Latest Obamacare Challenge is not Valid

New York Times‘ editorial page weighs in on the Supreme Court’s decision to hear religious challenges to  Obamacare’s requirement that employer health plans cover birth control:

“The 1993 [Religious Freedom Act] was not intended to cover profit-making corporations, and any burden imposed on the employer’s religion is trivial — the law, after all, merely allows employees to make independent decisions about birth control.”

“In short, there is no substantial burden on religious exercise. Company owners remain free to protest against the different forms of birth control to which they object and call for repeal of the contraception coverage rule.”

“The Supreme Court’s challenge now is to recognize the real assault on religious freedom here — namely the assertion by private businesses and their owners of an unprecedented right to impose the owners’ religious views on workers who do not share them.”

Obama Seeks to Shine Light on Dark Money

According to The New York Times, the Obama administration has taken a major step toward greater oversight of political activity by 501(c)4 non-profit organizations.

“New rules proposed by the Treasury Department and the Internal Revenue Service would clarify both how the I.R.S. defines political activity and how much nonprofits are allowed to spend on it. The proposal covers not just television advertising, but bread-and-butter political work like candidate forums and get-out-the-vote drives.”

“Political spending by tax-exempt groups … skyrocketed to more than $300 million in 2012 from less than $5.2 million in 2006, according to the Center for Responsive Politics.”

Although the proposed rules would not prohibit non-profits’ political activity, it would, as a Treasury spokesman explained, be a “first critical step toward creating clear-cut definitions of political activity by tax-exempt social welfare organizations.”

Some Obamcare Bright Spots

All is not lost for Obamacare, according to David Nather.  Nather contends that “the Obamacare roll-out that we’ve all seen is not the story of a fatally flawed law. It’s a story of incompetence.”

“There are states that are running their own websites and enrolling a lot of people … Medicaid enrollment, another part of the law, is going significantly better than the signups for private insurance — nearly 400,000 people were determined to be eligible in October.”

“And nationally, 1.5 million people applied for health coverage in October — suggesting that there’s a lot more potential interest than the 106,000 who got all the way through the federal and state Obamacare websites to select a private health plan.”

Nather acknowledges there are major obstacles to success, including poor mismanagement,  “unpopular tradeoffs”, and certain aspects of the law that are “fatally flawed”. But he also highlights what has worked in states that have had higher enrollment:

  • Less bells and whistles
  • Using existing technologies
  • Using outside contractors
  • A supportive political environment
  • Picking the right vendors
  • Aggressive outreach

The bottom line: “It’s not impossible for the law to work … because if it really were impossible, it wouldn’t be working anywhere.”

White House Cautious as Relaunches

According to The New York Times , “White House officials, fearful that the federal health care website may again be overwhelmed this weekend, have urged their allies to hold back enrollment efforts so the insurance marketplace does not collapse under a crush of new users.”

“At the same time, administration officials said Tuesday that they had decided not to inaugurate a big health care marketing campaign planned for December out of concern that it might drive too many people to the still-fragile”

“With a self-imposed deadline for repairs to the website approaching on Saturday, the administration is trying to strike a delicate balance. It is encouraging people to go or return to the website but does not want to create too much demand. It boasts that the website is vastly improved, but does not want to raise expectations that it will work for everyone.”

“Officials said the website was now able to handle 50,000 users at a time, providing enough capacity on a daily basis to enroll millions of people in the next four months.”

“But those charged with fixing the site worry that 250,000 people might try to use the site simultaneously at times on Saturday and in the days ahead.”

A Perverse Form of 'Minority Rule'

In making a case to abolish the filibuster for legislation (“that’s arguably where the most damage has been done”), Steven Hill details recent Senate filibusters where Democrats tried and failed to obtain the necessary 60 vote. This doesn’t include the cases where Senate Democrats, under threat of a filibuster, didn’t even try to reach the 60 vote threshold.

“There is one other rarely discussed aspect to all this that illustrates why the Senate today, far from being “’he most deliberative body in the world,’ is one afflicted by the most perverse form of ‘minority rule.’ Because of the Senate’s distorted and malapportioned structure, in which every state has two senators regardless of population … the 41 GOP senators who block legislation often represent only about a third of the national population, since Republicans disproportionately represent sparsely-populated states.”

Hill concludes that, in addition to the three ‘kill points’ (The president, House, and Senate) created by the Constitution for rejecting federal legislation, “frequent filibuster abuse has created a fourth kill point: the Senate minority. Since it’s necessary to run the gauntlet and overcome all four kill points to enact a law, it’s no surprise that this has been an historically unproductive Congress.”

Supreme Court Takes Up Obamacare Again

The Supreme Court agreed “to wade into another heated Obamacare case–and opened the door to a new round of “war on women” attacks ahead of the 2014 midterms,” National Journal reports.

“The justices agreed to hear a challenge to the health care law’s contraception mandate, which requires most employers to include contraception in their employees’ health-insurance policies without charging a co-pay or deductible. A ruling would likely come in June–just months ahead of midterms that could determine which party controls the Senate and thus the confirmation process for new Supreme Court nominees.”

Majority of Americans Support Pathway to Citizenship

The New York Times reports on a new survey conducted by the Public Religion Research Institute: “A consistent and solid majority of Americans — 63 percent — crossing party and religious lines favors legislation to create a pathway to citizenship for immigrants living in the United States illegally, while only 14 percent support legal residency with no option for citizenship.”

“In June, the Senate passed a broad bipartisan bill with a 13-year pathway to citizenship that includes the hurdles mentioned in the poll: paying back taxes and passing English tests and criminal background checks. House leaders have said they will not take up that measure, but will address immigration issues in smaller bills. Several House Republican leaders have said they are drafting measures that would provide “lawful status” for many unauthorized immigrants but no “special path” to citizenship.”

“According to the report, nearly seven in 10 Americans believe the 13-year wait for citizenship under the Senate bill is too long, while 24 percent said it was just right.”

“Nearly two-thirds of Americans — 65 percent — say the United States’ immigration system is either completely or mostly broken.”

Obama's Next Broken Promise?

President Obama’s pledge that “if you like your doctor, you can keep your doctor”, is the next statement to undergo intense scrutiny.

While it is illogical to assume that people can keep their doctor “no matter what”, Jonathan Chait asserts that this latest controversy is “flecked with shades of gray.”

“The main difference between Keep Your Plan and Keep Your Doctor is that Obamacare’s disruption of the individual insurance market was a conscious policy choice … [Keep Your Doctor] does not create regulations designed to force people out of existing doctor-patient relationships. Keep Your Plan has been a political disaster for Obama because it was a broken promise. Keep Your Doctor is not even close to a clear-cut broken promise.”

Furthermore, “the [new health-care] exchanges turn out to be imposing some real market discipline on the process. People may like the idea of being able to go to any doctor or hospital, but what they really want is to pay low insurance premiums. The market is giving them what they want. Some people are not keeping their doctors because, it turns out, they don’t want to pay for the privilege.”

Healthcare Website Won't Be Fixed By December

Despite repeated assurances by the Obama administration that will be up and running by December, White House “officials said Monday that some visitors to will experience outages, slow response times or try-again-later messages,” reports The Hill.

A Centers for Medicare and Medicaid Services spokesperson claims: “The system will not work perfectly on Dec. 1, but it will work much better than it did in October,”

“Further technical problems at would also threaten the wave of enrollments expected in the first three weeks of December, putting consumers at risk of lacking coverage they need on Jan. 1.”

Job Anxiety at an Unprecedented Level Among Low Income Americans

According to a recent Washington Post-Miller Center poll “more than six in 10 workers … worry that they will lose their jobs to the economy, surpassing concerns in more than a dozen surveys dating to the 1970s. Nearly one in three, 32 percent, say they worry ‘a lot’ about losing their jobs, also a record high, according to the joint survey, which explores Americans’ changing definition of success and their confidence in the country’s future.”

“Job insecurities have always been higher among low-income Americans, but they typically rose and fell across all levels of the income ladder. Today, workers at the bottom have drifted away, occupying their own island of in­security.”

“What matters in this new anxiety, what unites the people who worry more now than ever, are income and education.”

Economist Heidi Shierholz: “It’s no surprise that security concerns are off the map now [among those workers] because the labor market is so bad …High unemployment hurts workers across the board, but it hurts workers with low and moderate incomes more.”

Health Care's Biggest Test Still to Come

“While failures in launching the federal insurance Web site and online exchanges have thrust the Department of Health and Human Services to the center of public attention,” the Washington Post notes that “the IRS also has a huge role in carrying out the law, including helping to distribute trillions of dollars in insurance subsidies and penalizing people who do not comply.”

“None is more crucial than enforcing the requirement that all citizens secure health insurance or pay a penalty. But those efforts have been hampered by a one-year delay in applying new insurance regulations to large employers. Those employers had been expected to provide insurance coverage information that the IRS would use to help identify who has insurance and who does not.”

“The lawmakers who drafted the health-care law intentionally barred the IRS from using its customary tools for collecting penalties — liens, foreclosures and criminal prosecution. The only means of collecting the fine is to essentially garnish tax refunds for people who overpaid their taxes.”

The good news: “IRS officials say that they are on track to meet the law’s requirements and that their computer systems are performing as hoped.” is the Case for Single-Payer

Nancy Folbre: “The malfunctioning website has magnified problems inherent in coordinating enrollment across many different companies in many different exchanges in cooperation with many different government agencies. The harmonization challenges are orders of magnitude greater than those faced by a single company or a single state, making streamlining difficult.”

“A single-payer insurance system, whether based on an extension of Medicare or on the Canadian model, promises many profoundly important benefits. Right off the mark, it promises simplicity.”