Obamacare Is Going Back to the Supreme Court

Obamacare Is Going Back to the Supreme Court

Printer-friendly version
Plus: Elizabeth Warren’s $400 Billion Coronavirus Plan
Monday, March 2, 2020

Obamacare Is Going Back to the Supreme Court

The Supreme Court said Monday that it will consider a legal challenge that has the potential to overturn the Affordable Care Act, though a final decision in the case is unlikely before the election in November.

The fate of the health care law has hung in the balance since the Fifth U.S. Circuit Court of Appeals ruled in December that a key provision of the ACA was unconstitutional, opening the door to a complete repeal of the law.

The case: The court will hear an appeal on two consolidated cases, California v. Texas and United States House of Representatives v. Texas, that spring from an effort by a group of Republican-led states — and backed by the Trump administration — to invalidate the Affordable Care Act based on its individual mandate provision, which requires all individuals to obtain health insurance. In 2012, the Supreme Court cited the mandate penalty as a key factor when it upheld the law in a separate case, saying the penalty was a tax and therefore constitutional. The Republican coalition argues that the ACA became unconstitutional once the individual mandate penalty was reduced to zero in the 2017 tax legislation.

The appeals court did not address a second claim, however, which holds that if the individual mandate is unconstitutional, then the whole law is also unconstitutional and must be thrown out. Instead, it sent the case back to the trial court for additional analysis.

What could happen: A Supreme Court ruling could result in a variety of outcomes, including maintaining the status quo, invalidating some of the ACA’s provisions and overturning the law entirely.

Why it matters: Many experts say that if the lawsuit succeeds and the ACA is overturned, about 20 million people could lose their health insurance, and millions more would be affected by turmoil in the U.S. health care system, which has been modified by the ACA in myriad ways. The Trump administration says it has a plan to deal with the fallout — including the loss of legal protections for people with pre-existing conditions — but has provided no details.

Democrats will make political hay: Although the court’s decision will not be announced until next year, the justices will hear arguments in the fall, possibly as early as October, putting the issue back in the headlines shortly before the election. Democrats see health care as a winning issue and are expected to exploit the administration’s support for the case in the fall.

Newly revived Democratic candidate Joe Biden wasted no time Monday trying to gain advantage from the court’s announcement. “This fall, Donald Trump will be trying to get the Supreme Court to strike down Obamacare — ripping health insurance away from 30 million Americans, ending protections for 100 million more with preexisting conditions, destroying families, and costing a million jobs,” Biden said in a statement.

Warren Calls for $400 Billion Stimulus to Fight Coronavirus Hit to Economy

Pete Buttigieg is out. So is Amy Klobuchar. Oh, and Tom Steyer. Yet even as the Democratic presidential field is winnowed after Saturday’s South Carolina primary, leaving Bernie Sanders and Joe Biden as the two clear leaders for the nomination, Elizabeth Warren’s campaign reportedly insists she isn’t going anywhere.

Not only that: She’s still putting out detailed policy plans, in keeping with her campaign’s emphasis on her technocratic competence. She’s got a plan for everything — and that includes fighting the coronavirus.

Warren on Monday called for Congress to quickly pass a stimulus package of at least $400 billion to counter potential economic damage or ward off a recession due to the virus outbreak.

Warren said she strongly supports Senate Democrats’ request for $8.5 billion in emergency supplemental funding, but that she believes we must do more. “History shows that it’s often hard to pass multiple stimulus packages in succession—and it’s better that the initial package is too big rather than too small,” she says.

The stimulus proposal includes:

  • Low-interest or no-interest loans to companies hit by supply chain disruptions or other effects of the coronavirus, with the money to be used to avoid layoffs or reductions in worker hours;
  • Additional unemployment insurance;
  • Aid to state and local governments;
  • Efforts to increase U.S. production of pharmaceutical ingredients;
  • Investments in green infrastructure investments.

Her plan also proposes an emergency paid leave program for those who show symptoms of infection and seeks to ensure that every American can get evaluated or treated for free, with the government requiring insurers to fully cover care and reimbursing health care providers and hospitals for uncompensated services. Warren also says Congress should ensure that any vaccine developed be made available with no out-of-pocket cost to the public and the Federal Reserve should announce an emergency lending program to help companies whose supply chains have been affected.

“Companies across America are already struggling with supply chain disruptions, and we don’t want these temporary struggles to lead to widespread layoffs or for otherwise solid companies to go under,” Warren’s plan says.

Warren says her stimulus could counteract a decline in U.S. gross domestic product of about 3%.

RIP, Jack Welch and James Lipton.

Send your tips and feedback to yrosenberg@thefiscaltimes.com. Follow us on Twitter: @yuvalrosenberg, @mdrainey and @TheFiscalTimes. And please tell your friends they can sign up here for their own copy of this newsletter.

Switching From Extended-Release Drugs Could Save US Billions: Study

Medicare and Medicaid could save billions if doctors prescribed short-acting medications instead of extended-release versions, according to a new study in JAMA Network Open.

Researchers looked at Medicare and Medicaid spending between 2012 and 2017. They found that switching from extended-release drug formulations to equivalent generic immediate-release formulations would have saved the health care programs nearly $14 billion, including $8.5 billion for Medicare and $5.2 billion for Medicaid. The savings in 2017 alone would have been $2.6 billion.

“It’s not a huge difference in terms of patient convenience, but the cost difference is remarkable,” study coauthor Dr. Ambarish Pandey of the University of Texas Southwestern Medical Center in Dallas told Reuters.

Pandey told the news service that insurers should demand that drug companies lower the cost of extended-release drugs so that they’re comparable to the short-acting versions. “If Medicare puts its foot down and says it won’t put the extended-release versions on their formulary unless the price is similar to that of the immediate-release formulations, things will change,” he said.


Views and Analysis