Among its many provisions, the Affordable Care Act included a $1 billion fund to cover various implementation costs. The law didn’t commit that fund to any particular activity, but rather allowed the administration to use it wherever needed to lay the health care overhaul’s foundation. Read full article > >

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Why the IRS gets half of health reform’s implementation dollars

If the individual mandate falls, the Washington health policy community is left with a difficult question: What policy, that isn’t a tax penalty, could stand in its place? Some might say the question is moot. If the Supreme Court rules against the mandate, congressional Republicans will never permit the Obama administration to repair the battered law. But it might not be up to them. If the mandate is overturned but the rest of the law stands, many states might go looking for policy solutions to stabilize the health-care markets that they set up under the Affordable Care Act, but that are now missing the steadying influence of the mandate. And they’ll probably start with a 2011 Government Accountability Office report that lays out nine alternatives to the individual mandate. Read full article > >

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What happens if the individual mandate falls

David Orentlicher says that court decisions since the 1940s provide ample support for the constitutionality of the Affordable Care Act.

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Opinion: Precedent says law should stay

Today’s the day. The Supreme Court will begin hearing oral arguments as to the constitutionality of various provisions of the Affordable Care Act. Note that phrase: “Various provisions.” The Supreme Court is not looking at the act as a whole. Rather, it’s considering four separate questions related to separate parts of the law. Here’s my colleague Sarah Kliff with a primer of what they are, and why they matter. And after that, a special round-up of news, analysis, and opinion on the subject. And after that, your regularly scheduled Wonkbook: Read full article > >

Originally posted here:
Wonkbook: Absolutely everything you need to know about health reform’s Supreme Court debut

Don Berwick spent 18 months as the administrator of the Center for Medicare and Medicaid Services, making him the point man for the Obama administration’s implementation of the Affordable Care Act. He began in the post in July 2010 and resigned last November, in the face of Republican pledges to block his nomination in the Senate. Republican legislators seized on remarks he made praising Britain’s National Health Service as an “example” for the United States to follow. Many accused him of supporting the “rationing” of services, a claim Berwick has rejected. Read full article > >

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Conversations: Don Berwick looks ahead on health care

Last year and during the 2010 election cycle, House Republicans promised that their plan  for health care was “repeal and replace” – they would repeal the Affordable Care Act and replace it with new legislation. In fact, during 2011 they voted to repeal it several times, but they never quite got around to the “replace” portion of it. I thought that  was all, but just last month Energy and Commerce Health subcommittee chair Joe Pitts (R-Penn.) revived “replace” talk, saying that Republicans would be ready to move on a bill after the Supreme Court acted. Read full article > >

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Jonathan Bernstein: GOP’s ‘plan’ for health reform

Reckoning that the best defense can be a good offense, conservative activists now have amped up their efforts to force Supreme Court Justice Elena Kagan to recuse herself from the looming High Court showdown over the  Patient Protection and Affordable Care Act . But when you compare the latest points in their “recusal case” to ones offered by progressive activists pressing Justice Clarence Thomas to step aside in the fight over the new health care law, it just isn’t a close call.   The new charges against Justice Kagan come from a conservative website run by the Media Research Center  which in turn is run by the seemingly ageless Brent Bozell . Following a Freedom of Information Act request of the Justice Department, the Cybercast News Service posted a long take last week based upon internal emails between DOJ officials discussing the formal government defense of the Affordable Care Act. The piece is a good read — mostly because it gives ammunition to both sides in the partisan war over the Court. It gives conservatives fuel for their theory that Justice Kagan’s hands were all over early federal strategy in the pending Care Act litigation, a status that would generate another statutory reason for her to consider recusing herself (remember, no one can force her to do so). In this world, the DOJ emails indicate (or imply, anyway) that Kagan was a wily operator who was smart enough not to create a “written” record about her involvement in the law’s defense. But the piece gives progressives ammunition, too. If this is the best Bozell and company can do to link the junior justice to the Care Act, it’s small beer – and hardly worthy of yet another recusal for Kagan. From what I can tell, the two ostensible “money quotes” CNS has uncovered so far from (then-Solicitor-General) Kagan’s emails are: “You should do it” (responding to a request from her principal deputy, Neal Katyal , who wanted to take the lead in defending the statute) and: “What’s your phone number?” (responding, again, to Katyal, who was asking her if she wanted to be involved in DOJ strategy sessions about the new law). That’s it. Like bringing a putty knife to a gunfight. No judge, not even a justice who already has recused herself from dozens of cases , would reasonably recuse based upon that. Here’s how Tony Mauro covered the story for the National Law Journal . He wrote:  The documents, mainly in the form of printouts of internal email chains, show that now-Acting Solicitor General Neal Katyal – not Kagan herself — was the point person within the office on discussions of the new health care reform law and how to defend it in court. Released to CNSNews.com, a conservative-oriented news outlet, the emails also reveal how Kagan was walled off from discussions of the law — possibly because she already knew she might be nominated to the high court, where a challenge to the statute would ultimately be decided. The release has raised eyebrows among lawyers familiar with the long tradition of the solicitor general’s office resisting release of internal documents so as not to hamper deliberations on cases. Numerous redactions in the documents shield portions of the emails, including the names of associates in the SG’s office. But Kannon Shanmugam, a veteran of the SG’s office who is now an appellate partner at Williams & Connolly, said the documents represent “an unusual if not unprecedented” look at the office’s operations. “It raises concerns about chilling lawyers in the office in the conduct of their work, and gives an incentive not to put things down in emails.” Justice Kagan’s involvement, or not, in strategy and tactics over the Care Act is a legitimate question for anyone to pursue. In a legal and political vacuum it might even be reasonable to spend some time and energy figuring out the various contradictions, if any, between the contents of FOIA documents and her testimony last summer before the Senate Judiciary Committee during her confirmation hearing. I suspect that her testimony was as complete, at least, as was the testimony of her three immediate predecessors onto to the bench, Justices Sonia Sotomayor and Samuel Alito and Chief Justice John Roberts. But of course the new recusal “questions” about Justice Kagan don’t arise without compelling context and perspective. They arise from the shadows of the pending  conflict allegations against Justice Thomas. His wife is a conservative activist with ties to groups campaigning for the repeal of the Care Act. He did not declare on federal financial forms hundreds thousands of dollars of her income from a conservative group. He attended conservative events hosted by the Koch brothers , the billionaire brothers who are overtly hostile to the new health care law. And in late February, the justice himself, in a  speech sharp with political overtones, pointedly said that he and his wife ”believe in the same things” like “liberty.” Is there a doubt in the mind of any sentient American how Justice Thomas will rule on the Affordable Care Act? Of course not. Are there similar doubts in anyone’s mind about how Justice Kagan will vote on the Act if and when it comes before her? Not really. But my point is narrower; all the Kagan-busters  do when they focus upon the junior justice’s ”ties” to the Care Act is make Justice Thomas’ recusal problem seem that much more severe. The contrast flatters Justice Kagan, not Justice Thomas, since she’s not out on the speaking circuit telling everyone that she “believes in the same things” as some of the law’s most strident defenders. If Justice Kagan has to recuse herself because she might have discussed with a subordinate how government lawyers were going to make arguments the whole world knew they were going to make then what’s Justice Thomas’s excuse for non-recusal after openly taunting his critics (and future Care Act litigants) by pointedly telling them all that he believes in the “same things” as his anti-Care Act wife? Conversely, if conservatives believe that the recusal calls against Thomas truly are ” insipid ” then how do they pivot and build a legitimate recusal case against Kagan based upon “What’s your phone number?’ and “you should do it”? Is there a word for “below insipid?”      Oh, that’s right. Each individual justice is allowed to search his or her own heart and mind to determine whether a conflict exists. And so Justice Thomas naturally has a different internal Recuso-meter than does Justice Kagan. Here’s what ought to happen. Justice Kagan, the mensch that she is, out to tell Justice Thomas that she’ll recuse herself from the Affordable Care Act if he recuses himself as well. Such a proposal would almost certainly leave the Kagan-busters speechless, a state they would then often share with the man we all know is going to stick around in the health care case so that he may vote “no” when formally asked if the Affordable Care Act is constitutional.

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Conservatives Still Losing the Kagan-Thomas Recusalfest

On the first anniversary of the Affordable Care Act, despite months of spin both for and against, public opinion of the law has barely changed. It’s been about evenly split along partisan lines since around the summer of 2009. The bill’s passage and the subsequent year of fights over implementation have had barely any effect.

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The health care stalemate

Because we clearly have not lifted enough from Matt’s blog today, I want to double down on this point about the value of fast food  in regards to weight-loss: I think that sometimes people need to be just a bit more patient with the operation of things. I see the McDonald’s oatmeal saga as in some ways optimistic. The first piece of good news about McDonald’s oatmeal is that, as a marketing strategy, they clearly think there’s money to be made in selling people food that they perceive as healthier than the existing McDonald’s options. The second piece of good news about McDonald’s oatmeal is that, as a matter of corporate policy, McDonald’s discloses extensive nutritional information about the food they sell. Thanks to the second piece of good news, we know that the promise of healthy McDonald’s oatmeal is a lie. And thanks to the Affordable Care Act, more extensive and aggressive calorie information will be coming. Last year I found myself traveling a lot and thus ending up in my room with McNasty’s or Burger King. I can not overstate the benefit of knowing, as much as possible, the precise amount of calories you’re taking. Many of the fast food chains make that really easy. This is a very good thing. As Matt says, calories are most certainly not intuitive. There are “salads” out there that will hit you like a burger I love Maoz. But the Junior. falafel ultimately, has roughly same amount of calories as the Junior Whopper . Again, there are other important and very good reasons (overall health, ethical, environmental etc.) to go with the falafel. But I don’t think weight loss–in and of itself–is a good one.  Food is complicated. When in doubt, I try to avoid the hidden price tag.

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The Awesome Junior Whopper

This week, the House of Representatives plans to vote to repeal the Patient Protection and Affordable Care Act. It will succeed.

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Opinion: No health reform repeal