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Health Care Mandate -
Now The Legal Fight Begins
By Joel Skousen
Editor - World Affairs Brief 
3-26-10
 
Begin Excerpt
 
If ever America needed proof that Obama never intended to deliver on his campaign promise to "change the way Washington works," it can be found in the manner Obamacare was shoved down America's throat. The administration and Democratic leaders pulled out every sordid, coercive trick in the book to get around normal rules, the will of the people, and the constitution itself. So legally twisted was the course they took, it will take years to sort out the legal and constitutional questions. Fortunately, we have until 2014 to get the mandatory portion overturned in the courts. But, better sooner than later since Obama is intending to stack the Supreme Court with his own cronies. With it all, America officially crosses the line into a socialist state. ''
 
Obama also promised to allow the public five days to view bills before he signs them. But, he and fellow Democrats couldn't wait to celebrate their victory. Some 40% of Americans also think they will benefit from this legislation since it prohibits insurers from rejecting people with prior existing conditions. But it doesn't (yet) stop insurance companies from raising premiums to cover this massive cost increase. That in turn will someday lead to cries of premium caps, which will lead to failure, which will lead to the need for a government run system. Slick!''
 
How It Was Done: All of the detailed machinations are hard to know since none of the negotiations were done with any of Obama's promised transparency. They bought every representative that could be bought; they threatened with exposure every representative who had moral or financial skeletons in the closet (no shortage there); and they invented special deceptive legal devices or language to help others betray their principles without making it obvious. ''
 
Kimberly Strassell has many of the details: "You could see it all coming a week ago, when New York Rep. Louise Slaughter let leak a breathtaking strategy whereby the House would not actually vote on the unpopular Senate bill. The House would instead vote on a 'reconciliation' fix to that bill, and in the process 'deem' the underlying legislation----with its Cornhusker kickbacks and Louisiana purchases----passed. The Slaughter Solution was both blunt admission and warning. House Speaker Nancy Pelosi did not have 216 votes to pass the Senate bill, there never was going to be majority 'support' for it, but they'd pass it anyway. ''
 
"The final days were a simple death watch, to see how the votes would be bought, bribed or bullied, and how many congressional rules gamed, to get the win. President Obama flew to Pennsylvania (home to five wavering House Democrats), Missouri (three wavering), Ohio (eight), and Virginia (four) to hold rallies with small, supportive crowds. In four days, Mr. Obama held 64 meetings or calls with congressmen. The goal was to let undecideds know that the president had them in his crosshairs, that he still had pull with the base, and he'd use it against them. By Saturday the tactic had yielded yes votes from at least half the previously undecided members of those states. ''
 
"As for those who needed more persuasion: California Rep. Jim Costa bragged publicly that during his meeting in the Oval Office, he'd demanded the administration increase water to his Central Valley district. On Tuesday, Interior pushed up its announcement, giving the Central Valley farmers 25% of water supplies, rather than the expected 5% allocation. Florida Rep. Suzanne Kosmas (whose district is home to the Kennedy Space Center) admitted that in her own Thursday meeting with the president, she'd brought up the need for more NASA funding. Retiring Tennessee Rep. Bart Gordon flipped to a yes vote on Thursday. Outside heavies were enlisted to warn potential no votes that unions and other Democrats would run them out of Congress. Al Lawson, a Tallahassee liberal challenging Blue Dog Florida Rep. Allen Boyd in a primary, made Mr. Boyd's previous no vote the centerpiece of his criticism. ''
 
"The SEIU (service employees union) threatened to yank financial support for New York's Michael McMahon. The liberal Working Families Party said it would deny him a ballot line. Obama deputy campaign manager Steve Hildebrand vowed to challenge South Dakota Rep. Stephanie Herseth Sandlin if she voted no. New York's Scott Murphy was targeted as a part of a $1.3 million union-financed ad campaign to pressure him to flip. Moveon.Org spent another $36,000 on ads in his district and promised a primary. Oregon's Pete DeFazio threatened to lead a revolt unless changes were made to Medicare payments to benefit his state. On Saturday Mrs. Pelosi cut a deal to give 17 states additional Medicare money. ''
 
"By the weekend, all the pressure and threats and bribes had left the speaker three to five votes short. Her remaining roadblock was those pro-life members who'd boxed themselves in on abortion, saying they would vote against the Senate bill unless it barred public funding of abortion. The solution? Remove it from Congress altogether, having the president instead sign a meaningless executive order affirming that no public money should go to pay for abortions. The order won't change the Senate legal language----as pro-choice Democrats publicly crowed within minutes of the Stupak deal. Executive orders can be changed or eliminated on a whim (one of Obama's first executive orders was to repeal of the Mexico City Policy to allow for international funding of abortion). Pro-life groups condemned the order as the vote-getting ruse it was. Nevertheless, Mr. Stupak and several of his colleagues voted yes, paving the way to Mrs. Pelosi's final vote tally of 219.''
 
"Even in these waning minutes, Senate Democrats were playing their own games. Republicans announced they had found language in the House reconciliation bill that could doom this entire 'fix' in the Senate. Since many House Democrats only agreed to vote for the Senate bill on promises that the sidecar reconciliation would pass, this was potentially a last-minute killer. Senate Democrats handled it by deliberately refusing to meet with Republicans and the Senate parliamentarian to get a ruling, lest it be unfavorable and lose House votes. The dodge was a clear dereliction of duty, but Democrats figure the Senate parliamentarian won't dare derail this process after ObamaCare passes. They [were] right." Parliamentarian Alan Frumin ruled that the proposed tax on high-end health insurance plans does not violate Senate budget rules previously passed.''
 
So worried were some Democrats over losing their seats if they voted for this bill, that House leader Pelosi came up with a strategy to get as many extra yes votes as she could from Democrats with "safe" seats so that Democrats "at risk" could vote no. This deception allows them to appear to have been against the bill. ''
 
The PRNewswire-USNewswire detailed other vote buying tactics: "President Obama succeeded in winning the Congressional Hispanic Caucus's endorsement of his health care reform legislation by pledging to push an overwhelmingly unpopular amnesty plan for millions of illegal aliens... The announcement also coincided with the release of an outline for amnesty legislation authored by Senators Charles Schumer (D-N.Y.) and Lindsey Graham (R-S.C.)." ''
 
Thus, it was no coincidence that the Obama administration announced on Tuesday that it is halting funding of the fence along the U.S.-Mexico border--demonstrating that his former promise to "secure the border first" was a lie. Homeland Security Chief Janet Napolitano bragged in a speech this week that the administration will never take no for an answer on its amnesty proposal. That's what I've always said. These people have a ruthless agenda. ''
 
The Legal Challenges: At this writing, some 14 states have joined forces to file suit challenging the Constitutionality of the new law. David Rivkin, Jr., an attorney representing 13 of the states told ABC news, "We are convinced that this legislation is fundamentally flawed as a matter of constitutional law, that it exceeds the scope of proper constitutional authority of the federal government and tramples upon the rights and prerogatives of states and their citizens." Washington State's Attorney General Rob McKenna decided to join the lawsuit but the Democratic governor and legislature are trying to use budgetary threats to stop him. ''
 
Establishment lawyers are preparing the normal (and bogus) expansionist arguments that have been used in the past to thwart constitutional restrictions. Senator John Conyers, when challenged on the constitutionality issue made this mis-spoken claim: "Under several clauses, the good and welfare clause [he meant the "General Welfare Clause"] and a couple others. All the scholars, the constitutional scholars that I know -- I'm chairman of the Judiciary committee, as you know."''
 
Almost all establishment law school professors tend to dismiss the strict constructionist view of constitutional language. Bruce Jacob, a constitutional law professor at Stetson University in Florida, said the suit was unlikely to succeed. "The federal government certainly can compel people to pay taxes, can compel people to join the Army," he said. But those examples are based upon clearly different legal issues, distinguishable from a mandate to force citizens to buy some private service deemed necessary for their own welfare, and not the defense of the nation. ''
 
Another legal avenue is for States to exercise their 10th Amendment powers to refrain from participating in the mandatory aspects. Virginia and Idaho have already enacted opt-out laws, while similar laws have been proposed in 34 other states.''
 
Reuters gives a detailed rundown on all the state efforts: "At least 36 state legislatures are weighing legislation to limit, alter or oppose the federal healthcare reform, and 26 of those are considering amending their state constitutions by ballot. Arizonans will vote on an amendment in November. Virginia was the first state to react legislatively, by enacting a statute entitled 'health insurance coverage not required.' Idaho Governor C.L. (Butch) Otter signed a bill on Wednesday allowing the state's attorney general to file a lawsuit opposing federal healthcare legislation requiring individuals to buy medical insurance. Texas Governor Rick Perry says the plan will cost the Lone Star state $24.3 billion over 10 years, but it is currently not planning to sue [Perry is a globalist only masquerading as a conservative]. ''
 
"Utah's two legislative chambers have passed a bill opposing parts of the healthcare plan that now awaits the governor's signature [which requires the Utah Legislature to pass legislation before recognizing any health reform bill passed by Congress]. Florida, Georgia and Missouri have begun embarking on constitutional resolutions. The New Hampshire legislature has passed a bill prohibiting any expansion of Medicaid, the healthcare system for the poor, unless it is paid for by the federal government. States not considering legislative responses includeIllinois, North Carolina, New York, Connecticut, Rhode Island, Vermont, Maine and Massachusetts [Mass has already done itself in, thanks to compromising Republican governor Mitt Romney]. Also, there are no measures in Montana, Nevada, Oregon and Texas as there are no regular legislative sessions in these states in 2010." ''
 
The Democrat's bill also requires the federal government to cover 100% of all new Medicaid enrollees through 2016. After that it becomes another unfunded federal mandate and the states will be caught in a huge budget squeeze they can ill afford. As Bloomberg News notes, "The health-care overhaul will make as many as 15 million more Americans eligible for Medicaid nationwide starting in 2014 and will cost the states billions to administer."''
 
Prospects for Repeal: I agree with Daniel McCarthy that the prospects that Republicans will successfully repeal this new entitlement system are nearly nil. Obama knows it and even taunted Republicans to try. The politics of benefit-corruption always win out in the end. That is why the best of the founders of the constitution hated raw democracy. Voters can always be bought with benefits. "Conservatives are at least as mad over Obamacare as liberals were about Bush's conduct of the War on Terror. But just as Obama has not repealed or significantly amended the Patriot Act or closed down Guantanamo, what does anyone seriously expect from the next batch of Republicans to take power?''
 
"If the GOP takes back one chamber of Congress this year, that won't be enough to make significant revisions, and if the party manages the minor miracle of taking back both House and Senate, you can be sure Republicans would amend the legislation only to the point of offering their own big-government 'solution' to the healthcare 'crisis.' As far as growth of federal power is concerned, Obamacare, like the War on Terror, is two leaps forward, and the most we're likely to get from the opposition is one half-step back [Absolutely true]... The danger is that the election of conventional politicians who talk a good anti-statist game but vote like the people who gave us the Patriot Act and Obamacare will quench popular dissatisfaction before anything can come of it."''
 
What the Bill Does: Here's a summary from the Associated Press: ''
 
COST: "$940 billion over 10 years, according to the Congressional Budget Office [grossly underestimated costs]. ''
 
COVERAGE: "32 million uninsured. Major coverage expansion begins in 2014. When fully phased in, 95 percent of eligible Americans would have coverage, compared with 83 percent today. ''
 
THE MANDATE: "Almost everyone is required to be insured or else pay a fine. There is an exemption for low-income people. Mandate takes effect in 2014.''
 
INSURANCE REFORMS: "Starting this year, insurers would be forbidden from placing lifetime dollar limits on policies, from denying coverage to children because of pre-existing conditions, and from canceling policies because someone gets sick. Parents would be able to keep older kids on their coverage up to age 26. A new high-risk pool would offer coverage to uninsured people with medical problems until 2014, when the coverage expansion goes into high gear. Major consumer safeguards would also take effect in 2014. Insurers would be prohibited from denying coverage to people with medical problems or charging them more. Insurers could not charge women more. ''
 
MEDICAID: "Expands the federal-state Medicaid insurance program for the poor to cover people with incomes up to 133 percent of the federal poverty level, $29,327 a year for a family of four. Childless adults would be covered for the first time, starting in 2014. The federal government would pay 100 percent of costs for covering newly eligible individuals through 2016. A special deal that would have given Nebraska 100 percent federal financing for newly eligible Medicaid recipients in perpetuity is eliminated. A different, one-time deal negotiated by Democratic Sen. Mary Landrieu for her state, Louisiana, worth as much as $300 million, remains. ''
 
TAXES: "Dramatically scales back a Senate-passed tax on high-cost insurance plans that was opposed by House Democrats and labor unions. The tax would be delayed until 2018, and the thresholds at which it is imposed would be $10,200 for individuals and $27,500 for families. To make up for the lost revenue, the bill applies an increased Medicare payroll tax to the investment income and to the wages of individuals making more than $200,000, or married couples above $250,000. The tax on investment income would be 3.8 percent. ''
 
PRESCRIPTION DRUGS: "Gradually closes the 'doughnut hole' coverage gap in the Medicare prescription drug benefit that seniors fall into once they have spent $2,830. Seniors who hit the gap this year will receive a $250 rebate. Beginning in 2011, seniors in the gap receive a discount on brand name drugs, initially 50 percent off. When the gap is completely eliminated in 2020, seniors will still be responsible for 25 percent of the cost of their medications until Medicare's catastrophic coverage kicks in. ''
 
EMPLOYER RESPONSIBILITY: "As in the Senate bill, businesses are not required to offer coverage. Instead, employers are hit with a fee if the government subsidizes their workers' coverage. The $2,000-per-employee fee would be assessed on the company's entire work force, minus an allowance. Companies with 50 or fewer workers are exempt from the requirement. Part-time workers are included in the calculations, counting two part-timers as one full-time worker. ''
 
SUBSIDIES: "The proposal provides more generous tax credits for purchasing insurance than the original Senate bill did. The aid is available on a sliding scale for households making up to four times the federal poverty level, $88,200 for a family of four. Premiums for a family of four making $44,000 would be capped at around 6 percent of income. '
 
CHOICES: "Small businesses, the self-employed and the uninsured could pick a plan offered through new state-based purchasing pools called exchanges, opening for business in 2014. The exchanges would offer the same kind of purchasing power that employees of big companies benefit from. People working for medium-to-large firms would not see major changes. But if they lose their jobs or strike out on their own, they may be eligible for subsidized coverage through the exchange." ''
 
Long-term Effects: These are the real costs that will affect the nation: Insurance groups will be forced to raise premiums and cut jobs in order to stay profitable under the new regulations. Medicare cuts to doctors will force most to stop taking new Medicare patients. Drug companies will have even more power to keep lower cost competing drugs from being imported. Medical protocols will become even more rigid, restricting a doctor's ability to find alternative solutions. The IRS will have to hire thousands of additional tax agents to enforce the health care mandate and audit the books of small business owners to see if they fall within mandated levels of compliance. The deficits will skyrocket as in all nations with socialist health care mandates. The costs, regulations and controls will ever escalate as the private health care industry fails to meet the "something for nothing" government mandate model. ''
 
One of the best overall commentaries on the cost issue came from Douglas Holtz-Eakin, a former director of the Congressional Budget Office, in a NY Times Op-Ed opinion piece. Targeting the fantasy of a $950B cost projection during the next 10 years, he says, "If you strip out all the gimmicks and budgetary games and rework the calculus, a wholly different picture emerges: The health care reform legislation would raise, not lower, federal deficits, by $562 billion. Gimmick No. 1 is the way the bill front-loads revenues and backloads spending. That is, the taxes and fees it calls for are set to begin immediately, but its new subsidies would be deferred so that the first 10 years of revenue would be used to pay for only 6 years of spending. ''
 
"Even worse, some costs are left out entirely. To operate the new programs over the first 10 years, future Congresses would need to vote for $114 billion in additional annual spending. But this so-called discretionary spending is excluded from the Congressional Budget Office's tabulation. Consider, too, the fate of the $70 billion in premiums expected to be raised in the first 10 years for the legislation's new long-term health care insurance program. This money is counted as deficit reduction, but the benefits it is intended to finance are assumed not to materialize in the first 10 years, so they appear nowhere in the cost of the legislation. ''
 
"Finally, in perhaps the most amazing bit of unrealistic accounting, the legislation proposes to trim $463 billion from Medicare spending and use it to finance insurance subsidies. But Medicare is already bleeding red ink, and the health care bill has no reforms that would enable the program to operate more cheaply in the future. Instead, Congress is likely to continue to regularly override scheduled cuts in payments to Medicare doctors and other providers. Removing the unrealistic annual Medicare savings ($463 billion) and the stolen annual revenues from Social Security and long-term care insurance ($123 billion), and adding in the annual spending that so far is not accounted for ($114 billion) quickly generates additional deficits of $562 billion in the first 10 years. And the nation would be on the hook for two more entitlement programs rapidly expanding as far as the eye can see. ''
 
"The bottom line is that Congress would spend a lot more; steal funds from education, Social Security and long-term care to cover the gap; and promise that future Congresses will make up for it by taxing more and spending less. The stakes could not be higher. As documented in another recent budget office analysis, the federal deficit is already expected to exceed at least $700 billion every year over the next decade, doubling the national debt to more than $20 trillion [numbers all grossly understated]. By 2020, the federal deficit ---- the amount the government must borrow to meet its expenses ---- is projected to be $1.2 trillion, $900 billion of which represents interest on previous debt. The health care legislation would only increase this crushing debt."''
 
End Excerpt
 
 
Commentary and Insights on a Troubled World
 
Copyright Joel Skousen. Partial quotations with attribution permitted.
 
Cite source as Joel Skousen's World Affairs Brief http://www.worldaffairsbrief.com
 
World Affairs Brief, 290 West 580 South, Orem, Ut 84058, USA
 

 
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