House Republicans Are Quietly Advancing Their Next Tactic To Dismantle Obamacare




Reproductive health care policy has captivated the national conversation, thanks to Republican lawmakers threatening a government shutdown over Planned Parenthood funds and planning congressional inquiries into the national women’s health organization. But these issues have, perhaps intentionally, overshadowed another legislative move in the health care arena.

On Tuesday, House Republicans quietly advanced a strategic bill gutting key parts of the Affordable Care Act — a move that could lay the groundwork for a future Obamacare attack if a Republican wins the presidency in 2016.

Legislation seeking to repeal Obamacare is far from novel; the House has voted on over 50 similar bills in the past, most dying in the Senate. But this specific measure may have a better chance of advancing further. That’s because it relies on a complex strategy to get around a potential Democratic filibuster in the Senate.

Using a method called “reconciliation” that allows tax-related measures to be fast-tracked to the president’s desk, GOP lawmakers can dodge the Senate by slashing the budgetary pieces of Obamacare. This complicated workaround wouldn’t repeal Obamacare outright. However, it would eliminate the central policy that the Affordable Care Act is founded on: The individual mandate that requires Americans to purchase health insurance, which was ruled a “tax” when it was upheld by the Supreme Court in 2012.

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Clinton to Propose New Rules for Drug Makers – By LAURA MECKLER And PETER LOFTUS Sept. 22, 2015 12:01 a.m. ET

Democrat would force pharmaceutical companies to spend a set portion of revenue on R&D

Hillary Clinton at a campaign stop in Baton Rouge, La., on Monday.

Hillary Clinton at a campaign stop in Baton Rouge, La., on Monday. Photo: Lee Celano/Reuters

Hillary Clinton is proposing new rules that would pressure prescription-drug companies to spend a set portion of their revenue on research and development, one of several ideas aimed at controlling the rising cost of pharmaceuticals.

Her plan, to be laid out in Iowa on Tuesday, also would attempt to dissuade drug companies from spending large sums on consumer advertising by barring that from counting as a tax-deductible business expense.

The proposals are part of Mrs. Clinton’s effort to acknowledge shortcomings in the Affordable Care Act even as she aligns herself with what Democrats see as one of President Barack Obama’s biggest achievements. She is defending the law against both Republicans, who see it as far too much government, and, more subtlely, against her chief rival for the Democratic nomination, Sen. Bernie Sanders, who says it is nowhere near enough.

At least for now, the campaign is highlighting the contrast with Republicans. On Monday in Louisiana, she criticized Gov. Bobby Jindal, who is running for the GOP nomination, for not expanding Medicaid to more low-income Americans, as the law encourages states to do.

“Your governor turned away federal dollars that would have paid to expand Medicaid,” she said at an organizing event in Baton Rouge. “He put ideology ahead of the well-being of the people and families of this state. And everyone pays a price.”

Twenty-one states have declined to expand Medicaid. GOP governors, including Mr. Jindal, have said that neither the states nor the federal government can afford to expand the Medicaid program, which they contend is inefficient.

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Dem bill would cut lawmaker pay during shutdowns – By Cristina Marcos September 18, 2015, 06:13 pm

Rep. Rick Nolan introduced legislation on Friday to prevent future Congresses from getting paid during government shutdowns.

The Minnesota Democrat’s proposal wouldn’t apply to the current Congress, which faces a potential government shutdown on Oct. 1 if lawmakers don’t pass a spending bill in time.

The Constitution’s 27th Amendment prohibits any law that changes lawmakers’ salaries during their current terms. Lawmakers can only enact measures that affect future sessions of Congress.

Nolan said withholding lawmaker pay would put those serving in Congress on par with other federal employees who would be furloughed in the event of a shutdown.

“If hundreds of thousands of other federal employees are to go without their salaries — twisting slowly in the wind in a government shutdown — then the Congress should not be paid either,” Nolan said.

“This legislation would require the Congress to work full time — with no salary — during any government shutdown until they pass a bill to fund our government and pay the public employees who go to work on our behalf every day,” he added.

Many conservatives want to defund Planned Parenthood in the wake of controversial undercover videos depicting the organization’s use of fetal tissue donations with a spending bill as leverage. But such a measure does not have the votes to surmount a Democratic filibuster in the Senate or President Obama’s veto.

Only a handful of legislative days remain for Congress to pass a stopgap funding bill. Neither the House nor Senate currently has plans to vote next week on a bill to avoid a shutdown.

Some lawmakers opted to donate their pay to charity during the 16-day shutdown in 2013 over defunding ObamaCare.

Court rules against ObamaCare birth control mandate – By Sarah Ferris – 09/17/15 04:23 PM EDT

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A federal appeals court on Thursday ruled against ObamaCare’s birth control mandate in a decision that could invite a Supreme Court review.

The 8th Circuit Court of Appeals ruled that four Christian nonprofits should not have to comply with the ObamaCare rule that all employer healthcare plans include contraception options or face a fee. While employers can seek exemptions to the law, the court argued that doing so poses a “substantial burden” on that organization’s religious rights.

The decision is particularly important because it directly contradicts another federal court’s ruling.

“With today’s decisions, the [Supreme] Court will have great reason to decide this issue in the next term,” one religious rights group, the Becket Fund for Religious Liberty, wrote in a statement Thursday.

The Supreme Court already has several cases involving the birth control mandate it could take up in its fall term.

Conservatives were quick to praise the decision, which reignites a years-long battle against the ObamaCare rule.

“This court ruling is a victory for the rights of freedom and liberty that were critical to our Founding Fathers and American exceptionalism to this day,” Rep. Peter Roskam (R-Ill.) wrote in a statement Thursday.

The ruling includes 30 references to Burwell v. Hobby Lobby, the 2014 Supreme Court case that allowed certain for-profit companies to opt out of the mandate. Since that decision, multiple nonprofits, including universities, have taken legal action demanding to be granted the same permissions.

Under ObamaCare, employer healthcare plans are required to cover all federally approved forms of birth control. That includes, as the court notes, emergency contraception that some religious organizations believe is “functionally equivalent to abortion on demand.”

Groups can receive an exemption by writing a letter to the Health and Human Services Department or filling out a two-page form to document their objections. Houses of worships are automatically exempt from the law.

A White House spokeswoman on Thursday said the administration is “disappointed” in the decision, but believes the mandate will ultimately be upheld.

“As all of the other seven courts of appeals to address this issue have held, the contraceptive accommodation process strikes the proper balance between ensuring women have equal access to health care and protecting religious beliefs,” the spokeswoman said.

– Updated at 4:56 p.m.

Kentucky Is Obamacare’s Undeniable Success Story. This Man Is Trying To Burn It All Down. – BY EMILY ATKIN & JOSH ISRAEL SEP 14, 2015 8:20AM

CREDIT: AP PHOTO/TIMOTHY D. EASLEY Kentucky GOP gubernatorial nominee Matt Bevin

Kentucky GOP gubernatorial nominee Matt Bevin

Though it has been largely ignored by national media and pollsters, Kentucky’s November gubernatorial election could mean striking changes for the Bluegrass State. The nation’s most unlikely Obamacare success story — a state system that has provided more than 500,000 Kentuckians with affordable health insurance — might well be ransacked by a Tea Party candidate named Matt Bevin.

From the earliest days, Kentucky’s efforts to implement Obamacare have earned national acclaim. As the troubled roll out of the national health care exchange website was ruthlessly mocked by late night television, Fortune praised “one health exchange success story“: Kentucky’s new state-level marketplace.

Unlike most southern states, Kentucky opted to both set up its own state exchange (the Kentucky Health Benefit Exchange, commonly known as “Kynect”) and to expand Medicaid under the Affordable Care Act. These efforts, ordered by Gov. Steve Beshear (D) and overseen by Governing magazine’s 2014 Public Official of the Year Carrie Banahan, helped get 521,000 Kentuckians insurance coverage in the first year alone. According to a Gallup poll, by the first half of 2015, Kentucky’s uninsured rate had fallen from 20.4 percent in 2013 to just 9 percent, the second largest drop of any state. Governing fêted Kentucky as “one of the few states that got everything right.”

In testimonials provided to ThinkProgress by Kentucky Voices for Health, a coalition of health advocacy groups, many Kentuckians agreed. “Thank God for Kynect,” said Eddie Alvis, who after years of struggling financially was able to get health insurance, and discovered he had severe asthma. “It has really empowered me,” said Lynn Young, a Louisville resident who got insured despite her recent unemployment. And Helen Spalding, who lost her job and benefits after a serious car accident, was also able to purchase insurance. “Kynect has been here for me,” she said. “It’s a blessing.”

But with Beshear term-limited, Bevin, the GOP nominee, has made it clear he wants to reverse course. The Tea Party-backed candidate vows he’ll do away with both the successful state exchange and the Medicaid expansion that has helped hundreds of thousands get affordable health care — moves that the governor could likely make unilaterally.

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Right sees leftward tilt in Roberts Supreme Court era – By Peter Schroeder and Lydia Wheeler – 06/27/15 06:00 AM EDT

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Supreme Court rulings affirming ObamaCare and gay marriage are unnerving the right, which sees a leftward tilt in the Chief Justice John Roberts era.

To be sure, the court has issued right-leaning rulings since Roberts was confirmed in 2005, perhaps most notably by opening up campaign coffers to private organizations in Citizens United v. FEC, and striking down a section of the 1965 Voting Rights Act.

But in a series of other rulings, the court has issued decisions cheered by the left that have disappointed conservatives and soured them on Roberts.

“People had felt that the Roberts court might be one of the most conservative courts in recent history,” said Paul Rothstein, a Georgetown Law professor. “That expectation and belief has been a little bit beyond the mark.”

The court’s early direction under Roberts appeared in line with expectations.

In 2010, a New York Times analysis of the first five years of the Roberts Court found it to be one of the most conservative in decades, issuing conservative opinions 58 percent of the time.

Some of the recent decisions have highlighted a disturbing trend for conservatives.

While the court’s four liberal justices have ruled in unison on gay marriage, ObamaCare, discrimination in housing and other issues, conservatives on the court have been split.

While Justices Antonin Scalia, Clarence Thomas and Samuel Alito have generally aligned on the right, Roberts wrote both ObamaCare decisions and Kennedy has been a frequent swing voter.

Even Thomas broke with the other four conservatives last week in a ruling that said Texas could block people from putting the Confederate flag on license plates.

Given that Kennedy and Roberts were nominated to the court by GOP presidents, Ronald Reagan in the case of the former and George W. Bush in the latter, their surprise decisions have left a sour taste.

“They lied to the presidents who appointed them. Is there any doubt in anyone’s mind what Ronald Reagan wanted when he picked Anthony Kennedy?” said Matt Schlapp, president of the American Conservative Union. “I don’t trust the court. I don’t trust John Roberts to do the right thing. I definitely don’t trust Anthony Kennedy to do the right thing.”

Some legal experts say the court only appears more liberal because the big cases would have never come before the court if it weren’t so conservative.

“The only reason they heard the Obamacare case is because we have some really deeply conservative justices who thought this could be used as mechanism to strike it down,” said Kent Greenfield, a law professor and Dean’s Research Scholar at Boston College. “With same-sex marriage, they’ve been avoiding taking the case.”

But a ruling this week on fair housing shows it is not just the high-profile political cases where a conservative justice can surprise.


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Republicans Fear Victory for Health Care Could Pave Way for Education, Environment – BY ANDY BOROWITZ JUNE 25, 2015


WASHINGTON (The Borowitz Report)—The Supreme Court’s decision to preserve Obamacare subsidies has drawn sharp rebukes from Republican Presidential hopefuls, who warn that the victory for health care might eventually pave the way for similar advances in education and the environment.

“The Supreme Court has decided, apparently, that every American should have access to quality health care,” said Senator Ted Cruz (R-Texas). “What if it decided to say the same thing about education? I don’t mean to be an alarmist but, after today, I believe that anything is possible.”

Senator Rand Paul (R-Kentucky) also blasted the Court, telling reporters that “a government that protects health care is one small, dangerous step away from protecting the environment.”

“The nightmare that I have long feared is now suddenly upon us,” Paul said. “Mark my words, we are on a slippery slope toward clean air and water.”

On the campaign trail in Iowa, the former Arkansas governor Mike Huckabee raised another doomsday scenario, telling his audience, “If the Court thinks people should be allowed to see a doctor when they want, they probably also think that people should be able to marry anyone they want. My friends, that is not what God intended when He created America.”

Speaking from New York, candidate Donald Trump offered his own scathing critique of the Supreme Court. “You look at them in their robes, and you say, ‘Those robes look freaking cheap,’ ” he said. “When I’m President, we’re getting more expensive robes.”

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Anti-Obamacare senator braces for court ruling – By MANU RAJU and JENNIFER HABERKORN 6/25/15 5:15 AM EDT

Ron Johnson, R-Wisc., stands off stage as he is introduced to speak during the Road to Majority 2015 convention at the Omni Shoreham Hotel  in Washington, Thursday, June 18, 2015. (AP Photo/Andrew Harnik)

Ron Johnson won his Senate seat in 2010 on an anti-Obamacare campaign, railing against the law as “the greatest assault on our freedoms in my lifetime.”

Now, the Supreme Court may give the conservative Wisconsin Republican more than he bargained for.

The justices will rule any day now in King v. Burwell, a case that could eliminate health insurance subsidies for 6.4 million Americans, including more than 166,000 Wisconsinites. And few Republicans have done more to prepare for the ensuing uproar than Johnson, just as he heads into a closely contested reelection race that could determine the next Senate majority.

Johnson is the lead author of legislation aimed at responding to the Supreme Court decision, a bill that has been embraced by 31 colleagues, including Senate Republican leaders. Yet, Democrats already are bashing his plan as nothing more than a political message that has no chance of becoming law — while conservatives believe it is too generous because it temporarily extends those subsidies for up to two years.

“Let’s face it, I’ve poked my neck out here,” Johnson said in an interview. “I’m getting attacked on both sides, but it’s the responsible thing to do. It’s the fair thing to do. My guess is the citizens of Wisconsin will take a look at that and say, ‘He’s being a responsible representative for us.’”

That Johnson now is in a pickle highlights the quandary for Republicans: While railing against the law is politically popular, they don’t want to be held responsible for eliminating a financial benefit that Americans have been getting for more than a year. And it showcases the challenges of running for office as an insurgent outsider, as Johnson did in 2010, versus as an incumbent who now needs to deliver results to voters.


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King v. Burwell won’t destroy Obamacare – Updated by Ezra Klein on June 19, 2015, 8:20 a.m. ET

What happens if the Supreme Court rules for the plaintiffs in King v. Burwell? The simplest answer is that Republican states get screwed.

You wouldn’t know that from the political debate, which pits Democrats who fear a ruling for the plaintiffs against Republicans who welcome one. But both sides are operating under an outdated model of the politics around Obamacare — one in which the law’s survival remains an open question.

It’s not. Obamacare is here to stay — as even congressional Republicans now realize. And the King v. Burwell case doesn’t threaten the law itself. It threatens Republican states that don’t want to implement the law. Residents in those states will end up paying a huge amount of money to fund a law that delivers no benefits to them and their state — and, in fact, turns their insurance market into a disaster zone.

More importantly, King v. Burwell threatens the 6.4 million people receiving insurance subsidies in states that don’t want to implement the law. For them, an adverse ruling by the Supreme Court won’t just be an interesting political story — it’ll be a genuine disaster that may leave them unable to afford care they badly need.

In the states that want to implement Obamacare, however, the law will be just fine — in fact, it will be entirely unaffected. And, over time, most or all states will decide to implement Obamacare.

King v. Burwell challenges a regulation, not Obamacare itself

The extremely smart Larry Levitt, a vice president at the Kaiser Family Foundation, told Vox that “this Court challenge is the last point at which it seems really like the law could completely go away.”

On this, I have a rare disagreement with Levitt: there is no plausible version of a King ruling in which Obamacare vanishes. Unlike the challenge to Obamacare’s individual mandate, the King case doesn’t contest the Patient Protection and Affordable Care Act itself. It contests a specific IRS regulation that interprets how subsidies flow through federally run exchanges.

As Jonathan Adler, one of the lawyers behind the case, told me, this is “a challenge to the lawfulness of this specific regulation. If the plaintiffs are successful, the court declares this regulation is unlawful.”

In the individual mandate case, there was a chance of the Supreme Court overturning Obamacare in its entirety. Here, the Court isn’t considering Obamacare in its entirety. The worst it will do is overturn the IRS’s regulation, shutting off subsidies in states that haven’t built their own insurance exchanges.

It’s common for reporters to say that SCOTUS might “gut” or “destroy” Obamacare — a shorthand for the very real, and truly devastating, consequences of cutting off insurance subsidies in 34 states. I’ve probably used the formulation myself. Those consequences are real, and for the newly insured, scary. But — in another divergence from the individual mandate case — states can choose whether to face them.


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Obama, GOP on Offense Leading Up to Health Care Ruling – By Kimberly Leonard June 15, 2015 | 12:01 a.m. EDT

What Obama’s comments on King v. Burwell tell us about the case’s outcome.

Supporters of the Affordable Care Act gather in front of the Supreme Court during a rally March 4, in Washington, D.C. Supporters of the Affordable Care Act gather in front of the Supreme Court during a March 4 rally in Washington, D.C. The justices are expected to decide on the constitutionality of Obamacare subsidies by the end of the month.

President Barack Obama in recent days has stumped in favor of his signature health care law and even second-guessed its review by the Supreme Court – choices some commentators questioned, given that the fate of his Affordable Care Act is expected to be revealed before the end of the month by justices who almost certainly have arrived at a verdict

Obama appears to be laying out his plans to the public and to his opponents so they know what to expect from the administration regardless of the outcome. But, analysts say, while the court has likely decided the fundamental issue, the president might yet have the opportunity to sway certain parts of its decision to his favor in a manner that could go a long way in determining the scope of the ruling or the timing of its implementation.

“There are nuances that have not been decided, but the big picture of who is going to win or lose has been decided,” says James Blumstein, professor of constitutional law and health law and policy at Vanderbilt Law School. “The president may have an effect tinkering around the edges.”

Obama’s recent remarks in two separate forums during the past week have projected confidence that his administration will win the case, King v. Burwell, but they also put onus on the Republican opposition regardless of the outcome. If the administration loses, the White House has said it will be up to congressional Republicans to repair the consequences. If the administration wins, the White House expects congressional Republicans to back off.

A female doctor or nurse talks with a patient while measuring his blood glucose levels.


Data Show Obamacare Is Working

Republicans, however, are engaging in the same type of rhetorical spin, having introduced their own laws to repeal and replace the Affordable Care Act and suggesting the law is hurting Americans. But analysts say the political theater that surrounds the issue is fairly routine in contentious cases and is unlikely to sway the justices.

“This kind of thing is conventional and normal when you get near the end of the term and a big case,” says Lyle Denniston, a reporter for SCOTUSblog. “This kind of outside noise is not going to make any difference on the outcome.”

The case centers on whether plaintiffs’ arguments that middle- and low-income adults who purchased health insurance through the federally run marketplace are entitled to subsidies. The language of the law, they argue, says tax credits are only to be distributed for online marketplaces “established by the state.”

If the Supreme Court rules in favor of the plaintiffs, about 6.4 million Americans will lose their health insurance because they will no longer be able to afford it, according to the Department of Health and Human Services.

Obama has not been shy about weighing in. At a G-7 meeting in Germany last week, he said the Supreme Court never should have taken up the case in the first place and that if it ruled against the administration it would be a result of a “contorted reading of the law.” Opinions were mixed as to the appropriateness of a sitting president weighing in on a pending Supreme Court case. He expressed confidence that the court would rule in favor of the administration, as it did in 2012 when the justices upheld the law’s most controversial provision requiring Americans to buy health insurance or pay a tax penalty.

Tuesday, at the Catholic Health Association’s 100-year anniversary event in Washington, D.C., Obama used moral and religious language to justify the health care law.

Graphic quote by President Obama: "Congress could fix this whole thing with a one-sentence provision."

“There’s something just deeply cynical about the ceaseless, endless, partisan attempts to roll back progress,” he said, referring to the Supreme Court case as well as the continued efforts by Republicans to repeal and replace the law.

Denniston called the optimism shown by the administration “a bit of whistling in the dark.” He added: ”They don’t have any more information than you and I do, but it’s not politically kosher for them to say they will lose.”


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