Posted 6/29/12 on Medscape Connect’s Care and Cost Blog
Like most health law watchers, I was surprised by yesterday’s decision. I’m sure that on this issue, as with everything else, zealous responses will rationalize the result and split the country down the middle.
I expected the Court to be purely partisan, but apparently Chief Justice John Roberts acknowledged the gravity of his role and saw his way clear to support the law with some constraints. Here’s the comment from SCOTUS (Supreme Court of the United States) Blog:
Salvaging the idea that Congress did have the power to try to expand health care to virtually all Americans, the Supreme Court on Monday upheld the constitutionality of the crucial – and most controversial – feature of the Affordable Care Act. By a vote of 5-4, however, the Court did not sustain it as a command for Americans to buy insurance, but as a tax if they don’t. That is the way Chief Justice John G. Roberts, Jr., was willing to vote for it, and his view prevailed. The other Justices split 4-4, with four wanting to uphold it as a mandate, and four opposed to it in any form.
Continue reading “The Game’s Not Over, and It May Not Even Be The Real Game”
Posted 3/29/12 on Gooz News
This is what conservative justices will do if they strike down or cripple the health-care law … A court that gave us Bush v. Gore and Citizens United will prove conclusively that it sees no limits on its power, no need to defer to those elected to make our laws. A Supreme Court that is supposed to give us justice will instead deliver ideology. now – E.J. Dionne, The Washington Post
The insurance mandate was effectively reduced to a bumper sticker by the opponents in their constitutional challenge, and the entire law reduced to little more than an appendage to the mandate. . . The fate of the mandate should not determine the survival of the other elements of the law — like prohibiting insurers from denying coverage to people with pre-existing conditions or charging them higher fees — which can operate without the mandate. – New York Times editorial
Overturning the whole law would be an act of judicial restraint. – The Wall Street Journal editorial
Continue reading “Day Three – The Wrap Up”
Posted 3/28/12 on Health Policy and Marketplace Review
First, trying to predict how the Court will rule is at best just speculation. I know what Justice Kennedy said both today and yesterday and it certainly doesn’t look good for the Obama administration and upholding at least the mandate.
But I will remind everyone, based upon oral arguments, most Court watchers expected a ruling in favor of the biotech industry on a recent case involving health care patents. “Surprisingly,” the Court ruled against the industry.
Continue reading “If the Supreme Court Overturns the Individual Mandate”
Posted 3/25/12 on The Hospitalist Leader
To get a sense of why this case is different and will dominate the news cycle now until the decision in June, appreciate this fact: the time allotted for arguments—the period in which plaintiffs and defendants present their views to the justices—is six, instead of the usual one. Moreover, the proceedings will transpire not just in one day, but three. This is substantial.
There are several issues under debate, but the most significant, and the one you have likely heard about, is the individual mandate. This is the requirement in the Affordable Care Act that all individuals without insurance must purchase it. The alternative is paying a penalty (but not a tax)–and this is important. Nevertheless I will revisit that below. For most people, the mandate is not applicable, as folks with Medicare or Medicaid, or receiving insurance from their employer meet the necessary waiver requirements.
Continue reading “Health Care and the Supreme Court: Prepare Your News Dial”
Posted 3/14/12 on Gooz News
What will they do? The Supreme Court (more or less) that gave us Bush v Gore in 2000 will later this month hear arguments by states challenging the Affordable Care Act, a.k.a. health care reform. The heart of the legal challenge raised by conservative state attorneys general is whether the individual mandate is constitutional. What happens if the Supremes say no? Does the entire law fall, or just the mandate?
The issue for lawyers is called “severability.” Did Congress when passing the law believe the mandate was necessary to the smooth functioning of the rest of the law? Clearly there are large swaths of the law for which the mandate is largely irrelevant: the physician payments sunshine act (disclosure of drug company payments to doctors); the creation of the Patient Centered Outcomes Research Institute to conduct comparative effectiveness research; the numerous payment pilot projects; and more.
Continue reading “Defending the Affordable Care Act”
Posted 12/20/11 on Health Populi
2012 will be a dynamic year for health information technology (health IT) in the U.S., which I outline in my annual health IT forecast in iHealthBeat, the online publication on technology and health care published by the California HealthCare Foundation. The full forecast can be found here.
The key headlines for you Reader’s Digest abridged fans are that:
- The Health IT sector will continue to grow jobs in the ongoing Great Depression, particularly in key competencies in data security, analytics, integration, and EHR implementation.
- There will be more data breaches, and consumers will be justifiably concerned about data security. Government will more consistently implement sharper “teeth” in their punishment of health organizations who leak personal health information.
- Health IT suppliers will consolidate. The Microsoft-GE combination, announced in December 2011, is a sentinel event in this regard.
- Health IT start-ups will continue to emerge in 2012, some of which will have sound business models that will be acquired by larger firms to round out their offerings and address, in particular, consumer/patient-facing applications that support health engagement to enhance health outcomes.
- Connected health, in the form of telemedicine, mobile health, and remote health monitoring to the home will gain traction and business models as health payment moves toward accountable care, medical home, and paying for outcomes.
- IBM’s Watson is an example of high-powered data analytics, which will get more practical and targeted in 2012. A ripe area for this will be preventing re-hospitalizations, a focus of health reform and Medicare financing.
- People – patients and providers – live multi-channel, multi-platform lives every day. Thismodus vivendi is translating into health and health care. Patients want online connections with doctors for administration (e.g., Rx refills and appointments), clinical decision making, and communications (e.g., email with practices).
Continue reading “Health IT in 2012: a Dynamic Sector in the Context of a Fiscally-Challenged Health System”
Posted 12/19/11 on Health Care Reform Update
The schedule for the Supreme Court to hear arguments on the constitutionality of provisions of the Affordable Care Act was announced this week. The following is the agenda.
On March 26, the Court has allotted an hour to hear arguments on whether the Anti-Injunction Act makes challenges to the individual mandate premature until 2015. With neither the government nor the ACA’s opponents pressing the point, the argument for the precedence of the Anti-Injunction Act—an argument that four appellate judges had earlier found convincing—will be presented by Washington attorney Robert Long as a “friend of the court”.
Continue reading “Affordable Care Act: A Date With Destiny”
Posted 11/18/11 on Health Care Reform Update
The announcement on November 14 that the Supreme Court will review various aspects of the constitutionality of the Affordable Care Act has set legal experts to guessing possible outcomes.
The Court accepted just one of four Appeals Court decisions for review, but the one chosen, from the Eleventh Circuit, covered every major issue and included as plaintiffs twenty-six state attorneys general who oppose the ACA. The Eleventh Circuit ruled in August that the ACA’s individual mandate provision was unconstitutional, but ruled against the plaintiffs on all other issues.
It’s obviously naïve to think that the Justices haven’t already thought a great deal about the issues, and their thinking presumably influenced the decisions as to which questions raised in the lower courts they should address. So what can we guess from the four issues to be argued before the Court in the spring of next year?
Continue reading “Reading the Supreme Court Leaves”
Posted 11/12/11 on Health Care Reform Update
The final federal Court of Appeals decision on the constitutionality of the Affordable Care Act, before the Supreme Court meets to decide which cases to consider, was issued this week. It includes some interesting twists.
The DC Circuit upheld the law’s requirement that nearly all Americans must have health care coverage in a 2-1 ruling. However, the minority vote was cast not because of the constitutionality issue, but because the dissenting judge, Brett Kavanaugh, a George W. Bush appointee, considered that—under the Anti-Injunction Act, which limits attempts to strike down proposed taxes—no ruling was appropriate at this time. Judge Kavanaugh’s citing of the Anti-Injunction Act echoed an earlier decision by the full Fourth Circuit that imposition of the individual mandate’s penalties could not be considered until they were implemented and individuals had been forced to pay them, in effect interpreting the penalties as a form of taxation.
Continue reading “Yet Another Appeals Court Heard From”
First posted 9/29/11 on The Health Affairs Blog
Copyright ©2011 Health Affairs by Project HOPE – The People-to-People Health Foundation, Inc.
Wednesday, September 28 was a busy day at the Supreme Court clerk’s office.
It had been widely expected that there would be a major pleading filed with the clerk in an Affordable Care Act challenge, as the response of the United States to a certiorari petition in the Sixth Circuit’s Thomas More case, which had upheld the ACA as constitutional, was due. A cert. petition asks the Supreme Court to exercise its discretion to review the decision of a lower court, and the losing plaintiffs in Thomas More had requested the Supreme Court to reverse that decision and find that Congress had no authority under the Commerce Clause of the Constitution to adopt the ACA’s minimum coverage requirement.
Continue reading “The Affordable Care Act Supreme Court Petitions: Issues and Implications”
First posted 9/28/11 on Health Care Reform Update
Hot on the heels of Monday’s news that the Obama administration had decided not to ask for a re-hearing of the Eleventh Circuit Court’s ruling that the individual mandate is unconstitutional, came today’s announcement that the Justice Department had asked the Supreme Court to hear the case.
Given that other Appeals Court decisions may also be forwarded to the Supreme Court, it is not certain which case or cases the Court will decide to hear. However, a request by the administration is almost sure to be granted.
While the rationale for the Justice Department decision cannot be known, it seems that the administration believes that it has a better than evens chance of prevailing.
The critical issue now is timing, with a hearing most likely in the spring, and a decision—in the middle of the presidential election campaign—in June 2012.
First published 7/15/11 on Neuroskeptic
Back in June, the U.S. Supreme Court ruled that a Californian law banning the sale of violent videogames to children was unconstitutional because it violated the right to free speech.
However, the ruling wasn’t unanimous. Justice Stephen Breyer filed a dissenting opinion. Unfortunately, it contains a whopping misuse of neuroscience. The ruling is here. Thanks to the Law & Neuroscience Blog for noticing this.
Breyer says (on page 13 of his bit)
Cutting-edge neuroscience has shown that “virtual violence in video game playing results in those neural patterns that are considered characteristic for aggressive cognition and behavior.”
Continue reading “Violent Brains in the Supreme Court”