Affordable Care Act

A Case of Jiggery-Pokery


Katherine Welles / Shutterstock 

THIS SUMMER’S ATTEMPT to dismantle the Affordable Care Act began as the very height of frivolous lawsuits. Cooked up with the help of the Competitive Enterprise Institute, a libertarian think tank, the case (King v. Burwell) depended upon a very narrow reading of four words in Section 36B of the ACA: “established by the State.”

Essentially, Obamacare foes argued that Congress intended to provide health-care subsidies (or tax credits) only to those Americans living in states with state-operated insurance exchanges. Those who lived in states without exchanges—including Florida, Texas, Wisconsin, and others—and were, therefore, dependent upon the federal exchange would be ineligible for subsidies.

Of course, Congress intended no such thing—as the Supreme Court upheld. Throughout dozens of hearings and hundreds of hours of debate, it was clear that ACA subsidies would be available to every American, regardless of what state they lived in.

In a 6-3 ruling, the court rejected King, with Chief Justice Roberts explaining, “A fair reading of legislation demands a fair understanding of the legislative plan. Congress passed the Affordable Care Act to improve health insurance markets, not to destroy them.”

Had the suit carried the day, 6.4 million Americans would have lost their subsidies. 

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Obama to Catholic Health Leaders: Only ‘Cynics’ Would Dismantle Health Reform

Photo via REUTERS / Jonathan Ernst / RNS

Sister Carol Keehan greets President Barack in Washington on June 9, 2015. Photo via REUTERS / Jonathan Ernst / RNS

With some members of Congress and Health and Human Services Secretary Sylvia Burwell in the audience, Obama’s speech was entirely about the success of his signature legislation and the need to keep it alive.

Obama recited statistics on how many uninsured are now covered and on the economic value of “portable plans in a competitive marketplace.” But he anchored his speech in the faith-based association’s moral calling.

“What kind of country do we want to be?” he asked in a series of rhetorical questions:

Is access to care a commodity “only for the highest bidders?” Or is it “a fundamental right?”

Obamacare Marches On, Step by Step

THE AFFORDABLE CARE ACT, which has now been the law of the land for five years, is beginning to reshape the national landscape in significant ways.

According to a New York Times analysis of the ACA’s first enrollment period, about 10 million additional people gained insurance in 2014. Many of them fall into demographic groups that have historically struggled to access coverage, such as low-income Americans, people of color, and women. Ultimately, President Obama’s health law is slowly making the country more equal.

There are a few ways the ACA is accomplishing that goal. It has built-in consumer protections to ensure that insurance companies treat people more fairly. It’s created state-level marketplaces to give people new options for purchasing private plans. And it’s expanded the pool of people who are eligible for public coverage through the Medicaid program.

Health policy experts agree that adding more low-income people to the Medicaid rolls represents one of the biggest successes of the ACA so far. According to the Urban Institute, a nonprofit research group, the states that agreed to expand their Medicaid programs—27 so far, plus the District of Columbia—have seen about a 40 percent drop in their uninsured rates.

“This has been a lifesaver for me. I hadn’t seen a doctor for 11 years,” Marc Sigoloff, a freelance writer in Illinois, told me. Sigloff signed up for Medicaid and subsequently discovered he had a brain tumor.

Carol Fisher Hardaway is now covered through Maryland’s Medicaid program. She told me she has a newfound peace of mind since she doesn’t need to worry about affording the treatment for her multiple sclerosis. Her reduced stress, in fact, is quantifiable. When we talked in October, she had just found out her blood pressure was at a healthy level for the first time in nearly 15 years.

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Following Evangelicals, Traditional Catholics Create a Health Insurance Alternative

David E. Wilson, Michael J. O'Dea, and Louis Brown Jr. introduce Christ Medicus Foundation CURO. Photo via Sally Morrow/RNS.

If you are a Christian who doesn’t smoke, abstains from sex outside your heterosexual marriage and can get your priest to vouch that you go to church at least three times a month, you may qualify for a new Catholic alternative to health insurance.

Taking a cue from evangelicals, a group of traditionalist Catholics on Oct. 2 unveiled a cost-sharing network that they say honors their values and ensures that they are not even indirectly supporting health care services such as abortion that contradict their beliefs.

Christ Medicus Foundation CURO, as the group is called, will be financially integrated with Samaritan Ministries International, which was launched in 1991 by an evangelical home-schooling dad. The SMI network now serves 125,000 people and is exempt from the Affordable Care Act.

“Think about the Gospels and how the Apostles lived,” said CMF CURO director Louis A. Brown Jr. at the program’s Washington, D.C., debut. “They very much shared and cared for each other. And we’re saying: ‘Catholics, you can do that too.’”

Five Takeaways From the Hobby Lobby Case

The nine Supreme Court justices, public domain

The nine Supreme Court justices, public domain

Five things to know about one of the most anticipated Supreme Court decisions of the year:

1. Corporations can’t pray, but they do have religious rights.

Hobby Lobby isn’t a person. It’s a chain of crafts stores owned by a religious family. And though the evangelical Green family objects to parts of the Affordable Care Act’s emergency contraception mandate, it’s not the Greens but the company that writes the check for employees’ health insurance. The first question the justices had to answer was this: Does Hobby Lobby have religious rights? To many Americans, this sounds a little nutty. Does a craft store believe in God?

A majority of the justices held that a closely held company such as Hobby Lobby does have religious rights. The court didn’t apply those rights, however, to publicly held corporations, where owners’ religious beliefs would be hard to discern.

But well before the justices had delivered their verdict on this question, many legal scholars said they wouldn’t be surprised were they to affirm the company’s religious rights. American corporations do have some of the rights and responsibilities we usually associate with people. And in the 2010Citizens United campaign finance case, the justices overturned bans on corporate political spending as a violation of freedom of speech — corporations’ free speech.

What Does the Hobby Lobby Decision Mean?

Supreme Court Building, Orhan Cam /

Supreme Court Building, Orhan Cam /

The Supreme Court on Monday sided with the evangelical owners of Hobby Lobby Stores Inc., ruling 5-4 that the arts-and-crafts chain does not have to offer insurance for types of birth control that conflict with company owners’ religious beliefs.

Beyond the specifics of the Hobby Lobby case before them, the justices broke new legal ground by affirming that corporations, not just individual Americans or religious non-profits, may claim religious rights.

Does Monday’s decision mean, however, that the religious beliefs of business owners stand paramount? That they are more important than a female employee’s right to choose from the full array of birth control methods she is promised under the Affordable Care Act? Or that a business owner may invoke his religious rights to deny service to a gay couple?

Not necessarily, legal experts say.


SCOTUS Rules in Favor of Hobby Lobby

Hobby Lobby in Mansfield, Ohio. by Nicholas Eckhart,

Hobby Lobby in Mansfield, Ohio. by Nicholas Eckhart,

Closely held corporations cannot be compelled to pay for contraception coverage, the Supreme Court ruled Monday in its highly anticipated Burwell v. Hobby Lobby Stores case. The "contraceptive mandate" in the federal health care law was challenged under the Religious Freedom Restoration Act, which requires that the government show that a law doesn't "substantially burden" religious exercise.

According to SCOTUSBlog, the Court ruled that the government "has failed to show that the mandate is the least restrictive means of advancing its interest in guaranteeing cost-free access to birth control."

But the decision is applicable only to the contraceptive mandate, and does not apply to other health care mandates.

From Washington Post :

The justices’ 5-4 decision Monday is the first time that the high court has ruled that profit-seeking businesses can hold religious views under federal law. And it means the Obama administration must search for a different way of providing free contraception to women who are covered under objecting companies’ health insurance plans.

Hobby Lobby is an evangelical family-owned chain, and CEO David Green says that the Affordable Care Act infringed upon the family's religious freedom by compelling them to pay for certain contraceptives the family considers to be abortifacients, such as versions of the morning-after pill and IUDs.

Justices Ginsberg, Sotomayor, Breyer, and Kagan dissented.

Read the decision HERE.

Reframing Failure

City Profile With Dramatic Sky. Via Jan Carbol / Shutterstock

I’ve recently been thinking a lot about failure.

Not my failures, though I suspect we could come up with a few.

No, I’ve thinking about Scott Walker’s failed governorship in Wisconsin.

And Barack Obama’s failed presidency in the nation.

And our failed foreign policy.

And the failed Affordable Care Act.

And Walker’s failed jobs policy for the Badger State. And so on.

Then I started thinking about the failure of our political dialogue these days.

Religious Groups Play Key Role in Obamacare Insurance Sign-up

The National Council of Jewish Women Sacramento Section. Photo courtesy National Council of Jewish Women. Via RNS.

On one Friday earlier this month, more than 11,000 Muslims in mosques across the country heard a sermon about the Affordable Care Act.

Hindu and National Baptist groups, meanwhile, are posting online announcements about the White House’s “Faith and Community ACA Days of Action” this weekend.

Jewish women’s groups have visited college campuses to get students who think they’re “invincible” to sign up for health insurance.

As the national March 31 deadline for health insurance enrollment looms and with President Obama’s encouragement, organizations across a range of faiths are working to sign up uninsured Americans for coverage under Obamacare.