A thoughtful article by a Senator

Ben Sasse is a Senator from Nebraska, but not one of the Senators one hears a lot about; I had barely heard of him. But a column he wrote on the online Web site of the National Review, entitled “The Three Republican Camps after King v. Burwell,” is so good that I need to display it.

In the wake of the Supreme Court’s disappointing King v. Burwell decision, many are asking what comes next for those of us who have opposed Obamacare as a disastrous federalization of American health care.

I predict that the Republican party will quickly divide into three camps on health-care politics:

1. There are those who will want to throw in the towel. They will say it is time to move beyond the fight for repeal and admit that Obamacare is here to stay. They will condescendingly shake their heads at us unsophisticated conservatives, claiming that the only constructive path forward now is to make our peace with Obamacare, and to try to make it 12 percent less bad.

2. At the other extreme, there will be those who remind the first camp that no voter sent us to Washington to be slightly more efficient central planners than the Democrats. We are not here to sweep the floor of the Titanic by modestly adjusting Democrats’ unaffordable entitlement expansions. They will insist that we should invest 100 percent of our efforts in repealing Obamacare, and stop there. Even though the president would veto all repeal attempts (presuming such efforts could even clear the Senate), forcing such vetoes is necessary to remind voters where each party stands and thus why the 2016 presidential election is so crucial to America’s future.

3. Finally, there are those who — while remaining committed to full repeal — believe that there is no viable political pathway to repeal without simultaneously outlining our replacement plan. And then actually winning voters to support that vision. This group recognizes that it has a harder messaging job than the other two camps but believes that actually getting rid of Obamacare — rather than just romantically fighting lost causes — requires admitting that you cannot beat something with nothing. I propose that we name these three camps: the Fix-It Caucus; the Repeal-Only Caucus; and the Replacement Caucus.

Actually, I do not know of many Republicans that will join Sen. Sasse's “Fix-It Caucus.” But this is, of course, the direction that the Democrats are trying to push the Republicans to go.

To the Fix-It Caucus, I say: There is no way to sufficiently improve the command-and-control foundations of Obamacare, because it starts with the flawed (and unconstitutional) demand that Americans buy only the full-service insurance-and-redistribution products that Washington’s empowered bureaucrats compel us to buy. If the Beltway class’s Greek-style overspending is ever to be restrained, it will be accomplished only by giving the central planners even more power over rationing access and setting prices for drugs, devices, and procedures. The central planners’ answer to imperfect central planning is always more power for the central planners. Their answer is never more freedom. We ought not go down this road with the Washington-always-knows-best authors of Obamacare.

To the Repeal-Only Caucus, I agree that we should indeed use every available means — including reconciliation — to fully repeal Obamacare. But we must admit something else as well: American health care wasn’t healthy before Obamacare. And thus that even though the public disapproves of Obamacare (by an average of eight percentage points, according to Real Clear Politics), large portions even of Obamacare’s opponents are not persuaded by a repeal-only message. A family’s desire to be able to keep its health insurance when changing jobs or geography (a problem that Obamacare doesn’t make any better, by the way) is perfectly reasonable. We should acknowledge it and advance that cause.

So count me in the third camp.

And I would say the same for myself: “count me in the third camp.”

We must make the 2016 election a referendum on Obamacare vs. an understandable, common-sense, patient-centric alternative. We need a 2016 presidential nominee who can not only prosecute the case against Obamacare, but who will also enthusiastically champion the conservative cause of putting families in control of their own health futures. An exclusively negative set of talking points is a path to a dead end, both on Obamacare and in the 2016 presidential election.

Democrats have long held an advantage over Republicans on health care, mostly due to a perceived empathy problem in my party. But Obamacare has been such a train wreck that this Democratic advantage is mostly gone today. Obamacare is not popular. It’s going to be less popular than ever by Election Day 2016.

So here is the good news: The American people might finally be ready to listen to Republican ideas on health care. But they’re not looking for us to only say no to Obamacare — although that remains part of our task. They want us also to be for actual health-care reform that empowers families, expands choices, and comes with an honest budget.

We owe them that much this time.

Let’s remember how we got here: It was not simply that President Obama had a bad idea on health care and Democratic majorities in Congress. Obamacare arrived also because Republicans failed to persuade the public that we could address the avalanche of problems government had already created by decades of interfering with the health-care market. As a result, Obama filled the vacuum while Republicans appeared not to care. We cannot make that mistake again.

Beginning now, presidential contenders must present a constructive vision for health-care reform. It should be a minimum requirement that any candidate worthy of consideration must have a coherent plan for the voters. The primary election for Republicans is partly about what vision of a replacement for Obamacare we think our nominee can sell to voters in the general election — and then successfully implement in 2017. If Republicans fail to offer compelling alternatives to Obamacare in the 2016 campaign, we will lose — and we will deserve it.

The only point where I might differ from Sen. Sasse is that he says “The primary election for Republicans is partly about what vision of a replacement for Obamacare we think our nominee can sell to voters in the general election — and then successfully implement in 2017,” and I might say that “The primary election for Republicans is mostly about what vision of a replacement for Obamacare …” Obamacare is, I think, the #1 issue on which we need to fight the 2016 campaign.

The danger for Republicans over the next year is that the circular firing squad so dominates the conversation that the media latches on to a “There they go again, Republicans infighting” narrative, and then the third group — the Replacement Caucus — is never heard.

There’s an election here to be won, but there are no shortcuts. We have to do the hard work of making the case one voter at a time. Fixing Obamacare certainly is not the solution. And neither is being the “Party of No.” That will simply turn off the swing voters we need in order to put a conservative in the White House who can repeal and replace Obamacare.

We have an opportunity here, but let there be no more talk of waiting until some future date to produce the Republican health-care alternative. Now is the time.

Your move, 2016’ers.

I like what Sen. Sasse says. I would nearly totally agree with his points. And in particular, the Republicans need to come up with ideas for a better way to do health care.

Incomprehensible!

Yesterday the Supreme Court ruled on King v. Burwell, and all I can say is that, since they are the final arbiter, their decision has to be accepted as law. Apparently, Chief Justice John Roberts has decided that the Court will not decide on the basis of what is actually written in the law, but rather on what the apparent intent of the majority of the members of Congress who voted to pass it was.

Since ruling the other way would have made “Obamacare” unworkable, the Court has kept it alive for now by its ruling. And this means that it certainly will be alive for the remaining year and a half of Barack Obama's term as President, since he will veto any attempt to revise it. Which makes the election of a Republican in next year's election even more important than it would have otherwise been.

This is not the worst decision ever made by the Court — that would probably be Plessy v. Ferguson or Dred Scott v. Sandford — but certainly, I think it is one of the bad ones. But this is a nation of laws, and the Supreme Court is the supreme interpreter of what the laws mean, so for now we have to live with it. And since it is not a Constitutional decision, but only a ruling on the meaning of an Act of Congress, it can eventually be changed by a new act; it doesn't require amending the Constitution, as the Fourteenth Amendment was the only way to counteract the Dred Scott decision.

President Obama has no right to control what cases the Supreme Court considers!

According to a report by The Associated Press,

President Barack Obama says the U.S. Supreme Court probably shouldn't have taken up the latest challenges to his signature health care law.

Obama says there was no reason for the health program to end up in court, maintaining that “it's working.”

The high court is expected to decide soon whether Congress authorized federal subsidy payments regardless of where people live, or only for residents of states that created their own insurance marketplaces.

The decision could have far-reaching implications because millions would lose their insurance if the court said people who enrolled through the federal site couldn't get the subsidies.

Obama says it has been well-documented that Congress never intended to exclude people who went through the federal exchange.

Obama commented Monday in Elmau, Germany, at the conclusion of a summit.

The President seems to feel that any challenge to the way he does business to accomplish his goals is unjustified. Well the news for President Obama is that thuis is a government of laws. The President does not have the power to rewrite a law, just because it is worded in such a way that the President's goals atre not met, in order to make it work the way he wants it to.

Obamacare's failure

A column on the Real Clear Politics site, by Jack Kelly, dated June 7, 2015, entitled “Spare Us From Obamacare,” makes very interesting reading. So I reproduce it here.

The Affordable Care Act isn’t.

Some major health insurers seek eye popping rate increases for 2016 — such as 25 percent in Oregon, 30.4 percent in Maryland, 36.3 percent in Tennessee, 51.6 percent in New Mexico.


Insurance commissioners won’t approve all companies ask for. Rates will rise modestly in some states. But the odds are your premium will cost a lot more next year.

Premiums for non-group policies rose 24.4 percent more last year than they would have without Obamacare, said the National Bureau of Economic Research. Premiums in this market rose more after two years of Obamacare than in the eight years preceding, said eHealth Insurance, a private health exchange.

Despite subsidies for the industry of at least $16 billion, many insurers lose money. Far fewer individuals signed up for Obamacare than expected (and the administration claimed). Those who did are older and sicker.

“Only about 40 percent of those eligible eventually signed up after two full open-enrollments,” insurance expert Robert Laszewski told the Washington Examiner. “Carriers need more like 75 percent.”

Subsidies for insurance companies mask the true cost, said Stephen Parente, director of the Medical Industry Leadership Institute. Unless reauthorized in 2017, premiums for the cheapest plan could rise nearly 100 percent for individuals, 50 percent for families, he said.

That’s on top of sky-high deductibles. The average deductible for the cheapest Obamacare plan is about $5,180 for individuals, $10,500 for families — four times the IRS threshhold for a “high deductible” plan.

The column then cites an example of why Obamacare hardly qualifies as useful insurance:

Patricia Wanderlich, who suffered a brain hemorrhage in 2011, skipped the brain scan she should have every year because her Obamacare policy has a $6,000 deductible.

“To spend thousands of dollars just making sure (her aneurysm) hasn’t grown?” Ms. Wanderlich told The New York Times. “I don’t have that money.”

The column then goes on to cite some interesting statistics:

About 25 percent of non-elderly Americans with private insurance can’t afford to pay a mid-range deductible ($1,200 for individuals, $2,400 for families), The Wall Street Journal said in March.

People with a policy they can’t afford to use are no better off than the uninsured. Which may be why — despite the threat of fines — so few without insurance signed up for Obamacare.

About 75 percent of those who did are subsidized. Subsidies could end for people in 36 states if later this month the Supreme Court rules for plaintiffs in King v. Burwell.

We have, of course, already discussed this case, but the column makes a good reminder of what it entails:

As written, the ACA permits subsidies only for insurance purchased on exchanges “established by the state,” plaintiffs note.

That was a drafting error, politicians told New York Times reporter Robert Pear. Not true.

The words “established by the state” appear nine times in the ACA. No “drafting error” is repeated that often.

And finally, in summary:

Nearly every promise Democrats made has been broken. The average family pays more (some much more) for insurance, not $2,500 less. About 9 million Americans (so far) have learned they couldn’t keep the health plans they had if they wanted. Or some of their doctors.

Federal spending for health didn’t go down. It’s zoomed upward. So have emergency room visits. Overhead costs are exploding.

The Congressional Budget Office estimates that Obamacare will lower full-time employment by 2.3 million in 2021, compared with what might have been without reform.

The ACA has hurt millions more than it’s helped. The worst is yet to come. President Barack Obama delayed or altered (mostly illegally) unpopular provisions at least 50 times. If they’re implemented fully, up to 100 million who get insurance from their employers could have their policies canceled, the American Enterprise Institute has estimated.

As premiums and deductibles rise, and the job-killing employer mandate goes into effect, a “death spiral” — begun because so few healthy people have signed up — will accelerate. If the Supreme Court rules the ACA must be enforced as written, it would be a mercy killing.

Returning to the blogging scene (continued): The Supreme Court cases

Getting back to blogging, there are not a lot of things that can be discussed at the moment, which is part of the reason I have not been active the past few months. There are two pending Supreme Court cases which I think are very important: King v. Burwell, which could throttle Obamacare if it is decided on the plain language of the statute, and Obergefell v. Hodges, which might lead to gay marriage being recognized nationwide. But until June, the Supreme Court is keeping silent on how they will rule. And yet, the Justices have likely made their decisions already, so nothing I say can do much. (Of course, I doubt my blog is being read by any Supreme Court Justices, but one can only hope!). And besides these cases and the 2016 election, which I discussed yesterday, it's hard to come up with a topic to discuss. But I will try.

The Supreme Court will hear King v. Burwell!

The Supreme Court has decided that they will hear King v. Burwell. When two different appellate courts originally ruled in opposite ways on the language in the Affordable Care Act that says subsidies can only be paid in states that have established their own exchanges, it looked as though the Supreme Court would get to rule on it. But then the court that had ruled against the Administration's interpretation, in Halbig v. Burwell reversed itself in an unusual procedure where the decision of a three-judge panel was overruled by the full court, there was no longer a diversity of appellate court decisions, so the Supreme Court might not have heard the case. However, the Supreme Court announced yesterday that the King v. Burwell case will be taken up.

How anyone can believe that words as specific as “exchange established by a State” can include an exchange established by the Federal Government because a State chooses not to do so escapes me. The original decision in Halbig makes sense; its overruling — and the King decision — was simply an attempt by partisan judges to save the Act no matter what. And the Supreme Court is acting sensibly here, and I compliment the Justices who chose to take up the case.

A great day for foes of Obamacare

The Court of Appeals for the D. C. Circuit has issued a ruling in the case of Halbig v. Sebelius, which says that the subsidies in the Affordable Care Act (a. k. a. Obamacare) can only apply in states that have created their own exchanges, a clear interpretation of the plain language of the Act, which makes total sense. Meanwhile, the 4th Circuit, in the case of King v. Burwell, has ruled the opposite way. When two appeals courts have issued rulings so sharply in conflict, this guarantees that the Supreme Court will get to settle this. If Halbig is sustained by the Supreme Court, many other parts of the Act will fail to apply in all those states which use the federal exchange. So this could send Obamacare crashing down.

It's a case of bad drafting, because the Congress and President Obama were in such a hurry to force this down the throats of the American people. If they had been willing to work things out, and not dismiss the Republicans' efforts to change the plan, perhaps a clearer bill would have passed, but it might not have met Obama's demand to give health care that covers certain things to everyone whether they want it or not. Of course, that would have been a better bill, though Obama would not have liked it as much. But now he may be left with such a mess that the Act will have to be repealed and the government will start over. And that is good news.