Obamacare ruled constitutional. Scott Walker hopes he can Romney out of it.


UPDATE from AP at roughly 12:50PM: Wisconsin Attorney General J.B. Van Hollen says Gov. Scott Walker must follow the federal health care law.

The U.S. Supreme Court found the law constitutional on Thursday, but Walker, a Republican, has vowed not to implement it until after the November elections. The governor hopes the next president and Congress will repeal the law.

Nearly 30 states, including Wisconsin, sued over the law, alleging it was unconstitutional. Van Hollen, a Republican, handled Wisconsin’s participation in the lawsuit.

But he said Thursday that Walker is obligated to follow the law according to its deadlines.

Asked at a news conference whether he was obligated to conform to the law, Walker responded by saying the legislation establishes multiple timelines. from Madison.com

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This morning the Supreme Court upheld ACA commonly known as “Obamacare” in a 5-4 decision to sustain the mandate as a form of tax. The conservative Roberts sided with the liberal bench. More to be found at The mandate is constitutional: In Plain English

Both CNN and Fox briefly reported that it had been knocked down. “The mandate is gone,” the Fox correspondent Shannon Bream announced at 10:08 a.m. as a graphic on the screen called it unconstitutional. A moment later, the Fox anchor Megyn Kelly cautioned that Ms. Bream might be wrong.”

Scott Walker has not wavered from his vow to ignore the law as long as possible.

Scott Walker vowed in January to not set up a health exchange as required by the ACA until the SCOTUS ruled on it. But earlier this week he decided to be even more bullheaded and announced he would not do a thing about Obamacare until after he learned who becomes President of the United States in November.*

Walker today released a hyperbole-laden announcement on the SCOTUS decision which calls Obamacare “high cost”, and “damaging” and says “Governor Romney is the leader Wisconsin and America needs to reverse this disastrous law”.

Romney is quickly making a profit off of the decision. According to Atlantic Wire, “Mitt Romney’s spokeswoman said the candidate raised $300,000 off the ruling in the first hour after it was handed down.”

Romney is going to need the help of friends skillful with spin like Walker as he constantly side-steps the fact that as Governor of Massachusets he instituted a similar plan – what CATO Institute called “the nation’s most far-reaching state health care reform proposal”.

Only now does Romney flip to a right wing populace that is capable of calling out, lynching-style, “Let him die”. At least Marie Antoinette had the good graces to tuck her wishes for doom in sugar with her own, “Let them eat cake”.

About Medicaid

The court also narrowly defined Medicaid in their ruling. This is a bigger deal than many understand right now and will hurt vulnerable populations in states with conservative leadership.

“The narrow reading of the Medicaid provision is, in a word, unjust. By not requiring states to expand their Medicaid coverage, so many poor folks will have no recourse for getting health care, aside from buying it from insurance companies. How will states ensure that it will be affordable?” –C.F.C.

According to Kevin Russell of SCOTUSblog, a state can choose to refuse to participate in the expansion of Medicaid and not lose all of its Medicaid funds which gives it the option of continuing its current, unexpanded plan as is. ACA originally planned for expansion of coverage in all states to everyone up to 133% of the federal poverty level.

There is no question in my mind that Scott Walker will refuse to expand Medicaid on principle and politics alone never mind any perceived benefit. Meanwhile, Walter Dellinger, a former Solicitor General, said today that states would be ‘insane’ to turn down the new Medicaid funds.

As ProPublica reports, under ACA as originally written, the federal government would cover nearly 93 percent of the costs of Medicaid expansion from 2014-22, according to the Center on Budget and Policy Priorities, in the process covering 16 million Americans by 2019.

However Scott Walker is the governor that appointed as his Secretary of the Dept. of Health Services Dennis Smith who penned “Medicaid Meltdown: Dropping Medicaid Could Save States $1 Trillion” when he worked for the Heritage Foundation. At the moment I am finding little in the way of expert analysis on this loss of Medicaid expansion. But American Cancer Society CEO John Seffrin said his organization was looking at the ruling on Medicaid, and is “concerned that the decision may limit the expansion of quality coverage to some of our nation’s most vulnerable citizens.”

If you’d like to see what it is Wisconsin or other states could be gaining or missing out on in possible Medicaid expandion, see the Kaiser Commission on Medicaid and the Uninsured created in 2010. To my untrained eye, it appears that Wisconsin would put around 127,000 new unenrolled people on Medicaid by 2019 with expansion under Obamacare for an increased cost to Wisconsin of $205 million or an additional 0.9% of the state’s Medicaid bill.

Wisconsin is fortunate to be doing well with health insurance compared to other states in the nation. “Based on 2010 U.S. Census Bureau data, 90.6 percent people in Wisconsin had insurance coverage. That tied with Maine for the third-highest rate of any state, after Hawaii at 92.3 percent and Massachusetts at 94.4 percent.”-from Post Crescent

Update – I’m going to add this helpful note on Medicaid coverage and states from Michael Cooper of New York Times from the newspaper’s “Live Coverage of SCOTUS”:
“As states weigh whether to expand Medicaid coverage of the uninsured, with the federal government picking up at least 90 percent of the cost, some officials are expressing concerns that even a small increase in health care costs could be tough to manage.

Gov. John Kasich of Ohio, a Republican, warned of the tradeoffs involved in a statement he issued Thursday with his lieutenant governor, Mary Taylor.

“We are very concerned that a sudden, dramatic increase in Medicaid spending could threaten Ohio’s ability to pursue needed reforms in other areas, such as education,” they said in the statement.

The Supreme Court struck down the part of the health care law that threatened to withhold the money that states get for their existing Medicaid programs if they failed to expand coverage for the uninsured.

With the threat gone, states are left with a choice. If they expand coverage, the federal government will pay the full cost at first, and ultimately pay 90 percent of it. If they do not, they will forgo all that extra federal money, but save the small state share they will eventually owe.

Medicaid costs have risen dramatically in recent years. It is the largest single portion of state spending, and rose to 24 percent of all state spending last year, according to the National Governors Association and the National Association of State Budget Officers. Over the past decade, the groups found, the growth in state spending on Medicaid exceeded the growth in all other categories, and has been twice as much as the growth in education spending.

Traditionally the promise of a big new stream of federal aid has been sufficient to persuade states to adopt new programs. But in recent years Republicans governors in Ohio, Florida, Wisconsin and New Jersey have turned down billions of dollars in federal money for transportation projects, arguing that their states could not afford the projects involved. Now the debate will center on whether they will accept federal money to expand health care coverage for the uninsured.”

More from the SCOTUS live blog:
“There were not five votes to uphold it on the ground that Congress could use its power to regulate commerce between the states to require everyone to buy health insurance. However, five Justices agreed that the penalty that someone must pay if he refuses to buy insurance is a kind of tax that Congress can impose using its taxing power.” The tax argument was the 3rd argument presented. The first argument revolved around the Commerce Clause and the second involved the Necessary and Proper Clause.

The court also more narrowly defined how Obamacare may force states to expand Medicaid:
“On the Medicaid issue, a majority of the Court holds that the Medicaid expansion is constitutional but that it w/b unconstitutional for the federal government to withhold Medicaid funds for non-compliance with the expansion provisions.”

The court’s four liberal justices, Stephen Breyer, Ruth Bader Ginsburg, Elena Kagan and Sonia Sotomayor, joined Roberts in the outcome.

Justices Samuel Alito, Anthony Kennedy, Antonin Scalia and Clarence Thomas dissented.

*from PostCrescent.com “Walker, an outspoken critic of the law, originally said in January that he would not begin setting up the state’s health insurance exchange required by the law until after the court ruled. Earlier this month, the Republican governor went even further, saying that if the law is upheld he will not do anything until after the election, hoping that the next president and Congress will repeal it.

Only after those two fail would Wisconsin “figure out some alternative within the state,” Walker said in a statement released by his office this week”
“The U.S. Department of Health and Human Services has set a Nov. 16 deadline for states to submit plans for their health insurance exchanges, which must be in place by 2014. The federal government would step in and run exchanges in states that don’t have them.”

Further reading:
Mystery After the Health Care Ruling: Which States Will Refuse Medicaid Expansion? – ProPublica

Health care reform, politics and power: Is the Supreme Court Crunk?


  1 comment for “Obamacare ruled constitutional. Scott Walker hopes he can Romney out of it.

  1. June 28, 2012 at 8:30 pm

    Great title, Blue!

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