Supreme Court and the Affordable Care Act

In defense of President Obama's leadership on health-care reform

By Tom Daschle, Published: March 26 | Updated: Tuesday, March 27, 6:00 AM

I will never forget my conversation with President Obama just days after his inauguration. A growing number of his staff members were arguing that he should abandon his goal of health reform in his first term. And I was beginning to doubt the president's personal willingness to commit to leading—and to risking political capital—in this cause.

But then he said to me, "Health care is the most important thing we will ever do. It will be my legacy. And it is more important to me now than ever before. Don't ever doubt that."

The rest, we could say, is history. But in this historic week for health reform, that history remains contested.

As we mark the law's second anniversary—even as the Supreme Court hears arguments on its constitutionality—we should pause to consider what the law reveals about the leadership of this president, and about the qualities of strong leadership in general.

At its core, the debate about health care in America is a deeply political and ideological disagreement over the proper role of government. Democrats say the government must remedy what is fundamentally a market failure. Republicans say the solution to our health-care crisis lies in freeing the market further. With the ideological chasm that exists today, how does one govern? How does one lead in such a poisonous political environment?

In answering these questions, we should consider three measures of leadership: approach, resolve and results.

The most important approach a political leader can take is committing to finding common ground with those on the other side of the argument. Good governance is best served by negotiation and compromise. As Senator Henry Clay declared, "all legislation, all government, all society is founded upon the principle of mutual concession." History is filled with examples, from Clay's own efforts to preserve the Union to the modern legislative compromises that brought us the Civil Rights Act, Social Security and Medicare.

Meet a Young Person

A Special Program For Supreme Court Justices

In the recent Supreme Court arguments over the health care law, the Court was very interested in hypothetical "young healthy" people ( see transcript). The Justices repeatedly described these imaginary persons, and their likely reaction to the health care law.

In response, Young Invincibles launched a brand new initiative: the "Meet a Young Person" Supreme Court Program.

Justices enrolled in this special program will hear directly from real, live members of the "young adult" species to get their thoughts on health care and the new health care law. Check out what the Justices had to say below, and get the facts in the YI amicus brief. Got your own story for the Supreme Court? This e-mail address is being protected from spambots. You need JavaScript enabled to view it

Facts About Young Adults and Health Care

1. Young people go to the emergency room more than any age group under 75.

2. 15% of young adults have a chronic condition.

3. The #1 reason young people don't have health insurance is cost, and #2 is jobs that don't provide benefits.

4. Only 5% of young adults choose not to have health insurance.

5. When offered insurance, young adults take coverage at the same rate as older Americans.

6. 2.5 million young adults have gained coverage under the Affordable Care Act.

7. By 2014, 17 million uninsured young adults would qualify for the Medicaid expansion or for subsidized insurance in the exchange.

All cites from The State of Young America Report and the YI Amicus Brief.

Tuesday, March 27, 2012

Can Congress require everyone to have health insurance?

By Christine Vestal, Stateline Staff Writer

Today, the Supreme Court will hear two hours of oral argument on the central issue in the case against the Obama administration's health law — whether the federal government has the constitutional authority to make people either purchase health insurance or pay a fine.

It is this question — corresponding to a provision of the law known as the "individual mandate" — that has been the primary focus of intense political opposition and public outcry ever since the law was proposed. It has been the focus of numerous lower court lawsuits as well.

Of the four appeals court decisions on the constitutionality of the health law, two upheld the mandate, one found it unconstitutional, and one ruled the question could not be decided until the mandate takes effect.

The challenge to the individual mandate, one of four separate issues in the case, stems from two lawsuits filed in Florida and later consolidated by the U.S. Court of Appeals for the 11th Circuit in Atlanta. One was filed by the National Federation of Independent Businesses and two individuals who lacked health insurance. The other was filed by Florida and joined by 25 other states.

The business group and individual plaintiffs challenged only the individual mandate. The states challenged the mandate and the Medicaid expansion provision, which will be argued tomorrow. The 11th circuit struck down the mandate, but found the Medicaid expansion constitutional.

Monday, March 26, 2012

Supreme Court hears first issue: jurisdiction

By Christine Vestal, Stateline Staff Writer

On the first day of argument in the health care case, the justices will consider whether they have jurisdiction to hear a challenge to the law's individual mandate provision before it goes into effect.

Seen by supporters as the Obama administration's signal achievement, the Affordable Care Act was challenged the day it was signed, March 23, 2010. Within months of its passage, 30 separate lawsuits had been filed against it, several involving states as plaintiffs. One — brought by Florida and joined by 25 other states and the National Federation of Independent Businesses — was accepted on appeal by the Supreme Court last November.

The process that begins with today's arguments may lead to a clear decision by the end of June. That is, unless the court rules that the centerpiece of the law, the so-called individual mandate, is not ripe for a decision until 2015. It is this jurisdictional question that will dominate today's initial court consideration.

Join us at the Supreme Court to rally for the Affordable Care Act!

On Tuesday, March 27^th, we will gather on the sidewalk in front of the Supreme Court beginning at 8:00 a.m. and ending at noon.  Families USA will have signs available for supporters. For more information or questions, please contact Jennifer Rison at This e-mail address is being protected from spambots. You need JavaScript enabled to view it .

Urban Institute Paper Shows the Affordable Care Act Delivers a Significant Investment in Children's Health

Press Release
March 22, 2012

Contact: Ed Walz
202-657-0685 (office)

Washington – A research brief released today by the nonpartisan Urban Institute shows that the Affordable Care Act (ACA) will increase the federal government's investment in children's health and help both children and parents get needed health care. The paper, Federal Health Expenditures on Children on the Eve of Health Reform: A Benchmark for the Future, was commissioned by First Focus and authored by Urban researchers Heather Hahn, Genevieve M. Kenney, Christine Coyer, and Katherine Toran.

Key findings include:

•The ACA will increase federal investments in children's health and cover more uninsured children; and

•Investments in health have historically increased as a share of total federal investments in children;

"This research confirms that the Affordable Care Act will increase our national investment in the health of America's children, if federal leaders protect Medicaid and CHIP" said First Focus President Bruce Lesley.

Health Care Reform and the Supreme Court (Affordable Care Act)

Updated: March 19, 2012

Beginning March 26, the Supreme Court will hold three days of hearings on the Affordable Care Act, the health care reform bill pushed by President Obama and passed by Congress in March 2010 over bitter Republican opposition.

It will be one of the most significant cases heard by the court in decades, with implications for the presidential race as well as the future of health care coverage. The decision, due in late June, is also likely to be a major factor in shaping the legacy of Chief Justice John G. Roberts Jr., as well as Mr. Obama, whose signature domestic initiative is on the line.

The court has set aside six hours for hearings over three days — the most time allotted to a single case since Miranda v. Arizona in 1966.

The Affordable Care Act is meant to extend health care coverage to tens of millions of previously uninsured Americans. The law is more than 2,000 pages long, but most of the legal challenges to it have focused on one central element: its requirement that nearly all Americans obtain insurance coverage or face a financial penalty to be collected under the tax laws.

Sunday, March 18, 2012

Much to celebrate after first two years of health law

By MARYLOU BEAVER and LISA KAPLAN HOWE

This week will mark the second anniversary of the Affordable Care Act, the landmark health reform initiative that strengthens our health care system with broad consumer protections and expanded access to coverage – and which also sparked national dialogue about health policy in our country.

In the two years since President Barack Obama signed the bill into law, many of the new benefits have gone into effect. Simultaneously, debate has continued, with the U.S. Supreme Court scheduled to hear oral arguments regarding the law during the last week in March.

No matter which side of the debate you are on, one thing is certain – the Affordable Care Act is working for New Hampshire children and families. Here are just a few of the ways:

Insurers can no longer refuse to insure children with serious illnesses.

Insurance companies are no longer allowed to deny or exclude coverage for children based on a pre-existing condition such as asthma or diabetes. This reform means that 16,100 New Hampshire children who have been diagnosed with conditions that could have resulted in denials of coverage are now protected.

Publicity Push as Health Law's Court Date Nears

By JENNIFER STEINHAUER and ROBERT PEAR

Published: March 19, 2012

WASHINGTON — Republicans on Capitol Hill have put together a highly coordinated two-week renewed assault on the health care law, seizing on the legislation's second anniversary and the next week's oral arguments before the Supreme Court concerning its constitutionality.

On Monday, Congressional Republicans took to the floor of both chambers to denounce the law, presaging a vote in the House this week to dismantle the law's payment advisory board, the 26th legislative attack on the law in the Republican-controlled House in the 112th Congress.

Daily news conferences are planned on the Hill next week, featuring state attorneys general, lawmakers who are physicians and others.

Republican members are also holding sessions on Twitter, making videos and scheduling television interviews day and night, with one veteran lawmaker, Senator Roy Blunt of Missouri, appearing on Fox News on Monday.

On the Senate floor on Monday, Ron Johnson of Wisconsin said, "The reason I ran for the United States Senate was primarily because of this law." Outside groups like the National Federation of Independent Business and Americans for Tax Reform are joining the efforts. Roughly 50 events are planned this week alone by party leaders and members.

PROPOSED MEDICAID CHANGES THREATEN ADOLESCENT HEALTH

Overview

The Medicaid program currently provides health care coverage to 8.4 million low-income adolescents ages 12 through 21 -- approximately one-quarter of the nation's adolescent population. These low-income adolescents are more likely than other adolescents to suffer from chronic physical and mental health conditions, such as asthma, diabetes, obesity, depression, post-traumatic stress disorder, and have conditions that result in disability. Low-income adolescents are also more likely to suffer the effects of significant health risk behaviors, such as unprotected sex and substance use, to be victims of physical or sexual abuse, and to experience injuries due to violence. In fact, as many as 30% of adolescents covered by Medicaid or other public insurance have a special health care need.

Medicaid plays a critical role in ensuring access to care for adolescents whose families are without the financial resources to obtain health care services on their own. Medicaid meets the needs of this high risk population by making available, primarily through the mandatory EPSDT benefit, comprehensive preventive care for the early identification and treatment of physical, emotional, behavioral, and dental health problems -- problems that if left untreated will likely persist into adulthood and in many cases result in increased costs to the individual and to society. Medicaid covers a wide range of vitally important services for adolescents. These include:

• Health education services to help adolescents become more health literate,

• Lab work and drug therapies to reduce sexually transmitted diseases among adolescents,

• Prescription medications and intensive mental health interventions to treat and support adolescents who develop serious mental illnesses,

• Primary and specialty care to enable those with complex physical conditions or injuries to function at their optimal level and learn self-care management, and

• Dental care to prevent and treat dental disease.

Yet, Medicaid coverage for adolescents is relatively inexpensive. Adolescents and younger children constitute 54% of Medicaid enrollees but account for only 27% of federal and state program costs. For the most part, major costs and potential cost savings lie elsewhere.