FACTBOX-Lawsuits challenging U.S. healthcare reform
Most legal scholars expect one of the suits to reach the U.S. Supreme Court, but not until its 2011-12 term that begins in October. Individuals, advocacy groups and hospitals have also sued.
The following are details of the current state of legal challenges to the law:
LAWSUITS MOST LIKELY TO REACH THE SUPREME COURT
* The Supreme Court on Monday refused to speed up a definitive ruling on the law in a suit brought by the state of Virginia, saying the state’s challenge must go through the typical appeals process. A U.S. appeals court in Richmond will hear oral arguments on May 10 challenging the recent ruling by U.S. District Judge Henry Hudson that the federal government could not compel a person to buy health insurance. In a twist, both the federal government and the state of Virginia appealed Hudson’s decision. Virginia says the judge erred by not throwing out the entire law. Hudson said the penalty charged for not having health insurance is not a tax, shooting down the federal government’s argument that it is based on its power to levy taxes.
* In a lawsuit filed by more than half the states and led by Florida, Judge Roger Vinson said the requirement that individuals buy health insurance is unconstitutional. A U.S. appeals court will hear arguments in early June in Atlanta. While Vinson said the entire health care law “must be declared void” because the requirement is inextricably linked to other parts of law, he put his decision on hold pending appeal.
OTHER RULINGS
* Another appeal, in a lawsuit filed by Liberty University, the college founded by conservative evangelical leader Jerry Falwell, will also be heard by the Virginia court on May 10. In November, a federal judge ruled the individual mandate and a requirement some employers buy coverage for employees was legal under the Commerce Clause. The judge also said the law did not illegally permit federal funding for abortion.
* In June, a U.S. appeals court in Cincinnati will hear an appeal in one of the first suits, filed by Michigan’s Thomas More Law Center. Last October, a federal judge partly dismissed the suit, ruling Congress had the authority to enact the law under the Commerce Clause of the Constitution.
* In April, the U.S. District Court in New Jersey decided two individuals who said they represented “we the people” and the “citizens of the state of New Jersey,” did not have any standing to sue, primarily because they could not establish they had been harmed by the law. The suit had said the law is illegal because it originated in the Senate, which cannot create revenue-raising measures on its own, and is unconstitutional because Obama is ineligible to hold the office of president. The court had already dismissed on Dec. 9 a lawsuit filed by a cardiologist, a patient and a physicians’ advocacy organization that had alleged the law violates the U.S. Constitution’s Commerce Clause and the Fifth Amendment.
* A California federal court dismissed a lawsuit, now before the the Ninth Circuit Appeals Court, that said the healthcare law violates individual rights, increases taxes and violates physician-patient privileges, along with violating the Commerce Clause.
* In November, U.S. District Court Judge David Dowd partially denied and partially granted a motion to dismiss a lawsuit filed by the U.S. Citizen’s Association in Ohio. While he dismissed arguments that the law violates freedom of association, due process and privacy protections, Dowd is considering arguments that the law exceeds federal authority granted by the Commerce Clause.
* At least 24 lawsuits have been filed in federal courts by states and private parties. One suit, Shreeve vs. Obama, was filed by a group of approximately 25,000 individuals and entities.
WHAT IS AT ISSUE?
* States like Virginia have passed, or are considering, legislation declaring the healthcare law cannot be enforced in their states. State legislators in Maine, Montana, Nebraska, Oregon, Texas and Wyoming have introduced bills that establish penalties, including fines and jail time, for any agent seeking to enforce the healthcare law within their states’ borders. North Dakota’s legislature passed a “nullification” bill in April authorizing it to enact any measure necessary to prevent enforcement of the law.
* The states’ main concern is that the law permits the federal government to force people to buy things, in this case requiring that all Americans purchase health insurance or pay a penalty under the “individual mandate.” The federal government counters that everyone will inevitably pay for healthcare, whether through insurance or during an emergency, and that without the individual mandate, premiums will rise.
* If the courts decide the individual mandate is unconstitutional, it is unclear if the mandate can be cut away from the law while leaving the other requirements intact. The states say that without the individual mandate the law is rendered toothless.
* Parts of the U.S. Constitution that have come into play are the Commerce Clause, which regulates commerce among states, the Supremacy Clause, which makes federal power supreme to states’ power, and the 10th Amendment, which leaves to states all powers not explicitly granted to the federal government.
* Some of the suits also focus on whether abortions are funded with taxpayer dollars under the law.
* When Obama lobbied for the bill, he said there would not be a new tax associated with the individual mandate requiring coverage. The penalty for not having health insurance, though, is collected through tax filings and the federal government argues the fine is indeed a tax it is empowered to levy. States say the U.S. government does not have the authority to charge the fine and point to the discrepancy between Obama’s statements and the U.S. government’s arguments.
Vermont Senate advances health care bill
The state Senate gave preliminary approval Monday to health care legislation that is a key part of Gov. Peter Shumlin’s agenda.
The bill, a version of which already has been passed by the House, would put Vermont on a path toward what it calls a “universal and unified health system” and what the Democratic governor calls single-payer health care, with the objective of ensuring health insurance coverage for every resident.
The Senate legislation won initial approval on a 21-8 vote and is due for final action Tuesday. It calls for setting up a health care marketplace, called an exchange, in keeping with federal health care legislation. It also sets up a board that would review and approve designs for a publicly financed program available to all residents.
Differences between the House and Senate versions of the legislation would be worked out in a conference committee, and then the bill would go to the governor for his signature.
Sen. Claire Ayer, D-Addison and chairwoman of the Senate Health and Welfare Committee, began the Senate debate by reading a comment from a resident upset with the rising cost of health care. Someone identified only as Aunt Serena wrote to The Burlington Free Press about the difficulties of paying medical bills.
“The patient not only has to be sick and is full of aches and pains and other hardships … (but also) has to scrabble to pay his taxes and his grocery and feed bills,” Ayer read.
Liberals Try to Rekindle Town Hall Fury That Inflamed Health Care Debate
Democrats still scarred over the town hall fury that inflamed the health care debate two summers ago and came to symbolize the unpopularity of that legislation are hoping Republicans suffer a similar fate over their deficit-reduction plan that would revamp social safety-net programs.
Democratic lawmakers and their liberal supporters are trying to ignite a storm of protest at town hall meetings being held by Republicans during the current congressional recess that they hope will give them momentum going into the 2012 presidential election season.
The GOP-led House this month approved Rep. Paul Ryan’s plan to cut $6.2 trillion from federal spending over 10 years and balance the budget by 2030 in part by making the elderly pay more for their Medicare. It would also cut the top income-tax rate for both individuals and corporations from 35 percent to 25 percent.
The plan has no shot of becoming law so long as Democrats control the Senate and the White House, which has released a plan that it says would cut $4 trillion over 12 years and would raise taxes on the wealthy. But liberals still want to punish Republicans who voted for it in hopes that it will help their party recapture the House and hold onto power in the Senate.
MoveOn last week reportedly urged its members to turn out at town halls and ask Republicans about plans to cut Medicare and Medicaid.
Rep. Lou Barletta of Pennsylvania faced outbursts at his town hall meeting that led police to remove a constituent. Others, including Rep. Charlie Bass of New Hampshire, Patrick Meehan of Pennsylvania, Robert Dold of Illinois, and Paul Gosar of Arizona, were grilled over the budget plan that would cut nearly $6 trillion from the deficit, in part by making the elderly pay more for their Medicare.
Ryan himself was booed lustily last week at his town hall meeting when he expressed support for cutting taxes for the wealthiest Americans.
Liberals have seized on that moment, arguing that residents in his own district don’t support the plan.
Ryan is holding more town hall meetings this week.
So far, the back-and-forth at GOP town halls have not risen to the level of the Democratic ones two years ago when there were near riots that ended in arrests and protests that fueled the Tea Party movement.
But liberal groups aren’t deterred.
Americans United for Change, a D.C.-based liberal group, has unleashed robo-calls in 23 Republican-held districts. The group has also targeted four lawmakers in particular with TV ads: Ryan and Reps. Sean Duffy of Wisconsin; Chip Cravaack of Minnesota and Steve King of Iowa.
In a statement, Tom McMahon, the group’s executive director, asked, “What are Republicans in Congress thinking, demanding that our most vulnerable citizens make more sacrifices but millionaires and big corporations to make less?”
As part of its effort to hold 25 House Republicans’ feet to the fire, the DCCC released an ad showing the elderly stripping at a house party, selling lemonade and struggling to mow lawns to pay for their health care under the Ryan plan.
“This is a defining moment for House Republicans: they chose to end Medicare rather than end taxpayer giveaways for Big Oil or tax breaks for the ultra rich,” DCCC Chairman Steve Israel said in a statement.
Sen. Barbara Mikulski, D-Md., sent out a fundraising email Tuesday for the Democratic Senatorial Campaign Committee, which is seeking to raise $145,590 by the end of the week, asking, “Is nothing sacred to these people?”
“First, Republicans spent months attacking women and families. Now they’re going after seniors,” she said. “There’s no end to what they’re willing to destroy to achieve their extremist vision.”
Claims by Democrats that the Republican plan would end social safety-net programs have been dismissed by fact-checking groups as outright lies.
But Republicans aren’t taking the attacks lying down.
“The Democrats tried to cover it up when they robbed $500 billion from Medicare to pay for their government takeover of health care, and now they’re using false scare tactics to again cover up the real Democrat plan to put a bureaucrat in-between seniors and their doctor,” Joanna Burgos, a spokesman for the National Republican Congressional Committee, said in a statement to FoxNews.com.
“The reality is that the Republican budget blueprint saves Medicare for future generations with no disruption for those in and near retirement, while the Democrats’ plan cuts Medicare benefits and raise taxes on job creators and every person who receives a paycheck.”
Memoir Highlights Long-Term Health Care Challenges
“A Bittersweet Season: Caring for Our Aging Parents — and Ourselves” (Knopf), by Jane Gross: Decades after screen star Bette Davis famously declared that “growing old is not for sissies,” Estelle Gross expanded on the woes of the ailing aged with her lament that people live too long and die too slowly.
On the day after the Sept. 11 attacks, after helping cover that story for The New York Times, an exhausted Jane Gross was finally able to drop by the nursing home a few miles north of ground zero where her mother had just moved to what would be her final residence. In a furious maternal vent, she greeted her daughter by saying, “I wish those planes had hit this building.”
Gross was a feisty octogenarian with a grab bag of chronic conditions that for nearly three years forced her to rely on others to carry out the simplest of daily activities. On the other hand, her cognitive abilities remained sharp until the end, a contrast to many others in her nursing home who endured the ravages of Alzheimer’s disease and other types of dementia.
Gross’ ordeal, and that of her daughter as principal caregiver, is one that is becoming more widespread as baby boomers are compelled to reverse the roles of their childhood and take on the challenging task of becoming their parents’ parents.
In her book, “A Bittersweet Season: Caring for Our Aging Parents —and Ourselves,” Gross, who went on to launch a blog called The New Old Age, recounts her own experiences in shepherding her mother through the intricacies and indignities of long-term care.
The narrative begins in 2000 with Estelle Gross’ move from Florida to New York, a “reverse migration” that is becoming more common for parents who need chronic care. It ends in 2003, when she dies at 88 in a nursing home after a decline that left her paralyzed, incontinent, unable to speak and unable to eat on her own.
An incisive reporter with a fine eye for detail, Gross laces her account of her mother’s decline and its impact on her own life with suggestions and warnings for other caregivers who find themselves in similar situations: Avoid the chaos of hospital emergency rooms, assume that costs associated with long-term care are not reimbursable by Medicare, find a family doctor, internist or — best of all — a geriatrician to manage the inevitable cascade of medical problems.
Gross recounts a succession of middle-of-the-night phone calls, emergency summonses from the workplace, financial costs that swiftly escalate and the need to play social engineer to ensure that nursing home staff aren’t slacking off when the need arises to change diapers or prevent bed sores.
“Once a parent has passed eighty-five, easy and affordable passings are few and far between. Believing you’re going to get one is magical thinking,” she writes.
The book is written from the perspective of the caregiver — more often a daughter than a son — whose relationship with the parent can be fraught with decades of resentment and other family baggage. In the author’s case, however, the ordeal brought her closer to her mother.
The path isn’t smooth, but rather an all-consuming and emotional roller coaster ride that Gross describes as “living in a soup of fear, guilt, heartbreak, resentment, loneliness, and exhaustion from bearing the weight of so much responsibility.”
While Gross’ memoir outlines the end-of-life decisions that often confront health care providers, clergy and ethicists, her mother’s ability to think rationally until the end gave her the control that others must often surrender. Instead, she exits on her own terms, without sentiment or self-pity.
“A Bittersweet Season” is sure to become required reading for anyone with an elderly parent who depends on long-term care. It’s also a worthwhile read for anyone who is interested in America’s health care system as it braces for the demands posed by demographic changes that include a sharp rise in the group now termed the “old old.”
Of course, the time to read the book is before the crises begin to mount, to be better prepared to make wise decisions and deal with whatever arises.
