, "You're fired!"  

There's something of an irony to this. As the Democrats are slowly beginning to get their mojo back by winning hyperlocal special elections, Price is now out of government after having quit his House seat in Georgia to join Trump's Cabinet, that House seat now occupied by another Republican.  Democrat Jon Ossoff, having failed in his bid for Price's House seat, must be laughing his Ossoff!   

Price, an orthopedic surgeon by training, now has to have required surgery on his reputation.

To think, after all of his attempts to help Trump get rid of Obamacare, the Affordable Care Act is in place and Price is out of Washington.  But at the same time, he won't be in a position to ignore and underfund the Affordable Care Act in order to undercut it.  Trump can do that simply by . . . not replacing him.

Because the incoming Acting HHS Secretary, Don Wright, will have an appropriate title, doing no more than playing a part in Donald Trump's new reality show.

Not Again

I thought the Affordable Care Act repeal bill in the Republic House of Representatives was dead.  But after only a month of its failure, the House is bringing it up again, and this time it might go through. The Senate is a different chamber altogether, but the Republican majority will do its darnedest to get it to Trump for his signature.

I also thought that after the rainy April we had, we'd get a break from the wet weather for awhile.  But April downpours being May downpours; tomorrow my area is supposed to get one to two inches of rain - the equivalent of one to two feet of snow - and the ground is still saturated from all the rain from April.

Did I happen to mention there could be thunderstorms also? 

I also thought I'd taken care of my radiator fluid after it got to low and I had a local VW dealer take care of the problem just before New Year's Eve.  Almost four months to the day later, the fluid got too low again, and I had to add water as a stopgap solution.  I called the dealership that serviced my car in December, and the service guy told me that the water I added should fix the problem until my next regular service.  I've since learned from other Volkswagen owners online that if it doesn't, the water pump could be failing.

Oh yes, just when you thought he was gone for awhile . . . James Comey is back!     

From ACA to CACA

The Republican bill that would replace Affordable Care Act (ACA) wouldn't just repeal it, it would unravel it to the point where there would be even less of a health care system than there was in 2008, before the the ACA.

Among the things the legislation would do is replace income-based subsidies with age-based tax credits at its centerpiece. The GOP says that this would make health insurance more affordable for older people, but the smaller subsides for younger people would discourage the young to buy insurance and thus drive up premiums for whoever's left in the insurance pool - thus, the older people in the system would pay more than the tax credits could help them.

Meanwhile, although the Medicaid expansion program would continue until 2020, no one could enroll after the beginning of that year, and Medicaid itself would be funded with block grants - fixed amounts for each state in the name of the "flexibility" for the states to pay as they see fit.  So, New York would be generous, Mississippi would be stingy, and many states would be caught with less money to spend in the event of a recession.

Oh yeah, the Republican bill would eliminate taxes on upper-income earners, capital gains, insurance plans and medical device manufacturers, and it would delay implementing a tax on high-end insurance policies until 2025.  Tax breaks for people who don't need them would be doled out to the tune of $275 billion.

Watching the Republicans craft a health care reform bill is like watching Michael Scott on "The Office" hold his own diversity seminar after his bosses at Dunder Mifflin held one to hide the fact that he was the only one who needed it.  Paul Ryan wants to fix a problem that someone else took care of and that had been created by his own party, so he looks like the good guy.

He doesn't look like the good guy.  He isn't.  Democrats are up in arms over it, constituents have been flooding congressional town halls to protest changes to the current law (which is why GOP House members stopped having town halls until after this bill is passed at the end of the current session on April 7, just before the Easter recess), and it's even gotten opposition from Republican governors who expanded Medicaid and even Senate Republicans opposed to changes in Medicaid or to the tax credit.  Republican senators said the House bill couldn't make it through the Senate.

If this bill becomes law, it will be for the same reasons other Republican legislative initiatives have become law; because the GOP will have rammed it down or throats despite public opposition and because the Democrats in Congress will be too mealy-mouthed in their own opposition.  None of that, of course, is anything new in Washington.  

RIP ACA

The Affordable Care Act is dead.

On Wednesday, incoming Vice President Mike Pence met with his onetime Republican U.S. House colleagues to prepare for repealing the law known as Obamacare, and they're trying to get a head start on defunding and scrapping it in an expeditious matter.  They're hoping to put it on a repeal-and-delay timetable, in which they officially repeal the Affordable Care Act and set up a period for the Republicans to come up with an alternative.

Which will likely be a return to the way things were in 2009.

And don't think the Democrats will be able to stop them, either; the Republicans plan to push the repeal through in a Senate-filibuster-proof budget resolution, which is, ironically, how the Democrats passed the Affordable Care Act in the first place.

At least one Republican in Washington, as well as with some Republican governors, is fearful that this move could lead millions of  people in limbo and without health insurance.  U.S. Senator Rand Paul (R-KY) has demanded that his party come up with a health care plan of its own before scrapping the current law.  "We need to think through how we do this, and it's a huge mistake for Republicans if they do not vote for replacement on the same day as we vote for repeal," he said.

He's unlikely to get any support from any fellow Republicans, except maybe Senator Susan Collins (R-ME).

Meanwhile, President Obama, with only a few days left to go in office, held a pity party to buck up Democrats in Congress to urge them fight the Republican onslaught on his signature legislation, even though they're outvoted.  The biggest Obamacare proponent in the Senate is Democratic leader Charles Schumer (NY), who famously attributed the Democratic loss of the Senate in 2014 to the party paying too much attention on - you guessed it - health care.

Ironically, Obamacare was based on Republican market reform ideas from the nineties.  The Democratic proposal of the time - Medicare for all - never got anywhere, and it certainly won't get anywhere in this Congress, as Paul Ryan is working on a new program - Medicare for no one.  

Yeah, Obamacare is as good as gone.  And don't start threatening to move to Great Britain, boys and girls, because the British National Health Service is slowly being done away with too.   

Funny how what took the Tories in the U.K. seventy years to do, the Republicans are going to be able to do in a few short months.